Shoulder pain: Is it really my shoulder that hurts?

Here's the scenario: You are having right shoulder pain located at the top of the shoulder going down the shoulder/deltoid area into your biceps area.  You haven't had really bad neck pain since this shoulder started hurting and you haven't seriously injured your neck before either.  But you do rub your neck quite a bit throughout the day. You have a hard time lifting your arm up with weights either in front of you or to the side, reaching in front of you, sometime even holding a glass or cup of coffee.  It's been coming on little by little and has gotten to the point where it's really affecting your normal day.

So which is it?  is it your shoulder or something else???

In a this type of scenario, you want to get your shoulder looked at first and do some basic strengthening for the shoulder.  This includes scapular stabilization exercises, scapular retraction exercises, stretching all your tight muscles (pecs and lats and teres), then some isolated strengthening for the rotator cuff both in static and dynamic positions.  

But after about 2-4 weeks, it's gotten a lot better, but still hasn't fully resolved.  What else could it be?!?!?

Well, when you go to an orthopedic doctor who specializes in the shoulder, more often than not, they are focused on the shoulder and the problem at the shoulder.  They may even get imaging at the shoulder as well to verify their findings.

But more often than not, there is also a component relating to the neck that might be the culprit.  This is due to a cervical radiculopathy, which in lay mens terms is a mild impingement at the neck that makes the shoulder weak and also be painful.

Treatment for this is pretty easy once you've identified it as this.  A physical therapist or a trained professional can perform gentle joint mobilizations to the neck, more specifically to the two vertebrae which are locked/impinged to loosen them up.  Also you will want to retrain your neck muscles to find midline again without any deviations.  Once you are aware that your neck is stronger, then you will want to slowly incorporate functional movements with keeping your neck muscles engaged and in midline while slowly incorporating shoulder strengthening so that you're whole system begins working together again.

Now your shoulder problem/pain should decrease.  But remember, strengthening quickly does no one any good.  Strength can take about 6-8 weeks to make a substantial change.  And most of all, remember that your neck muscles are endurance muscles, so the exercises should be repeated at least 2-3 times a week just to keep them in check!  =)

Knee Braces (Genutrain)

Have you ever twisted your knee, felt a little unstable in your knee, or had any kind of “pain” in or around your knee?  Did you have surgery to fix it and it feels about 80% back to normal?  And how many brace or taping products have you tried and had minimal relief?

As a volleyball player I know the importance of getting back on the court as soon as possible, but as a physical therapist I know the importance of proper training, muscle facilitation, and edema control.  Only if I could find a brace that could marry the two…..

And I have!! I found a Bauerfeind product, more specifically the Genutrain knee brace, that does just that!  I haven’t found a more form fitting knee brace out there that does what it’s suppose to do.  After two knee surgeries (right ACL and medial meniscus and left medial and later meniscus arthroscopies) my knee continued to swell no matter how much I iced it.  Even after it felt better and I was playing on it, it swelled up after 2 days of playing and I just knew I had to wait until the swelling went down.

Then my surgeon prescribed the Genutrain S (which gives you lateral support as well as edema control) and I played on the court and low and behold, my knee didn’t swell up at all!  Now that I’ve been post surgical for about 1.5 years, I use the regular Genutrain brace to make sure that my knee doesn’t click or swell. It also reassures me, as a physical therapist, that my knee is functioning with maximal muscle activation when jumping and landing.

So here’s why this product is much better than any other:

            1) The Omega pad delivers targeted pain relief at the patella and anterior meniscus with two friction points (Hoffa Pads) exerting pressure on the infrapatellar fat underneath the patella.

2) The “Train” line of Bauerfeind has a 3D active knit which helps reduce swelling while you play your sport.

3) The stability of the knee joint is positively influenced by the muscles through the focused stimulation of surface and deep-lying nerve tracts (proprioception increases).

4) Genutrain can stimulate the feedback mechanism (part of the reflex system) by allowing the proprioceptors in the muscles, tendons and joints to act as mediators (they send signals to activate active structures more).

5) With 8 different sizes and the potential to make a custom fit brace, the anatomically-contoured knitted support with integrated viscoelastic padding fits like a glove and is very easy to wear.

I wear this knee brace every time I play now for both security and for prevention. I highly recommend any person who has had any type of knee injury (acl strain, ligament reconstruction, patella tendonitis, patella dislocation, meniscus repairs, bursitis) to wear one and see the improvement in your focus for your sport rather than the pain in your knee.