3 min read

Myodetox

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Education

What Is A Rotator Cuff Tear?


It’s the summer season, you’ve been asked to pitch for an upcoming pick-up softball game. Heck, you’ve been playing for over 20 years: this should be fun.

When you go to throw your first pitch, you suddenly feel a sharp pain at the top of your arm. You try to fight through the pain, but it’s hurting more and more to move your arm. What was that? Did I not warm-up enough? Did I hurt my rotator cuff? You’ve hurt your shoulder before, but not like this. This time…you can barely move! And all you were doing was something you’ve done for years.

Sadly, this isn’t an uncommon occurrence. And you may have a rotator cuff tear to blame.




What is Rotator Cuff Tear?

Hearing the word “tear” is never fun, especially when it comes to your body. Nearly 70% of people will experience shoulder pain at some point in their life, and this pain often involves the rotator cuff muscles and tendons. The worst of this is rotator cuff tears.

The rotator cuff muscles consist of four muscles: the infraspinatus, supraspinatus, teres minor, and subscapularis. All these muscles have tendons that attach to the top of your arm. These rotator cuff muscles surround your shoulder blade to do two things – initiate and stabilize your shoulder movement. They bear the brunt of responsibility when it comes to shoulder movement, and we take them for granted until we get injured.

The tendons are often injured when we do quick movements with load, or when we’re challenging our shoulder beyond the capacity it can handle. But, time can work against your shoulder, too. Many partial rotator cuff tears are a result of degeneration i.e. wear and tear.




rotator cuff tear


What Does It Look Like?
Tears of our rotator cuff tendons are either incomplete (e.g. partial) or complete. The most common being the partial rotator cuff tear.

Partial rotator cuff tears can limit your shoulder range of movement and strength. Everyday tasks like putting a bra on, opening the fridge, or pouring a cup of coffee can become irritating. Suddenly, lifting overhead or getting into downward dog can be a pain. And that itch on your back? It will be nearly impossible to reach!

Immobility and compensating movements are often seen with partial tears, followed by pain with movement. But this isn’t always the case. In fact, there are people with partial tears that have no limitations in movement and no pain.


rotator cuff



Who Does It Affect?
What makes partial rotator cuff tears interesting is that many of them can go unnoticed over the years. We typically start to develop rotator cuff weakness as we enter our 30’s, and this weakness tends to progress as we age – unfortunately, this weakness is more prominent in women. As we age, partial and complete rotator cuff tears become more common.

The exact mechanism of this weakness is not known, but this much is true – tears do not always lead to pain, and tears are not always the direct result of injury. Time and our biological make-up can play a significant role in developing a partial tear. Of course, injuries and trauma can lead to partial and complete rotator cuff tears. But this does not mean you’ll never be able to move your shoulder the same way again.

What Can Be Done?
Surgery is rarely done for partial rotator cuff tears. It is encouraged to manage rotator cuff tears conservatively with physical therapy prior to considering more invasive interventions.

Managing shoulder dysfunction is simple in theory:

1. Work needs to be done to optimize shoulder range of motion. This can involve hands-on therapy and corrective exercises dedicated to mobility optimization.

2. Strength needs to be gained so that your shoulder can handle the load needed to carry-out everyday tasks, as well as participation in the sports and activities that make us happy.

For those experiencing incomplete rotator cuff tears, try these exercises below to get you started: CARS

The work that needs to be put in is the hard part. The shoulder joint is complex in that its movement and stability relies heavily on our muscles, joints, ligaments, and nervous system. Thankfully, having the right therapist by your side ensures you have the right tools needed to address this. The evidence fully supports the use of non-surgical interventions to manage partial rotator cuff tears.


Ready to play ball?
After the pain that was felt trying to throw a ball, you decide to see your physician who orders imaging for the shoulder. A week later, two things happen: your shoulder feels better with movement, and your imaging finds a partial rotator cuff tear. How can this be? Your shoulder movement has improved within a week, but a partial rotator cuff was found. Turns out, the physician points out that the rotator cuff injury appears old – you’re only feeling some of its effects now. It’s time to see a Physical Therapist.

When we have damage to the shoulder, the body is amazing at adapting to the given circumstances. Identifying areas of weakness is identifying opportunity – strengthening and stabilizing the shoulder can re-establish movement and ensure you’re getting back to doing the things you love.

Consulting your physician is never a bad step, but what’s found in imaging doesn’t always correlate with how a damaged shoulder moves and feels. A rotator cuff tear can be overcome with the right therapist and team by your side.

Find your nearest Myodetox clinic!

2 min read

Myodetox

Posted on

Education

What Is Frozen Shoulder?


If you’ve experienced a serious injury to the shoulder, like a rotator cuff tear, you may have been warned about developing adhesive capsulitis, otherwise known as “frozen shoulder”.

This condition gets the name “frozen shoulder” due to the stiffness and pain it causes.




What Is Frozen Shoulder?
Frozen shoulder is significant shoulder mobility restriction and pain that develops slowly, and can sometimes last for 1-2 years. It typically develops during long periods of rest (e.g. post-fracture and post-surgery).

The shoulder joint has connective tissue surrounding it. This tissue typically serves to stabilize the ball-and-socket joint of the shoulder, and acts as a support structure. With this condition the connective tissue becomes immobilized and inflamed.

stiff shoulder


Who Gets Frozen Shoulder?
Frozen shoulder affects up to 3% of the US population. Of all the shoulder conditions that cause immobility and pain after the age of 40, adhesive capsulitis is the leader. The major risk factors for developing it include:

  • Non-dominant hand/arm.
  • Rotator cuff pathology.
  • Glenohumeral fracture.
  • Systemic diseases such as diabetes mellitus, thyroid dysfunction, cardiovascular disease, and Parkinson’s disease.

    frozen shoulder


    What Causes Frozen Shoulder?
    There are two primary causes for frozen shoulder, but the mechanism of development is largely unknown. Primary adhesive capsulitis is idiopathic – pain and immobility gradually develop without any specific cause.

    Secondary adhesive capsulitis is associated with systemic issues of the body such as diabetes mellitus, hormone issues, rotator cuff injuries, shoulder injuries, calcific tendinitis, cervical spondylosis, and strokes to name a few.

    What Are The Symptoms?
    The main symptoms of adhesive capsulitis involve movement restriction and pain. There are three stages involving these symptoms:

  • Freezing stage: shoulder range of motion begins to diminish, and general movement (particularly overhead and behind the back) movements become painful. This stage ranges from 1-9 months.

  • Frozen stage: shoulder movements become even more stiff, though pain begins to reduce. Functional use (e.g. reaching overhead, putting a coat on) becomes much more difficult. This stage ranges from 4-12 months.

  • Thawing stage: this is when movement and pain begin to improve, and previous loss of functional movements slowly return. This stage ranges from 5-24 months.

    How Do You Prevent and Manage It?
    Most cases of adhesive capsulitis develop during long periods of immobility such as healing from a shoulder break, stroke, or a post-surgical rotator cuff tear. For some it will develop without any associated cause. Regardless of cause, once safe, movement will be key.

    Maintaining health movement, strength, stability, and facilitating appropriate muscle recovery of the neck-back-shoulder complex is key.

    The physical therapy interventions that are most favorable focus on manual therapy, progressive stretching, and myofascial techniques to maintain optimal shoulder movement and strength. This is most important in frozen and thawing stage.

  • Myofascial techniques: focus on the muscle and fascial tension that builds with frozen shoulder, providing stimulus to aid in movement and recovery.

  • Progressive manual therapy: mixing joint mobilization, deep tissue massage, progressive stretching, and muscle energy techniques.

  • Exercise: focused on challenging and progressing range of motion, scapular stability, and strength for functional movements.

    Frozen shoulder is a long road for many, but the right treatment can get you back to moving at your best.

    Ready to start managing your shoulder mobility?

    Find your nearest location

    • 1 min read

    Dr. Nicole Chambers

    Posted on

    Education

    3 Types of Shoulder Instability


    Learn the 3 types of shoulder instability to help prevent pain!

    Shoulder injuries are very common. Your shoulder is a highly mobile joint, imbalances in its stability and strength can easily lead to dislocations.




    3 Types Of Shoulder Instability
    Shoulder instability occurs when your muscles and ligaments are challenged to the point of pain and discomfort.
    There are three major types of instability: anterior, posterior, and multidirectional.

    1) Anterior
    Anterior instability occurs when the humeral head (e.g. the “ball” of the shoulder joint) translates forward. Primarily seen in athletes and males aged 15-30. Dislocations generally occur with an outstretched arm. Anterior is the most common form of instability.

    2) Posterior
    Posterior instability is less common but typically seen in overhead athletes like football, tennis, baseball, lacrosse, and water polo. Posterior instability is usually aggravated with the arm forward and across, under load.

    3) Multidirectional
    Multidirectional instability is not associated with trauma. This type of instability occurs when there is general instability in all directions of shoulder movement. People with this type of instability are typically “double-jointed”, hypermobile individuals and/or have developed chronic dislocations of the shoulder.
    Learn more about hypermobility here.





    How Do You Manage Shoulder Instability?
    Exercises dedicated to stabilization and neuromuscular control yield the best results. Managing shoulder instability requires specific strengthening and stabilization exercises that become natural to the individual.

    The progression of your exercises should train you up to positions in which the shoulder was previously vulnerable. The reaction time for your shoulder stability needs to become second nature, which will require significant work and time.

    Exercises should focus on the rotator cuff muscles, and the global movers of the shoulder. Training should focus on both open movements (e.g. overhead, unloaded movements like throwing), and planted movements (such as weight training, specialized push-ups, and core strengthening).


    Want To Work On Your Shoulder Stability?
    Book a session with me! I will assess your movements and set you up on a FutureProof plan to increase your mobility, reduce pain and prevent injury.

    Book your session today

    2 min read

    Myodetox

    Posted on

    Education

    Hypermobility Explained:
    More Than Just Party Tricks?


    When does a party trick turn into a pain?
    Understanding hypermobility and when it’s time to seek help.


    We all have that friend who moves their joints in strange ways. Their classic party tricks include twisting their body into all sorts of shapes like hyper-extended elbows, knees, and thumbs.

    These wildly mobile individuals are often labeled double-jointed when in fact, they have hypermobility. But what does that mean? And what, if any, are the risks?



    What Is Hypermobility Syndrome?
    The main risk of being hypermobile is developing hypermobility syndrome. The syndrome manifests when you have excessive joint mobility combined with debilitating symptoms. There is no issue with having joints that move beyond “normal”. Just ask dancers, yogis, musicians, and gymnasts – many will attest to benefiting from an increased range of motion. But when problems begin to arise, then it becomes a syndrome.

    Increased “laxity” in the joints is often associated with other hypermobility disorders such as Ehlers-Danlos Syndrome, Marfan Syndrome, and Rheumatoid Arthritis (this list is not exhaustive). These disorders tend to appear due to genetics, affecting the strength of collagen in our body. When collagen becomes weak, our ligaments and joints become loose and stretch, leading to hypermobility. hypermobility-symptoms



    What Are The Risks And Symptoms?
    Though being hypermobile in itself is not bad, it becomes a problem if you present:

  • Pain or stiffness at the joint and muscle group.
  • Dislocations and subluxations at the joint.
  • Weakness at the muscle or muscle group.
  • Poor balance and movement coordination.
  • Generalized fatigue e.g. extremely tired throughout the day.
  • Dizziness and fainting.
  • Constant muscle strains and ligament sprains e.g. ankle rolling.
  • Thin and stretchy skin
  • Digestive issues.



    Who Is Most Affected?
    Children and adolescents, specifically females, tend to present with the syndrome more than adults. In fact, hypermobility tends to reduce as we age. It is believed that hormonal changes over time affect collagen strength in the body and reduce hypermobility symptoms.



    What Can You Do About It?
    You can think of hypermobility syndrome as over-indexing on the amount of space a joint can move within. The more range of motion (or “space”) you have at a joint, the more you need to strengthen and stabilize the area to reduce the risk of overuse and injury.

    Compound weight lifting and stability training can significantly improve symptoms. Speaking to a physician and physical therapist will be your main source to help create a plan for managing hypermobility.



    Worried You May Have Hypermobility Syndrome?
    Give us a call! We’ll book you a session with one of our incredible therapists. They’ll assess your movements and set you up on a FutureProof plan.

    Find your nearest clinic

    • 2 min read

    How To Spoon Without Shoulder Pain

    Posted on

    Education

    How To Spoon Without Shoulder Pain

    So you have your evening planned with dinner reservations, some drinks, followed by some alone time spent at home.

    I’m sure a romantic night with your significant other will involve some spooning, but cuddle time with your partner could result in back and shoulder pain the morning after.

    Here is your 4 step guide on how to avoid shoulder pain after an evening of spooning.

    ralph

    Think about your shoulder position

    • Spooning can put your arm in significant protraction and put a lot of stress on your shoulder. Before you settle into your spooning position, put your shoulder in a better position by creating more shoulder retraction to create better alignment.

    ralph

    Add durability to your shoulders 

    To help bulletproof your shoulders for cuddling sessions, incorporate more shoulder stabilizing workouts.

    • Plank – Perform 30s hold / three sets
    • Row – Perform ten reps/ three sets

    ralph

    Take turns being the little spoon

    • I know the man usually sets the tone for the cuddling position, which usually involves playing the big spoon. But who’s to say only one person has to play the “little spoon” role in the relationship? By switching roles, you will provide a break for your shoulders and lessen the stress for each of you.

    ralph

    Switch positions

    • We all have our preferred position, regardless if it is right for you or not. If you regularly sleep on your right side a couple of times a week, you should challenge yourself to switch sides. Same goes for tonight’s spooning session. If you slept on your left last night, try to cuddle laying on your right side.

     

    3 min read

    How To Carry Your Bag And Avoid Shoulder Pain

    Posted on

    Education

    How To Carry Your Bag And Avoid Shoulder Pain

     

    While living in the digital age, it’s easy to choose fashion over function. Without thinking twice, we will purchase the fancy looking purse or handbag over the practical and functional option, which can lead to shoulder pain.

    The problem is that while we may look fly AF walking with our large *insert name brand here* purse, the constant load on our shoulder can lead to neck, shoulder pain, lower back pain and dysfunction.

    Carrying that heavy bag can cause your natural gait to be thrown off (by interfering with your arm swing), your center of gravity will shift to the side, and your bag will also cause your upper trapezius muscles to become overactive and stiff.

    Here are five tips you can use to try and decrease the adverse effects of carrying a purse.

    Try a cross body bag

    ralph

    Instead of loading one side of your body with a heavy weight, causing your body to carry an asymmetric load, try using a cross body bag to distribute the forces through the body better.

    Reduce the load

    ralph

    While this may seem like an obvious one, lessening the burden that you carry on the daily can significantly reduce the strain you place on your shoulders and neck. Consider doing a weekly inventory of your purse to see what you need or don’t need.

    Switch your bag on your other shoulder

    ralph

    This may be a tough one to get used to as you likely have developed muscle memory and subsequent tension on the side you carry your bag on, but switching shoulders periodically can help distribute the load, and decrease the strain and asymmetry on your body.

    Try a backpack

    ralph

    I know you are probably rolling your eyes at this one, but there are a lot of fashionable backpacks to choose from! Switching to a two strap bag can significantly reduce the amount of strain and asymmetry a large shoulder bag would otherwise cause. The load will evenly distribute the weight through your body, and you will be able to walk with a normal gait.

    Use a dynamic purse/bag

    ralph

    Try using a bag with different strap options. Switching between cross-body, on the shoulder, and holding the purse as a clutch can offer rest to those often overused, upper trapezius muscles.