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Is shoulder pain affecting your plans for the summer?

As summer approaches many experience shoulder pain, typically due to increased activity. Whether you aspire to athletic endeavors such as golf, baseball, tennis or prolonged activities such as gardening, shoulder pain is often the first sign of a muscle imbalance and weakness.

Rotator cuff problems are one of the many injuries we treat and resolve at Premier Physical Therapy. The two most common questions patients have for us are:

1. What does this diagnosis mean?
2. How can physical therapy help me return to normal?

The shoulder is an extremely complex area of the body made up of four joints and a multitude of supporting ligaments and muscles. These structures work together to allow mobility needed to perform activities such as reaching to a high shelf or playing tennis. Since there is minimal stability within the shoulder, it is critical for all muscles to work together providing support during movement. When compromised, rotator cuff problems can occur resulting in pain with activity.¹ Changes such as tendonitis, muscle tears and bone spurs are common. Muscular imbalances and ligament tightness within the shoulder joint are often the cause and can be treated conservatively, without surgery.²

After completing a comprehensive evaluation, your physical therapist will create an individualized program based on their findings. Common goals of physical therapy are to help relieve pain, improve mobility and strengthen weak musculature while educating the patient on techniques to keep their shoulders “happy” and pain free.  One key area that can help to relieve shoulder pain is posture. It has become more common for people to spend long periods of the day sitting in front of a computer. This causes people to demonstrate a rounded shoulder posture due to adaptive shortening of their pectoral muscles and weakness/adaptive lengthening of their scapular stabilizer muscles. By elongating (stretching) the tight pectoral muscles and strengthening the scapular stabilizer muscles the scapula is able to be in its proper position on the body, which can help to improve mobility. As a result, there will be less stress on other structures within the shoulder reducing compression on the rotator cuff muscles. It is also common for physical therapists to focus on strengthening the rotator cuff muscles utilizing therapeutic exercises. This is critical since these muscles are extremely important to provide support during quick or extreme movements. As therapy progresses, you will begin to incorporate sport or recreational activity specific activities so that you can get back on your field of choice or into the garden.

Citations:

1. Neer CS. Impingement lesions. Clin Orthop. 1983; 173: 70-77.
2. Ellenbecker TS, Manske RC, Kelley MJ. The shoulder: physical therapy patient management utilizing current evidence. In: Current Concepts of Orthopaedic Physical Therapy. 2011; 3: 20-29.

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Our joints go through a lot every day, whether it’s simply standing or walking, or even sitting while at school/work. It is essential to protect our joints in order to reduce pain and allow us to participate in all of the activities we want. Remaining active with regular exercises is not the only way to take care of your joints — what you put into your body can also have an affect. A healthy and diverse diet can directly contribute to joint health via nutrients, and can also help with weight loss, which makes life a lot easier on your joints. Studies have shown that losing 1 pound of body weight can result in a reduction of 4 pounds of joint stress in the knees. Add this up for every step you take during your day, and you can really save a lot of work on your knees. The focus of my article today is to help you get the nutrients your joints need and easy ways to promote weight loss with diet modifications. Here are the ingredients required for good joint health.

 Calcium and Vitamin D

Calcium is an essential mineral and is stored in our bones. Vitamin D is needed as it helps absorb the calcium we ingest. Without adequate Vitamin D levels, eating foods rich in calcium won’t help you out very much. Calcium is required for basic body functions including the ability of the bones to withstand force. Calcium and Vitamin D can be found in:

Calcium – dark leafy greens, dairy products (milk, cheese, yogurt), nuts, fish.

Vitamin D – produced by the body with exposure to sunlight without sunscreen for about 10-20 minutes.

Omega- 3 Fatty Acids and Antioxidants (Vitamins A, C, E)

Omega-3 fatty acids help reduce inflammation (swelling). As we use our joints more or if we have pain in our joints, the body responds with inflammation to the area as a protective response – however, this inflammation can further contribute to pain and reduce range of motion. Anti-oxidants help fight off free radicals, which can promote inflammation and can further damage joints. Found in:

Omega-3 – halibut, salmon, shrimp, nuts, whole grains, fish oil.

Antioxidants –fruit, dark leafy vegetables, carrots, almonds, avocado

Fiber

Fiber plays a role in reducing blood glucose levels, which have been linked to inflammation. In addition, foods high in fiber help digestion and typically make you feel fuller for a greater time, which in turn helps with weight loss. Found in:

Fruit, vegetables, beans, whole grains, nuts and seeds.

Protein

Protein is the essential building block for muscle, bone, and tissue including joints. Regular protein intake will ensure that the body has the resources necessary to protect its joints as well as the muscles that surround each joint. Lean protein is recommended as it contains less fat and therefore will help contribute to weight loss. Found in:

Chicken, turkey, free-range grass-fed beef, fish, beans, soy.

Water

Joints have fluid running through them to act as both lubrication but also a source of receiving nutrients from the blood. Remaining hydrated will ensure a greater blood volume with better delivery of nutrients to the joints, as well as increased lubrication for smoother and less painful motion. It is suggested to have roughly 0.5-1.0 oz of water per pound of body weight.

Supplements

Due to poor dietary choices and access the average American is deficient in many essential vitamins, minerals and other nutrients, which are the building blocks for healthy joints. Obtaining nutrients from organic, unprocessed foods should always be your first choice. However there may be times when your body requires additional nutrients via supplementation due to injury or poor diet. Here are the top two for joint health.

 Glucosamine and Chondroitin

Key components of cartilage, which makes up joint tissue. Although naturally produced by the body, supplementing may be necessary when joint pain or arthritis is present. Glucosamine/chondroitin has been scientifically researched and found to aid with joint health.

 Curcumin, Ginger & Bromelaine

Studies have shown curcumin, ginger and bromelaine to have anti-inflammatory effects, decrease pain an increase joint health. Curcumin is naturally occurring in the spice turmeric and bromelaine is an enzyme found in pineapple. Ginger is a commonly used in teas and stir-fry.

Now that you have a wide variety of foods to choose from, here are some suggestions for meals/snacks that will not only promote joint health, but also weight loss.

 Breakfast:

Low fat milk with low-sugar whole grain cereal

Low fat Greek yogurt with a berry medley topped with whole grain oats

2-egg omelet with spinach, avocado and low-fat cheese

Ginger tea

Orange Juice

Lunch/Dinner

Spinach and arugula salad with lean chicken, tomatoes walnuts, flax seed with freshly-squeezed lemon juice dressing

Grass-fed, free-range beef or turkey burger with whole-wheat bun accompanied with a dark-leafy green salad

Grilled salmon crusted with almonds served with a side of roasted broccoli and brussel sprouts

Tuna sandwich with a cabbage slaw

Lean grilled chicken with a cucumber-mint yogurt sauce wrapped up in flatbread with red bell peppers and cucumbers

Snacks and Sides (Instead of reaching for that bag of chips, try these)

Carrots, celery, and other crunchy vegetables with low-fat hummus

Low-fat Greek yogurt

Vegetable/Fruit Juices

Fruit (Apple, banana, pineapple, orange, etc)

Mixed nuts

These are just a few options but you now have all the ingredients to get creative and protect your joints at the same time. Remember! A program to rehabilitate an injured joint from trauma, surgery or disease should include physical therapy combined with sound nutrition principles. This will be the quickest path to healing.

In good health,

Mohit Birdi, PT, DPT, CSCS

References:

http://education.athletesperformance.com/articles-2/articles-from-ap-specialists/using-nutrition-to-support-joint-health/

http://www.arthritistoday.org/what-you-can-do/eating-well/arthritis-diet/eat-to-beat-inflammation.php

http://healthyeating.sfgate.com/bone-joint-nutrition-4741.html

http://www.naturemade.com/resource-center/articles-and-videos/joint-and-bone-health/food-and-nutrients-that-fuel-joint-health

 

 

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