Have you been to PT for shoulder pain? Have you been given shoulder blade strengthening exercises plus actual shoulder exercises?
Here is a picture of an actual shoulder (ball and socket) exercise:
Here a picture of a shoulder blade (scapula) exercise:
If I were a patient, I'd be thinking, "those therapists sure are giving me a lot of exercises." The truth is, the shoulder blade has to elevate and rotate up for your arm to reach all the way up overhead.In fact, if the shoulder blade does NOT raise up, the rotator cuff muscles will get pinched when the arm raises up.
So, in fact to really get better from shoulder pain a person needs BOTH shoulder and shoulder blade exercises.
Patients never really say it, but I can tell they don’t really want to commit to 2-3 times a week of physical therapy treatment. I’m not sure I would want to commit to that much time, given my busy schedule. So…..I often schedule patients 1-2 times a week unless they hurt really badly or they have an injury, surgery or goal that demands they come in 3 times a week.
If you’ve had a fresh injury like an ankle sprain, knee sprain, etc, PT right away is important to keep you as mobile and strong as you can be without making your injury worse. This idea applies to some surgeries (see the surgeries mentioned in this post http://comstockpt.com/2014/02/01/physical-therapy-hurt/). You may wonder, what happens if I don’t go to PT early on?
Let me tell you, it is BAD news! When you are in a lot of pain from an injury some muscles shorten up and spasm to protect you and other ones get shut down. As a matter of fact recent science has shown that the big muscle on the front of your thigh (the quadriceps) begins to get shut down by your central nervous system 12 hours after pain begins.
When your pain level is lower, and your condition not as fresh you can cut down to 1 to 2 times a week. Chances are you will do well at 1 x per week if you are consistent in doing the exercise program the therapist has given you for homework.
Talk to your PT, she or he will work it out with you.
People often wonder, if I go to physical therapy will it hurt? Sometimes I’ve heard people say “PT” stands for “pain and torture.”
So, does physical therapy hurt? This is the good news: most of the time the answer is NO!
When will physical therapy hurt? Once in a while the answer is yes, BUT that is because of the surgery you have had and the steps that you need to go through to get past the normal side effects of having a surgery. What surgeries will be more painful to rehabilitate from? In my experience as a physical therapist, new knee replacements seem to be the most painful. Second to that is shoulder surgery. The worse pain is usually there for a while only then gets better as you recover and move more, usually within a few weeks to a month.
When should physical therapy be comfortable? Most of the time physical therapy should be comfortable and make you feel better as each treatment progresses. The old adage of “no pain no gain” does NOT apply. When you have an injury, working weak muscles until they are tired will be a good limit of exercise; if you push past the muscle you are working feeling tired (heavy and achey) you might cause more pain because your body is working in its weak zone and that is when more pain happens.
Will there be soreness after my physical therapy session? It is pretty common for patients to feel sore after their PT appointment, especially your first visit because we have to have you move a lot to fully evaluate your problem. Sometimes after introducing a new exercise, or increasing resistance you will be sore too. You should not be in pain, however and if your soreness is there for more than 1-2 days, speak up on your next PT session because that is too long.
Most of the time physical therapy should be comfortable and leave you feeling good!
New information from a class I just took: the "core" as a piston that moves with you! Turns out that the stability of your trunk, in other words your rib cage to your pelvis, is dependent on the diaphragm working together with the transverse abdominis, multifidus and the pelvic floor.
What does this mean in for you if you have pain or you are trying to get more fit? When you are going to lift something heavy do the following:
- make sure to breathe in before you lift, letting your tummy relax and lower ribs expand as you prepare to lift.
- start breathing out by pursing you lips then quickly lift your pelvic floor and then pull your tummy in as you lift
Here is a link to a video from the instructor of the class, Julie Wiebe PT:
Enjoy looking at her video!
How does this concept apply to Muscles In-Sync(R)? It directly applies because the muscles, to work best, need to work at the right time and the right way, and we can help you feel better by getting them In Sync!
The levator scapulae muscle causes a lot of pain. Stretching and giving the muscle trigger point massage will give you only temporary relief. How do you get a permanent fix? Take the strain away!
The muscle is strained, or has too much tension on it when it is always stretched. The muscle lifts the inner upper corner of the shoulder blade up towards the neck AND also rotates the shoulder blade down, so the outer corner is lower than the inner corner.
The actual treatment is to strengthen the muscles which pull the shoulder blade back as well as those that lift and stretch tight muscles which pull the shoulder blade forward.