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physical therapy

Why are you giving me Shoulder Blade exercises if I have Shoulder pain–Part 2

More about how the shoulder blade works with the shoulder and how bad shoulder girdle strength can cause shoulder impingement. The image and movie clip below show shoulder blade elevation, with the actress in the video showing LESS elevation and upward rotation on the left than the right.

scapular elevation and upward rotation

scapular elevation and upward rotation

Like this:

The space between the ball (humeral head) and the shelf above (acromium) which sits on the shoulder blade is where impingement of one or two of the rotator cuff tendons happens (supraspinatus or infrapinatus).
Here is an image of a normal shoulder and one with impingement:

normal shoulder anatomy

normal shoulder anatomy

shoulder pain impingement

shoulder pain caused by impingement

If the shoulder blade is hanging low (like the one on the left in the video) the space for the tendon is a lot smaller. So doing shoulder blade strengthening exercises to elevate the shoulder blades will help with shoulder blade pain itself.

Kayaking in the San Juans-Avoid Shoulder Pain

I have been vacationing this past week on San Juan island on the west side of the island.  My husband I went out kayaking (on a guided tour, thank goodness) and had a great time.  We saw harbor seals, a giant jelly fish and beautiful scenery. 

While we were kayaking, I noticed the movements could have caused me some shoulder pain, but I used positions which kept my upper arms down lower than shoulder height, and avoided a rotator cuff strain or impingement. 

As you can see, shoulder impingment and bursitis can be caused when the arm is at or above shoulder height by jamming the ball of the shoulder up into the acromium.

The  correct arm stroke is to keep the elbow a few inches below the shoulder, and push forward with the elbow while pullling back the the other arm.  Use your oblique abdominals to help power your stroke to keep the strain off the shoulder, too.  Here's a video from Youtube about proper kayak technique

http://youtu.be/pz51i1XiniI

At Comstock PT, We’re Team Players

Have you ever been treated by a physical therapist, chiropractor and massage therapist at the same time for lower or upper back pain, or neck pain?

Did they:

A) work together as a team and respect one another?

Or

B) did you feel as if you were betraying one health professional if you also saw a different one?

If it was “B” you probably felt like you were stuck in the middle between your different care providers.  You are not sure if their treatments are working together or at cross purposes.

Welcome to a fresh approach, an approach where the client is the center and the providers work together for your benefit.  If you are receiving chiropractic and massage therapy, we will work with your other care to providers to coordinate care and make sure treatments work together.

We work with a number of local chiropractors to assist you in receiving an exercise program which will support your other treatments.  We cross refer back and forth.  We also do this with massage therapists.

In short, if you add PT rehabilitation with your chiropractic and massage, your adjustments may be smoother and easier.  PT will help you hold and progress the gains you make in chiropractic and massage therapy.

 

 

Skateboarder’s Ankle Sprain Gets Better!

 

Ligaments Lateral View, ankle of skateboarder

At Comstock Physical Therapy we treat all kinds of folks, younger, older, and in between. We treat athletes from club teams, recreational athletes and folks with other,  more unique kinds of injuries.  

This young man received an ankle sprain when falling off his skateboard and  had a lot of pain walking an appreciable distance when he first came to physical therapy.  He had difficulty even fully squatting to tie his shoes, or pick something up from the ground.  He was not able to skateboard, which is his long term goal.  

After he started physical therapy, it was found that he had pain with squatting due to pinching and painful feeling where he actually sprained his ankle, on the outside and front of the ankle.  The ligament is called the anterior talofibular ligament.  

The ligament swelled and got pinched.  After moving the specific joints to improve his ability to squat, and giving him strengthening exercises, he began to get better.   His exercises inclued balance exercises on a dynadisc, theraband exercises for strengthening and range of motion exercises to improve his mobility both with his foot up in the air (open chain exercises) and with his foot in the ground and him in the sitting position (closed chain with partial weight bearing).  

After about 4 weeks we put him on an IJOY machine which challenges patients in side to side motions and kind of moves like a skateboard.  Here is a picture of how he did:

 

 

After another week he got quite a bit better and actuallty did a 180 flip on the IJOY

 

 

This week I've asked him to skateboard on a dry, flat surface and he has been cut down to 1x/week.  Hopefully he'll be done sone and back to the sport he loves:

skateboarding!