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

Thurston County

Do physical therapists get along with chiropractors?

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.

Why are you giving me Shoulder Blade exercises if I have Shoulder pain–Part 3 Olympia WA

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.

serratus muscle upwardly rotates the shoulder blade

serratus muscle upwardly rotates the shoulder blade

latissimus dorsi pulls shoulder blade down

latissimus dorsi pulls shoulder blade down

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

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.

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.

Pelvic Health Physical Therapy–Physical Therapy treats WHAT?

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.

Levator ani muscles, otherwise know as Pelvic Floor muscles

Levator ani muscles, otherwise know as Pelvic Floor muscles

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

Comstock
Physical Therapy

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

360.455.8014

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