Shoulder injuries are annoying because they seem to take forever to get better! One of the most common injuries has to do with the rotator cuff muscles. The rotator cuff is a group of 4 muscles - supraspinatus, infraspinatus, teres major and subscapularis - that stabilise the head of the humerus in the shoulder socket. These muscles are relatively small compared to the other muscles of the shoulder like the deltoid, biceps and triceps.
Doing exercise or gym work incorrectly, as well as poor ergonomics at work, are common causes of rotator cuff injury like strains or tears. They can also be caused by traumas like falling or aging. Overhead motions like pitching in baseball or overhead pressing in weightlifting may lead to impingement. It may be hard to determine if it is an impingement or a tear as the symptoms are similar - pain on certain movements, weakness with exercise or certain movements like lifting the kettle.
Osteopathy and massage are wonderful to kick start your recovery and regain mobility. Here are some simple exercises you can do to in addition to help with your shoulder rehab.
1) Internal and external rotation with a theraband. You can also do them with a dumbbell lying on your side.
2)Scapula push ups
3) The "face-pull" (see below)
American Academy of Orthopedic Surgeons also have a really informative pdf document of exercises.
When I was in school, sit-ups were my least favourite exercise. Now, many years later, I finally feel vindicated. The US Army is considering phrasing out sit ups due to too many spinal injuries.
An editorial from the Navy Times recently called for sit-ups to be banned completely. It called them an ‘outdated exercise today viewed as a key cause of lower back injuries’. The US Marine Corps is also reviewing its physical fitness and body composition standards – in an attempt to improve fitness and reduce injuries.
The Canadian Armed Forces has already phased out sit-ups; Canadian soldiers now lift 44-pound sandbags instead. Stuart McGill, a professor of spine biomechanics at the University of Waterloo in Canada said that dozens of studies showed that sit-ups can squeeze the discs in the spine. Over time these discs can bulge, pressing on nerves and causing pain.
Instead of sit-ups or crunches, fitness trainers say men and women should replace them with the plank pose, which is when you stay in the upward part of a push-up.
Knee pain can strike young or old and can be from a variety of causes - sports injuries, osteoarthritis, flat feet and trauma are the most common reasons that osteopaths encounter. Besides treatment, exercise can be extremely helpful in keeping the knee pain free. There are three types of exercise:
The knee joint relies heavily on the muscles around it to maintain normal postural alignment during walking and other activities. Muscle weakness is common in knee osteoarthritis and other chronic knee conditions. Strengthening exercises help to build up weak muscles around the hip and knee to protect the knee from forces that load and stress the cartilage.
You can strengthen your knee at the gym or just using a flexible band at home. Cycling is great, as well as pool-based exercises (swimming or aqua aerobics).
Neuromuscular control is a type of strengthening exercise based around everyday movement. People with knee osteoarthritis often adapt their movement patterns to compensate for their knee symptoms. These abnormal movement patterns can cause further weakening of key muscles, especially those around the knee-cap. It is important to do these exercises slowly and with control.
Often, stiffness is a big complaint along with the pain. However the loss of movement in the knee is not caused by the joint alone but also often involves the muscles. Stretching exercises aim to improve the flexibility of the body by stretching out tight muscles, joints and other tissues. Stetching can be incorporated into any exercise program or you may want to take a class that focuses on flexibility such as yoga. Important muscles to stretch are the hamstrings, calves, quads and ITB.
Here is a set of 4 yoga stretches you can do to relieve the pain caused by sitting at a desk too long. These poses focus on stretching the lats and opening the chest, muscles that can get achy and shortened after prolonged sitting.
And here is another yoga sequence that involves balancing a glass of wine. Have fun!
I found an amazing resource that shows the muscle you are stretching. These illustrations were created by Vicky Timón, a yoga expert and author of “Encyclopedia of Pilates Exercises,” and James Kilgallon, CSCS, creator of Mazlo’s Body Maintenance Program.
And remember, a stretch should be pain-free and you need to hold it for at least 30 seconds. Stretch after exercise, not before.
This pectoral stretch (29) has to be the one I give the most often, it helps reverse "desk posture" where the shoulders are hunched forward. I find this to be the cause of many instances of upper back and neck pain, as well as contribute to headaches, RSI and carpal tunnel syndrome.
Frozen shoulder or adhesive capsulitis is a common condition where the shoulder becomes painful to move for no apparent reason and can last years. Suddenly, simple things like brushing your hair, doing up your bra or other household chores become impossible.
Although the condition affects around two million - mostly women between the ages of 40 and 60 - doctors still know little about it and often don’t refer patients soon enough for treatment.
Two years ago, UK journalist Vivenne Parry wrote about her experience in the Daily Mirror. She described: "The slightest knock to my arm would set off an intense spasm in my shoulder that hurt so much it made me feel sick. I became sleep deprived, as the pain was much worse at night, and my shoulder just didn’t want to move as it should. It was incredibly stiff and getting my jacket on became increasingly difficult.
"Soon, I could hardly raise my arm at all. I couldn’t dress without help or even put a phone to my ear. Worst of all for me, I could no longer garden or swim."
Frozen shoulder occurs when the joint capsule becomes thickened and inflamed. This causes the space inside to shrink, restricting movement in the joint and causing pain. This capsule also contains lubricating fluid to enable bones in the joint to slide smoothly over each other. In frozen shoulder, the amount of lubricating fluid reduces by a third, which further restricts mobility and increases pain. The inflammation can cause thick bands of scar tissue to form within the joint, also hampering movement.
The initial trigger for this inflammation is still unknown. As more women are affected, and most have recently gone through the menopause, some experts say changing levels of hormones may be to blame. However, women who go through early menopause do not seem to develop it at an earlier age.
There is also a range of other conditions that make it more likely, including under and overactive thyroid, heart problems, diabetes and previous injury to the shoulder. Poor posture, particularly round-shouldered hunching, is also thought to increase the risk, and genetics may play a role.
Once you’ve had the condition in one shoulder, you almost never get it there again — but there is about a 10 per cent risk that you will get it in the other shoulder. Frozen shoulder can cause severe pain and loss of movement for up to 3 years. After this time, it often gets better of its own accord but as osteopaths, we say to get it treated as soon as possible. When your shoulder is stiff and painful, other parts of your body have to compensate and it can throw everything else out of whack.
Steroid and saline injections have been shown to be effective in the short term, but these must be delivered at specific points in the joint, and studies suggest if they are not done under X-ray guidance, 70 per cent will miss their target.
You can also do simple exercises at home, in conjunction with treatment, to speed up your recovery.
Dr Andrew Weil (above) is a pioneer of fusing western medical science with ancient traditions of mindfulness and meditation. In this video, he explains and demonstrates "The Relaxing Breath", which has its roots in pranayama, a type of breathing used by yoga practitioners.
The gist is this: Place your tongue against your top teeth and the roof of your mouth. Breathe in through your nose for 4 counts, hold for 7 and breath out through your mouth for 8, making a whooshing noise. This is 1 cycle, Don't do more than 4 breath cycles when you're trying this out for the first time as changing the way you breathe (by breathing more deeply) can make you dizzy. Dr Weil stresses that it is important to make it into a habit, so do 4 breath cycles twice a day for a month.
Holding your breath in this sequence allows oxygen to fill your lungs and then circulate throughout the body. It is this that produces a relaxing effect in the body and is “a natural tranquilizer for the nervous system,” according to Dr Weil.
And the possibilities are endless. If you do it religiously for 2 months. it will start lowering your heart rate and blood pressure even while you are not doing the breathing technique. Dr Weil says you can also use it in emotional situations or during cravings for food or nicotine. He said: "Once you finish 4 cycles, the craving will have passed."
Some internet users found this breathing technique helped them to falls asleep in under 60 seconds, while others found it has helped with dealing with anxiety.
After a few months, once you've got the hang of it, you can increase it to 8 breath cycles.
If you can't imagine running for longer than 10 minutes, you're not a lost cause. In fact, running for just 10 minutes, five days a week could be all it takes to reap running's big benefits.
Researchers at the Mayo Clinic have found that running for about 50 minutes each week -- or approximately 9.6km -- can protect the body from risk for stroke, arthritis, diabetes, high cholesterol, high blood pressure and even some cancers. A moderate amount of running is even good for runners with osteoarthritis and decreases their risk of needing a hip replacement.
Running increases your metabolism, so you burn more calories all day after a bout of vigorous exercise. A 5-minute run generates the same benefits as a 15-minute walk, and a 25-minute run is equivalent to a 105-minute walk. Check out the couch to 5k websites or apps if you need help getting started.
Walking is a great way to exercise, we know that just walking 10000 steps daily or roughly 30 minutes a day is the bare minimum for a healthy lifestyle. Here's a great tip to make walking even more efficient at burning the calories: Change your pace, do unusual things while walking.
Varying your speed while out on a stroll can burn as much as 20 percent more calories than if you were just maintaining a constant pace, says a study by Ohio State University.
"Measuring the metabolic cost of changing speeds is very important because people don't live their lives on treadmills and do not walk at constant speeds. We found that changing speeds can increase the cost of walking substantially," said Manoj Srinivasan, co-author of the study and professor of mechanical and aerospace engineering at Ohio State University.
Srinivasan gave more examples: "How do you walk in a manner that burns more energy? Just do weird things. Walk with a backpack, walk with weights on your legs. Walk for a while, then stop and repeat that. Walk in a curve as opposed to a straight line."
A recent article in the British Journal of Sports Medicine compared the number of injuries between barefoot runners and those wearing regular running shoes. It is not clear from the abstract if the barefoot runners were wearing minimal, thin-soled running shoes or had no shoes at all. The results, gathered over a year, showed that the 107 barefoot runners in the study had fewer injuries overall, but had the same rate of injury as the 94 shod runners.
Barefoot runners tended to suffer from more calf injuries but fewer incidences of plantar fasciitis, knee and hip injuries than shod runners. If you are thinking of transitioning to barefoot running, the worst thing you can do is buy a pair of barefoot shoes and start pounding the pavement straightaway! You need to give your body time to readjust to how your sole lands and build up flexibility and strength in the lower legs.
UK barefoot running coach Lee Saxby. shares a few tips in this video. On a side note, I've been wearing barefoot casual shoes from Vivobarefoot for two years now and they are insanely comfy. We've got some discount vouchers for Simply Well patients, so just mention it to your practitioner if you want to check them out.
All entries complied by osteopath Dr Wei Chua unless otherwise stated.