Physical Therapy for Shoulder Impingement & Tendonitis

Shoulder inflammation can be painful, and should be taken care of. It is common among swimmers, or sports where arm swings and shoulder rotation are used consistently. Here are a few exercises explained by Jessica Wellons in an article posted on Livestrong.com, to help strengthen your shoulder and thus prevent shoulder impingement and tendonitis. For questions, call us at 619-756-7500!
Physical Therapy for Shoulder Impingement & Tendonitis

The rotator cuff consists of four muscles and tendons that cover the head of the humerus and attach it to the shoulder blade, or scapula. They provide stability and strength during rotational movements in the arm. Shoulder impingement refers to mechanical compression or inflammation of the rotator cuff tendons. This occurs when the space in the shoulder joints narrows and the rotator cuff tendons or bursa, lubricating sacs located over the rotator cuff, become compressed, irritated or damaged, resulting in pain, inflammation and reduced mobility. Exercises that target the rotator cuff will strengthen the surrounding muscles and tendons, improve circulation to the joint, flexibility and range of motion.

External Rotation

Stand with your back against a wall, ensuring that your torso and shoulders remain straight. Bend your right elbow to form a 90-degree angle and bring your arm across r youabdomen, remembering to keep your thumb upright and flattening your palm against your stomach. Perform an external rotation by moving your arm and forearm away from the abdomen, remembering to keep your elbow bent. Continue this external rotation until the back of your arm is flat against the wall. Hold this position for five seconds and rotate your arm back to the starting position. Perform one set of 10 repetitions on both arms, once daily.

Supraspinatus Stretch

You will need two dumbbells to perform this exercise. Standing upright, holding a dumbbell in each hand with thumbs pointing down. While keeping your elbows straight, slowly bring your arms outward to form a 45-degree angle. Hold this position for five seconds and slowly return to the starting position. Perform three sets of 20 repetitions, once daily to strengthen the muscles and tendons in the rotator cuff, thus stabilizing the shoulders and restoring mobility.

Triceps Stretch

Stand upright and bend your right elbow to form a 90-degree angle. Raise your right hand so that your forearm forms a 90-degree with your shoulder and place your opposite hand over your elbow. Using your left hand, grab the opposite elbow and gently pull that arm down behind your head. Continue this gentle pull until you feel a stretch in your shoulders. Hold this stretch for five seconds and relax. Perform one set of 10 repetitions on both arms, two to three times daily to stretch the tendons and joints in the shoulder and help restore your range of motion.

Scapular Squeezes

Lie on your back and bend both knees. Plant your feet firmly on the ground and extend your arms away from your body, with palms up. While maintaining contact between the ground and your lower back, begin squeezing your shoulder blades together, downward and toward your spine. While performing this exercise, try to not shrug your shoulders and remember to relax your neck. As your perform this exercise, the lower muscles between your scapula should be contracting. Hold each shoulder blade squeeze for five seconds and relax. Perform one set of 20 repetitions three times a day to strengthen the muscles in the shoulders and prevent further injury.

Physical Therapy Exercises for Core Stabilization

You probably use your core more than you realize. Core strength is extremely important and necessary balance, it is the base of your body that ultimately keeps you stable. Helen Mitchell, a physical therapist assistant, offers some great exercises written for Eastpoint Health & Fitness to strengthen your core. For more questions give us a call at 619-756-7500!

Core stabilization, or core strengthening has been around for many years and has been incorporated into sports performance training programs, exercise programs such as Yoga, Pilates and Boot Camps. In Physical Therapy and rehabilitation, core stabilization means that activation of the trunk muscles must occur first in order for us to create a stable base of support that allows us to move our arms and legs. Making the trunk muscles stronger keeps the spine stable and helps the body stay balanced with movement; preventing falls and injury.

Most people think of the “core” as just being the abdominals (stomach muscles) when in fact the “core” muscles run the entire length of the torso from the hips to the shoulders. When these muscles contract, they stabilize the spine, pelvis and shoulder girdle and create a solid base of support. This allows us to stand upright and move on two feet, shift our weight and move in any direction. This distribution of weight protects the back from injury. An effective core conditioning program needs to target all muscles of the core to be effective.

Benefits of Good Core Strength:

A strong core:

• Reduces Back Pain and Prevents Injury
• Improves Athletic Performance
• Improves Postural Imbalances

Exercises that Build Core Strength:

The most effective core strengthening exercises work the torso as a solid unit with both front and back muscles contracting at the same time. The most basic core strengthening exercise is Abdominal Bracing where you try to pull your navel in toward your spine without holding your breath. Most core strengthening exercises don’t require equipment and include:

• Planks: Position yourself face down on hands and balls of feet. Straighten arms. Tighten stomach muscles and lift hips to form a straight line from head to toe. Hold 15-30 seconds. Do not let hips sag to the floor.

• Basic Push Up: Position yourself face down with hands under shoulders and on balls of feet. Tighten stomach muscles and bend elbows to lower chest towards the ground. Keep neck in neutral by gazing towards floor. Straighten elbows to complete one repetition. Do not let hips sag to the floor.

• Bridging: Lay face up on flat surface, knees bent and arms by sides. Slowly raise buttocks and hips, keeping stomach tight. Slowly lower hips again. This completes one repetition.

• Supermans: Lay face down on flat surface with arms stretched overhead and straight legs. Tighten stomach muscles and simultaneously lift arms and legs into the air a few inches then slowly lower them.

Other exercises include the use of stability balls, medicine balls, kettlebells, wobble boards, yoga and pilates. These particular exercises should only be performed under the supervision of a trained professional and when beginning any type of exercise program, always consult your physician first.

Bone Health

Whether or not you know this, bone health has a lot to do with mobility! Take a look at this article from MoveForwardPT to learn more about the different aspects of bone health and how to prevent injury.

Physical therapists are experts in improving and restoring mobility and play an important role in ensuring optimal bone health. Healthy bones can help you stay strong and active throughout your life. If good bone health is achieved during childhood and maintained, it can help to avoid bone loss and fracture later in life. For healthy bones, it is important to maintain a physically active lifestyle and eat a balanced diet with plenty of calcium, vitamin D, and perhaps other supplements as needed. Physical therapists can design a unique program for you to help keep your bones healthy.

Osteoporosis is a common bone disease that affects both men and women (mostly women), usually as they age. It is associated with low bone mass and thinning of the bone structure, making bones fragile and more likely to break.

Some people are more at risk for osteoporosis than others. Not all risk factors can be changed, but healthy habits and a proper exercise routine designed by your physical therapist can keep bones healthy and reduce risk. Risk factors* include:

Age: More common in older individuals
Sex: More common in women
Family History: Heredity
Race and Ethnicity: Affects all races. In the US, increased risk for Caucasian, Asian, or Latino
Weight: Low body weight (small and thin)
Diet, especially one low in calcium and vitamin D
History of broken bones
Menopause
Inactive lifestyle
Smoking
Alcohol abuse
Certain medications, diseases, and other medical conditions

Physical therapists can help prevent osteoporosis and treat its effects by designing individualized exercise programs to benefit bone health, improve posture, and enhance core stability and balance. Most of these exercises are simple and can be done at home with no special equipment.
Fight Fracture with Fitness

Inactivity is a major risk factor for osteoporosis. The right exercises and good habits can keep bones strong and prevent or reverse the effects of osteoporosis. Weight-bearing exercise, such as walking, is an important way to build and maintain healthy bones. Muscle strengthening exercises have been found to stimulate bone growth and can help prevent and treat osteoporosis. These types of exercises are best if started early in life and done regularly. However, it is important to remember that you can begin exercising at any age and still reap great benefits.

If you have osteoporosis, are at high risk for a fall or fracture, or have a medical condition, affecting your ability to exercise, do not begin an exercise program without first consulting your physician and a physical therapist.

Avoid exercises and daily activities, which round the spine, such as sit-ups, crunches, bending down to tie your shoes, exercise machines that involve forward bending of the trunk, and movements and sports that round and twist the spine.
Benefits of Good Balance

Preserving balance and stability with exercises can help reduce falls and resulting fractures. Exercises that improve posture, core stability, balance, and coordination, can also protect the spine against compression fractures. An individualized program may include a walking regimen, Tai Chi, and other exercises geared toward conditioning, balance, and coordination.
Bone Health Begins With Good Posture

Physical therapists recommend good posture and safe movements to protect bones from fracture during daily activities. Using proper posture and safe body mechanics during all activities protects the spine against injury. Here are some tips:

Keep your back, stomach, and leg muscles strong and flexible.
Keep your body in alignment, so it can be more efficient when you move.
Do not slouch. When sitting, keep your spine and head straight. Put a small pillow behind your waist to keep your spine in a good position.
Use good body positioning at work, home, or during leisure activities.
When lifting or bending forward, bend your knees, keep your back straight, bend forward at the hip crease, and lift with your legs. Keep the load close to your body.
Ask for help or use an assistive device to lift heavy objects.
Maintain a regular physical fitness regimen. Staying active can help to prevent injuries.

*National Osteoporosis Foundation

Acknowledgements: APTA Section on Geriatrics