Monthly Archives: September 2014

Shoulder pain with crunching

The rotator cuff is a common source of pain in the shoulder. Pain can be the result of Tendinitis or the rotator cuff tendons can be irritated or damaged. Bursitis is also common. The bursa can become inflamed and swell with fluid causing pain.

When you raise your arm, the space between the acromion and rotator cuff narrows and the acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.

The quadrangular space is an intersection of the triceps muscle, the teres major and teres minor muscles and subscapularis. The axillary nerve gets caught in a “traffic jam” between the muscles causing limited movement from sore, tight muscles. Heat may temporarily alleviate pain but produce more swelling, further limiting motion. If ice is tolerable, it is the preferred choice for any swelling in the body.

Crepitus is the medical term used to describe a grinding, crackling or grating sensation and/or sound in the body. It is most commonly used to describe joint cracking, such as knee joint cracking or grinding.

Crepitus is a prominent symptom of arthritis and particularly common in arthritis of the knee joint. This symptom occurs because as arthritis causes the cartilage in the affected joint to degenerate, the cushioning function of the cartilage is lost and the bones tend to grind against one another.

If this is occurring in both shoulders, likely your neck and thoracic spine are playing a big role in the pain and numbness going down into your hands. It is possible that the biomechanics of your shoulders are exacerbating muscle tension, restricting nerves contributing to the sensations you have.

Often, tight pectoral muscles, both the pectoral minor and pectoral major, can pull your shoulders forward, throwing off the mechanics of all the other muscles, creating a tight capsule of the shoulder joint. I have seen this in my clinic where it presents similar to arthritis, however slow and gentle pectoral stretches, and eventually stretching the latissimus dorsi muscles will begin to alleviate the snapping, crackling and popping. Another muscle that should be looked at with similar problems would be the levator scapulae muscle which affects both your neck and shoulder biomechanics.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Therapeutic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Shoulder Popping and Crunching

Crepitus is the medical term used to describe a grinding, crackling or grating sensation and/or sound in the body. It is most commonly used to describe joint cracking, such as knee joint cracking or grinding.

Crepitus is a prominent symptom of arthritis and particularly common in arthritis of the knee joint. This symptom occurs because as arthritis causes the cartilage in the affected joint to degenerate, the cushioning function of the cartilage is lost and the bones tend to grind against one another.

If this is occurring in both shoulders, likely your neck and thoracic spine are playing a big role in the pain and numbness going down into your hands. It is possible that the biomechanics of your shoulders are exacerbating muscle tension, restricting nerves contributing to the sensations you have.

Often, tight pectoral muscles, both the pectoral minor and pectoral major, can pull your shoulders forward, throwing off the mechanics of all the other muscles, creating a tight capsule of the shoulder joint. I have seen this in my clinic where it presents similar to arthritis, however slow and gentle pectoral stretches, and eventually stretching the latissimus dorsi muscles will begin to alleviate the snapping, crackling and popping. Another muscle that should be looked at with similar problems would be the levator scapulae muscle which affects both your neck and shoulder biomechanics.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Therapeutic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Severe Muscle Tension

One of the most common complaints is tension in the neck and across the upper back or shoulder area.
Sitting at a desk or computer is one of the main causes of chronic neck and shoulder tension, producing not only joint and muscle pain, but headaches as well.

Take the time to stretch whenever you get the chance and whether sitting, standing or walking, concentrate on holding your chin in and your shoulders back. In other words changing your posture. I cannot stress enough, POSTURE, POSTURE, POSTURE!

There may be something mechanically causing a re-exacerbation of your symptoms for instance extra cartilage or an extra first rib, or a previous injury such as a fractured clavicle which would re-exacerbate neck pain. Stress is another big problem which will limit your diaphragmatic breathing, contributing to poor posture and restricted movement. Myofascial restrictions throughout certain areas have also caused chronic pain for years in some of my clients. This can only be released in a certain way, not just through deep tissue massage. Also touch for health kinesthesiology has helped some of my chronic pain patients who had muscle reactivity.

Lack of stability in your spine and neck may not have been addressed in prior therapies, especially as yoga emphasizes only certain stretching.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Therapeutic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Shoulder pain that extends down the arm

The rotator cuff is a common source of pain in the shoulder. Pain can be the result of Tendinitis or the rotator cuff tendons can be irritated or damaged. Bursitis is also common. The bursa can become inflamed and swell with fluid causing pain.
When you raise your arm, the space between the acromion and rotator cuff narrows and the acromion can rub against (or “impinge” on) the tendon and the bursa, causing irritation and pain.

The quadrangular space is an intersection of the triceps muscle, the teres major and teres minor muscles and subscapularis. The axillary nerve gets caught in a “traffic jam” between the muscles causing limited movement from sore, tight muscles. Heat may temporilarly alleviate pain but produce more swelling, further limiting motion. If ice is tolerable, it is the preferred choice for any swelling in the body.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Theraputic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Pain in Upper Back

The thoracic spine (also called upper back, middle back, or mid-back) is very different in form and function than the cervical spine (neck) or the lumbar spine (lower back). While the neck and lower back are designed to provide us with mobility, the thoracic spine is designed to be very strong and stable to allow us to stand upright and to protect the vital internal organs in the chest. Because this section of the spinal column has a great deal of stability and only limited movement, there is generally little risk of injury or degeneration over time in the upper back. There can be an injury to a disc in the upper back (such as a thoracic herniated disc or degenerated disc) that causes upper back pain, but such injuries are not common.

Your ribs attach to a long, flat bone in the center of the chest called the sternum and attach to and wrap around your back. If a nerve in this area is pinched, irritated, or injured, you may also feel pain in other places where the nerve travels, such as your arms, legs, chest, and belly.

Overuse, muscle strain, or injury to the muscles, ligaments, and discs that support your spine as well as poor posture are the most common causes of pain in the area. Osteoarthritis or breakdown of cartilage that cushions the small facet joints in the spine is also a factor.

Whenever it is difficult to breathe, it is imperitive to see your doctor. Sometimes pain with breathing could be from a broken rib or compression fracture of a vertebrae. However, if the pain is mostly in the morning and improves throughout the day it could be as simple as your mattress causing a muscle spasm which can appear as a variety of other severe problems. The type of pillow you use could also be a problem.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Theraputic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Severe Back Pain

Most low back pain is muscular but there are many other causes. One particular muscle is the psoas muscle which causes most back pain, even when you have other conditions such as arthritis or degenerative disc disease. By balancing the two psoas muscles and their tension will aleviate most back pain.

The intervertebral discs are a very common source of pain in the low back. Improper gait and posture can put abnormal stress on the discs and the material between them that acts as a cushion. Bone degeneration increases with age. Pain can affect the facet joints of your lower back along with surrounding soft tissues when you have degenerative arthritis.

Persistent pain indicates the need for a Physical Therapy evaluation to provide a customized treatment program. Traction and joint mobilization, if indicated, along with stretching, strengthening and stabilization of the tissues are typical physical therapy treatments for low back pain.

If your pain is spreading it could possibly be the condition called “sciatica” which can be resolved by similar low back pain treatments.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Theraputic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

http://healingcenteraz.com/

Skateboard hip injury

A younger patient told me he hurt his hip skate boarding. “I think I over extended or something like that. The pain is in front at the top of my hip. There is no other pain shooting down or anything. Now its become pretty painful to just walk, and can’t put much weight on it. Is there anything that I can do myself before having to go see a doctor”

A simple muscular strain can be treated with ice for 20 minutes at a time, or hamstring/quadriceps stretches to reduce the pain and stiffness. If the pain is getting worse or has been going on for more than three days it would be a good idea to get an x-ray, especially if you are having trouble walking.  X-rays will help to identify the problem or indicate further testing.

Using a cane or crutch can help reduce weight on the limb to speed healing. If it was your ankle or knee you could wrap it, but it’s hard to wrap your hip. Doing gentle hip exercises in the pool will also help if there is no pain with it. By going to physical therapy for a hip strain, ultrasound therapy and manual therapy with some specific exercises can heal the hip up pretty quickly.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Theraputic Movement which is based off of Mulligan theory, a joint mobilization technique which will help stabilize the back and improve stretch to the hip for quicker results.

Jeff Juraska, PT

http://healingcenteraz.com/

Low Back Pain

A  43 year old female patient recently mentioned “the lower part of my back hurts and feel like it spreading to my spine”
Most low back pain is muscular but there are many other causes.

The intervertebral discs are a very common source of pain in the low back. Improper gait and posture can put abnormal stress on the discs and the material between them that acts as a cushion. Bone degeneration increases with age. Pain can affect the facet joints of your lower back along with surrounding soft tissues when you have degenerative arthritis.

Persistent pain indicates the need for a Physical Therapy evaluation to provide a customized treatment program. Traction and joint mobilization, if indicated, along with stretching, strengthening and stabilization of the tissues are typical physical therapy treatments for low back pain.

If your pain is spreading it could possibly be the condition called “sciatica” which can be resolved by similar low back pain treatments.

At the Healing Center of Scottsdale, we offer a unique treatment program with the ATM2 device. ATM2 stands for Active Theraputic Movement which is based off of Mulligan theory, a joint mobilization technique.

Jeff Juraska, PT

Hip Pain

Recently, someone asked:

“What can I do for my hurt hip?”

When most people refer to hip pain, they are usually referring to one of the areas of the pelvis, groin, buttocks or lower back which may or may not be the hips themselves. The pain could be coming from the hip, but the lower back and sacroiliac joint are also common causes of pain in the area.

If the pain has a sudden onset, it could be related to sports or other activities. Stop the activity until you feel better. Mild strains and sprains can be relieved with gentle stretching or ice and will improve in a period of a few days. If your pain is severe, prevents sleep, or persists more than three days, you may have a more serious injury which would require an in depth evaluation. Early diagnosis and treatment will significantly help avoid later complications or the need for surgery.

Chronic hip and low back pain can be managed with manual therapy and therapeutic exercise to strengthen the affected area and improve ability to tolerate daily activities. After your particular needs are assessed, a customized therapy program can produce demonstrable long term improvement.