Author: rauschpt

BY JONATHAN MELTZER, DPT, RAUSCH PHYSICAL THERAPY

Have you ever felt an annoying or painful pinch in your shoulder when lifting your arm? Shoulder impingement is a common diagnosis that we at Rausch Physical Therapy treat in a surprisingly wide variety of people, from tennis players to swimmers to desk employees. I’ve even treated a businessman who felt a terrible pinch every time he put his luggage in the overhead bins while traveling. Do you present with this painful arch of motion?

What is Shoulder Impingement?

Imagine your shoulder as a ball-and-socket joint, where the ball is the arm and socket is a suction cup within the shoulder. When the arm moves through space, the ball is designed to sit in the suction cup to freely rotate and spin around. Injuries develop and patients will notice a pinch when the ball has migrated too far upward or backward so that it’s now hitting on the shoulder component every time the arm lifts to the 90° range. Once the ball clears the socket, the pain stops because there’s no longer compression at the top of the shoulder, hence the quick “pinch” feeling.

If you take a look at the diagram here, you’ll see:

1. The rotator cuff muscle
2. The bursa: a fluid filled cushion sac
3. The acromion: the top of your shoulder blade

As you can see, these three structures have very little space between them to begin with. The more the ball resides in the superior position, the more these individual structures are going to become damaged. The chronic wear-and-tear on this impingement is similar to rubbing a rope on a rock over and over again; if impingement is left untreated, there could eventually be the development of a rotator cuff strain or even the potential for a full tear.

Who is at Risk for Shoulder Impingement?

For one, if you’re an overhead athlete (baseball, swimming, volleyball, etc.) you are constantly jamming the shoulder joint, which creates further compression of the rotator cuff. Or, if you are like the majority of Americans and sit at a desk for work, your shoulders start to roll forward from sitting in this position five days a week. Without postural correction, over time your body actually changes its alignment to round over, which again decreases the space in your joint and ultimately limits your overhead motion.

Three Stretches to Help Alleviate the Pinch

Here are three exercises to help alleviate shoulder impingement and encourage the recruitment of our shoulder blade muscles to improve posture:

Click to enlarge image

1. Pec Stretch in Doorway: Lean forward in a doorway until stretch is felt (30 seconds x 3)
2. Prone I, Rows: Laying on a flat surface, squeeze your shoulders blades together, then slightly lift your arms (15 reps x 2)
3. Bent Over Lat Stretch: Grab band, turn palm up, kneel on opposite knee, then carefully lean back to feel stretch (30 seconds x 3)

In addition to these recommended stretches, you should also make modifications to certain activities that aggravate your shoulder, such as limiting overhead lifting and correcting your sitting posture throughout the day. If the painful arch continues, call us to make an appointment (no, you don’t need a doctor’s referral or Rx!) Our licensed physical therapists at Rausch Physical Therapy will quickly evaluate your specific injury and help alleviate pain and recommend additional exercises to help you finally find relief from chronic shoulder pain.

Jonathan Meltzer graduated from the University of Redlands with a bachelor of arts in biology and a minor in physical education. Following graduation, Jonathan discovered his passion for physical therapy while working as a Physical Therapy Aide. After graduating top of his class from Loma Linda University in 2012 with a Doctorate in Physical Therapy, Jonathan began his career at Rausch Physical Therapy and Sports Performance. Jonathan’s goals are to identify limitations and treat his patients with the most recent and innovative techniques in order to maximize functional independence and obtain his patients’ individual goals.

BY LYNDSAY DEFILIPPO, DPT, RAUSCH PHYSICAL THERAPY

We have officially reached February! Are you still keeping up with that New Year’s Resolution to get back to the gym and get in shape in 2016? Hopefully you’re all answering with a resounding, “YES,” because healthy is where it’s at! For those of you who may have already broken your resolution, that’s okay, too! We still have quite a bit of 2016 left. Whether you’re looking to exercise more to get the body you want or to get back to your glory days of sporting, there are a few important notes to remember when kick starting a new workout regimen.

The beginning of the year is always a busy time for physical therapy clinics, not only because everyone starts fresh with their insurance, but also because so many people have a fierce new motivator (in the form of New Year Resolutions.) You probably notice how much more packed your gym, sports club, or Pilates class is with hopeful people looking to shed those extra holiday pounds, and with greater numbers of people exercising comes more injuries, and more patients for us! While we love our patients, we’d rather see you on the table for “pre-hab” not rehab, so here are a few tips for avoiding any New Year Resolution injuries.

7 Tips When Starting a New Exercise Regimen

1. Start slow, and don’t expect to begin where you left off.

Often we find that patients overdo it in the first few weeks of their program causing increased injury to the tissues. Some people write it off as “out of shape” pain, when in fact it could be a greater underlying issue. While it’s tempting to hit the ground sprinting on Day 1, don’t burn out your body or motivation! Take it slow that first month and allow your body to get used to working out again.

2. Have your form assessed by a professional.

Form evaluation is necessary for everything from running, lifting, swimming, throwing, etc. If you don’t have the necessary mobility, flexibility or stability, you can damage your body from the repetitive motions that cause stress on your joints, muscles and tendons. Having a professional evaluation by a sports performance expert will pay off in the long run by not only keeping you injury-free, but also by helping to improve your performance. We’re lucky to have running, biking and throwing analyses here at Rausch PT, but we can also assist with form in other areas as well.

3. Don’t compete with other people.

Your workout plan should cater to your body and your current abilities. A competitive drive is deep-seated in most of us, but when it comes to an advanced yoga pose and you are in your first ever class, swallow your pride and sit that one out. Start from the basics, ask for help and modifications, and I promise your body will thank you later.

4. Know your limits.

It’s okay to push your body to reach new levels, but you should always proceed within reason. Don’t ignore the signs where your body may be telling you to slow down, such as fatigue, excessive thirst, loss of motivation, long duration aches, pains, cramping, and even sleep disturbances and immune system crashes. There are also more serious side effects of overtraining which may require immediate medical assistance. You can read more about overtraining symptoms here.

5. Allow your body to recover.

This includes rest days, stretching and foam rolling before and after every workout, doing a nice dynamic warmup prior to exercise, staying hydrated, getting a good night’s sleep, and scheduling a therapeutic massage at least once a month. Your muscles and body are working hard for you, show them a little TLC!

6. Remember: Health starts in the kitchen.

I can’t stress enough how important it is to maintain a healthy diet that’s specific to your body. Avoid fad diets if you can and think long-term meal planning and healthy eating. Remember, you want this newfound routine of health to be for life! Also, don’t be afraid to seek help from a nutritionist who can craft a meal plan to match your lifestyle and your goals.

7. Switch it up and HAVE FUN!

If you find yourself getting bored with your exercise routine, change it up. If you’re a runner, try an upper-body-focused Pilates workout, or if you’re a swimmer, go for a bike ride. Cross-training will not only keep you entertained and your body guessing, it will also help you to avoid repetitive movements that can injure muscles.

If an injury should occur when getting back into an exercise routine, don’t wait for it to go away on its own or push through the pain. Make an appointment with your physical therapist; we here at Rausch Physical Therapy can quickly evaluate your injury and get you back on track toward your wellness goals.

Lyndsay DeFilippo PT, DPT, CKTP received her Doctorate of Physical Therapy from New York University in 2010. She’s a Graston Practitioner and a Certified Kinesiotaping Practitioner. Lyndsay looks at each injury as a constantly changing puzzle, which is only solved when her patient returns to what s/he loves doing. She enjoys helping with the full recovery process, which includes providing the education, tools and fundamentals to prevent re-injury and the potential for new injuries.