TrueRelief – A New Electro Therapeutic Treatment from a Fibromyalgia Specialist in Visalia

New Information: Physical therapy (not your ordinary treatment either) plus a new electrical medical device can alleviate fibromyalgia symptoms.

Are you looking for a fibromyalgia specialist in Visalia?  We have clinicians that specialize in fibromyalgia treatment in Visalia and Hanford.

Fibromyalgia is an extremely common pain disorder that affects nearly 5 million Americans. Women are affected far more frequently than men, as about 80-90% of cases develop in females, with symptoms usually beginning to develop between ages 30-50. Fibromyalgia is also a chronic condition, which means that the majority of individuals who have it are affected over a long period of time.

The cause of fibromyalgia is not clearly understood, but it’s believed to be related to changes in how the nervous system processes pain and may be triggered by trauma, surgery, infection, arthritis, or major emotional stress in some patients. Fibromyalgia is also considered a complex syndrome that involves many components, rather than just an individual condition. This is the main reason it can include many different signs and symptoms, such as widespread pain, tender points throughout the body, muscle stiffness, fatigue, depression/anxiety, thinking or memory problems, and numbness/tingling sensations. These symptoms can really get in the way of normal functioning and may also lead to reduced physical activity levels and additional health problems in the future.

There is no cure for fibromyalgia, but physical therapy is one intervention that’s been found to significantly help patients by easing symptoms and improving their quality of life. A typical physical therapy program for fibromyalgia will consist of aerobic exercise recommendations, stretching and strengthening exercises, ice and/or heat therapy, hands-on therapy (manual therapy), and possibly water-based aquatic exercise.

TrueReliefTM is a New Treatment Tool that Can Make a Huge Difference

Another tool that physical therapists might use for fibromyalgia is a medical device called True ReliefTM. This doctor-prescribed intervention sends an electric current to painful areas of the body affected by fibromyalgia, which is intended to “reboot” the nerves in the involved area to bring back a normal impulse. Resetting these impulses leads to a release of the body’s natural pain-relieving chemicals, which in turn alleviates the symptoms of fibromyalgia. TrueReliefTM can be used as many times as are needed and is not associated with any significant side effects.

If used, TrueReliefTM will always be combined with some of the other physical therapy techniques described above to produce the best possible outcomes. Utilizing an exercise-based approach has been supported by a number of research studies, including a high-quality review published in 2017, which features the following conclusion:

This study concludes that aerobic and muscle strengthening exercises are the most effective way of reducing pain and improving global well-being in people with fibromyalgia and that stretching and aerobic exercises increase health-related quality of life. In addition, combined exercise produces the biggest beneficial effect on symptoms of depression.

So if you’re dealing with wide-ranging symptoms that may be due to fibromyalgia, we strongly recommend that you try the chronic pain and fibromyalgia experts with offices in Visalia and Hanford.  We provide laser therapy, TrueRelief, and personalized, progressive physical therapy.

For a comprehensive treatment program designed specifically with your goals and abilities in mind, contact us today to learn more.

Chronic Pain Expert in Hanford


If you are seeking the specialty advice and treatment of a chronic pain specialist in Hanford, you’re at the right website.

For long standing pain, specialized treatment like TrueRelief or class 4 laser therapy, combined with the expert care of one of our chronic pain specialist physical therapists is a far better option than most medications.

Even though it may seem like nothing more than a serious distraction & inconvenience, pain is actually the body’s way of informing you that something is wrong and needs your attention. In most cases, this “pain signal” goes away either on its own or after addressing it—like putting ice on a sprained ankle. But for some people, the pain signal continues long after the problem has been resolved, which is called “chronic pain” when it lasts for more than three months. Chronic pain is often a troublesome issue to resolve, but a new electrotherapy called TrueRelief plus personalized physical therapy is an effective option that will target its source rather than just mask it (like most pain medications).

When you injure yourself, pain-detecting sensors become activated in that area. These sensors then send a message in the form of an electrical signal to the brain, which processes the signal and sends out a message that something is wrong. After most injuries, this signal stops after the cause of pain is resolved, meaning the injured area has healed. But with chronic pain, these nerve signals continue sending messages that you are in pain even though there is no longer any damage to your body. It’s not entirely clear why this occurs, but the general belief is that the nervous system accidentally communicates the presence of pain because it has repeatedly sent these pain signals for a long period of time.

Chronic pain is usually far more difficult to treat than typical injuries since the problem is more related to the nervous system than a physical issue. Many patients are being prescribed pain medications like opioids to address their condition, but there are far more risks than benefits associated with this approach. Opioids are highly addictive and often lead to abuse, overdose, and possibly even death. They are also only meant to decrease the perception or sensation of pain and are not intended to actually address the factor responsible for it.

Physical therapy, on the other hand, works with patients to help them better understand their condition and how their thought process can affect the way they feel. They also provide a number of techniques and tips to overcome chronic pain through specific movements and positive habitual changes. A physical therapy program for chronic pain will usually consist of the following components:

  • Education on how chronic pain works and the importance of physical activity
  • Strengthening exercises
  • Flexibility exercises
  • Hands-on (manual) therapy techniques
  • Posture and body mechanics awareness

The effectiveness of physical therapy and exercise on chronic pain has been highlighted in a number of studies, including a large-scale review published in 2017, which concludes with the following statement on physical activity for fibromyalgia:

The available evidence suggests physical activity and exercise is an intervention with few adverse events that may improve pain severity and physical function, and consequent quality of life

Living with chronic pain can feel as if there’s a constant barrier preventing you from doing the things you love normally, but it does not have to be this way. If you’re dealing with chronic pain, contact your local physical therapy clinic and get started on a positive path to recovery that does not include pain medications.

If you would like to learn more about how we can help, you can contact us at:

Our Hanford Physical Therapy Office: (559) 582-1027

Our Visalia Physical Therapy Office: (559) 733-2478

Plantar Fasciitis Treatment in Visalia


If you’ve ever experienced a piercing pain in the bottom of your foot the first thing in the morning, there’s a strong chance plantar fasciitis was to blame. Before you start taking pills, you should consider seeing one of our plantar fasciitis experts in Visalia.  As one of the most common causes of heel pain in existence, plantar fasciitis can strike people who exercise too much just as easily as those who wear the wrong pair of shoes. But whatever causes it, most patients would agree that it’s a pesky problem that they’d prefer to eliminate.

The plantar fascia is a thick band of tissue that runs across the bottom of your feet and connects the heel bone to the toes. Its primary purpose is to absorb the majority of the stresses we put on our feet, but it has a limit: too much pressure or strain can damage the tissue and lead to inflammation in that region.

This inflammation results in the most typical symptom of plantar fasciitis: a stabbing pain near the heel that’s usually worse with the first few steps of the day or after standing for a long period of time. Plantar fasciitis is particularly common in long-distance runners, but can stem from repeatedly performing any weight-bearing activities or spending too much time standing every day. People who are overweight, older than 40, and those who have high arches or flat feet are also at an increased risk of developing plantar fasciitis.

As is the case with any other painful condition, trying to push through or ignore plantar fasciitis can go on to cause chronic (long-term) heel pain and may result in pain in other parts of your body if you alter the way you walk. The good news is that most cases of plantar fasciitis with some basic modifications, such as the following:

  • Limit or completely stop the activity that led to pain in the first place
  • Ice the bottom of your foot for 20 minutes, 3-4 times a day
  • Avoid walking around barefoot, which puts more strain on the foot
  • Purchase a new pair of supportive shoes with good arch support

If your pain doesn’t improve within a few weeks after making these changes, your next step should be to see a physical therapist, who can address the issue with a number of interventions and techniques. In addition to stretching and strengthening exercises, your treatment program is also likely to include manual therapy, in which the therapist uses their hands to perform a variety of movements and mobilizations to the muscles and soft tissue of the heel that will release muscle tension and reduce pain. There is strong evidence that shows manual therapy techniques to be beneficial for plantar fasciitis, including one study published last year, which concludes as follows:

According to reviewed moderate and high-quality randomized-controlled trials (high-quality studies), soft tissue mobilization is an effective modality for treating plantar heel pain (another term for plantar fasciitis)

In light of this information, we encourage you to seek out physical therapy if you’re experiencing any symptoms that suggest plantar fasciitis is present. Taking this step will put you on a path to recovery and a future with less pain.

Prevent the cycle of ankle sprain recurrence by taking action now

Our ankles serve one of the most important roles of any of the body’s joints by supporting the weight of our entire body. With such a heavy task at hand, the ankles are also one of the most frequently injured regions, and ankle sprains are at the top of that list.

Ankle sprains result from the stretching or tearing of ligaments in the ankle and usually lead to some degree of pain, swelling, and tenderness. They are the most common injury in the athletic population, accounting for approximately 45% of all sports injuries. They are most frequently seen in basketball, football, and soccer, but can occur during any sport or activity when the ankle moves beyond its normal range of motion.

Ankle Sprains Usually Heal Quickly

Fortunately, the pain from ankle sprains will typically subside after 4-6 weeks if the patient follows the RICE protocol (Rest, Ice, Compression, and Elevation) and does not aggravate the injury further. But if the ankle sprain is not properly rehabilitated, it can lead to decreased range of motion of the ankle joint, particularly a loss of dorsiflexion motion (raising the foot upwards). This can lead to not only recurring ankle sprains, but excess stress on the knees, hips, and even the lower back, which may all be forced to overcompensate for the bad ankle in order to allow the body to move normally.

Physical Therapy Can Help in More Ways than One

For patients that do fail to recover properly from an ankle sprain and go on to experience additional sprains or other injuries, physical therapy can help prevent the problem from getting any worse with a targeted treatment program that typically includes:

  • Stretching exercises to restore ankle movement
  • Strengthening exercises to help patients regain strength and prevent long-term ankle disability
  • Balance training to improve stability and help patients to learn to deal with any potential hazards
  • Functional training, which consists of performing activities patients might have difficulty with like walking, running, or jumping

Prevention Should Be Part of Your Plan

But taking it a step further, physical therapy can also help individuals prevent a first ankle sprain from occurring altogether with a similar type of program designed specifically to prepare the ankle for increased stress loads. Athletes involved in some of the high-risk sports mentioned particularly stand to benefit from these types of program, which have been supported by research as effective for reducing the risk for ankle sprains. One study published in 2017 evaluated the effectiveness of proprioceptive exercises (which improve ones sense of where their body is in space) for preventing ankle sprains, and concluded:

Proprioceptive training programs were effective in reducing the incidence rates of ankle sprains in the athletic population, including those with and those without a history of ankle sprains

So if you’re concerned with your risk for ankle sprains and would like to reduce it, or if you’ve already suffered from a sprain and would like it to be your last, take action now by connecting with a physical therapist and addressing you risk head-on.

Knee Arthritis Treatment in Visalia

Research suggests that hands-on techniques may be best.  So, if you are in need of knee arthritis treatment in Visalia, this post may help.

There are more than 100 different types of arthritis, but osteoarthritis is by far the most common. Osteoarthritis is a painful condition that most frequently occurs in people who are older than 50, but it can be seen in younger people as well. In a normal joint, articular cartilage serves as a natural cushion between bones that absorbs shock and prevents the bones from rubbing against one another. In osteoarthritis, this cartilage gradually diminishes, which creates an environment where bones have less protection and can eventually come in contact in severe cases.

Any joint in the body can be affected by osteoarthritis, but it’s especially common in the knees. Patients who develop knee osteoarthritis typically experience pain that gets worse with physical activity, swelling around the knee, a feeling of warmth in the joint, stiffness (especially in the morning or after sitting for a while), and sometimes a creaking sound that’s heard when the knee moves. These symptoms in turn lead to less mobility of the knee, which make it more difficult to walk and perform basic movements like getting in and out of a car and climbing stairs.

Age is the most common cause of knee osteoarthritis, since the ability of cartilage to heal decreases as a person gets older. There are a number of other factors that may increase the chances of developing knee osteoarthritis, but being overweight is another major one. The knees absorb a great deal of impact when standing, and being overweight or obese will place even more pressure on the knees, which stresses the tendons and other structures of the joint. This can accelerate the process of cartilage thinning away, which will increase the chances of getting knee osteoarthritis or make pain worse for those who already have it.

This is why it’s strongly advised to lose weight if you have knee osteoarthritis or are at risk for getting it, as losing just one pound can reduce the amount of pressure on the knees.

If weight loss isn’t appealing and you are looking for natural knee arthritis treatment in Visalia, there are other options.

One effective way to address symptoms is by becoming more active and performing exercises that improve the strength and flexibility of the muscles surrounding the knees. Doing this not only relieves the pressure on the knees, but also increases fitness levels, which can allow you become more active and improve your quality of life.

A physical therapist can help in all of these areas, but they can also perform manual therapy, in which they use only their hands to move, massage, and manipulate the knee joint in various ways to further reduce pain and other symptoms. The effectiveness of manual therapy for knee osteoarthritis has been pointed out in a number of studies, including one published in 2018 that concluded with the following statement:

This review indicated orthopedic manual therapy compared with exercise therapy alone provides short-term benefits in reducing pain, improving function, and physical performance in patients with knee osteoarthritis

Physical therapists are movement experts that work with patients on a one-on-one basis to determine which treatments will be most beneficial for their condition. So if you’re experiencing any knee-related issues that may be knee osteoarthritis or want to reduce your risk for the condition, we strongly recommend that you take action by getting in touch with one of our physical therapist today.

For more on knee arthritis treatment in Visalia, you can contact us at (559) 733-2478

Treatment for Runner’s Knee

Treatment for Runner’s Knee in Visalia & Hanford – If runner’s knee is holding you back, physical therapy can put you back on track

Whether you’re entering the final stages of a long-term training program for an upcoming marathon or you’re a casual runner that logs a few miles every week, you’ve probably dealt with an injury of some sort in the past.

Runners can be affected by a wide array of potential injuries, but some consider patellofemoral pain syndrome—or runner’s knee—to be the most common. Accounting for about 20% of all running injuries, runner’s knee can actually result from any activity that requires repeated knee bending—such as walking, biking, or jumping—but as you might expect, it’s more prevalent in runners than any other population.

Runner’s knee is not a specific condition itself, but a loose term used to describe several similar disorders with different causes, and for this reason, it’s not always easy to peg down the exact reason why it develops. Misalignment of the kneecap (patella), weak thigh muscles, overuse, flat or over-arched feet, and direct trauma to the knee are all factors that can contribute, and if any one or a combination of these factors is strong enough, the result can be runner’s knee.

Stress from running causes irritation where the patella rests on the thighbone, and symptoms of runner’s knee include tenderness behind or around the patella, pain—especially when walking downhill—swelling and a popping or grinding sensation in the knee. For runners of any level, these symptoms can really interfere with training and prevent you from keeping up with your running schedule. Fortunately, you may be able to avoid runner’s knee by making these basic changes to your running routine:

  • Run on softer surfaces, keep your mileage increase to less than 10% per week and gradually increase your hill workout without overdoing it
  • Go to a specialty shoe store and have a gait analysis to ensure you’re using proper shoes for your foot type and gait
  • Be sure you’re using proper running form; click here for more information
  • If you do experience any pain, cut back your mileage significantly and avoid knee-bending activities and downward slopes until it subsides

If pain continues even if you’re following these tips and after cutting down your mileage, it’s best to see a physical therapist for further guidance. A physical therapist will help to identify any issues that may be causing your pain and provide you with an exercise program that focuses on improving the strength and flexibility of your thigh muscles. The program may also include manual therapy, in which the therapist carefully and systematically moves your joints and muscles to alleviate pain and improve your function. The benefits of this type of approach to runner’s knee are highlighted in a study published last year, which concludes with the following statement:

The data from this review cautiously suggest that manual therapy may be helpful in the short term for decreasing pain in patients with patellofemoral pain (runner’s knee). Several studies integrated manual therapy into a comprehensive treatment program.

So if you’re concerned with your risk for runner’s knee or are looking for treatment for runner’s knee in Visalia or Hanford, we strongly recommend seeing one of physical therapist as soon as you can to figure out what’s causing your pain and how to properly address it.

Specialists for Swimming Injuries

Year-round swimmers can reduce their risk for shoulder pain
by taking time off and seeing a physical therapist

For the hardcore swimmers out there, training is a year-round affair. Over one million Americans are involved in recreational or competitive swimming, and more than one-third of these individuals practice and compete throughout the entire year. Competitive swimming is certainly a great way to stay fit all year, but it also carries with it a risk for shoulder pain that can be managed with certain precautions and staying conditioned.

Swimming is a great form of physical activity that strengthens multiple regions of the body and improves flexibility and endurance. The lack of impact helps swimmers avoid lower-body injuries, but its intense involvement of upper-body muscles increases the chances for overuse injuries.

Overuse injuries occur gradually over time and primarily result from fatigue and failure to adhere to proper stroke techniques. About 90% of swimmers’ complaints relate to their shoulders, and the most common injury overall is swimmer’s shoulder, which is a general term to describe any type of shoulder pain. Swimmer’s shoulder is usually due to tendinitis of the rotator cuff—a group of muscles and tendons that surround and stabilize the shoulder—and if left untreated, it can cause more pain and other injuries.

Other swimming-related injuries include foot and ankle issues, hip pain, breaststroker’s knee (knee pain related to ligament or tendon damage), and back pain. As with shoulder injuries, most of these problems occur when swimmers push their bodies too hard without enough time to recover. The best way to reduce the risk for shoulder pain and other swimming-related injuries is to ensure that you’re practicing and competing with the proper technique. While it’s best to consult with a swim trainer, here are some general tips to keep in mind:

  • Warm up and stretch thoroughly before entering the water
  • Avoid overuse injuries by mixing up strokes and spending less time practicing those that are causing pain; also be to take enough time to rest and recover
  • Practice good communication between coaches, swimmers and sports trainers
  • Perform core strengthening and cross-training exercises

Physical Therapists can Help Prevent and Treat Swimming Injuries

Another effective way to both prevent and treat swimming-related injuries is physical therapy. Physical therapists can create sport-specific training programs that will keep swimmers properly conditioned throughout the year and reduce their risk for enduring an injury to the shoulder or elsewhere in the body. If any injury does occur, they can also provide patients with an individualized treatment program that addresses their symptoms and focuses on the mechanics and muscles involved in swimming. The benefits of physical therapy for swimming injuries are highlighted in a published study in 2017, which evaluated whether surgery or non-surgical (conservative treatment) was better for tears of the rotator cuff. The conclusion states the following:

There is limited evidence that surgery is not more effective in treating rotator cuff tear than conservative treatment alone. Thus, a conservative approach is advocated as the initial treatment modality.

This shows that swimmers and any other patients with suspected rotator cuff injuries should see a physical therapist first before considering surgery. Doing so can help them reduce their pain levels and regain shoulder function with significantly lower costs and less risk for complications compared to surgical interventions.

Contact Us if You Have Questions or Need Help

Baseball Injury Specialists in Visalia

Baseball can put extreme stress on the shoulder and elbow and sometimes, and maybe you are a player looking for a baseball injury specialist in Visalia. If so, we read on to learn more about how we can help.

Every year, approximately three million children play baseball in the U.S., and many continue to play on through their adolescence into high school. Due to the mechanics involved in baseball, strain on the elbows and shoulders is unavoidable, and injuries are therefore more common in these areas than anywhere else in the body. Young players of all positions are at risk for getting injured, but the risk is significantly higher for pitchers. In fact, research has shown that as many as 45% of pitchers under the age of 12 already experience pain in their elbow on a regular basis.

Most of this pain is due to performing the same motions repeatedly, which is referred to as overuse. One of the most common causes of elbow pain in young athletes is a condition called little league elbow—or medial epicondyle apophysitis—an overuse injury to one of the growth plates on the inside of the elbow. Little league elbow is most commonly seen in young pitchers and occurs because the growth plates are weaker than the muscles that attach to them. As a result, the stress placed on the growth plates from repetitive throwing can cause them to become inflamed, and the result is pain and swelling that makes it challenging to throw normally.

Other common overuse injuries of the elbow in youth baseball include the following:

  • Ulnar collateral ligament (UCL) injury: often results from pitchers throwing too often or too hard, and can range from minor damage to a complete tear
  • Flexor tendinitis: inflammation of the tendons of the elbow that attach to the upper arm bone (humerus), which leads to pain on the inside of the elbow
  • Valgus extension overload: a condition in which the protective cartilage on the bony point of the elbow (olecranon) wears away and a bony growth develops
  • Ulnar neuritis: irritation of the ulnar nerve, which stretches around the bony bump at the end of the humerus; the result is numbness, tingling, and pain

Since these elbow injuries result from overuse, the best way to prevent them is to ensure that young athletes are training within their limits and not pushing themselves too far. Parents and coaches can do their part by monitoring participation levels and pitch counts for young pitchers, and encouraging rest and recovery when it’s needed. Another key component of injury treatment and prevention is physical therapy. A physical therapist can provide a specific prevention program for young players, which will include stretching and strengthening exercises individualized to their specific needs and based on any weaknesses that might be present.

One, study published in 2017 shows just how effective physical therapy can be for baseball-related elbow injuries and why it should be the treatment-of-choice for these patients. The study, which focused on UCL injuries in throwing athletes, concluded with the following statement:

Non-operative management of sprains of the medial UCL of the elbow should be considered as first-line treatment in the majority of cases. After adequate rest, a structured return-to-sport interval-training program is crucial for successful return. Prevention of further injury may be provided by evaluating the athlete’s throwing technique and training regimen.

Our physical therapists are trained to help with both of these recommendations: they can provide a return-to-sport training program that is personalized for each athlete, and they can also evaluate the athlete’s throwing technique and guide them with prevention techniques that will reduce their risk for future throwing-related injuries.

To learn more or book an appointment with one of our clinical specialists, click here for additional contact information.

Herniated Disc Treatment in Visalia

If you have neck pain that radiates into your shoulder and/or down your arm, you may have a herniated disc.  If so, then of course you’re likely to be looking for a specialist – one that provides herniated disc treatment in Visalia.

Successful Treatments for Cervical and Shoulder Pain – Physical Therapy Offers Relief

A common problem treated in Physical Therapy clinics is cervical pain combined with shoulder pain.  The patient may experience radiculopathy into either upper extremity, or pain radiating proximally into the suboccipital region or distally into the spine.  As with all effective treatment, addressing the cause of the problem leads to fast, effective relief for our patients.

A primary cause of cervical and shoulder pain is poor posture.  Many patients we treat work at a desk or computer terminal for eight or more hours a day, or 2,000 hours per year.  With time his or her posture will break down resulting in a forward head, rounded shoulders, and increased thoracic kyphosis.  If this process is not addressed, the patient may eventually experience degenerative cervical changes, cervical apophyseal disease, tightening of the anterior cervical musculature, rhomboid and upper trapezius muscle spasms and other permanent postural changes.

Poor Posture Causes Other Problems

Poor postural habits change the angle of the resting scapula on the thoracic cage.  This leads to impingement of the rotator cuff muscles (especially the supraspinatus) with shoulder elevation.

Try this yourself:

  1. Sit with good posture. Shoulder blades are pulled back and down.  Low back is slightly arched into lordosis.  Eyes are looking forward and level.  Chin is up.  Raise your arms as high as you can.  This typically is close to 160 degrees or near vertical.
  2. Now sit with poor posture typical of patients we see in our treatment or exam rooms. Slouch your low back.  Round your shoulders forward.  Let your chin and eyes drop forward.  Now try and raise your arms overhead.  Most people will experience a 60 degree decrease in range of motion or more.

Thoracic Outlet Syndrome is the peripheral entrapment of the brachial plexus producing symptoms often mistake for shoulder tendonitis, elbow tendonitis, nerve root pain or musculoskeletal pain of the neck and shoulder.

The Journal of Shoulder and Elbow Surgery (1995:4: 113-117) and JAMA (2004;196: 109-111) reported Thoracic Outlet Syndrome is suspected in cases of a patient history involving upper extremity heaviness or numbness with prolonged postures such as sitting and when laying on the involved side.



Shoulder Impingement & Labral Tears – Do You Really Need Surgery?

Reference for image .

Physical therapy should be your first choice for shoulder pain, regardless of what’s causing it because it’s conservative, there are little to no side effects, and recent research suggests surgery is no better.

The shoulder is an incredible joint. As a ball-and-socket joint, it allows for an extremely wide range of motion and is the only type of joint that can rotate in a full circle around its axis. But as a result of its design, it’s vulnerable to injury.  The rotator cuff can be pinched between the ball and a bone above the ball called the acromion.  Also since the shoulder ball is much bigger than the socket, it makes the cartilage labrum around the socket also vulnerable to injury.

The issue is that the ball of the joint (the end of the upper arm bone, or humerus) is much larger than the socket (a structure called the glenoid fossa). Due to the major difference in size, the shoulder is considered an unstable joint, and the ball can slip out of the socket to cause pain and dysfunction. The good news is the rotator cuff helps actively hold the ball and socket together. One other feature of the shoulder that helps prevent dislocation is the labrum, which is a band of cartilage around the edge of the socket that adds depth and keeps the humerus in place. But despite this added protection, shoulder injuries are still quite common.

Two Diagnoses that Might (Yes, We Said “Might”) Cause Pain

shoulder anatomy diagram

Shoulder impingement occurs when the rotator cuff tendons, primarily the supraspinatus tendon, is pinched between the humerus, subacromial bursa, and the acromion.  See the above image to try to orient yourself.  Imagine what could happen if the arm bone (the humerus) was raised overhead and pinched the rotator cuff and blue bursa that’s below the acromion bone.  That’s what happens with shoulder impingement.  It’s common but as indicated in the main image of this article at the top, recent research suggests that surgery isn’t better than conservative care.

While we agree that conservative care, especially provided by one of our professionally trained and licensed musculoskeletal experts, is the best thing to do first, we’ve also seen a number of patients that have had surgery and good outcomes as well.  Bottom line, research often doesn’t adequately summarize all possible outcomes.  Nevertheless, we agree with the research – you should first try conservative care before you have any surgical procedures.

Similar Research Suggests Conservative Care First for SLAP Lesions Too

A SLAP (superior labrum, anterior to posterior) tear is an injury to top of the labrum (or superior), from its front to back (anterior to posterior). SLAP tears can come about from a single incident, such as falling on an outstretched arm or shoulder, or from doing lots of overhead activities on a regular basis. Participation in overhead sports like baseball or tennis, or lifting heavy objects repeatedly can all increase the likelihood of experiencing a SLAP tear. In other cases, they result from the labrum gradually losing strength over time as a natural part of the aging process.

Typical symptoms of a SLAP tear include pain when moving the shoulder, a sensation of locking, popping, or catching, a decrease in shoulder strength and flexibility, and a feeling that the shoulder will suddenly “pop out.” If you’ve been experiencing these symptoms, a SLAP tear my be possible, and some medical professionals might recommend getting an MRI to confirm the diagnosis. While MRIs can be helpful, they should not be relied upon too heavily in these types of situations. Research has shown that the MRIs of many patients—particularly older individuals—with no shoulder pain will actually reveal the presence of a SLAP tear. For example, one study of 53 individuals between the ages of 45-60 concluded:

There is a high prevalence of superior labral tears diagnosed by MRI in the asymptomatic shoulders of middle-aged people. These findings suggest that superior labral tears noted by MRI may not be the cause of symptoms in this patient group with shoulder pain.

Regardless of whether a SLAP tear is responsible for your shoulder pain, physical therapy is the best first step to address it in nearly all situations. A physical therapist will work with you to identify the specific ways your condition is limiting you, and then create a personalized treatment program to address these impairments. Every program is different, but most will include the following:

  • Flexibility exercises to stretch the shoulder capsule that surrounds the joint
  • Strengthening exercises for the muscles that support your shoulder
  • Manual therapy from the physical therapist to increase shoulder range of motion
  • An analysis of your movement patterns and correction of any overhead faults
  • Heat, ice, and/or electrical stimulation

Before you get an MRI of your shoulder in order to find out exactly what’s wrong, see a physical therapist. While specific diagnoses are helpful in some cases, they can also be distracting and take away from time that can be better spent getting treated and working your way back to full strength.

To Learn More about How We can Help, Call Us at: (559) 733-2478