Tag: Physical Therapy

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What’s causing your shoulder pain? 3 causes and fixes.@ClevelandClinic

cleveland shoulder pain

Shoulder pain, stiffness or weakness can make it difficult to carry out everyday tasks, like reaching for something on a high shelf, driving a car or brushing your hair. If you have pain that won’t go away, it’s time to see a doctor.

There are a number of possible causes of shoulder pain, but the most common causes of shoulder pain are rotator cuff injuries, rotator cuff tears and osteoarthritis, says orthopaedic surgeon Mark Schickendantz, MD.

1. Rotator cuff injuries

The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint, and connect the shoulder blade to the upper arm bone. Bursae, small sacs near the joint, provide lubricating fluid that decreases friction among the bones, tendons and ligaments.

Rotator cuff problems occur through overuse, and they include tendonitis, strains and partial and complete tears of the tendon.

Tendonitis is when the rotator cuff tendon becomes inflamed and irritated; bursitis is when the bursae swell. Tendonitis and bursitis cause pain in the front and side of the shoulder, and you might also feel some stiffness.

“These two conditions can occur with activities that involve using your arms overhead, like tennis, yoga or painting a room,” Dr. Schickendantz says. “Often the pain will be worse at rest and improve with activity.”

Treatment involves rest, applying ice, and taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, which is sold under the brand names Advil and Motrin, or naproxen, which is sold under the brand name Aleve. After a few weeks, most people with tendonitis recover, Dr. Schickendantz says.

2. Rotator cuff tears

If you experience shoulder pain at night that makes it difficult to fall asleep or awakens you, you may have a tear in one or more of the rotator cuff tendons.

“Night pain is the hallmark of a rotator cuff injury,” Dr. Schickendantz says.

You also may have this type of injury if you feel pain when lifting your arm overhead and weakness in the shoulder when trying to lift anything above shoulder level.

A rotator cuff tendon can tear from a single event, like falling down on an outstretched arm. It also can happen from a motion that is repeated over time. For example, a plumber who frequently uses his or her arms overhead can develop a rotator cuff tear. The rotator cuff also can weaken with age.

Treatment is rest, avoiding aggravating activities, physical therapy, applying ice, and NSAIDs. Some people with more severe pain may be helped with a corticosteroid injection, which is a powerful anti-inflammatory medication.

“I usually reserve the use of corticosteroids for someone who has severe night pain and is not responding well to oral medications,” Dr. Schickendantz says.

Surgery to repair the rotator cuff tendon is an option if these measures don’t give relief.

3. Osteoarthritis

Osteroarthritis happens when cartilage, which is the cushioning material that covers the ends of your bones, deteriorates, which leads to pain and stiffness.

Osteoarthritis causes a deep ache in the back of the shoulder. As osteoarthritis worsens, stiffness in the shoulder develops. People with osteoarthritis typically lose the ability reach behind their back.

“Patients often say they are unable to scratch their back or thread a belt,” Dr. Schickendantz says.

Osteoarthritis symptoms develop over time. For some people, an old shoulder injury from sports or some other activity, may kick off the degenerative process that years later results in osteoarthritis. But many people have no specific cause — it’s just wear and tear over time.

Treatment for osteoarthritis of the shoulder is similar to treatment for a rotator cuff tear, involving physical therapy, NSAIDs and ice. If the condition is severe, you can undergo shoulder joint replacement surgery, which is similar to joint replacement for hips and knees.

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Physiotherapists allowed to refer patients for medical radiological procedures for the first time @RCSI_Irl

RCSI welcomes progress in physiotherapist referral for medical radiological procedures

RCSI University of Medicine and Health Sciences has welcomed the policy decision to permit physiotherapists to refer patients for medical radiological procedures, and the progress made in implementing this important new measure which will make it quicker for patients to access a diagnosis and begin their treatment.

Physiotherapist referral for medical radiological procedures results in fewer health professionals being involved in the patient pathway. At present, physiotherapists with advanced training can refer their patients for radiological investigations, such as X-ray, in several jurisdictions including England, Sweden, Canada and New Zealand. 

Physiotherapists in Ireland will soon be invited to undertake advanced training which will allow them to refer their patients for radiological procedures. Initially, clinical specialist physiotherapists working in roles in specific clinical areas in the HSE are being invited to train for the authority to refer. In early 2025, application to the training programmes will then be opened more widely.

Professor Suzanne McDonough, Head of the RCSI School of Physiotherapy, said: “This is an important development which will lead to efficiencies in the patient pathway and reduce barriers to effective treatment for a range of musco-skeletal conditions.

“The evidence from the countries which already permit physiotherapist referral for radiological procedures is positive, with no serious adverse events reported and with many advantages for the patient and the health system,” added Professor McDonough. 

An Expert Working Group was established in March 2024 to support the development and implementation of this policy. The group includes representation from Department of Health, Health Service Executive, CORU, UCD and the Irish Society of Chartered Physiotherapists.

Established in 1999, the RCSI School of Physiotherapy aims to educate professionally safe, competent, reflective and analytical physiotherapists.

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Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!@ClevelandClinic

cleveland muscles

Cleveland Clinic
@ClevelandClinic

Muscles in your body are a use-or-lose proposition. You need to use them to keep them strong!

You may not realize it, but we all start losing 1 percent of muscle mass each year after age 30. That’s why your diet in later years should not look the same as it did when you were younger, says endocrinologist Susan Williams, MD.

Skipping breakfast, eating fast food and being inactive in your 20s and early 30s might not hurt your health in the short term. However, poor nutrition and lifestyle habits take their toll over time.

People who embrace good habits early on really get ahead of the game, Dr. Williams says. But it’s never too late to start eating better and taking better care of your body.

Whether you’re 30 or 50, Dr. Williams offers three important tips to get started in eating right when you are thinking about your long-term health.

RELATED: Do You Know How Much Exercise You Really Need? 

1. Keep your weight in check

A roller coaster of weight gain and loss can change your body composition and leave you with more fat mass and less lean muscle mass.

2. Eat three balanced meals a day

You also want to limit your snacks in between. The word “balanced” is especially important because eating a wide variety of foods will help you prevent nutritional deficiencies.

Dr. Williams suggests this simple shopping list:

  • Lean proteins. Choose chicken, white fish, oily fish like salmon, eggs, tuna fish and red meat (less frequently than other protein).
  • Whole grains. This includes multigrain breads, and long-cooking rice or oats.
  • Veggies. Go for fresh or fresh frozen. Choose what’s in season and enjoy a variety to get the vitamins and minerals your body needs.
  • Fruit. Fresh fruit is best, followed by frozen. Canned fruit can be OK, but choose options in light syrup or water. Check the label and avoid added sugar.
  • Dairy. Choose milk, yogurts, cheeses and cottage cheese that are low-fat or fat-free.

Steer clear of cookies, cakes, pies, ice creams, juices and rich desserts. If that sounds like no fun, Dr. Williams advises treating these foods as treats. Save them for dining out or special occasions, but don’t make them part of your daily diet.

RELATED: Which Bread Is Best For You — Whole-Grain, Multigrain or Whole Wheat?

3. Use your muscles

Eating protein and being physically active are equal partners in the quest for maximum health, Dr. Williams says. Muscles are made of protein, but simply eating protein is not enough to save them.

“Muscles in your body are a use-or-lose proposition,” she says. “You need to use them to keep them strong.”

Can’t carve out time for the gym? Try this daily routine:

  1. In the morning, stretch for 10 minutes.
  2. At lunch, eat and then walk for 10 minutes.
  3. After dinner, spend 10 minutes with stretch bands or light weights.

Even a half hour of physical activity can make a world of difference, especially if you make it a habit in your 30s. “Don’t let your weight creep up while your muscle mass creeps down over your 30s and 40s,” Dr. Williams says. The longer you wait, the harder it will be to get started — and the more muscle you will have already lost.

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Why a strong core is important + exercises to try. @ClevelandClinic

cleveland evrything starts wit your core

If you’re planning to start an exercise program and wondering where to begin, start with your core first, says physical therapist Brittany Smith, DPT. People often think of the core muscles as being the abdominal muscles, but the core includes the muscles in the abdomen, back and hips, all working together as a group.

“The core muscles provide stability for the entire body as it moves,” says Smith. “These muscles are activated when you stand up, turn, bend, reach, twist, stoop and move in most other ways. Everything starts with your core.”

Strong core muscles help you maintain good posture, while weak ones can lead to slouching and slumping. Poor posture can be a cause of aches and pain, especially in the back.

Getting started with your core

To get your core muscles in shape, you need to exercise.

“Our bodies were made to move, so any physical activity is really important,” says Smith.

She recommends these specific core-strengthening exercises below.

The first one engages the deep muscles in the abdomen, called the transverse abdominis. “These muscles help hold us in a better position to stabilize our core, thereby stabilizing our arms and legs,” says Smith.

“The more you work on these muscles, the more it will become second nature to hold these muscles tight when you’re lifting grocery bags, doing yard work or any other kind of physical activity,” says Smith. This will help support your body.

Other muscles that tend to be weak are the gluteus maximus in the buttocks, and the gluteus medius and gluteus minimus on the side of the hip. The bridge and clamshell exercises can help strengthen these muscles.

Smith emphasizes that getting the proper position of these exercises correct is more important than the number of repetitions you do. “It’s better to take your time, maybe do fewer reps, but with better quality,” she says. For that reason, it can be helpful to have the guidance of a physical therapist to get started.

Move on from the core

Core exercises are the starting point of overall fitness because you need to hold those muscles engaged while you strengthen other muscles, such as the biceps in the arms or the quadriceps in the legs.

Smith suggests setting short-term goals (for about a month) and then more long-term goals. Once you have achieved short-term goals, such as getting around more easily, add other types of weight-training or resistance exercises to build muscle elsewhere.

With any exercise you do, always listen to your body, warns Smith. If you have pain other than muscle burn, take it easy. Reduce the number of repetitions, the weight or the duration of the exercises. Then build up gradually. “You don’t have to be in pain to make gains,” she says.

Beginner exercises for core strength

For each of the following, work up to one to two sets of 10 to 15 repetitions once a day.

Abdominal bracing

Lie on your back with your knees bent and feet flat on the floor. Contract your abdominal muscles, and press the arch of your back down toward the floor, pulling your belly button toward your spine. Hold for 5 to 10 seconds. Make sure your lower back stays flat on the floor. Relax and repeat.

Bridge

Lie on your back with your knees bent and feet flat on the floor with your arms at your sides. Squeeze your abdominal and buttocks muscles, push your heels into the floor and slowly lift your buttocks and hips off the floor. Keep your back straight. Hold for 5 to 10 seconds.

Clamshell

Lie on your side with knees bent in line with your hips and back, draw up the top knee while keeping contact of your feet together as shown. Don’t let your pelvis roll back during the lifting movement. Hold for 5 seconds.

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