Frozen shoulder – what is it and what to do about it

Have you been diagnosed with frozen shoulder? Here is a brief summary on what it is, what to expect, and what can be done about it.

What is Frozen Shoulder?

Frozen shoulder, or adhesive capsulitis, is a poor and exaggerated response by the body to an injury to the shoulder.  It is unknown what causes it, but it is more prevalent in women, if you’re in your middle ages, and in those with diabetes.  There are 3 stages to this nasty condition:

Freezing stage: this stage can last weeks to months.  The capsule around the shoulder starts to stiffen and scar and you lose significant movement in the shoulder.  It is also very painful during this stage!

Frozen stage: again, this stage can last for months.  During this stage, the shoulder becomes less painful, but it is still very limited in movement.

Thawing stage: the shoulder begins to settle in pain and stiffness.  Finally, you will be able to regain some function to your shoulder.

How to Treat Frozen Shoulder?

During the freezing stage, anti-inflammatories and/or a corticosteroid injection may help to settle the pain and irritation.  During the frozen stage, you guessed it, physical therapy, can be started to get the shoulder stronger and moving again.  During the thawing stage you will get the most gains from physical therapy.  It is important you get hands on physical therapy.  This article shows that joint mobilizations in addition to exercise is far superior in regaining your range of motion and function than exercises alone.  You will be in good hands at our clinic, as during every session you will receive hands on treatment to massage and stretch tight muscles and tissues, mobilizations to your shoulder and shoulder blade, and perhaps acupuncture or dry needling to treat your pain and trigger points.

http://journals.sagepub.com/doi/abs/10.1177/0269215515597294

Please contact our clinic if you have any further questions or would like to book an appointment.

Running season is coming! Here are some tips for training and preventing injury

Elizabeth Clark, one of our physical therapists, is training for another marathon and sharing her advice for those who are starting up their running season. Through her talks at The Running Room, here are answers to some of the common questions she gets from runners.

Running Room Presentation

If you have any questions or would like to get further assessed, feel free to contact us at 780-756-3535 to book an appointment with Elizabeth.

Torn ACL? Surgery may NOT be the answer!

I recently attended a talk on ACL injuries in the knee and whether surgery was necessarily the best option for treatment.  The key points from the talk were:

  • Managing expectations is always the key – it is important to realize that you may not get your old knee back with surgery!  Even with surgery, you may not be able to return to sports like before. Post ACL repair there is also a high risk for re-injury of the ACL again; in females it is in the opposite knee, and in males the same injured knee.
  • After 5 weeks of physical therapy rehab post injury, you’ll have a good indication of how your knee will recover.  It is possible to return to high level sports with torn ACL’s!
  • Delaying surgery up to 6 months post injury may be more beneficial, as this allows time for the inflammation to settle and the knee to recover in strength prior to deciding whether surgery is required.  A recent long term study showed that after 2 years, there were few differences in knee function and return to high level sports in those who had surgery versus those who did not.

So the take home message is that physical therapy is important post ACL injury.  Physical therapy may be all that you need to regain your function!

Attached are 2 articles that were discussed at the talk:

JOSPT-JBJS_March_30_webinar_articles

For more information, you can contact Janice at The Grange Clinic at 780-756-3535

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition which impacts the median nerve at the level of the wrist joint.  The median nerve is one of the three main nerve supplies to the hand.

carpal-tunnel

Carpal tunnel syndrome refers to compression of this nerve which can result in:

1) pain
2) tingling and/or numbness (usually of the thumb, index, and middle fingers)
3) weakness
4) decreased and/or loss of fine motor function of the hand

Treatment scenarios for this condition can include the following:


1) night splinting
2) physical therapy
3) cortisone injections
4) in severe cases, surgical release of the carpal tunnel

Treatment “tips” to minimize carpal tunnel include the following:

1) Avoid prolonged repetitive tasks which include the wrist, digits, or both
2) Avoid extremes of wrist range of motion – either wrist extension (backward motion) or wrist flexion (forward motion)
3) Rest periods of just a few seconds for the hands can go a long way to the prevention and/or minimization of carpal tunnel syndrome

For more information or to be assessed to see if you have carpal tunnel syndrome, please contact our Grange location and book an appointment with Gail Hamilton.  Gail has over 40 years of experience and specializes in treating hands.

What to do if you’ve been in a car accident?

With all the rain we’ve been getting this winter, the roads have been quite slick and if you’ve been involved in a motor vehicle accident (MVA) we’re here to help.  Here is a step by step guide to help you through this stressful time.

 

  1. If you were seriously injured, have either paramedics at the scene or a friend/family member take you to Emergency to be assessed. Such injuries would include if you suspect a broken bone or dislocation, have lacerations which require stitches, or lost consciousness at the scene and have signs of a concussion:

  – dizziness

  – blurred or double vision

  – headache

  – nausea or vomiting

  – drowsiness

  – problems focusing or with memory

 

  1. If there is more than $2000 worth of damage you will need to go to a police station and fill out a police report

 

  1. Regardless of who is at fault, contact your motor vehicle insurance company. They will start up a claim and put you in contact with an adjuster who will handle your claim. They will also send you a form(which they call an AB-1 form) to fill out and send back to them. You can find this form on our website under “Forms” if you’d like to get started on filling it out.  Insurance companies typically want this form returned to them within 10 business days.

 

  1. If you’re injured and require treatment, depending on the injury your treatments could be directly covered by your motor vehicle insurance company. You can contact our clinic to make an appointment to be assessed by a physical therapist, who can then advise you if treatments will be covered and also refer you to massage therapy if warranted. You do not need to see a physician to be referred to physical therapy, however, you may want to see one if you require any medication or time off from work.  Please note, it can take up to 2 weeks for injuries to fully present themselves.

 

  1. Ice versus heat? Typically we recommend ice for the first 2 days to settle your inflammation, then switching to heat.  A towel placed around a frozen bag of peas is a convenient way to apply ice on any area.  Make sure you have good sensation on the area you are applying ice or heat so that you will be able to tell if it gets too cold or too hot.  Usually 15 minutes of application is enough and can be repeated every 1-2 hours as needed.

Repetitive Ankle Sprains

Are you fairly active? Do you suffer from repetitive ankle sprains? Well let’s discuss about ankles this time!

The ankle is a complex joint that is able to move in many directions but it is also expected to take your body weight (and more if you are jumping or running). This makes it necessary for the ankle to be supported by many active structures like muscles and tendons and also passive structures like ligaments.  When you injure the muscles/tendons in the ankle, it is referred to as a strain, and when you injure the ligaments (which are more common) it is referred to as a sprain.

The following picture gives a brief idea about the anatomy of ligaments that are often involved in most ankle injuries. In the majority of situations, the ligaments injured are the ones that support the outside of the ankle, primarily the anterior talofibular ligament and middle calcaneofibular ligament.

 ankle-diagram

Our body can, as in most situations, heal an injured structure with scar tissue so long as the injury is not too severe, but if not managed properly there could be some degree of leftover:

  • Weakness in the joint
  • Decreased movement in the joint
  • Decreased proprioception

Of the above three the first two are self-explanatory and if left unrestored can lead to repetitive ankle sprains. Let’s discuss about proprioception a bit here. 

To put it simply: proprioception is the ability to perceive the relative position of a joint in any given situation. This awareness leads to better muscle activation, thereby leading to improved active protection of the joint.

If left untrained, the decreased proprioception and hence the decreased position sense in the joint makes an individual more prone for a repeated injury. Proprioception can be restored by doing proper…

  • Balance training and
  • Impact training

These exercises are to be initiated once adequate healing has occurred in the ankle and may have to be continued for several weeks depending on the severity of the original injury.

So physical therapy will help not only with improving your muscle strength and restoring your ankle mobility, but also with providing you proper proprioceptive retraining to help prevent another injury in the future.

Sudharshan Sundararajan is a physical therapist at our Grange location and with over a dozen years of experience behind him, he has successfully treated numerous ankle injuries in the past.  Please contact one of our clinics if you’ve suffered an ankle injury and would like to have your ankle assessed!

Do you have heel or arch pain?

Plantar Fasciitis

With the warmer weather (finally!) many of you are getting back into running and walking outdoors.  So this month’s topic discusses a common cause for heel and arch pain – plantar fasciitis, which is inflammation of the thick ligamentous tissue which starts at the heel of the foot and fans out to the base of the toes.

 

heal pain or plantar fasciitis

 

Symptoms:

–          Dull pain to the heel of your foot and into the arch

–          Pain is worse and often sharp after sleep or rest and subsides after walking a few minutes

–          Pain may increase with a full day of being on your feet

–          Symptoms usually start in one foot and can move to the other due to limping/compensating

Causes:

–          Poor/improper footwear

–          Increased standing, walking, or activity level

–          Walking/standing on hard surfaces

–          Running hills or on soft terrain (sand)

–          Genetics: pronated feet or a high rigid arch

–          Heel spurs

–          Increased age or weight

The good news is that plantar fasciitis is completely treatable and curable.

We will help settle the inflammation, release active triggers in your muscles and plantar fascia, assess and treat for any joint stiffness, as well as recommend proper footwear for your feet.  We also carry a wide range of Superfeet insoles that can fit into your regular footwear to provide heel and arch support.

These insoles are an affordable and effective option as most people do not require custom orthotics for proper support.

If you have any questions or would like to book an appointment, please contact one of our clinics today!

Janice Bealer, a runner herself, works at our Grange location and has a keen interest in treating injuries related to running. Acupuncture and dry needling are often included in the treatment plan as well. Feel free to contact her if you would like any further information.

Did you get diagnosed with “lumbar spinal stenosis”?

Lumbar spinal stenosis (LSS) is a condition in which there is a narrowing of the pathways that nerves and blood vessels pass through within the lower aspect of the spine.

This leads to back/leg pain in clients and significant disability (most commonly in a reduced ability to walk). Spinal stenosis is the most common diagnosis for spinal surgery in adults over 60 years of age.

Physical therapists are able to diagnose spinal stenosis based on signs and symptoms from a thorough verbal history, a physical examination, and a detailed investigation of tests like X-rays and MRIs.

Prior to the option of surgery becoming available, most patients are recommended for physical therapy. Research done by our group saw approximately 60% of patients with LSS in Canada are referred for physical therapy.

Our team had the opportunity to conduct a detailed review of the current state of research evidence on LSS, a process known as a systematic review. In our study, we found that exercise therapy is more effective for LSS than not exercising for back and leg pain.

Physical therapy was also found to be just as effective for improving walking distance in the long-term (2 years later) as surgery. Prescription of lumbar braces were also effective in improving walking distance. The advantage of seeing physical therapy is that we can tailor exercises to your symptoms and make sure that you are exercising safely and effectively.

Prescribing a lumbar brace is also very important through us as you want a proper, tailored fit specifically to your condition. There are many products available and getting the best one for your back is vital. While typically long-term pain outcomes are in the favor of surgery, improving quality of life and disability with physical therapy is just as effective and can be a good option for those attempting to avoid surgery.

Research is still ongoing but current evidence shows physical therapy has a large role to play in helping LSS.

Joey Mo is one of our physical therapists at our Callingwood location. Staying up-to-date on the current state of research is an important aspect of being a physical therapist so that we can best help our clients. You can read Joey’s paper titled Physical Therapy Interventions for Degenerative Lumbar Spinal Stenosis: A Systematic Review published in the prestigious journal Physical Therapy: Journal of the American Physical Therapy Association and Royal Dutch Society for Physical Therapy. If you are experiencing back pain or difficulties walking, or if you would like to speak to our physical therapists more on LSS, give our clinics a call to see if we can help you on your road to recovery.