A rotator cuff is a group of muscles and tendons surrounding the shoulder joint, keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. A rotator cuff injury can result in a blunt ache in the shoulder that often aggravates while you try to sleep on the affected side.
This type of injury is a common occurrence for those who regularly perform overhead motions in their jobs or sports, for example, painters, carpenters, shotput throwers, etc. The possibility of rotator cuff injury increases with age.
The rotator cuff treatment comprises of comprehensive physical therapy sessions in order to restore elasticity and strength of the muscles and tendons cushioning the shoulder joint. On the other hand, an extensive rotator cuff injury may require surgical repair, transfer of alternative tendons or joint replacement. Let’s take a sneak peek at what causes the condition, how to prevent it, and its treatment options.
Causes of Rotator Cuff Injury
Rotator cuff injury may be the result of either a substantial injury to the shoulder or too advanced disintegration or wear and tear of the tendon tissue. A repeated overhead movement or heavy lifting over an extended period of time may further destruct the tendon.
Symptoms of Rotator Cuff Injury
The pain associated may display the following rotator cuff injury symptoms:
A dull ache deep in the shoulder,
Disrupted sleep cycles, especially if you lie on the affected shoulder,
Difficulty in performing simple activities that involve reaching behind your back, and – Weakness in the arm.
During the rotator cuff injury test, your doctor will apply pressure on various parts of your shoulder and even move your arm into different positions. The strength of the muscles around your shoulder and in your arms shall be evaluated too.
In some cases, imaging tests like X-rays, ultrasounds, and magnetic resonance imaging (MRI) will be prescribed as well to rule out any other possibility leading to the condition.
Isometric shoulder exercises and rotator cuff exercises are a must if you are at risk of rotator cuff injuries or if you have had suffered few in the past. These include daily shoulder stretches and strengthening exercises in order to prevent future trouble.
Most patients also exercise the front muscles of the chest, shoulder and upper arm. Your doctor or a physical therapist may prescribe you a suitable exercise routine.
Conventional treatments — such as rest, ice and physical therapy — sometimes are all that is required to remedy your rotator cuff injury and assist you in recovering. Depending on the severity of your trauma, like in case of a total tear of the muscle or tendon, you might need surgery.
To reduce the pain further, steroid injections are recommended. But, physical therapy is the primary choice preferred by doctors. Exercises tailored to the exact position of your rotator cuff injury can help in restoring flexibility and strength to your shoulder. It also plays a significant role during the recovery phase after rotator cuff surgery.
The precise reason behind pelvic pain for most women can be unidentifiable, irrespective of any examinations or scans. In a few cases, the symptoms are associated with a problem that is often overlooked. Pelvic pain may arise from a pelvic floor muscle condition that can be aided by a particular form of physical therapy known as the pelvic physical therapy.
What are the Pelvic Floor Muscles?
The floor of the pelvis includes multiple layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back to the pubic bone in the front. When your pelvic floor muscles are unable to control themselves, it is known as pelvic floor dysfunction.
What are Pelvic Floor Conditions?
The pelvic floor conditions comprise of the following:
Fecal Incontinence, and
Bowel Conditions, such as Constipation.
Why Do the Pelvic Floor Muscles Weaken in Women?
The pelvic floor muscles in women can be weakened due to the following factors:
Pregnancy and Childbirth;
Repetitive Heavy Lifting;
A Chronic Cough (Smoker’s Cough, Acute Bronchitis, Asthma, etc.);
Hormonal Imbalance at;
Surgery (E.g. Prostate or Episiotomy); Weak Core Muscle Strength; and A Lack of General Fitness.
What is Pelvic Floor Physiotherapy?
In order to maintain the strength of pelvic floor muscles, it becomes important for both women and men of all ages to reap the benefits of pelvic floor physiotherapy and rehabilitate the weakened muscles. It can help not only with the pain but also reduce symptoms of other conditions caused by pelvic floor problems, such as urinary and fecal incontinence, painful intercourse, and sexual dysfunction. Relaxing tapered and compressed muscles can help ease pain in the pelvic floor, just as it would in other muscles in the body.
Although many women might find pelvic physical therapy unusual and offensive, it can be quite effective. The effectiveness of the therapy will always depend on the severity of the case. It can also serve as additional therapy and does not always have to be the only treatment option.
Pelvic Floor Physiotherapy Techniques
Education: A patient should be aware of his/her pelvic anatomy and how different components work alone and together. They should also have knowledge of how their habits and hygiene affect their symptoms.
Pelvic Floor Exercises: Exercises involving contraction and relaxation of pelvic floor muscles in relation to other muscles are a must. Few breathing and timing techniques that make the exercises more effective are also taught. Such exercises can assist them in stretching the constricted muscles, strengthen the weak ones, and improve flexibility.
Manual Therapy: A physical therapist may use hands-on massage or stretching to help with posture, blood circulation, and mobility.
Pelvic floor physical therapy may be part of a treatment plan involving primary care physicians, sex therapists, and mental health professionals.
Misinterpreted as well as mismanaged, lower back pain is a significant cause of agony and distress for many across the world. Though common and recurrent in nature, it is definitely not very severe. Before we learn about how physiotherapy aids in treating back pain, here’s the up-to-date knowledge on the ailment.
What Causes Lower Back Pain?
Strenuous physical activity can result in stretching or tearing of muscles and ligaments in the lower back. It is usually characterized by pain and soreness in the affected area, and even, muscle cramps.
As we age, the risk for the discs in the back to get injured, increase. Some frequent disc injuries include a herniated disc and compression of the nerve root. They occur unexpectedly after lifting something or twisting the back. The pain can usually span across for more than 72 hours.
Sciatica generally follows when the herniated disc presses on the sciatic nerve. Since the sciatic nerve links the spine to the legs, this ailment can cause shooting pain in the legs as well.
This condition is identified by narrowing of the spinal column that applies pressure on the spinal cord and spinal nerves. Spinal Stenosis is a common development of degeneration of the discs between the vertebrae. Its symptoms tend to worsen while standing or walking.
Abnormal Spine Curvatures
Scoliosis, kyphosis, and lordosis result in abnormal curvatures in the spine. These ingrained conditions are first diagnosed when patients are children or teenagers. The curvature puts pressure on the muscles, tendons, ligaments, and vertebrae causing pain and feeble postures.
Conditions like arthritis, fibromyalgia, spondylitis, osteoporosis, and spondylosis comprise factors that generate lower back pain symptoms.
Symptoms of Lower Back Pain
One of the major symptoms is an ache in the lower side of the back that sometimes even travels to the buttocks and legs. The pain usually goes away without any medical treatment, but if it is persistent with the following symptoms, you need to see a doctor:
Inflammation or swelling on the back,
Continuous back pain, where lying down or resting does not help,
Pain down the legs,
A recent injury, blow or trauma to the lower back,
Difficulty in Urination,
Loss of control over bowel movements,
Numbness around the genitals, and
Sore buttocks and anus
How Can You Prevent Lower Back Pain?
To lower the risk of developing back pain include the following factors:
Establish an exercise routine.
Maintain your body weight as per the BMI.
Perfect your posture alignment, while both, standing and sitting.
Use the correct lifting techniques.
Do not lift and twist at the same time.
Wear flat shoes to avoid straining the lower back. Ensure back support while driving.
How Does Physiotherapy Treat Lower Back Pain?
Early treatment that focuses on exercise, mechanics, and posture is the key to reducing your pain and returning to an active lifestyle. To relieve your lower back pain, a physical therapist will design a treatment plan pertaining to your explicit problem, based on a systematic investigation. The sooner you visit the physiotherapist, the more effective will be the treatment. Based on your examination, the best treatment for lower back pain shall revolve around the following:
Manual Therapy (Mobilization of the Joints in Your Back): Physiotherapists accomplished in manual therapy customize accurate hands-on procedures to relieve stiffness and improve the affected spine joints and muscles by initiating movement.
Movement Exercises: In order to reinstate the lost motion and lessen the prickling pain, most physiotherapists prescribe these exercises, using a protocol called the McKenzie method. If your pain is enduring, physiotherapy is a must for you. Along with the first two options, chronic low back pain is best managed with progressive strengthening exercises.
Progressive Strengthening Exercises: These usually highlight stability and endurance. A comprehensive assessment analyzing the kind of pain, how it occurred, how to better it and what makes it worse will let the physiotherapist prescribe the right treatment option for you.
It’s no secret that car rides can be hard on your lower back—especially if you have to travel for an extended period of time.
The key to finding relief is to make a plan before you set off on your trip, and these 3 little-known tips can help you do exactly that:
1. Schedule regular stops for exercise
Sitting in one position for an extended period of time can tighten your back muscles, which in turn can lead to pain and even muscle spasms. So then, it’s a good idea to schedule stops every 30 to 60 minutes so you can walk around and stretch your lower back. This activity loosens your muscles and encourages blood circulation, bringing nutrients and oxygen to your lower back.
In addition to scheduling regular stops, try adjusting the position of your seat every 15 to 20 minutes. You can also pump your ankles to stimulate blood flow and to provide a slight hamstring stretch. Basically, any movement that’s safe to perform while driving can contribute to the relief of your back pain.
2. Bring a cold pack to relieve your lower back pain
More often than not, back pain is accompanied by inflammation. Applying a cold pack for 15 to 20 minutes can reduce this inflammation and numb sore tissues, both of which can relieve your pain.
Of course, finding relief through cold therapy on a road trip requires advanced planning. Here are a few simple options you can consider:
Before you leave on your trip, fill a cooler with reusable ice packs. You can also make your own customizable ice packs at home and toss them in the cooler.
Purchase instant ice packs at a pharmacy or general merchandise store. You can store these instant packs in the glove compartment of your car.
If you’re in a pinch, you can purchase ice and plastic bags on your trip—just make sure the bags are leak-free.
Regardless of which option you choose, remember to place a protective barrier between your skin and the cold pack to avoid ice burn.
3. Break up your trip into manageable stages
It seems counterintuitive, but sitting places more pressure on your spine than standing. So if your lower back pain is severe, consider breaking up your road trip into manageable stages. For example, rather than traveling 12 hours in one day, try 2 travel days instead. This strategy can help reduce the pressure on your spine—and it may encourage you to seek out unique tourist destinations.
Of course, breaking up your trip may cost you additional time and money—but it’s worth it if you can avoid lower back discomfort.
I hope all of the above advice will help keep your lower back happy and healthy during your next road trip.
Classically CTS presents as pins and needles, numbness, burning or pain in the thumb, index finger, middle finger and half of the ring finger. The symptoms can be associated with swelling, difficulties distinguishing between hot and cold temperatures and reduced coordination of the hand. Commonly, people affected by this condition wake at night with symptoms and have to shake their hand to obtain relief.
What’s going on inside
The carpal tunnel is a canal formed by ligaments and the small bones of the wrist on the palm side of your hand. Several tendons, blood vessels and a nerve pass through the carpal tunnel as they travel from the forearm to the hand. The nerve that passes through this narrow tunnel is called the Median nerve. If the median nerve is be com-pressed, it may result in carpal tunnel syndrome
CTS is thought to occur as a result of increased pressure in the carpal tunnel. In some instances there is an obvious reason for the increase in pressure such as:
– A fracture of the small bones in the hand or the bones of the forearm. – Swelling of the tendons that pass through the carpal tunnel. Other causes can be related to occupational practices such as: – Exposure to vibration. – Maintaining the wrist in a bent position for prolonged periods e.g. sewing, painting, writing and computer work. Other contributing factors/causes are: – Pregnancy – Age – Diabetes – Rheumatoid arthritis
How a physio can help
Determining the cause and contributing factors is important in the management of CTS. Reducing inflammation associated with a fracture or an injured tendon will help reduce pressure in the carpal tunnel. If symptoms are related to vibration then modifying work practices to avoid prolonged exposure is important. Similarly avoiding prolonged positioning of the wrist in a flexed or extended position is important. Splints, different equipment, different grips may all be useful to change and support the wrist mechanics.
Wear a splint:
A specific carpal tunnel splint that helps to keep the wrist in a neutral position helps minimise the pressure in the carpal tunnel. Initially the splint may need to be worn for long periods to allow symptoms to settle. As symptoms settle the splint is worn for shorter periods.
Rest from aggravating activities is important, it helps settle inflammation and alleviates symptoms.
Your physiotherapist will give you stretches and exercises that help to mobilise the median nerve, help strengthen the muscles around the wrist and stretches to stretch the structures around the wrist to help settle and alleviate symptoms and to prevent recurrences. Surgery?
In cases that are left untreated, serious cases, or cases that don’t respond to treatment, surgery is sometimes needed. Surgery involves decompression of the nerve. Most people do well after such surgery.
The Ontario Physiotherapy Association is currently running a campaign called #PhysioHelpsLives to educate Ontarians about physiotherapy.
Muslim Link spoke to physiotherapists Mohamed Fouda and Keltouma Nouah. Fouda is the manager of Prime Physio Plus Clinic in Ottawa and Nouah is a recent graduate of the University of Ottawa’s Master in Physiotherapy program who works at the Prime Physio Plus Clinic. We asked them about physiotherapy’s benefits, why more Muslims should consider seeing a physiotherapist, and why Muslim youth should consider a career in physiotherapy.
Physiotherapy is a physical means to treat health problems. Best known for treating issues such as muscle pain, Fouda explains that it can also help in many other ways, “It can help people who are having breathing problems, like asthma. Some dermatological problems require phototherapy. Other issues may be treated with hydrotherapy, so you work with the patient in a pool. If you have back problems, we can use spinal decompression.”
While accepted as a mainstream form of medical treatment, it differs in its approach to healing, “We try to use as little intrusive means as possible to heal the patient. So we don’t use medication, we don’t use injections,” Nouah states.
Physiotherapists use a combination of methods to heal the patient. Treatments can include massage therapy, which is used for soft tissue pain and tightness, but that is just one of many treatments. Other treatments might involve the use of heat, cold, electrical currents, ultrasounds or even acupuncture.
Both Nouah and Fouda find that many people think of physiotherapy as just massage. “People just expect us to massage them,” says Fouda,”They have knee pain, back pain, neck pain and they think their only option is gentle massage. People don’t realize that a lot of different techniques could be used to help them.”
Despite growing up in Canada, Nouah herself was not aware of physiotherapy until three years before she applied for the program, “I heard the term but I didn’t really know what we did.”Something that physiotherapy might not be traditionally associated with is pregnancy. It can help during pregnancy with back, neck, and knee pain, but it can also help mothers during labour and after birth. “There are also techniques you can use to help with a smoother delivery and that can also reduce pain during delivery. You also have a condition called diastasis recti, so this is when the muscles of the belly have so much pressure on them that they separate and your stomach pushes out. This condition can be treated by physiotherapy,” explains Nouah. Fouda points out that physiotherapy can also help with issues after birth such as incontinence or uterine prolapse.In addition to helping with many different health conditions, physiotherapy can also play a role in preventative medicine—to help prevent certain conditions or injuries. Fouda stresses the importance of addressing health issues early on, “For example, if you have shoulder pain, you go to a physiotherapist to get it check out because it could develop into a condition called frozen shoulder that means you can’t move your shoulder at all. But that condition could be avoided just with very simple exercises if you get assessed early enough.”
For Nouah, she would like to see more Muslim women using physiotherapy, “I find that Muslim women, it doesn’t matter what culture we are from, we don’t seem to take care of our bodies all that well and we ignore the fact that there are ways to treat pain; we don’t have to just be patient with it. You can be patient with other things, but not your pain. It is important to know that physiotherapy can help. There are women physiotherapists who can help you. Often we have a lot of clients who are uncomfortable going to any other clinic; they like coming here because they know that they can definitely get served by a female physiotherapist, we offer privacy for women. We can serve them in Arabic if they need that. “
“If you have discomfort, check it out before it gets worse,” Fouda recommends, “Sometimes you go to the doctor for an issue and they can’t treat it or they just give you pain medication, but that doesn’t really address the problem. But you can also come into a physio clinic, get yourself assessed, it doesn’t take that long, and we can figure out what treatment is best for you.”
Physiotherapy also involves developing exercise plans for patients. Fouda states that patients have an active role in physiotherapy, “You have to be active in your treatment if you want to see improvement. That is why we create exercise plans and it is so important that people follow through with them.”
Typically, Nouah explains, patients tend not to leave the clinic without exercises, “We always try to tailor it to the patient’s time, what they are capable of, and also how much pain they are in. But we want to help people be able to handle their conditions outside of the clinic. We are not trying to get people to come to our clinic every day for the rest of their lives. We want you to come in, we work with you, we bring down your pain level, but we also give you the tools so you can manage your condition at home so that you won’t always have to see us. Although we would love to see you again!”
So, why consider becoming a physiotherapist? For Nouah, she discovered physio by volunteering at a physio clinic near her home. She loved it and realized that the Muslim community is not as diverse as it could be when it comes to careers, “It is either be a doctor, be a lawyer, be an engineer, be a teacher if we are really pushing it. But that doesn’t make us a strong community. It is better if we have someone in our community who does every job, so they can be a go to person, a resource.
But in the Muslim community, particularly if you wear hijab, it is like we feel some careers are off limits for us. Because physiotherapy is seen as involving a lot of touching, I think some people may see it as a taboo for us to go into it. But the reality is that there is more touching in medicine. And the way I see it, I want to help people, and I feel that physiotherapy is really needed and it can help a lot more people at this time because of the type of conditions we are seeing people develop, particularly as they age.”
The Master program in physiotherapy that Nouah just graduate from is the first of its kind here in Canada. Anatomy, exercise prescription, and rehabilitation are just part of the program. They also focus on the cardiovascular and respiratory systems to help people breathe better, on the nervous system to support conditions such as MS or Parkinson’s, and on geriatrics to help people as they age. The last year of the program includes a lot of clinical work to provide sufficient hands-on experience for students.
Nouah, who wears hijab, discusses the challenges she had while studying physiotherapy, “It is never not awkward when you wear hijab and are pursuing a career where there are not many women who wear hijab. But my professors were very supportive,” she shares, “You just have to know who you are and be a strong person. As part of our program, you have to do rounds and placements in hospitals so I can’t tell a patient, ‘I’m sorry, I can’t treat you because you are a man.’ As a healthcare professional, you can’t discriminate because of gender. If you want to be a good practitioner you need to know everybody type, you need to know what feels right or what doesn’t feel right and unless you are touch, you won’t know.”
Nouah is glad she has pursued this career because she feels it puts more Muslim women at ease who need physio treatment to receive services from another Muslim woman. “ I speak Arabic and French, as well as English, so I can offer them the support they need as a trained professional who also understand the language and the culture,” she explains.
In Ontario, most private healthcare plans including Ontario Auto Insurers and workplace injury claims cover physiotherapy. But to be eligible for physiotherapy treatment under the Ontario Health Insurance Plan (OHIP), you do have to meet certain criteria.
For Fouda, this is a concern, “But what about the people who don’t meet these criteria and don’t have the money to pay for treatment? I was able to apply to be covered to treat newly arrived Syrian refugees because many of them need physiotherapy. But we need to find a way to make physiotherapy more widely available for those who need it because it can help so many people.”
We aim to remove your pain and develop personalized treatments while maintaining up-to date practices provided by our qualified experts. It is through dedication and a cohesive team of energetic and educated individuals that we will continue to uphold this vision.
We will start with identifying the cause of the problem, not only the symptoms. We can then design a tailor-made treatment plan that will help you recover in the shortest period of time, so you can get back to enjoying your life to the fullest.