165 Lilly Rd NE, Suite B, Olympia • 360.455-8014

Shoulder Pain

Why are you giving me Shoulder Blade exercises if I have Shoulder pain?

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:

infraspinatus strengthening

shoulder pain exercise

Here a picture of a shoulder blade (scapula) exercise:

serratus anterior

one arm wall push up

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.

scapular elevation and upward rotation

scapular elevation and upward rotation

In fact, if the shoulder blade does NOT raise up, the rotator cuff muscles will get pinched when the arm raises up.
impingement

shoulder impingement

So, in fact to really get better from shoulder pain a person needs BOTH shoulder and shoulder blade exercises.

Do I REALLY need to go to physical therapy 2 or 3 times a week for 4-6 weeks?

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.

Physical therapy- will it hurt?

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!

 

 

 

 

 

The “new” core–the “Piston”–Diaphragm, Transverse Abdominis, Multifidus and Pelvic Floor

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: 

  1. make sure to breathe in before you lift, letting your tummy relax and lower ribs expand as you prepare to lift.
  2. 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: 

Core as a piston

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 "Core" as Piston for back pain

Muscle of the week/month: Levator Scapulae

Levator-Scapula-triggerLevator Scapulae–That muscle is TROUBLE! 

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.

When you stand with your shoulder and shoulder blade forward on the rib cage like the picture here the levator scaplae gets strained and pulled at the upper inner angle.  : anteiror humeral glide syndrome

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.

Comstock
Physical Therapy

165 Lilly Rd. NE, Suite B
Olympia, Washington 98506

360.455.8014

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1 week ago

Comstock Physical Therapy

This is great information about your pubic bone (which can impact the sacroiliac joint) alignment.

myPFM
Hello friends!⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Pelvic pain can affect your ability to walk, sleep, move, lift, carry, sit, pee, poop, have sex and more!!⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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This simple self check can clue you into whether you have pelvic asymmetries. ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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What is an asymmetry? Your pelvis is like two halves an Easter egg that is fitted together. If the two sides aren’t lined up, you will have asymmetries (one pelvic bone higher or lower, flared in or out etc)⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Keep in mind that it’s possible to have asymmetries without pain and it’s possible to have pain without asymmetries!!⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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So, what to do if you do have asymmetries? ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Get checked out! The following professionals are trained to assess and address this:⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
Physical Therapists ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
Chiropractors⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
Doctors of Osteopathy⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
Orthopedists⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
And more! (If you’re a provider that assesses and addresses this that I didn’t include, drop a comment below please so others know too!). ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Pregnant people are especially vulnerable to asymmetries due to the increased pelvic movement that is occurring. ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Many times some simple exercises or some gentle hands on stretching combined with an external brace can provide incredible relief so you can live your daily life! ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
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Questions? I’m here friends! ♥️Jeanice ⁣⠀⠀⠀⠀⠀⠀⠀⠀⠀
#mypfm #mypelvicfloormuscles #mypfmambassadors #pelvicpain
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