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October 18, 2021Quick question: Have you ever suffered with a pain in your shoulder without having a clue where it came from in the first place, and hoping it would just go away on it’s own?
Many people have, and one of the most common causes of shoulder pain we see here at the clinic is this:
Sitting.
Sitting down for long periods of time, and sitting in an awkward position.
Take our patient Sarah for example,
Prior to Sarah coming to see us her shoulder pain got so bad that she suffered from countless late nights tossing and turning to find that one position she could fall asleep in ’comfortably’… For almost two years.
No matter what she did, shoulder pain seemed to always find her.
Sarah was sitting down all day at work hunched over a computer, she tried to improve her posture herself, but it didn’t work.
Then Sarah tried standing more, which only worked for a little while, and then the pain started showing up elsewhere – in her neck and back.
She tried buying a new mattress and special pillows.
NOTHING worked.
It was the most frustrating thing Sarah had ever been through… but when she came to see us she soon realized she wasn’t alone.
A lot of people suffer with the exact same annoying and frustrating pain too.
Did you know that a huge 45% of office workers suffer from shoulder pain at some point in their life?
So if you have shoulder pain it is NOT a coincidence.
If you didn’t already have an idea that your posture at work may be causing your shoulder pain, we’ve seen hundreds of patients who suffer from it as a consequence of using a computer, how they sit at work and a sedentary lifestyle.
The two are linked, and I’m going to show you why, and how to ease the aches and pains they cause.
And even if you’re active but your shoulder pain is stopping you from exercising properly at the moment, there’s something for you to take away here too, read on…
Shoulder, neck and back pain are extremely common health issues that occur in people who spend a lot of time sitting throughout the day (and those who are sedentary). The reason you’re probably getting that burning sensation in your upper back, in your shoulders and that dreaded neck pain is because they’re all related.
For a moment I want you to sit in your natural position as if you were at a table, or a desk.
HOW ARE YOU SITTING?
Is your back hunched over, your shoulders slightly raised and your neck reaching forward?
Or… Is your spine straight with no arch in your back, your shoulders and arms relaxed on the desk, and your head positioned up straight as if a piece of string were attached to the crown of your head holding you up?
One of them instinctively looks and feels more natural and healthy, right?
This is one reason why you’ve got neck and shoulder pain.
Firstly, misaligned shoulders that are typically hunched lead to a misaligned neck (sticking out forward), which leads to a great deal of strain on the neck muscles, which leads to chronic pain and a build up of tension and potential other long term effects like headaches.
Here’s what’s happening to your shoulders, when you have your shoulders repeatedly in a hunched over position, you’re impairing how they are naturally supposed to move.
As a result you get grinding, popping, clicks, overuse injuries and burning sensations between your shoulder blades.
So how can you begin to ease your shoulder pain as soon as today?
You’ve got to learn how to sit at your desk. Might sound simple, right?
Most people don’t like to hear it because it’s not a magic, surprising answer, but the thing is, if you sit properly throughout the day you won’t have problems and pains in your shoulders when you get to the end of it. It really is as simple as that!
NEXT TIME YOU’RE SITTING AT YOUR DESK AND YOU FEEL SHOULDER PAIN, BE AWARE OF YOUR POSTURE, SET A REMINDER TO HAVE A CHECK IN EVERY HOUR AND ASK YOURSELF…
Is my neck leaning forwards?
Are my shoulders hunched?
Is my back rounded?
So, make sure your computer screen and printer and close enough to you so that you don’t have to strain your neck when looking at the screen, and you don’t have to over reach for the printer when you need to use it.
If you ignore your overall posture throughout the day, you’ll just find the pain coming back again and again. So fix you posture to say goodbye to frustrating aches and pains.
And lastly, another thing we do for our patients that helps ease pain fast while they’re monitoring how they sit is massage.
When you’ve got a lot of tension held in your back, neck and shoulders from sitting all day, we massage the areas to help eliminate those points of tension.
Sometimes tension can cause aches and pains in other areas such as your back and can even result in headaches, so massage is a great way to help you live with less pain quickly.
Check out our page dedicated to giving you information specific to Shoulder Pain
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October 10, 2021It can sometimes be hard to see what you are doing wrong in your lifestyle because, well, it’s your lifestyle.
Your daily routine is so well known to you that it can become second nature to read before bed, look on your tablet or round golf on a Saturday morning.
What if I told you that all of these could be making your shoulder pain worse? That all these movements cause unnecessary strain on your shoulders, leaving you in pain the next day?
So I’ve given you a few ways that you will find a great benefit to easing shoulder pain in your day-to-day routine…
First things first, when you wake up don’t forget to stretch. I know this is something I say often but it’s because stretching can often be underestimated.
Imagine this, someone has been in the same position for roughly 8 hours, without much movement. Would you think that they would need to stretch afterwards?
I bet your answer would be – yes! Exactly.
You may have woken up but your joints haven’t yet. It’s like going for a run without warming up. So with this in mind, stretch before you get up. Even if it’s just for a few minutes, it’s better than doing nothing.
Looking at your phone or tablet has to be one of the worst culprits for shoulder pain. Yes, looking at your phone or tablet can have an effect on your neck as well, but the pain often starts at the neck and spreads to your shoulders.
I understand that you may need to check emails on your tablet, or are very popular on your phone but with many of us spending hours on our devices, it interrupts our body’s natural state.
Since your head is facing down using these devices can result in poor posture and slouching. What most people don’t know is that your head is supposed to be in a position where your ears are in line with your shoulders.
As soon as you start looking down, your body is more likely to feel a strain in the neck and shoulders.
My advice on this would be to either, only use your phone for about 10 minutes at a time to avoid strain. As for other devices, now we have cases for them that can sometimes provide stands for tablets and e-readers! Perfect!
My tip here would be to take advantage of the stand and use it, so that your eyes do the adjusting, not your head!
This also goes for reading at night too. I understand that reading at night is sometimes a habit picked up as a child, which is a great habit to pick up. For your body however, it can sometimes have an effect on your posture.
Another problem that can come from reading on a night is actually from holding the book. It’s not something you really think about but holding a book causes particular muscles to be tensed.
Not only this but your neck is also likely to be tensed to keep you upright whilst reading. Now think of how long you read for. How many times do you say, ‘just one more chapter’ before you finally drift off?
I really love this habit so I would recommend to continue reading but to only sit in the same position for up to 20 minutes.
Another great way of thinking about your shoulder pain throughout the day is to think about when it occurs. Is it when you tend to carry shopping bags, when you sit at work or while you exercise?
If you have an idea when it occurs, then focus on making sure your head is straight and your ears are in line with your shoulders. This is the best tip that I know and if you apply it to as much of your daily routine as possible, you will start to see a difference. […]
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October 3, 2021Sometimes, it can often surprise us how the smallest things in life can actually affect our health. Small things like wearing that heavy bag on the same shoulder everyday, or that terrible posture you’ve been in at work, but so desperately want to get rid of. That’s right everyone… it all adds up. I will be discussing a few exercises later on in this article.
Today I’ll be going over the importance of exercising in the workplace and how it can help your shoulder pain. The reason why I’m writing about the workplace is because not many people realize how much time you spend at work.
For example, the average full-time worker spends on average 2,000 hours at work per year. That’s equivalent to 83 days or 12 weeks of continuous work!
Now… imagine if you had an office job, or if you DO, think of all those hours you actually spend sat down, not moving and potentially developing poor posture. It’s no wonder you have shoulder pain!
That is why it’s important to exercise at work and to keep moving as much as possible. Having only 2 weeks away from work can take its toll on your body. This truly shows how long you are at work for and how it can affect your health.
With that in mind, here’s a few of my tips that are handy to use to ease that shoulder pain…
Yoga before and after work is a MUST to stretch away those potential aches and pains in your muscles. It is ideal to do yoga in the morning as you have been sleeping in the same position for a while and will continue to do so at work.
After work is just as important. Doing Yoga after work will stretch your muscles after being sat for so long! Not only this but it will leave you feeling a lot calmer and stress-free. If you decided to do yoga before bed, then this is just as good for you, as it will help you to get to sleep quicker.
Get some fresh air on your lunch break. This is something I keep telling my staff to do! Not only is a change of scenery good for the mind, it gets you up and moving! Even if it’s just a walk to a park bench, it’s better than nothing!
If you are lucky like me and have an hour for your lunch break, then why not try and go for a brisk walk. This will ease your muscles further of any pain.
If you do decide to do this then I would recommend leaving your bag in the office. My reason for this is that if you carry your bag over your shoulder, you will be putting more pressure on one of your shoulders, which will leave you with more shoulder pain to go back to your desk with!
Don’t forget to move around at least once within an hour. I’m not saying you need to sprint to one end of the office and back! It could be as simple as walking to the restroom or even standing up and walking to your colleagues desk to see how they are doing.
It doesn’t even have to be for very long, as long as you stand and walk around a bit!
If your shoulder pain still hasn’t eased during lunch, but the yoga in the morning worked… then here’s a few exercise that you can try from your desk.
Desk Angels Sounds sweet doesn’t it? Right, so here’s how you do them…
1. Once you’re sitting straight in your chair, raise your arms straight up, like you’re trying to touch the ceiling.
2. Now keep your body still, (it will be harder than you anticipate!)and move your arms together, back and forth. You’ll notice the stretch, pull in your mid back when you move your arms behind your head.
3. Now repeat this 10 times.
Shoulder Rolls This one is probably the most common out of the exercises.
1. Keep your back straight and your chin tucked in.
2. Roll your shoulders forwards 10 times, and then repeat backwards.
Desk Upper Trunk Rotation This one is probably the most difficult, in the sense that different people will feel this stretch in different areas. When you do though, you’ll know you need to be working on this one! This exercise targets the muscles in the chest, and down the back.
I also advise that it might be best to do this one when you’re on your own in the office, as you might look like you’re modifying the old “sprinkler dance” from the 90’s! So here it is…
1. Stand and place one hand on your desk, and the other behind your head.
2. Reach the elbow of the arm with the hand behind your head up to the ceiling, then down like you’re tying to touch the armpit of the hand that’s resting on the table.
3. Hold for 3 seconds and repeat 15x on each side.
Like I said before, it might be best to do this one when everyone has gone for lunch, so you’re on your own!
So, quick summary! Now you know how long you actually spend at work and potentially in an office chair, it’s clear to see the importance of exercise in the workplace.
Shoulder pain can often come from poor posture in the workplace. So Remember! The hours you work build up and so does the pressure and pain in your shoulders!
If you have or are about to retire, then these exercises can still be done at home and I would still recommend using these tips to ease any shoulder pain that you may have.
So give these tips a try and start to feel the benefits quicker! […]
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August 2, 2021
Why didn’t my last physical therapist do this for me?
If I were to write a book covering the most frequently asked questions I get in my clinic, this one might be very near the top of the list.
The reason I get this question so often has to do with many people believing that all physical therapy clinics basically provide the same care. This is fundamentally not true of any business regardless of what industry they are in. There are good and bad dentists, restaurants, mechanic shops, and certainly good and bad physical therapists. Now I would never bash my profession as a whole, or even in part, but many PT’s are handcuffed by the policies of the business they work for, and the regulations of the insurance company they are working for. YES! I said that correctly. When you go to a PT that is in-network with your insurance, the PT is working for the insurance company, not you (the patient). You see, that in-network PT office will provide services that will best be reimbursed by the insurance company. Sadly, some services that would be more effective in relieving your pain, or getting you back to the activities you are missing out on right now may get passed on due to time constraints, or how well the company gets paid to provide that treatment.
In 2021 there is yet again, another round of cuts to reimbursement for Medicare services to PT’s. While we PT’s have done miraculous things with the reimbursement we have gotten over the years, the simple fact that wages and expenses continue to climb, and with revenue being cut, there is little choice in the matter than to offer “bare bones” service. I see offices pack the schedule with 4 or more clients at one time spread across a PT, an aide, a volunteer or a student. Not always does this fit with what the legal standard, or ethical standard of what can be billed as PT “skilled intervention”, but some businesses are desperate to stay profitable, and stay open. This was actually the topic of my research thesis in PT school. “Managed care’s effects on patient outcomes and clinical decision making” (The actual title is much longer, but I’ll spare you the boredom!!)
When I ask my clients what a session looks like at some of the other clinics they have gone to, there is a pattern that I see across the board. First, they say that the place is super busy and hard to get appointments. When they do go, the intake process is a problem with too much paperwork. There is commonly a wait time to be seen. They get put on a piece of equipment to warm up for up to 10 minutes each time they go. After a few sessions they take them through the same routine of exercises that they have been performing at home. For my athletes, they are either bored, not challenged, or discharged when they can do regular day to day activities like walk or climb stairs, but aren’t ready to get back to running, cutting, jumping or sport.
The other thing that my clients have been treated elsewhere tell me is that they have no idea what the cost is for a session when they use their insurance, and the ones that have actually tried looking at the explanation of benefits that the insurance sends them after the session has been billed…they can’t make heads nor tails of what the insurance actually paid the therapist for the session. Their main concern (and rightfully so) is that they don’t have a bill, or that it is clear of how much of a bill there is.
Here is the beauty of our clinic, and the reason people are treated so differently here to prompt all of the questions.
We are very transparent about what our sessions cost, and regardless of your financial situation, if you want our help, we have affordable packages and payment plans to help you access the care you need. Our sessions are not cookie-cutter recipes of protocols that have been copied for decades. We have been personalizing programs from day 1 in business, and in fact, you can work with the therapist based on your condition and choose the length of session you want. For instance, maybe you know that there is a component of exercise needed for you to heal at the fastest rate possible, but you know you won’t do it at home and you want to spend the extra time in the clinic to ensure you do absolutely everything you can to get better… You can choose to do that. Or , if you know you will be diligent with a self-care program at home, and you want to focus on the hands-on parts of treatment and have a few exercises filmed so you know what to do at home, that can be arranged.
We spend the first part of our sessions hands-on with most of our clients to ensure the muscles are relaxed, activated and prepped for use before we do exercise, to ensure you don’t leave worse than you walked in. We are constantly testing and retesting your movement to ensure what we are doing is working. Anyone that is hands-on with you is someone that holds a license, and isn’t a volunteer or a student just learning at your expense.
We provide revolutionary treatment options like cold LASER therapy that many other offices don’t. The cold LASER we use was the original device that was FDA approved in 2002, and that our therapist have been using since 2004! LASER is incredibly effective at reducing pain, helping with inflammation, and accelerating tissue healing. It is one modality that can shorten healing timelines, and keep you from missing out on activity for prolonged periods of time.
Not only do we do all of those things, we can provide you with invoices that you would submit to the insurance to be reimbursed at the coverage level your plan allows. Which means you may be able to use your insurance, and reap all of the benefits of working with a higher level of care and attention than you may otherwise have been able to if you just went where the insurance, or your doctor sends you.
We’ve also cut out all unnecessary paperwork and never keep anyone waiting. We respect your time, and not waiting is one of the 2 main policies we have. The other is that we will never say “our policy is..” Every time I’ve ever heard those words, they were followed by an excuse as to why I can’t get satisfaction from that business. Instead, we have employed a CSC motto.. meaning Creative Service Care. That means where you may have heard “I’m sorry, there’s nothing I can do for you” from another business, you will hear, “let me see what I can do” and then we will move heaven and Earth to make you happy. […]
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May 25, 2021COMMON INJURIES IN BASEBALL AND HOW THEY OCCUR
Shoulder pain with baseball is an incredibly common occurrence. Whether it be in Little League through high school and beyond, young athletes have been pushing themselves until their body says “no more”. Despite the best efforts of athletes and their parents and coaches to prevent overuse injury through the use of pitch counts, specialist pitching mechanics coaches and training tools, it seems that to prevent injury is impossible.
There are a multitude of structures that can be involved in developing shoulder pain from pitching. I wanted to cover a very infrequently talked about structure – the biceps tendon. This was not a common injury until younger and younger athletes started to pick up weighted balls to increase their throwing velocity. The mistake I see over and over is people see this new tool (that does work), but don’t quite understand when NOT to use it. There may be coordination issues in the athlete or weaknesses elsewhere in the body that prevents them from using the tool correctly. If there is poor timing of the arm or lack of use of the lower body, the shoulder will recruit whatever it has at it’s disposal to accelerate the arm. That’s where the bicep gets involved. Fortunately, we see most of these biceps tendon problems early where the tendon is just inflamed. If left alone, that biceps tendon will continue to pull from it’s attachment leading to a more serious injury to the labrum- or cartilage of the shoulder socket!
Weighted balls are not the only thing that causes the biceps tendon to become painful. Another usual suspect is GIRD. Glenohumeral Internal Rotation Deficit occurs frequently in baseball players from the constant overstretch of the structures in the front of the shoulder in a position called “layback” causing a relative tightening in the back of the shoulder. It can also come from an athlete that doesn’t follow though with their throw and having to abruptly stop the arm causing too much load on those muscles in the back of the shoulder, eventually causing them to tighten. If GIRD develops, the tight back of the shoulder causes the shoulder to vault forward, putting stress on the biceps tendon.
GIRD not only affects the biceps tendon and labrum of the shoulder, it can also put the rotator cuff tendons in jeopardy, and can eventually lead to issues in the elbow as well.
TIPS ON HOW TO PREVENT BASEBALL INJURIES
Tip #1: Stop using the ALPHABET: The T, W, and M positions of the arm!
Straight abduction of the shoulder (T Position) and excessive upper trapezius involvement and abduction (W and M positions) cause a mechanical impingement of the shoulder which will undoubtedly damage your labrum and rotator cuff. You cannot throw from this vulnerable position of the arm.
Tip #2: Throwing Through the PAIN will CAUSE MORE PAIN AND INJURY
When your arm, shoulder, and elbow hurt before, during, or after your pitch, STOP THROWING you are injured. Many “sources” on the internet will tell you to keep throwing and promote throwing from greater distances (LONG TOSS). This is the wrong advice. If you have pain,you need to stop immediately. Focus on the fundamental movements to restore proper (pain free) throwing motions, then resume empty hand throwing until you can have high intensity “throws”. Then, we can put the ball back in your hand.
Tip #3: FIX YOUR MECHANICS: Shorten your arm path as to throw WITH gravity or “downhill”.
The quicker you take your hand out of the glove, the more the body needs to use muscles to hold it up. This immediate release causes a long arm path. A long arm path makes your arm “late” once the torso turns towards home plate. The means your arm will have to accelerate against gravity and not downhill with gravity. To decrease the stress of the component, you must throw with gravity assistance.
Tip #4: FIX YOUR MECHANICS: BE TALL,
Shoulders relaxed Stand tall on the mound. Take a deep breath and allow your shoulders to drop or depress. Tension in your upper traps will cause your shoulder blades to elevate rather than naturally depress.
Tip #5: EXERCISE: STRENGTHEN and COORDINATE your BUTT!
Strength and control (coordination) of your Posterior Kinetic Chain (Back Extensors, Glutes, and Hamstrings) are vital for balance, power, velocity, control, and command. Do these “Sit to Stands” to help your pitching. This is a simple exercise, but must be mastered to be able to perform more aggressive strengthening safely:
Tip #6: EXERCISE: GET CONTROL OF YOUR SHOULDER BLADES!
Scapular Retraction is a vital move, exercise, and technique that you have to master.
TIP #7: The hidden engine for throwing with velocity.
This is a mobility technique that engages the glute, and is vital in pitchers throwing with velocity. The proper firing of your glutes is the hidden key to driving the ball to home plate with maximum velocity.
Tip #8: Use Ice And Heat:
This may be the question we get the most. Do I use ice or heat?
Heat is best for loosening up stiff muscles and joints. A lot of people find it useful in the morning when they’re stiff and having trouble moving, or before a practice or game.
Ice is good after any aggravating activity, to manage excessive inflammation and soreness. The goal isn’t to stop the inflammatory process altogether, as it is essential to have inflammation as a chemical marker for your body to mend the area. If we are constantly icing, you can delay healing or make healing incomplete, making you vulnerable to further injury.
Tip #9: Consult an Expert FAST.
Do not wait to get your sore arm looked at. The fastest way to take care of your arm/shoulder/elbow is to see an EXPERT with a very long record of patient results for your arm/shoulder/elbow injuries. Research the provider and act fast once you find one you like.
HOW AND WHERE CAN I TREAT MY BASEBALL INJURY?
While the previous tips can’t replace getting with a skilled physical therapist expert in treating baseball injuries, they can be a nice place to start until you can be seen. And the best news is that there are easy assessments that can even be done through video conferencing, so you don’t have to be in the same part of the country to get the help you need. Whether you are local to our clinic or not, the best way to find out if we can help you would be to talk directly to a PT.
We’ve created a way that you can start with a 15 minute free phone call to see if we can help you and answer all of your questions that are concerning you about shoulder pain after pitching.
BOOK YOUR PHONE CONSULT HERE […]
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October 21, 2015If you live in the Inland Empire and you play softball, baseball, volleyball, waterpolo, or tennis,Shoulder-PAinthere is a good chance that you may have experienced shoulder pain or elbow pain or injury. The traditional method for managing these issues is the P.R.I.C.E. principle, which stands for Protection, Rest, Ice, Compression, Elevation, or using an over-the-counter pain reliever, or anti-inflammatory.
From my experience, athletes in Southern California tend not to heed that advice well. Rest is out of the question in the age of competitive club and travel ball, so the alternative is to tough it out or ice. Neither of those options are very good either. Inflammation is always thought of as a negative thing, but it is a natural process, and your body uses inflammatory chemicals as a marker for your cells to remodel the injured tissue. So ice slows cellular processes and can reduce acute swelling, but continued icing can delay or inhibit the tissue from healing completely, and turn a short-term problem into a chronic condition. Ignoring the pain and playing through it isn’t very wise as well. Pain is a sign that something is wrong, and ignoring the problem can make it worse. Your body will adapt, or compensate for the pain leading to abnormal stresses in other parts of the body.
So… What’s the best treatment for throwers and other overhead athletes? The clear answer in our practice is Cold LASER. Rather than slowing the cellular processes involved with healing, cold LASERs penetrate deep into the tissues, using photons to stimulate and energize the cells to be more efficient in healing the tissue. They normalize the nerve an make them less sensitive to sending off pain signals. Reduced pain and more rapid healing is the result, and over 80% of our clients FEEL a difference in under 5 minutes.
We have had success in our Rancho Cucamonga location working with throwers with Tommy John (UCL) tears and strains, rotator cuff strains and tears, glenoid labrum (cartilage) , injuries and many more.
Even if you’re not an athlete, and have pain in your shoulder or elbow you should come in for a screening and see what LASER can do for you. The treatment is inexpensive, and there are no side effects. For those looking to avoid surgery, injections or medication for their shoulder or elbow problems, LASER is a great alternative. […]
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