The Shoulder Pain Break Down

Let’s start with a little 101: defines shoulder pain as: Shoulder Pain – The shoulder is a ball-and-socket joint formed by the head of the humerus (the arm bone) and the glenoid labrum (the name for the socket of the shoulder joint in the scapula). The shoulder joint is very mobile – allowing great freedom of movement for the arm (much more than the equivalent joint in the hip). This greater mobility means that the shoulder joint is less stable. The stability of the shoulder joint also relies a lot on the ‘rotator cuff muscles’ – four muscles (supraspinatus, infraspinatus, subscapularis, teres minor) inserting around the shoulder joint that help move it, as well as providing stability. These muscles are a common source of pain. Shoulder pain is common, and can result from a number of conditions. Importantly, pain felt in the shoulder region does not necessarily mean that the pain is coming from the shoulder. The pain could be caused by neck problems, or referred from internal structures like the lungs, heart, or even the liver or gallbladder.


Most shoulder pain stemming from a non traumatic injury is a combination of rotator cuff problems and/or shoulder alignment problems called impingement.

*The number one thing to know about shoulder pain is to get treatment EARLY.  Waiting for shoulder pain to go away (especially after the age of 30) most often results in things getting worse.  Addressing the pain early most often results in avoiding major injury or surgical intervention.


As a society we spend a lot of our time bent forward.  We slouch over desks, computers, on couches and recliners and have poor posture in general.  This prolonged forward bent posture reduces the space in the front of the shoulder joint and tightens everything down.

Here is one stretch that our clinicians use frequently to open up the chest and get the shoulders “back” where they belong.


This is the “doorway” stretch.  Hold this position for 30 seconds 3 times. Rest between each stretch for 10 seconds.  Do this 3-4 times a day.

The 4 muscles that make up the rotator cuff can be strengthened to further improve your shoulder pain.  External rotation exercise is the number one way to strengthen your rotators.


It’s best to start with a low resistance band and 10 reps.  Do 2-3 sets of the 10 reps, allowing rest time between.  Always use a rolled towel to improve alignment and blood flow to important structures in the shoulder while doing this exercise.  Do this 2 times a day.

And most importantly if your shoulder doesn’t feel better in 3 days, call a physical therapist.  They can help target where your pain is coming from and give you specific ways to treat it.


The Plantar Fasciitis Fix

Plantar Fasciitis can be a pain.  Physical therapy can help give your plantar fascia pain the boot.  Here are five simple and easy tips used by the pros to help kick your plantar fasciitis to the curb.

1.) Stretch

Use moist heat on the affected area for up to 5 mins prior to stretching.  Hold each stretch for 60 seconds.  Complete these stretches twice each, 3-4 times a day.

Plantar stretching1
Stand with balls of feet on step.  While holding handrail, gradually lower heel until a stretch is felt in your calf muscle.  Hold for 60 seconds.
Using a strap or belt around the ball of foot, gradually pull until you feel stretch in calf muscle.  Hold for 60 seconds.


2.)  Massage

Again, moist heat for 5 mins prior to massage and complete the massage for 5 minutes twice a day.  You can roll your foot over a ball with pressure.  The ball should be firm.  Or you can use your hands and deeply rub along your arch area.  Deep pressure works best.  If it doesn’t feel uncomfortable, you’re probably not pressing hard enough.

self massage footplantar-fasciitis-massage

3.) Strengthen

You can strengthen the arch of your foot and your calf muscle with these exercises.  This will help support your foot.

towel scrunch
Scrunch a towel under your foot for 2-3 minutes twice a day.
While holding onto something like the back of a chair or a counter top, lift your heels off of ground as high as you are able, hold 5 seconds and repeat 10-20 times twice a day.

4.) Ice

Although heat is to be used prior to stretching and massage, always end with ice.  Plantar fasciitis is an inflammation of the tissue and ice helps reduce inflammation.

Roll your foot over a frozen water bottle for 3-4 minutes or place ice on affected area for up to 10 mins.  Wear skin protection such as a thin for feet

5.) Support

Arch inserts, orthotic supports and kinesio taping techniques will be necessary to support your foot and help keep the pain away.




**If your pain doesn’t subside significantly within 2 weeks of stretching, strengthening, ice and support it’s time to call your local physical therapist.**

Click here for more information or to set up your appointment.


foot pain


Pack it light, wear it right. Backpack 101

backpack safetyBack to school shouldn’t mean back to back pain.  Check your child’s backpack to make sure they aren’t being set up for back pain by Thanksgiving break.  15% of a child’s bodyweight is the maximum recommended amount.

backpack_handout-1 (2)

Shoulder straps should be wide and padded; and both shoulder straps should be worn at all times.  The backpack should never sit more than 4 inches below your child’s waist.  back_pack_safety2

Pockets should be used to store various items which will help more evenly distribute the weight.

backpack safety4

Have your child’s back and check their pack.  Wishing you a healthy and safe 2018-2019 school year!

Assess your “movement health” to lower your risk of back pain.

Americans spend more than $87 billion each year on low back and neck pain treatment, according to a study in the Journal of American Medical Association. To prevent that figure from rising further, we must find ways to prevent the high rate of back pain incidences from occurring in the first place. And that means getting real about how we move during a variety of activities throughout the day, whether we’re working at a desk, tending to a garden or lifting a heavy object.

back pain

The path to better management of patients with back pain begins long before the first stab of pain, and that means getting to the root cause. How healthy are your movements? Physical therapy is one of the most effective ways to identify the movement patterns that put you at risk for back pain.

movement screen

With the use of yearly screens and measures that are designed to assess how your body moves, such as the Functional Movement Screen™, physical therapists can work with patients to prevent low back and neck pain and a variety of other degenerative conditions. And with eight in 10 people suffering from back pain at some point in their lives, preventing incidences all together could take a huge chunk out of the staggering annual costs associated with treatments like medications and surgeries.

Preventing more cases of back pain would also ease some of the burden on providers, as well as the entire healthcare system. In fact, a study published in Mayo Clinic Proceedings identified back problems as the third most prevalent non-acute condition driving participants to see a doctor. By actively preventing back pain with the help of a physical therapist, you can save yourself a trip to the doctor.

During a movement screen, PTs observe how patients’ knees, hips, core, ankles, shoulders and back perform as they complete a series of movements. It helps the rehab professional to identify or rule out issues, uncover areas of strength and weakness, and determine whether any preventive steps need to be taken. how do you move

Think about making an appointment with your physical therapist to assess your “movement health.” You may just find that there’s something you can be doing—or not doing—today to prevent the limitations and costs of low back pain.

IMG_5600Click here to request information on your personalized movement screening.

About The Private Practice Section of the American Physical Therapy Association Founded in 1956, the Private Practice Section of the American Physical Therapy Association champions the success of physical therapist-owned businesses. Our members are leaders and innovators in the health care system. The American Physical Therapy Association (APTA) represents more than 85,000 physical therapists, physical therapist assistants and students of physical therapy nationwide. For more information, please visit

Physical Therapy Help for “Texting Thumb”

tech injury6A new Nielsen Company audience report reveals that adults in the United States devoted about 10 hours and 39 minutes each day to consuming media during the first quarter of this year.  That is A LOT of texting, clicking and typing.  Over half of the average American’s day is spent staring at a screen.  The way you hold your device, send your text out, or even type on your laptop can have a negative effect on the muscles, tendons and ligaments that support your wrist and hand.  One of the most common overuse tech injuries is “texting thumb”, and it’s caused by overuse of your thumb in typing out smart phone messages.  text-thumb-300x298 Pain can occur at 2 main areas with this problem.  First at the bottom of your thumb, and at the joint where your thumb meets your wrist. Texting-thumb Here are a few things to help you relieve your sore texting thumb.  First, rest the joint.  Try holding and using your device a different way to reduce the stress to the area.  Pop sockets are just one device that can help with using your device in a more ergo friendly way. popsocket  Secondly, stretch the thumb in the opposing direction.  Stretch it away from your hand to allow the tendons and muscles some relief.  thumbtableextensionstretchDo this 5 times, holding each for 10 seconds.  If you’re still experiencing some discomfort, try a self release of the muscle in the base of the thumb.  You can do this by pressing your other thumb into the muscle at the base of your affected thumb.  Hold this area until you feel some tension relax out of the muscle, and attempt the gentle stretch again. thenar

Rest, ice, stretching and massage are some of the best ways to deal with sore and inflamed tendons.  If you have pain lasting for more than 3 days, or if it is accompanied by any numbness, tingling or burning sensations see your physical therapist right away.  Text-thumb-cartoon-300x296Click here for more an appointment.

Is your phone becoming a pain in the neck?


Tech neck
How heavy is your head as you read this blog?

carrying on head

The average human head weighs anywhere between 10-12 pounds. The neck was designed to hold that weight (and much more) when aligned properly on your spine.

When you look down at your cell phone, laptop, or tablet you exponentially increase the amount of weight placed on your neck. A good rule of thumb is that for every inch forward your head moves the weight of your head increases by 10 pounds.

tech neck5

This excess weight or stress on your neck over a period of time creates a pain in the back of your neck we like to refer to as “tech neck”.

Symptoms of “tech neck” include:

  • upper back, neck and shoulder pain or stiffness
  • head aches
  • numbness down arms and hands

If not addressed and corrected “tech neck” can permanently damage postural alignment.

To put it in perspective imagine you are holding a 10 pound weight for an hour. Now, exchange that weight for a 60 pound dumbbell. How long could you hold it? Most people couldn’t hold it for more than a few minutes, yet we expect our neck muscles and ligaments to do it for hours as we gaze down at our devices.

posture test

Posture Test

Try this quick posture test: Stand with your shoulders, buttocks, and the back of your head touching the wall with your eyes looking straight ahead. Although this is normal posture, not everyone can achieve it. Were you able to maintain this posture comfortably?

Conservative treatment of the symptoms of tech neck can be very effective and reduce risk of long term postural damage.

Here are a few simple tips to keep you from developing tech neck.

  1. Set time limits. For every 20 minutes you are looking at a device you need a 3 minute break. If that seems unrealistic then simply try looking up for 10 seconds after looking down for several minutes.
  2. Use device holders on your phone and tablet to allow you to get your head in a better position.
  3. Check your work station to make sure your angles are ergonomically friendly.
  4. Use pain as your warning. If you’re having neck pain, stiffness or any of the other symptoms listed above more than twice a week, you need to contact a physical therapist to help you address these issues.

work station set up

chalk talk tech neck

Click here to set up your appointment or request more information on your symptoms.

Reduce your pain without medication.

In our last blog we explained that pain, defined as “physical suffering or discomfort caused by an illness or injury”, is simply a built in alarm system to warn us of possible danger.  In chronic pain situations this alarm system (otherwise known as our nervous system) gets stuck in bad loop. We’ve all experienced the blue “circle of death” on our computer, and it’s a very similar situation with much chronic pain. The tissues have healed (because that’s what tissues do), the threat that once caused the pain is long gone, but for some reason the pain remains. You’re nervous system, including the pain receptors, need a restart in order to return to normal functioning levels. So how do you begin your reset? The good news is that you already have! Simply by educating yourself on what pain is, why it exsists, and how it works you can effectively reduce your pain levels up to 10%. (Moseley GL. Widespread brain activity during an abdominal task markedly reduced after pain physiological: fMRI of a single patient with chronic low back pain. Aust.j physiother. 2005.;51(1):49-52.). 

  • The second thing you can do to help reset your overactive or stuck pain alarm system is AEROBIC activity, not to be confused with anaerobic, (see chart above). How much do you need to effectively reset your receptors and reduce your pain? 10-20 minutes, 4-5 times a week with a target heart rate of at least 100 beats per minutes will do it. Exercise hurts at first, but remember…hurt doesn’t always equal harm. A good motto is “sore but safe”. A physical therapist can help you move through this initial challenge, and find the balance safe and effective activities at a level that’s right for you.  Some other effective nervous system reset and pain reducing activities include:
  • Diet
  • Relaxation / Meditation
  • Massage
  • EFT / tapping
  • Deep breathing techniques
  • Sleep