Tag Archives: Melissa Graham

What is the Rotator Cuff?

Written by: Melissa Graham, PT, DPT, OCS

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The rotator cuff consists of four muscles that provide shoulder joint stability and is important for shoulder movement. The four muscles are the supraspinatus, infraspinatus, subscapularis and teres minor. All four of the muscles start on the shoulder blade (scapula) and connect to the head of the upper arm bone (humerus). The shoulder joint is a ball and socket joint which resembles a picture of a golf ball (head of upper arm bone) sitting on a golf tee (shoulder joint). The rotator cuff muscles surround the joint forming a cuff. It is important during shoulder motion to maintain the proper position of the ball in the socket. The rotator cuff muscles assist in lifting the arm out to the side and rotating the shoulder for activities such as opening doors or tucking in the back of your shirt.

 

There are differing degrees of injury to the rotator cuff. An injury to this area can vary from a strain of one muscle, to a partial tear(s), to a complete tear of one or more muscles. Injury to the rotator cuff can be caused by age-related degenerative changes, muscle imbalances in the shoulder, repetitive overhead motions or trauma. Symptoms of rotator cuff involvement include shoulder joint pain, upper arm pain and functional limitations, such as difficulty lifting arm up overhead or reaching behind your back.

 

Physical therapy can be extremely beneficial to rehab rotator cuff injuries. During the evaluation, the physical therapist will assess shoulder range of motion and strength and perform special tests to determine the cause of pain. From there, an individualized treatment program will be designed. If rehab is unsuccessful or the muscle is completely torn, surgery may be necessary.

 

Iliotibial Band Syndrome – What’s That?

Written by: Melissa Graham, PT, DPT, OCS

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The iliotibial band, also known as the IT band, is a superficial thickening of tissue on the outside of the thigh. It extends from the outside of the pelvis, over the hip and knee, and inserts just below the knee. The IT band is very important in stabilizing the knee. Irritation is often found around the insertion of the band as it rubs on the outside of the knee area and is referred to as iliotibial band syndrome (ITBS). ITBS is a common injury in runners and cyclists due to the repetitive knee range of motion, which can cause excessive rubbing along the knee.

There are many different causes of irritation that can vary from training habits to anatomical abnormalities or muscle imbalances. Running on banked surfaces and/or cycling with a toe in increases the stress to the insertion and make these individuals even more prone to injury. ITBS may also be found in individuals with foot abnormalities, such as high or low arches, that affect the knee position during walking or running. Muscle imbalances, especially weakness in the hip muscles and excessive tightness of the IT band, may also cause friction along the knee area. In addition to knee pain, injury to the IT band can cause hip pain.

 

As you can see, ITBS can have various mechanisms of injury which can be addressed with physical therapy. On your first visit to physical therapy, the physical therapist evaluates the injury, determines the cause or source of pain and tailors a treatment program specific to the individual. The goal is not only to restore the individual to full function, but to address the primary cause to decrease the risk of future occurrences as well.

 

Heat or Ice? What’s Best for Your Injury?

Written by: Melissa Graham, PT, DPT, OCS

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One of the most commonly asked physical therapy questions is, “should I use heat or ice on my injury?” or “I didn’t know which one to use, what is the difference?”

 

Heat increases blood flow to the applied area and can help to relax and loosen tissues. Heat is often used with areas that have been bothersome for some time or before participating in activities. Ice causes the opposite effect; it decreases blood flow and is often used to minimize swelling, inflammation and irritation to an area.  Ice tends to be used on new injuries and areas of swelling. Both heat and ice can have pain-relieving effects if used appropriately and sometimes it may be appropriate to use both. For instance, some individuals might heat up a chronic painful area before activity and ice it down after to decrease soreness.

 

Here are some common examples and suggestions as to what is best for certain types of injuries. A newly sprained ankle should be iced to decrease the swelling and inflammation. Ice is also commonly used after surgeries to minimize inflammation and can be used indefinitely for pain and inflammation. It is often recommended to ice injured areas for ten minutes twice a day. On the other hand, a tight back or stiff leg would most likely respond favorably to heat before physical activity. Heat will help to increase blood flow and loosen the muscles whereas, back pain, that is caused by nerve irritation or inflammation, would probably respond better to ice as ice will minimize swelling and inflammation.

 

Heat and ice should never be applied directly to the skin and should not be left on longer than 15-20 minutes at a time. Both can be applied throughout the day, but you should allow 45 – 60 minutes between applications. The skin should be monitored for excessive redness and pain, which could be signs of a burn or frost- bite.

 

Hopefully this information has helped so that next time you have an injury you know exactly how to assist in treating it. Do you have any specific examples that you would like guidance on?

 

Can the Weather Affect Your Pain?

Written by: Melissa Graham, PT, DPT, OCS

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Many individuals can vouch for the fact that their muscle and joint pain feels worse when it is cold and rainy, but few can tell you why. Is it possible that the weather can affect your pain? Yes, there is some truth behind that statement when we look at specific factors of the weather, such as atmospheric pressure and temperature.

 

Atmospheric pressure is the force or pressure exerted on us by the weight of air above the surface. When there is a change in a front or rainy weather, there is often a decline in air pressure. Therefore, with a drop in atmospheric pressure, there is decreased pressure on the body. This allows the tissues in the body to expand to fill the space. For an area of injury, the already inflamed tissue may swell even more. This creates an area of high pressure within the body and may cause increased pain.

 

Another possible reason has to do with temperature. Research shows that pain thresholds are lower in colder weather which allows individuals to feel pain sooner than under normal conditions. Individuals also tend to be less active in colder weather. Many health conditions respond favorably to activity and, therefore, stiffness and pain can worsen with inactivity.

 

As with many things, there are multiple factors that influence an individual’s pain, but in response to the original question: yes, the weather can most certainly affect your pain.