The Rotator Cuff: What You Need to Know

The rotator cuff, an often neglected muscle group, is a group of four muscles and tendons that surround the shoulder joint.  The rotator cuff helps to keep the head of your upper arm bone firmly within the shallow socket of the shoulder joint. In addition to keeping your shoulder stable, these muscles help to lift and rotate your arm. Injury to this muscle group is common, particularly in those who perform repetitive overhead motions as you would in a sport like tennis or a profession like painting.

The key to preventing shoulder pain or injury to these muscles is maintaining good rotator cuff strength in addition to good posture to improve your shoulder mechanics. Here are four simple exercises that you can start performing at home to start building better shoulder strength and stability.

  1. Side-lying External Rotation with Weight

     2.  Shoulder Internal Rotation with Band

     3.  Scapular Rows

If you are currently suffering from shoulder pain, the physical therapists at Harbor Physical Therapy will help you to develop an exercise program that is specific to your injury.

 

Written by:

Dr. David Reymann

Staff Physical Therapist
Harbor Physical Therapy

Common Causes of Sciatica

What is sciatica?

Sciatica is a term commonly used to describe pain, weakness, numbness, or tingling that radiates down the back of the leg. These symptoms can be debilitating for some and contribute to difficulty performing daily activities.

Where does it come from?

There are 4 common causes of sciatica:

  1. Disc Herniation – Pressure on the sciatic nerve can occur from the protrusion of a disc in the lumbar spine. This pressure can cause pain to travel through the pathway of the sciatic nerve down the leg.
  2. Spinal Stenosis – Narrowing of the space where the nerve roots exit the spinal canal can also cause pressure on the nerve.
  3. Piriformis Syndrome – The piriformis is a muscle deep in your gluteal region that the sciatic nerve runs underneath and sometimes through. Tightness or spasm of this muscle can cause pressure on the nerve that sends pain down the leg.
  4. Referred Pain from Trigger Points – Trigger points are tight knots in muscles that can cause local or referred pain. Trigger points found in the gluteal muscles can cause referred pain that is felt down the leg and is similar to sciatic nerve pain.

How can PT help?

 A physical therapist is trained to evaluate your symptoms and do a thorough assessment to determine what may be causing them. The aim of treatment is to restore your range of motion, increase your flexibility, increase strength and stability, decrease trigger point formation, and improve your functional mobility. Treatment plans are individualized and are determined based on the causes of your symptoms and your specific presentation. If you are suffering from sciatica-related symptoms, call Harbor Physical Therapy to help eliminate your pain and prevent it from reoccurring.

Written by:

Dr, David Reymann
Staff Physical Therapist at Harbor Physical Therapy

What is the Difference between a Physical Therapist and Chiropractor?

 

Have you ever wondered whether you should see a Physical therapist or a Chiropractor for your symptoms? Check out the descriptions below to learn the differences and which type of provider you should see depending on your injury.

Physical Therapist

A physical therapist performs an exam of an individual’s impairment, disability or functional limitation by examining their movement, affected joints and tissue, neuromuscular imbalances and misalignment. They determine a diagnosis and intervention of treatment and set treatment goals.  Physical therapists work to alleviate pain, restore range of motion, regain any function lost, promote and maintain fitness and prevent further injury. The physical therapist may use heat/cold, electric stimulation, ultrasound, soft tissue mobilization, stretching, exercise and other manual techniques to reach treatment goals. There are many different specialties/settings in physical therapy.  Examples of this are outpatient, women’s health, acute care, sub-acute care, sport, and neurological.  An average physical therapy treatment program consists of the patient attending physical therapy 2 times a week for 4 to 6 weeks.  The end goal for a physical therapy treatment program is to decrease the patient’s symptoms and educate the patient on how to prevent their injury/symptoms from recurring through continued exercise.

Chiropractor

A chiropractor concentrates on musculoskeletal and systemic disorders through a controlled manipulation of the spine. Some chiropractors perform x-rays of the spine to check for misalignment. Chiropractors look to the physiological and biochemical aspects of the patient’s structural, spinal, musculoskeletal and neurological components. They also may use heat/cold electrical stimulation and ultrasound for pain control. Chiropractors practice in a private practice setting and occasionally you can find them staffed in a hospital setting.  In the state of Maryland, Chiropractors can take an exam to receive physical therapy privileges.  Therefore, you might see a facility advertising chiropractic and physical therapy services together. However, be mindful that most of these facilities only employ chiropractors.  A chiropractic treatment program on average is once a week and then tapers down to once a month for a long period of time.  Chiropractors typically see their patient consistently for sometimes years to continue to assess for misalignment of the spine to manipulate.

If you are wondering what practitioner you should see for your injury, it is always beneficial to see a physical therapist.  I typically educate my patients that you should always see a physical therapist first as we are more conservative than chiropractors.  Physical Therapists are able to increase strength/range of motion of a muscle/joint which in turn naturally corrects misalignment of the spine.  If you have not reached your goals with physical therapy, then try your local chiropractor.

Written by:

Amanda Macht, D.P.T.
Owner/Physical Therapist Harbor Physical Therapy

How to Decrease Arthritic Symptoms

One in four people suffer from arthritis. Arthritis causes stiffness, pain, deformity and decrease function of your joints. Physical therapy can help to decrease pain and restore mobility with the use of exercises and modalities.

Harbor Physical Therapy provides patients with arthritis instruction in exercises to help increase flexibility and improve muscle strength around the joint. A daily home exercise program will help to prevent loss of the use of your joints and preserve muscle strength.

If you are interested in learning more about how physical therapy can help with your arthritic symptoms, please contact us to schedule an appointment.

The Upper Trapezius and its Role in Neck Pain

If you find yourself suffering from neck and shoulder pain, it may be coming from one muscle in particular: the upper trapezius. The upper trapezius makes up one of three parts of the large trapezius muscle in the upper back and neck and runs from the base of the head to the clavicle. The upper trap works with the middle and lower trap to stabilize the scapula and assists in upward rotation of the scapula and shrugging of the shoulder.

Increased stress, poor posture, and weakness in the rotator cuff and scapular stabilizers can contribute to overcompensation from the upper traps. This can lead to increased tightness, neck/shoulder pain, and trigger point formation in the muscle. If pain and muscle tightness persists, it can affect daily activities such as sleeping, sitting, reaching, head turning and can also contribute to headaches.

If you suffer from this, here are some quick tips to help relieve pain:

1. Stretch the upper trap by placing one arm behind your back on the same side as your neck pain. Then, gently pull your ear to your shoulder with your other hand until a stretch is felt. Hold the stretch for 20-30 seconds. Repeat 3 times and perform throughout the day as needed.

2. Work on your posture. Squeeze your shoulder blades back and down towards each other and hold for 5-10 seconds while keeping your head in an upward position. Repeat multiple times throughout the day.

If your pain persists, the physical therapists at Harbor Physical Therapy can help by using a combination of manual therapy, strengthening and stretching exercises to decrease muscular tension and pain.

Written by:
Dr. David Reymann
Staff Physical Therapist
Harbor Physical Therapy

How Do I Lift Something Heavy Without Hurting My Back?

A lot of people end up having back pain from lifting heavy objects.  Most likely if they thought before they lifted the object, they would avoid causing themselves back pain. Listed below are steps to follow when lifting a heavy object to avoid straining your lower back muscles:

  1. Square your body to the object so it is right in front of you.
  2. Make sure the object is close to your body.
  3. Place your legs shoulder distance apart.
  4. Hinge forward slightly at the waist
  5. Squat down making sure your center of gravity is towards your heels not your toes.
  6. Pick up the object.
  7. If you need to place the object in a certain location, make sure to move your feet not twist your back.

If you continue to have back pain while lifting objects from the floor, call Harbor Physical Therapy to have one of our doctorate level physical therapists evaluate you to determine the source of the issue.

 

 

What is a Hamstring Strain?

A hamstring strain is a common injury that involves one or more of the 3 hamstring muscles in the back of your thigh. Hamstring strains usually occur during running, jumping and climbing. Hamstring strains are common among sprinters, hurdle jumpers and football players.

Hamstring Description-
The hamstring muscle group is made up of 3 muscles, the semitendinosus, semimembranosis and the biceps femoris muscles. These muscles are responsible for bending your knee and extending your hip.

Symptoms-
Symptoms include a sharp pain in the back of the leg, pain with bending over and stretching the hamstring muscles, and pain when contracting the hamstring muscle. Sometimes there may be bruising or swelling.

Treatment-
1. Rest, ice, compress and elevate for the first 48 hours.
2. Slowly begin gentle stretching and strengthening exercises.
3. Make a physical therapy appointment.
4. Physical therapy will include modalities such as ultrasound, massage, dry needling, electrical stimulation, ice/heat to decrease of pain/swelling and promote healing.
5. Physical therapy will provide you an exercise program to improve the flexibility in your muscles and improve your strength to return you to your daily activities.

Ankle Sprain Treatment and Prevention

An ankle sprain occurs when the ligaments in the ankle are stretched or torn, and most commonly occurs on the outside of the ankle. This occurs when the foot rolls inward, placing excessive stress on the ligaments and can occur during a fall, landing awkwardly after jumping, or running or walking on an uneven surface.

Signs & Symptoms

  • Swelling
  • Bruising
  • Painful to touch ankle
  • Painful to move ankle

Treatment

  • Within the first 48-72 hours, it is important to utilize the RICE principle (Rest, Ice, Compression, Elevation) to minimize inflammation, pain, and swelling.
  • Range of motion exercises in all directions and stretching of the calf muscle will help to minimize loss of mobility and stiffness in the ankle joint.
  • Ankle strengthening exercises will increase the stability of the ankle to allow full return to all activities with decreased risk of re-injury.
  • Proprioception allows you to sense where your body parts are in space and in relation to the rest of your body. This is accomplished through sensory receptors called proprioceptors located in the muscles, tendons, and joints. Using proprioceptive and balance exercises helps to train this sense, thereby increasing ankle stability. These exercises are an important component to any ankle sprain treatment program.

A physical therapist will devise the most appropriate treatment and exercise plan for your specific injury, progressing you to a point where you are able to return to all functional and sport-related activities. If you suspect an ankle sprain, the physical therapists at Harbor Physical Therapy can evaluate you to determine the degree of injury.  Based on the severity, we may refer you to a medical doctor if a more serious injury such as a fracture or complete ligament or muscle tear is suspected.

Poor Posture Can Cause Headaches

There are 3 major types of headaches:

  1. Cluster
  2. Migraine
  3. Tension

Cluster and migraine headaches generally are due to a problem with the blood vessels while tension headaches are typically due to poor posture. Tension headaches usually cause a dull pain in the head, neck, temples, scalp or shoulders.

Forward head posture is a leading cause of neck pain, headaches, and shoulder pain. For every inch your head is located more forward from sitting right on top of your shoulders, the perceived weight of your head increases by 10 pounds.

Steps to improve posture:

  1. Set-up your work station to decrease strain on your neck.
    • The top 1/3 of the screen should be even with your eyes.
    • Elbows should rest comfortably by your sides.
    • Hips should be slightly higher than your knees with your feet flat on the floor.
  2. Use a supportive neck pillow for sleeping.
  3. Perform neck stretches throughout the day.
  4. Perform postural strengthening exercises throughout the day.

If these steps do not improve your posture, schedule an appointment at Harbor Physical Therapy to address tight musculature and receive a catered exercise program based upon your presentation.