The Rotator Cuff is an amazing piece of kit that allows the arm to raise and rotate at the shoulder and helps to stabilise the shoulder joint during movement.  Although each Rotator Cuff muscle moves the arm from the shoulder joint in a specific direction, they all work together to stabilise the shoulder joint.

A strain or tear in the Rotator Cuff may occur suddenly from trauma like a fall or happen gradually from overuse.

Strengthening exercises for the muscles that control the Shoulder Blade is also important, as the Shoulder Blade (Scapula) helps the Rotator Cuff to dynamically stabilise the shoulder.

The Importance of Strengthening the Rotator Cuff

Many muscles are involved in shoulder movement and all work together, but strengthening the Rotator Cuff is especially important. The Rotator Cuff is the main stabiliser of the shoulder joint during movement of the shoulder.

If the ball of the upper arm is not kept centered, abnormal stress is placed on surrounding tissue and may cause gradual injury. Strengthening the Rotator Cuff helps prevents common Rotator Cuff injuries including Tendonitis, Rotator Cuff tears, and Shoulder Impingement Syndrome.
As we get older, changes in Rotator Cuff tendons reduce in elasticity and more susceptible to injury. There is also a gradual loss of muscle mass that occurs, but this can be counteracted with strengthening exercises.

Rotator Cuff Muscles

The Supraspinatus is located at the top of the shoulder and abducts the shoulder – it raises the upper arm and moves it away from the body.

The Subscapularis is at the front of the shoulder… same side as your face.  It internally rotates the shoulder.
The Infraspinatus and Teres Minor are in the back of the shoulder – they externally rotate the shoulder.

Though each Rotator Cuff muscle moves the shoulder in a separate direction, though they all work together to stabilise the shoulder joint.

Strengthening the muscles of the Rotator Cuff is important.
The two small external Rotator Cuff muscles are often weaker than the larger internal Rotator Cuff muscle.

The Rotator Cuff muscle involved in abduction (taking the arm away from the body) is the Supraspinatus, and is the one most often injured of the Cuff muscles due to its position between two bones which often squeeze this tendon during overhead movement.

Other Shoulder Stabilisers:
The Scapula or Shoulder Blade helps the Rotator Cuff to stabilise the shoulder joint as it moves. The Rotator Cuff muscles rise from the Scapula and attach to the head of the upper arm bone or Humerus.

If the Shoulder Blade isn’t stable, pressure may be placed on the Rotator Cuff, so strengthening the muscles that support the Scapula are important.

The Bicep Tendon is the one that runs over the top of the Humerus and connects at the top of the shoulder joint helping stabilise it. Overloading the Biceps by lifting something too heavy can result in Biceps Tendonitis (also known as Shoulder Tendonitis).

Strengthening the Biceps helps prevent injury.

Exercise after Shoulder Injury

The question is… how long should the shoulder be rested?
The amount of time to rest an injured shoulder before starting rehabilitative exercises hinges upon how quickly one heals, as well as the type and the severity of the injury.  Working it too soon may cause further damage.

On the other hand, if the shoulder is not used enough, the shoulder muscles weaken, so strengthening exercises are an important part of rehabilitation. Stretching exercises increase the range of motion of the shoulder.

Stretching exercises may… may… help prevent Frozen Shoulder from occurring after an injury that causes one to restrict shoulder movement due to excruciating pain.
Stretching exercises are often started after a few days of rest, but it’s best not to overdo it.

Building up Strength:
Warming up with five minutes of ‘a mini version’ of the exercise you are about to do prepares the body by increasing heart and breathing rates, and increasing blood flow to the muscles, and raising body temperature. Warming muscles and tendons improve range of motion and reduces the risk of injury and warm muscles are more flexible than cold muscles.

Have Patience. Too much too soon can cause overuse injuries. Strengthening a group of muscles should only be done every second day to give the muscles a chance to heal. Strengthening exercises load the muscles slightly beyond their limits and cause micro tears. If given a proper chance to heal, muscles become stronger. If not given a chance to heal, chronic inflammation and problems may develop.

You should feel a bit fatigued by the end of a dozen reps. If you feel fatigued after just a few reps, reduce the difficulty of the exercise by lowering resistance (e.g. use lighter weights or no weights). If you do not feel fatigued after a set, increase the difficulty of the exercise by increasing resistance, but again… not too much.

Don’t “lock” the elbows. Your elbows should be slightly bent. This makes the muscles work harder to increase the effectiveness of the exercise. Locking a joint while exercising also increases the chances of injuring the joint.

Posture: The shoulders should be kept back and down during exercise.  The same goes for when you are standing or sitting.  Slouching reduces the space the Rotator Cuff tendon passes through and puts unnecessary strain on the shoulder joint.

Take it easy and don’t  jerk. Proceed slowly and steadily to use the muscles, not momentum, to complete the exercises. For exercises involving lifting or pulling, slowly lift or pull, hold for a second, and slowly lower or return.

Stretching:
Stretch Gently:  No bouncing. Stretch until you feel a tug but don’t go past. Always hold a stretch for about 30 seconds. Do not stretch to the point of pain. Over-stretching can tear muscles.

Breathe normally during stretching exercises.

Dumbbells or resistance bands are often used to provide resistance in strengthening exercises. Handheld weights come in a variety of weights, so you can gradually increase difficulty of exercises.
Resistance bands provide resistance when stretched. They come in a variety of thicknesses to provide different levels of resistance and are usually color-coded. When using resistance bands, increasing the distance you stand from whatever you have them attached to increases the resistance.

Part of your Shoulder Stabilising should incorporate Remedial Massage and its wise to see a qualified therapist.  If you’re experiencing shoulder problems, make the call and book a massage today and see what a difference it can make.

Well, it’s the same for our muscles.  Every muscle has an opposing muscle.

Strength training is essential if we’re going to be fit.  However, if it’s not done properly, it can cause unbalanced muscles and even result in injury.

Opposing muscles, therefore, need to be worked and all of the muscles worked need to be stretched.

When we only concentrate on some muscles and the opposing muscles are forgotten, injury could result.   Training opposing muscles aids muscle balance and is essential for injury prevention.

It’s all a matter of back to front, and inner and outer, and here are some of our opposing muscles.

• Upper Arms: Biceps and Triceps

• Upper Torso: Pectorals and Latissimus Dorsi

• Shoulder: Anterior Deltoid and Posterior Deltoid

• Spine: Abdominals and Erector Spinae

• Legs: Quadriceps and Hamstrings

• Calves: Gastrocnemius and Tibialis Anterior

What are opposing muscles?

Opposing Muscles (antagonist) are the muscles that oppose the Working Muscles.  For example, when the Biceps are flexing (contracting), the Triceps (the antagonist muscles) are stretched (extended).

If you plan to build your Biceps then it is important to consider the opposing muscle group and work the Triceps.  The same applies to other opposing muscles.

It’s also important to stretch the muscles that have just been worked after the completion of the workout.

Working your opposing muscles and stretching the muscles that have been worked keeps one muscle from becoming tighter than its opposer reducing the risk of injury.

Training your opposing muscles prevents injury.  Muscles that work together to make a movement are in balance with one another instead of one dominating the other.

To avoid injury and keep the muscles balanced.  Train the opposing muscles and stretch after exercising.  Be sure to hold your stretches for at least 30 seconds.

The Rotator Cuff is a group of  four muscles along their tendons working together to give the Glenohumeral (shoulder) joint stability.  Each Rotator Cuff muscle moves the arm (from the shoulder joint) in a specific direction, and work together to stabilise the shoulder joint.

The Rotator Cuff muscle group include:

* Supraspinatus
* Infraspinatus
* Teres Minor
* Subscapularis

Causes of Rotator Cuff Injury:

A strain or tear in the Rotator Cuff may be the result of an injury such as a fall, or it can happen gradually from constant overuse.

Due to the function of these muscles, sports which involve a lot of shoulder rotation including involving repetitive overhead movement such as swimming, tennis, contact sports or continual high reaching.  These sorts of activities put the Rotator Cuff muscles under a lot of stress.

Minor injuries that are not given a chance to heal can cause severe inflammation and degenerative changes in the tissues, so early treatment is important.

Whether injury develops gradually from overuse or suddenly from a traumatic injury, it is often because the Rotator Cuff is not strong enough for the given task

Poor posture and slouching also places unnecessary stress on shoulder joint.

Tears of the muscles and or tendons  tends to happen as a result of a sudden, powerful movement. It can include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful throw.  Test cricketers are high risk candidates for Rotator Cuff injuries.

Symptoms of Rotator Cuff Injury:

The main symptoms of Rotator Cuff injuries are shoulder pain and weakness, and appear to worsen when lifting the arm above shoulder level.

Symptoms may occur suddenly if the Rotator Cuff is injured by a traumatic injury – like an accident or fall -or a blow during contact sport.. Though majority of Rotator Cuff injuries occur gradually and symptoms appear gradually, the  massage therapist should not mistake the symptoms for that of a Frozen Shoulder.

Massage Therapy:

Deep tissue massage is often used in the treatment of soft tissue injuries of the Rotator Cuff. Massage therapy relieves pain and increases range of motion while it improves blood  circulation and speeds healing. Massage therapy also reduces stress.

If there is swelling of the joint, massage should be lightly applied.

If you’re experiencing pain in the shoulder and haven’t tried massage therapy make a call today.  Arrange an appointment and experience the many benefits that massage has to offer.

When we can’t walk or stand because of feet or knee problems, we soon realise how much we take our limbs for granted in our day to day activities.

Despite the fact that arthritis or injury like torn ligaments or tendons are common complaints that cause the loss of mobility, often it is simply a collection of muscular problems causing pain in these areas.

Remedial massage can usually play a major role in either healing or significantly alleviating these problems.

For successful treatment, however, it is important… as in most cases of remedial massage… to consider the overall picture and look at all the muscles affecting the movement of the hips, thighs, knees, legs, ankles and feet, because they are all closely interconnected.

Remember the little ditty that goes something like “The toe bone’s connected to the foot bone’s connected to the leg bone’s connected to the knee bone….” was spot on.

Major leg muscles like Hamstrings, Quadriceps and “Calves” are fairly well known, but there are plenty of others with names names not so common, and their actions also play an important role in movement and stability of the legs and feet, and therefore, the entire body.

It is the feet, ankle and knee joints which support the entire weight of the body. Problems with these areas will cause “flow on” effects throughout body as a whole.

Which muscles to massage.

Starting from the top of the hips, here’s some movement muscles which, in most cases, should be massaged to effectively treat leg, knee or feet problems:

· One joint hip flexor (Iliopsoas) muscles:

From the side of the spine from about mid-back, it passes across the front of the hips to the top of the femur (thigh bone). When the hip flexor muscle on one side of the body pulls tighter than the other, it tilts the hip laterally (upwards) on that side, causing imbalances in most leg muscles. (If there is problems in the lower back, this should always be treated.)

One leg will hang slightly in adduction, the other in abduction, though this may not be evident to the untrained eye.

· Buttocks muscles:

Mainly the Gluteus Maximus, Medius and Minimus and Piriformis muscles, and play a key role in medially and laterally rotating the thigh (turning the leg inwards and outwards) and extending the hip. Problems with these will turn the knee and feet away from their proper alignment, also creating imbalances in leg muscles and exerting unequal forces on the knee joint and feet, in particular the arches.

· Two-joint hip flexor muscles (Tensor Fascia Latae/Iliotibial Band – ITB, Rectus Femoris (main Quadriceps muscle) and Sartorious:

These muscles get their “two joint” name because they go both across the hip joint and the knee joint.

· All the muscles of the thigh and lower leg, some of which go across the knee joint.

It is important to remember most of the muscles that go right to the tips of the toes extend up to just below the knees. So when trying to massage out a foot or ankle problem, it is important to follow the muscles right up to the knees.

· Feet Arches.

Last, but certainly not least, are the feet arches:
Flat feet will cause the legs to medially rotate (turn inwards) at the knees. High-arched feet will cause the legs to laterally (turn outwards) – again causing imbalances in the knees.

If you are being treated for leg, knee, ankle or feet aches and pains which you consider to be related to muscle imbalances (rather than to specific injury) and your practitioner does not include all the above factors, ask why.

Injuries like muscle tears and strains, post-operative recovery procedures, arthritis and gout however, will require more specific or specialised treatments.

Some people put up with leg or other problems for years assuming nothing can really be done when they may simply be related to a combination of tight muscles and easily treated by looking at the “big picture.”

With any massage however, it’s advisable to wear comfortable underwear that’s not too tight.

You’ve probably never given it a thought, but the answer may seem as obvious as breathing in and out.  But except for those rare occasions when we consciously regulate our breathing pattern, we do not decide when to inhale and when to exhale.  And even when we do this “controlled breathing,” it is not just sucking in air, and blowing it out, that gets air down the windpipe into our lungs and out again.

The main work of inhaling and exhaling is done by the contraction and relaxation of our big muscle immediately below the lungs and which marks the “floor” of the chest or thoracic cavity and the “ceiling” of the abdominal cavity.

This muscle is the Diaphragm.

It is the Diaphragm action that causes the lungs to expand and fill with fresh air, then partially collapses to expel used gases.  The muscles and tendons of the Diaphragm are attached to the spinal column at the back, at the front to the breastbone (sternum), and at the lower sides to the lower ribs.

The diaphragm contracts and relaxes as instructed by the brain.   Instructions  are delivered by the nervous system.  When the brain sends a signal to the breathing muscles to contract, the diaphragm is pulled downward, making the space filled by the lungs bigger.  This creates a partial vacuum, and air rushes in and fills the lungs.  When the diaphragm relaxes, the lung space is reduced, and air is expelled.

The diaphragm is an involuntary muscle.   Thankfully, like the heart, it keeps going 24/7 !…  and no…  you can’t kill yourself by holding your breath.

Other Breathing Muscles:

The Diaphragm muscle’s main role in breathing is supported by several other muscles that play minor parts.  These include the Intercostal muscles between the ribs that give the rib cage a slight push upward and outward, enlarging the thoracic cavity, and the Serratus muscles, which are mainly along the ribs, to which other muscles are attached also.

Primary inspiratory muscles include the external intercostals and diaphragm while the main expiratory muscles are the Internal Intercostals, Rectus Abdominus (“abs”), and External and Internal Obliques.

Assisting the inspiratory muscles are the Sternocleidomastoid and Scalenes in the neck, Pectoralis Major and Minor (“pecs”) in the chest, and Serratus Anterior and Latissimus Dorsi (“lats”) in the side of the torso.

Helping us to breathe out is the Serratus Posterior as well as the Quadratus Lumborum and Iliocostalis Lumborum in the back.

These muscles are used in any gym or training session and can often become very tight without you realising it.

Many respiratory muscles also act as “postural” muscles” designed to hold your body erect against gravity and hold a contraction for a long time without fatiguing or feeling sore.  But while there may be no pain, these muscles may still be too tight and affect other muscles.

Proper use of the respiratory muscles is only possible with good posture.  If there is a tendency to shrink forward, it is not possible to completely fill the lungs with fresh air.  If the lower back tends to curve inwards, it is not possible to effectively empty the lungs of air.

When postural problems limit trunk (spinal) rotation and side-bending, both inspiration and expiration become restricted also.

Remedial massage can play an important in helping you breathe easier and feel much better overall by releasing and stretching tight muscles all through the body?  That sharp pain felt in the chest or upper back during deep respiration is due to tension in the deep muscles of the back.

Deep tissue massage will help.

Relaxation, both mental and physical, brings about a decrease in oxygen consumption by skeletal muscles and more compliance of the chest wall.  Massage and practicing a pattern of deep breaths and sighing can reduce the work of breathing and help relax a person having difficulty breathing.  When you breathe easier, you will also sleep easier and more soundly.

Make an appointment today and try a massage which includes all the breathing muscles and see how much better you feel.

If so, do you also spend adequate time stretching the muscles you specifically exercise?

The answer should be a definite “yes.”

But whether you’re a fitness fanatic, an armchair sportsman, or if normal day to day activity is your only exercise, there are some muscles you work hard regularly but rarely or never stretch.

Can you name two of the most heavily exercised but most taken for granted and under-stretched muscles in the body?

Pecs and Hip Flexors:

Ten points if you said Pecs (Pectoralis Major and Minor – in the chest) which draw the arms around to the front, and Hip Flexors (mainly Iliopsoas group – across the front of the hips) which lift the legs.

What singles out these muscles for special mention is that for long periods of each normal day they are being used (contracted) and exercised.

But most people are unaware this is even happening.

Whenever you sit down – for example, at your work desk for most of the day, watching TV or driving a vehicle – the hip flexor muscles stay contracted.

Similarly, every time you work with your arms  to your front – like at a desk or computer, peeling prawns over the sink, laying paving blocks, hammering nails, serving at a counter, etc – your Pec muscles (also known as shoulder medial rotators) are contracted and being exercised.

But even most serious fitness enthusiasts, who would never dream of exercising a  muscle group without also stretching it, ever think about stretching these particular muscles for their routine daily activities.

Now, with all the above in mind, how many of you ever get sore or tight in the lower back, or in the back of the neck and shoulders? (If you answer “no,” you’re definitely in the minority).

Back Pain from the Front:

It may surprise you to know that apart from cases of specific injury or slipped disc, etc., lower back pain or tightness can usually be attributed to tight hip flexor muscles in the front.

Similarly, tight front Pec and other shoulder medial rotators are generally responsible for muscular aches and pains in the back of the neck, shoulders and between the shoulder blades.

One joint hip flexor (Iliopsoas group) muscles go from the side of the spine from mid to lower back and down across the front of the hips to the top of the legs. When they are tight, they tilt the hips forward, which causes the smaller muscles in the lower back (from the top of the hips to the spine) to also tighten by default. This is where you feel sore.

Think about the sore lower back you get after driving or sitting at a desk for several hours without a break.

When you get up to stretch, you generally lean backwards, not forwards. In other words, you stretch your hip flexor muscles – across the front of your hips – to make your back feel better.

• When Pec muscles are tight, they make the shoulders rounded and pull the cervical spine and head forward.

• For the eyes to focus ahead rather than down, muscles in the back of the neck and shoulder area are forced to tighten to pivot the head back and upward on top of the neck.

What this all means is pain in the lower back and shoulder areas is often just a symptom – not the main cause of the pain, which is often in the front of the body.

As unlikely as it sounds, it may be that releasing tight hip flexors in the front is also needed to help alleviate pain between the shoulder blades at the back.

It could be that a tight hip flexor on one side raises one hip higher than the other. This in turn tightens muscles on one side of the spine in the lower back, which in turn pull on other spinal muscles up between the shoulder blades on that side.

Unfortunately, for time, cost and other reasons, many health professionals focus on only treating the SYMPTOM, not the CAUSE, in the case of muscular aches and pains.

Take the Time:
However, most qualified and experienced remedial massage therapists are prepared to take the time to not only relieve the symptom, but also try to determine and remove the main cause or contributing factors.

Remedial Massage and stretching can alleviate or heal most muscular aches and pains, as well as have many other benefits.

If you’re experiencing muscular pain in your body, make an appointment today.  You’ll be surprised at the difference a Remedial Massage can make.

Posture is the bearing in which you hold your body plumb when you are standing, sitting or lying down.  Good posture involves training your body to stand, walk, sit and lie in positions where the least strain is placed on supporting muscles and ligaments during activity or weight-bearing movements.

Correct Posture:

• Keeps bones and joints correctly aligned so that muscles are being used properly.
• Decreases the stress on the ligaments holding the vertebrae together.
• Decreases the abnormal wearing of joint surfaces that can bring upon arthritis.
• Prevents the spine becoming fixed in abnormal positions.
• Reduces fatigue.
• Prevents strain or overuse problems.
• Prevents back and muscular pain.
• Contributes to a good appearance.

It’s mortifying to hear “Posture is inherited.  My parents had bad posture, so did their parents, and so I have bad posture too.  I guess I’m just stuck with it”.

What an absolute load of rubbish!  The theory of inheriting bad posture is completely false, so why do so many sufferers of back pain believe it?

The answer is simply that medical profession is failing to help people with postural problems.  So much trust is put into our doctors, that when they can’t help us, we often give up all hope.  What most people don’t realise is that doctors aren’t really experts on posture, and 80% of Australians suffer from back pain.”

Improving your “computer posture” is one of the most effective ways to avoid getting rounded shoulders and neck ache.   While we need to be aware of your posture on any computer, using a laptop makes it is especially easy to pick up bad habits.

The trouble with laptops is that they keyboard and display are too close together, which means you are either you are looking down too much which is bad for your neck, or your hands are too high which encourages tense shoulders.   If only used for short periods at a time, laptops don’t really pose much risk, but increasingly people are spending more hours a day on them.

A sign of the aging process is poor posture, but it is actually possible to prevent this with posture exercises.

We can’t do anything about wrinkles or gray hair as we grow old…  (well, maybe the ladies will disagree,) but it is possible to maintain good posture as we mature.

Avoid sending your child to School.

Obviously, we can’t do that, but watch any child when they are in their preschool years and you will see an example of a good posture.  Children naturally hold no excessive tension in their bodies and move effortlessly regardless of what they are doing.  We look at them galavanting around and think “I wish I could still do that”.  This stops when the child starts school, and is made to sit in poorly designed furniture, in a static position, for hours on end.

Holding the body still for any extended period of time causes the muscles to tire and tense.   A typical school chair slopes backwards, thus tipping the pelvis away from the desk.   This leaves the child with no option but to round their back and shoulders in order to reach their desks.

In countries where children are not made to sit at school desks, you will almost always see that they maintain their perfect posture into adulthood.

Lack of Exercise.

Movement and exercise is commonly overlooked.  Actually they are perhaps one of the best posture exercises that you can do to ensure good health.  The reason for this is that our bodies are designed for continuous movement.   We are never really still for any length of time.  Even the act of standing, which many would assume is a static position, actually involves mini movements that are performed unconsciously over and over.  An exercise you can try is to stand on one leg and then close your eyes and see how hard it is to maintain your balance.  It shows how much we rely on our eyes to make the tiny adjustments in muscle tension that keep us upright.

Despite movement being such an important activity, we often make no plan for it.  Instead, people linger and tell their posture has become progressively worse to the point where they have to go and see a doctor.  Sadly, the doctor has not much to offer for back pain, and anti inflammatories just hide the symptom doing nothing for the cause.  However, if a little exercise were taken a few times a week it would probably have a more significant effect than anything a doctor or surgeon could accomplish.

The major problem seems to be that from the time a child goes to school until a person expires, we are typically expected to spend most of a day in a sitting position.  It’s no wonder that so many people have back pain these days when you consider the time that the average adult will spend in a chair.

In spite of age, muscle strength can be achieved even at 70 and above.  It’s simply a case of use it or lose it…  So use it! Walking, cycling, jogging, swimming, etc are all good posture exercises that you can enjoy and do you a whole heap of good.

Have you ever wondered why one side of your neck sometimes gets really tight.  Maybe it hurts to turn your head to the right.  Stand relaxed and check in the mirror to see if your left shoulder is raised.
You might be thinking you slept badly the night before, but it might be that your crook neck  is an indication of a more extensive muscular imbalance that has been coming on.

Ever felt the outer thigh get really tight or sore on, say, the left leg? Sportsmen might know the muscle as the ITB or iliotibial band.  Possibly combined with that the inner thigh (adductor muscles) on the other leg is tight or sore? Stand relaxed with your arms loosely down by your side and check to see if your right hip is higher than the left.
If in this instance your right shoulder is also lower than the left, you probably have at least a mild scoliosis…  a curvature of the spine.

Posture gives a remedial massage therapist numerous clues about likely causes of muscular and joint aches and pains.

Qualified therapists are trained to recognise what muscles are likely to be involved in postural imbalances, how to check the muscles for flexibility and strength, and how to loosen or strengthen them if there is a problem.

It can go without saying of course,that postural problems may be due to an injury, a birth defect or other reasons.  However, in the vast majority of cases it is simply due to an imbalance in the muscles between left and right side of the body, or the front and back.

As well as Remedial Massage, a therapist will often give stretching exercises to help correct a problem.

Frozen Shoulder Syndrome is an extremely painful condition characterised by pain and stiffness of the shoulder and has the medical profession stumped.

There’s lots of theories about the cause and pain killers are prescribed by the bucket load, but from my experience, nothing works. If there was a medicinal cure for Frozen Shoulders, the chemist shops would have walls covered with the stuff.

Some doctors say “leave a frozen shoulder alone for 18 months” and it will get better on its own. It will eventually get better, but in reality, it will take a lot longer than that.

X-rays can’t reveal the cause of shoulder stiffness in most cases of primary adhesive capsulitis, and an MRI (Magnetic Resonance Image) shows soft tissue and may be used in cases in which another disorder is suspected, such as a rotator cuff tear. So when nothing shows up, it’s frustrating to be told there’s nothing wrong with your shoulder when it’s really hurting like blazes.

Signs and symptoms of frozen shoulder.

The pain of a frozen shoulder can be horrendous. Ask a sufferer what the pain would be on a scale between 1 and 10 and you’ll often hear 20.  To say  ‘My shoulder is really hurting’ doesn’t even come close to describing what you’re actually experiencing.

The major symptoms of frozen shoulder are pain and loss of motion:

• Night pain and especially when trying to lay on the affected side.
• Severe sharp catching pain at the front of the shoulder when you inadvertently extend the arm and lasting up to a minute or so. (You have to protectively hold the shoulder tightly).
• Pain from seemingly harmless activity.
• Pain reaching for the hip pocket, (not necessarily a bad thing especially if it’s your shout) putting on or taking off a shirt, brushing the hair and inability to do up bra.
• Pain down the outer upper side of the arm.
• Inability to drive.
• Swelling of tendons causes severe limitation in movement, especially reaching up behind the back.

Immobility / Stiffness

This is the key diagnosis of a frozen shoulder. You can’t move the arm and neither can anyone else if they lift the arm for you. If they do try, it’s extremly painful! The shoulder becomes stiff or stuck anywhere between 48 hours to a month from the initial pain and it’s all downhill from there. If your shoulder is not ‘stuck’ you may not have a true Frozen Shoulder. Many people are forced to give up work as a result of the pain and stiffness that commonly persists for many years.

The inability to work and the constant pain and stiffness can have a considerable impact on you psychologically as well as financially and you can become extremely depressed and anxious as a result.

Frozen Shoulder Facts:

• 2-5% of the population suffer from it. (This doesn’t mean 95-98% enjoy it.)
• It is more common in women (60%)
• It is five times more common in diabetics.
• It is common, but not limited to people with Dupuytren’s contracture (an uncommon hand condition where the connective tissue under the skin of the palm contracts and hardens over time.
• It may be genetic. i.e it can run in the family.
• It seems to affect 40-70 year old.
• About 15% of people get it on both sides.

There are three phases to frozen shoulder, (which lasts an average of 30 months… perhaps longer) if untreated.

1. Freezing (1 – 8 months) You notice some things you normally do are starting to hurt.
2. Frozen (9 – 16 months) It’s full on! Any movement using the arm is incredibly painful.
3. Thawing (12 – 18 months) Slowly gets back to normal and pain free use of the arm.

Not much to look forward to, is it.

The pain and loss of function associated with this condition can become so severe that it can significantly affect the quality of life, and prevent some people from sleeping well or working.

Why did I develop a frozen shoulder?

There’s no explanation for the development of frozen shoulder in most patients. The majority of cases seem to be more prevalent in women. Some who develop frozen shoulder have sustained an injury and developed stiffness as a result. The trauma can be quite mild or severe, and the body’s response to the event is probably more important than the event itself.

What is happening inside my frozen shoulder…?

The shoulder joint is a ball and socket (Gleno-humeral) joint. The ball is at the top of the Humerus (arm bone), and the socket is a shallow cup on the end of the scapula (shoulder blade).

Surrounding the Gleno-humeral joint (shoulder joint) is a bag or sack called the Capsule. When the arm is raised above the head, this Capsule is fully stretched. When the arm is lowered to the side, the capsule hangs down like a small pouch.

Inflammation.

In a Frozen Shoulder Syndrome, the lax capsular sack and the synovial fluid it contains becomes sticky and thick and can sometimes form adhesions. The stickiness is brought on through inflammation. This can occur after a small injury, like reaching for the back seat of the car, but often you may not remember anything. Once established this inflammation spreads into other shoulder soft-tissues and can cause swelling in other shoulder sacks (bursae).

Stiffness.

The stiffness is an ‘overreaction’ to the inflammation within the biceps groove. The body seems to ‘switch off’ muscles in a co-ordinated sequence. This sequence is the same for everyone. Arm movements start to diminish, and within a few weeks the arm literally becomes frozen and for many, cannot be raised more than 40° in any direction. The muscles of the rotator cuff become weak and start slowly to waste away, leaving the arm to hang stiff and immobile.

The inability to work and the constant pain and stiffness can have a considerable impact on you psychologically as well as financially, and patients can become extremely depressed and anxious as a result.

Stiffness may not be fully stiff for several months and both active and passive movements are stiff and neither you nor anyone else can lift it because it’s too painful!

Halleujah.

The good news is that even very severe types of Frozen Shoulder syndrome can be treated effectively. Treating Frozen Shoulders is massage based and naturally utilises the body’s own healing mechanisms. No drugs, no surgery. It utilises a specific sequence of manipulations to the shoulder joints and soft-tissues.

Conventional approaches to treating frozen shoulder syndrome involve painful injections of cortisone, months of physical therapy and or surgery.

In a frozen shoulder there is masses of inflammation and on top of this the brain starts to recruit the ‘wrong’ muscles to move the shoulder.

I ‘trick’ the body and the brain into healing itself by addressing the two main components of the problem … the pain and the stiffness.   Initially the aim is to significantly reduce the pain by treating the swelling around various shoulder tendons, especially the biceps tendon.

Following this, the technique moves on to rapidly ‘defrost’ and improve the range of shoulder motion by stimulating a unique sequence of reflexes hidden within the muscles.  One reflex is triggered against another in sequence and the arm is not forced.  Instead it’s kept still whilst applying the pressure.

Patients treated with this massage based technique will notice a definite improvement with each treatment session. These should be twice a week for twenty to thirty minutes a session and complete relief will be within twelve weeks.

There is a couple of testimonials regarding Frozen Shoulders you might care to visit, and if you believe you maybe displaying the symptoms of this condition… call me.  Frozen Shoulders CAN be fixed… but NOT with medication.

The shoulder girdle consists of  a whole bunch of bony joints and muscles that connect the upper limbs to the rest of the skeleton and provide an impressive range of movement.
The three bones which form the Shoulder Girdle are the Scapula, the Clavicle, and the Humerus, and the most important feature of the shoulder is the large range of movement that it allows, which is of prime importance to daily life.

Trapezius.

The Trapezius Muscle has many functions:

• Moving the shoulder blade in toward the spine.
• Moving the shoulder blade up and down.
• Bringing the head and neck in a backward direction.
• To rotate and side bend the neck.
• Assists in breathing.
• Rotates the shoulder blade so that the upper-most part of the upper arm faces up.

The Effects on the Neck:

Because the Trapezius Muscle works to move the neck in several directions, its degree of tightness or looseness affects neck flexibility.

For people who work at desks and computers, or who spend many hours driving, the Upper Trapezius is that muscle above your shoulder that becomes very sore and painful.

The Trapezius Muscle is in four parts:

The upper fibres of the cervical vertebrae is the weakest part of the muscle and only provides minor elevation of the clavicle.

• The area commonly known as’ Upper Traps’ is a strong elevator, rotator and retractor of the Scapula.
• The mid-portion of the Trapzius is mainly responsible for scapula retraction.
• The lower fibres of Trapezius assists in retraction and rotation.

Working together they have the effect of simultaneously lifting and retracting the Scapulae. The Trapezius is used most commonly to fix the Scapula to allow the Deltoid to move the Humerus.

Action:

• Laterally rotates, elevates and retracts Scapula. If Scapula is fixed, extends and laterally flexes neck.

Typical uses:

• Shrugging shoulders.
• Overhead movements.

Levator Scapulae.

Shrugging the shoulders (scapula elevation) involves the use of Levator Scapulae and Trapezius.

Fixation of the scapula by other muscles, allows the Levator Scapulae muscles to work together to aid cervical extension, or independently to laterally flex (side bend) the neck towards the side of the working muscle.

Action:

• Elevates the scapula and gives lateral flexion of the cervical spine (each side independently)
• Also responsible for the extension of the cervical spine (each side independently).

Typical use.

• Shrugging shoulders.
• Carrying a heavy shopping bag.

Rhomboids.

There are two rhomboid muscles – Rhomboid Major and Rhomboid Minor.

Rhomboid Major is larger and positioned below Rhomboid Minor.  Chins and dips are excellent activities for developing these muscles.

Action:

• Retracts Scapula (bringing the shoulder blades together). Rotates Scapula downwards to rest position.

Typical use.

• Pulling a draw open.

Pectoralis Minor.

The Pectoralis Minor muscle is the smallest of the two pectoral (chest) muscles.

It works together with the Serratus Anterior  which protracts and rotates the Scapulae upwards.

When the two work together, pure protraction (without rotation) is produced.

Actions:

• Elevates ribs if scapula fixed, protracts scapula (assists Serratus Anterior).
• Rotation of the scapula downwards.

Typical use.

• Pushing a door open.

Serratus Anterior.

The Serratus Anterior muscle is used in activities which draw the scapula forwards.

It is used strongly in push-ups and bench presses. Winged Scapulae are an indication of a weak Serratus Anterior.

Actions:

• Laterally rotates and protracts Scapula.

Typical use.

• Reaching up to open a high window.

Sternocleidomastoid.

Sternocleidomastoid can clearly be seen when you turn your head to one side, on the opposite side of the neck.

Actions:

• Flexes and laterally rotates cervical spine. Protracts head when acting together . Extends neck when neck already partially extended

• Contraction on one side only: Laterally flexes (side bends) to the same side and rotates to the other.

Typical use:

• Looking at the floor.
• Looking over your shoulder.
• Holding the phone between your ear and shoulder.
• Generally being a sticky beak.

They can also be named for their origin and insertion point, like the Semispinalis Thoracis which has its origin on the transverse process of the Thoracic Vertebrae and inserts on the spinous process of the Thoracic Vertebrae.  The Quadratus Lumborum covers the area of your kidneys, and is involved in side bending.
Those on the front of the body are collectively known as the abs.  Actually there are a few different abdominal muscles that work together.  The Rectus Abdominis is known as the “six pack”.  It flexes the trunk so that the rib cage moves toward the pelvis, and covers the Transverse Abdominis, which is responsible for keeping your internal organs just that… internal.

Rectus Abdominus.

The Rectus Abdominus is the most superficial of the abdominal muscles. It is this muscle which forms the six-pack shape!
It is a key postural muscle and is responsible for flexing the lumbar spine, as when doing a “crunch”.  The Rectus Abdominis assists with breathing and plays an important role in respiration.

It runs vertically on each side of the anterior wall of the abdomen and controls the tilt of the pelvis and curvature of the lower spine.

Action:

• It flexes trunk and lumbar spine, aids forced expiration and raise intra-abdominal pressure.

• It also tilts pelvis forward improving the mechanical positioning of the Erector Spinae.

Typical use:

• Moving from lying to sitting.

External Obliques.

Your External Obliques run diagonally down from your lower eight ribs, attaching to the top half of your hip and your Rectus Abdominis.

The External Obliques, along with the Internal Obliques, are the rotators among the muscles that make up your abdominal muscle anatomy. They twist your body at the waist and straighten your body when you bend to the side.

Action:

• Supports abdominal wall, assists forced expiration, aids raising intra-abdominal pressure and, with muscles of opposite side, abducts and rotates trunk.

• Contraction of one side alone laterally bends the trunk to that side and rotates the trunk to the other side. It also compresses the abdomen and supports the abdominal organs.

Typical use:

• Raking leaves.

• Mopping the floor.

Internal Obliques.

The Internal Obliques are under the External Obliques and run diagonally in the opposite direction.  The Internal Obliques work with the externals to rotate the trunk. They will also compress the abdomen when both sides contract.

It’s the same with the External Obliques, but unlike the External Obliques, they are not visible when fully developed.

Action:

• Supports abdominal wall, assists forced respiration, aids raising intra-abdominal pressure and, with muscles of other side , abducts and rotates trunk. Conjoint tendon supports posterior wall of inguinal canal.

• Contraction of one side alone laterally bends the trunk to that side and rotates the trunk to the other side. It also compresses the abdomen and supports the abdominal organs.

Typical use:

• Raking leaves.

• Mopping the floor.

Transversus Abdominus.

Of the four muscles of the abdominal muscle group, the Transverse Abdominis is the one that does not cause trunk movement.  When you “suck it in,” it’s muscle that pulls the ab wall in.  It is located deep in your abdomen, underneath your obliques. It holds your organs in place and forces expiration when contracted.

This muscle is often mistakenly overlooked, because with training, it can pull your stomach in, giving you a slender appearance.

Action:

• Supports abdominal wall and organs, aids forced expiration and raising intra-abdominal pressure. The conjoint tendon supports posterior wall of inguinal canal.

Typical use:

• Maintaining good posture.

Quadratus Lumborum.

The Quadratus Lumborum is a muscle with many functions.  It laterally flexes (sidebends) the trunk, and elevates the hip. It also helps to stabilise the low back, and is usually involved when low back pain is present.

It has fibers that run vertically and in two diagonals.

The Quadratus Lumborum act as guy ropes for the thoraco lumbar junction and lower ribs to the pelvis.  Due to abnormal stress patterns, mainly through poor posture, one or both of these will be chronically or acutely contracted, tender to touch and a common cause of lower grade back pain.  Pain is felt mainly locally and stimulates pain coming from the kidneys.

Action:

• Fixes 12th rib during respiration and lateral flexes (side-bends) trunk.

Typical use:

• Bending sideways to pick something up.

Erector Spinae.

The Erector Spinae is often described as a group of different muscles called Iliocostalis, Longissimus and Spinalis.

Erector Spinae consists of lots of small fibres which are situated very close to the spine.
They are the chief flexors of the vertebral column. They straighten the flexed column and can also bend it posteriorly. They also release during its flexion so that the movement is slow and controlled.

Actions:

• Extension of the spine.

• Lateral flexion (side-bending) of the spine.

• Maintains correct curvature of the spine.

Typical use:

• Maintaining good posture.

Splenius.

Splenius is often divided into two muscles, Splenius Capitus which insert on the skull, and Splenius Cervicis that inserts onto the cervical transverse processes of the spine.
The two flat muscles extend from the upper vertebrae to the base of the skull and help to rotate, flex or extend the head and neck.

Actions:

• Extension of the head and neck.

• Contraction of one side laterally flexes and rotates the neck to the same side.

Typical use:

• Looking up at the stars.

• Looking over your shoulder.

Multifidus.

Multifidus is a series of small muscles which travel up the length of the spine. It is an important muscle in the rehabilitation of lower back pain and can have an extraordinary impact on your body.
Although the Multifidus muscle is very thin, it’s a “powerful” muscle that provides support to the spine.  Multifidus muscle is a series of muscles that are attached to the spinal column.

The Multifidus muscles help to take pressure off the vertebral discs so that our body weight can be well distributed along the spine.  It also keeps our spine straight while the deep muscle group contributes significantly to the spines stability. These two groups of multifidus muscles are recruited during many actions in our daily living, which includes bending backward, sideways and even turning our body to the sides.

Studies have shown that the multifidus muscles get activated before any action is carried out so to protect our spine from injury.  When you are about to carry an object… even before moving your arm, the Mutifidus muscles will start contracting before to the actual movement of the body and the arm to prepare the spine for the movement and prevent it injury.

Actions:

• Extension, lateral flexion and rotation of the spine.

Typical use:

• Maintaining good posture of the spine.