Posts Tagged ‘#Rehabilitation’

Shoulder Problems

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Shoulder problems are extremely common. In fact, following back complaints, shoulder problems seem to be the next most common area of pain and discomfort. This is possibly due to the shoulder being a very complex joint that relies heavily on the surrounding muscles for support. A multitude of problems can occur in and around the shoulder joint. Because of this, it can be difficult to fully understand what might be causing your pain and what is the best course of action. Below is a brief description of the shoulder joint and some common complaints regularly seen in the clinic. 

The Shoulder Joint is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). Just like the hip, the shoulder is a ball and socket joint, though unlike the hip, which has a deep socket, the shoulder joint has a very shallow socket.

This shallow socket does make the joint somewhat unstable, however, it also allows the shoulder joint to have a vast range of movement. The down-side to this configuration is that the shoulder joint then depends heavily on the surrounding muscles for strength and stability.

There are several ligaments within the shoulder joint attaching the bony parts together. The joint is made a little deeper where the ball and socket meet, by ring of fibrous tissue called the ‘glenoid Labrum’. A membrane then covers the whole joint to provide further stability, as well as secreting synovial fluid which lubricates the joint. Enclosing all these structures are four deep stabilising muscles collectively known as the rotator cuff muscles. The rotator cuff muscles, along with the deltoid, latissimus-dorsi and pectoralis muscles, provide additional stability, protection and of course, movement. There are no less than eighteen muscles that directly or indirectly affect the shoulder.

Common Problems:
One of the most common shoulder problems seen in the clinic is an impingement. This often occurs when a particular rotator cuff muscle gets pinched between the head of the humerus and the acromion process. Pain usually presents when the arm is raised sideways or twisted, resulting in weakness, restriction of movement and referred pain into the upper arm.

Impingements can happen for several reasons, such as a falling over, arthritis, or even a bony spur pushing into the muscle tendon from above. Treatment can often be quick and simple along with some postural advice, or occasionally it may require keyhole surgery.

Impingements can also be caused by a muscular imbalances and poor posture. Further to this, sports such as swimming, tennis, badminton and gymnastics can all contribute to an impingement injury. Occupations such as painters, decorators and plasterers also provide their fair share of impingement problems due to the position of the shoulder when working.

Frozen shoulder: Medically referred to as ‘adhesive capsulitis’, frozen shoulder is a disorder in which the capsule surrounding the joint becomes painful and greatly restricted. This condition typically affects people between 40-60 years of age and generally lasts between 18-24 months. Frozen shoulder seems to be more common in females, often occurs after an injury and seems more prevalent in certain conditions such as diabetes, overactive thyroid and Parkinson’s disease.

Recovery is often slow and frustrating, but over time, progress can be made. It is important to keep exercising the shoulder as much as possible as this may affect the overall outcome in terms of mobility. 

The Acromio-Clavicular (AC) Joint: The (AC) Joint is found where your collar bone (clavicle) meets the shoulder at the acromion. This joint is often problematic following a fall or trauma such as a traffic accident where the seatbelt forces the clavicle backwards. Excessive loads, such as bench pressing in the gym, or repetitive pushing movements can also irritate this joint. Pain can often be resolved quickly with minimal treatment and rest, although occasionally an operation is needed if the joint completely dislocates. 

Other causes of shoulder pain include: dislocation, muscular strain, ligament sprain, bursitis, arthritis, fracture, labral tear or referred pain from the neck. Non-mechanical pain includes: polymyalgia, infection, cancer and referred pain from the heart, liver, gall bladder, stomach or pancreas.

Stay Injury Free: Exercise is important to keep the ‘tone’ of the muscles. Without good support from the muscles the shoulder can become unstable and vulnerable to dysfunction. If you weight train regularly, it is very important to balance your workouts properly and be aware of your posture! Avoid slouching wherever possible, both at work and at home when sat at the table or watching T.V. Sportspeople who are involved in activities that require large shoulder movements such as golf or tennis, should also have their technique checked occasionally to help avoid injury and optimize performance.

How an Osteopath can help:
An osteopath should be able to examine your shoulder and identify the root cause of the pain or discomfort. Osteopaths can often help relieve pain through manipulation and other treatments modes such as TENS or acupuncture. Further to this, osteopaths should also advise on exercise, posture or other issues which could improve your condition; or refer to your GP if necessary. 

“Take care of your body; it’s the only place you have to live.” – Jim Robin

For more information visit: www.jhoughtonosteopath.co.uk or contact Jason at: info@jhoughtonosteopath.co.uk or Tel: 01603 291925. M: 07736 449603. Thank you for reading.

Slipped Disc – The do’s and dont’s of Rehabilitation

A slipped disc in the lower back (lumbar spine) is a common problem and can often be overlooked, mis-diagnosed and treated with exercises that may worsen the problem rather than help it. It is extremely important to have a correct and specific diagnosis for your low back pain in order to treat and advise any rehabilitation. 

Lower Back Pain

Lower back pain affects 80% of us at some point during our lives. There is no specific category of people who suffer back pain more frequently than others; men are affected as often as women and physical workers as much as sedentary workers. However, there are several factors that could be working against you, which do increase your chances of developing back pain. Below is a brief description of the spine and some of the more common causes of back pain that you may be able to avoid. 

The spine is a fascinating and complex structure containing muscles, ligaments, nerves, discs, blood vessels, bones and of course the spinal cord. All these structures are basically stacked on top of each other in a way that protects the spinal cord, yet allows it to connect the brain to the body. The vertebrae are placed above one another and separated by the discs, while the joints between them allow for movement. The spinal cord sits in the spinal canal and sends out branches which connect to every muscle, every organ and every blood vessel. This connection allows constant two-way communication to and from the brain.This intricate system is not without its flaws and a multitude of problems can occur. Some of these problems are beyond our control, but some are well within it.

Muscle strain: By far the most common back complaint is a muscle strain. Muscle strains can be mild, or they can be extremely painful and literally bring people to their knees. They can occur from the simplest of movements, such as bending forward when cleaning your teeth, or from the more obvious causes like lifting a heavy object. Weakness of the lower back muscles also increases their susceptibility to a strain and often leads to poor posture over extended periods of time.

It is important to keep the back muscles strong and flexible, and the best way to achieve this is with regular exercise. A variety of exercises would be the ideal, but at the very least, regular walking will have a significant benefit. Strong core muscles around the trunk, will also help protect the spinal joints and discs, as well as creating a stronger and more appealing posture. This in turn will help prevent that hunched shoulder stance and reduce the chances of spraining other structures in the spine, such as the ligaments.

Slipped disc: Another very common source of back pain is a ‘slipped’ or ‘prolapsed’ disc. Your discs are the shock absorbers between each vertebra within the spine; they have a tough outer layer with a fluid centre. A prolapsed disc is common between the ages of 20-40, although it can happen far beyond that age group. A prolapsed disc occurs when the thick viscous fluid (nucleus pulposus) deep inside the disc, bulges through the outer layers of the disc (annulus fibrosus). This fluid then pushes onto the closest nerve resulting in back pain and often ‘Sciatica’ (pain radiating into the gluteal, hamstring and lower leg).

Prolapsed discs often resolve over time and the vast majority won’t need an operation. However, be cautious as disc problems can be made worse by constant bending forward, lifting heavy objects or slouching for hours at a time at work or on the sofa. Exercises such as walking, swimming, Pilates and core stability training can aid healing, though recovery speed is often dependent on how bad the disc has ruptured.

Osteoarthritis: Firstly, let me start by stating that osteoarthritis (OA) is very different to rheumatoid arthritis (RA). Rheumatoid arthritis is an ‘auto-immune’ disease, which means the body’s immune system is attacking a variety of joints, causing damage and pain. Whereas osteoarthritis is a condition often referred to as ‘wear and tear’ of the joints, and as so, tends to commonly affect the weight bearing joints such as the lower neck, lower back, hips, knees, ankles and fingers.

Osteoarthritis produces small cracks within the cartilage at the end of the bones. These cracks tend to worsen over time resulting in the underlying bone being exposed and damaged. The joint will then often swell, thicken, stiffen and become painful, especially during weight bearing activity. As time goes by the joints can become less painful but remain stiff.

Certain types of exercise can often help as joint movement produces synovial fluid, which lubricates the joints. Exercise also helps to keep the muscles strong, which in turn helps to support the joints. However, be cautious as exercises which involve leaning backwards could potentially aggravate the lower back joints. It’s often a case of trial and error to see what your back is comfortable with, and for how long you can continue. Painkillers will also have their place in treating back pain, but other options such as heat packs and gels give relief too.

Helpful foods: Another option available to improve osteoarthritis is through your diet. Foods such as tomatoes, white potatoes, peppers and eggplant are members of the ‘Nightshade’ family and are thought to promote inflammation in the body, leading to joint pain. Sugary foods are also thought to promote an inflammatory response in the body. This doesn’t mean people with OA should completely cut these foods from their diet, but perhaps reduce them to see if it does make a difference. There are also plenty of anti-inflammatory foods out there such as omega-3 oils, salmon, avocados, broccoli, green tea and many more.

There are of course plenty of other causes of back pain including infection, ligament sprain, fractures, ankylosing spondylitis, rheumatoid arthritis and cancer. Fortunately, most back problems are mechanical and improve over time; sometimes with treatment, sometimes without. But, if you are in pain and concerned, you should consult your GP or a qualified therapist.

Osteopathy

How an Osteopath can help: your osteopath will have studied the spine in detail and Lower back pain will be aware of the many factors that can cause pain. Osteopaths should be able to test and diagnose the likely cause of pain, followed by treatment and advice to help improve the situation. Should further investigation be required, your osteopath can liaise with your GP to discuss the best way forward for you. Osteopathy is primarily a ‘hands-on’ treatment although often includes acupuncture, ultrasound or TENS therapy.

“Happiness is nothing more than good health and a bad memory” – Albert Schweitzer

For more information, visit www.jhoughtonosteopath.co.uk or contact Jason at: info@jhoughtonosteopath.co.uk or T: 01603 291925. M: 07736 449603. Thanks for reading.