Thursday, March 30th, 2017
Shoulder injuries most commonly occur during sports activities, work-related tasks, projects around the home, falls or motor vehicle accidents. Shoulder pain may be acute or chronic, depending on the structures involved. If untreated, these injuries can lead to severe loss of shoulder function and mobility. While an acute injury may occur from a fall on an outstretched arm or a direct blow to the shoulder, overuse injuries can be the result of too much stress placed on a joint or other tissue, or overdoing an activity. An established multi-disciplinary practice on Long Island, Comprehensive Healthcare Group (CHG) with two locations in Valley Steam and Oceanside NY offers state-of-the-art treatment for shoulder injuries.
Common Shoulder Conditions
Bursitis - Injury or strain to the shoulder joint causes shoulder bursitis. Bursae are small, fluid-filled sacs located in the joints throughout the body, including the shoulder. These sacs act as cushions between bones and the overlying soft tissues, helping to reduce friction between the gliding muscles and the bone. Common risk factors for shoulder bursitis include throwing a ball, lifting objects overhead, and trauma from a fall onto the shoulder.
Tendinitis - Tendons are thick cords that join muscles to bones. Inflammation of tendons results in rotator cuff tendinitis, or tendonitis. The most common cause of tendinitis is repetitive action, where the tendons need to make a certain movement over and over. Chronic tendinitis is mostly caused by degenerative diseases like arthritis or repetitive wear and tear due to age. Athletes who play certain sports — such as tennis, golf, bowling, or basketball — are at higher risk of this condition.
Tendon Tears – A patient with this injury may not be able to lift or rotate his / her arm with the same range of motion as before the injury. Patients also experience significant pain associated with shoulder motion. Tendon tears may result from acute injury, degenerative changes in the tendons due to advancing age,or a sudden injury. These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone.
Arthritis - Shoulder pain can also result from arthritis. Arthritis is inflammation of one or more of your joints. In a diseased shoulder, inflammation causes pain and stiffness. The most common type of arthritis in the shoulder is osteoarthritis. This condition develops slowly and destroys the smooth outer covering of the bone. The pain it causes worsens over time. Other types of arthritis that typically affect the shoulder include Rheumatoid and Post-traumatic arthritis, periarthritis of the shoulder.
Non-surgical as well as surgical treatments are currently available to restore shoulder mobility and flexibility. For better understanding of shoulder problems and injuries, physicians may review the anatomy and function of the shoulder using digital X-rays.
Treatment for a shoulder injury may include:
- Ice or Heat Applications
- Physical Therapy
- Physical Medicine
- Orthopedic Treatments
- Joint, Trigger Point Injections
- Chiropractic Care
- Exercise Programs
Based on Long Island, Comprehensive Healthcare Group (CHG) provides effective shoulder pain treatments. Specialists at the center develop a customized treatment plan depending on the type and severity of the injury, how long ago the injury occurred, the patient's age, health condition, and activities such as work, sports, or hobbies.
Friday, December 23rd, 2016
The Physical Medicine and Rehabilitation (PM&R) services at Comprehensive Healthcare Group (CHG) aim to restore mobility to those who are immobilized following an injury or disease. The Physiatrists or PM&R Physicians at our Oceanside and Valley Stream offices on Long Island, NY will evaluate your injuries and prescribe the appropriate treatment plan.
Understanding Physical Medicine
Physical medicine and rehabilitation services specialize in the evaluation and treatment of injuries, illnesses and disability. A comprehensive treatment program is then designed to enable the individual to manage their pain and get him/her back to normal life.
Patients are evaluated, diagnosed and treated for various reasons including, work related injuries, car accidents, slip and falls, sport injuries, arthritis and more.
A plan for non-surgical treatment is devised with the aim of restoring the function and mobility of the injured part of the body. Long-term rehabilitative programs are sometimes necessary when the condition is complicated.
The Rehabilitation Process
The rehabilitation process is designed to enhance or restore the functionality of the injured joint, limb, ligament, tendon, muscle or bone. PMR doctors focus on non-surgical treatments for the spine, shoulder, wrist, elbow, hip, knee and ankle. Coordination of care may also involve an on-staff Orthopedic surgeon where surgery is indicated. The goal of CHG's Physical Medicine and Rehabilitation program is to restore maximum mobility to the affected area.
Common treatment modalities include:
- Stretching and strengthening exercises
- Myofascial techniques
- Manual hands on therapy
- Electrical stimulation
- Heat and cold applications
- Alternative therapies
- Kinesio tape strapping techniques
Trigger point injections, therapeutic joint injections and synovial injections are also used as physical medicine treatment options. Trigger point injections help alleviate pain that’s generated due to muscles forming knots, irritating the surrounding nerves and causing pain. Therapeutic joint injections help in relieving pain caused by inflammatory conditions of the joint. Synovial injections help in lubricating and restoring the elasticity of joints, and are particularly essential for patients with osteoarthritis.
At Comprehensive Healthcare Group, physical medicine and rehabilitation is an important element of our care as it helps people get back to the lives they left behind. With more than two decades of offering dedicated services in the Nassau County area, you can trust our specialists to provide the most professional and customized care.
Tuesday, June 17th, 2014
Why Does My Shoulder Hurt? And What Can Be Done About It?
You wake up in the morning and get out of bed. You do your big morning yawn and stretch and OW! Why does my shoulder hurt? Did you sleep wrong on it? Was it last night’s basketball game with the guys? Are you just getting old?
Many things can cause shoulder pain. When should you see your healthcare professional for shoulder pain? If any of the following are present:
- Inability to carry objects or use the arm
- Shoulder pain that occurs at night or while resting (as in when you aren’t asking your shoulder joint to do any work)
- Weakness in the shoulder
- Shoulder pain that persists beyond a few days
- Inability to raise the arm
- Injury that causes deformity of the joint (or change in normal appearance of the shoulder joint and arm), swelling or significant bruising
- Signs of an infection, including fever, redness, warmth
Anatomy of the Shoulder Joint - the bones, muscles, ligaments and tendons all work together beautifully to make your shoulder work smoothly. When one or more of these doesn’t work right, pain and dysfunction result.
The clavicle or collarbone is a long bone that connects the scapula and the sternum. [Interesting factoid! It is the only long bone in the body that lies horizontally.] For our purposes talking about shoulder pain, we are only concerned with the connection the clavicle makes to the shoulder.
The humerus is the long bone in the arm that runs from the shoulder to the elbow.
The scapula or shoulder blade connects the humerus and the shoulder blade.
The acromium is the part of the scapula that meets up with the clavicle at the acromioclavicular joint. This joint is one of the places where problems can occur, either through traumatic injury or repetitive motion.
How is a Diagnosis Made?
Your health care professional will identify what is causing your shoulder pain through diagnostic testing such as x-rays, MRIs and a thorough physical examination that likely will include range of motion testing and shoulder strength testing.
Possible diagnoses include:
Shoulder bursitis, rotator cuff tendonitis - inflammation of a particular area within the shoulder joint (rotator cuff tendons and the bursa or lubricating bodies between tendons and bones) that causes impingement.
Impingement syndrome occurs when there is inflammation of the rotator cuff tendons and the bursa that surrounds these tendons, in the acromioclavicular space (A/C joint). It can be caused by an initial trauma or injury, or reaction to chronic overuse. Inflammation leads to thickening or calcification of the subacromial bursa and/or supraspinatus tendon leading to more crowding of the anterior shoulder (A/C joint) causing more pain and restriction of motion.
Shoulder Arthritis - often called wear-and-tear arthritis. Osteoarthritis is the leading cause of arthritis in the shoulder.
Adhesive Capsulitis (Frozen Shoulder) - in this condition, the capsule surrounding the shoulder joint contracts and forms scar tissue leading to marked stiffness of the joint and significant pain which causes further inability to want to use the shoulder.
Shoulder Trauma – these conditions are related to sports injuries, car accidents, Workers’ Compensation injures and falls. They are often initially treated differently than the previously described conditions and sometimes require surgery.
- Acromioclavicular separation – a disruption of the acromioclavicular joint
- Rotator cuff tears – these can occur when the tendons rupture or separate from the bone
- Shoulder Instability (Loose Joint) – often caused by traumatic injury or developed over time
- Labral Tear – the labrum is cartilage in the shoulder joint
- SLAP lesion – a labral tear specifically at the top of the joint – typically seen in overhead and throwing activities (pitchers, tennis players)
- Shoulder Dislocation - occurs when top of the humerus becomes disconnected from the scapula
And Now the Part You’ve Been Waiting For!!!
How Can My Shoulder Pain Be Treated? How Can You Make My Pain Go Away?
Stretching and strengthening of the muscles around the shoulder joint may help decrease the burden on the shoulder. Preventing atrophy of the muscles through exercise is an important part of maintaining functional use of the shoulder.
- Joint mobilization is a highly skilled painless technique that our physical therapists provide. This involves the loosening of the restricted joint and increasing its range of motion.
- Myofascial release is a soft tissue therapy for the treatment of muscle immobility and pain. The therapy relaxes contracted muscles, improves blood and lymphatic circulation, and stimulates the stretch reflex in muscles.
Our physical therapists are trained to provide pain relief and manual therapy, and also to teach you a home exercise program. Most times a period of physical therapy is initiated for at least 2-4 weeks before any surgical consideration.
Injections may help decrease inflammation and reduce pain within a joint. While this will not cure shoulder arthritis or other shoulder conditions, they can quickly diminish the symptoms and help control pain.
Prescription and non-prescription drugs that treat pain and inflammation. These can be very effective utilized along with physical therapy to help the patient achieve the most relief.
Has been shown to be extremely helpful in relieving pain. Our facility offers acupuncture from our trained heath care professionals.
Kinesio taping is very effective in relieving pain and permitting motion and recovery of shoulder joint pain. Your physical therapist is skilled in the proper application of tape to achieve maximum relief.
The health care professionals at Comprehensive Healthcare Group in Oceanside and Cedarhurst strive to bring you maximal comfort quickly when you are in pain. Up-to-date training in the latest techniques along with tried-and-true therapies combine to give you pain relief in our state-of-the-art facilities.
We will be talking again soon about pain in other joints. Also watch for our next article on that irritating “pins-and-needles” sensation. As always,
Yours in Good Health!