Joint Ventures Physical Therapy and Fitness - Boston, Massachusetts Kenmore Square

The rotator cuff is a very commonly injured group of muscles in the shoulder.   It is made up of a group of four small muscles at each side of the scapula, or shoulder blade, and it functions as a dynamic stabilizer for the shoulder.  Since the shoulder is a “ball in socket” joint, it can be very unstable, and this is where the rotator cuff comes in to play.  The purpose of the rotator cuff muscles is to keep the “ball” in the “socket” when the arm is moved (i.e. stabilize the joint during a dynamic activity).  The four muscles are the supraspinatus, the infraspinatus, the teres minor, and the subscapularis muscles.  Each muscle provides a slightly different force to the mechanics of the shoulder movement, but the muscles work together to make the movement fluid and painfree.  Therefore, given the function of the rotator cuff, it is extremely important to keep each of the muscles in a healthy condition to ensure the most optimal stabilization of the upper body.  And this is where your health care professionals can guide you…don’t hesitate to ask your physical therapist for assistance on the proper stretching and strengthening routine for your rotator cuff!

Believe it or not, there are over 150 different documented types of headaches!  The most common categories include: Tension, Cluster, Migraine, Sinus, Cervicogenic, Mixed, Rebound and Hormone Headaches.  How do you know what category your headaches fall into?  Using the information below and on the linked website, you can help get the best care for your headaches. 

Migraines are severe or moderate headaches (which often occur on one side of the head and cause pulsating pain) and last from several hours to a few days. Women are three times more likely to experience migraines than men - possibly because of hormonal fluctuations that occur with menstruation. No one knows the exact mechanisms that cause migraines, but researchers suspect that hormonal cycling and a genetic predisposition to migraines play a role. And even though doctors can’t cure migraines, they can prescribe a variety of medications (including preventive drugs). Doctors can also help you identify and learn to avoid migraine triggers, and they can recommend alternative therapies to help reduce the frequency of your headaches.  Some triggers can be physical, and physical therapy may be able to help reduce the frequency, duration or intensity of your headache, utilizing joint mobilization, traction, massage and postural awareness/strengthening.

But first, you need to know what kind of headache you are having.  To find out, the quiz on this website: 
http://www.everydayhealth.com/specialreport/topamax/quiz-migraine/question.aspx

Frozen shoulder (also known as adhesive capsulitis) is a condition characterized by shoulder pain and limited range of motion. This condition is the result of inflammation, scarring, thickening, and contracting of the capsule that surrounds the shoulder joint. Over a period of time the pain subsides and the individual is left with a stiff shoulder that limits functional activities. About 2% of the general population are affected by this condition.

The etiology of frozen shoulder remains unknown, but multiple contributing factors have been identified.  Factors associated with frozen shoulder include age, gender, trauma, diabetes, stroke, myocardial infarction and long periods of immobility of the shoulder. Frozen shoulder commonly affects women more than men, individuals between the ages of 40 to 60 years old, diabetics, individuals who sustain a shoulder injury or those who have undergone surgery with prolonged immobility. 

Frozen shoulder has 3 stages of progression. Stage one is the “freezing” stage and typically last up to 4 months. This stage is characterized by a slow onset of pain and decreasing range of motion. Stage two is the “frozen” stage that can last up to a year. During this stage the pain is reduced, but the shoulder continues to stiffen. Range of motion is severly limited during this time. The last stage is the “thawing” stage that can last a year or more. During this phase, the shoulder range of motion is slowly restored.

If a frozen shoulder is left untreated, it is likely that the range of motion may not be fully restored. Treatment for a frozen shoulder often includes anti-inflammatories, physical therapy and a home exercise program. Physical therapy focuses on the restoration of range of motion and developing a home exercise program that is appropriate for the individuals’ needs.  Surgical intervention is typically reserved for individuals that do not respond to the conservative treatments.

Dutton, Mark.  Orthopaedic: Examination, Evaluation, and Intervention. McGraw Hill.  2004

http://orthoinfo.aaos.org/topic.cfm?topic=A00071 

http://orthopedics.about.com/cs/frozenshoulder/a/frozenshoulder.htm