Shoulder Impingement

Shoulder impingement is a common condition that occurs when there is a compression of the rotator cuff tendons and bursa (a fluid-filled sac) between the acromion (a bony prominence on the shoulder blade) and the head of the humerus (upper arm bone). It is also known as subacromial impingement. This condition can occur in both athletes and non-athletes, and is more common in individuals over the age of 40. Subacromial impingement is a common condition caused by compression of the rotator cuff tendons and bursa between the acromion and the head of the humerus. It is often accompanied by rotator cuff tendinitis, which is inflammation of the rotator cuff tendons. If left untreated, it can lead to partial or full thickness rotator cuff tears. Treatment options include physical therapy, corticosteroid injections, and surgery. Early diagnosis and treatment can prevent progression and reduce risk of tears.

Anatomy

Shoulder impingement, also known as subacromial impingement, is a condition that occurs when there is compression of the rotator cuff tendons and the bursa between the acromion and the head of the humerus. The rotator cuff is a group of four muscles and tendons that attach the humerus to the scapula, and acromion is a bony prominence that forms the roof of the shoulder joint. Impingement occurs when the space between the acromion and the head of the humerus becomes narrowed, causing the tendons and bursa to be compressed against the acromion. Common causes of impingement include anatomic variations of the acromion, degeneration of the rotator cuff tendons, overuse and trauma. Factors such as obesity, smoking, and diabetes can also contribute to the development of impingement, resulting in pain and weakness in the shoulder.

Diagnosis

Shoulder impingement is diagnosed through a combination of a physical examination, patient history, and imaging studies. The orthopedic surgeon will assess range of motion, strength, and pain in the affected shoulder, and perform specific tests such as the Neer test or Hawkins-Kennedy test. Imaging studies like X-ray or MRI can reveal degenerative changes in the bones and inflammation or tears in the rotator cuff tendons. A diagnosis of impingement is typically made when the patient has pain and weakness in the shoulder, and the physical examination and imaging studies reveal evidence of impingement. In some cases, a diagnostic injection may be done to confirm the diagnosis and to help to determine the best course of treatment.

Treatment

Shoulder impingement treatment usually begins with conservative measures such as rest, ice, and physical therapy. Medication and corticosteroid injections may also be used to reduce pain and inflammation. In more severe cases, or cases that don’t respond to conservative treatment, surgery such as subacromial decompression may be necessary. This involves removing a small portion of the acromion to create more space for the rotator cuff tendons and bursa. Physical therapy and exercises are essential for recovery after surgery. The treatment of shoulder impingement depends on the underlying cause of the condition and the severity of the symptoms.

Exercises

  • Pendulum exercises: This exercise helps to gently move the shoulder and improve range of motion. Stand with your good arm leaning on a table or wall for support, and let the affected arm hang down. Use your body weight to gently move the arm in small circles.
  • Isometric rotator cuff exercises: These exercises involve contracting the rotator cuff muscles without moving the arm. An example is the “empty can” exercise, which involves holding a light weight with the arm at a 90-degree angle to the body and squeezing the shoulder blade towards the spine.
  • Scapular stabilization exercises: These exercises help to strengthen the muscles that support the shoulder blade, such as the serratus anterior and the trapezius. An example is the “wall slide” exercise, which involves sliding the back against a wall while keeping the arms and elbows in contact with the wall.
  • Theraband exercises: This exercise helps to improve the strength of the rotator cuff muscles, such as the supraspinatus and the infraspinatus. An example is the “external rotation” exercise, which involves holding the theraband in one hand and turning the arm outwards against the resistance of the band.
  • Strengthening exercises: To improve shoulder strength, it’s recommended to do exercises such as shoulder press, lat pulldown, and rows. These exercises can be performed with free weights or resistance bands.

It’s important to note that exercises should be performed under the guidance of a physical therapist or other healthcare professional, to ensure that they are performed correctly and to avoid further injury.

Prevention

  • Maintain good posture: Keeping your shoulders back and down will help to reduce the stress on your rotator cuff tendons and decrease the risk of impingement.
  • Strengthen the rotator cuff muscles: Performing exercises that target these muscles can help to improve their strength and stability, which in turn can help to prevent impingement.
  • Avoid repetitive overhead motions: Repetitive motions like throwing a ball or lifting weights over your head can put stress on the rotator cuff tendons and increase the risk of impingement.
  • Take breaks when doing repetitive tasks: If you do a lot of overhead work or other repetitive tasks, take regular breaks to give your shoulders a rest.
  • Use proper technique when lifting: Using proper form when lifting can help to reduce the stress on your shoulder and decrease the risk of impingement.
  • Maintain a healthy weight: Being overweight can put extra stress on your shoulders and increase the risk of impingement.
  • Avoid smoking: Smoking is associated with increased risk of impingement due to the decreased blood flow and oxygenation in the shoulder.
  • Control chronic conditions: If you have a chronic condition such as diabetes, it’s important to control it to avoid the risk of impingement.
  • Wear the right equipment: If you play sports or engage in other activities that put your shoulders at risk, wear the appropriate protective gear to help prevent injury.
  • Listen to your body: if you experience pain or discomfort in your shoulder, it’s important to seek medical attention, rest the shoulder and avoid activities that exacerbate the pain.

If you want to know more about correct technique or would like professional advice from one of our personal trainers then please get in touch. Furthermore, if you are including shoulder exercsises into your regime and they are causing you some aches and pains, then we can help there too with our specialist sports massage service. For more information on how these types of massage could help you, contact us on 07939 212 739 or drop us an email at info@livewellhealth.co.uk

Raynaud’s Disease

Raynaud’s disease causes areas of the body, such as the fingers and toes, to feel numb and cold in response to cold temperatures or stress. It causes the smaller arteries that supply blood to the skin to narrow, limiting blood flow to affected areas, called vasospasm. There are two main types of Raynaud’s: Primary (or Raynaud’s disease), where the cause is unknown, and Secondary (Raynaud’s phenomenon) (less common), that occurs from an underlying disease, condition, medication, or lifestyle factors. Although there is no cure for Raynaud’s that occurs on its own, it can be controlled through treatment, that varies depending on the severity of symptoms. Lifestyle changes may be enough to manage the condition, however in more severe cases, medication and a sympathectomy may be recommended if other treatment have not worked.

Anatomy (what happens during an attack?)

Raynaud’s syndrome is an exaggerated version of a normal body process called vasomotor response, where the blood vessels open (vasodilation) and tighten (vasoconstriction) to help the body respond to its environment (such as cold weather or stress). Raynaud’s disrupts this process, causing the blood vessels to constrict greater than normal. This interrupts your normal blood flow and limits the oxygen available to your fingers or toes, and in rare cases can affect the nose or ears, in which symptoms typically last for around 15 minutes.

Symptoms

Symptoms of Raynaud’s are episodic (∼ 15 minutes). The symptoms can vary depending on the type of Raynaud’s (primary or secondary), which are usually milder for primary, as secondary is typically more severe, including skin ulcers.

  • Cold fingers or toes
  • Areas of the skin that may turn white to blue to red
  • Cold and numb, prickly feeling or stinging pain of skin
  • Skin ulcers and gangrene (only for secondary Raynaud’s)

Causes

The causes of Raynaud’s is still not fully understood, but cold temperatures are the most likely cause of an attack. For primary Raynaud’s the cause is unknown but is most common for females between the ages of 15-30 years, and those with a family history of primary Raynaud’s. For secondary Raynaud’s, an underlying disease or condition, such as lupus, scleroderma, can cause Raynaud’s, however, can also affect those with jobs, that require repetitive pressure on hands, such as keyboard operators, or those repetitively using hand tools such as chain saws. Certain medication can also increase the risk of developing secondary Raynaud’s such as beta-blockers and chemotherapy.

Diagnosis

Raynaud’s is usually easy to diagnose, however it is more difficult to differentiate between primary and secondary, where diagnostic tests may be required. Symptoms are the most common way to diagnose Raynaud’s, where you may be asked to take photos of your skin changing. A physical exam and diagnostic tests may then be performed to identify or rule out underlying condition as causes, some examples being nailfold capillaroscopy (to check for connective tissues disease), antinuclear antibody (to check for autoimmune disease), or complete blood count (to check for a range of conditions).

Treatment

Treatment often depends upon the severity of symptoms; however, lifestyle changes can be enough to manage the condition such as avoiding caffeine, cold spaces, touching cold objects, managing stress and strong emotions that triggers the attack, and wearing warmer clothes during cold weather. However, medication may be advised, to relax and open the smaller blood vessels (calcium-channel blockers), or a cream to apply to your fingers to heal any skin ulcers (Nitroglycerin skin ointment). In more severe instances, if the treatment methods are not working, a procedure called sympathectomy may be recommended, which temporarily blocks or cuts small nerves near the affected blood vessels, that prevents the blood vessels getting too narrow. This procedure should relive symptoms between 1-2 years.

 

Is bad posture the cause of your back pain?

Is bad posture the cause of your back pain?

Poor posture can be a contributing factor to back pain in some cases.

Maintaining good posture is essential because it helps distribute the body’s weight evenly and reduces the amount of stress on the spine. Poor posture, such as slouching or sitting in a hunched position, can put extra pressure on the muscles, ligaments, and discs in the back, leading to pain and discomfort.

Other factors such as injury, underlying medical conditions, and lifestyle habits can also contribute to back pain. It’s important to speak with a healthcare professional to determine the underlying cause of your back pain and develop a plan for treatment and prevention.

Is bad posture the cause of your back pain

Exercises that can help with back pain

Several exercises can help with back pain, but you must consult a healthcare professional or a qualified physical therapist before starting any exercise program to ensure that you perform the exercises correctly and are safe for your specific condition. Here are some exercises that may be helpful for back pain:

  1. Cat-cow stretch: Get on your hands and knees and alternate between arching your back up towards the ceiling (the “cat” position) and rounding your spine downwards (the “cow” position). This can help stretch and mobilize the spine.
  2. Pelvic tilt: Lie on your back with your knees bent and feet flat on the floor. Tighten your abdominal muscles and press your lower back into the floor. Hold for a few seconds, and then release. This exercise can help strengthen the abdominal muscles and stabilize the lower back.
  3. Bird dog: Start on your hands and knees and extend your right arm forward and your left leg back at the same time. Hold for a few seconds, and then return to the starting position. Repeat on the other side. This exercise can help strengthen the core and improve balance.
  4. Wall sits: Stand with your back against a wall and slide down until your knees are bent at a 90-degree angle. Hold for a few seconds, and then slowly stand up. This exercise can help strengthen the muscles in the lower back and legs.
  5. Bridge: Lie on your back with your knees bent and feet flat on the floor. Lift your hips towards the ceiling and hold for a few seconds before slowly lowering back down. This exercise can help strengthen the glutes and hamstrings, supporting the lower back.

Remember to start slowly and gradually increase the intensity and duration of your exercises as your back pain improves. More stretches & exercises can also be found on our Back Stretches and Exercsises page.

If you want to know more about the correct techniques or would like professional advice from one of our personal trainers then please get in touch. . For more information on how these types of techniques could help you, contact us on 07939 212 739 or drop us an email at info@livewellhealth.co.uk