Franklin Chiropractor | Scapular Dyskinesis

About your problem Scapular Dyskinesis. Your shoulder is formed by three bones; the scapula (shoulder blade), the clavicle (collar bone), and the humerus (long arm bone.) These bones come together to form a shallow ball & socket that relies upon the surrounding muscles for support. All of your shoulder muscles must work in a coordinated fashion to have a healthy and stable joint. Disruption of the normal rhythm of your shoulder blade creates abnormal strain on your shoulder and rotator cuff called “Scapular dyskinesis”. This dysfunction crowds the area of your shoulder where your rotator cuff tendons live and may create a painful pinching of your tendons or bursa each time you raise your arm. Many shoulder problems, including sprains/strains, tendinitis, bursitis, or rotator cuff irritation, result from this often overlooked culprit. Scapular dyskinesis most commonly originates from weakness or imbalance of the muscles that control your shoulder blade. Sometimes the problem is caused by other shoulder conditions like prior fractures, arthritis, or instability. Irritation of the nerves that control the shoulder muscles is the culprit in about 5% of cases. Although scapular dyskinesis can cause a variety of shoulder problems, it may initially go unnoticed. Up to 75% of healthy college athletes show some form of abnormal shoulder blade movement. If the condition is left untreated, you may begin to notice pain near the top of your shoulder. Sometimes the discomfort can radiate toward your neck or into your arm. Franklin Chiropractor. Patients will often complain of a tender spot on the front of their shoulder. Long-standing altered mechanics can lead to bigger problems, including rotator cuff injury, shoulder instability, and arthritis. Franklin Chiropractor. The good news is that the Franklin chiropractor have recognized the underlying cause of your shoulder problems and have treatments to correct it. You will need to perform your exercises consistently. You should also be conscious of your posture and try to avoid sitting or standing in “slouched”positions, as this is known to aggravate your problem. Our Treatment Hhre is a brief description of the treatments the Franklin chiropractor may use to help manage your problem. 1.Joint Manipulation -Your Franklin chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your Franklin chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints. 2.Myofascial Release -Overworked muscles often become tight and develop knots or “trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your Franklin chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility. 3.Therapeutic Exercise -Muscle tightness or weakness causes discomfort and alters normal j oint function, leading to additional problems. Your Franklin chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury. Some Things That You Can DoTo Help Yourself1.Sleep Posture – Your mattress and the position you sleep in may affect your condition. •Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses. •Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach. •Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms. 2.Exercise- Aerobic -Aerobic exercise requires your heart and lungs to work harder. Aim to get at least 20-30 minutes of exercise daily, 4-6 times per week to help prevent problems ranging from heart disease to back pain. •Start off gradually, and consult your doctor to determine your appropriate level of exercise. •Vary your activities to prevent overuse injuries. Examples include – Walking, swimming running, bicycling and low impact aerobics. •Work out with a friend for motivation. •Make sure that you are still able to talk while exercising (referred to as the “talk test”). Franklin Chiropractor
3.Workstation Ergonomics -Ergonomics is the science of adjusting your workstation to minimize strain in the following ways: •Maintain proper body position and alignment while sitting at your desk – Hips, knees and elbows at 90 degrees, shoulders relaxed, feet flat on floor or footrest. •Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge. •Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets). •Monitors should be visible without leaning or straining and the top line of type should be 15 degrees below eye level. •Use a lumber roll for lower back support. •Avoid sitting on anything that would create an imbalance or uneven pressure (like your wallet). •Take a 10-second break every 20 minutes: Micro activities include: standing, walking, or moving your head in a “plus sign” fashion. •Periodically, perform the “Brugger relief position” -Position your body at the chair’s edge, feet pointed outward. Weight should be on your legs and your abdomen should be relaxed. Tilt your pelvis forward, lift your sternum, arch your back, drop your arms, and roll out your palms while squeezing your shoulders together. Take a few deep cleansing breaths. 4.Nutrition-Brief – The foods we eat have a dramatic impact on how we feel and our bodies will perform best with quality foods. Franklin Chiropractor. Here are a couple of nutrition tips for better health & healing: •Decrease consumption of red meat & refined carbohydrates like sugar and white flour. •Choose “healthy” oils like olive or canola. •Increase consumption of vegetables and fruits. •Choose water over carbonated, caffeinated or calorie -laden beverages. •Consume six 8-oz glasses of water daily. 5.Lifting Mechanics -Here are some tips to help you lift safely: •Avoid lifting or flexing before you’ve had the chance to warm up your muscles (especially when you first awaken or after sitting or stooping for a period of time). •To lift, stand close directly facing object with your feet shoulder width apart. •Squat down by bending with your knees, not your back. Imagine a fluorescent light tube strapped to your head and hips when bending. Don’t “break” the tube with improper movements. Tuck your chin to help keep your spine aligned. •Slowly lift by thrusting your hips forward while straightening your legs. •Keep the object close to your body, within your powerzone” between your hips and chest. Do not twist your body, if you must turn while carrying an object, reposition your feet, not your torso. An alternative lifting technique for smaller objects is the golfers lift. Swing one leg directly behind you. Keep your back straight while your body leans forward. Placing one hand on your thigh or a sturdy object may help. 6.Exercise- Resistance -Resistance exercise involves pushing and pulling against weights or resistance. Resistance exercise should be performed three to four times a week. Consider the following: •Lifting lighter weights for higher repetitions (12-20) will build strength and endurance. •Lifting heavier weights for fewer reps (6-10) builds strengths but increases risk of injury. •Make sure that you alternate your routine between “pusher” and “puller,” muscles, ideally working them on different days. “Pushers” include: Shoulders, chest, triceps, abs, quadriceps, and calves. “Pullers” include: Biceps, back and posterior shoulder muscles and hamstrings. •Always check with your doctor before starting any exercise program. 7.Racquet Sports -Here are a few pointers for selecting your racquet: •Improper grip size is a known contributor to elbow problems. When you grip the racquet, you should be able to snuggly slide the index finger of the other hand between the tips of your fingers in the base of your palm. •A good grip overwrap can help prevent slipping and decrease the amount of force required to hold the racquet. (Factor the ext ra wrap into grip size, though) •Players should quickly release their grip tightness after ball-to-racquet strike in order to reduce stress on the elbow.•Increasing the size of your racquet head can help to reduce arm stress. •Avoid choosing “longer” or “heavier” racquets that will increase the amount of stress on your elbow. •Graphite is a light racquet but does not absorb vibration well. When possible, choose a more flexible frame that helps to absorb some of the shock of the ball’s impact. •Avoid playing with old or wet tennis balls as the additional speed and mass of the ball increases stress on your elbow. “Softer” or “stage 2” tennis balls weigh less than standard tennis balls which will produce less stress on your elbow when you strike the ball. These balls can also slow down the game slightly. 8.Sleep Habits -Researchers recommend sleeping for 7-9 hours per night. Even small deficits can pose problems like decreased athleticism, diminished brain function, increased inflammation and a greater likelihood to get sick- sleeping only 6 hours per night makes you four times more likely to catch a cold when compared to sleeping 7 or more hours. Follow these additional tips for better sleep: •Limit screen time before retiring- the blue light emitted from computer monitors, phones and TV’s can limit melatonin production and adversely affect sleep. Try reading from a book or magazine instead. •Ideally, eat your last meal 3-4 hours before bedtime and especially limit heavy, spicy or high-fat foods. Ration how much you drink before bedtime to minimize bathroom breaks. Particularly limit caffeine in the afternoon and evening- caffeine has a half-life of 6-9 hours and can keep you awake long after the last sip. •Stick to a sleep schedule, trying to retire and arise at the same time each day, including weekends. •Sleep on a comfortable mattress and pillow. Choose 100% cotton sleep clothes and sheets over synthetic materials (i.e. polyester). Some research has suggested that your “deep” REM sleep improves when your mattress is oriented so that your body is aligned North and South as opposed to East and West. •Most people sleep best in a cool room; ideally between 60-67 degrees F. 9.Yoga – Yoga is a popular method to stretch and strengthen the body. Many people enjoy yoga and it can be performed in groups or individually. Studies suggest that yoga may help reduce chronic pain and improve your ability to walk and move. Regular yoga exercises might have other health benefits such as reducing heart rate and blood pressure, and may even help relieve anxiety and depression. Follow these yoga tips to stay healthy: •If you’re new to yoga, find a reputable, experienced instructor and start with a Level I or Beginners class. •Start slowly and stay within your limits; don’t feel bad if you need to slow down or skip some poses. Listen to your body and avoid any position that causes pain. Remember this is all about relaxation, not competition. •Don’t compare yourself to others. Everyone has varying levels of flexibility and experience. Be patient. Like any other athletic activity, practice makes perfect (or at least better). 10.Mattress Replacement -The age and quality of your mattress have a major impact on how you feel. A worn-out mattress can certainly contribute to back and neck problems. Most experts agree that traditional mattresses should be replaced every 5-8 years. Since you spend about one third of your life in bed, choosing the right mattress is critical. Unfortunately, mattress selection is a highly individual process as there is no single “best” mattress. The following tips will help you make an informed decision: *Choose a medium-firm model. Mattresses that are either too soft or excessively firm can aggravate back pain. *Keep the pillow-top relatively thin. An excessively plush topper is the equivalent of placing a cheap mattress on top of a good one. *Always replace the box spring foundation when you replace the mattress. *Don’t choose the most expensive mattress in the store- but don’t set your budget unreasonably low. Bargain mattresses are not a good option. Your savings should be focused on avoiding unnecessary add-ons (mattress covers, custom sheets, pillows, etc). *Look for vendors that provide an in-home warranty that allows you to exchange the mattress if it does not meet your expectations. *Your chiropractor may be able to provide additional suggestions to help you choose between, coil spring, memory foam, water and air beds. Your Home ExercisesPatients often ask “What caused my problem and how do I keep it from returning?” Sometimes the origin of a condition may be easily identified as an accident or injury. More often, the exact cause is more difficult to pinpoint because the problem was generated by a series of seemingly harmless events and circumstances (i.e. your posture, increased activity, mild repetitive strains, etc). Most conditions are started by a “recipe” of irritants rather than any single “ingredient”. Muscle, bone, joint and nerve problems begin when life’s physical demands exceed your bodies tolerance for those challenges. So the answer to the second half of the “…and how do I keep it from returning” question is answered by increasing your flexibility and strength, so you can increase your “thre shold” for future injury. When your injury threshold is greater than life’s demands-you win and stay healthy! The following exercises have been specifically selected to assist with your recovery and help minimize future problems. Exercises should be performed slowly and within a relatively comfortable range. Maintain good posture and breathe naturally. Do not hold your breath. Unless otherwise instructed, stop any exercises that cause pain, or radiating symptoms. Phase I1.YTWL Scapular Depression -Stand with your straight arms raised above your head in a “Y” position. Squeeze your shoulder blades together and downward throughout the following sequence of movements. Lower your straightened arms to shoulder level, into a “T” position. Next bend your elbows so that your fingers are pointing straight up while slightly lowering your elbows to make a “W”. Finally, while keeping your elbows bent 90 degrees, lower your arms to your sides so that your elbows are touching your ribs to form an “L” on each side and squeeze. Hold each position for 1-2 seconds and repeat 3 sets of 10 repetitions, twice per day or as directed. 2.Trapezius Stretch -While sitting or standing, reach down with your right arm, grasping your thigh or the bottom of a chair for stability. While looking straight ahead, place your left hand on top of your head, and gently pull your head sideways toward the left. Against the resistance of your arms, attempt to bring your right ear and right shoulder together for seven seconds. Relax and stretch further toward the left. “Lock in” to each new position, and do not allow any slack. Repeat three contract/relax cycles on each side twice per day or as directed. Franklin Chiropractor
3.Corner Pectoral Stretch -Begin standing, facing a corner with your palms on the walls above head level. Step toward the corner and “lean in” to stretch your chest muscles. Against the resistance of the wall, attempt to push your hands into the wall and toward each other for 7 seconds. Relax and “lean in” to increase the stretch. Lock into this new position and repeat 3 contract/ relax cycles, twice per day or as directed. Phase IIThe following Phase II exercises will be started at a later date as you progress. Do not begin Phase II e xercises until you are directed to do so by our office. You will continue your Phase I exercises until otherwise directed. 1.Low Row – Attach the center of an elastic exercise band to a doorknob or other sturdy object in front of you. Grasp one end of the band in each hand and with straight arms at your side, stretch the band backwards. Keep your palms facing backward and arms pointed straight down throughout the exercise. Return to neutral and repeat 3 sets of 10 repetitions daily, or as directed. 2.Brugger with Band -Begin sitting or standing with an elastic exercise band wrapped and secured around your palms. Begin with your arms at your side, elbows bent, forearm’s pointing forward. Move your hands apart from each other to maximally stretch the band while simultaneously rotating your palms out, straightening your arms, and pinching your shoulder blades together as your hands move behind your hips. Return to the start position and repeat 3 sets of 10 repetitions daily, or as directed. Franklin Chiropractor