If you’ve had a nagging pain in your shoulder or can’t quite reach the top shelf lately, you may be suffering from frozen shoulder.

What is Frozen Shoulder?

Adhesive capsulitis, commonly known as frozen shoulder, is a common ailment. As the name implies, frozen shoulder presents with extreme stiffness and limited range of motion in the shoulder joint. Typically the stiffness begins gradually and then becomes more severe. During this early freezing stage, patients experience pain and their range of motion becomes more restrictive. 

In the next stage, called the frozen stage, the range of motion becomes so limited that patients may not be able to lift their arm above their head. Typically pain begins to decrease at this point, even though the range of motion becomes worse. Finally, the thawing stage will see some improvement in range of motion as the shoulder starts to relax again.

Moving through the stages is a long process. The freezing stage can last months and the frozen and thawing stages can take one to three years to completely get back to normal.

Causes

There is no single direct cause for frozen shoulder, but according to the Mayo Clinic, it is more common in diabetics, those with thyroid issues, and patients recovering from ailments that limit movement of the arm. It can also stem from a mild injury caused by something as simple as throwing a ball or catching your arm on a wall while walking. Adhesive capsulitis is more common in women than men and most commonly affects patients between the ages of 40 and 60.

Diagnosis

Your doctor can typically diagnose adhesive capsulitis with a physical exam. However, he or she may order imaging tests just to make sure there isn’t something else going on. During your exam, your doctor will ask you to move your arm in different directions to evaluate your range of motion and level of pain. He or she will likely also provide counterpressure, asking you to push against their hands in different directions. This helps identify whether the problem lies in a muscle, tendon, or ligament rather than the shoulder joint. It helps eliminate other common shoulder injuries like a torn rotator cuff.

Treatment

Your doctor may tell you to take a consistent dose of ibuprofen to help with inflammation and pain. Ice and heat can help at home too. Your doctor may also suggest a cortisone shot, which is administered into the shoulder joint capsule.

Movement

Part of the reason your doctor may recommend physical therapy is to keep your shoulder from freezing up in the first place. Doctors commonly recommend range-of-motion exercises that can help keep frozen shoulder from settling in, but if it’s already limiting you, movement is still the best treatment. 

Physical Therapy

Improving your range of motion can begin during any stage of frozen shoulder. Your physical therapist will walk you through exercises like the following to improve your range of motion. He or she may also use heat to relax the muscles before stretching and other techniques to help with pain, inflammation, and limited movement. 

Wall Walk

Standing a comfortable distance from a wall, place both hands on the wall in front of you. Use your fingers to walk up the wall as far as you can without serious pain.

Shoulder Rotation

Stabilize yourself while leaning forward 90 degrees, allowing your arms to hang naturally. Your shoulder may not allow your arm to hang straight. Regardless, move your hand in a circular motion, increasing the size of the circle as your range of motion improves. 

Door Stretch

Start facing the side of a doorway with your elbow bent at 90 degrees and the hand of your affected shoulder pressing against the inside or outside of the door jamb. Then rotate your body away from your arm for a gentle stretch.

Crossover Stretch

Sitting upright or laying on your back, use your unaffected arm to pull your affected arm across your chest. Hold for 10-15 seconds for a deep stretch and release slowly.

 

If you’re experiencing frozen shoulder, give Encore Physical Therapy a call to see how we can help.  

Sources:

Mayo Clinic, Frozen Shoulder, https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/symptoms-causes/syc-20372684

Ortho Infor, Frozen Shoulder, https://orthoinfo.aaos.org/en/diseases–conditions/frozen-shoulder/

 

Neck pain is a common complaint. If it makes it difficult to get out of bed in the morning, perform everyday tasks during your day, or keeps you from activities you love, it might be time to seek medical care for that pain in your neck.

Causes for Neck Pain

Tension, misalignment, stress, muscle strain, injury, joint issues, and nerve damage are just a few possible causes for neck pain. Although there are some serious illnesses that cause neck pain, the overwhelming majority of cases stem from poor body mechanics or posture. That means the way we sit and move. 

When you meet with your physical therapist (PT), be sure to discuss your hobbies, work practices, and sleep situation to provide insight on where the problems lie. With this information and an examination, your PT can suggest anything from the right kind of keyboard to a shoe lift.

Home Care for Neck Pain

When your neck feels tight, practice basic stretches such as looking slowly to the left and then to the right. With your head back at center, tip one ear towards your shoulder and repeat on the other side. Be gentle with yourself. The goal is to stretch tight muscles, not to cause more injury. 

You can also take anti-inflammatory medications for a few days and practice a schedule of ice and heat. You could even look into seeing a massage therapist to help relieve tight and stiff muscles.

Most of the time, neck pain is nothing to worry about, but see a doctor if you experience severe pain, you can’t get any relief after several days, the pain radiates down your arms or legs, or you also have a headache, numbness, or weakness in your extremities.

Benefits of Physical Therapy for Neck Pain

When you find it difficult to look over your shoulder while driving, raise your eyes to the sky, or have a nagging pain that you can’t seem to resolve, physical therapy can likely help. 

While strengthening muscles and improving your range of motion are certainly benefits, there may be other perks you haven’t thought about.

For example, PT can help decrease the intensity, frequency, and duration of headaches. As a result of fewer headaches and reduced neck pain, you may also be able to decrease medication use. Overall, if you can get that pain in the neck under control, you’ll experience a better quality of life. 

PT Techniques to Relieve Neck Pain

Whether you’ve decided to begin PT or are still wondering how it can benefit you, understanding what a typical appointment might look like is a good place to start in your journey. Note that every case is different, so a personalized plan will follow your initial evaluation, but the techniques below are generally helpful for many types of neck pain.

Manual Therapy

Stiff muscles and alignment issues both contribute to neck pain and headaches. An experienced physical therapist can use manual therapy techniques to alleviate stiffness, increase mobility, decrease muscle tension and spasms, and improve muscle performance.

Exercise

Although you may feel like movement is the antithesis for your painful problem, research has shown benefits of exercise as a treatment for neck and other types of pain. Your PT will evaluate your abilities and design a treatment plan that fits within your capabilities. These stretches and exercises will help build strength, range of motion, stability, and endurance, which will result in less pain and inflammation.

Education

A big part of helping yourself is understanding what is going on beneath the surface. Your PT can provide images and materials in order to gain a better image of what the joints and muscles are battling. Depending on your diagnosis, education around stress relief, understanding triggers, or proper posture can also help.

The bottom line is that you likely don’t have to live with that pain in the neck. Give Encore Physical Therapy a call to see how we can help.

 

There are nearly as many reasons to go to physical therapy as there are treatments once you get there, so it’s not surprising you may be wondering what to expect from the process. After all, there’s no, What to Expect When You’re Going to PT book that’s handed out when your doctor recommends making an appointment. So here’s a bit of information to give you a better idea of what that first appointment and the follow up visits will entail.

The First Appointment

Your mind might be swirling with questions, so this article about your first appointment is a good place to start. It covers what to bring with you, what to wear, and how long you can expect the appointment to take.

Sharing Information

In order for your physical therapist to provide the best treatments, try to provide a complete picture of your situation. Be sure to mention prior and current injuries and provide a comprehensive medical history. Share your hopes for treatment, whether that be as focused as strengthening your calves or as general as overall improved balance and stability. 

You might be surprised by the conditions physical therapy can treat, so although you come in for something like recovery after surgery, with effective communication you might also find yourself treating incontinence.

Who Will I Work With?

The Encore team works together with the same goal–to provide professional and effective treatment with a focus on the needs of the patient. For your initial visit, you’ll meet with one of our skilled physical therapists for a complete evaluation. This is the time to ask questions and provide as much information as you can about your condition and your goals. 

Many patients are surprised to see a new face when they arrive for their second visit. That’s because our qualified Physical Therapist Assistants (PTA) commonly meet with patients after the initial visit. The PTA will walk you through warm ups, stretches, exercises, and other movements that increase flexibility, strength, balance, and range of motion. For reduction of pain and inflammation, your PTA may also hook you up with heat, ice, ultrasonic treatment, and manual (hands on) therapy.

Your PT and PTA regularly share information and work together on your treatment plan so there’s no need to explain everything twice. Your PT will monitor your progress through conversations with the PTA and by meeting with you periodically throughout your treatment.

How Long Will it Take?

Near the end of your initial appointment, your PT will outline a plan for additional appointments, often starting at 2-3 times each week and slowly reducing in frequency as you improve. This can come as a shock if you’ve expected to have the issue resolved in a session or two, but be aware the number of appointments depends on several factors including insurance, budget, your schedule, and your area of concern. Typically you will make appointments for the first few weeks and reevaluate the frequency as you progress.

Depending on what you’re dealing with, PT can help in a few visits or can be ongoing for months.

What Can I Expect From Treatments?

Patients have all kinds of perceived notions about what physical therapy looks like. Regardless of the image you have in mind, it’s probably not that. The first rule is physical therapy should never hurt. You may have some discomfort during certain movements, but pain is a boundary to pay attention to. 

The goal of PT is to reduce or eliminate that pain by correcting the core issue. Typically that revolves around strengthening and improving flexibility. This is not an exercise class. Don’t expect to break a sweat or break records for an upcoming spin class. Most PT is centered around minute movements–with surprising results. You may feel like you’re doing basically nothing, yet soon you’ll see how those micromovements lead to improvement.

Anticipate Homework

Much of the work you do will be in between appointments. After each appointment, your PT or PTA will provide you with written or printed sheets outlining exercises to work on at home. The more closely you follow your homework plan, the more improvement you will see. During your next appointment your PT will ask how the homework is going, evaluate your progress, and suggest new work-at-home activities to continue your improvements.

Be Open to Suggestions

You might remember the childhood song, “The Skeleton Dance,” with lyrics like, “The foot bone’s connected to the leg bone.” Even though you seek treatment for pain in one area, the core of the problem may lie elsewhere. So don’t be surprised if treatment for lower back pain involves stretching your calves or relaxing your hips. Similarly, even though you might feel like the exercises aren’t challenging enough, trust your PT to keep you at the right level of progress. Feel free to communicate concerns, but give the process a chance and be patient as you work together to achieve your goals. 

 

Anterior Cruciate Ligament Injury (ACL) is a common ailment in the sports world, both for athletes in the big league and those at the backyard volleyball pit. Typically, the injury occurs when the foot is planted but the knee twists, causing damage to the ACL. Treatment and recovery take many forms, but your physical therapist can be a strong advocate for your success.

Early Intervention

The most common symptoms of a torn ACL are a loud popping sensation or sound in the knee, severe pain and inability to continue the activity, rapid swelling, loss of range of motion, and a feeling of instability when bearing weight. It’s important to seek medical attention if you experience these symptoms. With the ACL out of commission, the job of tackling weight and mobility transfers to the meniscus. If the meniscus tears, the risk of a long-term impact such as osteoarthritis increases significantly. With all of this in mind, it’s critical to get an accurate diagnosis and to stay off of your injured knee as much as possible to avoid further damage. The exam is basic and mostly non-invasive unless the doctor feels it’s necessary to insert a camera for a better look, a process called arthroscopy. You may also be sent in for x-rays or an MRI as needed to determine whether you should undergo surgery for the repair.

Treatment

The initial treatment for tears not requiring immediate surgery consists of rest, cold applications, and compression in the form of a knee wrap or brace. Many ACL tears heal with the proper care. If rest, ice, and compression don’t do the trick your doctor may recommend surgery. Whether you have surgery or not, you can rely on your physical therapist’s guidance throughout the process. 

What to Expect from Physical Therapy

Without surgery physical therapy will target increased muscle strength, agility, and balance. Your therapist will also help you identify movements that can defer pressure from your knee so you can increase activity without further injury. Since each person’s response to an ACL injury is unique, your physical therapy plan will be customized for your situation. 

If you undergo surgery, the recovery process will be somewhat different. In fact, your therapy will likely begin before you have the surgery in order to strengthen surrounding muscle groups, decrease swelling, and improve your range of motion. 

Following surgery, the goals of therapy are to improve knee health and prevent subsequent injury. With this in mind, you will likely wear a brace for the first month or two to keep the knee from hyperextending. You will also rely on crutches initially, slowly working with your therapist to increase the amount of weight you can bear on your leg. Along with protecting the area, your therapist will help with pain control, improving your gait, and reduction of swelling. Over time, they help you increase strength, range of motion, balance, and flexibility. As you improve your therapist will support you towards personal goals such as getting back to an activity like swimming, climbing the hill to the mailbox, or even returning to contact sports such as football.