10 months after falling on an outstretched hand (FOOSH) his shoulder pain had become so severe and chronic, it required surgery to repair a piece of cartilage. He later found another, relatively rare problem with the other shoulder. [Read more…] about 16 y/o After Labral Repair
39 y/o Active Male with Frozen Shoulder
He reports that his pain started gradually, about nine months ago, getting worse over time until he had to start limiting his exercise and began having pain with dressing, grooming, and sleeping. He saw an orthopedist and underwent MRI which showed that he had fraying of his labrum and supraspinatus tendonosis. He was treated for frozen shoulder with subacromial and intra-articular injections, with gave him significant pain relief, but did not improve his ability to move. [Read more…] about 39 y/o Active Male with Frozen Shoulder
Don’t I Need an MRI?
Patients will hear me say over and over “MRI is really only for surgical planning. If you’re ready for surgery, then you need an MRI.” It doesn’t tell you “what’s wrong” or tell us if you need surgery or not. I ran into a research study today that demonstrates my point. [Read more…] about Don’t I Need an MRI?
Management of Stiff/Frozen Shoulder
Chronic or acute inflammation of the shoulder can result in stiffness of the shoulder capsule, severe pain, and occasionally severely limited motion. While treatment of a stiff/frozen shoulder can be very painful, it is generally not terribly complicated and improves in a reliable fashion. Physical therapy can also serve prepare the patient for consultation with an orthopedic surgeon, by restoring optimal shoulder flexibility, strength and function. Because normalized passive motion is a prerequisite to successful RTC repair, even patients with a diagnosed RTC will benefit from skilled physical therapy intervention. [Read more…] about Management of Stiff/Frozen Shoulder
Chasing “The Latest Thing”
I recently received a voicemail message from a former patient (whose son I had also treated) asking if I practice a specific proprietary, trademarked, and well-publicized technique. I responded via email, and then realized that this response could have been written a dozen or so times over my previous 17 years as a therapist, so I ought to just make a generic letter regarding all such techniques: [Read more…] about Chasing “The Latest Thing”
Mobilization Techniques in the Treatment of Frozen Shoulder
Frozen shoulder syndrome entails the progressive loss of both passive and active motion. It’s cause(s) (etiology) is not well understood, although significant risk factors include age, posture, diabetes, presence of neck pain, and sedentary work. In a frozen shoulder, the covering of the shoulder joint, called the joint capsule, becomes inflamed, very painful, and tightens up around the shoulder. An article was published in the October issue of Physical Therapy comparing mobilization techniques in the treatment of frozen shoulder. [Read more…] about Mobilization Techniques in the Treatment of Frozen Shoulder
The Role of Posture in Shoulder Impingement
Subacromial impingement (SAI – aka shoulder bursitis) like most other orthopedic problems is influenced a number of factors. Some are structural – like the presence of a “hook” acromion – while others are related to lifestyle and body mechanics. Specifically, sedentary individuals seem to suffer far more from SAI than those who are not sedentary. One of the reasons may be related to posture. [Read more…] about The Role of Posture in Shoulder Impingement