6676 4000
Showing posts from tagged with: shoulders

WHAT TO DO WITH A FOAM ROLLER AND WHY!

07.08.20

Why everyone needs a foam roller! What is Fascia?

  • Fascia is a layer of connective tissue that surrounds the outer surface of muscles , individual muscle fibres, vessels, nerves and organs binding them together
  • Fascia connects our skin to our muscles and our muscles to each other forming chains that help to redistribute stress throughout the body
  • The connection between the muscles and fascia is the myofascial system
Why treat the fascia?
  • For various reasons including inactivity, repetitive motion, injuries and poor posture the fascia and underlying muscles can become stuck together of bind causing ‘knots’ or trigger points. This restricts movement, decreases flexibility, causes muscles to fire improperly during exercise and causes pain.
How does self myofascial release (SMR) with foam rolling work?
  • It increases range of motion and decreases pain by sending information to the brain to enhance muscle activation and relaxation via the nerves and therefore breaking down adhesions. The elastic fibres are also directly manipulated from a knotted position into a straight position which is the correct orientation for the fibres
  • Tension is released via stimulation of the golgi tendon organ(GTO) (the nerve receptor where the muscle and tendon meet). When excited the GTO causes the muscle to relax
Benefits of foam rolling
  • Increased blood flow / circulation and therefore improved vitality
  • Allows muscle relax and to fire efficiently
  • Reduces pain
  • Assists injury prevention
  • Acts as an indicator of when muscles are tightening even though you may not feel pain with activity
  • Alternative to a massage
  • Reduce cellulite
How to use the foam roller
  • Identify the problem area
  • Hold on the tender spot for 30-60 sec or until the discomfort decreases by 50-75%
  • Roll over the whole muscle looking for other tender spots
  • Roll the entire length of the muscle to stimulate the GTO
  • Remember muscles are 3 dimensional so you may need to roll in multiple directions
  • Do not roll on 1 area for longer than 1-2 minutes.
  • If there are no tender spots you can you long sweeping rolls over the long muscles such as the hamstrings
  • Start with gentle pressure and gradually increase as your tolerance allows
  • Stay on soft tissue and avoid bones, joints and tendons
  • Also roll the areas above and below the problem area
  • You should expect mild to moderate discomfort when rolling but NOT pain especially sharp pain
  • While rolling focus on your breath: in through the nose for 4 sec and out through the nose for 6 sec. The longer exhalation helps to activate the para-sympathetic nervous system which allows the body to relax.  You must not hold your breath
  • It is good idea to do some core exercises prior to rolling
When to use the foam roller
  • Pre workout: roll quickly for 15 sec to
  • Increase blood flow
  • Optimise length / tension relationship of a muscle
  • Improve movement efficiency
  • Psychological ramp up for activity
  • Post workout: roll slowly for 30 sec to
  • Flush the tissue,
  • Create elasticity of the tissue,
  • Begin recovery process
  • Relax
  • Any time for the benefits already discussed, primarily getting rid of any niggles and bringing tight muscles back toward a normal state
If you have the following conditions you shouldn’t use the foam roller or need to take care
  • Osteoporosis
  • Diabetes
  • High blood pressure
  • Varicose veins
  • Pregnant
  • Taking anti-coagulant therapy

Feeling The Pinch? The Stubborn Shoulder Impingement Syndrome

11.09.19

Feeling The Pinch?

The Stubborn Shoulder Impingement Syndrome

  Do you get a sharp, debilitating pain in your shoulder when you are performing tasks like brushing your hair, putting on certain clothes or showering? During these movements, where you raise your arm out to the side and then upwards over your head, do you alternate between no pain and pain? For example, during the first part of the moment you don’t feel any pain, and then suddenly your shoulder “catches” and there is sharp pain, followed by no pain again as you continue to move your arm upwards.   These are all signs of a condition called Shoulder Impingement Syndrome (SIS), where the tendons of the rotator cuff muscles that stabilise your shoulder get trapped as they pass through the shoulder joint in a narrow bony space called the sub-acromial space. Impingement means to impact or encroach on bone, and repeated pinching and irritation of these tendons and the bursa (the padding under the shoulder bone) can lead to injury and pain.   Shoulder complaints are the third most common musculoskeletal problem after back and neck disorders. The highest incidence is in women and people aged 45–64 years. Of all shoulder disorders, shoulder impingement syndrome (SIS) accounts for 36%, making it the most common shoulder injury.   You shouldn’t experience impingement with normal shoulder function. When it does happen, the rotator cuff tendon becomes inflamed and swollen, a condition called rotator cuff tendonitis. Likewise, if the bursa becomes inflamed, you could develop shoulder bursitis. You can experience these conditions either on their own, or at the same time.   The injury can vary from mild tendon inflammation (tendonitis), bursitis (inflamed bursa), calcific tendonitis (bone forming within the tendon) through to partial and full thickness tendon tears, which may require surgery. Over time the tendons can thicken due to repeated irritation, perpetuating the problem as the thicker tendons battle to glide through the narrow bony sub-acromial space. The tendons can even degenerate and change in microscopic structure, with decreased circulation within the tendon resulting in a chronic tendonosis.  

What Causes Shoulder Impingement?

  Generally, SIS is caused by repeated, overhead movement of your arm into the “impingement zone,” causing the rotator cuff to contact the outer tip of the shoulder blade (acromion). When this repeatedly occurs, the swollen tendon is trapped and pinched under the acromion. The condition is frequently called Swimmer’s Shoulder or Thrower’s Shoulder, since the injury occurs from repetitive overhead activities. Injury could also stem from simple home chores, like hanging washing on the line or a repetitive activity at work. In other cases, it can be caused by traumatic injury, like a fall.   Shoulder impingement has primary (structural) and secondary (posture & movement related) causes:   Primary Rotator Cuff Impingement is due to a structural narrowing in the space where the tendons glide. Osteoarthritis, for example, can cause the growth of bony spurs, which narrow the space. With a smaller space, you are more likely to squash and irritate the underlying soft tissues (tendons and bursa).   Secondary Rotator Cuff Impingement is due to an instability in the shoulder girdle. This means that there is a combination of excessive joint movement, ligament laxity and muscle weakness around the shoulder joint. Poor stabilisation of the shoulder blade by the surrounding muscles changes the physical position of the bones in the shoulder, which in turn increases the risk of tendon impingement. Other causes can include weakening of the rotator cuff tendons due to overuse, for example in throwing and swimming, or muscle imbalances between the shoulder muscles.   In summary, impingement usually occurs over time due to repetitive overhead activity, trauma, previous injury, poor posture or inactivity.   When your rotator cuff fails to work normally, it is unable to prevent the head of the humerus (upper arm) from riding up into the shoulder space, causing the bursa or tendons to be squashed. Failure to properly treat this instability causes the injury to recur. Poor technique or bad training habits such as training too hard is also a common cause of overuse injuries.   Over time pain can cause further dysfunction by altering your shoulder movement patterns which may lead to a frozen shoulder. For this reason, it is vitally important that shoulder impingement syndrome is rested and treated as soon as possible to avoid longer term damage and joint deterioration.  

What are the Symptoms of Shoulder Impingement?

  Commonly rotator cuff impingement has the following symptoms:
  • An arc of shoulder pain approximately when your arm is at shoulder height and/or when your arm is overhead
  • Shoulder pain that can extend from the top of the shoulder down the arm to the elbow
  • Pain when lying on the sore shoulder, night pain and disturbed sleep
  • Shoulder pain at rest as your condition worsens
  • Muscle weakness or pain when attempting to reach or lift
  • Pain when putting your hand behind your back or head
  • Pain reaching for the seat-belt, or out of the car window for a parking ticket
 

Who Suffers Shoulder Impingement?

  Impingement syndrome is more likely to occur in people who engage in physical activities that require repeated overhead arm movements, such as tennis, golf, swimming, weight lifting, or throwing a ball. Occupations that require repeated overhead lifting or work at or above shoulder height also increase the risk of rotator cuff impingement.  

How is Shoulder Impingement Diagnosed?

  Shoulder impingement can be diagnosed by your physical therapist using some specific manual tests. An ultrasound scan may be useful to detect any associated injuries such as shoulder bursitis, rotator cuff tears, calcific tendonitis or shoulder tendinopathies. An x-ray can be used to see any bony spurs that may have formed and narrowed the sub-acromial space.  

What does the Treatment Involve?

  There are many structures that can be injured in shoulder impingement syndrome. How the impingement occurred is the most important question to answer. This is especially important if the onset was gradual, since your static and dynamic posture, muscle strength, and flexibility all have important roles to play. Your rotator cuff is an important group of muscles that control and stabilise the shoulder joint. It is essential the muscles around the thoracic spine and shoulder blade are also assessed and treated as these too work together with the entire shoulder girdle.   To effectively rehabilitate this injury and prevent recurrence, you need to work through specific stages with your therapist.    These stages may include:
  1. Early Injury: Protection, Pain Relief & Anti-inflammatory Treatment
  2. Regain Full Shoulder Range of Motion
  3. Restore Scapular Control and Scapulohumeral Rhythm
  4. Restore Normal Neck-Scapulo-Thoracic-Shoulder Function, including posture correction
  5. Restore Rotator Cuff Strength
  6. Restore High Speed, Power, Proprioception and Agility Exercises
  7. Return to Sport or Work
  The early stages of treatment will involve manual therapy, including massage to relieve pain and release tight structures as well as mobilisation techniques to restore normal shoulder movement. Strapping/taping has been shown to be helpful in reducing pain as well as ultrasound and laser therapy. As you move through the other stages of treatment your therapist will prescribe rehabilitation exercises specific to your shoulder, posture, sport and/or work demands.   Corticosteroid injections can be useful in the initial pain relieving stage if conservative (non-surgical) methods fail to reduce the pain and inflammation. It is important to note that once your pain settles, it is important to assess your strength, flexibility, neck and thoracic spine involvement to ensure that your shoulder impingement does not return once your injection has worn off.   Some shoulder impingements will respond positively and quickly to treatment; however many others can be incredibly stubborn and frustrating, taking between 3-6 months to resolve. There is no specific time frame for when to progress from each stage to the next. It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration. For more specific advice about your shoulder impingement, contact Pottsville and Cabarita Physiotherapy - 6676 4000.  
  • The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case.

Osteoarthritis and supplements

08.10.17

Osteoarthritis and supplements

Osteoarthritis is a common inflammatory condition characterised by joint pain. See below example. osteoarthritis knee Osteoarthritis affects 2.1 million Australians.  The prevalence is higher in women and joint symptoms are experienced by more than 25% of people aged 65 years or older. Osteoarthritis is particularly burdensome, on individuals and on the healthcare system and is the main reason for knee replacement surgery.  This is of great concern considering the projected rise in the aging population.   In recent years, omega 3 fatty acids (from fish oil), glucosamine and chondroiten have increased in popularity. Research into these and osteoarthritis is showing some promising results, however more research is still needed.   Should you take these supplements if you have Osteoarthritis?? You can as there is some worthwhile evidence but it should form only a small part of your management plan. Score your pain on a scale of 1-10 before taking the supplement, then after 3-6 months score your pain again to see if there has been any change. If you are taking chondroitin it is recommended that you take a supplement containing 800mg such as BioOrganics glucosamine 750g and chondroitin 400mg.   There is much stronger evidence to show that dietary induced weight loss (>10% of body weight) and physical exercise such as strength training and aerobic exercise can have a moderate to large improvement in pain, function and quality of life.   In addition, learning effective pain – coping skills have been shown to have positive outcomes not only for pain but also for function, stiffness and disability.  

Upper Crossed Syndrome – What is it? And how can Remedial Massage help?

28.09.17

Upper Crossed Syndrome 

What is it? And how can Remedial Massage help?

  Upper Crossed Syndrome (UCS) is an extremely common musculoskeletal imbalance of the upper body. It is usually caused by poor posture or repetitive tasks in prolonged standing or sitting positions. texting As a consequence certain muscles become chronically tight, while others become long and weak. This muscular imbalance results in rounded shoulders/upper back, winging/tipping shoulder blades, and a forward head position with a poking out chin. The-Forward-Head-Posture-Fix The muscles affected in this common syndrome are the Pectoralis Major and Minor muscles in the chest, the Sub-Occipital muscles at the base of the skull and Upper Trapezius and Levator Scapulae in the upper shoulder/neck which all become overactive, short and tight. This excessive shortening of muscles causes an imbalance between muscles groups. Muscles such as Mid-Lower Trapezius, Rhomboids and Serratus Anterior of the upper back and the deep cervical flexors in the neck therefore become underactive, long and weak. The musculoskeletal imbalances of UCS can result in an array of pain or discomfort presentations. For example mid- upper back pain/tightness, neck pain/tightness, headaches, or pins and needles down the arms, just to name a few. Also overtime if untreated, these muscular imbalances can affect the position of the skeletal system leading to other chronic conditions such as shoulder instability, shoulder impingement and shoulder bursitis. Luckily Remedial Massage and correctly prescribed exercises can dramatically help with this condition. Remedial Therapists can use their skills in soft tissue work to release the tight, short and overactive muscles, and can give simple homework stretches/exercises. This is extremely important for while these large powerful muscles such as the Pecs or Upper traps remain tight, it is very challenging to properly strengthen the weak muscle groups. Remedial Therapists can also use techniques to stimulate the long, weak and underactive muscles encouraging them to activate and strengthen. Remedial Massage can be used as an effective complementary treatment for UCS,  alongside Physiotherapy allowing the exercises prescribed by Physios to be most effective. If you feel like you relate to any of these symptoms, don’t wait, find the time to care for yourself and book some Remedial treatment today so you can move and feel your best!

Carly’s Birthday Blog

01.09.17

Why do you love Pilates? I love Pilates because it is a form of exercise that can be modified to suit ANYONE. The layers of challenge you can add are endless. I also love that age is no barrier, it's the practice that counts! What's the best thing about being a physio? Being able to help people reach the goals that are most important to them. No matter how big or small, it's really rewarding to be a part of that journey. I also love that physio can take you in so many directions. From the clinic to the sports field, the possibilities are endless! Why work at Pottsville and Cabarita Physiotherapy ? I grew up in Cabarita, so it's nice to be able to come back to my roots. It's an amazing community with a great coastal vibe and being so close to the beach is always a plus. But, most importantly, the team is amazing! Best relaxation tip? A nice long walk along the beach followed by some guided meditation.  There is nothing better. Best lifestyle tip? Find something you love and do it consistently. Challenge yourself in some way each and every day. Favourite activity? Doing some high intensity interval training or boxing. It gets the heart racing and the sweat pouring. It's even better when you have some amazing people to work out with. Favourite recipe? Tacos. Need I say more? A special mention to Kai's choc chip oatmeal cookies. If you haven't tried them, you should! A typical Sunday... A nice long sleep in followed by a Pilates workout. I then like to go to one of my favourite cafes on the Coast and enjoy multiple coffees and a delicious brunch. You might catch me running around the rugby league scene in the afternoon. That's my other passion!Carly    

Rosie

Birthday Blog – Rosie Remedial Masseuse

28.03.17

Why do you love Pilates:
To be completely honest I haven't actually done Pilates, not that I wouldn't like to, It just hasn't found it's way into my life yet.
But I know that clinical Pilates is one of the best forms of rehab, and fitness out, I'll have to try it soon.
 
What is the best thing about being a Remedial Masseuse ?
Well as a Remedial therapist the best thing would be being able to help people along in their healing journey, helping them out of pain and therefore enjoying the activities they love.
Why work at Pottsville and Cabarita?
It's a beautiful clinic, by a beautiful river/beach, with beautiful staff. Plus, Pottsville is just 15-20 mins from my house which is a plus.
Best relaxation tip:
Tapping into the breath, giving yourself time to breathe deeply and think clearly. I also like to support myself by using calming essential oils like lavender or frankincense to relax as well.
Best lifestyle tip:
Love and care for yourself! I like to do this in ways like eating healthy and consciously, and finding a nice relationship with exercise, try and do it regularly and make it fun!
Favourite activity:
Dancing with friends.
Favourite recipe:
Baked white sweet potatoes served with quinoa and topped with fresh tomato, leafy greens, avocado, broccoli sprouts and hummus- YUM!
A typical Sunday:
Would probably involve a morning bike ride through the hills or to the beach with my partner or some yoga, or both. I'll probably be putting some love into house jobs too like washing or the garden etc And then possibly ending with dinner with friends or prepping for the week coming.

What is the best training for surfing? – Kai Allison

15.03.17

There are many different ways to train for surfing, each one with it’s own strengths and limitations. Surfing is a challenging sport that incorporates a number of physical skills and abilities. Much of the training for surfing has previously involved isolated movements and lacked specificity and functional relevance to the sport. People in the past have said that surfing itself is the best form of training, due largely to the difficulty in replicating the demands of surfing on dry land. Whilst nothing will ever replicate the same thrill, uncertainty and excitement unique to surfing, the surfset is a way to increase the functionality of training for surfing. The surfset is specifically designed for surfing training and can be seen as a more functional approach to training for surfers, as it enables replication of the movements and perturbation challenges inherent in surfing. The surfset consists of a modified surfboard set upon unstable surface, which creates a functional platform to replicate the dynamic integration of body systems required in surfing. The surfset is designed to engage the core and stabilising muscles, through challenging the body in a dynamic environment. Exercising on the surfset is a full-body approach to training, moving away from training in isolated and non-functional ways. Training in this way helps to develop functional movements sequences and functional muscle activation patterns specific to surfing, resulting in improved function and surfing performance. Workouts on the surfset can be specifically designed to develop aspects of surfing performance such as aerobic fitness, along with muscular strength, power, endurance in addition to balance and coordination. Workouts can also be designed to isolate specific movement sequences in surfing such as the pop up and allows replication of the dynamic balance and proprioceptive demands of surfing. In addition to being a challenging full body workout, exercising on the surfset is also a fun, engaging and unique way to exercise.  

Is there any evidence for exercising with the surfset?

  Completing exercises such as squats on unstable surfaces such as a surfset has been found to increase core muscle activation, along with an increase in lower limb muscle activity, making this type of training particularly effective and functional for this population (Nairn, Sutherland & Drake, 2017).   Specific benefits of surfset training can also be related to common injuries in surfing. Ankle injuries and sprains are one of the most common injuries in surfing and training on the surfset can be targeted specifically to rehabilitate functional stability, range of movement, balance and proprioception for these injuries (Nathanson, Haynes & Galanis, 2002).  

To summarise, the benefits of training on the surfset include: 

 
  • Increased dynamic balance
  • Improved core stability
  • Greater lower limb joint proprioception
  • Development and refinement of surf specific movement patterns
  • Increases in muscular power, strength and endurance
  • Greater aerobic fitness
  Training on the surfset provides the opportunity to incorporate functional movement sequences unique to surfing, whilst incorporating the same dynamic balance demands and challenges involved in surfing. Thus, the surfset is a highly functional and specific way of training for surfing and has the potential to result in increased surf fitness and greater performance, which is essentially what we are all searching for. To find out more go to: http://www.surfsetfitness.com To book a surf fitness class go to: http://pottsvillephysio.com.au   References   Nathanson, A., Haynes, P., & Galanis, D. (2002). Surfing injuries. The American Journal of Emergency Medicine, 20(3), 155-160. doi:10.1053/ajem.2002.32650     Nairn, Sutherland and Drake. (2017). Motion and Muscle Activity Are Affected by Instability Location During a Squat Exercise. Journal of strength and conditioning research. 31(3). DOI: 10.1519/JSC.0000000000001745

How to look after your body at your work station

27.02.17

  Guidelines for healthy computer use • Move and stretch every hour to promote blood flow • Respond to any feeling of discomfort by changing position • Add variety to your tasks • Make sure you are sitting correctly and have your workstation set up to avoid strain   Postureimages (3) • Relax shoulders • Elbows at 90 degrees • Forearms level • Head upright and looking forward • Neck lengthened • Back supported by chair • Use a lumbar support • Feet fully supported on floor or footrest   Work space • Place items close to your position based on how often you use them. Regularly used items should be placed within easy reach • If you are using the phone a lot look into a head set or speaker phone. Never cradle the phone between the side of your head and your shoulder.   Chair • Adjust seat height so that feet or flat on floor or foot rest with your knees at or slightly below the level of your hips • With your bottom pushed into the back of the seat, adjust the back rest height so that the lumbar support is in the lumbar or curved area of your spine • Recline the back rest angle between 95-110 degrees so that both the upper and lower part of the back is supported • Adjust the armrest height so that your shoulders are not elevated   Computer • The top of the monitor should be positioned at eye level • Torso must not be twisted • Keyboard and mouse should be just below elbow level • Keyboard should be centred in front of you • Adjust the keyboard tit so that your wrist is in neutral (straight) • Monitor should be about arms length away • Lighting should be even and glare free