All Posts Tagged: physical therapy

Rotator Cuff

Rotator Cuff Tear Recovery Tips

Rotator cuff injuries are very common, especially for those who use their arm in a repetitive motion, those who do heavy lifting, and those who are over 40.  To properly recover from this injury and avoid surgery, you must listen to your Physical Therapist and follow the plan of care that has been customized for you so that you can heal.  It is important to strengthen and increase the flexibility of the muscles surrounding the shoulder. It is equally important to rest and use ice to keep these muscles receptive to the therapy.

Your Rotator Cuff Muscles

Understanding about this injury will enable you to understand and accept the treatment plan that will be put into place so that you can heal.

Your shoulder is made up of three bones:  your upper arm bone, your shoulder blade, and your collarbone.  The shoulder is a ball-and-socket joint. The ball of your upper arm fits into the socket of your shoulder blade.  Your arm is kept in this socket by your rotator cuff. The rotator cuff consists of four muscles and their tendons that stabilize the shoulder. These are the muscles that allow you to rotate your shoulder.  Your shoulders allow you to do many things that are taken for granted:  lifting your arms above your head, combing your hair, playing catch, reaching into the back seat of your car, and swimming…just to name a few.  There is also a sac called a bursa that allows your arm to move freely. When the rotator cuff is injured or damaged, the bursa becomes inflamed and painful which will be diagnosed as bursitis.  “Itis” means inflammation.

A ‘torn’ rotator cuff means you have torn though one or more of the four muscles or tendons.  Typical signs for this kind of injury would be pain. Any shoulder pain should never be ignored.  When diagnosed with a rotator cuff injury, a tear is not always the case. You might have strained the muscle or tendon.  If you do not get therapy for the strain, it could lead to a tear. Torn rotator cuffs have swelling and loss of full range of motion.  If you cannot raise your arm half as far as you used to before the pain started, there is something seriously wrong.

Remember This

Physical Therapy improves strength, flexibility, and range of motion.  Therapy will help alleviate the pain, and your therapist will work with you using light weights, but you must continue your plan of care to achieve optimal results to be pain and surgery free.  Your therapist will give you all the tools to work at home safely so you do not hurt yourself. It is important to remember that this is not a ‘workout’ but a strengthening process. Keeping your shoulder immobilized (without movement) for prolonged periods of time can lead to the thickening and tightening of the the connective tissue causing further complications (frozen shoulder).  It is important to not only strengthen and exercise the front muscles, but you must work the entire shoulder area, front and back, to get and keep your muscles balanced. It is imperative that stretching and strengthening is done every day at home and not only when you are at the therapy office so that you can gain your range of motion back.

Some key factors to remember while you are working to heal your shoulder injury:

  • Consult your therapist to use the correct weight
  • Always use light weights
  • Use the warm up routine provided by your therapist before each session
  • Remember this is therapy and not a workout
  • Patience is needed as you undergo healing
  • Consult with your therapist if you wish to use resistance bands
  • Resistance bands come in different degrees, and  you want to be sure you are not overdoing it
  • Ice your shoulder after every therapy session and make sure to get adequate rest
  • You are still able to do lower body exercises, but you must make sure your shoulders are not involved at all
  • A rotator cuff injury is serious, but it is not one that cannot heal with proper therapy and patience  
  • Slow and steady always wins the race!
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Rotator Cuff

Recovering from Rotator Cuff Injuries

A rotator cuff tear is a common cause of pain and disability among adults. Over 2 million people a year report rotator cuff injuries. This injury most often occurs in people who repeatedly perform overhead motions, progressive degeneration, wear and tear of the tendon tissue, family history (a common occurrence in some families), and heavy lifting over an extended period of time.  Rotator cuff injuries have the risk of increasing with age. Many people recover from rotator cuff injuries with Physical Therapy exercises that increase the strength of the muscles surrounding the shoulder joint and to improve flexibility. There are occasions that the rotator cuff tear can result from a single injury. This should be addressed immediately. Extensive tears may require surgery, but with early intervention and strengthening the muscles with therapy, you have a great chance of avoiding surgery.  The two types of rotator cuff injuries are acute tears that result when you fall on your outstretched arm or lift something too heavy and/or degenerative tears that result as a wearing down of the tendon. Degenerative tears usually occur in your dominant arm, and there is a likelihood of this injury being in your opposite shoulder even if you don’t experience pain.

Prevention is key to any injury, but daily shoulder stretches and strengthening exercises can help prevent future injury of the rotator cuff.  The issue with preventative care is that people tend to resort to their exercises when they are in pain. It is imperative that stretching and strengthening is done every day at home and not only when you are at the therapy office.  Physical Therapy will help alleviate the pain, and your therapist will work with a variety of modalities while you are in the office, but you must continue your plan of care to achieve optimal results and be pain and surgery free. Keeping your shoulder immobilized (without movement) for prolonged periods of time can lead to the thickening and tightening of the the connective tissue causing further complications (frozen shoulder).  It is important to not only strengthen and exercise the front muscles, but you must work the entire shoulder area, front and back, to get and keep your muscles balanced.

 

Anatomy Of An Injury

Your shoulder is made up of three bones:  your upper arm bone, your shoulder blade, and your collarbone.  The shoulder is a ball-and-socket joint. The ball of your upper arm fits into the socket of your shoulder blade.  Your arm is kept in this socket by your rotator cuff. The rotator cuff consists of four muscles and their tendons that stabilize the shoulder.   Your shoulders allow you to do many things that are taken for granted: lifting your arms above your head, combing your hair, playing catch, swimming… just to name a few.  There is also a sac called a bursa that allows your arm to move freely. When the rotator cuff is injured or damaged, the bursa becomes inflamed and painful.

Symptoms of a rotator cuff injury are as follows:

  • Increased pain when you move your shoulder away from your body
  • Pain that spreads down your arm and even into your elbow
  • Difficulty lifting your arm above your shoulder
  • Difficulty holding your arm up for extended periods of time
  • Pain when performing simple tasks such as combing your hair
  • A clicking or crackling sensation when moving the shoulder
  • Increased pain and stiffness with tenderness in the inflamed area of the shoulder
  • Disturbed sleep, especially if you lie on the affected side
  • Arm weakness

 

Non-Surgical Options

Physical Therapy improves strength, flexibility, and function.  Therapy will help alleviate some of the pain, and your therapist will work with you with a variety of modalities while you are in the office, but you must continue your plan of care to achieve optimal results and be pain and surgery free.  Keeping your shoulder immobilized (without movement) for prolonged periods of time can lead to the thickening and tightening of the the connective tissue causing further complications (frozen shoulder). It is important to not only strengthen and exercise the front muscles, but you must work the entire shoulder area, front and back, to get and keep your muscles balanced.  It is imperative that stretching and strengthening is done every day at home and not only when you are at the therapy office.

Rest and ice help decrease pain and inflammation and give the torn tendons time to heal.

Nonsteroidal anti-inflammatory medications to decrease inflammation and pain.

 

Flexibility Exercises

  • Doorway stretch – Grip the sides of the doorway with each hand at or below shoulder height and lean forward through the doorway until you feel a light stretch.  Keep a straight back and shift your weight onto your toes, but do not overstretch. This is a light stretch. Do this 10-20 times.
  • Side lying external rotation – Lie on the side opposite your injured arm with knees bent and injured arm across your abdomen at a 90 degree angle.  Keep your elbow touching your side, and with a light dumbbell, slowly raise the dumbbell toward the ceiling. Stop rotating your arm when you feel the strain.  Repeat 3 sets of 10. When this becomes easy, increase to 20 reps.
  • Reverse flys – Stand with your feet shoulder width apart and your knees slightly bent.  Keep your back straight and bend forward slightly at the waist. With a light weight in each hand, extend your arms away from your body.  Squeeze your shoulder blades together. Do not raise your arms above shoulder height. Repeat 3 sets of 10.
  • Lawn mower pulls – Stand with your feet shoulder width apart.  Place one end of a resistance band under the foot opposite your injured arm.  Keeping your other hand on your hip and without locking your knees, bend slighting at the waist.  As if starting a lawn mower, straighten upright while pulling your elbow across your body. Keep shoulders relaxed and squeeze blades together.  Repeat 3 sets of 10.
  • STOP any of the exercises if they are causing you pain

Therapy Goals

  • Manage your pain
  • Increase mobility
  • Strengthen and improve flexibility

Also keep in mind that healing properly from a rotator cuff injury can take a very long time. Be patient and stay committed to your physical therapist’s advice on how to care for your injury.

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Top Ten Exercises to Help You Regain Balance and Reduce Your Risk of Falling

From the time we learn to take our first steps, we also begin to learn what it feels like to fall. Likewise, we learn to hold onto things like the edge of a table or our parents’ fingers to avoid falling. This natural avoidance to losing our balance is an important thing to have. According to the Center for Disease Control, one out of five falls will result in a serious injury such as a broken bone or a brain injury. Falls are not to be taken lightly!

On the other hand, we cannot stop our everyday pursuits because we dread of experiencing a fall. Being cautious and preventing certain actions or regions that can make us prone to falling is sensible, but such as the CDC also notes, keeping active is one method of keeping us more powerful, which can also help us stop falling. Another manner to help us construct strength and combat the possibility of falling is by exercising frequently. These ten exercises, even when performed under the oversight of your physical therapist, can help you recover your balance and decrease your danger of falling.

  1. Simple Leg Lift – For this work out, begin with a kitchen chair setting before you. Secure yourself by holding onto the back of the chair, and raise one foot off the ground by twisting your knee and bringing it up toward your midsection. (It is best that you let go of the chair back so that you are balancing on your own without help, yet in the event that you’re uncertain or insecure, keep your hand on the chair.) Hold this position for 5-10 seconds; then take a stab at shutting your eyes and holding the position for 5-10 seconds. Then switch to the other leg and do the same exercise.
  2. Weight Shifts – Another practice to start with is a Weight Shift. Stand with your feet hip-width apart. With your hands down at your sides, or on your hips, lift one foot an inch or two off the floor and hold it there for 20-30 seconds. Put it down and repeat with the other foot. Do this the most number of times as you believe you can without getting too tired. As time passes by, the objective is to slowly increase the number of reps you do. If necessary, you can use a chair with this practice to help give you increased balance.
  3. One-Legged Clock – Standing on one foot, expand your arms straight above your head, as if you are flagging 12 o’clock on a clock face. Leaving your right hand on the “12,” move your left hand to the three, six, and nine o’clock positions (stopping at every position). Return your left hand to the 12, and repeat the steps with your right hand. Presently, switch feet and repeat. To challenge yourself further, do it with your eyes shut.
  4. Tai Chi – Whether you attend a class, or follow online recordings, Tai Chi has been demonstrated to enhance balance.
  5. Yoga – Like with Tai Chi, yoga has additionally been indicated to enhance the balance of those who practice it. Once more, you can choose to take a class or follow an online course or DVD.
  6. Heel-to-Toe Walk – This practice is basic, yet compelling. Walk 20 paces forward, heel-to-toe. If necessary, do this inside arm’s scope of a wall to help you with keeping your balance. After you go ahead 20 paces, go backward 20 paces — toe-to-heel. Doing this all the time can help you recover a feeling of balance.
  7. Squats – To complete a squat, stand with your feet hip-width apart. Bowing at the knee, and not the midsection, crouch toward the floor, holding your arms straight out before you. Imagine you are sitting in an invisible chair. If necessary, keep a chair before you to help you get up and down. This exercise will help strengthen your leg muscles, which is vital for the anticipation of falls. An alternative way to squat: begin with your back and heels against a wall. Keeping your arms out before you, twist at the knee and slide down the wall to a seated like position (once more, imagine you are sitting in an invisible chair). Utilizing your legs, propel yourself back to a standing position. Having a wall behind you can be a major help when you’re beginning or if you require extra help with balance.
  8. Back Leg Raises – You can hang on to a kitchen chair while doing these leg raises, or you can put your hands on a wall, whichever is most agreeable for you. Once you have chosen your preference, you will stand on one leg while raising the other one behind you. Attempt not to lean forward or twist the knee of the leg you’re raising; simply lift your leg as far away the ground as is comfortable for you, hold it for two or three seconds, and let it back down. Do this for 10 reps, then do the same thing with the inverse leg! This helps to build back muscles and buttock muscles.
  9. Side Leg Raises – Like with the Back Leg Raises, you can utilize a divider or a chair to unfaltering yourself with. Then, standing on one foot, lift your other foot out to the side. Go as high as you are OK with, hold it for a few seconds, and let it back down. Once more, do this for 10 reps, then repeat with the other leg. This practice helps strengthen your buttocks, as well as helps with your thigh muscles and your hip muscles.
  10. Stability Ball – This ball may resemble a curiously large inflatable ball, yet it’s definitely not. Simply learning to sit on a steadiness ball can help enhance your balance. Subsequent to getting the hang of sitting on it, you can then use it in different exercises. You can sit on it while using dumbbells or you can utilize it while doing sit-ups. It’s an extremely flexible tool to help enhance balance and stability.

Even though these exercises might be a good beginning point to help you enhance your balance and decrease your danger of falling, your physical therapist may have additional exercises or variants that they may tailor specifically for you.

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Is Your Balance Setting You Up for an Injury?

It is what truly gives us the capability to walk on two legs and remains with us our whole life, balance. Our balance and vestibular system develop as we grow from an infant all through maturity. The majority of individuals don’t understand their balance isn’t ideal until they endure a sports injury, a fall, or lose their balance while showering. Regardless of your age, balance impacts your capability to be active.

CAN YOU TRULY DO THIS?

• Stand next to a counter or sink shoeless with your hand on the counter surface
• Put one foot in front of the other, with your rear foot’s toes touching the heel of the other foot
• Tenderly lift your hand up, yet keep it close to the counter on the off chance that you require to get it rapidly. Attempt to hold this for 10 seconds (just do this if you feel safe or have somebody close-by for support)
• Now try it with your eyes closed
• Do you wobble a bunch or even lose your balance? Your balance needs work!

THERE ARE NUMEROUS EXPLANATIONS BEHIND OUR DECREASE IN BALANCE:

• Changes in our vestibular framework
• Changes in bulk, adaptability and quality
• Changes in visual perception
• Decreasing reflexes
• Past injuries to lower leg, knee, hip or spinal joints

HOW BALANCE INFLUENCES SPORTS EXECUTION

The more active you are in sports, the better your balance and reflexes have to be. Numerous lower leg, knee, hip and back injuries in running, tennis and other sports are ascribed to ineffectively performing balance. By joining basic balance practices into your exercise schedule, you can set yourself up for progress and anticipate injuries, and also upgrade your sports performance.
HOW BALANCE INFLUENCES BACK PAIN

How you walk specifically impacts your back and can really be a major contributor to back pain. By enhancing balance, coordination and quality in your hips, pelvis and legs, your spine will be upheld and guided, lessening strain. This thus, helps your back work regularly without disturbance and aggravation. Balance exercises are an imperative segment of our SPINE Program for easing back issues.

ANTICIPATING FALLS

According to the Centers for Disease Control (CDC), more than 2.5 million grown-ups were dealt with for nonfatal injuries in crisis divisions in 2013. In more established grown-ups, falls are the driving reason for deadly and nonfatal injuries. A great many people don’t consider keeping their balance fit as a fiddle, until the point that it is too late and they fall, cracking an arm, leg or injuring their back. The uplifting news is that most falls can be prevented just by the normal practicing of your balance framework.
WHAT YOU CAN DO

You can enhance your balance, and it includes performing straightforward balance works out. Attempt this simple exercise to strengthen your balance:

CALF RAISE

• Stand facing a counter, gently touching it with your hands.
• Gradually raise-up and down on your toes.
• Repeat 10 times, rest, then complete 2-3 more sets.
• Try without holding on for a greater challenge.

The very initial step in preventing injury or fall is examining your balance and being truthful with yourself that your balance requires work. Our physical therapists are able to make a difference in enhancing your balance and vestibular system, enhancing your capability to be active, safely. Contact NJIB today to learn about our programs and the way you can get back to a lively, hassle free way of life!

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5 considerations before settling for back surgery

In our contemporary times, there is an overwhelming inclination towards quick fixes and fast outcomes. Irrespective of what it is, we always seem to want it fast. While getting fast outcomes is ideal in some situation and context, there are other situations in which fast could be dangerous.

Not taking our time when looking at our health, wellness and general well-being, is not necessarily a good idea. For instance, backaches which is one of the most common health issue plaguing many folks don’t start instantaneously or manifest out of the blue. It is gradual and evolves with time until it becomes a problem. Given this consideration, it is only expected that it will require a while to fix. Nonetheless, there are folks who assume that they can easily correct backaches with a surgery and get rid of the problem instantly.

While this seems like a great idea, it should be unequivocally stated that surgery is not the ideal decision when seeking relief from back pain.

Explore other alternatives

Mayo Clinic maintains that the majority of backaches will be alleviated during a period of 2 months. They make it abundantly clear that there are many other therapeutic and effective procedures that do not require cutting the body. While most people are oblivious to this fact, bodywork, workout, acupuncture, chiropractic methods and various bodily treatment are often more economical, less dangerous and often offer better results.

Recuperating could take forever

Interestingly, it would surprise you to know that back surgeries require much longer to heal. Therefore, it becomes clear that surgery does not offer an instant solution. It is estimated that a small procedure would take two months for recuperation and big procedure could require 4 months for full recuperation.

Based on the nature of the surgery, some folks will require assistance to perform some of the most basic and essential activities like laying down to sleep or visiting the lavatory. More so, you will have to shoulder the responsibility of catering to the surgical cut. There is a high chance that you will be placed on medications that stop you from any potentially dangerous activity, like handling a machinery or driving. It is quite common that you will be inactive for a long time.

Pain back surgery will not tackle the root of your backaches

The problem is that surgery will not tackle the underlying reason for your backache. Sometimes back aches have its roots in strenuous activities, reduction in thigh muscle vigor and strength, use of heavy machinery, muscular problems and so on. Therefore, surgery may only provide a palliative as the lifestyle factor that causes the condition will cause it to reoccur if left unattended.

Every surgery poses a threat

While every medical cautionary measure will be taken to ensure a safe surgery, it should be noted that there is still a possibility of a surgery going sour. While efforts can be made to lower the chances significantly, the possibility still exists and could be life-threatening.  The presence of an existing health problem could raise the dangers and exacerbate the situation. When you consider that there is an extensive range of possibilities when it comes to surgeries, it is only right that you undertake such procedures when it is inevitable.

You may still have persistent aches afterward

It is quite disheartening to engage in surgery without the full assurance that it will alleviate your aches. Sadly, this is the reality for many folks that opt for back surgery as there is no guarantee of relief.  Often times, a back surgery is just like stabbing in the dark.

When you take all of the following into consideration, you begin to realize that surgeries should be exclusively for life-threatening situations or severe cases with no foreseeable alternatives.

 

 

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What You Need to Know About Shoulder Pain

Though most of us take our shoulders for granted, they’re important parts of our bodies. From typing at our computer and driving to putting away groceries and going to bed at night, our shoulders are used for many daily tasks. However, they’re complex organic structures that can be subject to damage and pain. If a shoulder does begin to hurt, it can be difficult to think about anything else.

If you’re experiencing persistent pain in one of your shoulders, there are a number of potential causes, including bursitis, tendonitis, osteoarthritis, and a whole slew of dysfunctional diseases. But perhaps the most common reason people seek treatment for their shoulder is for rotator cuff tears, a problem that afflicts nearly 2 million Americans each year.

Your shoulder is composed of three bones linked together in a ball-andsocket joint, with everything supported by a collection of four muscles called the rotator cuff. The whole setup is remarkably complex, working perfectly — until it doesn’t. If any of the rotator cuff tendons become torn or frayed, the rotator cuff can no longer attach completely to the bones, leading to all kinds of dysfunction and severe, debilitating pain.

These tears usually occur from falling down on your outstretched arm, lifting something too heavy, or a gradual deterioration of the muscles. Symptoms almost always include severe pain, even when resting or sleeping, that spikes when lifting or lowering the arm. Some serious cases may cause general muscle weakness and an inability to lift the arm at all.

Luckily, if you have a rotator cuff injury, you don’t have to tolerate chronic pain. While some intense cases will require surgery to correct, it’s important to consult a physical therapist before going under the knife. Contact the experts at New Jersey Institute of Balance today and take the first step toward eliminating shoulder pain for good

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