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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.

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!