Tag Archives: shoulder injury

When Is the Time Right for Physical Therapy?

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Often, we end up in physical therapy based on the referral of our physician after dealing with and injury for a certain period of time. However, physical therapy can be used for many different ailments and can actually help cut down the time off work, off of sports and promote healing much faster.

Physical therapy can be used for many of your minor and major injuries. Following surgeries or traumas (accidents, dislocations, fractures, sprains) it can cause a considerable reduction in swelling and allow things to heal 75-80% faster than if without therapy. It has been shown that following surgery, the quicker someone goes for therapy, the less likely they are to stiffen up or have complications due to loss of range of motion. It also helps to significantly reduce pain and swelling.

Physical therapy is not only used following surgeries or sports injuries, but can be extremely helpful in preventing symptoms from getting worse and developing into more problems. If you’ve been having pain in your shoulder for 3 months or so, your body now has altered the way it moves your shoulder and in turn, you have developed some compensation patterns which could cause things to develop into other areas, such as your neck from your altered movements. This then, can lead to more significant problems which could have been easily avoided if therapy had been started and symptoms had gotten under control.

Remember, the quicker you get into therapy following an injury or persistent pain, the quicker your response time will be to therapy. If you are having some issues, talk to your physician about starting therapy. You don’t have to wait until it has a complete impact on your life or your recreational activities. Stop pain in your life and feel better by visiting one of our PT & Me physical therapists today.

labral tear physical therapy

ATC Tip: The Labrum

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Anatomy of the Shoulder
The shoulder can move in almost every plane of motion, it’s the most mobile joint in the human body; but more mobility = more instability. The shoulder joint is often described as a “ball in socket,” but it’s wide range of motion makes it a highly vulnerable joint. We have a network of soft tissue structures, such as the rotator cuff and ligaments, whose main job is to keep the humeral head in its assigned seat. However, often these muscles alone are not sufficient as they can become weak or tight and thus less efficient. The labrum is a small ring of cartilage that provides additional stability to the shoulder joint.

How Does a Labrum Become Damaged?
Direct trauma, shearing forces, or repetitive stress can cause damage to the labrum. Often, this damage will present as a tear in the labrum, which can restrict motion, decrease strength, and cause pain in the shoulder. Picturing that ring of cartilage, imagine a roughening of the edges of the bowl-like golf tee, or even a rip that flaps when the ball is spun around. It is not uncommon for a shoulder dislocation or subluxation to be accompanied by a labral tear; chronic shoulder instability can also lead to labrum injury.

What Does a Labrum Do?
Because the “ball and socket” is so shallow, the shoulder joint is often described, quite accurately, like a “golf ball sitting on a tee.” To picture the shoulder labrum, imagine a ring around the outer edge of a golf tee, effectively deepening the overall bowl shape, almost suctioning the humerus into the space. The labrum helps stabilize the shoulder by making the “ball” more difficult to remove from the “tee.”

How Can I Prevent a Labrum Injury?
The best way to prevent a labral tear is to strengthen the musculature surrounding the shoulder joint. The best case scenario is all of the muscles are working together to keep the shoulder joint moving fluidly through its full range of motion. Important within this group of muscles are the muscle that control the shoulder blades. By strengthening the stabilizing muscles individually and functionally, it helps them stay balanced and strong with the other, stronger muscles (like the RTC). The other way to prevent a labrum tear is to avoid excessive contact, repetitive overhead motions, and falls.

This article about athletic injuries was provided by PT & Me physical therapy partner: The Center for Physical Rehabilitation. More information about the center and their locations throughout Grand Rapids, MI can be found on their website at www.pt-cpr.com

To see a shoulder strengthening program visit our Sports Medicine Tip Page by clicking here.

hockey upper body images

Most Common Hockey Upper Body Injuries

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Hockey season is getting ready to start and the sport of hockey can be quite dangerous. It is important for players to know how to prevent and treat injuries that occur during games. Unfortunately, these injuries leave us with some questions with descriptions such as “lower-body” and “upper-body” injuries. These injuries are purposely vague to leave some question as to the exact nature of the injury.

The accompanying infographic gives players an assist by listing off some common “upper body injuries.” It features tips and tricks to remain healthy both on and off the ice. The following should ease the minds of players who want to play the game as safely as they possibly can.

Click arrows in the bottom right corner to expand full screen

Upper Body Injuries by Pro Stock Hockey, an online resource for authentic pro stock hockey equipment (https://www.prostockhockey.com/)

Guidelines to Prevent Throwing Injuries

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In this third intallment of our series to prevent throwing injuries, we examine the proper ways to exercise and prevent throwing injuries in baseball. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your primary care provider.


INTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high up on a doorway and face away from door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the ceiling. Rotate from your shoulder bringing your hand forward while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


EXTERNAL ROTATION WITH SHOULDER AT 90 DEGREES OF ABDUCTION
Attach band high on a doorway and face toward the door. Hold band and move your arm out sideways away from your body until your arm is parallel with the ground. Bend your elbow to 90 degrees and point your fist toward the door. Rotate from your shoulder bringing your hand away from the door while keeping your arm parallel to the floor and your elbow bent to 90 degrees.


SHOULDER INTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising closest to the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand toward your stomach while keeping the elbow bent to 90 degrees.


SHOULDER EXTERNAL ROTATION AT SIDE
Attach band to the doorway at chest height. Stand perpendicular to the doorway with the arm you are exercising furthest from the door. Keep your arm at your side with a towel roll under the arm and bend the elbow to 90 degrees. Bring your hand away from your stomach while keeping the elbow bent to 90 degrees.

This information was written by Advance Rehabilitation Physical Therapy, an outpatient physical therapy group with 24 locations in Georgia and Florida. Advance Rehabilitation is a physical therapy practice that focuses on providing the highest quality rehabilitation services. We specialize in physical therapy, sports medicine, industrial rehabilitation and athletic training. Our staff includes highly-trained professionals that serve as a bridge between injury and recovery to help patients get back to pre-injury status as quickly as possible. For more information click here.

See the entire Guidelines to Prevent Throwing Injuries series here:

   Prevent Throwing Injuries

   prevent throwing injuries

throwing injuries PTandMe

repetitive strain injury

Repetitive Strain Injury (RSI): Prevention Tips for Strain and Injury in the Workplace

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The Following are Seen as Causes of Repetitive Strain Injury:

  • The overuse of muscles in our hands, wrists, arms, shoulders, neck and back
  • The area is affected by repeated actions, which are usually performed on a daily basis over a long period
  • The repetitive actions are done in a cold place
  • Forceful movements are involved
  • Workstations are poorly organized
  • Equipment is badly designed
  • The individual commonly adopts an awkward posture
  • There are not enough rest breaks

RSI

Prevention 101: Nine Easy Ways to Reduce Your Risk of Developing Repetitive Strain Injury:

  • TAKE BREAKS when using your computer. Every hour or so, get up and walk around, get a drink of water, stretch whatever muscles are tight, and look out the window at a far off object (to rest your eyes).
  • Use good posture. If you can’t hold good posture, it probably means it’s time for you to take a break from typing. If you are perpetually struggling to maintain good posture, you probably need to adjust your workstation or chair, or develop some of the support muscles necessary for good posture.
  • Use an ergonomically-optimized workstation to reduce strain on your body.
  • Exercise regularly. Include strengthening, stretching, and aerobic exercises. Yoga and pilates may also be helpful.
  • Only use the computer as much as you have to. Don’t email people when you could walk down the hall or pick up the phone and talk to them. It’s not only better for your hands – it’s friendlier. Think before you type to avoid unnecessary editing.
  • Don’t stretch for the hard-to-reach keys, e.g. BACKSPACE, ENTER, SHIFT, and CONTROL… basically everything but the letters. Instead, move your entire hand so that you may press the desired key with ease. This is crucial when you are programming or typing something where non-letter keys are used extensively.
  • Let your hands float above the keyboard when you type, and move your entire arm when moving your mouse or typing hard-to-reach keys, keeping the wrist joint straight at all times. This lets the big muscles in your arm, shoulder, and back do most of the work, instead of the smaller, weaker, and more vulnerable muscles in your hand and wrist. If you find it difficult to do this, then your shoulder and back muscles are probably too weak. It is OK, and in fact a good idea, to rest your elbows/wrists when you are not typing.
  • Use two hands to type combination key strokes, such as those involving the SHIFT and CONTROL keys.
  • When writing, avoid gripping the writing utensil tightly. Someone should be able to easily pull the writing utensil out of your hand when you are writing. If your pen or pencil requires you to press too hard, get a new one (my favorite is Dr. Grip Gel Ink).

Article provided by Fit2WRK. The information noted above is a summary of one of the components of Fit2WRK.

shoulder surgery

Self Care: Safe Dressing Following Shoulder Surgery / Injury

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When recovering from shoulder surgery, it can be difficult to dress and undress without assistance. With the help of one of our trusted Certified Hand Therapists (CHT) they have compiled a list of tips to get dressed safely and independently while recovering.  It is highly recommended that you follow the instructions prescribed by your surgeon or attending physician.

DRESSING

Upper Body
• Bend forward at your hips and let your affected arm dangle loosely forward
• Always dress the affected arm through the sleeve of your shirt first
• Proceed to dress the unaffected arm

Lower Body
• One handed techniques to don socks: touch all fingers to your thumb, then slide the sock over your hand. Spread your fingers apart to open the sock and slide it onto the foot

Bra
• Clip the bra from the front and as low as possible to your waist. Guide the bra enclosure towards your back. Slide the strap over the affected arm and then slide

shoulder_3D

GROOMING

• Bend forward at the hips and dangle arm in order to clean and apply deodorant

These post shoulder surgery dressing tips were provided by The Hale Hand Center, with locations in Melbourne and Rockledge, FL. The Hale Hand Center offers both physical therapy and certified hand therapy services, as well as provides custom splinting. More information about The Hale Hand Center can be found on their website here.

ice hockey injuries

Common Ice Hockey Injuries

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Ice hockey is one of the most popular sports played in North America. Physical therapy can provide specific treatment to a number of specific ice hockey injuries. Here are a few injuries that can happen during a hockey game or practice:

Common Ice Hockey Injuries

BACK INJURIES
Hockey players are at risk for low-back injuries due to the flexed (forward) posture of skating and the frequent hyperextension (backward) stress. Low-back pain and/or a pulled muscle are the most common injuries. Stretching of the hip flexors along with strengthening of the back and abdominal muscles will help avoid these injuries.

HIP INJURIES
The hip joint and groin muscle are susceptible to injury due to the mechanisms of the skating stride. Some of the most common soft tissue injuries in hockey players include a groin strain and a hip flexor strain. Off-season strengthening and dedicated stretching before and after practice are important to prevent these injuries. In addition, a direct blow to the outside of the hip can cause a hip pointer or trochanteric bursitis. Hockey pants with reinforced padding over these areas may help protect them.

KNEE INJURIES
The medial collateral ligament is the most susceptible to a sprain because of the leg position – pushing off the inside edge of the skate blade – and contact to the outside of the knee. Anterior cruciate ligament (ACL) disruption and meniscus tears (torn cartilage) can also occur but are less common in hockey that in other sports such as football, soccer and basketball.

hockey_goalie

SHOULDER INJURIES
The most common shoulder injuries in hockey are a shoulder separation and a broken collarbone. These injuries occur from direct contact of the shoulder with another player, the boards or the ice. Treatment can include a sling, rest and in serious cases surgery.

ELBOW INJURIES
The point of the elbow is a frequent area of contact, which can result in the development of bursitis. Thick and scarred bursal tissue (which feels like bone chips, but isn’t) can be a source of recurrent inflammation. The best prevention method is wearing elbow pads that will fit well and have an opening for the elbow, soft padding and a plastic outer shell.

WRIST INJURIES
A fall on the outstretched arm or contact with the boards that forces the wrist up or down, may cause a fracture. Players should try bracing themselves against the boards using their forearms instead of their hands.

avoid pitching injuries

Physical Therapist Tips on Avoiding Injury to Your Throwing Arm & What to Do in Case You Do

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Throwing a baseball or softball is one of the most demanding motions on the human body in sports. For each throw, the athlete generates high levels of energy in the arm and body to accelerate the baseball and softball to a high velocity. Just as it is important to understand proper biomechanics to improve performance, it is important to understand the stresses placed on the throwing shoulder and elbow by the throwing process.

Physical Therapist Tips on how to avoid pitching injuries

• Teach young athletes to be mindful of how their bodies feel. Pain is the first sign of a problem, and athletes of all ages need to pay close attention to any type of muscle twinge, tightening, or burning sensation.

• Coaches should carefully observe their pitchers’ techniques. Success on the field may be fleeting if the pitches ultimately are damaging a young player’s shoulder.

• Conditioning and strengthening exercises are most effective after mechanics are learned and put into action. If possible, begin a conditioning program at least a month before the season begins. A basic stretching regimen should be used before a player ever picks up a baseball.

• Players should start with short tosses and gradually work up to throwing the ball a greater distance. Increasing the velocity should be the final step.

• If the arm region is sore or tight, apply ice to the area for 10-15 minutes to help diminish the amount of blood that might otherwise leak into the muscle. When there is microscopic tearing of the muscle tissue, blood is leaking into the surrounding muscular tissue, causing pain and muscle spasms. Using ice will help reduce the pain, spasms, and inflammation associated with this condition.

• Before age 10, only fast ball and change-up should be permitted.

This information about how to avoid pitching injuries was written by University Physical Therapy, an outpatient physical therapy group with eight locations in New River Valley, Virginia. University PT is THE choice for outstanding sports rehabilitation, physical therapy and occupational therapy services. For more information click here.

Common Football Injuries

Common Football Injuries

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Football is one of the most popular sports played by young athletes, and it leads all other sports in the number of injuries sustained. In 2007, more than 920,000 athletes under the age of 18 were treated in emergency rooms, doctors’ offices, and clinics for football-related injuries, according to the U.S. Consumer Product Safety Commission. Physical therapy can provide specific treatment to a number of specific football injuries. Here are a few injuries that can happen during a football game or practice:

KNEE INJURIES
Knee injuries in football are the most common, especially those to the anterior or posterior cruciate ligament (ACL/PCL) and to the menisci (cartilage of the knee). These knee injuries can adversely affect a player’s long-term involvement in the sport. Football players also have a higher chance of ankle sprains due to the surfaces played on and cutting motions.

Physical therapy treatment for knee injuries may include:
• Exercises to help promote recovery. Specifically, therapists will design a program to strengthen the whole leg as well improve its range of motion.
• Balance exercises to allow the return to daily activities (including work and sports) while decreasing the risk of falls and reinjury
• Hands-on treatment to keep the knee joint from becoming stiff
• Ice and vasopneumatic pressure to reduce swelling and pain

SHOULDER INJURIES
Shoulder injuries are also common. The labrum (cartilage bumper surrounding the socket part of the shoulder) is particularly susceptible to injury, especially in offensive and defensive linemen. In addition, injuries to the acromioclavicular joint (ACJ) or shoulder are commonly seen in football players.

Physical therapy treatment for shoulder injuries may include:
NON-SURGICAL
Most labral tears will respond well to non-surgical treatment and may be just one component of a multi-factored pathology of the aging shoulder. Physical therapy will typically address a labral tear from the biomechanical approach of improving the motion and reducing the repetitive injury. If the inflammation and mechanical stress on the structures can be reduced then the tissue has a chance to heal.
SURGICAL
If the athlete has had surgery to the shoulder, the therapist will follow a specific protocol to apply just the right amount of strain on the shoulder to keep it safe after surgery. A sling may be recommended in the early stages but the therapist will get the arm moving with assistance within a relatively short period of time. Physical therapists will give instructions on how to provide varying levels of assistance to the arm for motion in safe planes in front of the body, and eventually throughout the entire range of motion. Once the tissues are healed, the therapist will begin to put resistance on the support structures in order to improve the mechanics of motion and reduce the risk of another injury.

kid football player

CONCUSSIONS
Football players are very susceptible to concussions. A concussion is a change in mental state due to a traumatic impact. Not all those who suffer a concussion will lose consciousness. Some signs that a concussion has been sustained are headache, dizziness, nausea, loss of balance, drowsiness, numbness/tingling, difficulty concentrating, and blurry vision. The athlete should return to play only when clearance is granted by a health care professional. It is recommended that players go though a concussion baseline test before the start of the season. Results from baseline tests (or pre-injury tests) can be used and compared to a similar exam conducted by a healthcare professional during the season if an athlete has a suspected concussion. More information here.

Physical therapy treatment for concussions may include:
EVALUATION: The physical therapist will take time to talk with you and perform a thorough examination of your condition.
THERAPY: The physical therapist will plan a treatment program suited to your individual condition, which will involve exercises for your balance, vision, inner ear and more in order to restore brain function.
TEACHING: Physical therapists will spend time reviewing information with you regarding your diagnosis and progress as well as answering your questions. This empowers the patient to make a lifelong impact on their health.
RETURN TO SPORT: Physical therapists are uniquely qualified to guide you towards a safe return to sport. A therapist can guide recovering athletes through a stepwise protocol to keep patients symptom free,  and to prevent serious, life-threatening conditions associated with a second head injury due to early return to football.

OVERUSE INJURIES
Low-back pain, or back pain in general, is a fairly common complaint in football players due to overuse. Overuse can also lead to overtraining syndrome, when a player trains beyond the ability for the body to recover.

Physical therapy treatment for overuse injuries may include:
Pain-relieving techniques (such as ice) and decreasing or modifying painful activities. This diagnosis often occurs from muscular tightness or weakness which causes posture to get out of alignment. A physical therapist will educate and assist in proper stretching and strengthening exercises for the back. They may perform hands on, manual therapy techniques to further increase joint flexibility. The final phase of rehab will involve strengthening during functional activities and education to prevent the injury from recurring.

RESOURCES:
U.S. Consumer Product Safety Commission
www.cpsc.gov

Stop Sports Injuries
www.stopsportsinjuries.org

REFERENCES:
Preventing Football Injuries. http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Football_Skating_Injury_Prevention.aspx