The rotator cuff is a group of four muscles that coordinate movement and provide dynamic stability of the shoulder joint. These muscles are crucial for rock climbers who put extreme stresses through their shoulders, often in awkward positions that can cause bone structures to rub or impinge on the rotator cuff muscles. Because of this,...
Rotator cuff tears are commonly found in both painful and pain free individuals and often are found in equal prevalence between the involved and uninvolved sides of the same patient. Tears found on MRI can be secondary to trauma, including falls, or secondary to the aging process. Importantly, researchers have not found a significant correlation...
Patients often receive exercise handouts from physicians when initially presenting with musculoskeletal pain. The idea behind the handout makes sense on the surface, a low cost treatment option which may help a patient’s symptoms. Unfortunately, these handouts (often photocopied to death) lack specificity including providing the right handout to the right patient, as well as,...
Normal movement at the shoulder is distributed between motion at the shoulder (glenohumeral) joint and movement of the scapula. Although there is variability with how shoulders move, normal arm movement is made up of a ratio of glenohumeral joint movement to scapular movement that is between 2:1 and 2.4:1. A normal shoulder will move 180o...
Shoulder pain is a common occurrence affecting 2/3 of adults and is one of the top three reasons patients will seek care from a primary care physician or Physical Therapist. The most probable reason for shoulder pain remains rotator cuff pain including impingement, rotator cuff tendon pain, and rotator cuff tears. Research studies on MRI...
Physical Therapy strengthening exercises remain the first line treatment for patients with shoulder diagnoses including impingement and rotator cuff pain. While immediate gains in range of motion and pain can be found using spinal and extremity manual therapy interventions, long term outcomes are achieved through a focused strength training program. Exercises are prescribed to target...
Neck pain remains one of the constants in life along with death, taxes, and low back pain. Thankfully, similar to low back pain, the vast majority of neck pain (although painful) is not serious in nature. Prior research has shown a Physical Therapy treatment program consisting of manual therapy and exercise helps accelerate a patient’s...
Post operatively, I am normally concerned with two presentations in patients. Patient’s with significant post operative range of motion and those with minimal to no pain have the highest risk of tearing their repaired tissues due to the lack of protection from either stiffness or post operative pain. Patients may incorrectly assume the absence of...
Shoulder pain is one of the most common reasons patients seek the care of a primary care physician and Physical Therapist. Shoulder impingement or the compression of soft tissue structures, including the rotator cuff tendons, between the bones and ligaments of the shoulder remains the most common diagnosis behind these symptoms. Physical Therapy is the...
Rotator cuff tears are a common injury in middle to older aged adults. Tears can be gradual or degenerative in nature associated prior injury (tendinopathy) or acute and traumatic from a fall or sudden trauma to the shoulder. The severity of the injury including tear depth and size, as well as, the number of tears...