Shoulder pain is super common… luckily physical therapy has been shown to be just as effective (not to mention much safer) than surgery. There are four main types of shoulder pain. Here they are…
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1. Weak & Painful Shoulder
2. Stiff & Painful Shoulder
3. Unstable Shoulder
4. Other (often from the neck)
WEAK & PAINFUL SHOULDERS: People who have weak and painful shoulders are often told they have shoulder impingement, a rotator cuff tear, tendinitis, bursitis, or bone spurs. These people can often move their arm fully, without loss of motion, but often have pain while doing so. The pain commonly occurs while reaching up and out the side or behind the back. Treatment for this type of shoulder involves gradually strengthening the shoulder and restoring painfree movement through hands on therapy and exercise.
STIFF & PAINFUL SHOULDERS: People who have stiff and painful shoulders often have a gradual onset of pain and loss of motion. Common problems that cause a stiff and painful shoulder include shoulder arthritis or frozen shoulder (adhesive capsulitis). You’ll know if you have a stiff and painful shoulder… reaching up and out to the side with be difficult (not just because it hurts)- you physically cannot move it in that direction. A quick test would be to stand with your arms by your side (elbows by side and bent upwards)… try and rotate the back of your hand outwards. You may notice that shoulder pain and stiffness on one side prevents your from moving very far… but the other painfree side might move fine. Treatment for this type of shoulder involves gradually increasing your motion through stretching and strengthening.
UNSTABLE SHOULDERS: People with unstable shoulders often have a history of their shoulder dislocating or popping out socket. Sometimes there is clicking and popping or an ability to “pop your shoulders” in and out. Often these folks are “double jointed” and are very flexible. Unstable shoulders occur commonly in sports such as baseball and gymnastics (where the shoulder is required to move through a lot of motion). Treatment for unstable shoulders can sometimes involve surgery (if it becomes a recurrent problem) or strengthening of the unstable shoulder.
A PROBLEM IN THE NECK (OTHER): Some people I see who think they have a problem in the shoulder actually have a problem in the neck causing their shoulder pain. These people may describe their shoulder pain as burning, or may experience pain, numbness, or tingling down their arm. If the neck is in fact the problem, your shoulder pain should reproduced by specific movements of your neck. Discs, joints, and nerves in or about the neck can send pain signals to your shoulder blade and shoulder, elbow, or hand. Treatment for this cause of pain involves hands on therapy of the neck and sometimes the nerves in the neck- as well as specific neck and postural exercises.
To help determine if your shoulder pain could be coming from the neck- watch this video.
Call 484 552 3767 if you’ve got shoulder pain and want relief.
One of the most common questions I get when people with lower back pain come to see me for physical therapy is “So what’s causing my lower back pain?”
And the truth is- all lower back pain (or any pain for that matter) is created by the BRAIN. Meaning- pain is an experience created by the brain to protect you from some perceived threat or danger. In other words, a problem in the back isn’t really the cause of your lower back pain… it’s just that the signals from the back are being sent to the brain- where the brain is processing them to be painful. Now, don’t think for a second that I’m trying to tell you that you’re lower back pain isn’t real.. or that “it’s all in your head”- NOT TRUE…
Get this… Pain is normal.
Pain is an experience created by the brain to protect you from threatening situations and injury.
Even if no problems exist in your body, nerves, or immune system…you may still feel pain if the brain thinks you are in danger.
Simply put, without your brain, you feel no pain.
Think of your brain and the pain you experience as your alarm system…
In everyday life, you have a “normal” threshold for pain – as your nerves buzz around happily waiting to react to whatever your body feels.
So your alarm system is set and ready to go. Your nerves are just buzzing along waiting to be stimulated…
If you hit your finger with a hammer, it hurts like heck, but eventually after several hours/days, it calms down to where it was before.
Now, imagine you’ve had lower back pain for a long time…it’s likely that your alarm system has become extra sensitive leaving you with little room for you to do things before your alarm systems goes off.
When we are not in pain and life is grand, it takes a lot for your alarm system to go off — just like a car’s alarm when you have to break the windows in order to set the alarm off.
Now, when your body’s been in pain for some time, the alarm system becomes extra sensitive — Instead of having to break and bash the windows before the alarm goes off, a leaf blower goes by and your alarm goes berserk!
Simply put… your body’s alarm system becomes sensitive and leaves little room to move and do things without feeling lower back pain.
Important Point: Pain does not equal damage or injury…it is simply an experience created by the brain when it thinks your body is in danger.
Imagine you get a paper cut…
Wouldn’t you be worried if the pain stuck around for months?
Sure you would, because normally the pain goes away in minutes to hours.
Then what makes your back any different?
Most people live with lower back pain for years…yet this simply couldn’t be caused by a simple injury to your lower back muscles or disc.
All tissues in your body heal, including the muscles, ligaments, discs and nerves in your lower back within about 3-6 months.
When pain lasts longer than 3-6 months or becomes chronic and lasts for years, it doesn’t mean that something is wrong with your back or your back didn’t heal properly, it simply means that your alarm system is sensitive…and for some reason, your brain still senses danger.
Think about when you get a bruise and are not aware of it…
As long as your brain doesn’t sense danger, you won’t feel pain.
Another Point: You’re not crazy…pain is very real.
BUT remember, pain is an experience…
We’ve all heard about the crazy stories of people who are injured and feel absolutely no pain.
Picture the soldier injured in war who continues to run in order to save his life.
OR the man who had his arm trapped in between two rocks and cut his own arm off in order to escape the wilderness and survive. Yikes… but a true story.
On a more basic, less extreme level…think about the pain someone would feel if they hurt their back while running across a busy highway versus getting out of a chair.
I’d be willing to bet that the person running across the highway feels much less pain than the person who’s getting out of the chair.
So, situation can impact pain.
Other things that can change your pain experience include emotions, beliefs, sleep, your job, or your pain memories… just to mention a few.
Emotions: People who feel sad or worried often feel more pain. People who are happy and relaxed generally feel less pain.
Beliefs: Growing up, some people were taught to be afraid of pain or that pain is bad. Others were taught to “get up and brush it off.” Depending on your beliefs about pain you may feel more or less pain.
Sleep: People with good sleep habits generally feel less pain. I recommend 8 hours of sleep per night. Restful sleep has been shown to decrease the sensitivity of your alarm system.
Job: People who have stressful jobs and are unhappy with their careers often experience more pain compared to those who enjoy their work.
Memories: If your back was injured in a car accident…just thinking about driving could make your pain worse. Pain memories can be powerful.
Now, you should be asking yourself, “How do I calm my alarm system down?”
First things first, in order to calm your alarm system down, we need to review a few key points:
Point Number 1: Understand that pain does not equal harm.
Just because you feel pain doesn’t mean anything serious is wrong…it just means you’re alive and your alarm system is on high alert, that’s all! Your back heals itself in 3-6 months, but your alarm system might still be sensitive.
Point Number 2: Pain does not equal gain. Remember, even though pain is created by the brain, which can sometimes cause your alarm system to become extra sensitive…even when everything has healed, it is very real. And you should still listen to it.
Okay, now that you understand these two big points, here’s how you can begin decreasing the pain that you experience…
Respect pain and listen to it, but do not fear it.
Again, pain is normal…sometimes the brain gets a little confused and senses pain incorrectly.
Sometimes the brain senses pain incorrectly OR it thinks there is actually something dangerous when really everything is just fine.
Gentle movement and exercise helps relieve pain and release chemicals that soothe nerves and calm down your alarm system.
Choose a form of exercise you enjoy…walking, biking, or swimming are all great options.
Slowly increase the amount of time you exercise week by week. Exercise up until the point you start to experience your pain, then stop. If you stick with it, you should notice that you are able to do a bit more week by week with less pain.
Okay, so this is really going to make you think…
Recent research has clearly shown that there is little to no relationship between the issues found on an X-ray or MRI and the pain you feel in your lower back.
That is to say, just as many people with pain have bulging discs as those who have absolutely no pain at all.
The same goes for things like spinal stenosis.
Wrapping things up here…
If you’ve given up hope- and have lower back pain in the Royersford, Collegeville, Phoenixville, King of Prussia, OR Philadelphia areas- call 484 552 3767 for specialized lower back pain treatment.