Keys to Managing Your Shoulder Pain

Shoulder pain is a game changer. A painful shoulder can quickly limit the activity level for athletes and non-athletes alike.

The shoulder joint is the most mobile joint in your entire body.  With that being said, eliminating the pain in such loose joint is no easy task.

7 Sports Medicine Tips to Manage Your Shoulder Pain.

Pendulum Swings – With the hand of the pain-free shoulder resting on a chair and a 10-15 lbs weight in the other hand, slowly move the weighted hand in a slow circular motion.  This will distract and relax the muscles surrounding the painful shoulder joint. Swing the hand/arm like a pendulum in both clockwise and counter-clockwise directions.

Pliable Chest Muscles – Longer and more flexible chest muscles are vital for a happy pain-free shoulder. Start by aggressively massaging the deep chest muscles with fingers or a baseball (warning; it hurts but it works). Next, stretching the superficial chest muscles in a door frame is a simply way lengthen your broad, strong chest muscles.  By doing so, the more flexible chest muscles will now allow for greater mobility of three (3) bones which make up your shoulder girdle (upper arm bone, shoulder blade & collar bone).

Strong Shoulder Blade Stabilizers – You have 17 muscles anchored to each of your shoulder blades.  Keeping your upper back strong helps protect the shoulder joints by controlling the intricate motions of the shoulder blade.  To do so, seated rows, bent-over flies, cable “T’s” and good ol’ scapula squeezes need to be part of your shoulder plan.

Enduring External Rotators – Of the four (4) muscles forming your rotator cuff, the two external rotators are the most important when it comes to prevent shoulder injury.  The key factor with shoulder external rotators is not just strength. Hence, having great endurance of the external rotators should be your goal.  Doing high repetitions (>15 reps) using cable weights or simple exercise bands will help accomplish this.

Overhead Stretches – Add low-intensity pain-free overhead stretches to your routine. Examples include 25-50% body weight hangs from a pull-up bar/door frame or bend-over stretches with hands on a high counter.

Limited Overhead Strengthening – Anytime you perform strength work above your shoulder level, you’re increasing the stress on your rotator cuff. You can sufficiently strengthen all your shoulder, back and chest muscles without ever elevating your elbows above your shoulder.

Strong Posture – Daily tasks like driving, working on a computer and carrying objects all contribute to poor posture and shoulder pain.

Strong posture = Shoulder blades “back and down” + chin over ribs

The Quest for Happy Shoulders

Most of the painful shoulder joints I treat have key problems related to their shoulder girdle. These 7 sports medicine tips will help you protect two very important joints.

Remember this simple formula: Happy shoulders have mobile shoulder girdles, great endurance of their external rotators and strong upper back muscles.

The Myths and Truths Inside a Painful Shoulder

Because it is one of the most mobile joints, the shoulder joint is also one of the most injured joints in the human body. This is because joint mobility and stability are inversely related.

Simply stated; The more motion a joint has the more instability of inherits.

Because of the high stress on the shoulder joint during a demanding and active lifestyle, it gets injured often.  A painful shoulder may have multiple sources of pain including tendons, muscles, bursas, labrums, loose bodies, rotator cuff or arthritis.

Learn the top 3 myths of shoulder pain and the simple solutions to manage your painful shoulder.  The recovery doesn’t have to be complicated.   During my past 30 years as a physical therapist, I’ve learned the patients with a simple plans and a consistent routine typically have the best outcome.

Click Here For My Spartan Race Article Titled: SHOULDER PAIN? 3 MYTHS & 3 SOLUTIONS

As the Sports Medicine Expert for Spartan Race, I write posts for fellow Spartan racers and SGX coaches related to helpful sports medicine topics.

How Sleep Impacts Injuries

  By Sarah Westgreen at Tuck Sleep

When you don’t sleep enough, you’re not at the top of your game. Sleep deprivation can make you more susceptible to injuries — and make it more difficult to recover from existing injuries.

Sleep and Injury Prevention

Sleep deprivation makes physical and mental activities more difficult to complete, as your cognitive and motor skills are diminished. When you’re short on sleep, your muscles don’t respond as quickly as they would if you were well-rested, and your concentration and attention suffer. Sleep deprivation can affect your balance and motor skills. A lack of sleep can lead to injuries, as you aren’t physically or mentally prepared to perform at your best.

According to a recent study of adolescent athletes, when athletes slept enough each night (eight or more hours), they had a 68 percent lower risk of injury than sleep-deprived athletes. The decreased likelihood of injury was significantly associated with the number of hours of sleep per night. Rest was a greater factor than how many sports the athletes played, whether the athletes played year-round, and the trend toward athletes specializing in a particular sport.

💤💤💤 and Injury Recovery

Skeletal muscles can regenerate after a muscular injury, but your body needs support to do so. Sleep is an integral part of the process of regeneration, and when you’re sleep-deprived, your ability to repair and regenerate muscle tissue is weakened.

A recent study suggests that sleep has a permissive role in damaged muscle tissue regeneration and that sleep loss impairs recovery from muscular injuries. Subjects who were sleep-deprived showed lower indications of muscle repair and indicated deficits during recovery.

Injury Rehabilitation and Prevention

Sleep is one of the most effective tools for supporting athletic wellness. When you get enough sleep, you’re less likely to become injured during athletic activity, and you support better recovery from existing injuries. Athletes should always get the recommended amount of sleep each night: generally, adults need about seven hours of sleep. However, during intense training or recovery periods, up to 10 hours of shuteye may be beneficial. Adolescents typically need about nine to 10 hours of rest every night.

Use these tips to maximize your recovery and reduce the likelihood of sports injuries with sleep:

  • Prioritize Your Rest – Sleep is a more significant factor in preventing injuries than the number of practice hours. Don’t sacrifice sleep for training. Plan ahead and make sure you have enough time each night to get the sleep you need. Figure out what time you need to wake up in the morning, and count backward to determine your bedtime.

  • Mattress Meeting Your Needs – Choosing a mattress that supports your preferred sleeping position can help you sleep better and feel better when you wake up. With the right bed, you’ll be well supported and take the pressure off of pain points on your body. Some mattresses offer features that may reduce inflammation and aid muscle recovery.

  • Avoid Late Night Exercise – Exercise is generally beneficial for sleep, but when you exercise late at night, you may feel too energized to get to sleep. It’s best if you finish activities at least a few hours before bedtime.

  • Practice Healthy Habits – Good sleep hygiene can help you make the most of your sleep hours. Maintain a regular sleep schedule and bedtime routine, and make your bedroom a healthy sleep environment that’s cool, dark, quiet, and comfortable. Avoid pitfalls that can interfere with quality sleep, such as late-night caffeine, eating heavy meals before bed, and using electronic screens in bed.

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Tuck Sleep is a community devoted to improving sleep hygiene, health, and wellness through the creation and dissemination of comprehensive, unbiased, free web-based resources. Tuck has been featured on NPR, Lifehacker, Radiolab and is referenced by many colleges/universities and organizations across the web.

Pain Management Made Easy

For most, the term “pain management” creates haunting visions of pain medicine, drastic lifestyle changes and expensive doctor bills. In the sports medicine world, that same phrase paints a much rosier image.

“Not all pain is created equal.”  Different types of tissue in your body can generate varying types of pain. Here’s a list of body tissues, which can all be located in the same small part of a joint, and the different types of “pain” sensed in each:

Nerves – Burning, numbness, shooting, weakness.

Bone – Stabbing, deep ache, shooting.

Muscle – Cramping, stabbing, shooting, aching.

Ligament – Instability, snapping, stabbing.

Cartilage – Catching, stabbing, pinching.

I never really thought about how many different type of pain I can feel“, you’re probably thinking.

One of the biggest challenge facing a physical therapist, athletic trainer and doctor is asking the right types of questions and interpret their tests to find the source of pain in their patients.  Pain management starts with finding where the pain is coming from.

Think about it this way: If we, the sports medicine specialist, can quickly determine that 90% of your pain is coming from, say, your supraspinatus muscle of your shoulder’s rotator cuff, we can quickly develop a rehab plan to reduce your specific pain.

Pain Management Plan

It’s time to stop focussing on pain pills as the solution for reducing pain in orthopedic injuries.  Sure, check with your doctor to get his/her thoughts but know there are many safer, cheaper and effective ways to use physical therapy to reduce your pain.

Ice

Ice will reduce pain and swelling.  Ice will hurt at first but it works.  Toughen up and try icing your pain for at least 6 times before judging it’s results.  Ice can change your life.

Methods of icing:

Ice Bucket – Place the injured/sore body part into a bucket of ice water. It’s an aggressive way to ice but the benefits are quick and lasting. Timing: 10 minutes max.

Ice Bags/Packs – Wrap with an ace bandage to add compression.  Timing: 15 minutes max.
Ice Massage – Peeling down a paper cup filled with frozen water is the best way to ice a localized area of pain.  Timing: 10 minutes max.

Massage

Massage will increase blood flow into a body part while increasing the lymphatic drainage out of an area of discomfort.

Flexibility

Good old stretching will lengthen tissue such as muscles, joints and fascia to reduce the pressure on nerves and painful soft-tissue while enhancing the blood flow into your entire extremity.

Hydro Therapy

When it comes to reducing pain, hydro therapy can consist of using a hot tub, cold tub, hot show, cold shower, cold mountain stream or a combo of both hot and cold water. The benefits of hydro therapy can range from relaxing painful tissue, numbing a body part, tricking the nervous system, altering the blood flow to an extremity and/or blocking the sensation of pain.

That last sentence may sound out of character or even barbaric when discussing a “medical” topic. The truth is I’m a huge fan of hydro therapy because it has a way of healing the body in a peculiar manner when other more scientific techniques fail.

Ending Ice Bag….

In closing, pain doesn’t have to be part of your day. Challenge yourself to find safe and effective ways to put pain in your rearview mirror. Initially, eliminating your pain completely may not be a realistic option.  But just think how much better your lifestyle will be if you used these techniques to reduce both the intensity and the frequency of your pain by just 50%?!

NOW is the time to rewrite your Pain Management Plan.  Let me know how I can help you to beat your pain the smart way.

Lifestyle Matters: What I Learned from my Physical Therapy Patients This Week

“Educate your physical therapy patients” was the message my fellow classmates and I heard as we polished our healthcare skills in the outstanding physical therapy program at UConn.

30 years later I know the truth is this: My physical therapy patients teaches ME something every day, as long as I’m truly listening…with my ears, eyes, hands and heart.

What’s the most important message I learned from my rehabilitation patients this week?  Their lifestyle matters.

The professional physical therapist and certified athletic trainer in me is trained to help my patients restore important skills such as muscle strength, joint range of motion, flexibility, balance, endurance and coordination.  That all sounds important to me but those same skills are not always a top priority for my patients.

I learned a valuable lesson this week, thanks to my awesome physical therapy patients.

I had four high level patients from completely different sports all tell me, in various ways; “I want my lifestyle back!”  Their passion and pain was raw and honest.  I would have been a fool to not hear their pleas.

What Were My Physical Therapy Patients Really Saying?

My patients were telling me: ‘Instead of you focussing on strength numbers, fancy orthopedic tests and big medical words, just help me get back to doing what makes me happy!’  It’s just that simple.  Their words and body language made it clear:

“Stop trying to make me move like the perfect athlete.  Instead, help me get back to the same active lifestyle which made me excited to jump out of bed every day!”

How cool is it that we, as trusted partners of those in pain and body limitations, have the ability to restore someone’s lifestyle?!  That role is so important to those in our care.  As a physical therapis or athletic trainer, it’s our job to listen to them and respond accordingly.

My Take Home Points

    • People need to live the lifestyle which makes them happy and it’s my job to help that happen.
    • Ask those in pain better questions, then shutup and listen.
    • Teach others how to listen to their body.  Our amazing bodies are much smarter than we think.

To my patients, thank you.

MDR

Checklist for Surgery: Rehabbing Like a Pro Athlete

I’m often asked: “How do pro athletes heal so fast following a major surgery?”

My answer is two-fold: “They lock into a positive attitude before they go under the knife and, more importantly, they take an active approach to jump-start their recovery immediately after surgery.”

Successful elite athletes never take a passive approach following any surgery.  An active game plan going into and coming out of a surgery is a secret trick used by professional medical staffs.

On the eve of my 7:30 AM hernia surgery tomorrow, I already started my recovery game plan exactly like I did for the Jacksonville Jaguars players when I was their Head Athletic Trainer and Physical Therapist.  If this checklist proved to be a successful for my players during my 26 years in the NFL, I’d be a fool not to utilize this powerful recovery tool for myself!

Let me share with you my Checklist for Surgery: Rehabbing Like a Pro Athlete.

  1. Pre-Surgery Treatment – Consistent flexibility and massage of every muscle impacted by the upcoming surgery.  This provides relaxed, blood-filled and healthy tissue for the surgeon to work his/her surgery magic.
  2. Medical Team On-Call – Surgeon, primary care doctor, physical therapist, massage therapist and the all-important spouse are all on the same page AND available 24/7 if a problem or question arises.
  3. Written Rehab Protocol – Not assumed, guessed upon or TBD’ed….the rehab game plan, aka “the protocol”, is in writing and in the hands of everyone on the medical team.  No aspect of that rehab protocol will be changed without the direct approval of the surgeon, period.
  4. Ice Pack, Cups and Tanks – Every form of ice therapy is in place and easily accessible for the athlete before they arrive home after the surgery. Trust me; hammer an ice block at 2 AM to make an ice bag is not a fun option for a post-operative athlete.
  5. Mind Management – The mind of an inactive athlete in pain is not pretty. Having mental projects to solve, books to read, game plans to write,…etc. are all beneficial tools to help to stimulate an athlete’s brain during the long boring days immediately following a surgery.
  6. Written Physical Goals – Writing out the goals for the athlete before the surgery provides great focus and motivation for an athlete in pain who yearns for physical challenges.
  7. Fuel the Machine – Starting a week before the surgery, hydrating aggressively with good ol’ water while eating a balanced diet along with extra antioxidants will optimize your body’s ability to heal quickly.

This checklist proved to be a valuable tool for hundreds of professional athletes I’ve rehabilitated to help them “win today” as they rebuild their status as an elite athlete ASAP.  I know it will help me starting tomorrow.

I’m ready.  Let the healing begin!

MDR

 

 

Cold Truth About Ice Therapy

To convince my patients, fellow #SpartanRace athletes and friend that ice therapy works, I simply tell them: “Ice is your best friend”!

Ice is cheap, easy to use, mobile, effective and, most importantly, ice therapy works!  Its time we all stop complaining how “ice hurts” and “it makes me stiff”.  Sure it hurts and it requires some warmup after the 10-15 minutes of ice treatment.  But if ice therapy works, isn’t 4 minutes of discomfort (that’s how long it usually takes for the area of treatment to go numb) a mild sacrifice to feel better?

Smart athletes put pain medicine down and pick up ice to manage their pain.  Follow their lead.

As a Sports Medicine Expert for Spartan Race, I write posts for fellow Spartan racers and SGX coaches related to important sports medicine topics.  Recent posts include topics such as wrist injuries, injury prevention, rehabbing an ankle injury, injury management, and resolving low back pain.

Here’s a link to a recent post I wrote on Spartan.com to keep you “In the Game”!

Click Here For:  THE COLD TRUTH ABOUT ICE THERAPY

Keeping you healthy, happy and a helluva lot easier to live with, Mike

Managing Your Wrist Pain

Managing Your Wrist Pain

Wrist pain will humble even the toughest of athletes.

With a painful wrist, suddenly simple tasks becomes painful.  Opening a door, picking up our kids and shaking hands becomes a painful event.

As a Sports Medicine Expert for Spartan Race, I write posts for fellow Spartan racers and SGX coaches related to important sports medicine topics.  Recent posts include topics such as injury prevention, rehab, injury management, smart workouts and heat illness.

Here’s a link to a recent post on Spartan.com to keep you “In the Game”!

Click Here For:  YOUR WRIST OWNERS MANUAL

Keeping you healthy, happy and a helluva lot easier to live with, Mike

Spartan Race Recovery Made Easy

Spartan Asheville 8-2016 cI competed in the Asheville (NC) Super Spartan Race with my buddies last weekend. From the 7 hour ride north with my friends, to the jokes at the rental house to the tough race itself, it was a great time for all of us. Now it’s time to focus on my Spartan race recovery.

It was a great race loaded with challenging obstacles, amazing athletes and all the passion that makes Spartan Races so special.

Getting out of the car after the 7-hour ride back home to Ponte Vedra Beach, FL, two things were crystal clear to me:

  1. I’ll be racing plenty of Spartan Races in the near future.
  2. I will be stiff and sore in the morning.

After 26 years as a physical therapist/athletic trainer in the National Football League, a certified Spartan SGX Coach and a veteran mud racer, I’ve learned plenty of sports medicine tricks to accelerate an athlete’s recovery.

I’d like to share some of those Spartan Race recovery tips with my fellow Spartans.

Why am I sore?

I think we’d all agree that obstacle racing isn’t easy. Reflecting back on your race, you may focus on the obstacles themselves but there are plenty of elements during a Spartan Race which factor into why you’re walking like 70 year old on broken glass the next morning!

  • Soft tissue inflammation – from prolonged stress on tendons, muscles, ligaments and fascia.
  • Scrapes, scratches and bruises – from climbing, crawling and falling.
  • Increased joint stress – arches, ankles, knees, hips, low back, necks, shoulders, elbows, wrists and fingers are all stressed with ever yard on ever-changing surfaces.
  • Lactic acid  – your body’s “exhaust” or waste product produced during intense muscle activity.

Sports Medicine Tips to Accelerate your Spartan Race Recovery

Joint Motion – Almost all 360 joints in your body are used in an obstacle course race. Many of those joints were stretches and twisted in a very different manner than how they move during your 9-5 job. During your recovery, simple and slow stretches and movements from your neck to your big toe will enhance vital inner-joint lubrication and help restore normal joint motion.

Hydrate & Eat Healthy– Drinking lots of water with healthy foods will help your body flush out the “bad stuff” while replacing the “good stuff” such as inner muscle fluids, healthy calories, sodium (salt) and important electrolytes.

Drain your Legs – Elevate your legs straight up in the air for 5-10 minutes while pumping your ankles and toes 3x/day.  Gravity was not your friend in the race but now it’s time to take advantage of gravity to help your lymphatic system to drain “the bad stuff” from your loyal legs.

Just Run – “What?!”  Trust me on this one….running the next day after a race is a key part of your recovery.  It only needs to be an easy 1 mile trot on the soccer field or a 10 minutes of light side-shuffles and agility drills in the back yard. Your legs will thank you two days from now.

Massage and Stretch – Get your feet, legs, hips and low back massaged and stretched as soon as possible to minimize the amount of waste products from embedded in the membranes of your muscles.

Ice and Compression Are Your Best Friends – Sure Ice hurts but ice a valuable tool for serious athletes training and racing hard.  If you have localized pain or swelling in a muscle or joint, ice the area for 15 minutes followed by a compression sleeve.

Wound Care – Like friendly reminders, the flesh wounds are there. They range from simple scrapes to the deep cuts to the bloody blisters to “where-did-that-come-from?” battle marks. Take care of open wounds quickly to avoid complications by cleaning the open wounds thoroughly with soap & water, applying an antibiotic ointment and, if needed, covering them with a sterile dressing.

Spartans Heal Fast

Doing a better job with your Spartan Race recovery will get you back to what you want to do: Living a healthy and active lifestyle. Challenges await you and having a plan of attack for the aches and pains that come with those challenges will surely make you stronger.

AROO!

Avoid Sports Injuries With 1 Simple Question

I flipped a giant tire today during my Spartan workout.  Flipped, as in singular.  One.  Uno.  Eins.  Once was enough. I’m allergic to sports injuries.

I didn’t need to flip it a second or a third time for both the physical therapist and the athlete in me to know the risk of an injury with this exercise was way too high.  I had plenty of other safer leg and low back strengthening exercises in my daily workout routine.  Checking my ego at the door while keeping my body injury-free was a much smarter plan than trying to keep pace with the impressively tough athletes I workout with, many of which are half my age.

“Fun”-ctional Fitness?

I quickly dropped my butt low and aggressively dug my fingers under the black beast as it angrily tried to anchor itself to the humid Florida asphalt. I hadn’t flipped a 400 lbs tire in about 15 years but I was ready!  Under the eager watch of my Spartan Race buddies, I pried the rubber behemoth from its nest with a loud groan and awkwardly wrestled it upward.  My low back creaked, my hips moaned and my knees griped as the round monster slowly rose to its tread.  As I thrust the dominated creature onto it’s back as it moaned a hollow “thud”, I convincingly announced: “….last #*@% time I’ll do THAT!”

Painful Hindsight

How many times have you injured yourself only to regretfully say: “What was I thinking?”  It’s a frustrating predicament and, as we age and hopefully we get wiser, it’s a situation we eagerly try to avoid.

Avoiding Sports Injuries Start With One Question

My solution: Before engaging in a new exercise, activity or event I ask myself one powerful question:

“Is the RISK worth the REWARD?”

It’s that simple.  Only you can answer the question because only you have to live with the outcome.  For me, the reward of flipping a tire was minimal because the risk of an injury was at way too high of a cost.  It was an easy answer for me.

Reward Outweigh Your Risk of a Sports Injury?

Looking back at previous injuries in your life, how would you have answered the Risk – Reward question prior to the injury?  With some overuse injuries or freak accidents there is no way to predict something in your body was going to tweak, pop or tear.  But more times than not, we do have an opportunity to alter our path to the doctor’s office.

Ask the Question

By no means am I trying to divert any of us away from cross training workouts to avoid all risk.  Lord knows most couches in today’s society have reached their seating capacity!  My message is to think before you blindly jump into new exercises or workouts to help reduce your risk of an injury.  Asking yourself the powerful Risk – Reward question before you start will help you avoid careless injuries as you gain strength and conditioning while you enhance your health.

Smart Exercises

Maximizing the long-term benefits of your workouts starts with avoiding sports injuries.  As you increase the volume of your workout routines, it’s wise to substitute lower risk activities for higher risk exercises such as tire flipping.

Here are some smarter alternatives for athletes interested in reducing the risk of more aggressive exercises:

   Higher Risk     >>     Lower Risk

Tire Flipping   >>   Body Squats, Kettle Bell Swings, Med Ball Wall Throws

Box Jumps   >>   Lunges, Burpees, Star Jumps, One-Legged Box Squats

Dead Lifts   >>   Wall Sits, Dumbbell Cleans, Bear Crawls

Hanging Knee Tucks   >>   Crunches, Leg Flutters, Med Ball Throws

The Bottom Line

Asking yourself the question “Is the RISK worth the REWARD?” before major changes in your workout and your life can help you avoid sports injuries and heartache.  It’s a simple way to help you to stay in the game of life by saving you pain, $$, stress, downtime and sleep.   MDR

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