Tips for Preventing Shoulder Impingement

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Most of the activities you perform throughout the day involve the shoulder joint. This is exactly why the shoulder is highly susceptible to injury. However, not all shoulder injuries have similar symptoms. If you experience pain on the outer side of your shoulder during overhead activities, it could be a sign of shoulder impingement. Consider visiting a physiotherapy clinic for proper diagnosis and treatment.

You can get shoulder impingement from swimming, throwing, heavy lifting or any other activities involving overhead arm movements. But don’t worry! This medical condition is often avoidable with the right preventive measures taken at the right time. Here are some useful tips.

Do warm-up exercises

One way to prepare your shoulder to withstand the pressure of repetitive overhead activities is by doing some warm-up and stretching exercises before the activity.  This helps improve blood circulation in your shoulder muscles, so you can perform the activity more easily.

Lift your arms up above your head and stretch them upward as much as possible. Now stoop down with your arms stretched and stop where your upper body forms a 90 degree angle with your lower body. Now move your arms back and forth like a pendulum for at least two minutes. Take rest and repeat the same exercise for several times.

Avoid muscle imbalance

If you regularly do strength training or weight lifting, look for any imbalance in your shoulder muscles. For instance, the muscles in the back of your shoulder may not look as strong as the muscles in the front. Take help of your physical trainer to correct any such imbalances as it can cause shoulder impingement.

Watch out for poor posture

If you often need to work long hours on a computer, you should be extra careful about any bad posture. When you sit on a chair, try to keep your chest open and your shoulders stretched back.

 

What is Plantar Fasciopathy & how do I get better?

 

·       Are you suffering from a sharp and achy pain under the heel of the foot, often worse when walking barefoot?

·       Are you experiencing pain in prolonged standing, or difficulty walking/running long distances?

·       Pain that is worse in the morning when taking the first few steps out of bed or after a long period of rest?

You are likely experiencing Plantar Fasciopathy.

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The plantar fascia is a tough fibrous tissue that runs under your foot to serve as load distribution and maintaining stability when we are walking or running. The pain can be acute or chronic, meaning it can have come on suddenly or you may have been experiencing this for months. This can be a debilitating condition affecting up to 10-15% of the population in all ages, but is most commonly experienced in the female population aged 40-60 years.

Unfortunately plantar fasciopathy can last up to or greater than 6 months….although the good news is that approximately 90% of cases are treated successfully with conservative care and physiotherapeutic rehabilitation (which means using non-invasive techniques). Your physiotherapist can help guide you through your journey to optimise a safe return to your daily activities and return to sport.

Rest - As physiotherapists, when we talk about ‘rest’, we do not mean sitting down for a week as this can lead to a poorer outcome. What we actually mean is rest from the aggravating activity, for example, reducing your standing time or holding off running for 2 weeks. We always work closely with you to get back to your goals.

Ice – this is a quick and cost-effective way to help reduce acute pain. Evidence suggests ice is an effective treatment therapy for short-term pain relief.

Taping - taping assists with passive mechanical arch support and has been found to be effective in the short term. Evidence also suggests taping can be more effective in reducing pain when combined with stretching.

Soft Tissue Release - this can be performed by your physiotherapist and we can teach you techniques that you can perform at home using a trigger release ball. We often advise our clients to place a bottle of water in the freezer to help reduce pain with self-massage. No studies have proven its effectiveness; however, physiotherapists and patients have reported good clinical feedback.

Stretching – this treatment is evidence based, cost-free and can be done from the comfort of your own home. Short calf muscles have been shown to be a predisposing factor for getting pain in the first place, so it is important to address this issue. Evidence recommends a minimum of 3 times a day with at least 10 repetitions of each stretch, held for 10 to 30 seconds.

Strength Training - this is a longer-term preventative treatment strategy. Strengthening the structures around the foot and ankle will help support the joint and improve your functional movements.

Proprioceptive exercises – when suffering from a foot injury it is important to re-educate the body’s ability to balance, improve coordination and agility.

Addressing your Risk Factors - this is a really important one and can include obesity, standing for long periods on hard surfaces, poor foot biomechanics, poor shoe fitting, age and sex. It is not possible to address your age and sex, however you can make changes to your weight, your standing habits and foot biomechanics with appropriate training.

Berbrayer, D. and Fredericson, M. (2014). Update on Evidence-Based Treatments for Plantar Fasciopathy. PM&R, 6(2), pp.159-169.

3 More Mistakes that Can Worsen Your Back Pain

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A persistent back ache can severely affect your lifestyle. Although the best way to deal with your pain is by visiting a physiotherapy clinic, you should also avoid some common mistakes for the best results. Avoid the following mistakes to manage your pain better

1. Ignoring the pain far too long

Most of us tend to ignore pain till it becomes truly difficult to tolerate it. This is one of the biggest mistakes that can worsen the symptoms over time. The moment you experience back pain, the best thing to do is head to a physiotherapy clinic for a complete check-up. Your doctor will advise exercises and even massage therapies for treating the pain before it becomes adverse. A stitch in time can truly save nine!

2. Sitting long hours at work

Most of us are saddled with desk jobs. This means sitting for long periods of time. However, if a back pain is peeping round the corner, it is important to be mindful about your sitting hours. Count the number of hours you spend sitting at your desk. Plan intermittent breaks and walk around or stretch a bit before you get into the sitting position again. This will help in managing your back pain.

3. Going under the knife without knowing the risks

Unless your pain has been caused by an anatomical problem of specific nature like a herniated disc that is exerting pressure on a nerve or due to a degenerative disc disease, surgery is not the solution to your problems. Chronic back ache is better managed with the help of a long term therapy comprising of physical therapy and exercise.

A lingering back pain can also be a symptom of a more serious condition. So, make sure you consider a complete medical check-up for ruling out all complications and continue physical therapy as advised.

3 Mistakes that Can Make Your Back Pain Worse

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A chronic back pain is like an annoying guest who doesn’t wish to leave you any time soon. You really need to devise strategies for shooing it away, the faster you can. Of course, physiotherapy treatments prove to be extremely helpful. However, there are some common mistakes to avoid for a complete recovery or prevention. Here are a few of the common mistakes that worsen a back pain.

1. Not knowing the triggers

Not everyone with a back pain suffers the same symptoms. And the triggers could be distinctly different too. So, you need to understand the ones that worsen your condition. It could be your sleeping pose, any particular exercise, any food item or even any medicines you usually take for back pain. You need to identify your triggers and avoid them as much as possible.

2. Incorrect posture

Your physiotherapy specialist will advise you on the more desirable postures. Slouching is the most common mistake we all commit. Be it while standing or sitting, your back needs to be upright at all times. Even at work, you need an ergonomic chair with an upright back support, for complete comfort and rest. An additional support for your lower back might also helpful.

3. Skipping warm up due to lack of time

If you have no time for warm up, it is advisable to skip the actual workout as well. If you do not warm up, the muscles are not in proper condition to endure the exercise since the blood circulation within the muscles is not adequate. This undue stress put on the muscles can cause pain.

If you suffer lower back pain, you should handle it with utmost seriousness. Consider visiting a physiotherapy clinic and making the necessary lifestyle changes. It is important to be mindful about your condition and act accordingly.

 

Exercises for Back Pain

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Regular exercises provide excellent respite, especially from lower back pain. When performed correctly under the supervision of a physiotherapy clinic, the exercises help in mobilizing the spine and strengthening the muscles. We look at some simple yet effective stretches and exercises for effective management of back pain.

Bottom to heel stretching

Begin by kneeling on all fours. Place the knees under your hips and the hands under your shoulders. Elongate the neck and push your shoulders back. Now take your bottom towards the back without disturbing the natural spinal curve. Hold this position, take a deep breath and return to where you started. A set of eight to ten repetitions would be ideal for the right impact. Begin with mild stretches and intensify as your body flexes.

The classic half lunge

Keep your feet staggered and stand upright with your left leg in front. Bend the front knee to a right angle and lower the back knee by a few inches from the floor base. Now press the right hip forward and you will feel a stretch along the frontal hip. Hold this position for about 20 to 30 seconds. Change legs and perform a set of five for each.

Child’s Pose

This is a yogic posture that stretches your back and allows muscle relaxation.  Sit on the heels with your knees separated by hip distance. Exhale and bring your upper body down between the thighs. Elongate your hands forwards. You may even join your palms. Hold this position for 30 to 60 seconds.

Pilates and strength training are also excellent for managing back pain. However, it is important to understand that these exercises will result in some initial discomfort. It is always better to do them under the supervision of your physiotherapy clinic. The discomfort will fade away and you will certainly be able to realize the true benefits soon enough.

How to Sleep with Lower Back Pain

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Most people suffer lower back pain at some point in their life. Often, the pain goes away naturally after a few days. Physiotherapy treatment can help you heal even faster. However, so long as the pain persists, it usually makes sleeping at night difficult for you.

When you have lower back pain, consider sleeping with your back aligned in a comfortable position. The right sleeping position for lower back pain varies from person to person, but the following three positions work best for most patients.

1. Sleeping on your side

If sleeping on your back hurts, try sleeping on either your left or right side. Also, consider placing a pillow between your knees for a comfortable alignment of your spine. If the gap between your waist and the mattress is quite wide, you can even put a small pillow under your waist.

When sleeping on your side, ideally you should avoid the fetal position. However, depending on how the position feels, you may be advised to sleep with your knees pulled towards the chest. For instance, patients with a herniated disk find the fetal position more comfortable for sleeping.

2. Sleeping on your back

Depending on the location of your lower back pain, sleeping on your back with a pillow placed under your knees could be more comfortable for you. You may also want to add a rolled up towel under your back to support the natural curvature of your spine.

3. Sleeping on your stomach

In some cases of back pain, sleeping on the stomach could be helpful. If you choose to sleep in this position, consider placing a small pillow under your lower abdomen area. This will help take the pressure off your spine. If required, you may even want to avoid using a pillow under your head for better alignment.

How is Stress-induced Back Pain Diagnosed and Treated?

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Stress, which most of us are forced to deal with in some form or the other, manifests itself through a myriad of physical and psychological symptoms. Often, mounting stress may result in unexplained irritability, fuzzy thinking, forgetfulness, and so on. Among physical symptoms, aches and pains could be most common. When we are anxious or stressed out, the muscles in our body lose the ability to relax and remain tensed for a long time. This results in chronic aches. Although physiotherapy can help improve the condition, stress-induced pain needs to be diagnosed and treated the right way.

Symptoms for diagnosis

How do you know if your pain has been induced by stress? Well, when you are stressed, the body is likely to experience muscle aches that are diffused in nature. Back pain would most often be accompanied by neck and shoulder pain as well. There could be tender points in your muscles. Patients also experience sleep disturbances and chronic fatigue. Patients may feel that the pain is “moving around” or shifting from one place to another.

Treatment specifications

The treatment for stress-induced back pain usually requires taking a holistic approach. Muscle relaxants and pain killers have to be taken for managing the physical symptoms. Physiotherapy sessions are often recommended for sustained pain relief. In addition, anti depressants can be prescribed for stress relief and mood alleviation. Regular exercises, yoga and meditation should also be advised for calming the mind.

Often times, counseling techniques can also go a long way in helping to manage stress induced pains and aches. Counselors help the patient deal with their inner fears and insecurities that are causing stress and leading to manifestations, such as muscle pain and back pain. Once the root cause responsible for triggering the stress is identified and dealt with, the manifestations can also be managed better.

When to See a Doctor for Your Back Pain

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Back pains can be benign or a sign of something more serious. Often times, we tend to treat a persistent back pain with home based remedies like local application of muscle relaxants, hot fomentation and so on. What if the problem continues and gets worse by the day? When is the right time to reach out to a doctor or a physiotherapy clinic? Here are some red flags or warning symptoms that you need to make the move.

Fever that accompanies the pain

According to doctors, fever along with the regular back pain could mean a serious infection. At times, the fever may have been caused due to an entirely different nature of viral attack and the back pain could be an allied symptom for the same. Doctors will evaluate your condition and prescribe antibiotics in case a spine related infection is detected. In the absence of such a cause, anti inflammatory drugs and plenty of rest would be prescribed.

A pins and needles sensation   

If your back pain is accompanied by a tingling sensation in and around the lower back region, it could well be much more than muscle tension. A tingling feeling is often associated with nerve irritation which might be caused due to spinal stenosis or a set of herniated discs that might be putting unnecessary pressure on the nerves. In such cases, your doctor might advise you to visit a physiotherapy clinic for quick relief.

Emergency signs and symptoms

Often times, a dull ache in the lower back accompanied by symptoms like dizziness, vomiting, nausea, confusion, chills, sweating and so on signal emergency health conditions that could be serious in nature. These should never be ignored and medical help should be sought immediately.

Any persistent problem experienced by the body should be dealt with utmost seriousness. It is always better to be safe than sorry.

Causes and Symptoms of Piriformis Syndrome

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The piriformis syndrome is a relatively uncommon neuromuscular disorder that occurs when the piriformis muscle puts pressure on the sciatic nerve. This muscle is band-like in shape and is located at the top of the hip joint, around the buttocks. The sciatic nerve is thick in structure and passes through the piriformis muscle and eventually branches into smaller nerves which run right up to the feet. Compression of this nerve can occur as a result of spasms in the piriformis muscle. The best way to alleviate the pain is by visiting a physiotherapy clinic.

Causes and Symptoms

In most cases, the condition is characterized with a pain or a numbness and tingling sensation in the buttocks. The pain can be extensive and severe and can run along the sciatic nerve, much like sciatica pain. Any posture that causes further compression to the sciatic nerve can aggravate the pain. So, it can be triggered by sitting in the car, while running, climbing stairs, applying pressure on the piriformis muscles, being seated for long duration and so on.

However, it is important to remember that most cases of sciatica pain are not causes by the piriformis syndrome. Irrespective of the cause of sciatic nerve compression however, a physiotherapy clinic is certainly the place to head to for some quick relief. A trained physiotherapist can help in relaxing the nerve and hence reducing the pain.

How is it diagnosed?

Typically, there is no specific diagnosis for piriformis syndrome.  There are no tests. Sometimes, an MRI may be performed for ruling out any allied causes for nerve compression. Doctors perform a physical examination and check the symptoms shared by patients for arriving at a conclusive diagnosis.

Apart from physiotherapy, pain killers might also be advised for acute pains. Steroids may also be prescribed in certain cases.