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Shoulder Injuries: The Rotator Cuff

A common pain to have is shoulder pain. Shoulder injuries are often diagnosed as a ‘Rotator Cuff’ injury, but what does this mean and what can YOU do about it?

Case Study – PJ

PJ came to the clinic reporting a left-sided shoulder injury that was sustained 1 month previously. At the time PJ was having severe pain and difficulty reaching forward, backwards, sideways and overhead. He was limited in daily activities experiencing pain up to 8/10 with getting dressed (particularly getting the left arm into a shirt or jacket). By the time PJ sought treatment he had already changed many of the ways that he moved, compensating for the pain and weakness. This client had also already had an ultrasound taken of the shoulder and a rotator cuff tear was identified on the report and he had been referred to an orthopedic surgeon. He was fearing the worst – that this injury would stop him from doing all the things he wanted to do through the summer, including getting back to his active job and it had been ‘too long to get it fixed’.

During the assessment a few things were discussed with PJ:

  1. Imaging does not always clearly indicate that you will or will not need surgery. In fact, many individuals end up resolving their pain with physiotherapy alone!
  2. The length of time an injury has been present does not dictate if it will get better or not
  3. Hurt does not necessarily equal harm – but we don’t always push through pain. There is a time and place for ‘no pain no gain’ just as much as there is a time and place to protect and rest
  4. If the client was able to complete the exercises, stretches and guidelines provided then things should get better pretty quickly

When we started the assessment PJ was unable to lift his arm sideways past the level of his belly button, was unable to reach past his hip behind his back, and unable to reach overhead without pain reaching up to 8/10 and stopping him from going farther.

After 8 appointments, PJ is now working on return-to-work programming, strength and conditioning and is back to full PAIN FREE range of motion. This does not happen by accident. PJ was encouraged to complete the exercises and stretches provided, and he was able to stick with them and continue to make progress between appointments.

Our motto at Warman Physio is that

We are here to help you help yourself

There is no point having a client into the clinic to just do things to you that you are unable to continue progress at home. We want to help you resolve your shoulder injuries as quickly as possible.

Now many people will think…

My shoulder injury can’t get better because:

  1. I don’t know how I hurt it
  2. It has been going on for ‘too long’
  3. It just keeps coming back
  4. I’ve already seen someone for it and it didn’t help

What we are here to tell you is:

  • You do not need to know HOW you hurt yourself, you just need to be able to explain how it hurts (and we help you with that!)
  • It is ideal to get in for physiotherapy as quickly as possible after an injury (we do after all do sports therapy and assess injuries as they happen on the field!)
    • BUT this doesn’t mean that pain lasting a month, a year, or 10 years cannot be assessed, treated and resolved
  • If you have a pain that keeps coming back, there could be some underlying factor that keeps starting it up – weakness in another area, tightness in the front or back – our job is to identify what that underlying cause is
  • Seeing one therapist does not mean that they had the right tools to help you at the time that you saw them. Sometimes it just takes seeing someone at this particular time that allows you to get better

So what are you waiting for? Stop suffering with your shoulder injuries and pain (or any other pain for that matter!) and book and appointment with your local Warman Physio

shoulder-advert1

 

There is no ‘one treatment’ for ALL shoulder pain, as each underlying reason and client is different. This means that although we would really love to provide “4 simple exercises to cure your shoulder pain” we are unable to, since each client requires their own assessment, exercises and stretches that is individual to each of them.

You can call to book, or schedule online with our Physiotherapists, in WARMAN and SASKATOON starting September 23, 2019 we will have SAME and NEXT DAY availability for assessments!

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Pregnancy, Pain & Physiotherapy

As physiotherapists that works with women who are pregnant and women’s health (pelvic floor physiotherapy) and many of us parents ourselves, we find that often women have many questions while pregnant.

Shouldn’t I be sore? Isn’t it normal to have pain while pregnant?

A little bit of pee when I sneeze/laugh/stand-up is ok though right?

My answer to this in short is NO!  Often newly pregnant women will be told a variety of things to appease them in reply to many complaints.

 well it’s what you signed up for…

you’re pregnant, what did you expect?

Women are often otherwise brushed off when concerns of pain are raised. This is beginning to change! Women who are pregnant need not be in pain, discomfort or other physical distress; and are often not accepting these as answers to their concerns.  Often, physiotherapy can help!

12605341_1021012697944690_92971813689463588_oPelvic Girdle Pain

First up PGP or pelvic girdle pain (think your gluts or bum, pubic bone and hips). This can often be addressed with not only manual skills of a physiotherapist but also home programming and Rost Therapy “rescue” exercises.  We work with women who are pregnant to assess and determine their specific underlying causes of the pain and provide you with a home program that helps you help yourself. Our basic principle is, if we are able to do something in-clinic to help a client to feel better then we should be able to provide a home exercise to help keep it that way.  Rost Therapy in particular takes a look at pelvic symmetry and utilizes the muscles that attach around the pelvis to promote symmetry. This can be provided to you with some home exercises to help.  To us there is nothing worse (from treatment perspective) than providing a treatment the client must continue to return and pay for over and over, ultimately not allowing them to continue their progress at home. In the image above you can see the start of the Rost Symmetry position (feet together, knees apart), often when in this position individuals experiencing SIJ pain will have one knee sitting higher than the other.

How can I help PGP now?

Check how you are sitting or laying.  We often want to cross our knees or pull them together; this creates tight muscles and tension in the inner thigh which can be an underlying cause pelvic girdle pain.  Instead of crossing your knees, cross your ankles and let your knees sit open (wider than your hips).  This is also why when laying on your side we suggest you place a pillow between your knees (think thick enough to lift knee to hip height).  This will encourage relaxation and decreased tension in those inner thigh muscles.

Pelvic Health Issues

Now, the pelvic floor and pregnancy.  We get many women who are pregnant coming into the clinic that are anxious because they haven’t been ‘doing their kegels’.  Do no fret, we do not necessarily recommend kegels to women who are pregnant.  Let’s think of the reason why for a minute.  Kegels are a strengthening exercise for your pelvic floor muscles.  These muscles are like a sling between your pubic bone and tail bone, and their main function is to close the anus, urethra and tighten the vagina.  Essentially kegels are intended to pull everything up and in.  Now, when we go into labour, we want the babies to come down and out.  See my predicament? We work with women to promote pelvic floor relaxation and function, as well as labour and delivery prep of the pelvic floor.

Leaking, pain with intercourse, back pain, hip pain, and constipation can all be signs of pelvic floor dysfunction!

How can I help my pelvic floor now?

Relax that pelvic floor! If you’re sitting in a chair imagine that you are trying to drop your vagina/vulva towards the chair (similar sensation to relaxing prior to a bowel movement) while breathing in, then rest as you exhale. This is an active relaxation.

Many times when we see women for pelvic floor therapy we find the pelvic floor is very tight and high. Anyone only ever really talks about the kegel ‘strengthen the pelvic floor!’ and strengthen we try.  Without a balanced relaxation all we do is shorten.  Imagine you go to the gym and you want to do bicep curls (hand to shoulder) and someone tells you to just pull up and hold there for 10 seconds, rest for 1 second then repeat.  Your elbow wouldn’t straighten all the way down and it would begin to stay bent.  This decreased relaxation causes tight and short muscles which makes it very difficult for them to do their job, which at this time (pregnancy) the end goal is allowing a baby down and out.  This could be one (of many) reason women are experiencing higher degree tearing of the pelvic floor during delivery.

No one individual is the same, and each assessment will lead to different treatment plans for my clients.  Which is why I recommend a comprehensive prenatal assessment when pain starts, or at approximately 32-36 weeks gestation prior to delivery for delivery prep. Keeping these things in mind could save you later.

In a nut shell: don’t ‘sit like a lady’ and relax that pelvic floor!

 

Haylie has been practicing pelvic health and focused in prenatal and post-partum care since graduating from the U of S MPT program in 2011. She now adds to this education and treatment, her knowledge and experience in pediatric pelvic health providing workshops and presentations in addition to assessment and treatment. Haylie has been advocating for treatment for women, ensuring appropriate and effective care throughout pregnancy and post-partum, and helping all expecting and post-partum moms since she started practicing. This ultimately brought her to open her family-friendly clinic in 2014.  At Warman Physio clients are encouraged to bring their infants and children to treatment if they need. Haylie was recognized as YWCA Women of Distinction finalist for Health & Wellness in 2017, the ABEX Young Entrepreneur Award Recipient in 2018, and a finalist in the 2019 SABEX and WMBEXA Awards.
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Don’t Let Your Love of Running HURT You!

Just in time for spring running weather, Warman Physio will be offering a Running Clinic March 10, 2016! The education session will provide information on:

– common running pains/issues
– typical training mistakes
– stretches that are geared towards runners to try
– possible gait analysis (chosen ahead of time)
– how to tell when an appointment is required
– possible information on ‘prehab’ before changing running routine
– the importance of strength as well as endurance and it’s affect on running

We will be providing snacks and beverages for those who attend. The location of the event will be determined by the number of people that register for the event – to register please e-mail info@warmanphysio.com titled “Registration for Running Clinic”, or call the clinic at 306-373-9355 (306-373-WELL). There will be a limited number of spaces, make sure you don’t miss out!

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Hello from Warman Physiotherapy & Wellness!

At Warman Physio we are continually looking to improve our client experience.  What we heard from clients in the past year is they would like to know more about various conditions, offers and promotions without having to head to our facebook page.  We have heard you and will be implementing a blog!

What will this blog do?
We are looking to provide our clients information on what we can do as Physiotherapists, Occupational Therapists and Massage Therapists – what conditions, pains, aches or other treatments that can be used to address your concerns.  We will also be aiming to let our clients, and the community know about any special offers, promotions or new therapist arrivals at the clinic.

Our first full-detail blog with information will be coming to you soon, but in the meantime we will provide a quick update and some information on the exciting things we hope to present to you this year!

Staff
Since opening in November 2014, beginning with Haylie Lashta MPT (Physio) and Lauren Profit RMT (Massage) we have expanded our team to include Chelsea Porter RMT and Kevin Bergen MPT. Our very own Lauren has also had her little baby boy; He arrived December 21, 2015 named Sawyer! Lauren will be returning to clients sometime in the spring of 2016. We also will have a new Occupational Therapist announcement to round out our therapies team very soon!

Promotions
Kevin Bergen MPT is providing Physiotherapy Medical Coverage for sports events and tournaments FREE OF CHARGE for February 2016! This coverage is available on a first come basis and he already has several spots taken, but has some flexibility if you or someone you know has a team that is interested they are welcome to contact us for more details at our website , facebook page or call us at 306-373-9355 (306-373-WELL).

Upcoming blogs will provide some information on injuries and various pains that can be addressed with physiotherapy, occupational therapy & massage.  We hope to shed some light on how we work as a team to better serve our clients, and how working with us, we hope to help you, help yourself (and we often joke that ‘hopefully we will see you around town instead of in the clinic!’ Unless you wish to book regular maintenance massage of course.)

Have a particular injury or diagnosis you would like for us to discuss? Let us know! Below are some of the areas we will aim to touch on this year:

  • Shoulder Injuries: The Rotator Cuff
  • Women’s Health (from leaking to pelvic pain)
  • Pregnancy & Physiotherapy (Rost Therapy: Amazing results for resolving pain during pregnancy)
  • Sports Therapy: Injuries, Rehab and Training
  • Running: Don’t let your love hurt you
  • Headaches: Physiotherapy & Massage
  • TMJ Pain & Dysfunction: Physio can help that!
  • Knee Pain: Sprains, Strains and Arthritis
  • Back Pain: start living again
  • Sciatica… or is it?
  • Carpal Tunnel: Double Crush Syndrome and why Physio First may solve the issue
  • Infant Development

Want to know more now? Contact us at the clinic through e-mail or our online form submission (www.warmanphysio.com), phone (306-373-9355) or facebook (facebook.com/warmanphysio) and we are happy to answer any questions!

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