Archive for December 2013

Shoulder Pain ? How Do I Tell What?s Wrong With Me?

Shoulder pain is a common problem that affects the majority of the population.  Most people will experience some degree of pain in their shoulder at some point.  The causes of the pain and the degree of the intensity of the symptoms will vary from person to person.  The recovery and return to normal function will also vary from person to person for a variety of reasons.  But how do you tell what is causing your shoulder pain?  This article addresses some common ways that the various pain generators of the shoulder are diagnosed from the perspective of an experienced Physical Therapist.

Three common pain generators of the shoulder are the rotator cuff muscles and tendons, the bursa and the shoulder capsule.  The purpose of the rotator cuff muscles and tendons is to move our shoulder in a rotating fashion (hence their name) and to help up elevate our arms over our head.  The purpose of the bursa or bursal sac is to protect the muscle from scraping on the edge of the bone.  So the bursa sits between the muscle and the bone and acts like a cushion.  Without it the rotator cuff muscles would repeatedly scrape on the edge of the bone and become easily irritated.  The shoulder capsule offers added stability to the shoulder joint.  Any one of these structures can become a pain generator if they are inflamed or injured.  Often times they will be inflamed in conjunction with each other. 

It can sometimes be tricky to diagnose the exact pain generator because the symptoms that are experienced by people with these pathologies are typically very similar to each other.  More often than not these pathologies will cause symptoms of pain, weakness, and loss of motion.  The pain is typically felt in the shoulder region and is often felt in the upper arm above the elbow.  People with shoulder pain will commonly feel an increase in pain when they are trying to raise their arm overhead or out to the side.  So if these pathologies are so similar in nature how can we tell them apart?

Well, in physical therapy there are some simple tests that can be performed that will help distinguish between the different pathologies described above.  I will describe them here briefly.

Rotator cuff tendonitis:  if one or more of the rotator cuff muscles is inflamed this is termed tendonitis.  This is diagnosed by simple manual muscle testing where the physical therapist will resist specific motions of the shoulder that the rotator cuff is responsible for.  If the patient experiences pain during a manual muscle test this is indicative of a tendonitis.
Bursitis:  this can pose a challenge for the therapist to diagnose but if they are well trained they can more easily identify this as a problem.  The tests start with manual muscle testing as described above.  If one of the manual muscle tests is painful the Physical Therapist can then perform a Pull Test.  This is a specific test that is specific to the bursa.  If it is positive then it is likely that the person has a bursitis of the shoulder. 
Adhesive capsulitis:  this is also commonly known as frozen shoulder.  To make a diagnosis of adhesive capsulitis the Physical Therapist must passively test the motions of the shoulder.  Remember as I mentioned above that any one of the pathologies discussed here can present with a limited range of motion.  Adhesive capsulitis presents with a very specific limitation in motion that will likely differ from the limited motion seen in tendonitis and bursitis. 

If the symptoms of these pathologies can be so similar then why do we need to be so specific in the diagnosis?  The reason is that although symptoms are similar the treatments for these conditions can vary slightly from each other.  Some things that I may do for an adhesive capsulitis I might not do to treat a tendonitis and so forth.  So a specific diagnosis can help guide the Physical Therapist toward a specific plan of treatment for the pathology in question.  A well-rounded treatment plan will lead to positive results in improving your painful shoulder.

Peter Harris is a licensed Physical Therapist with 17 years experience in the profession treating patients with shoulder pathology.? A painful shoulder can persist for years, significantly impacting your quality of life.? You don?t have to suffer any longer.?

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Foot Pain In Runners: How to Relieve the Pain

Foot pain in runners can be excruciating. Once you encounter heel or
arch pain, it may be difficult to adjust your lifestyle if you are used
to being active. It is important for runners to be aware of the
symptoms and treatments for some of the more common types of heel or
foot arch injuries. Understanding the different types of sports
injuries is the key to effective treatment of foot pain in athletes.

What is Plantar Fasciitis?

the plantar fascia, a thick, fibrous band of connective tissue in the
sole of the foot that supports the arch of the foot is inflamed, it
causes plantar fascia pain. The plantar fascia runs from the ball of
the foot to the heel. When the foot is on the ground and supporting all
of your body weight, it stretches this tissue. When placed under
excessive stress, the plantar fascia stretches too far and tears,
resulting in inflammation. A sudden movement or the effects of
long-term stress can cause this condition.

How Plantar Fasciitis Leads to Foot Pain In Athletes

Plantar fasciitis painis a common type of foot pain in athletes
for a number of reasons. Runners tend to exercise too long and apply
too much stress to the feet and plantar fascia, and those with flat
feet can be at a higher risk. Repetitive stress on the plantar fascia
can be caused by wearing shoes that lack support and running routines
that are too long. Inflammation occurs as the fibers tear, causing
severe pain.

The following are some of the more common causes of Plantar Fasciitis:

sudden increase in activity such as running or participating in sportspoorly-fitting footwear and inadequate arch supportexcessive pronation of the feetweight gain
pain is commonly felt on the bottom of the foot, where the plantar
fascia attaches to the heel bone. Due to the fact that the fascia
constricts when you sleep, you will typically feel the most pain in the
mornings. When you get up, the sudden stretch and load of your body
weight pulls on the attachment to the heel bone. Mild to severe
symptoms of foot pain in athletes may occur. The pattern of pain can be
very unpredictable over months at a time. Frequently, the pain
disappears for several weeks, only to re-emerge full-blown after a
single workout or change in activity.
The pain may even temporarily
fade as you walk. Runners often develop Plantar Fasciitis, and along
with the triggers shown above, may be caused by sudden intensification
in your training schedule, or by changing running surfaces. This is
noticeable, mostly when going from a soft surface to a harder one.

Ways to Prevent Plantar Fasciitis

While plantar fasciitis
can be treated, it does not heal quickly. foot pain in athletes can be
avoided in a number of ways. Here are some recommendations from
physiotherapists that can help prevent Plantar Fasciitis:

Use Adequate Shoes and Orthotics ? Ensure that you have good footwear. Many cases will benefit from wearing orthotic shoe insoles
inside the shoes to improve foot biomechanics. Going barefoot is a bad
idea, even at home. Avoid shoes without arch support, and get used to
running on a soft surface.

Apply Ice ? Applying
ice to the heel can help to reduce the inflammation and pain. Put your
foot on a frozen bottle of water or a bag of frozen peas wrapped in a
towel three or four times a day for five to ten minutes each time.
Desensitized tissue can be at risk of ice burn, so never ice more than
once an hour.

Try a Different Activity ?
Consider swimming or cycling, as they may be a better exercise option
for you. When you begin running, begin at a much lower level of
intensity and a shorter distance, then you can build up gradually.
Lessen the time you spend on your feet and reduce the intensity of your

Stretch – before, during, and after
physicalactivity. Tight calf and/or hamstring muscles (in back of
thigh) limit range of motion and put extra strain on the plantar
fascia. Stretching as a warm up and as a cool down will help you move
easily, keep muscles flexible and relaxed, joints mobile and relieve
tension and strain. Performing plantar fasciitis exercises to stretch
the plantar fascia is highly recommended.

If the problem persists, talk to a podiatrist or physiotherapist.

Heel pain is a problem experienced by many youngsters. The causes for heel pain
are often activities such as fast running, jumping etc., especially in
youngsters suffering from flat feet. However, these activities cannot
be avoided in the period of youth. That?s why Footminders shoe inserts
are considered as a vital resource to relieve heel pain in many young
men and women.