Shoulder, Elbow, Wrist
Scapular Dyskinesis (SICK scapula syndrome)
Scapular rotation is important for proper shoulder function. The scapula (shoulder blade) also serves as a stable base for rotator cuff activation and functioning. Any bony or soft tissue injury around the shoulder can alter the roles of the scapula in motion or at rest. Scapular dyskinesis (which may also be referred to as SICK scapula syndrome) is an alteration or deviation in the normal resting or active position of the scapula during shoulder movement. For most people, the scapula moves in abnormal ways due to the repetitive use of the shoulder. These changes, though sometimes asymptomatic, can increase the chances of injury.
Symptoms:
• Pain and or tenderness around the scapula when using the arm overhead or carrying heavy objects with the arm at the side.
• Snapping or popping sensation around the scapula with shoulder movement
• Loss of strength with shoulder and arm use.
• Asymmetrical posture (affected side usually sits lower)
• Winging of the scapula
• Instability of the shoulder (feels like it moves out of place)
Causes:
• Muscle weakness or imbalance.
• Poor overhead mechanics
• Overuse or repetitive motions such as throwing or serving
• Prolonged healing time if not appropriately treated or given adequate time to heal.
• Shoulder loss of motion
• Rotator cuff tendon tear(s)
• Poor technique
Treatment:
• Initial treatment – medication and ice (pain relief)
• Corrective stretching and strengthening exercises
• Modification of activity
Scapular rotation is important for proper shoulder function. The scapula (shoulder blade) also serves as a stable base for rotator cuff activation and functioning. Any bony or soft tissue injury around the shoulder can alter the roles of the scapula in motion or at rest. Scapular dyskinesis (which may also be referred to as SICK scapula syndrome) is an alteration or deviation in the normal resting or active position of the scapula during shoulder movement. For most people, the scapula moves in abnormal ways due to the repetitive use of the shoulder. These changes, though sometimes asymptomatic, can increase the chances of injury.
Symptoms:
• Pain and or tenderness around the scapula when using the arm overhead or carrying heavy objects with the arm at the side.
• Snapping or popping sensation around the scapula with shoulder movement
• Loss of strength with shoulder and arm use.
• Asymmetrical posture (affected side usually sits lower)
• Winging of the scapula
• Instability of the shoulder (feels like it moves out of place)
Causes:
• Muscle weakness or imbalance.
• Poor overhead mechanics
• Overuse or repetitive motions such as throwing or serving
• Prolonged healing time if not appropriately treated or given adequate time to heal.
• Shoulder loss of motion
• Rotator cuff tendon tear(s)
• Poor technique
Treatment:
• Initial treatment – medication and ice (pain relief)
• Corrective stretching and strengthening exercises
• Modification of activity
Carpal tunnel syndrome:
Carpal tunnel syndrome is a condition that can cause numbness, tingling and pain in the arm and hand. This common condition can occur when the median nerve is compressed or squeezed as the point of the wrist. This condition can progress and symptoms can get worse over time, so it is advised to seek medial advise early.
Causes:
Research shows that the condition is more common in women and older people, but anyone can suffer with it.
Symptoms:
• Numbness, tingling, and pain in your thumb and the first three fingers of your hand.
• Pain and burning that travels up your arm.
• Wrist pain at night that interferes with sleep.
• Weakness in the muscles of the hand.
Risk factors include:
• Heredity – the carpel tunnel can be narrower in some people so the are at great risk of developing the condition
• Repetitive use if the wrist
• Hand and wrist positions
• Pregnancy – hormonal changes
• Sufferers of: Diabetes, rheumatoid arthritis, and thyroid gland imbalance are at higher risk
Treatment:
• Massage
• Acupuncture
• Mobilization techniques
• Splints
• Non-steroidal anti-inflammatory drugs (NSAIDs).
• Surgery
Cubital Tunnel Syndrome
Cubital Tunnel Syndrome is a condition that involves pressure or stretching of the ulnar nerve (“funny bone” nerve), which can cause numbness or tingling in the ring and small fingers.
Causes:
• Pressure: Direct pressure (like leaning the arm on an arm rest) can press the nerve, causing the arm and hand — especially the ring and small fingers — to “fall asleep.”
• Stretching: Keeping the elbow bent for a long time can stretch the nerve behind the elbow. This can happen during sleep.
• Anatomy: Sometimes, the ulnar nerve does not stay in its place and snaps back and forth over a bony bump as the elbow is moved.
Symptoms:
• Cubital tunnel syndrome can cause pain, loss of sensation, tingling and/or weakness.
• “Pins and needles” usually are felt in the ring and small fingers.
• Aching pain on the inside of the elbow.
• Weakness and clumsiness can be seen.
Treatment:
• Avoid actions that aggravate the symptoms
• Wearing a splint, towel or pillow at night to prevent the elbow from bending
• Avoid leaning on the ‘funny bone’
• Massage and mobilization techniques
• In some cases, surgery maybe required
De Quervain’s tenosynovitis
De Quervain’s tenosynovitis is a painful condition that affects the tendons in your wrist. 2 tendons around the base of the thumb swell and inflames the sheaths (casing of the tensons). Pressure is then applied to the nerves which cases numbness and pain
Symptoms:
• Pain near the base of your thumb
• Swelling near the base of your thumb
• Difficulty moving your thumb and wrist when you're doing something that involves grasping or pinching
• A "sticking" or "stop-and-go" sensation in your thumb when moving it
Causes:
Women are more prone to the condition
Over the age of 40
Repetitive hand and wrist motions
Previous injured your wrist
Pregnancy – hormonal
Arthritis
Treatment:
• Heat and ice
• Non-steroidal anti-inflammatory drug (NSAID).
• Avoiding or adapting activities which worsen the condition
• Splints
• Steroid injection
• Massage
• Mobility techniques
• Ultrasound treatment
• Acupuncture
• Exercises and stretches
Tennis / Golfers Elbow:
Lateral epicondylitis (tennis elbow) & medial epicondylitis (golfers elbow) are painful conditions that effect the elbow joint. Tennis elbow effect the lateral or upper sider of the elbow and golfers elbow effects the medial or underside of the elbow.
These common conditions occur after strenuous overuse of the joint, or trauma to the joint.
Symptoms:
• Pain at the elbow joint
• Pain when lifting and bending
• Pain when gripping
• Pain when twisting arm
• Swelling / inflammation
• Heat and redness
Treatment:
• RICE (rest, ice, compression, elevation)
• Reduce movement that triggers pain
• Massage therapy
• Ultrasound therapy
• Acupuncture
• Exercises and stretching
• Taping and straps
• Ice
• Pain killers
• Surgery and steroid injections (in some cases)
Frozen shoulder (Adhesive capsulitis)
Frozen shoulder (Adhesive capsulitis) I a common painful condition that effects the shoulder joint and can cause stiffness for months or even years. The capsule within the shoulder becomes thick and tight, causing restriction and pain.
Symptoms:
• Pain and stiffness
• Lack of mobility – especially reaching up and behind your back
• Dull ach pain in the joint and surrounding muscles
• Pain at night, and pain when sleeping on the effected side
• Lose of strength
Causes:
• Effects more women then men
• Common between 40-60 years old
• More common if you have suffered a pervious stroke
• More common if you diabetic / heart disease, thyroid issues
• Trauma such as a fall or tug to the shoulder
Treatment :
• Physical therapy – specific exercises rehab plan
• Massage
• Mobilisation techniques
• Ultrasound therapy
• Acupuncture
ACJ (Acromioclavicular joint) Seperation
AC Joint is situated at top of your shoulder between your clavicle (collarbone) and your scapula (shoulder blade). Direct impact such as a collision or a fall can cause the joint to separate.
Symptoms:
• Pain at the top of the joint
• Swelling / bruising
• Loss of shoulder mobility
• Referred, neck, shoulder and elbow pain
• Sometimes a hard tender lump can form
An X-ray may be required to see the severity of the grading of the injury. In more serous injuries, surgery maybe required
Treatment:
• Exercises rehab
• Massage
• Ultrasound
• Acupuncture
• Pain killer
• Ice
• Rest
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Shoulder Impingement (tendon, bursa bone spur Impingement)
A common cause of shoulder pain. Impingements can occur when a tendon and/or the bursa inside the shoulder can catch on tissue and/ or bone. Shoulder impingements can also be causes by bone spurs which grow and catch There are factors that can cause this type or injury:
Causes:
• Trauma – a fall, sports related impact, car accident, object landing on shoulder
• Overuse
• Incorrect posture (rounded shoulders)
• Immobility (not using the shoulder)
• Other injuries
• Muscle imbalances
• Old age
Symptoms:
• Pain to the outer side of the shoulder
• Deep internal shoulder pain
• Pain when lifting the arm
• Pain when sleeping on effected side
• Pain when over using the shoulder
• Weakness in effected arm
• Back and neck pain
Treatment:
• Exercise rehabilitation
• Stretching
• Massage
• Ultrasound
• Acupuncture
• Taping / strapping
• RICE
• Avoid sleeping on effected side
• Avoid overuse
• Surgery / steroid injections (in some cases)
• Improve posture / muscle imbalances
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Scapula Winging
The scapula (shoulder blade) is a large bone which makes up the shoulder complex, where many muscle attached and play a role is shoulder movement. Over time, muscles can be over (or under) worked causing muscle imbalances. This can be causes by poor training methods and overuse.
Signs and Symptoms:
• Rounded shoulder
• Forward neck
• Neck, shoulder and back pain
• Tight pec muscles
• Weak serratus anterior muscle
• Weak trapezius muscle
• Prominent shoulder blades
Causes:
• Loss of function to the serratus anterior muscle and trapezius muscle
• Weakness in stabiliser muscles
• Overuse / poor technique
• Spinal conditions such as scoliosis
• Trauma to the shoulder
Treatment:
• Massage to the back, neck, shoulders and pecs
• Stretching out anterior (pecs)
• Strengthening serratus anterior and traps
• Be aware of posture try not to slouch
• Reduce activity that is causing the issue
• Strapping / taping techniques
• Improve posture / muscle imbalances
SLAP lesion (Superior Labral Anterior Posterior) Lesion:
A SLAP lesion occurs when the cartilage of the shoulder (labrum) is damaged. The is a condition of the shoulder which generally affects younger people but is not uncommon in all ages. The injury can be caused by a fall on the shoulder or in people who do a lot of repetitive throwing.
Symptoms:
• Instability
• Pain is worse when shoulder is in a throwing position
• Catching / Clicking sound
• Reduced movement
Treatment:
• Physical therapy
• Medication (pain relief)
• Surgery
