The Most Common Types of Shoulder Pain, Explained

The shoulder is an efficient combination of joints, muscles and tendons that enable a wide variety of movement and range of motion. However, its utility and versatility make the shoulder prone to a variety of injuries and conditions. In fact, shoulder pain will affect up to 70 percent of the population in their lifetime. It can be disabling and result in a host of unwanted consequences.

Below are some of the most common painful shoulder conditions:

Biceps Tendinitis

The biceps tendon is a structure that connects the biceps muscle to the humerus (upper arm bone) bone near the shoulder joint. Biceps tendinitis, a common cause of shoulder pain, is an irritation or inflammation of the upper part of the tendon.

Causes

Often, biceps tendonitis is due to wear and tear. It can also be connected to other shoulder issues, such as instability, shoulder impingement or a rotator cuff injury. It is particularly associated with damage to the rotator cuff tendon.

Repeated motion in work or sport—particularly those activities that require overhead motion, such as construction work, painting, swimming, tennis and baseball—can also cause biceps tendinitis.

Treatments

  • Rest (from overhead activity)
  • Ice
  • Medication
  • Physical therapy
  • Steroid injections

Surgery-If more conservative measures have been exhausted, surgery may be indicated. This may entail biceps tenodesis, which is detaching the tendon from the shoulder socket and reattaching it to the upper arm bone.

Rotator Cuff Tear

The rotator cuff is involved every time you move your shoulder. It helps to stabilize the shoulder. So, it stands to reason that it is a commonly injured area. Rotator cuff tears can either be partial or incomplete (a tear that is frayed), or complete, which entails a tear that goes completely through the tendon.

Causes

There are two main causes of rotator cuff tears. They can occur from an acute injury (such as a fall or other cause of severe twisting motion of the joint). An acute injury can also be caused by the stress of improperly lifting a heavy object.

However, most rotator cuff tears occur due to progressive degeneration (wear and tear) over time. The incidence of tears increases with aging. It is important to determine the cause of a rotator cuff tear since this impacts what treatment is recommended.

Treatments

  • Rest
  • Modified activity
  • Medications
  • Physical therapy
  • Steroid injections

Surgery: If conservative measures have not offered relief or if the tear is severe, surgery may be indicated. This is particularly the case for athletes or those who engage in repetitive overhead movement, since many tears do not heal on their own.

Shoulder Impingement

Shoulder impingement syndrome, which is also sometimes called “bursitis” or “tendinitis”, occurs with the repetitive compression (“impingement”) of the rotator cuff during movement. A thorough and careful examination is the best approach to a personalized diagnosis.

Causes

Shoulder impingement is also the result of repeated overhead activity involving the shoulder. It can also be caused by a shoulder injury. Finally, in some cases, there is no known cause of the condition.

Treatment

  • Rest (from overhead activity)
  • Ice
  • Medication
  • Physical therapy
  • Steroid injections 

Surgery: If other treatments do not provide results, surgery may be indicated to increase the space around the rotator cuff. The procedure, which can usually be done with minimally invasive arthroscopy, allows free movement without the compression or rubbing on the bone and the resulting pain.

Frozen Shoulder

Frozen shoulder, technically called adhesive capsulitis, is a condition causing stiffness, pain and immobility in the shoulder joint. It is due to a thickening and tightening of the shoulder joint capsule which restricts room for movement.

Causes

While the causes are usually unclear and cannot be identified, some people suffer frozen shoulder following a recent injury or fracture to the area which resulted in a need to immobilize the shoulder. In about 10 to 20 percent of cases, it can be caused by diabetes. Other medical problems may put people at risk for frozen shoulder (hypothyroidism, hyperthyroidism, Parkinson’s and cardiac disease).

Treatments

  • Medications
  • Physical therapy
  • Steroid injections

Surgery is rarely required for frozen shoulder. Although recovery can take a long time (up to a couple of years), in the majority of people it resolves on its own with the use of nonsurgical treatments. In the event of surgery, manipulation under anesthesia and/or arthroscopy are performed to release the scar tissue.

If you’re having shoulder pain, contact us today to find out what’s wrong and how we can help.

5 Simple Stretches for Sciatica

Sciatica can be a real pain in the back, among other things.

Also known as lumbar radiculopathy, sciatica (pronounced sci-at-ick-aa) is a term used to described a series of symptoms—most notably, pain—that occurs when the sciatic nerve is irritated. This large nerve runs from your lower back, past the buttocks and down each leg.

Sciatica is currently estimated to be the cause of low back pain in five to 10 percent of Americans.

What are some stretches to alleviate sciatica symptoms?

The beauty of creating a routine to manage your sciatic pain is that it also serves as a way to prevent sciatic pain and other symptoms from making a reappearance. In fact, though it may seem unlikely (or unpleasant), exercising actually helps to improve symptoms better than bed rest.

One of the forms of exercise to help relieve sciatica is performing stretches that externally rotate the hip. Here are five stretches that do just that:

  1. Reclining Pigeon Pose
    • While lying on your back, bring your right leg up to a right angle. Grip both hands behind the thigh and lock your fingers.
    • Lift your left leg and place your right ankle on top of the left knee.
    • Hold the position for a moment, then repeat with the other leg.
  2. Sitting Pigeon Pose (to be done once the reclining pigeon pose can be performed with ease)
    • Sit on the floor with your legs stretched out straight in front of you.
    • Bend your right leg, putting your right ankle on top of the left knee.
    • Lean forward and allow your upper body to reach toward your thigh.
    • Hold for 15 to 30 seconds.
    • Repeat on the opposite side.
  3. Knee to Opposite Shoulder
    • Lie on your back with your legs extended, and your feet stretched upward.
    • Bend your right leg and fasten your hands around the knee.
    • Lightly pull your right leg across your body toward your left shoulder. Hold it there for 30 seconds.
    • Push your knee so your leg returns to its starting position.
    • Repeat for a total of three reps, and then switch legs.
  4. Sitting Spinal Stretch
    • Sit on the ground with your legs stretched straight out with your feet arched upward.
    • Bend your right knee and place your foot flat on the floor on the outside of your opposite knee.
    • Place your left elbow on the outside of your right knee to help you gradually turn your body toward the right.
    • Hold for 30 seconds and repeat three times, then switch sides.
  5. Standing Hamstring Stretch
    • Place your right foot on a raised surface at or below your hip level. Flex your foot so your toes and leg are straight.
    • Bend your body forward slightly toward your foot (without feeling pain).
    • Release the hip of your raised leg downward as opposed to lifting it up. If you need help easing your hip down, loop a yoga strap or long exercise band over your right thigh and under your left foot.
    • Hold for at least 30 seconds, and then repeat on the other side.

The Scoop on Basketball Injuries (And How to Avoid Them)

When most people think about sports-related injuries, the first sports that typically come to mind are collision sports such as football, or ice hockey.  However, many sports are considered contact sports, and carry with them a significant risk of injury. These include sports like soccer, baseball, and – you guessed it—basketball.

According to the U.S. Consumer Product Safety Commission, more than 501,000 basketball-related injuries were treated in hospital emergency rooms in 2009. In addition, a study published in 2010 that was conducted over the course of 17 years and 1,094 players, professional athletes in the NBA experience a high rate of game-related injuries. Patellofemoral inflammation—inflammation that is the result of worn-down, softened or roughened cartilage under the kneecap—was the most significant injury in terms of days lost in competition.

These startling statistics don’t just apply to professionals, either. In high school basketball (according to the National Athletic Trainers’ Association):

  • 11 percent of injuries involved the hip and thigh
  • 22 percent of all male basketball players sustained at least one time-loss injury each year.
  • 42 percent of the injuries were to the ankle/foot
  • 9 percent of injuries involved the knee
  • Sprains were the most common type of injury (43 percent)

What are some other common basketball injuries?

Due to the fast-paced nature of the sport, the majority of the injuries incurred while playing basketball involve the foot, ankle or knee. There’s also a risk of jammed fingers and stress fractures occurring in the lower leg and foot.

What are some ways to prevent injuries?

Thankfully, there are many preventive strategies athletes of all ages can utilize to make sure they’re ready leading up to and during basketball season:

  • Stay fit. Players should maintain a regular exercise routine—both on and off season—that incorporates flexibility training, strength training and aerobic exercise.
  • Keep hydrated. If the body is dehydrated, it will have difficulty keeping cool when it’s highly active. According to the National Collegiate Athletic Association (NCAA), players should:
    • Drink 16 ounces of fluid two to three hours before exertion and about eight additional ounces 15 minutes before exertion
    • Take breaks when possible while playing (around every 15 to 20 minutes) to take in approximately four ounces of fluid
    • Drink 16 to 20 ounces of fluid for every pound lost after exertion
  • Warm the body up. It’s always a good idea to take time to stretch and warm the body up before any extended physical activity to avoid injury. Players can warm up with activities such as jumping jacks or running/walking in place for two to five minutes. After that, slow stretching is recommended, holding each position for at least 30 seconds before moving on.
  • Don’t forget technique. Players should remember to only use proper techniques for passing and scoring. Not doing so may result in self-injury or injury involving another player.
  • Wear and maintain appropriate equipment. Players should choose sneakers that fit snuggly, offer support for the foot and have non-slip soles. Mouth guards should also be worn to protect the teeth and head from injury as well as safety glasses or glass guards to protect those with glasses.
  • Avoid overuse injuries. Overuse injuries are becoming more common, especially in younger athletes. Players should not be allowed to play one sport all year long and should be limited to how many teams they can play on within a season.

Come to the Sports Medicine Specialists

If sports-related injuries do occur, our physicians at Northeast Orthopedics and Sports Medicine (NEOSM) have years of experience in effectively treating all orthopedic conditions. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get back in the game.

For more information on sports medicine or to schedule an appointment with one of our sports medicine specialists, contact us today.

New Games: 7 Tips for Transitioning From Winter Sports to Spring Sports

Spring sports and winter sports are similar: They require strength, speed, skill, agility and sweat. But while they both depend on these attributes, they have their own preparations and demands.

From playing surfaces to equipment to the stresses incurred by varying body parts, these changing needs require a winter-to-spring transition for athletes and fitness enthusiasts. This is particularly critical for younger athletes whose bones and joints are still developing, and who may be inexperienced at switching between sports seasons.

Safely transitioning sports is often a matter of experience. Many athletes—from recreational to professional—have learned through trial and error how to adapt to their activity, both for athletic improvement and injury prevention.

Below are some of the techniques they have used and you can use to make the smoothest transition possible between spring sports and winter sports:

1. Get a pre-season physical

Many sports require a pre-season physical for youth athletes as a rule of participation, but everyone should consider having a check-up. This will help to identify any potential health or injury risk, and in so doing, ensure you are ready to play.

2. Have a lesson or two

If you’re new to the spring sport or just rusty, consider investing in a lesson or two from a professional, such as a coach or a trainer. This will start you off on the right foot as proper technique aids both good performance and injury prevention.

3. Build up to the activity

Ideally, you want to do some pre-season conditioning and preparation relative to your spring sport. However, that conditioning can also be acquired by slowly acclimating to your new activity. If you’re not in shape in general, the best approach is to partake in some form of fitness prior to the season.

4. Invest in the proper equipment

Different sports mean different gear. Make sure you get the best gear for your spring activity. That includes sports equipment and attire. Constantly improving technology has resulted in clothing made of the most advanced sports performance fabrics.

5. Break in your equipment

Whether it is new shoes or getting accustomed to a racquet or glove, avoid discomfort such as blisters or foot and ankle problems by ensuring your gear is fully ready to use.

6. Remember general sports principles

Switching from one sport to another is no reason to change good habits. You can also use the new season to acquire them:

  • Always warm up and cool down
  • Drink plenty of fluids (but don’t overhydrate)
  • Don’t overdo your activity
  • Rest/recover between sessions

6. Protect your skin outside

Spring means enjoying the outdoors. An under-considered aspect of outdoor sports is the need for skin protection. Whether you’re young or older, whether it’s sunny or cloudy (the sun’s rays come through the clouds), apply sunscreen early and often, particularly if you perspire. Make sure children do so, as well. Now is a good time to educate them on skin safety.

Come to the Sports Medicine Specialists

If sports-related injuries do occur, our physicians at Northeast Orthopedics and Sports Medicine have years of experience in effectively treating all orthopedic conditions. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get back in the game.

For more information on sports medicine or to schedule an appointment with one of our sports medicine specialists, contact us today.

Cracking Big Toe?

A Possible Sign of Arthritis

Sadly, that crack, crack, cracking you’re hearing from your feet these days as you walk may be more than just another sign of getting old. In actuality, you may have arthritis and not know it.

What is arthritis, exactly?

The term arthritis is a bit of a misnomer and does not describe a single condition. Rather, it refers to the overall pain or disease that is caused by inflammation or stiffness in the joints. In fact, there are over 100 different types of arthritis and other related disorders that the term can actually cover.

When arthritis occurs in the joints (including the toes), it wears away cartilage between the joints. This causes inflammation in the associated tissues and/or wears away the synovial fluid (lubrication for the joints) over time. This makes the joints stiff and painful, which can become a serious problem for the big toe, as it is primarily responsible for balance when you walk.

Risk factors for developing arthritis in the toes may include:

  • Family history of arthritis
  • Increased age
  • Obesity
  • Wearing tight, high-heeled shoes for extended periods of time

What are some common symptoms of arthritis?

When it comes to arthritis in the toe(s), common symptoms may include:

  • Changes in the appearance of the toe(s), such as joint enlarging (think of what a bunion may look like) or toe curving (a.k.a. claw foot)
  • Pain in the big toe or several toes
  • Stiffness that makes moving the toe(s) difficult
  • Swelling, which may turn the toe(s) red, feel warm to the touch and make putting shoes on difficult
  • Toe joint(s) locking up

How can arthritic toe pain be treated?

There are a number of things you can try to ease the pain and other symptoms of arthritis, such as:

  • Applying topical treatments, like Icy Hot® (or any treatment that contains capsaicin)
  • Getting a foot massage
  • Taking non-steroidal anti-inflammatory drugs (NSAIDs) over the counter (e.g., Aleve®, Advil®, Motrin®, etc.)
  • Wearing wide, comfortable, supportive shoes with arch support, so the joints of the toes and feet are stabilized (e.g., toning athletic shoes)
  • Wiggling your toes to increase joint mobility

Could my symptoms be the result of something other than arthritis?

There are several conditions that can mimic the symptoms of arthritis (most notably rheumatoid arthritis). These include:

  • Certain infections, such as Lyme disease, human immunodeficiency virus (HIV) and Chikungunya virus
  • Lupus, a choric autoimmune disease in which the body attacks its own tissues
  • Morton’s neuroma, a condition in which the tissue around a nerve connected to the toes becomes thickened
  • Vasculitis, an inflammation of the blood vessels

>No matter what the cause, if you suspect you have arthritis in one or more of your toes, a trip to a rheumatologist may be in order (because self-diagnosing is so early 2000s).

Come to the Joint Specialists

At Northeast Orthopedics and Sports Medicine (NEOSM), our physicians have years of experience in effectively treating all orthopedic conditions and injuries, including those related to joint pain and arthritis. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get moving again.

For more information on arthritis or to schedule an appointment with one of our specialists, contact NEOSM today.

Chilled to the Bone: Can Winter Weather Affect Arthritis Symptoms?

Arthritis is classified as a condition that causes stiffness and inflammation in the joints. It can be very painful, and make it difficult to be active. According to a poll by the Centers for Disease Control and Prevention (CDC), arthritis affects more than 50 million Americans, with numbers rising each year.

The condition is classified in two categories, each affecting the joints differently. The following is a breakdown of both types of arthritis, and the ways that they affect the body.

1) Osteoarthritis

Osteoarthritis commonly begins with the abuse that joints’ cartilage takes over the course of time. In severe cases, the cartilage is completely worn away, causing painful bone-on-bone friction. This type of arthritis is brought on by age, but can arise earlier if there is a history of joint injury or infection.

2) Rheumatoid Arthritis

Rheumatoid arthritis occurs when the immune system attacks the tough membrane that lines the joints. The lining (known as the synovial membrane) then becomes inflamed and swollen. It is a progressive condition, and can eventually destroy the bones and cartilage within the joint membrane.

Risk factors for both types of arthritis include obesity, age, sex (women are more likely to have rheumatoid arthritis than men), previous injury and family history. There is also a possible risk factor that is not widely considered, and that’s colder weather.

How can arthritis be affected by cold weather?

For decades, there have been countless numbers of people who claim that they can predict weather changes like rain or snow based on pain in their joints. While many believe this is unfounded, studies have shown that perhaps there is some validity to the claims.

For decades, doctors have stood by the belief that weather is actually a factor in arthritic pain. According to some experts though, the overwhelming number of patients who claim that the phenomenon happens to them has caused for some questioning.

While there is not much evidence that explains the actual process of how arthritic joints are affected, there are certain elements related to colder weather that can help to explain this phenomenon.

Barometric pressure (also known as atmospheric pressure) is exerted by the weight of the air in Earth’s atmosphere. It can vary based on factors such as altitude, sea level and temperature/humidity changes. It has also been said to have effects on the human body.

During winter months, barometric pressure changes frequently. The theory is that this decrease/increase of pressure on the skin is what can cause swelling to occur more prevalently, leading to more arthritis pain. Another popular theory as to why the correlation between colder weather and arthritis exists is the “hibernation” lifestyle that many people adopt for the winter season.   

What can be done to prevent arthritic pain during winter?

During colder months, it’s well established that people tend to have changes in their exercise routines. However, low-impact exercise is known to be a great method of reducing stiffness and pain from arthritis. Exercise does not always have to be intense or monotonous. Just taking 20 minutes out of the day to do some form of activity can go a long way in avoiding arthritic pain. But unable to participate in outdoor activities, many feel that their choices are limited, and do not exercise as frequently as they should. Here is a list of activities to consider during the winter.

  • Household chores (vacuuming, rearranging furniture, etc.)
  • Hydrotherapy (swimming)
  • Joining a gym or fitness club
  • Playing with children
  • Running (which is beneficial to knee joints according to a recent study)
  • Stretching/ light exercise indoors
  • Using stairs instead of an elevator/escalator
  • Walking indoors (shopping mall or around the office)

There are measures that can further protect the joints during colder months. These are not related to exercise, but are more geared towards preparation when being out in the cold. Seeing a physician is first and foremost in the steps to finding relief. A doctor can confirm that pain being experienced is indeed arthritic, and can help to devise a treatment plan. Listed below are some precautions to consider that can help you to avoid joint pain during colder months.

Dress in layers and stay warm

By bundling up, joints can be protected from colder weather. As the cold progresses, dressing in layers is a good method of controlling body temperature and movement. It’s very important to make sure that the extremities (fingers and toes) are covered, as they are often sources for arthritic pain.

Keep hydrated

Dehydration can make the body more sensitive to pain, and can also make people feel lethargic and tired. By drinking a recommended average of 10 to 13 cups per day of water or fluids, a person will feel more active and less likely to experience arthritis-related pain.

Stay alert and cautious

During colder months, icy conditions are common, and can be a cause of injury. Those with arthritis need to be particularly cautious, as a joint injury can become a serious problem. Wearing supportive shoes with deep treads is an easy way to avoid a painful slip-and-fall.

Take supplements (fish oil, glucosamine-chondroitin, vitamin D)

Fish oil provides omega-3 fatty acids. According to the Arthritis Foundation, 2.6 grams of fish oil pills should be taken twice a day to ease arthritic inflammation. A doctor should be consulted if you are taking omega-3, as it can increase bruising and bleeding.

Glucosamine-chondroitin is an herbal supplement that can serve as a low-risk pain therapy for arthritis. It is not proven that herbal supplements can provide arthritis pain relief, but testimonials have supported some validity to the potential benefits.

Vitamin D is absorbed through sunlight, and can affect sensitivity to arthritis pain. By supplementing Vitamin D during the winter, one can gain the benefits even where sunlight is not present quite as often.

Although the scientific proof is unsubstantiated, it seems to be an all-too-common occurrence that people with arthritis experience more pain in colder weather. If atmospheric pressure is indeed the cause, it is seemingly unavoidable. However, by taking the proper precautions and being prepared when going out into the cold, pain and stiffness can be alleviated or avoided.

 

At Northeast Orthopedics and Sports Medicine, our physicians have years of experience in effectively treating all orthopedic conditions and injuries, including those related to joint pain and arthritis. Our multidisciplinary approach to care ensures that patients receive the customized treatment they need to get moving again.

For more information on arthritis or rheumatoid arthritis or to schedule an appointment with one of our specialists, contact NEOSM today.

 

The Multipurpose, Multigenerational Benefits of Strength Training

Once upon a time, people got strong with the lifting, bending and squatting of regular physical labor. This was true whether people worked in the kitchen, the fields or the factory. Today, in a sense, we make up for the lack of physical labor with strength training.

Strength training is a tremendous asset. Experts from multiple fields highly recommend it, and they attest to the proven benefits of this training for everyone from youth to seniors. For young people, it can protect them from sports injuries and also establish good lifelong habits. And for the older, it can help counter the natural loss of muscle mass.

Strength Training Defined

Strength training is a method of improving muscular strength by an increased ability to resist force. This resistance stimulates muscle strength. Strength training can be done with a person’s own body weight (e.g., push-ups, squats, lunges), free weights or machines, all of which stimulate muscle strength. Strength training builds anaerobic conditioning and contributes to coordination and balance.

The benefits of strength training are numerous. Strength training:

  • Enhances daily activities and task performance, by lessening the risk of falls
  • Enhances exercise/sports ability and performance by improving strength, speed, power and endurance
  • Prevents exercise/sports injuries by protecting bones and joints, improving alignment and balancing the strength of lesser-used muscles
  • Promotes weight management, burning calories while increasing metabolism
  • Strengthens bones as stress increases bone mass

Now that the major “why’s” of strength training are established, below are tips to optimize your efforts:

  1. Talk to your doctor. Generally, it is a good idea to consult your doctor before undertaking any exercise program.
  2. Welcome the work. Strength training is meant to be challenging; that’s why it works! So create the conditions that will assure your success.
  3. Consider a coach. Whether building or refreshing a program, an expert coach or trainer can be an important asset, even for just a session or two.
  4. Make it doable. Chose a place, time and type of program that will realistically work for you. A regular, consistent routine is the key goal.
  5. Practice proper habits. Form, breathing, rest between sets … It is important to adhere to proper technique.
  6. Work your way up. Strength training should progress. While you want to start easy, and not overdo it, don’t stick with the same routine indefinitely. It should get more difficult.
  7. Warm up. Warming up raises your body temperature and sends blood to the muscles to prepare for your session. This means a more efficient workout.
  8. Cool down. Winding down with a gradual recovery helps your heart rate and blood pressure return to normal, which can help prevent muscle soreness and/or stiffness.

So, hit the gym, the park or the living room. The beauty of strength training is that you can craft a program that’s doable anywhere. And the rewards are great!