The Frozen Shoulder
Ethology of frozen shoulder
- systemic (diabetes/metabolic conditions/hypothyroidism)
- extrinsic (CVA, Parkinson’s, direct trauma)
- intrinsic (rotator cuff/other shoulder muscle pathologies) factors of origin
Symptoms can vary greatly from person to person. Each person’s experience will be different. But could include one or several of the following:
Seeing a physiotherapist can help get rid of your neck pain by offering several pain-relieving modalities.
This could include:
The top 5 exercises for heel pain in runners will be discussed in this blog.
The exercises will help improve muscle strength and promote flexibility in the foot and leg muscles. Ultimately it will allow you to get back to running faster and free from pain.
This stretch will relieve the tension in the plantar fascia. In sitting with the injured foot resting on the other leg, bend the ankle and toes up as shown in the picture. Hold for 10 seconds and repeat 10 times, do this 3 times per day.
Tightness in the calf muscle can make the pain from plantar fasciitis worse. Stretching the calf muscle can help ease the pain. Stand near a wall with one foot in front of the other, front knee slightly bent. Keep your back leg straight, heel on the ground, and lean toward the wall. Feel the stretch along the calf of your back leg. Hold the stretch for 30 seconds, repeat 10 times 1-2 times a day.
Place a round object like a golf ball or trigger point massage ball under the arch of the foot. Rollback and forth for 2 minutes. Repeat 2-3 times throughout the day.
Of the top 5 exercises for heel pain in runners, this one is definitely the most challenging. Its best done barefoot.With a rolled-up towel under the toes. Push up into a calf raise, hold at the top, then slowly lower down. The speed should be 3 seconds up, 2-second hold at the top, 3 seconds lowering. Do 3 sets of 12 reps on each leg. If too painful or difficult, start on 2 legs and gradually progress under the guidance of a Podiatrist or Physiotherapist.
The short foot exercise can be a little tricky but with the help of a Physiotherapist or Podiatrist, it can be mastered. The idea is to shorten the foot by contracting the small muscles in the foot to raise the arch.Sit in a chair barefoot and form a 90-degree angle at the knee and ankle. Try to shorten the foot by bringing the ball of the foot towards your heel, doming the arch of the foot. Do one foot at a time and try to avoid scrunching up the toes. Hold for 10 seconds then relax and repeat 10-12 times. Practice throughout the day, you can even do it sitting at your desk.
Combine the top 5 exercises for heel pain in runners with an appropriate level of activity that doesn’t aggravate symptoms. Choose suitable footwear and consider foot orthotics to help the pain settle. Contact us for more information and a consult with our podiatrist
In this blog we talk about Futsal injury prevention and treatment. Playing soccer / football can be a great activity for all ages, but like any other sport there is always an associated risk of injury. There are some injuries that are more evident in younger players such as Osgoode-schlatters or Severs, while in older players we might see more ACL, meniscus or concussion type injuries. Some common injuries are:
Out of these there are 4 that stand out more than others.
Futsal injury prevention and treatment is important for every part of the body. Every injury will cause some sort of disruption to the athletes level of performance. At Ace we want to keep you on the court/field performing at your very best. See one of our health professionals to prevent injury or return to your best post injury and at a high level of performance. We are able to provide proper advice and education to better understand your injury as well as provide proper rehab exercises and make shoe recommendations.
A Rotator Cuff Injury is very common. The rotator cuff is a key group of four muscles that support the shoulder joint. These four muscles allow you to perform all sorts of movements like reaching, twisting, and raising your arm. The rotator cuff muscles attach to bones of the shoulder. These bones include your collar bone on the front, your arm (humerus) bone on the side, and the shoulder blade (scapula) on the back.
Without these bones and attaching muscles, your shoulder would not be able to perform any movements. They make activities seem easy like brushing your hair, getting dressed, lifting, and carrying heavy objects.
An injury to any one of these four supporting shoulder muscles can occur. Usually, they are from a direct traumatic incident to the shoulder. They can also develop over time from general wear and tear. Injury to the rotator cuff muscles may result in some degree of tearing or inflammation of the muscle. One of the rotator cuff muscles called the supraspinatus is the most common muscle to be injured. This muscle helps lift your arm up to the side. The degree of injury and symptoms can vary greatly depending on several factors.
A common injury athletes fear is ACL knee ligament injuries. Why is this though? You may hear announcers talk about an athlete’s rehab journey after they have returned. You may even hear them talk about how bad it will be if it was the ACL that was injured on the play. So why is it that this particular injury is feared more than others?
Like all ligaments, the ACL’s job is to maintain efficient movement within the knee. The ACL helps stabilize the knee and prevents the shin from sliding forward. It does this by attaching from the posterior aspect of the thigh bone (femur) to the anterior portion of the shin bone (tibia). The ACL does not work alone though. There are several other ligaments that surround the knee to help stabilize it. These include the MCL, PCL, and LCL. Along with the combination of ligaments, the muscles surrounding the knee also help the knee move and stabilize.
For the most part, we will see ACL injuries from athletes involved in contact sports, or sports with a quick change in directions. Depending on the severity, the injury can be classified under grade 1, 2, or 3. Grade 1 injuries can be described as mild, painful with minimal stretching/tearing of ligament fibers. The next is Grade 2 injuries can be described as moderate. It can be painful with up to 50% of ligament fibers torn. And finally, Grade 3 injuries can be described as severe. It may or may not be painful, and complete rupture of the ligament fibers.
Although grade 1 and 2 injuries are not as severe, we can still see recovery times lasting up to 12 weeks. But how do you tell the difference between the grade of injury? While a proper assessment by a health professional can determine this. Athletes will have an idea of when a grade 3 injury has occurred as there will be a popping sound.
Now to discuss the injury we all fear as athletes. Grade 3 ACL injury. Grade 3 injuries differ to the grade 1 and 2 injury for recovery as the ligament has been ruptured. This means that most athletes will opt for surgery. ACL reconstruction is a surgery performed to replace the ruptured ligament with a hamstring tendon or patella tendon. So we have a replacement ligament, but why does it take so long for athletes to return to sport? The tendon is not built the same way a ligament is but can adapt to do the job. This takes time for the adaption to take place. The recovery for this can last around 9 months for a full return to sport (sometimes longer).
Following surgery the new ligament will be limited in the movement it is allowed to prevent re-rupture. During this time we may lose muscle mass, and strength in the operated leg. Along with the surgeon’s protocol for exercises, it is important to work with a physiotherapist. A physiotherapist can safely manage exercises, and progress exercises to provide optimal recovery. As we start to feel better, less pain, and stronger we may think we are ready for a return to sport. However, returning too early can increase our risk of re-rupture.
From this understanding, it is important to work with surgeons, doctors, coaches, and physiotherapists to help design a return to sport plan.
Time for bone to heal? So, you’ve just broken a bone. Not only having to deal with the pain associated with it, you have to wear a cast and potentially may need surgery. We are given general time frames as to when the bone will heal. But what does this process entail and why are we told 6-8 weeks for bone healing? Bone healing occurs over 5 phases. Initially we will see tissue destruction and haematoma formation (blood clot). Followed by inflammation. Soft bone formation. Hard bone formation, and finally a remodelling phase.
Within the first week following a broken bone the body will respond by creating a blood clot. This is to provide the bone with increased blood supply and nutrients. Within the blood other responses occur to help begin clearing out dead bone fragments. As well we will see growth factors influence the bone to begin bone healing. Furthermore we will also see increased formation of blood vessels within the blood clot to help supply the area with the needed nutrients. Similar to tissue healing this is the beginning of the healing phase, and starts from the beginning of injury and may overlap with the next stages of recovery. This phase can last up to a week before moving on to the next phase.
Now following the initial phase and the cleaning of dead bone fragments, the body will begin to form a connection between the two bone ends. It does this by creating a soft bone made of cartilage in order to help stabilise the break. From this increased stability the bone is able to continue with the healing process, and will continue to use the methods used in phase one and two to progress to a healthy bone. As the process continues the soft or cartilaginous bone shifts to a harder bone (trabecular). This bone will now be evident on imaging and appear swollen with respect to the rest of the bone. These phases of the healing process can last up to 3 months. Within this stage you may be given the all clear from your doctor to remove any casts and begin using the affected area again.
Within the remodelling phase you may have been given the go ahead from your doctor already to start using the area again in a safe manner. This phase can be simply put as a use it to improve it principle. As bone is formed around the injury, it constantly reshapes itself to provide more support where its needed. This phase can last up to 2 years. This length of time will not prevent you from doing the things you enjoy. Although it is important to understand that although we are back to activity, the bone is still recovering.
It is important to note that with bone healing you should always listen to the advice of your doctor as to when you can return to activity. Furthermore, it is important to work with physiotherapists to help prevent other complications. Complications may arise, as well as maintain movement in the surrounding areas.
Following this a physiotherapist can begin to progress exercises to further strengthen the area and mobility following the prolonged time of inactivity. Contact us today and see how we can help you.
As we touched on last week, how long until I recover can vary depending on structures involved. This week we will focus on the healing time of soft tissues (muscles, tendons, and ligaments). Soft tissue repair can be broken down to 3 phases: Inflammation, Repair, and Remodelling phase. Each phase holds its own importance in recovery, as well as its own time frame.
As a lot of us may have experienced when we first get hurt is swelling or bruising around the area. Some of the signs that may signal the beginning of inflammation is: Heat, Redness, Swelling, Pain, Loss of Function.
So we might ask what is the point of this and how long will it last?
Our body uses inflammation to bring in more blood and nutrients to the injured site to help begin the recovery process. The aim of inflammation is to contain and limit the injury. Initiate the repair process and splinting of the injured area. As this can be an uncomfortable feeling, we may think it will never end. However the typical length of this inflammation phase lasts anywhere up to 72 hours. This is not to say that we will have no swelling after 72 hours as we may see some lasting effects.
When recovering from an injury the repair phase begins by overlapping with the inflammation phase. Within this phase we will see the beginning of scar tissue being formed. This scar tissue is weak and randomly laid down to quickly repair the injured area. Within this phase we will see an increase in movement, and decreased levels of pain. This phase can last anywhere up to 2-6 weeks.
The remodelling phase is further broken down to two stages. In the first phase the weaker scar tissue being put down begins to shift toward stronger scar tissue. This first stage takes up to 2 months before shifting to the second stage. Within the second stage the scar tissue is being remodelled. This remodelling phase can last anywhere from 2-12 months. This scar tissue is remodelled through forces acting on the scar tissue which can consist of exercise, massage, or mobilization of the scar tissue.
From this we can better understand the question of ‘how long until I recover?’ Although we can be pain free within the first few weeks, it is important to know that healing can continue for up to 12 months. This continued healing is to better allow the tissue to return to its optimal level. Contact us now to get your recovery started.
As an athlete this is a question you may ask yourself ‘When Can I Return To Sport after an injury?’ post injury. However the biggest challenge to returning can be an injury that has sidelined you. There are a few factors to consider when planning on returning to sport. These can be: the time since the injury, the type of injury, or the effects of the injury on our body. So how will we know when it is safe to return to sport?
As our bodies take the time to properly recover from an injury, it is important to know what this means for our return to sport. Early on following an injury our bodies begin to protect us. It does this by creating inflammation around the area. This so you may noticed an increase in size. Along with this you may find you have less movement in the area. You may even notice a colour change of the skin/bruising. This is the bodies natural protective process which allows more blood flow and nutrients to enter the injured area.
However what a lot of us have probably noticed is that the area becomes a lot more sensitive to touch or movement. This may cause an increased levels of pain for something that should not hurt. This process of inflammation will typically start within the first 24 hours, and should last about 3 days.
Now as we let our natural healing process begin with inflammation, the type of injury can have a huge impact as well. Each sport holds its own risks as to what area or structure will be injured. Some sports are more prone to different types on injury. Some are muscle injuries, while others we see ligaments being stretched or torn, and we may even see a bone break. With muscle injuries we can generally see a healing times of 2-4 weeks. This is dependent on the severity of the injury. While when we look at ligaments we may see healing time frames of 6-12 weeks.
However a ligament injury can sideline us for up to 9 months depending on the severity and which ligament. Finally looking at broken bones, healing times can range from 6-8 weeks for minor breaks. This can increase that duration to 30 weeks, depending on the severity.
As athletes, we want to return to sport as fast as possible. This means we may find ourselves asking, “when can I return to sport?” Although we see injury healing times or feel no more pain and think we are ready to return, however that is not true. With any prolonged time off, and potential surgeries or casting of our injuries there are other things to consider before returning. This prolonged time off and lack of use can leave our muscles weak, or our fitness at sub-par levels.
Although we may have met the time frame given to us for our injury to heal, it is important to get our body back to game shape. Returning to game shape is not always about lifting heavy weights and going for runs. It is using every aspect of the game to make our body function at its highest level. So the question still remains “When Can I Return To Sport after an injury?”
Return to sport is variable for every athlete and injury, it is important to work with coaches, doctors, physiotherapists and anyone else involved to allow the optimal time to recover and return to game shape. Physiotherapists will give you a guideline as to how to progress through activities and exercises. Furthermore they will be able to better understand how the injury happened in the first place and provide a program that will prevent a future repeat of the injury and safely return you to the game you love.