Health & Rehabilitation Section

I know there is no section in this area, but being I'm a physical therapist and I'm responsible helping people achieve healing I'd like to open up to any concerns, questions or comments in this area. Being most of us are getting our fit lives back injuries can happen, so I think it would be good if we were here for each other in that respect (listen to the new kid on the block talk). Just a suggestion.

I have a question for you - wondering if you have any experience with rehabbing swimmers? I swim about 3,000 yards 5 times a week, and my shoulders get pretty sore from all the repetitive motion.

Are there any kind of arm exercises I can do to strengthen my arms/back muscles without putting strain on my shoulders? I can't do push-ups or pull-ups - they make my shoulders hurt worse.

Well, it depends on what is causing the pain. It sounds like tendinitis but what motions hurt the most
1. raising your arms straight in from from your side to above your head
2. raising your arms straight out from your side to above your head
3. rotating your shoulder in and out (internal & external rotation).

That would probably give me a better idea of what the culprit may be. How is your posture meaning when you stand erect, do your ears line up with the middle of your shoulders? If the ears are a bit forward of the shoulders this is called "forward head" (don't worry we all have it). It causes alot of stress on our rotator cuff (especially the supraspinatus) and causes shoulder pain with repetitive activities where we lift our arms above our heads.

In the mean time try the following:
1. Mid trap exercises (if you have a band place the middle in a doorway or around a stable object and pull the shoulder blades together with the elbows horizontal to the ground)
2. Corner stretch - find a corner and place each hand about shoulder with and lean into the corne stretching the pectoralis minor

Try these for a couple of weeks and let me know if you have additional questions. I'm going to try and find diagrams of the two exercises which are minimally invasive/aggressive and should not cause more pain. You may have to cool down on the swimming and incorporate cycling/running or something that puts less stress on you rotator cuff. Keep me posted, hope this helps you.

I have a question....I have scoliosis with herrington rods (sugery at age 13) and lately I have developed sciatica. When I work out really hard, my hip and leg just throb all day. Is there some sort of streching I can do to minimize that? I always stretch after workouts, but apparently not the correct way.
It has really slowed my weight loss, because I haven't been able to make myself work out the past couple of weeks. I know I'm going to be in pain all day if I do, so I just don't bother. Thanks

Hmm this one is challenging.
What type of curve do you have in you spine (S or C)? Where are the rods? On which side do you get sciatica? What kind of stretches are you doing?

I know it's alot of questions, but when I see a patient I have to get as much information as possible from them before I can make recommandations (and remember they are only recommendations and don't always fix the problem).

I have a question for you - wondering if you have any experience with rehabbing swimmers? I swim about 3,000 yards 5 times a week, and my shoulders get pretty sore from all the repetitive motion.

Are there any kind of arm exercises I can do to strengthen my arms/back muscles without putting strain on my shoulders? I can't do push-ups or pull-ups - they make my shoulders hurt worse.

Well, it depends on what is causing the pain. It sounds like tendinitis but what motions hurt the most
1. raising your arms straight in from from your side to above your head
2. raising your arms straight out from your side to above your head
3. rotating your shoulder in and out (internal & external rotation).

That would probably give me a better idea of what the culprit may be. How is your posture meaning when you stand erect, do your ears line up with the middle of your shoulders? If the ears are a bit forward of the shoulders this is called "forward head" (don't worry we all have it). It causes alot of stress on our rotator cuff (especially the supraspinatus) and causes shoulder pain with repetitive activities where we lift our arms above our heads.

In the mean time try the following:
1. Mid trap exercises (if you have a band place the middle in a doorway or around a stable object and pull the shoulder blades together with the elbows horizontal to the ground)
2. Corner stretch - find a corner and place each hand about shoulder with and lean into the corne stretching the pectoralis minor

Try these for a couple of weeks and let me know if you have additional questions. I'm going to try and find diagrams of the two exercises which are minimally invasive/aggressive and should not cause more pain. You may have to cool down on the swimming and incorporate cycling/running or something that puts less stress on you rotator cuff. Keep me posted, hope this helps you.

3. rotating your shoulder in and out (internal & external rotation). - this is def the motion that makes my shoulders feel tender. It's not a horrible I-can't-stand-it-pain, but kind of like twinges.

For the mid trap exercise - is that facing the door? So like a rowing motion? (Pictures/link please!)

I know, I know...I'm in denial about putting the brakes on swimming (I'm training for some long distance swims) This shoulder problem is pretty common with LD/open water swimmers...just trying to see if there's anything I can do, preventively, before it gets worse.

Thank you!!!! You are awesome!

I see, if it's most painful when rotating the shoulder in while the shoulder is flexed in front at about 90 degrees it could be what is called "impingement sydrome". It's when the supraspinatus tendon (1 of the rotator cuff muscles) gets pinched under the acromion process (boney protrusion where the collar bone connects away from hte sternum.. Yes it's just like a row, good catch there. This site has some pretty good examples http://exercise.about.com/cs/exerciseworkouts/l/blbandworkout.htm
not saying you'll need the physioball though.

I have fibromyalgia so have all the inevitable aches pains fatigue etc and was told to either do thai chi or swimming so i chose swimming as thai chi here is a non starter in this rural area.. i am not allowed to put my knees through more than a 25 degree angle through exercise due to short tendons but i have some stretching exercises to do for them
but am also having problems with my elbows and i have inconclusive results with the carpol tunnel tests ... is there any other exercise u think could be helpful ?
my symptoms are that i find it difficult to open heavy doors carry pans of water or veg in the kitchen and take out pans from the oven as well as pains in my hands wrists etc so i find it hard to cut root veg etc

Have you tried "myofascial release"
http://www.myofascialrelease.com/home.asp

The link is to the home page of the myofascial release guru and has tons of information listed on it. Basically fascia courses throughout our bodies from head to toe and a disruption at any area can cause pain a the area where tension builds. Simple stretch and hold activities may lengthen and realign fascia sometimes eliminating or significantly decreasing pain in a few treatment sessions. This may be used in conjunction with massage to decrease pain associated with fibromyalgia.

As for exercise, so little is really known about what actually causes fibromyalgia (I know you've heard that one before). What I have found is any low impact activities that don't increase pain will be of some benefit. They have to be spaced out so as not to increase symptoms, you can try a forearm curls with a 2 lb weight shooting for greater reps (12 - 15) or squeeze a racquetball to increase grip/finger strength, but is would not be intense, very gentle to start paying close attention to how you hands handle it. Keep the pool work going, best exercise to unload joints and get some cardio/strength gains.

Keep me posted.

I have fibromyalgia so have all the inevitable aches pains fatigue etc and was told to either do thai chi or swimming so i chose swimming as thai chi here is a non starter in this rural area.. i am not allowed to put my knees through more than a 25 degree angle through exercise due to short tendons but i have some stretching exercises to do for them
but am also having problems with my elbows and i have inconclusive results with the carpol tunnel tests ... is there any other exercise u think could be helpful ?
my symptoms are that i find it difficult to open heavy doors carry pans of water or veg in the kitchen and take out pans from the oven as well as pains in my hands wrists etc so i find it hard to cut root veg etc

Have you tried "myofascial release"
http://www.myofascialrelease.com/home.asp

The link is to the home page of the myofascial release guru and has tons of information listed on it. Basically fascia courses throughout our bodies from head to toe and a disruption at any area can cause pain a the area where tension builds. Simple stretch and hold activities may lengthen and realign fascia sometimes eliminating or significantly decreasing pain in a few treatment sessions. This may be used in conjunction with massage to decrease pain associated with fibromyalgia.

As for exercise, so little is really known about what actually causes fibromyalgia (I know you've heard that one before). What I have found is any low impact activities that don't increase pain will be of some benefit. They have to be spaced out so as not to increase symptoms, you can try a forearm curls with a 2 lb weight shooting for greater reps (12 - 15) or squeeze a racquetball to increase grip/finger strength, but is would not be intense, very gentle to start paying close attention to how you hands handle it. Keep the pool work going, best exercise to unload joints and get some cardio/strength gains.

Keep me posted.

thanks i will have a look at the info u gave me i will try some forearm curls but i will have to be very careful with that i think ... i will defo keep the pool work going as since i began swimming i have felt so much better .. and i sleep better after a swim too

you're welcome, keep me posted

Great thread. I echo the many thanks here. Thank you.

So...why when I start up running again do my calf muscles feel REALLY tight? I keep having to stop and stretch them. After I run a month or two consistently it seems to get better. Any clues?

I'm going to start running again, now that my hip flexor tear is completely healed. I definitely waited long enough (2 years biking instead of running. I know I'm healed and want to stop procrastinating.) What can I do to keep my calve muscles from getting too tight while I run? They feel "full" after I run a little while. I am blessed with naturally muscular legs. My best friend calls them my Popeye legs:laugh: . I don't know how/if possible to change that...but how do I stop the pain/tightness from running?

Thanks so much.

One question: how are your arches? and is the tightness the same on both side? Also any pain associated with the pain.

If there are no problems in these areas your problem is probably the same as my problem.....very muscular calfs. The larger the muscle, the more attention it requires for warming up and stretching. I'd make sure you really warm them up good, with some calf raises and good stretches (towel or wall) holding them for >15 seconds. Like I've kind of been telling everyone else is this will let you know possibly if this is the problem (proper warm up).

Also remember there is high demand for oxygen by your calf muscles which is also probably why after they adjust to running, they adapt and you don't have the same problem.

Example, if my calves (is that right funny spelling) are used to speed walking then that is where they plateau. When I begin running they have to adapt to that new physical demand, hince more soreness and stiffness until they gradually adjust.

Hope this helps.
God bless (congrats on the muscular calf muscles, we may be related :yawn: :happy: )

Great thread. I echo the many thanks here. Thank you.

So...why when I start up running again do my calf muscles feel REALLY tight? I keep having to stop and stretch them. After I run a month or two consistently it seems to get better. Any clues?

I'm going to start running again, now that my hip flexor tear is completely healed. I definitely waited long enough (2 years biking instead of running. I know I'm healed and want to stop procrastinating.) What can I do to keep my calve muscles from getting too tight while I run? They feel "full" after I run a little while. I am blessed with naturally muscular legs. My best friend calls them my Popeye legs:laugh: . I don't know how/if possible to change that...but how do I stop the pain/tightness from running?

Thanks so much.

One question: how are your arches? and is the tightness the same on both side? Also any pain associated with the pain.

If there are no problems in these areas your problem is probably the same as my problem.....very muscular calfs. The larger the muscle, the more attention it requires for warming up and stretching. I'd make sure you really warm them up good, with some calf raises and good stretches (towel or wall) holding them for >15 seconds. Like I've kind of been telling everyone else is this will let you know possibly if this is the problem (proper warm up).

Also remember there is high demand for oxygen by your calf muscles which is also probably why after they adjust to running, they adapt and you don't have the same problem.

Example, if my calves (is that right funny spelling) are used to speed walking then that is where they plateau. When I begin running they have to adapt to that new physical demand, hince more soreness and stiffness until they gradually adjust.

Hope this helps.
God bless (congrats on the muscular calf muscles, we may be related :yawn: :happy: )

Aren't we all related?

Hmm, my arches are fine - probably average to high. My feet are strong. The tightness is pretty uniform to both legs/calves. (I do think the plural of calf is calves, but I'm a chemist and don't claim to spell well.) No pain other than the tightness/vice grip like pain/discomfort. I will redouble my warm up efforts and ease into running. No more excuses to put if off. Thank you.

Yes indeed we are related :happy: sounds like you're good to me for the first 3 weeks really focus well on the warmup//stretch aspect of the calves.