Farnsworth Orthopedic Physical Therapy

Orthopedic Physical Therapy

shoulder

Clavicle Injuries

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Better Know Your Clavicle

The clavicle is the medical term for your collarbone. On one end, the collarbone attaches to the top of your sternum (the “breastbone”). The other end attaches to a bone of the shoulder blade. The clavicle provides considerable support for the shoulder. In fact, the clavicle is the only direct bony attachment that your shoulder has to the rest of your skeleton. The clavicle attaches to the sternum and shoulder blade by ligaments (strong fibrous bands of tissue). It has very few muscles to help contribute to the support.

 

Injuries

Clavicle injuries usually happen because of a trauma such as a car accident. They can also happen when you fall on your shoulder or outstretched arm. The result is either a broken clavicle or a ligament tear.

When a clavicle gets inured, you will feel pain at your shoulder blade attachments or at your sternum. Your shoulder may also have what is known as a “drop off.” This means your shoulder is lower than the other shoulder and has a noticeable step off rather than a rounded appearance. The pain may increase as your shoulder is lifted, especially when lifting over your head.

This clavicle here is broken very badly.  Ouch!

Treatment

In either case, the first treatment is to brace and support the shoulder for a period of time to allow the fracture or the ligament injury to heal. In severe or complete fractures, a doctor will need to set your fracture. The amount of time of immobilization depends on your physician’s opinion and the degree of the injury. In severe injuries, you may need surgery.

After a period of immobilization, you’ll need a more active rehabilitation program. Avoid lifting objects with your injured-side arm. Also, you will need to avoid carrying items such as purses or backpacks. At first, modalities such as ice, ultrasound or anti-inflammatory procedures may be used to help decrease the pain and reduce inflammation. Gentle range-of-motion exercises are helpful, usually in the lower ranges, avoiding overhead activity. As your range improves and your pain is reduced, the exercise program transitions to a strength program with range-of-motion overhead exercises.

Decreasing your pain level is key.

Patience Is a Virtue

Clavicle injuries may be difficult and painful to rehabilitate, depending on the severity of the injury and ligaments injured. Ligaments can be slow to heal, so rehabilitation may be slow and relatively long. It is important to have patience and not become frustrated during this time. In most cases the outcome is good. Consult your doctor or health professional for the details of your injury.

Written by Travis Rohner PT

Labrum Issues

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The Labrum

The labrum is a cup-like structure in the shoulder that reinforces the socket portion of the ball-and-socket joint. The joint in the shoulder is rather shallow. This causes it to rely on the labrum as well as the surrounding rotator cuff muscles. It is composed of fibrocartilage which doesn’t easily regenerate on its own.. Damage to the labrum occurs from repetitive stress to the area. An injury to the bicep which attaches to this part of the shoulder, as well as dislocations to the shoulder joint can cause damage as well.

Tears

A labral tear is most commonly seen in overhead athletes. These are athletes such as volleyball or baseball players, or to those who have repetitive dislocations of the shoulder. A SLAP tear happens when you tear the upper part of your labrum from forward to back. This high energy, quick movement  can cause this to happen as it puts unwarranted stress on your bicep and labrum. A Bankart tear happens when there are recurrent dislocations of the shoulder joint. This can tear the lower portion of your labrum. This causes shoulder instability over time, which causes the shoulder to dislocate multiple times.

Symptoms

Symptoms of a labral issue include shoulder instability and weakness. You may also experience pain in the shoulder joint. Other symptoms can include grinding, clicking, or catching when you move your shoulder. Depending on the severity of the injury, you may need surgery to help correct it. As mentioned before, there is little to no regeneration of this part on its own. However, physical therapy and cortisone injections will help restore the mobility and strength. If physical therapy fails or if the initial injury is severe enough, surgery may be warranted to correct the torn labrum. This surgery can include arthroscopic cleaning of the joint, removing the torn areas, and/or relocating the bicep to prevent further stress to the area. The surgeon will determine that based on the patient situation and injury severity.

Treatment

Physical therapy is an integral part of rehabilitation of a labrum injury. This is true whether surgery is needed or not. If you have had a sports related injury, multiple shoulder dislocations or any of the symptoms above, please do not hesitate to contact our office for further evaluation.

 

Written by: Casey Badder PT

Weightlifter’s Shoulder

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Weightlifter’s Shoulder is a term that describes painful wear and tear of one end of your collar bone. It’s an injury that happens due to overuse.  It causes small fractures that can be quite painful and effect your range of motion. In some instances, something called osteolysis or bone breakdown occurs.

It’s called Weightlifter’s Shoulder because weightlifters are commonly affected due to the repetitive motions and heavy weight put on the shoulder joint when lifting weights. However, they are not the only ones affected. Jackhammer operators, baseball and football players and even soldiers can develop this problem.

Symptoms

The symptoms of this condition include tenderness over the front of the shoulder. You may also have pain while doing bench presses or dips, or you may be unable to do a push up due to the pain.  If you’re experiencing these symptoms it is very important that you do not try and push through the pain.  This will only lead to further damage and a longer healing process.

(Not being able to do a pushup due to lack of exercise is not a symptom.)

What Causes this Condition?

Repetitive stress from training and lifting can be a cause. For example, when your elbows drop below or behind your body during bench press, excessive traction on the AC (acromioclavicular) joint occurs. As a result, your shoulders extend too far.  If the bone does not have a chance to heal prior to your next workout, your shoulder can become painful and suffer from reduced strength and range of motion.

How to Treat It

Treatment for weightlifter’s shoulder usually starts with physical therapy and no surgery. This may include rest and changes in weight-training activities. You have to avoid over-training so that your joint can heal.  We can also help with suggesting modifications and design strength training for your condition.

(Rest is very important)

For those who don’t improve with therapy alone, or have a lot of damage to the shoulder joint, an arthroscopic surgery may be recommended. During the surgery, the surgeon removes portions of the damaged end of the collarbone in a procedure known as “distal clavicle excision”.  It is usually an outpatient procedure.  Most patients are able to return home the same day.

Physical Therapy is often recommended after surgery to improve strength and restore range of motion. Fortunately, most patients suffer no loss of function in the shoulder after surgery and are able to resume normal activities following rehabilitation.

Written by Travis Rohner PT

 

Head, Shoulders, Geeze My Phone!

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Is your phone killing your back and neck?

Are you reading this on your phone right now? If so, you might be doing the “smartphone slouch”. You’re tilting your head forward and downward to hunch over your phone.  You may not know this, but the human head weighs somewhere around 10 to 12 pounds.  But when you tilt your head forward it can cause strain on your back, neck and shoulders that is equal to you having a much heavier head.  How much heavier? Well at 15 degrees of forward tilt it equates to your head weighing 27 pounds. At 30 degrees forward, the strain on your neck equals a 40 pound head.  A 60 degree tilt is the same as if you had a 60 pound head!  That is some serious strain!

No one wants a head that big.

 

As you tilt your head, you also move your shoulders forward into a rounded position, which is another aspect of poor posture. All this excess strain creates extra wear and tear on the structures of your neck, upper spine and back.  The average person is on a computer or smart device between 2-4 hours every day.  That’s a lot of potential pain and strain.

What Can I do?

So how do you get your work done and use your phone and save your back and neck?  First, if you have to do extended work, don’t do it on your phone.  It’s much better if you do long tasks on a desktop computer.  If you have to do it on a laptop, make sure you’re positioned where you can have good posture.  Then, when you do have to use your phone, don’t hunch over it.  Instead, lift your phone up higher rather than tilting your head and rounding your shoulders forward.

 

Being aware of your posture is a great first step to relieving the pain of living life in the age of the smart phone.  But it’s almost inevitable that you’re going to have some pain and strain from time to time.  Here are a couple of things you can do to bring some much-needed relief to your upper back and neck.

First is the scap squeeze. It gets its name from your scapula, also known as your shoulder blades.  The goal is to squeeze your shoulder blades together.  Sit or stand up tall with your arms at your sides.  Keep your shoulders relaxed and down, not shrugged. Squeeze your shoulder blades together. Hold for 6 seconds, then relax.

 

Second, a lat pull down can help correct your posture and strengthen the muscles that will keep you from straining.  On a lat pulldown machine you’ll want to grab the bar with your hands shoulder width apart and be sure to pull the bar down to your chest and not behind your head.  You can see here and example of proper technique.  The goal isn’t to do this exercise with the most weight possible, but to get good steady repetitions in that will engage the muscles that help your posture.

 

Staying mindful of your posture, along with these simple stretches and exercises will help you beat the smartphone slouch.

Written by Tom Farnsworth PT

 

 

 

 

 

Fore Ways to Improve Your Golf Game

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Lower Your Score

The Arizona Golf Association estimates that approximately 8 million rounds of golf are played in Arizona each year. As the weather begins to get warmer in Arizona, there will be an increased number of tee times booked for the local golfers. The age range of the golf community can span from 10 years old and younger to more than 100. For some, playing golf is a daily or weekly event. For others it could be the first time you pick up a 5 iron in months. Golf is a complicated game. It requires a number of body movements that coordinate into one fluid motion. So, what can you do to prevent injuries while golfing and to potentially lower your score?

  1. Eliminate Pain: Often times, people may have lingering injuries that prevent them from an activity like golfing. It is important to address the pain that you may have. Too much pain can lead to compensating and causing yourself further injury.

 

  1. Improve Mobility/Flexibility With different moving body parts throughout the swing, it is essential that your body can move well at each individual joint. However, your joints must then work and move together to allow your golf swing to occur effectively.

 

  1. Improve Strength: Strength is required to create motion at the joints. It also ensures that all your body parts are aligned to hit the ball straight. Your core strength is essential to start and control your movement.  Strength in the distal limbs can help address swing faults.

 

  1. Improve Balance: Dynamic balance is the ability to coordinate all the movements performed at each individual joint while maintaining a good position for follow through. Balance is key to making your golf swing happen and eliminating the risk of injury.

It’s important to lower frustration levels too.

We Can Help

All of these aspects should be practiced and incorporated into your daily routine in order to help your everyday life. They are also crucial to your golf swing.  The coordination of all of these things will help reduce the risk of injury. The same principals apply whether you are a seasoned golfer or someone who is picking up the club for the first time. If you are a golfer athlete and feel that one of these things can benefit you, feel free to contact our office to see how we can assist in improving your game.

Written by Casey Badder PT

CRPS

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What is CRPS?

I think we can all agree that being in pain sucks. There are many conditions that cause pain, but only a few that have pain in the name. Complex Regional Pain Syndrome, or CRPS, is a condition which, like its name implies, is very painful. It was previously referred to as Shoulder Hand Syndrome. It’s a type of chronic pain that mostly affects your hand, arm or a leg. It usually develops after another type of injury.

I have seen this condition mostly in the hand, however I have seen lower extremities affected as well. This is something that is not fully understood. Medical science isn’t sure exactly why this pain happens.  It is thought to be an over-activity of a person’s peripheral or central nervous system.

Symptoms

 As the name implies, the first symptom is pain. This pain is way out of proportion to what it should be for the specific injury that occurred. It’s usually described as a burning or throbbing. The area is usually extremely sensitive to colder temperatures but heat can bring relief. I had a patient recently who used very descriptive words to explain her pain, although most are not appropriate to mention here.

Your skin can be extremely sensitive to the touch and anything covering your skin can cause intense pain. There can even be a different color and texture to your skin where it may look shiny. Joint tightness and swelling are common. This can cause weakness and muscle atrophy. This makes it a lot more difficult to use this particular limb. These symptoms can last anywhere from days to years. It’s most likely to improve when treated early on.

Treatment

The majority of treatment, at least initially, aims to reduce the painful symptoms. Modalities such as heat can be very soothing. Patients with CRPS can respond very well to electric stimulation at well. Due to the sensitive nature of this condition desensitization techniques are often used as well such as massage techniques, range of motion techniques, and using strengthening of the affected limb. All this improves blood flow and restores damage done to the nervous system. Medications can be beneficial which are proscribed under the direction of your physician.

Any way you look at it, this condition is not fun, however you should not have to go through this alone. A licensed physical therapist can assist you to reduce your pain and get back the use of whatever part is hurting. If this is something that we can help you with, please give us a call.

Written by Rod Walker PT

 

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