There are myths out there about physical therapists and physical therapy. One of them is “physical therapists do not get along with chiropractors.”
Here is a link that highlights the myth: http://physicaltherapy.about.com/od/typesofphysicaltherapy/a/Physical-Therapy-Mythbusters.htm
The truth is…in my experience chiropractors and physical therapists get along great and even refer to one another for the best interests of the patient. Physical therapists are really great at specific exercises that are customized to fix your precise problem, and chiropractors can manipulate your specific joint to get the pain down quickly.
Together, you feel better quickly and have long term results if you continue your specific exercise program.
Patients get the best of both worlds when there is teamwork between the professions. Add into the mix a great massage therapist and you’ve got a powerful mix that get people better.
The video demonstrated below, by an orthopedic surgeon, shows the mechanics of why shoulder impingement happens with the tendons.
See the small space between the ball acromium? That is where the impingement happens. Making sure the supraspinatus tendon, which pushes the ball down as the arm bone is lifted by the deltoid, is working well is a big part of the picture of shoulder healthy function. BUT….if you raise the shoulder blade UP by STRENGTHENING the muscles which lift it up, (such as serratus anterior) and STRETCH muscles which PULL it down (such as latissimus dorsi) you can gain more space, which puts less pressure and pinch on the supraspinatus tendon.
http://comstockpt.com/2011/11/22/neck-pain-stretches-out-olympia-wa/ This link will show you some latissimus stretches, and if you refer to Part 1 in this series of blog posts, with the man leaning against the wall you can see how to strengthen the serratus anterior
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.
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:
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.
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.
Okay, today we are discussing a very sensitive issue–Pelvic Health Physical Therapy. Having pelvic health issues can be intimidating–because, it is soooo personal. You may be wondering, what issues do people suffer that have poor pelvic health?
Lots of problems can happen down south. There are muscles in the pelvic floor (the levator ani aka pelvic floor muscles or PF) PF muscles can spasm or become weak, just like shoulder muscles, or any other muscle groups. The difference with these muscles causing problems, however, is that spasms here can cause other problems with how the pelvic organs function. Stress incontinence (leakage when you lift, cough, sneeze, run) can happen, often in women but also in men who have had prostate cancer surgery, from weakness.Urge and frequency incontinence happens when the bladder muscles decide it is time for your bladder to let go, even if You don’t think it is time, and then… you leak. Medicine can be helpful for urgency and frequency, but they leave you with dry mouth side effects.
These muscles can also spasm causing a lot of pain and difficulty with fully emptying your bladder.
A lot of other pelvic health conditions can be treated by pelvic floor physical therapy…more tomorrow