Acromioclavicular (AC) Injury

What is an acromioclavicular injury?

An acromioclavicular (AC) injury, also known as an AC joint injury or a separated shoulder, occurs when there is damage to the acromioclavicular joint. The AC joint is located at the top of the shoulder, where the acromion (a part of the shoulder blade or scapula) meets the clavicle (collarbone). This joint is responsible for connecting the shoulder to the axial skeleton and plays a critical role in various shoulder movements.

AC joint injuries can vary in severity and are often classified into different types or grades:

  1. Grade I: This is the mildest form of AC joint injury and involves a simple sprain of the ligaments that support the joint. There is no dislocation, and the clavicle and acromion remain in their normal positions.
  2. Grade II: In a grade II injury, the AC ligaments are partially torn, and there is a slight dislocation of the joint. The clavicle shifts slightly upward compared to the acromion.
  3. Grade III: Grade III injuries are characterized by complete tears of the AC ligaments and often the coracoclavicular (CC) ligaments. This leads to a significant dislocation of the joint, with the clavicle sitting well above the acromion.
  4. Grade IV: In this type of injury, the AC joint is significantly dislocated, and the clavicle has shifted to an even higher position, often piercing through the trapezius muscle in the shoulder.
  5. Grade V: A grade V injury is the most severe, with complete disruption of the AC and CC ligaments, resulting in a grossly unstable joint. The clavicle can dislocate backward or downward, causing severe deformity.

What causes an acromioclavicular injury?

AC joint injuries are commonly caused by traumatic events, and some common causes include:

  • Falls onto the shoulder or onto an outstretched hand.
  • Direct blows to the shoulder or clavicle.
  • Sports-related injuries, particularly in contact sports or those with a high risk of falls.
  • Motor vehicle accidents.

What are the signs and symptoms of an acromioclavicular injury?

The symptoms of AC joint injuries may include:

  • Pain at the top of the shoulder.
  • Swelling and bruising.
  • Tenderness and a visible deformity, particularly in more severe grades.
  • Limited range of motion and pain with shoulder movements.

What physiotherapy treatment is available for an acromioclavicular injury?

Physiotherapy can be an essential component of the treatment and rehabilitation plan for an acromioclavicular (AC) joint injury. The specific physiotherapy program will depend on the grade and severity of the AC injury, as well as the individual’s needs and goals. Here are some general principles of physiotherapy for AC joint injuries:

  1. Initial Assessment: The physiotherapy process typically begins with a comprehensive assessment to evaluate the extent of the AC joint injury, including any associated damage and complications. This assessment helps in tailoring a personalized treatment plan.
  2. Pain Management: In the early stages of treatment, the focus may be on pain management. This can involve modalities such as ice or heat application, electrotherapy, and potentially the use of anti-inflammatory medications as directed by a healthcare provider.
  3. Supportive Bracing: Depending on the grade and stability of the injury, your physiotherapist may recommend the use of a supportive brace or sling to immobilize the affected shoulder. This helps reduce strain on the injured joint and facilitates healing.
  4. Range of Motion Exercises: Once the pain and swelling are under control, gentle range of motion exercises are introduced to prevent stiffness and improve mobility in the shoulder. Passive and active-assistive exercises can help maintain or regain shoulder flexibility.
  5. Strengthening Exercises: As the injury heals and the AC joint stabilizes, strengthening exercises are gradually incorporated. These exercises focus on the muscles surrounding the AC joint, including the deltoids, rotator cuff muscles, and scapular stabilizers. The progression of strengthening exercises should be gradual to avoid overloading the healing joint.
  6. Proprioception and Neuromuscular Training: These exercises aim to improve joint awareness and control, which are important for preventing future injuries. Balance exercises, plyometrics, and functional training can be included to enhance shoulder stability.
  7. Stretching and Flexibility Exercises: Stretching exercises help improve the flexibility of the shoulder and the surrounding muscles. Stretches may target the chest, shoulder, and neck muscles to address any imbalances.
  8. Posture Correction: Education on maintaining proper posture and body mechanics is crucial for preventing the recurrence of AC joint injuries. The physiotherapist may provide guidance on good posture and ergonomic considerations for daily activities.
  9. Activity Modification: The physiotherapist will work with you to modify or adapt activities, especially sports or work-related tasks, to ensure you can safely perform them without aggravating the injury.
  10. Home Exercise Program: Your physiotherapist will design a customized home exercise program for you to perform regularly between therapy sessions. Consistency with these exercises is essential for recovery.
  11. Progressive Return to Activities: If the injury was related to a specific sport or activity, your physiotherapist will work with you to create a gradual return-to-sport or work plan. This involves ensuring you have the necessary strength and mobility to safely resume these activities.

The goal of physiotherapy for AC joint injuries is to facilitate healing, restore functionality, and reduce the risk of future injuries. It’s important to work closely with your physiotherapist and follow their recommendations to achieve the best possible outcome. The specific exercises and treatment plan will be tailored to your individual needs and the severity of your AC joint injury.

Bicep Tendonitis

What is bicep tendonitis?

Biceps tendonitis, also known as bicipital tendonitis, is a condition characterized by inflammation or irritation of the biceps tendon in the shoulder. The biceps tendon is a strong, cord-like structure that attaches the biceps muscle to the bone in the shoulder. Tendonitis occurs when this tendon becomes inflamed, typically due to overuse, repetitive motion, or age-related wear and tear. There are two primary parts of the biceps tendon:

  1. Long Head of the Biceps Tendon: This part of the tendon attaches to the top of the glenoid (the socket of the shoulder joint) and runs through the bicipital groove of the humerus (the upper arm bone).
  2. Short Head of the Biceps Tendon: This part of the tendon attaches to a different location on the scapula (shoulder blade) and merges with the long head tendon as it approaches the bicipital groove.

What causes bicep tendonitis?

Common causes and risk factors for biceps tendonitis include:

  • Repetitive overhead arm movements, which are common in sports like baseball or swimming.
  • Heavy lifting or weightlifting.
  • Aging, as tendons naturally become less flexible and resilient over time.
  • Shoulder impingement, where the tendon becomes pinched between the bones of the shoulder, leading to irritation.

What are the signs and symptoms of bicep tendonitis?

The symptoms of biceps tendonitis may include:

  1. Pain in the front of the shoulder, which may radiate down the arm.
  2. Pain that worsens with overhead activities or lifting.
  3. Tenderness and swelling in the front of the shoulder.
  4. Weakness in the affected arm.
  5. A “popping” or “clicking” sensation in the shoulder.
  6. Pain when reaching behind the back or reaching into a pocket.

What physiotherapy treatment is available for bicep tendonitis?

Physiotherapy can be an effective part of the treatment plan for bicep tendonitis, helping to reduce pain, improve strength, and restore range of motion in the affected shoulder. Here’s a general outline of how physiotherapy can be used to manage bicep tendonitis:

  1. Initial Assessment: The first step in physiotherapy is a thorough assessment by a physical therapist to determine the severity of the condition and identify any contributing factors. They will assess your range of motion, strength, and any specific movements or activities that exacerbate your symptoms.
  2. Pain Management: If you’re experiencing pain, the therapist may use modalities such as ice or heat to help alleviate pain and reduce inflammation. They may also recommend over-the-counter anti-inflammatory medications as directed by a healthcare provider.
  3. Range of Motion Exercises: Gentle range of motion exercises will help improve shoulder mobility while avoiding further irritation of the inflamed tendon. These exercises may include pendulum exercises, wand exercises, or passive stretching.
  4. Strengthening Exercises: Strengthening exercises are a crucial component of bicep tendonitis rehabilitation. These exercises focus on the muscles around the shoulder, including the rotator cuff muscles, deltoids, and scapular stabilizers. Examples of strengthening exercises include:
    • Isometric exercises for the biceps and shoulder muscles.
    • External rotation exercises using resistance bands or light weights.
    • Scapular stabilization exercises to improve the positioning of the shoulder blades.
    • Gradual progression to concentric and eccentric exercises to improve muscle balance and control.
  5. Proprioception and Neuromuscular Training: These exercises help improve the awareness and control of the shoulder joint and are important for preventing further injury. Balancing exercises and plyometrics may be included in your program.
  6. Stretching and Flexibility Exercises: Stretching exercises can help improve the flexibility of the shoulder and surrounding muscles. The therapist may include stretches for the biceps, pectoral muscles, and the shoulder joint itself.
  7. Posture and Ergonomics Training: Education on proper posture and ergonomics is essential to prevent aggravating the condition. The therapist may offer guidance on how to maintain good shoulder positioning during daily activities.
  8. Activity Modification: The therapist will work with you to modify or adapt activities that may contribute to bicep tendonitis, such as sports or job-related tasks.
  9. Home Exercise Program: Your physical therapist will design a customized home exercise program for you to perform regularly between therapy sessions. Consistency with these exercises is vital for recovery.
  10. Gradual Return to Activities: If your condition is related to a specific sport or activity, the therapist will help you safely transition back to those activities, ensuring that you have the necessary strength and mobility to do so without exacerbating the condition.

It’s important to work closely with your physical therapist and follow their guidance for the most effective and safe recovery from bicep tendonitis. The specific exercises and treatment plan will be tailored to your individual needs and the severity of your condition.

Frozen Shoulder

What is Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by stiffness, pain, and limited range of motion in the shoulder joint. It typically affects people between the ages of 40 and 60, and it tends to develop gradually over time.

While the exact cause of frozen shoulder is unknown, there are several risk factors associated with its development, including:

  1. Age and gender: Frozen shoulder is more common in individuals between the ages of 40 and 60, and it is more prevalent in women than in men.
  2. Previous injury or immobilization: Shoulder injuries, fractures, or surgeries that require immobilization of the shoulder joint can increase the risk of developing frozen shoulder.
  3. Systemic diseases: People with certain systemic conditions, such as diabetes, thyroid disorders, cardiovascular disease, and Parkinson’s disease, are more prone to developing frozen shoulder.
  4. Certain medical procedures: Prolonged immobilization or restricted movement of the shoulder after procedures like mastectomy or stroke can lead to frozen shoulder.

What are the signs and symptoms of Frozen Shoulder?

The condition progresses through three stages:

  1. Freezing stage: This stage is characterized by a gradual onset of pain and stiffness in the shoulder. The pain may worsen at night and during certain movements. Range of motion begins to diminish.
  2. Frozen stage: The pain may decrease during this stage, but the shoulder becomes significantly stiffer, limiting its range of motion. Daily activities become more challenging, and pain may arise with any movement.
  3. Thawing stage: The range of motion in the shoulder gradually improves during this stage, and pain subsides. It may take several months to years for the shoulder to fully recover.

What physiotherapy treatment is available to help Frozen Shoulder?

Physiotherapy plays a crucial role in the management and treatment of frozen shoulder. Physiotherapy aims to reduce pain, improve shoulder mobility, and restore function during each stage. Here are some common physiotherapy interventions for frozen shoulder:

  1. Joint Mobilization: Joint mobilization techniques may be used by the physiotherapist to help restore normal joint mechanics and increase shoulder mobility.
  2. Soft Tissue Mobilization: Soft tissue techniques like massage and myofascial release can help relieve muscle tension and improve shoulder function.
  3. Gentle Range of Motion Exercises: During the freezing stage, when the shoulder is most painful and stiff, gentle passive range of motion exercises are introduced to prevent the shoulder from becoming further restricted. The physiotherapist may assist in moving the shoulder through its available range.
  4. Stretching Exercises: As the pain subsides and the shoulder starts to improve, stretching exercises are introduced to gradually increase the range of motion in the shoulder joint. These exercises are performed with the help of the patient’s own muscles and are designed to reduce stiffness.
  5. Strengthening Exercises: Once the shoulder mobility has improved, specific strengthening exercises are prescribed to improve the stability and function of the shoulder joint. These exercises target the muscles around the shoulder girdle.
  6. Posture Correction: Addressing any postural imbalances that may contribute to shoulder pain and dysfunction is important. Physiotherapists may provide guidance on proper posture and body mechanics during daily activities.
  7. Functional Exercises: As the shoulder progresses through the thawing stage, functional exercises are introduced to help the patient regain full use of the shoulder during their regular activities.
  8. Home Exercise Program: Patients are usually given a home exercise program to perform regularly between physiotherapy sessions. Consistency in doing the prescribed exercises is essential for achieving optimal outcomes.
  9. Patient Education: Physiotherapists provide education on the condition, the importance of compliance with the treatment plan, and tips to prevent future shoulder issues.
  10. Pain Management: Initially, the focus is on pain relief. Modalities like acupuncture, ice or heat therapy, ultrasound, or transcutaneous electrical nerve stimulation (TENS) may be used to reduce pain and inflammation.

What other treatments are available to help Frozen Shoulder?

The treatment duration and response to physiotherapy can vary from person to person. It’s important to start physiotherapy early in the course of frozen shoulder to prevent further progression and improve outcomes.

In addition to Physiotherapy, other treatments may also be added such as:

  1. Pain relief: Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may help alleviate pain and inflammation.
  2. Corticosteroid injections: In some cases, corticosteroid injections into the shoulder joint can provide temporary pain relief and reduce inflammation.
  3. Hydrodilatation: This procedure involves injecting sterile fluid into the shoulder joint to help stretch and expand the capsule, promoting increased range of motion.
  4. Surgical intervention: In rare cases where conservative treatments fail, surgical procedures like manipulation under anesthesia or arthroscopic release may be considered to break up scar tissue and improve shoulder mobility.

It’s important to consult with an FCAMT Physiotherapist for an accurate diagnosis and appropriate treatment plan for frozen shoulder, as the condition can have a significant impact on daily activities and quality of life.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments. To book your assessment with one of our FCAMT Physiotherapists, click here.

Rotator Cuff Tendinosis

What is Rotator Cuff Tendinosis?

Rotator cuff tendinosis, also known as rotator cuff tendonitis, is a common condition characterized by inflammation and degeneration of the tendons in the rotator cuff of the shoulder. The rotator cuff is a group of four tendons that surround the shoulder joint and help stabilize and move the shoulder.

Tendinosis refers to a chronic condition where there is degeneration and microscopic tears in the tendons, rather than acute inflammation seen in tendonitis. Over time, repetitive stress, age-related changes, or certain activities can lead to the development of tendinosis.

What are the symptoms of rotator cuff tendinosis?

Symptoms of rotator cuff tendinosis often include:

  1. Shoulder pain: Typically felt at the front or side of the shoulder, which may radiate down the arm.
  2. Weakness: Difficulty lifting objects or performing activities that require shoulder strength.
  3. Limited range of motion: Reduced ability to move the shoulder freely, especially with overhead movements.
  4. Crepitus: A crackling or grinding sensation when moving the shoulder.

What is the physiotherapy treatment for rotator cuff tendinosis?

Physiotherapy plays a crucial role in the management and rehabilitation of rotator cuff tendinosis. The goals of physiotherapy for rotator cuff tendinosis are to alleviate pain, improve shoulder function, strengthen the affected muscles, and prevent further degeneration. Here are some common physiotherapy treatments and exercises for rotator cuff tendinosis:

  1. Assessment: The first step in physiotherapy is a thorough assessment by a physiotherapist to evaluate the extent of the tendinosis, identify contributing factors, and tailor the treatment plan to the individual’s specific needs.
  2. Manual Therapy: Physiotherapists may use joint mobilizations to restore normal movement to the glenohumeral joint and/or soft tissue techniques to release myofascial restrictions.
  3. Range of Motion Exercises: Gentle range of motion exercises are introduced to maintain and improve shoulder mobility. These exercises are typically performed within a pain-free range to prevent further irritation.
  4. Stretching Exercises: Specific stretching exercises target the muscles and tendons of the rotator cuff to improve flexibility and reduce tension. Stretching is typically performed after a warm-up or in conjunction with other exercises.
  5. Strengthening Exercises: Gradual strengthening exercises are introduced to improve the strength of the rotator cuff muscles and surrounding shoulder muscles. These exercises help stabilize the shoulder joint and reduce strain on the tendons. Common exercises include:
    1. Isometric Exercises: Isometric exercises involve contracting the muscles without changing the length of the joint. These exercises are often used initially to build strength without placing excessive stress on the tendons.
    2. Theraband or Resistance Band Exercises: Resistance band exercises are used to strengthen the rotator cuff and shoulder muscles in various planes of motion. Examples include external rotation and internal rotation exercises.
    3. Scapular Stabilization Exercises: Weakness in the muscles that stabilize the shoulder blade (scapula) can contribute to rotator cuff issues. Strengthening these muscles can improve shoulder function and reduce the risk of future problems.
  6. Posture Correction: Addressing poor posture and shoulder mechanics is essential in preventing further strain on the rotator cuff. Physiotherapists provide guidance on maintaining proper posture during daily activities.
  7. Functional Training: Exercises that mimic functional movements, such as reaching, lifting, and carrying, are incorporated into the rehabilitation program to ensure the shoulder can handle everyday tasks without pain or discomfort.
  8. Ergonomic Assessment: For individuals whose symptoms are related to work or daily activities, physiotherapists may conduct ergonomic assessments to identify and modify factors contributing to the tendinosis.
  9. Education: Patients are educated about the condition, potential triggers for symptoms, and strategies to prevent or manage future episodes of tendinosis.
  10. Home Exercise Program: A personalized home exercise program is typically prescribed to help patients continue their rehabilitation independently between physiotherapy sessions.
  11. Progress Monitoring: Regular assessments are conducted to track progress and adjust the treatment plan as needed.

The specific treatment plan for rotator cuff tendinosis will depend on the individual’s condition, the severity of symptoms, and the underlying causes. Consistency with prescribed exercises and a gradual progression of exercises are essential for a successful rehabilitation outcome.

Always consult with a physiotherapist, for a thorough evaluation and personalized treatment plan if you are experiencing symptoms of rotator cuff tendinosis.  If you would like to book with one of our FCAMT physiotherapists, click here.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

Shoulder Dislocation

What is a shoulder dislocation?

A shoulder dislocation occurs when the upper arm bone (humerus) pops out of the shoulder socket (glenoid). This is a common injury, and it can be quite painful. There are different types of shoulder dislocations, including:

Anterior Shoulder Dislocation: This is the most common type of shoulder dislocation and occurs when the humerus is displaced forward, out of the front of the shoulder joint.

Posterior Shoulder Dislocation: In this type, the humerus is displaced backward, out of the back of the shoulder joint. Posterior shoulder dislocations are less common but can be associated with specific injuries or events.

What causes a shoulder dislocation?

Shoulder dislocations can result from traumatic events, such as falls, sports injuries, or car accidents, where the arm is forced into an extreme position or experiences a direct blow. Dislocations can also occur due to underlying structural issues, like loose ligaments, that make the shoulder joint more prone to instability.

What are the symptoms of shoulder dislocation?

Common symptoms of a shoulder dislocation include:

  • Severe shoulder pain: Sudden and intense pain is typically the most prominent symptom.
  • Inability to move the arm: The injured individual may be unable to move the affected arm.
  • Deformity: In some cases, the dislocated shoulder may appear visibly deformed or out of place.
  • Swelling and bruising: Swelling and bruising can occur around the shoulder joint.
  • Numbness or tingling: Numbness or tingling sensations may be felt in the arm or hand due to nerve compression or injury.

What is the treatment for a shoulder dislocation?

Treatment for a shoulder dislocation typically involves the following steps:

  1. Reduction: The dislocated shoulder needs to be put back into its normal position. This is usually done by a healthcare professional, often in the emergency room, using gentle maneuvers to guide the humerus back into the shoulder socket.
  2. Immobilization: After the shoulder is reduced, it is often immobilized in a sling or brace to allow for healing and prevent further injury. The duration of immobilization depends on the severity of the dislocation and the individual’s specific case.
  3. Pain Management: Pain medications and anti-inflammatory drugs may be prescribed to manage pain and reduce inflammation.
  4. Rehabilitation: Physiotherapy exercises are often recommended to help restore shoulder strength and range of motion, as well as to prevent future dislocations.
  5. Surgery (In Some Cases): In cases where the shoulder has recurrent dislocations or there is significant damage to the surrounding structures, surgical intervention may be required to stabilize the joint.

It’s crucial to seek immediate medical attention if you suspect a shoulder dislocation. Attempting to relocate the shoulder without proper training can lead to complications or further injury. Early and appropriate treatment can help minimize pain, prevent complications, and facilitate a smoother recovery. 

If you would like to book an appointment with one of our FCAMT physiotherapists, click here.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

Shoulder Impingement

What is a shoulder impingement?

Shoulder impingement, also known as subacromial impingement, is a common orthopedic condition that occurs when the tendons and bursa (a fluid-filled sac that reduces friction) in the shoulder become compressed or pinched as they pass through a narrow space in the shoulder joint.

This narrow space is located beneath the acromion, which is a bony process of the shoulder blade (scapula). Shoulder impingement typically involves the rotator cuff tendons, which play a crucial role in stabilizing and moving the shoulder joint.

What causes a shoulder impingement?

The impingement process occurs when the space beneath the acromion becomes narrowed or reduced, leading to friction, compression, or irritation of the tendons and bursa during certain shoulder movements. This can result in pain, inflammation, and, in some cases, damage to the tendons or surrounding structures.

Common causes and contributing factors for shoulder impingement include:

  1. Repetitive Overhead Activities: Activities that involve repetitive overhead arm movements, such as painting, swimming, throwing, or weightlifting, can increase the risk of shoulder impingement over time.
  2. Muscle Imbalances: Weakness or imbalances in the muscles that support the shoulder can affect the positioning of the shoulder blade and contribute to impingement.
  3. Bone Spurs: The development of bone spurs or other anatomical variations in the shoulder can narrow the subacromial space and increase the risk of impingement.
  4. Trauma or Injury: A fall or acute injury to the shoulder can result in impingement, particularly if there is associated swelling or inflammation.
  5. Poor Posture: Slouching or poor posture can affect the alignment of the shoulder joint and lead to impingement.

What are the signs and symptoms of a shoulder impingement?

Symptoms of shoulder impingement may include:

  • Pain and tenderness in the front or side of the shoulder.
  • Pain that worsens with overhead arm movements or reaching out to the side.
  • Weakness in the affected arm.
  • Pain when lifting objects or reaching behind the back.
  • Pain that may radiate down the arm.

What physiotherapy treatment is available for a shoulder impingement?

Physiotherapy is a critical component of the non-surgical management of shoulder impingement. It can help alleviate pain, restore shoulder function, and prevent recurrence of impingement by addressing muscle imbalances, improving posture, and promoting shoulder stability.

Here’s an overview of physiotherapy treatment for shoulder impingement:

  1. Initial Assessment: The physiotherapy process typically begins with a thorough assessment of your condition, including an evaluation of your range of motion, strength, posture, and any contributing factors. The physiotherapist will use this assessment to design a personalized treatment plan.
  2. Manual Therapy: The physiotherapist may use manual techniques to alleviate pain, improve joint mobility, and address soft tissue restrictions in the shoulder and surrounding areas.
  3. Range of Motion Exercises: Gentle range of motion exercises are introduced to prevent stiffness and improve mobility in the shoulder. These exercises often include pendulum exercises and passive stretching.
  4. Strengthening Exercises: Strengthening the muscles around the shoulder is a fundamental aspect of physiotherapy. Exercises typically target the rotator cuff muscles, deltoids, and scapular stabilizers to improve shoulder stability and reduce impingement. The progression of strengthening exercises is gradual to avoid overloading the shoulder.
  5. Stretching Exercises: Stretching exercises aim to improve flexibility in the shoulder and chest muscles. Stretches may focus on the pectoral muscles, anterior shoulder, and neck.
  6. Proprioception and Neuromuscular Training: These exercises improve joint awareness and control, which are important for preventing future impingement. They may include balancing exercises and functional training.
  7. Scapular Stabilization Exercises: Exercises to strengthen the muscles that stabilize the scapula can help maintain proper shoulder alignment and reduce the risk of impingement.
  8. Pain Management: In the early stages, the focus may be on pain management. This can involve modalities like ice or heat application, or acupuncture.
  9. Posture and Ergonomics: The physiotherapist will educate you about maintaining good posture and body mechanics to reduce strain on the shoulder and prevent impingement. This may include recommendations for desk ergonomics and daily life adjustments.
  10. Home Exercise Program: Your physiotherapist will design a customized home exercise program for you to perform regularly between therapy sessions. Consistency with these exercises is crucial for recovery.
  11. Activity Modification: The physiotherapist will work with you to modify or adapt activities, particularly those that contribute to impingement, to ensure that you can safely perform them without exacerbating the condition.
  12. Progressive Return to Activities: If your impingement was related to a specific sport or activity, your physiotherapist will create a gradual return-to-activity plan. This ensures you have the necessary strength and mobility to safely resume these activities.

The goal of physiotherapy for shoulder impingement is to improve shoulder function, reduce pain, and prevent future impingement. It’s important to work closely with your physiotherapist, adhere to their recommendations, and progress at a pace that’s appropriate for your individual situation.

The specific exercises and treatment plan will be tailored to your needs and the severity of your impingement.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

Shoulder Instability

What is shoulder instability?

Shoulder instability is a condition in which the shoulder joint is prone to excessive movement or dislocation. The shoulder is a ball-and-socket joint, where the head of the upper arm bone (humerus) fits into a shallow socket in the shoulder blade (scapula).

Shoulder stability is maintained by a combination of ligaments, tendons, muscles, and the labrum (a ring of cartilage that surrounds the socket).

There are two primary types of shoulder instability:

  1. Subluxation: This occurs when the shoulder joint partially dislocates, meaning the ball slips out of the socket but then goes back in on its own. It may result in a feeling of the shoulder “slipping” or “popping out.”
  2. Dislocation: In this case, the shoulder joint completely comes out of its socket. This can be a painful and traumatic event, and medical attention is usually required to put the joint back into place.

What causes shoulder instability?

Shoulder instability can be caused by various factors, including:

  • Trauma or injury: A significant impact or fall can lead to shoulder dislocation.
  • Repetitive use or overuse: Certain activities or sports that involve overhead motions can gradually stretch or tear the ligaments and tendons that stabilize the shoulder.
  • Structural factors: Some individuals may have naturally loose or shallow shoulder sockets, which make them more prone to instability.
  • Muscle weakness or imbalance: Weakness in the muscles that support the shoulder can contribute to instability.

What are the signs and symptoms of shoulder instability?

The signs and symptoms of shoulder instability can vary in severity and may include the following:

  1. Shoulder Dislocation or Subluxation: The most obvious sign is the partial or complete dislocation of the shoulder joint, which may occur due to trauma or certain movements. Subluxation is a partial dislocation where the ball of the shoulder partially slips out of the socket and then returns, while dislocation is when it completely comes out of the socket.
  2. Pain: Individuals with shoulder instability may experience varying degrees of pain, which can be acute during a dislocation event or chronic in cases of repetitive subluxations.
  3. Feeling of Instability: Many people with shoulder instability describe a sensation that their shoulder is loose or unstable. They may feel like the joint is “slipping” or “giving way.”
  4. Weakness: Weakness in the shoulder, especially when lifting or using the arm, can be a symptom of instability. This weakness is often due to the inability of the shoulder muscles to provide adequate support.
  5. Limited Range of Motion: Instability can lead to a reduced range of motion in the shoulder, making it difficult to perform overhead or specific arm movements.
  6. Popping or Clicking Sensation: Some individuals may experience a popping or clicking sensation in the shoulder when moving the arm. This can be caused by the instability of the joint.
  7. Swelling and Bruising: After a dislocation or subluxation, the shoulder may become swollen, and bruising can occur in the affected area.
  8. Numbness or Tingling: In some cases, nerve compression or damage during a dislocation event can lead to numbness or tingling sensations in the arm or hand.
  9. Difficulty with Activities: Individuals with shoulder instability may have trouble with daily activities that require arm and shoulder movement, such as reaching for objects, lifting, or participating in sports.

It’s important to note that the severity of symptoms can vary from person to person and may depend on the underlying cause of the instability and any associated injuries. 

What physiotherapy treatment is available for shoulder instability?

Physiotherapy plays a crucial role in the management and rehabilitation of shoulder instability. A physical therapist can work with you to strengthen the shoulder muscles, improve joint stability, and enhance your range of motion.

The specific physiotherapy program will depend on the severity of your shoulder instability and whether you’ve undergone surgical intervention. Here are some common components of physiotherapy for shoulder instability:

  1. Assessment and Diagnosis: A physical therapist will assess your condition, including the degree of instability, range of motion, muscle strength, and any associated injuries. This assessment helps in creating a personalized treatment plan.
  2. Pain Management: If you’re experiencing pain, the therapist may use modalities like ice, heat, or ultrasound to reduce pain and inflammation in the shoulder.
  3. Range of Motion Exercises: Gentle range of motion exercises will help you regain normal shoulder mobility. These exercises can include pendulum exercises, wand exercises, and wall climbing exercises.
  4. Strengthening Exercises: Strengthening the muscles that support the shoulder is a key component of treatment. This often involves exercises targeting the rotator cuff muscles and the muscles that stabilize the shoulder blade. Examples include external rotation exercises with resistance bands, scapular stabilization exercises, and isometric shoulder exercises.
  5. Proprioception and Neuromuscular Training: These exercises help improve the awareness and control of the shoulder joint, which can be especially important for preventing further instability. Balancing exercises, plyometrics, and proprioceptive exercises can be beneficial.
  6. Stretching and Flexibility Exercises: Stretching exercises for the shoulder and the surrounding muscles can help improve flexibility and reduce muscle imbalances.
  7. Functional Training: The therapist will help you work on activities that are specific to your daily life or sports participation to ensure you can perform these tasks without pain or instability.
  8. Education: A crucial aspect of physiotherapy is educating patients on proper posture, body mechanics, and strategies to prevent re-injury or exacerbation of the instability.
  9. Bracing or Taping: In some cases, the therapist may recommend using a brace or taping techniques to provide additional support to the shoulder joint during rehabilitation.
  10. Home Exercise Program: To maintain progress between therapy sessions, the therapist may provide you with a customized home exercise program.

It’s important to follow your physiotherapy program consistently and communicate with your therapist about your progress and any changes in symptoms.

In some cases of severe or recurrent shoulder instability, surgery may be required before starting a rehabilitation program. Always consult with your healthcare provider and follow their recommendations for the most appropriate course of treatment.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

Shoulder Labral Tears

What is a shoulder labral tear?

A shoulder labral tear is a common injury that affects the labrum in the shoulder joint. The labrum is a ring of cartilage that surrounds the glenoid (socket) of the shoulder joint, helping to stabilize the joint and provide support to the arm bone (humerus). When the labrum is torn, it can lead to pain, instability, and a variety of shoulder-related problems.

What causes shoulder labral tears?

Shoulder labral tears can result from various causes, and they often occur due to a combination of factors. Here are some common causes and risk factors associated with shoulder labral tears:

  1. Traumatic Injury: One of the most common causes of labral tears is a traumatic injury to the shoulder. This can happen due to falls, sports-related impacts, car accidents, or any event that forces the shoulder joint beyond its normal range of motion.
  2. Repetitive Overhead Activities: Athletes who engage in repetitive overhead motions, such as baseball pitchers, swimmers, and tennis players, are at an increased risk of developing labral tears. The repetitive stress on the shoulder joint can lead to wear and tear on the labrum over time.
  3. Shoulder Dislocations: A previous shoulder dislocation can damage the labrum, making it more susceptible to tears in the future. When the shoulder dislocates, the labrum can be stretched or torn.
  4. Age and Degeneration: As individuals age, the shoulder joint can undergo natural degenerative changes. These changes can weaken the labrum and make it more prone to tears. Labral tears are more common in older individuals.
  5. Anatomical Factors: Some people may have structural abnormalities in the shoulder joint that increase their risk of labral tears. For example, individuals with a shallow or abnormally shaped glenoid (shoulder socket) may be more susceptible.
  6. Other Medical Conditions: Certain medical conditions or diseases, such as hypermobility syndromes or connective tissue disorders, can weaken the shoulder joint’s structures, including the labrum.

It’s important to note that not all labral tears have a single, easily identifiable cause. In many cases, they develop over time due to a combination of factors, including anatomical predisposition, repetitive use, and occasional traumatic events.

What are the signs and symptoms of shoulder labral tear?

A labral tear in the shoulder can present with a variety of signs and symptoms, which can vary depending on the location and severity of the tear. Common signs and symptoms of a shoulder labral tear include:

  1. Shoulder Pain: Persistent, deep-seated pain within the shoulder joint is a hallmark symptom. The pain may be a dull ache or sharp in nature. It is often felt deep inside the shoulder and can be challenging to pinpoint precisely.
  2. Pain with Specific Movements: Certain movements or activities may exacerbate the pain, such as reaching overhead, lifting heavy objects, or performing actions that involve twisting or throwing.
  3. Shoulder Instability: Some individuals may experience a sense of shoulder instability or a feeling that the shoulder is slipping or popping out of place. This sensation can be more common if the tear is associated with shoulder dislocations.
  4. Decreased Range of Motion: Labral tears can restrict the shoulder’s range of motion, making it difficult to move the arm freely, especially when trying to reach overhead or behind the back.
  5. Weakness in the Arm: Muscle weakness in the affected arm can occur due to pain and impaired shoulder function. This weakness may affect activities that require strength and stability, such as lifting objects or participating in sports.
  6. Popping or Clicking Sensation: Some individuals may hear or feel a popping or clicking sensation when moving the shoulder, particularly when rotating the arm.
  7. Pain at Rest: Pain from a labral tear can also occur at rest, especially during nighttime when lying on the affected shoulder.
  8. Reduced Performance: Athletes or individuals who rely on their shoulder for physical activities may notice a decrease in performance due to the pain, weakness, or instability caused by the labral tear.
  9. Numbness or Tingling: In some cases, a labral tear can compress nearby nerves, leading to symptoms like numbness or tingling in the arm or hand.

It’s important to note that these symptoms can overlap with other shoulder conditions, such as rotator cuff injuries or impingement syndrome, so a thorough evaluation by a healthcare provider is essential for an accurate diagnosis. Diagnosis typically involves a physical examination, a review of medical history, and imaging studies like MRI or arthroscopy.

What physiotherapy treatment is available for shoulder labral tears?

Physiotherapy plays a crucial role in the management of shoulder labral tears, whether you are considering conservative treatment or after surgical repair. A physiotherapist can design a customized rehabilitation program to help relieve pain, improve range of motion, strengthen the shoulder muscles, and enhance overall shoulder stability.

Here are some key components of physiotherapy for shoulder labral tears:

  1. Manual Therapy: Your physiotherapist may use hands-on techniques such as joint mobilizations or soft tissue massage to enhance tissue healing and joint mobility.
  2. Pain Management: Initially, the focus may be on reducing pain and inflammation in the shoulder. Modalities such as ice or heat application, ultrasound, or electrical stimulation may be used to help alleviate pain and discomfort.
  3. Range of Motion Exercises: Gently improving shoulder range of motion is essential. The physiotherapist will guide you through specific exercises designed to restore the full range of motion gradually.
  4. Strengthening Exercises: Strengthening exercises are crucial for stabilizing the shoulder joint and supporting the injured labrum. The program may include exercises for the rotator cuff muscles, deltoids, and scapular stabilizers. Initially, exercises are likely to be performed with low resistance and high repetitions to avoid excessive strain on the healing tissues.
  5. Postural Training: Correcting posture and scapular positioning is essential for proper shoulder function and reducing the risk of further injury. Your physiotherapist may work on improving your posture to relieve stress on the shoulder joint.
  6. Stretching: Stretching exercises can help alleviate muscle tightness and improve flexibility in the shoulder, neck, and upper back.
  7. Functional Rehabilitation: As your shoulder strength and range of motion improve, the rehabilitation program will progress to functional exercises that mimic everyday activities or sports-specific movements if applicable.
  8. Education: Part of the rehabilitation process involves educating you on proper body mechanics, posture, and ergonomics to prevent re-injury.
  9. Progressive Loading: As you progress in your rehabilitation, your physiotherapist will gradually increase the intensity of exercises and resistance to help you regain full strength and function.

The specific exercises and treatment plan will be tailored to your individual needs and the severity of your labral tear. It’s essential to follow the guidance of your physiotherapist diligently and communicate any changes or concerns during the rehabilitation process.

How long will it take to recover?

Recovery from a shoulder labral tear can be a gradual process, and it may take several weeks to months to achieve full shoulder function. In some cases, individuals may return to their previous level of activity, while others may need ongoing maintenance exercises to manage symptoms and prevent recurrence.

If you suspect a labral tear or are experiencing shoulder pain and instability, it’s crucial to consult a healthcare professional for a proper evaluation and diagnosis. They can determine the underlying cause and recommend the most appropriate treatment approach.  To book with one of our FCAMT physiotherapists, click here.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

Sternoclavicular Injury

What is a sternoclavicular injury?

A sternoclavicular (SC) injury, also known as sternoclavicular joint (SCJ) injury or SC joint dislocation, occurs when there is damage to the sternoclavicular joint.

The sternoclavicular joint is the point where the clavicle (collarbone) meets the sternum (breastbone) in the front of the chest. It is one of the four joints that make up the shoulder complex and is responsible for connecting the upper limb to the axial skeleton.

SC joint injuries can vary in severity, and they are typically classified into three categories:

  1. Sternoclavicular Joint Sprain: This is the least severe type of SC joint injury. It involves stretching or minor tearing of the ligaments that support the joint, without dislocation of the clavicle. This type of injury may cause pain, swelling, and discomfort but usually doesn’t require surgical intervention.
  2. Anterior Sternoclavicular Dislocation: In this type of injury, the clavicle is displaced in front of the sternum. It can result from a significant traumatic event, such as a direct blow to the shoulder or a fall on an outstretched hand. Anterior dislocations are often more painful and may require reduction (repositioning of the clavicle) in a hospital setting.
  3. Posterior Sternoclavicular Dislocation: This is a rare and more severe injury where the clavicle is displaced behind the sternum. Posterior dislocations can be associated with life-threatening complications, as they can compress vital structures in the chest, such as blood vessels and the trachea. Immediate medical attention is required for posterior dislocations, and reduction may be necessary.

What causes a sternoclavicular injury?

Sternoclavicular injuries, particularly dislocations, are often caused by significant traumatic events or overuse of the shoulder joint. Common causes of sternoclavicular injuries include:

  1. Direct Impact: A direct blow to the front of the chest or shoulder, such as during a car accident, a fall, or contact sports, can force the clavicle to dislocate at the sternoclavicular joint.
  2. Falls: A fall onto an outstretched hand or onto the shoulder can transmit a significant force to the sternoclavicular joint, potentially causing an injury.
  3. Motor Vehicle Accidents: The impact during a car crash, especially a frontal collision, can lead to sternoclavicular injuries due to the sudden deceleration and forces involved.
  4. Sports Injuries: Contact sports like football and rugby, as well as sports with a high risk of shoulder impacts or falls, can result in sternoclavicular injuries. Athletes involved in these sports may experience anterior dislocations if they are tackled or fall on their shoulder.
  5. Weightlifting: Overhead weightlifting exercises, such as the bench press, military press, or overhead squats, can put stress on the sternoclavicular joint. Lifting heavy weights with poor form or overexertion may lead to joint injury.
  6. Repetitive Overuse: Activities that involve repetitive overhead arm movements, such as swimming, tennis, or baseball, can place stress on the sternoclavicular joint and its supporting structures over time. This may result in joint instability or the development of chronic pain.
  7. Muscle Imbalances: Muscle imbalances in the shoulder girdle can also contribute to sternoclavicular injuries. Weakness or instability in the surrounding muscles can affect the joint’s stability and increase the risk of injury.
  8. Congenital Factors: In some cases, individuals may be born with congenital conditions that make them more susceptible to sternoclavicular instability or dislocation due to the joint’s anatomical characteristics.

It’s important to note that sternoclavicular injuries are relatively uncommon compared to injuries involving other joints in the shoulder complex, such as the acromioclavicular joint or the glenohumeral joint. However, when they do occur, they can be associated with significant pain and complications, particularly in the case of posterior dislocations. Seeking prompt medical evaluation and appropriate treatment is essential for the management of sternoclavicular injuries.

What are the signs and symptoms of a sternoclavicular injury?

The common symptoms of a sternoclavicular injury may include:

  • Pain and tenderness at the sternoclavicular joint.
  • Swelling and bruising in the front of the chest and shoulder.
  • Limited range of motion in the shoulder and arm.
  • A visible deformity if there is a significant dislocation.
  • Pain with movements of the arm and shoulder.

What physiotherapy treatment is available for sternoclavicular injuries?

Physiotherapy can be a valuable part of the treatment and rehabilitation process for sternoclavicular injuries, particularly after the acute phase when immediate medical care may be required for severe dislocations.

The specific physiotherapy program for a sternoclavicular injury will depend on the type and severity of the injury. Here are some general principles of physiotherapy for sternoclavicular injuries:

  1. Initial Assessment: The physiotherapy process typically begins with a thorough assessment of your condition to determine the extent of the injury, including any associated damage and potential complications.
  2. Pain Management: The initial focus may be on managing pain and inflammation, which can involve modalities like ice or heat application and potentially the use of anti-inflammatory medications as directed by a healthcare provider.
  3. Immobilization: Depending on the severity of the injury and the treatment recommended by a medical specialist, you may need to immobilize the joint with a sling or brace to allow for proper healing and to prevent further injury. Your physiotherapist will provide guidance on when it’s safe to remove the immobilization.
  4. Range of Motion Exercises: Once you’re ready, your physiotherapist will guide you through gentle range of motion exercises to prevent stiffness and improve mobility in the shoulder and arm.
  5. Strengthening Exercises: As your condition improves and the joint becomes more stable, strengthening exercises will be introduced. These exercises will target the muscles around the sternoclavicular joint, including the deltoids, rotator cuff muscles, and scapular stabilizers. Gradual progression is key to avoid overloading the healing tissues.
  6. Proprioception and Neuromuscular Training: These exercises help improve joint awareness and control, which is crucial for preventing future injuries. Balancing exercises, plyometrics, and functional training can be included.
  7. Stretching and Flexibility Exercises: Stretching exercises can help improve the flexibility of the shoulder and chest muscles. They may include stretches for the chest, anterior shoulder, and neck.
  8. Posture Correction: Education on maintaining proper posture and body mechanics is important for preventing recurrence of sternoclavicular injuries. The physiotherapist may provide guidance on good posture and ergonomic considerations for daily activities.
  9. Activity Modification: The physiotherapist will help you modify or adapt activities, especially sports or work-related tasks, to ensure that you can safely perform them without aggravating the injury.
  10. Home Exercise Program: Your physiotherapist will design a customized home exercise program for you to perform regularly between therapy sessions. Consistency with these exercises is essential for recovery.
  11. Progressive Return to Activities: If the injury was related to a specific sport or activity, your physiotherapist will work with you to create a gradual return-to-sport or work plan. This involves ensuring you have the necessary strength and mobility to resume these activities safely.

It’s crucial to work closely with your physiotherapist, adhere to their recommendations, and progress at a pace that’s appropriate for your individual situation. The goal of physiotherapy is to facilitate the healing process, restore functionality, and reduce the risk of future sternoclavicular injuries.

It’s important to undergo a comprehensive evaluation by a physiotherapist, to determine the cause of your vertigo and create an appropriate treatment plan. VRT is most effective when tailored to your specific type of vertigo, and consistency with prescribed exercises is essential for achieving positive outcomes.

With proper guidance and commitment, many individuals with vertigo can experience significant relief and improved balance through physiotherapy treatments.   To book your assessment with one of our FCAMT Physiotherapists, click here.

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