The Rotator Cuff
Four muscles in your shoulder, collectively termed the
"rotator cuff", provide stability to your shoulder. These
muscles are prone to tears and strains, especially if you overuse your
arm, have poor posture, or have muscle tightness and/or weakness.
How do you know if you have a rotator cuff
Injury may be sudden, i.e. the result of trauma, or come on more
slowly. Pain most often is located on the outside of your upper arm or
in your shoulder. Overhead reaching activities are commonly painful.
Why see a Physical Therapist?
Your physical therapist will perform an evaluation including the
identification of strength deficits, tightness, and poor posture.
After identifying factors that may be contributing to your symptoms,
we will then design a program to help alleviate the sources of the
Rotator Cuff Surgery
Rotator cuff surgical repair will differ with each individual.
Rehabilitation after surgery often includes extensive stretching
followed by the initiation of a strengthening program at the
appropriate time post surgery as indicated by your physician.
Modalities such as heat, ice, and ultrasound may be used to decrease
discomfort and facilitate recovery
If you have leg and/or foot pain, answer the following questions.
Do you stand on hard
Have you recently increased
your activity level (i.e. the amount of miles you run per week)?
Have you recently started
running or playing a court sport?
Do you have large calluses
on your feet?
Do you have a history of
any injuries to your legs? (they could be affecting you now in
Are the arches of your feet
If you have answered "yes" to any of the above questions,
you may have identified one or more causes of your leg or foot pain.
What can physical therapy do?
Our physical therapists will identify factors that may be
contributing to your pain. We will then design a program to alleviate
the sources of the problem. Your physical therapy program may include
treatments such as exercises to improve your strength and flexibility,
fitting for orthotics, thermal modalities such as heat and ice, joint
mobilization, and education to help you modify or eliminate
Can an ankle injury cause back pain?
Did you know that structural faults or muscular imbalances at the
ankle can effect other joints such as the knee, hip, or even your
back? Conversely, an injury to the back might effect the joints down
below. Your physical therapist will examine other symptomatic areas to
determine if one or more causes of your pain exist.
and postnatal back and neck pain
Why do you have back and neck pain in
Pregnancy is a natural physiological process that is accompanied by
factors that cause many changes in your body. Fluctuations in hormone
levels create laxity within the joints and muscles. The additional
weight of your baby causes a shift in your center of gravity. These
factors can lead to poor posture and may be associated with neck and
low back pain. In addition, poor pelvic alignment, a common result of
increased joint laxity with pregnancy, may result in low back pain.
Why see a physical therapist?
A physical therapist can provide instruction on safe and easy
exercises to help maintain good posture and an adequate level of
fitness. This includes strengthening of the abdominal and low back
muscles which assist in developing correct postures. Heat, ice, and
massage may be used to help decrease aggravating symptoms. Pelvic
floor exercises are taught to help you maintain and improve your
muscle tone in order to prevent the common occurrence of stress
Varicose veins sometimes occur with pregnancy. Your physical
therapist is trained to fit you for support stockings to help minimize
(temporomandibular joint) dysfunction
What is the TMJ?
The TMJ is the joint where your jaw bone meets your skull in front
of your ears.
What causes TMJ pain?
Symptoms produced by TMJ dysfunction can include jaw pain,
headaches, neck pain, ear discomfort, and facial soreness. In many
cases, these symptoms can be resolved by reeducating your muscles to
function properly, correcting poor postural habits, eliminating
stressful habits like ice and gum chewing, and learning how to relax
and rest your jaw in a proper position.
Should I attend physical therapy?
If your symptoms match the ones listed above, you may be a
candidate for physical therapy. You may also be a candidate for
physical therapy if you use a night guard or have had a dentist
suggest one due to teeth grinding. Lastly, constant teeth clenching
puts you at risk for developing TMJ problems.
Treatment is most effective if it is begun as early as possible. If
left untreated for too long, actual damage may be done to the
structures that make up the TMJ. Commonly after a few therapy sessions
you will have the information you need to continue your treatment on
So commonÖ so ignored! Help is available!
What is incontinence?
Incontinence or the loss of bladder control affects 12 million
Americans. This condition is a troublesome and embarrassing problem
that warrants treatment. Unfortunately, more than half of the people
who experience incontinence do not seek medical help.
Types of incontinence
People with stress incontinence lose urine when they exercise or
move in a certain way that places stress on the bladder. If you have
stress incontinence, you may leak urine when you sneeze, cough, laugh,
get up from a chair, get out of bed, or when you walk or do other
exercise. You may also go to the bathroom often during the day to
People with urge incontinence lose urine as soon as they feel a
strong need to go to the bathroom. If you have urge incontinence you
may leak urine when you canít get to the bathroom quickly enough,
when you drink even a small amount of liquid, or when you hear or
touch running water. You may also go to the bathroom very often; for
example, every two hours during the day or night. You may even wet the
People with overflow incontinence may feel that they never
completely empty their bladder. If you have overflow incontinence, you
may often experience one or more of the following: loss of small
amounts of urine during the day and night, getting up often during the
night to go to the bathroom, feeling as if you have to empty your
bladder but canít, passing only a small amount of urine but feel as
if your bladder is still partly full, or spending a long time at the
toilet but producing only a weak, dribbling stream of urine. Some
people with overflow incontinence do not have the feeling of fullness,
but they lose urine day and night.
How can physical therapy help?
At Action Rehab our goal is to help you improve your bladder
control through exercise instruction (Kegels), behavioral treatment
(i.e. modifying how frequently you urinate), and biofeedback therapy
What is a Kegel?
A Kegel is a contraction of the muscles of your pelvic floor which
support your bladder and help to control your urine output. Many women
suffering from stress incontinence have been told to perform Kegels
but have not been given any formal instruction. The result has been
that many women may be performing these exercises incorrectly. One
study found that in one group, 80% of the women were performing Kegels
improperly. Biofeedback can be used along with instruction in Kegel
exercises to monitor how well you are actually performing the
exercise. One form of biofeedback measures pressure to give
information about how well the exercise is being performed.
No matter what the cause of your incontinence, you can become more
actively involved in your health care. Donít let this condition
limit your enjoyment of life.
and Body Mechanics
Posture is defined as the position we allow our body parts to rest
in when we are sitting or standing. On the other hand, body mechanics
is the way we stabilize and move our body when we are lifting or
carrying objects. Poor posture and inappropriate body mechanics can
contribute to a variety of injuries including back and shoulder pain.
Often people are not aware that they are aggravating an injury when
they sit or stand with poor posture or move incorrectly.
The spine and soft tissue structures that surround it are best
protected when an appropriate posture is assumed. This attitude of the
body is also known as the "neutral spine" position, in which
oneís shoulders are held in line with the ears and a gentle curve is
maintained in the low back. The neutral spine position is the safest
position for the muscles to accept weight loads.
Good body mechanics begins with an understanding of how to maintain
good posture in a stationary position. The next step is to learn to
move your body while maintaining this correct posture in order to
minimize the strain placed on joints and soft tissue structures. The
use of good body mechanics is essential when lifting.
How can physical therapy help?
Your physical therapist can help you determine if poor body
positioning is contributing to your current physical condition. The
therapist can then provide instruction to help you to achieve and
maintain good posture with various functional activities, particularly
lifting. Donít be fooled into thinking you always lift with good
body mechanics. Unfortunately, a lot of people who believe they lift
properly donít quite have it right. It is also important to ALWAYS
lift with good body mechanics. Even the lifting of light items
repetitiously can, over time, cause injuries.
Neck and back pain can make even the most simple daily functions
uncomfortable. In most cases, an individual with back or neck pain has
the power to improve this condition through physical means. These
means include heeding to appropriate posture and body mechanics
instructions and completing an individualized exercise program.
Why Physical Therapy?
The general public is often unaware of how physical therapy can
address back and neck pain. As back and neck pain can result from many
causes, the first job of your therapist is to determine possible
physical factors contributing to your condition.
|Posture and Body Mechanics
||Poor posture and body mechanics
can contribute to a variety of injuries including back and neck
pain. You may not be aware that you are aggravating an injury
when you sit or stand with poor posture or move incorrectly.
||Tight muscles often place
abnormal stresses on the body which can cause pain. For example,
tight muscles in the back of the thighs may contribute to back
||Muscle weakness or strength
imbalances can hinder you from being able to support your spine
at rest or with movements.
||Decreased ability of your
joints to move over one another in the spine or poor joint
positioning may aggravate an injury.
||An ankle injury may affect the
knee, hip, or even your back. Conversely, an injury to the back
might effect a joint down below.
Your physical therapist will examine factors such as those listed
above that may be contributing to your symptoms. Then he or she will
design a specific program for you to help alleviate the sources of the
problem. Our goal is to decrease your pain, improve your ability to
function, and provide you the knowledge to treat your neck or back
independently in the future.
Do you ever feel an increase in pain in a muscle or joint when you
are experiencing stress?
What is stress?
Stress is the mental, emotional, and physical strains that are
placed on us daily. Both positive and negative stresses occur in daily
life. An example of a positive stress is preparing for a vacation; you
are excited and happy to be going on vacation, but you must plan your
events, pack, arrange a dog-sitter, etc. before you can go. Just the
preparation places a strain on you and can influence your body
adversely. One manifestation of stress is an increase in muscle
How can physical therapy decrease my
Physical therapists often treat individuals who are experiencing
muscle tension and pain that is associated with stress. Commonly a
patient is not aware that stress may be a primary contributor to his
or her discomfort, such as in the cases of neck or back pain. If the
patient can be made aware of his or her sources of stress and the
affect it has on the body, then it can be controlled. Controlling
stress may in turn produce a reduction in oneís pain. Your physical
therapist can provide you with instruction to help you get started in
managing your stress.
Physical therapists utilize stress reduction exercises and
visualization techniques to provide patients with tools to alleviate
stress. Another tool that a physical therapist may employ to help you
reduce stress is biofeedback. Biofeedback is simply the use of
machinery to provide you with an indirect measure of your level of
For example, imagine that after a stressful day at work you find
the muscles behind your neck are tense and painful. A biofeedback
machine is used to provide you with instant feedback regarding the
level of activity in the muscles of your neck. If you are getting more
tense in your neck, you will receive feedback through light and/or
sound indicating increased muscle tension. If you are relaxing, the
lights and/or sound will dim in proportion to the decrease in muscle
activity. This feedback, along with additional techniques used by your
physical therapist such as mental imagery, aims to increase your
awareness of tension in a specific part of your body. Our goal is to
help you to be able to relax your body when you feel stress building
before pain begins.
Tunnel Syndrome Therapy
What is carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) is the term used to describe a
condition that is thought by many to involve the compression of the
median nerve at the wrist. The median nerve runs though a tunnel
formed by the wrist bones on the palm surface of your wrist. Symptoms
of CTS may include numbness, tingling and/or pain in your thumb,
index, middle and ring finger. Pain may also be felt in the wrist,
forearm, or upper arm. It is possible that an injury to another area
of your body, such as your neck or shoulder, may cause similar
What causes carpal tunnel syndrome?
Activities requiring repetitive wrist movement such as typing or
writing may result in CTS. In addition, CTS may be caused by a job
that requires a high level of force to be generated at the wrist, or a
traumatic injury to the wrist such as a fracture.
Why see a physical therapist?
Your physical therapist will perform an examination that includes
the identification of physical limitations such as wrist tightness or
weakness that may be affecting your median nerve. Your therapist will
use this information to design a program for you to help alleviate
your symptoms. In addition, your therapist will help you identify
activities that are aggravating your condition and make suggestions
regarding how to modify these activities in order to decrease nerve
What is ergonomics?
Ergonomics is the science that studies the problems of people in
adjusting to their environment, especially seeking to adapt work or
working conditions to suit the worker (Websterís New World
Dictionary). In other words, ergonomics answers questions such as
"does your computer workstation fit the needs of a person of your
bodily characteristics (i.e. height)? How can you alter your
workstation so that you are able to perform all work or leisure
related computer activities while maintaining proper posture?"
Ergonomic principles can be applied to any profession whether
sedentary or active.
In addition, ergonomic principles should not be limited to the work
setting. Understanding the principles allows you to apply the same
concepts to leisure time activities. For example, activities such as
chopping wood, quilting, fine woodworking or needle crafts can be
adjusted to reduce the strain on your body.
Can ergonomics help reduce my pain?
Improper postures, using ill-fitting equipment while completing
excessive repetitions, or using excessive force, can all lead to
cumulative trauma on your body. Applying ergonomic principles to all
your activities can protect you from this type of injury. If you
already have an injury present, changing your environment to reduce
bodily stress is essential in order to aid the healing process and
How can my physical therapist help?
You and your physical therapist will work together to identify which
daily activities are contributing to your current injury. Once
identified, suggestions for activity modification, equipment
alterations, and supportive devices will be outlined to make you and
your job or recreational situations more compatible.
What is a work site assessment?
This assessment occurs when your physical therapist visits your
workplace to evaluate how your workstation is affecting your physical
condition. The visit allows your therapist to most accurately suggest
changes that will benefit you.
injury hand and wrist treatment
How will my hand work after an injury?
After an injury to your hand or wrist, such as a fracture or
sprain, you hand may not be the same as the opposite hand and wrist.
The injured hand may demonstrate swelling, muscular weakness, limited
mobility, and difficulty gripping and carrying objects like a coffee
cup or gallon of milk.
What can physical therapy do?
During your treatment sessions, a physical therapist may use
thermal modalities to decrease your pain and swelling. He or she may
also perform small movements at the individual joints of your hand to
increase your overall wrist movement. In addition, you will be
educated on exercises to help you regain motion and strength in order
to return you to your daily activities as soon as possible.
What causes headaches?
Tension headaches are usually felt at the base of your head and can
radiate across the top and side of your head. They may be caused by
one or more of the following factors:
poor posture, especially
if held statically for an extended period of time
nerve irritation in the
These factors may lead to a sustained muscle contraction in the
neck, which causes a decrease in local blood flow and results in pain.
Other causes of headaches include migraine, allergy, or sinusitis.