Overuse and Repetitive Strain Injuries

Repeatedly performing certain motions can produce pain and dysfunction over time

Most injuries will fall into one of two categories: acute and overuse. Acute injuries usually result from a single, traumatic event, such as a fall, slip, or collision with another athlete or object. Some common examples of acute injuries include wrist fractures, ankle sprains, shoulder dislocations, and hamstring strains.

Overuse injuries, on the other hand, occur gradually over time rather than on the spot. They are more common than acute injuries but are also more subtle, which makes them more challenging to diagnose and treat. Overuse injuries may result from training too hard and pushing your body past its limits, or simply by moving incorrectly or with bad posture on a repeated basis. Another term used is repetitive strain injuries, which shows how repeating the same movements can result in small trauma—or microtrauma—to tendons, bones and joints. Eventually, the damage gets so bad that symptoms begin to arise, in which cases treatment is usually needed.

Here at our practice, we treat a variety of sprains & strains. Below, we offer a brief overview of the mechanisms responsible for 5 common overuse injuries:

Shoulder Impingement – Consider Physical Therapy for Shoulder Impingement Syndrome in Visalia
Shoulder impingement syndrome (SIS) is a condition that involves the rotator cuff, a group of muscles and tendons that keeps the shoulder stable. In SIS, rotator cuff tendons become compressed—or “impinged”—as they pass through a small bone on top off the shoulder blade called the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted movement and pain that occurs at rest, when moving the shoulder overhead and/or when sleeping.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. The condition can also result from an injury that compresses the structures of the shoulder—like a fall—or from frequently sleeping on your side. Sleeping in this position regularly can strain the shoulder and cause impingement over time.

Plantar Fasciitis – We Provide Effective Physical Therapy for Plantar Fasciitis in Visalia
The plantar fascia is a thick, connective band of tissue that runs across the bottom of the foot and connects the heel to the toes. It’s a tough structure designed to absorb the regular stresses that are placed on the foot, but can become damaged when these forces are excessive. When this occurs, the resulting condition is plantar fasciitis.

Plantar fasciitis is a stubborn overuse injury and the most common cause of heel pain.
It occurs most frequently in runners—especially long-distance runners—due to the repetitive strain they place on their feet. People who have flat feet or high arches, are overweight or regularly perform any other weight-bearing activity are also at increased risk. The most common symptom of plantar fasciitis is a stabbing pain near the heel that’s most noticeable upon waking up and after standing for long periods.

Carpal Tunnel Syndrome – Relief for Those Searching for Physical Therapy for Carpal Tunnel Syndrome in Visalia 
The carpal tunnel is a space at the base of the palm that contains several tendons and the median nerve, which provides sensation to the fingers. If these tendons thicken or any other swelling occurs in the area, this tunnel narrows, which puts pressure on the median nerve and leads to a condition called carpal tunnel syndrome.

Carpal tunnel syndrome is extremely common, as it affects about 5% of the population.
The greatest risk factor is any task that requires repetitive hand motion, awkward hand positions, strong gripping, mechanical stress on the palms, or vibration. As a result, individuals who work on an assembly line—like manufacturing and meatpacking industries—are at the highest risk. The risk if also high in office workers. Symptoms usually start with a burning or tingling sensation, but eventually pain, weakness and/or numbness develop in the hand and wrist, and then radiate up the arm.

Golfers Elbow – Choose Physical Therapy for Golfer’s Elbow in Visalia
Golfer’s elbow is a condition that results from the repeated bending of the wrist that is necessary in a golf swing. This damages the muscles and tendons of the medial epicondyle—a piece of bone on the inside of the elbow that allows the forearm, wrist and hand to bend and move in several different ways—and eventually leads to inflammation. It is especially common in golfers because gripping or swinging clubs incorrectly or with too much force can take a toll on the structures within the elbow over time.

Common symptoms include pain, tenderness, swelling, weakened grip strength and a burning sensation on either the inside or outside of the elbow. These symptoms often develop gradually and are worsened by activities that involve the forearm, and if left unchecked, can go on to make many basic activities that require gripping or grasping a major challenge.

Lower Back Pain – Natural Physical Therapy for Back Muscle Strain in Visalia
Back pain is the most common musculoskeletal injury, and a significant number of cases are due to a strain of one or more back muscles. This condition—also known as a pulled muscle—is the result of muscle fibers tearing from being overstretched or overused, which can occur from repeatedly bending your back or using improper posture.

The most common symptom is pain in the lower back that is often most intense during the first few hours of the day. Pain also tends to get exacerbated with certain movements or positions that strain the muscles of the spine, like standing for long periods of time. Tenderness and stiffness of the spine is also likely.

Physical therapy for all types of overuse injuries
In addition to being the product of overuse or repetitive strain, another feature that all of these conditions share in common is responding to physical therapy. Our physical therapists can help by identifying the behaviors or habits that are responsible for your pain, and then recommending adjustments to your movements along with a personalized treatment program to help you move with less pain.

Contact Us for More Information About How We can Help

Physical Therapy After Shoulder Surgery in Visalia or Hanford

Searching for physical therapy after shoulder surgery in Visalia or Hanford?  We can help – read more below.

If you decide to have shoulder surgery, physical therapy is an integral part of the recovery process

The shoulder is an incredible joint. As the only joint in the body that can rotate a full 360°, the shoulder is the most mobile and flexible joint in the body, and this wide range of motion is the reason you can move your arm in so many directions. There is, however, one downside to all this mobility: it makes the shoulder particularly vulnerable to injury.

The Shoulder Joint is Complex – Therefore, There are All Kinds of Potential Problems

Although the shoulder is typically referred to as a single joint, it is technically more complex and consists of four joints, with the acromioclavicular and glenohumeral joints being the most important for movement. Bones of the shoulders are connected by several ligaments, while muscles connect to bones through various tendons. Other important structures of the shoulder include the rotator cuff, a group of four muscles that form a “cuff” around the upper arm bone, a ring of protective cartilage (the labrum), a fluid-filled sac that provides cushioning (the bursa), and the joint capsule, which encloses all the components of the shoulder.

Any of these structures can become damaged and lead to shoulder-related disability. The rotator cuff is one of the most commonly injured areas of the shoulder, with a condition called rotator cuff tendinitis being the most prevalent cause of shoulder pain. Tears of the rotator cuff also occur frequently, and these injuries can occur either traumatically from a single incident, or gradually over time, which is usually the case in older patients.

Physical Therapy After Rotator Cuff Surgery – We Can Help Both Visalia and Hanford Residents

In the event of shoulder pain from injury to the rotator cuff or any other structure of the shoulder, the patient will decide with a doctor whether surgery is needed or a conservative (non-surgical) approach—which primarily involves physical therapy—can be taken. Most shoulder injuries can be effectively treated with a conservative plan, but if this approach fails to produce significant improvements or the patient has suffered a severe injury like a high-grade, sudden rotator cuff tear, surgery may be needed. Surgery is also more likely to be selected by active athletes involved in overhead sports.  If you’d like additional resources, the American Physical Therapy Association also has some details – click here.

Physical therapy also essential after surgery

If you have a shoulder injury and decide to have surgery, physical therapy will still serve as a fundamental component of the recovery process. Through a movement-based, individualized strategy, physical therapy will help to bring you back to full strength and function with targeted exercises and other interventions. A typical treatment program for patients recovering from shoulder surgery will likely include the following:

  • Stretching and strengthening exercises: weakness and reduced flexibility/mobility are two major consequences of surgery, so the bulk of rehabilitation will aim to address these impairments; key exercises include:
    • External rotation: using a resistance band or dumbbell, keep your elbow bent at a 90° angle and slowly move your hand out from the body
    • Internal rotation: same as external rotation, but move your hand towards your body
    • Forward flexion shoulder raise: holding a dumbbell, keep your arm straight and lift it directly in front of you until it’s at eye level
    • Pendulum exercises: holding a dumbbell, let your arm hang loose and swing it around in a circle; then try swinging it back and forth
    • Scapular squeezes: lie on your stomach with arms at your sides, draw your shoulder blades together and down back as far as possible; ease about halfway off from position and hold it
  • Passive treatments: ice, heat, ultrasound, and other interventions will likely be utilized to alleviate shoulder pain
  • Activity modification: your therapist will teach you how to avoid positions and movements that can aggravate pain and make the condition worse, like sleeping on your side and carrying heavy loads

Contact Us Today if You are in Need of Physical Therapy After Shoulder Surgery

Remember that you always have options after a shoulder injury of any sort, and surgery is not necessary for many patients. But if you do opt to go the surgical route, keep in mind that physical therapy will play a major role in your recovery, and that better adherence to your treatment will lead to improved outcomes. Contact us to learn more about how we manage patients recovering from shoulder surgery or to schedule an appointment today.

Call Us in Visalia at (559) 733-2478 or Hanford at (559) 582-1027 for More Information

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

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

Reference for image https://www.bmj.com/content/364/bmj.l294 .

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

Rotator Cuff Tear Treatment in Visalia

When someone says you have a rotator cuff tear, you might automatically think that it should be repaired or fixed.  While that might seem to be common sense, fact is you don’t need to rush into surgery for a rotator cuff tear.

For tears of the rotator cuff, physical therapy may be just as effective as surgery according the the research, and we here at Bacci and Glinn Physical Therapy have treated many rotator cuff tears.  If you are looking for rotator cuff tear treatment in Visalia, and you don’t want to go through all of the risks and challenges of surgery, you should consider trying natural and conservative care first.

More on the Rotator Cuff

The rotator cuff is a crucial component of the shoulder that allows it to function. It connects the upper arm bone (humerus) to the shoulder blade (scapula) with four muscles, each of which has a tendon that attaches to different parts of the scapula. These tendons form a “cuff” around the head of the humerus, and all the muscles work together to control and stabilize the shoulder.

As a ball-and-socket joint, the rotator cuff helps secure the “ball” portion of the joint—the humerus—as the arm moves and rotates within the “socket” (the scapula). It plays an extremely important role in keeping the shoulder stable when performing many overhead movements, such as reaching, throwing, and picking things up. Unfortunately, because these movements are so common and the rotator cuff is used so frequently, it’s also quite vulnerable to injury.

When any of the tendons of the rotator cuff becomes injured or torn, the tendon becomes detached from the head of the humerus, and the injury is called a rotator cuff tear. Some rotator cuff tears occur after sudden injuries like falling on an outstretched arm or lifting a heavy object, but most develop gradually over time after the tendon gradually loses its strength. Athletes involved in overhead sports like baseball, tennis, and weightlifting, and those who are older than 40 are at a greater risk for rotator cuff tears.

If you happen to experience a rotator cuff tear, it’s important to understand that surgery is not the only option available. For many patients, physical therapy can lead to similar results as surgery, but at a much lower cost and with far fewer risks for complications. Similar outcomes between surgery and conservative treatments have been found in a number of studies, one of which—published in 2017—concludes with 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 (for these patients).

Whether or not surgery is needed depends on the seriousness of the injury, the age of the patients, and several other factors. If it is determined that physical therapy is appropriate, a typical treatment program will consist of:

  • Stretching exercises: intended to increase flexibility that has been lost
  • Strengthening exercises: intended to build back strength in the shoulder
  • Passive treatments: includes ice, heat, and ultrasound to alleviate pain
  • Activity modification: your therapist will teach you what positions and movements to avoid or modify to reduce aggravating your shoulder further

So if you’ve recently experienced a rotator cuff tear and are wondering what to do next, visit a physical therapist first before anything else. Taking this step will get you started on a treatment program and on your way to recovery right away, and will also help you reduce the chances of unnecessary tests or procedures down the line.

Rotator Cuff Tendinitis Treatment in Visalia

If you are looking for rotator cuff tendinitis treatment in Visalia, you’re not alone. Many shoulder issues are caused by rotator cuff tendinitis that require physical therapy

The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, and it is essential for allowing the shoulder to move and keeping it stable during movements. But due to its vital role and frequent use, the rotator cuff is also a very common site of injury. In particular, rotator cuff tendinitis is a frequent source of shoulder pain that can impair a patient’s ability to perform overhead movements. But for most of these patients, physical therapy can address the underlying problem.

Rotator cuff tendinitis is often an overuse injury that occurs gradually over time. It can result from something as simple as moving the shoulder into the same position repeatedly, or from sports and activities that consist of over-the-head motions like baseball, tennis, swimming or even painting. As time passes, these repetitive shoulder motions lead to inflammation and irritation of the tendons, which will eventually cause pain when performing these motions.

Common Symptoms of Rotator Cuff Tendinitis

The main symptoms of rotator cuff tendinitis are pain and swelling in the front of the shoulder and side of the arm, usually while raising or lowering the arm. Loss of mobility and strength, stiffness, and at times a “clicking” sensation may also occur. If you happen to notice any of these symptoms and are concerned, the only way to determine if rotator cuff tendinitis is present is with a physical therapist evaluation.

Fortunately, most cases of rotator cuff tendinitis are reversible and can be managed very successfully with a course of physical therapy. All physical therapy programs are different depending on the patient’s abilities and goals, but most will include the following components:

  • Pain-relieving modalities like laser therapy, heat, and/or ice
  • Recommendations to avoid activities that can further aggravate the shoulder
  • Posture education and training
  • Strengthening exercises to recover the strength of the rotator cuff and the shoulder girdle complex
  • Stretching exercises to increase flexibility of muscles surrounding the shoulder

A recent study highlights just how effective physical therapy can be for patients with rotator cuff tendinitis. In the study, three different types of exercises that are commonly used by physical therapists were compared, and the conclusion reached stated:

Open chain, closed chain and range of movement exercises all seem to be effective in bringing about short-term changes in pain and disability in patients with rotator cuff tendinitis

Rotator cuff tendinitis can be a major hindrance on your everyday activities, especially if you’re an active athlete. So if shoulder pain is holding you back from living your life normally, physical therapy is likely your fastest ticket to relief.  Click here for contact information for both of our locations.

NEW: If you are looking for shoulder treatment in Hanford or Visalia, ask about our New class 4 laser and how it might help your shoulder problem.

Shoulder Impingement Treatment in Visalia – Surgery Is Not Your Only Option

If you have pain in your shoulder, there’s a strong chance shoulder impingement syndrome is responsible

If you look at an x-ray or an MRI of your shoulder, and the doctor tells you that your rotator cuff and bursa are being pinched, you may think that the only shoulder impingement treatment in Visalia is a knife.  Let me share another natural option.

The shoulder is a complex joint consisting of numerous tendons, ligaments and muscles that allow the arm to move in several different directions. These structures help keep the shoulder stable and are crucial for its flexibility, but they also make it vulnerable to a number of injuries. This is one of the main reasons shoulder pain is so common, especially in individuals who perform lots of overhead movements. In most cases, this pain is due to a condition called shoulder impingement syndrome, but the good news is that physical therapy can help, regardless of its cause.

The shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). The humerus and scapula are surrounded and connected by the rotator cuff, which is a group of muscles and tendons that keeps the shoulder stable and allows for the ball-and-socket movements of the joint. There is also a fluid-filled sac called the bursa between the rotator cuff and a bony prominence on the top of the scapula (acromion), and its function is to provide a cushion during movement.

In shoulder impingement syndrome (SIS), the tendons of the rotator cuff become compressed—or “impinged”—as they pass through the narrow space beneath the acromion. Over time, this causes the tendons to become irritated and inflamed, and will lead to bothersome symptoms like swelling and tenderness, loss of strength, restricted shoulder movement and shoulder pain at rest, when moving the shoulder overhead and/or when sleeping.

SIS is most common in individuals that regularly perform lots of overhead activities like golfers, swimmers, and baseball and tennis players, as well as painters and construction workers. If the condition develops, it’s strongly advised to receive physical therapy as soon as possible in order to prevent it from progressing further. Physical therapy for SIS typically consists of the following components:

  • Activity modification/functional training
  • Stretching exercises
  • Strengthening exercises
  • Hands-on (manual) therapy
  • Posture education

A recently published study investigated the effectiveness of eccentric strengthening exercises—a treatment commonly used in physical therapy programs—for patients with SIS, and the results were very encouraging. The conclusion states:

An eccentric program targeting the external rotators was superior to a general exercise program for strength, pain, and function after six months. The findings suggest eccentric training may be efficacious to improve self-report function and strength for those with subacromial pain syndrome (another term for SIS).

Shoulder symptoms from SIS can severely impair your abilities to perform your job or just get through the day without pain, but it doesn’t have to be this way. If your shoulder is bothering you, contact your local physical therapist first and fast, and begin on your path to a pain-free future.

Shoulder Specialist Visalia – About Frozen Shoulder Treatment

Looking for a shoulder specialist in Visalia? We can guide you through every stage of treatment if you adhesive capsulitis

The shoulder is a ball-and-socket joint, with the upper arm bone (humerus) serving as the “ball” and fitting into the “socket” of the shoulder blade (scapula). The bones and other structures of the shoulder are surrounded by a structure called the shoulder capsule, which is made up of strong connective tissue that helps hold the humerus to the scapula. Adhesive capsulitis, or frozen shoulder, occurs when scar tissue forms within the shoulder capsule. Inflammation of the capsule causes severe pain, inflammation, scarring and a tightening of the shoulder joint, which means there is less room to move the shoulder normally.

Although frozen shoulder affects up to 5% of the population, it’s not entirely clear why it develops. In general, it’s believed that not moving the shoulder joint normally for a long period of time is one of the leading factors, as most people who get frozen shoulder have kept their shoulder immobilized due to a recent injury, surgery, pain or some other condition. People between ages 40-60, women and those with arthritis, diabetes, cardiovascular disease and other health conditions are also more likely to develop it.

The Stages of Adhesive Capsulitis Development and Resolution

Frozen shoulder usually develops slowly and gets progressively worse with more pain and loss of motion over time. This is typically broken down into four stages:

  • stage 1 consisting of the onset of symptoms, which gradually get worse over 1-3 months.
  • Stage 2 is the “freezing” stage, which generally occurs 3-9 months after symptoms start and is very painful.
  • Stage 3 is the “frozen” stage in which the shoulder becomes even more stiff and difficult to move.
  • Finally, the “thawing” of stage 4 occurs within 12-15 months, in which pain decreases significantly and range of motion begins to improve.

Conservative Care is the Best First Choice

There are a number of treatment options available for frozen shoulder, but physical therapy is one of the best options because it’s effective for addressing symptoms at every stage. The goal of physical therapy is to control pain and improve strength and flexibility to help patients move their shoulder more easily, and treatment will consist of:

  • Heat and/or ice
  • Stretching exercises
  • Manual therapy
  • Strengthening exercises
  • Specific activity training

The benefits of physical therapy for frozen shoulder can be seen in the findings of a recent study, which evaluated if several commonly used physical therapy interventions were effective for patients with this condition. Here are the results:

Adding a structured rotator cuff strengthening program to TENS and joint mobilization in the treatment of frozen shoulder resulted in improvements in pain, range of motion and function. Reference: https://www.ncbi.nlm.nih.gov/pubmed/27884497

If You Need a Shoulder Expert Here in Visalia, We Provide All Natural Care – No Drugs, Injections, or Surgery

Frozen shoulder is clearly a serious condition that requires a great deal of time to fully recover from, but physical therapy can significantly speed up this process. If you have symptoms of frozen shoulder, contact us for a consultation right away and we can get you started on a treatment program that will safely help you regain your shoulder function.

Shoulder Specialist in Visalia – What Rotator Cuff Patients Need to Know

If you are looking for a shoulder specialist in Visalia, because of a rotator cuff injury (a common cause of shoulder pain), seeing a physical therapist first can help you avoid unnecessary treatments like surgery.  This article provides common sense reasoning as to why we can help.

What’s the Rotator Cuff ?

You’ve probably at least heard of the rotator cuff—especially if you play or watch sports—but what you may not know is just how important of a structure it is. The rotator cuff is a group of muscles and tendons in the shoulder joint that allows the arm to lift and rotate.  In addition to permitting movement, it also stabilizes the shoulder and helps the joint maintain good alignment and posture during many daily activities.  So any time you experience one of the countless displays of flexibility in your shoulder, you have your rotator cuff to thank.

Because the rotator cuff serves such an important role and is used so frequently, it’s also a common site of injury.  Injuries to the rotator cuff most often occur in people who repeatedly perform overhead motions in their profession or recreational activities. Some examples of those affected by rotator cuff injuries include painters, carpenters and athletes involved in tennis, baseball—especially pitchers—and swimming.

Repeated Overhead Activity Leads to Injury Which Might Mean You Need to See a Rotator Cuff Rehab Specialist

When these activities are performed regularly for a long period of time—or through the aging process—the rotator cuff tendons eventually become inflamed from over-stretching or repetitive stress, which can lead to pain or injury.  The most common injuries seen are rotator cuff tendinitis (or shoulder impingement), shoulder bursitis and rotator cuff tears.  The primary symptoms of a rotator cuff injury is a dull ache deep in the shoulder that makes it difficult to reach behind the back or lift the arm.

To investigate just how many people in the general population have rotator cuff injuries, one study (click for the reference) examined the shoulders of 683 individuals, some of which had shoulder pain and others who did not. This is what they found:

  • Overall, 20.7% of participants had a rotator cuff tear
  • 36% of participants with shoulder symptoms had a rotator cuff tear
  • 16.9% of participants without shoulder symptoms had a rotator cuff tear
  • The risk factors for a rotator cuff tear were trauma to the arm and older age

This study shows that rotator cuff tears are very common, and in many cases, a tear may exist even if the individual does not have should pain or other symptoms. Unfortunately, if you have a rotator cuff injury and go to a doctor first for an evaluation, there’s a chance that you may be instructed to have unnecessary treatments like an injection or surgery if they find a tear. But as you can see, tears are present in many people who aren’t even in pain, and surgery is rarely needed to treat it. Surgery is also very risky and expensive.

Why Seeing a Physical Therapist First Makes Perfect Sense…

On the other hand, if you see a physical therapist for your rotator cuff injury first, in most cases they will treat you right away regardless of whether or not you have a tear. As a result, you can begin your path to recovery through various exercises, manual treatments and other interventions during your first session, while avoiding expensive and potentially dangerous treatments in the process.

So if your shoulder is bothering you and preventing you from functioning normally, make the smart choice of seeing a physical therapist first for the best possible outcome.

Click here to visit our Contact Page, then give us a call to learn more about how we can help.

Hands-on for Shoulder Pain Treatment in Hanford

A 2016 clinical trial confirms what we here at Bacci & Glinn Physical Therapy have been doing for years. If you are in need of shoulder pain treatment in Hanford, then this research may be pertinent to you.  In a study of office workers that suffered with shoulder pain, physical rehabilitation involving hands-on treatment was found to be an important part of a conservative treatment program.

Long-term computer use can lead to muscle dysfunction and disorder

Approximately 90% of white-collar workers use computers for more than four hours per day.  Over time, sitting and working at a computer can lead to a dysfunction of muscle stability and other disorders of the region, which may result in shoulder and neck pain, as well as a decreased threshold for pain.  One of the main reasons for shoulder pain is hyperactivity of an upper back muscle called the upper trapezius, which results in decreased control of two other muscles and instability.  To treat this muscle instability, several physical therapy interventions may be used, including manual therapy.  In manual therapy, the physical therapist performs various manipulations and mobilizations on the painful area in order to bring about tissue changes that will lead to less pain.  Manual therapy may therefore be helpful for office workers with shoulder pain, and to evaluate this possibility, a study was conducted.

Middle-aged office workers with pain serve as the study group

Individuals between the ages of 30-40 who had shoulder pain and worked on a computer for more than eight hours a day were invited to participate in the study and screened to determine if they were eligible.  This process led to 38 individuals who were accepted, and then randomly assigned to either the manual therapy group or the shoulder stabilization exercise group.  Both groups underwent treatment during two 40-minute sessions per week for six weeks.  In the manual therapy group, the therapist applied manipulations and mobilizations to various muscles in the back, chest and neck for three minutes each.  In the shoulder stabilization group, patients were instructed to perform a series of stretching and strengthening exercises for muscles in the same area.  All patients were assessed before and after undergoing treatment for pressure pain threshold (PPT) of certain muscles, which measures the minimum force applied that causes pain.

Manual therapy leads to greater improvements

After completing treatment, participants in both groups experienced significant improvements with an increased PPT of several muscles of the upper back; however, the manual therapy group showed greater PPT improvements in these muscles than the shoulder stabilization group.  This is likely due to the pain-relieving properties of manual therapy, as it increases blood flow and decreases the activity of muscles in such a way that it changes the length of tissues and results in less pain.

Here’s an excerpt from the abstract published on Pubmed.org:

The manual therapy group showed greater improvements than did the shoulder stabilization exercise group in the splenius capitis on both sides, left upper trapezius, middle trapezius on both sides, and right lower trapezius. [Conclusion] The results of this study suggest that manual therapy for shoulder pain is feasible and suitable for office workers and may be useful in clinical rehabilitation.
Reference: https://www.ncbi.nlm.nih.gov/pubmed/27799661

These results show that while both shoulder strengthening exercises and manual therapy appear to be effective for office workers with shoulder pain, manual therapy is even more beneficial for improving their threshold for pain.  Individuals currently dealing with this type of pain should therefore seek out the services of a physical therapist for appropriate treatment.

Diagnoses we’ve successfully treated – Check our medical library

There are a number of shoulder conditions that we regularly treat.  Here’s a link to our medical library where you can learn more about physical therapy for shoulder pain that we provide here in Hanford (and Visalia as well).

If you have questions about your shoulder pain, just give us a call.  Chances are we can help.   Click here to visit our contact page for more information.

-As reported in the September ’16 issue of  The Journal of Physical Therapy Science

 

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