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Athletic Therapy, Shoulder Injuries, Shoulder pain, Sports Injuries

Could Your Biceps be Contributing to Your Shoulder Injury?

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Don’t Forget About Biceps

Rotator cuff injuries are a common cause of shoulder pain and dysfunction. It commonly affects athletes, manual laborers, and the general population alike. While the rotator cuff itself—the group of muscles and tendons stabilizing the shoulder joint—often takes center stage in discussions, the role of the biceps tendon in these injuries is equally significant yet frequently overlooked. This blog explores the relationship between the biceps tendon and rotator cuff injuries. It will shed light on diagnosis, treatment, and injury prevention strategies of the biceps tendon.

Anatomy and Function of the Biceps Tendon

The biceps muscle has two tendons at the shoulder: the long head and the short head. The long head of the biceps tendon originates from the superior glenoid tubercle of the scapula and travels through the bicipital groove of the humerus. This tendon plays a crucial role in shoulder stability and movement, especially during overhead activities.

The Relationship Between Biceps and Rotator Cuff Injuries

  1. Anatomical Proximity:


    The biceps tendon and the rotator cuff tendons are anatomically close, sharing the same space in the shoulder joint. This proximity means that injuries to the rotator cuff often involve the biceps tendon as well.

  2. Mechanism of Injury:


    Repetitive overhead activities, trauma, or degenerative changes can lead to injuries. When the rotator cuff is damaged, the biceps tendon can be subjected to increased stress and strain, leading to inflammation or tears.

  3. Pathophysiology:


    Inflammation of the biceps tendon (biceps tendinitis) often accompanies rotator cuff injuries. In some cases, the tendon may partially or completely rupture, exacerbating shoulder pain and dysfunction.
Diagram showing the close physical relationship between the biceps tendon and the rotator cuff tendon

Symptoms of Bicep Tendon Involvement

Patients with biceps tendon involvement in rotator cuff injuries often present with:

  • Anterior shoulder pain, particularly during overhead activities.
  • Weakness in shoulder movements.
  • A popping or catching sensation in the shoulder.
  • Tenderness over the bicipital groove.

How is this Diagnosed?

  1. Physical examination:

    Physical tests such as strength, range of motion, and special tests (ex. Speed’s test and Yergason’s test) can help identify biceps tendon pathology.

  2. Imaging studies:

    Ultrasound and MRI are crucial for visualizing the extent of tendon damage and identifying concurrent rotator cuff injuries.

Treatment Options

  1. Conservative management:


    Rest, ice, and anti-inflammatory medications.
    Physical therapy focusing on strengthening the shoulder muscles and improving flexibility.

  2. Medical management:


    Corticosteroid injections may be used to reduce inflammation and pain.

  3. Surgical Intervention:


    In cases of severe tendon damage, surgical options such as biceps tenotomy or tenodesis (reattaching the tendon to a different location) may be considered.
    Rotator cuff repair may be performed simultaneously to address both issues.

Prevention Strategies

Preventing biceps tendon involvement in rotator cuff injuries involves:

  1. Strengthening exercises:


    Focus on building shoulder and rotator cuff strength to support joint stability.

  2. Flexibility and Mobility:


    Regular stretching and mobility exercises to maintain a full range of motion.

  3. Proper Techniques:


    Ensuring correct techniques in sports and activities to minimize undue stress on the shoulder tendons.

  4. Gradual Progression:


    Avoiding sudden increases in activity intensity or duration to prevent overuse injuries.

Need more help?

The biceps tendon plays a critical role in shoulder function and is often implicated in rotator cuff injuries. Understanding the relationship between these structures is essential for accurate diagnosis and effective treatment. By combining clinical expertise with appropriate diagnostic tools and tailored treatment plans, healthcare professionals can significantly improve outcomes for patients with these complex shoulder injuries. PhysioNow is a leading provider of Physiotherapy Services. Whether it is a sports injury or long term shoulder injury, our therapists can set you on the road to recovery. Book with PhysioNow today for your first assessment and treatment!

 

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Shoulder Injuries

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Shoulder Injuries

Shoulder Injuries

Shoulder injuries are a common problem for many people. It can happen to people of all ages from children to the elderly. The pain from shoulder injuries can be very severe and cause a lot of limitations with work and activity. Shoulder pain is one of the top 5 reasons why people seek out Physiotherapy and Registered Massage Therapy treatments.

What Causes Shoulder Pain?

There are several reasons why people suffer from shoulder pain.

  • Trauma

    – any type of direct or indirect trauma can produce shoulder pain if the arm and/or shoulder is involved

    • Motor vehicle accidents
    • Falls
    • Sports injuries
    • Violent incidents

  • Poor workplace ergonomics

    – For people who work in offices, they may spend the majority of their time sitting in front of a computer. If the desk set up is not properly, then this may start to produce stress and pain into the shoulder. For example,  poor ergonomics can include:

  • poor desk and screen height
  • improper positioning of the keyboard and mouse
  • inadequate chair height and support

Proper desk ergonomics

Proper desk ergonomics

  • Poor posture

    – Many people have developed poor body postures over time. For some it starts young with spending a lot of time studying. It can also happen after carrying a heavy backpack or playing a lot of video/computer games. For others it starts later in life with workplace demands and poor office set up.

  • Good-Posture-vs-Poor-Posture

    Good-Posture-vs-Poor-Posture

  • Repetitive activities

    – Some people perform tasks that are repetitive at work and/or home. If the shoulder is not strong enough to support the work that it’s having to do, then injury may occur. For example,this can  include:

  • Overhead lifting
  • Sorting things on a belt
  • Operating heavy machinery
  • Typing

 

  • Congenital or Developmental changes –

  • Some people are born with a unique bone structure that may place them at increased risk of injury. For example, the acromion of the shoulder blade can have 4 different shapes. For instance, if you have a hooked shape, there is more potential for rotator cuff injury.

Some Basic Shoulder Anatomy

Having some knowledge of basic shoulder anatomy will help with understanding why shoulder pain develops. The shoulder joint is quite complex. There are a lot of structures that attach to or around the shoulder. The shoulder allows for a lot of movement .  As a result, there is less stability through the area. It’s a joint that is held together by soft tissues.  Therefore, there is not a lot of bony protection. The shoulder is made of 4 separate joints that work together to allow function:

Shoulder Injury

Shoulder Anatomy

  • Glenohumeral (GH) joint – this is a ball and socket joint and is where majority of our arm movement happens. The socket is made up by part of the shoulder blade and the ball is made up of the humerus, which is the long bone of the upper arm.
  • Acromioclavicular (AC) joint – joint between the acromion of the shoulder blade and the collar bone.
  • Sternoclavicular (SC) joint – joint between chest bone and the collar bone.
  • Scapulothoracic joint – the joint between the shoulder blade and the ribs at the back of the chest.

The Soft Tissues around the Shoulder Joint

We know that the shoulder is held together by many soft tissues including ligaments, muscles and tendons.   Other important structures include the joint capsule surrounding the ball and socket joint.  Lastly, your shoulder has  subacromial and subdeltoid bursae. The function of the joint capsule is to protect the joint and produce a lubricating fluid. Shoulder bursae are small fluid-filled sacs that act as a cushion between the bone and other moving parts.

Bursae of the shoulder joint

What are some of the types of injuries that can happen to the shoulder?

  • Sprains/Strains of any of the muscles, tendons and ligaments
  • Tears/Ruptures of any of the muscles, tendons and ligaments
  • Rotator Cuff Tear
  • Rotator Cuff Tendonitis
  • Tendonitis/Tendinosis
  • Fractures
  • Bursitis
  • Dislocations
  • Adhesive Capsulitis or Frozen Shoulder
  • Osteoarthritis
  • Nerve entrapments/injuries

Signs and Symptoms of Shoulder Injuries

  • Pain
  • Swelling
  • Restricted movement
  • Weakness
  • Instability
  • Bony deformities

 

Healing Times for Shoulder Injuries

The healing time for shoulder injuries will vary depending on the injury. Most simple sprains/strains will likely take anywhere from 6-8 weeks to get better.

Fractures of the Shoulder can take 6-8 weeks to heal the fracture.  After the fracture is healed, the soft tissues may require up to 4-5 months to heal fully with proper Physiotherapy.

However, frozen shoulders  can take over 1 year to improve. There are also a lot of individual differences in healing time amongst different people, even for similar injuries. For example, some of these factors  can include:

  • Age
  • Severity of Injury
  • Was surgery required ?
  • Level of fitness and/or mobility
  • Commitment to treatment
  • Ability to modify workplace or home environment to allow for best treatment response
  • Presence of other injuries
  • Amount of time that the injury/pain has been present

Physiotherapy/Massage Treatment for Shoulder Injuries

Treatment for shoulder pain will depend on the type of injury. It will also depend on the area that has been injured.

However, since the shoulder is made up of 4 joints, treatments should target the whole shoulder and not just the individual area injured. This will allow the shoulder to return to its full function. It will also reduce the risk of re-injury.

In sum, the main goals of any shoulder pain treatment will be to:

  • Decrease pain
  • Regain full movement
  • Recover strength and stability
  • Return to pre-injury activities

Registered Physiotherapy for Shoulder Injuries

A Registered Physiotherapist will start with a full assessment so that we can identify the source of the shoulder pain. This will allow us to provide the best treatment for you. Treatment can typically include:

  • Manual therapy
    • soft tissue work
    • mobilizations
    • assisted stretching of the shoulder and nearby areas
  • Modalities – these are usually used in the early phase for pain relief
    • Ultrasound
    • Laser
    • IFC or TENS
    • Heat/Ice
  • Exercise prescription
    • Movement and strengthening exercises that are specific to the injury
    • So, it is important that you complete the prescribed exercises on a regular basis at home.
    • In short, this will ensure that you are continually providing treatment to the shoulder even when you are not physically present in the clinic.
    • Shoulder Exercise

 

 

 

  • Education
    • Explanation of the condition
    • Rationale for the treatment choices
    • In essence, Do’s and don’ts to help the injury along

Registered Massage Therapy for Shoulder Injuries

  • Registered Massage Therapy can be very helpful to release tight muscles around the upper back, neck and shoulder blades

  • shoulder injuries

    Registered Massage therapy for shoulder injuries

 

 

 

 

Shoulder injuries can be quite debilitating, and it is important to seek out a Registered Physiotherapist for assessment and treatment sooner rather than later. Like most other injuries, the longer an injury is left untreated, the more chronic it becomes. As a result, it makes it more difficult to resolve in a timely manner.

Call PhysioNow today to get treatment for your shoulder injury!

 

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Heat therapy

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Heat and Cold therapy

How it works

When we apply Heat therapy, it improves circulation and blood flow to  that area due to increased temperature. Heat therapy can relax and soothe muscles and heal damaged tissue.

Heat therapy

Types

  • Dry Heat therapy includes sources like heating pads, dry heating packs, and even saunas. This heat is easy to apply.
  • Moist Heat therapy includes sources like steamed towels, moist heating packs, Theratherm heating pads that take moisture from the air, or hot baths. Moist heat may be slightly more effective as well as require less application time for the same results.

Contraindications

  • diabetes
  • dermatitis
  • vascular diseases
  • deep vein thrombosis
  • multiple sclerosis (MS)

 Heat is useful for relieving:

  • osteoarthritis
  • strains and sprains
  • tendonitis, or chronic irritation and stiffness in the tendons
  • warming up stiff muscles or tissue before activity
  • relieving pain or spasms relating to neck or back injury, including the lower back

Cold therapy

How it works

Cold therapy is also known as cryotherapy. It works by Louis- hunting reaction theory. When we apply Ice to an injured site, it reduces the blood flow by vasoconstriction. After some time, it causes vasodilatation and increases the blood flow to the area. This process goes on continuously. This reduces inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain.

Types of Cold Therapy

There are a number of different ways to apply cold therapy to an affected area. Treatment options include:

  • ice packs or frozen gel packs
  • coolant sprays
  • ice massage
  • ice baths

Cold treatment can help in cases of:

  • osteoarthritis
  • a recent injury
  • gout
  • strains
  • tendinitis, or irritation in the tendons following activity

Contraindications

  • people with sensory disorders
  • uncontrolled diabetes
  • You should not use cold therapy on stiff muscles or joints.
  • Cold therapy should not be used if you have poor circulation.

Here’s a general guide that helps you to decide which to use heat or ice : https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold#cold-therapy

In General,  use ice for the first few days after an injury.  Beyond that, heat usually does the trick.  There is some evidence that suggests that using ice beyond the first few days can actually slow down injury healing.  It pushes away the healing agents that help you to get better.

If you have been injured and need advice or treatment, please call PhysioNow today.  We are always happy to help!

Exercise, General Category, Manual Therapy, Massage Therapy, Physiotherapy, Shoulder Dislocation, Shoulder Injuries, Sports Injuries, Sports Physiotherapy, Sports Taping

Shoulder Dislocation

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Shoulder Dislocation

Shoulder Dislocation can be a scary experience! A lot of times, the injury happens so quickly that a patient doesn’t even know what has happened to their shoulder. But what they do know is that there is intense pain and that the shoulder joint looks deformed.

Shoulder Dislocation

How does Shoulder Dislocation Happen?

A shoulder dislocation is usually caused by falling onto your shoulder, trying to stop a fall with the hand or getting hit in the shoulder. With this injury, the ball of the humerus, which is the long bone of the upper arm, has come out of its socket, which is part of the shoulder blade. When this happens, the soft tissue structures that make up the shoulder joint are also overstretched and torn. The ball of the humerus can either be moved out through the front or the back of the socket. The direction of the shoulder dislocation depends on how the hit to the shoulder occurred. However, 95% of dislocations occur through the front of the shoulder.

What can be done for a Shoulder Dislocation?

For a large majority of cases, a doctor “pop” the shoulder back into place. This is called closed reduction of the dislocation. The doctor then places the shoulder in a sling to protect the joint while the soft tissues heal. The sling has to be worn between 2-4 weeks depending on the nature of the shoulder dislocation. It is important to wear the sling appropriately because the shoulder joint is now considered unstable. Until the soft tissue structures heal around the shoulder, certain movements can cause the dislocation to occur again. Therefore it is important to follow the doctor’s recommendations on the sling and make an appointment with a Registered Physiotherapist.

How Can Registered Physiotherapy Mississauga Help?

The Registered physiotherapy Mississauga treatment promotes healing of the injured structures. It also prevents the instability from becoming a chronic problem with a good strengthening program. Modalities such as interferential current and Ultrasound help to reduce the pain from injured tissues. Mobilization and stretching is also very important in healing. Your Registered Physiotherapist at PhysioNow will teach you everything that you need to know. Registered Massage Therapy Mississauga can also be very helpful to relieve muscle tension compensating for instability.

Registered Massage Therapy For Shoulder Dislocation

Registered Massage therapy for shoulder dislocation

Will surgery be required for Shoulder Dislocation?

In cases where the shoulder dislocation keeps recurring because damage to the joint and/or soft tissue structures are too severe, surgery can be performed to get the shoulder joint back into place. However, this occurs only in severe cases. Hopefully, with a great Physiotherapist helping you, you will avoid this step! Call PhysioNow today to book your appointment!

Acupuncture
General Category, Health and Wellness, Manual Therapy

Acupuncture

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Acupuncture

Acupuncture

Pain is an alarm signal of the human body. When dealing with pain it is important that underlying causes are understood and dealt with. However it is desirable to relieve pain in the shortest amount of time. An acupuncture practitioner can deal with these underlying causes thru acupuncture.

Acupuncture is one of the oldest forms of therapy in traditional Chinese medicine. This states that any sign of disease is an imbalance between ying and yang forces in the body. Acupuncture promotes the flow of life force energy and therefore brings balance to the human body. Acupuncture commonly includes manual stimulation of needles. It may also include electrical acupuncture. In this case, an electrical stimulator is connected to a needle.

Acupuncture can be effective in so many different conditions. The conditions that we treat in our Mississauga physiotherapy clinic are: Headache, Bell’s palsy, tennis elbow, OA (osteoarthritis), Low Back Pain, carpal tunnel syndrome, neck pain & Muscle related joint disorders.

Acupuncture has a much lower incidence of poor effects in comparison with many western treatments e.g. drugs like antiinflammatories/ cortisone injections which have possible harmful adverse effects. The ill effects associated with acupuncture are: Minor (bruising, bleeding, nausea, broken needles, worsening of symptoms) Major (infection, perforation of organs). These ill effects can be avoided when treatment is carried out by a well trained Registered Physiotherapist. This includes proper sterilization techniques. It also includes sound knowledge in anatomy and physiology. Treatment frequency is usually 2-3 times/wk which lasts for 15min up to a max of 30 min duration.

Acupuncture may be used together with other treatment modalities such as interferential therapy, ultrasound, exercise, or mobilization techniques by a Registered Physiotherapist. A full assessment by a Registered Physiotherapist will allow for a proper diagnosis and treatment options that are the best for each patient.

If you are interested in learning if acupuncture may help with your symptoms, please call to make an appointment with our Registered Physiotherapists Mississauga today!

General Category, Health and Wellness, Manual Therapy, Physiotherapy, Shoulder Injuries, Sports Injuries, Sports Physiotherapy

Registered Physiotherapists Mississauga

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Registered Physiotherapists Mississauga

Registered Physiotherapists Mississauga are health professionals who specialize in recovery of the body from an illness or injury to the highest level of function possible. Registered Physiotherapists Mississauga can also be called physical therapists. This means the same thing.

Registered Physiotherapists Mississauga

Registered Physiotherapists Mississauga

To become a registered physiotherapist you must attend a university and graduate with a physiotherapy degree. The degree has changed over the years. You may meet some therapists who have an occupational and physiotherapy degree. These therapists are called POTS.

Registered Physiotherapists Mississauga that graduated before the late nineties have a bachelor of science (physical therapy). After the late nineties and more recently, physiotherapist graduates are awarded with a Masters of Science. Regardless of the degree they earned, all Registered physiotherapists in Canada must pass a licensing exam. This allows them to use the term Registered Physiotherapist (RPT). Make sure when you are seeking help, you ask for a Registered Physiotherapist Mississauga.

If you are interested in becoming a Physiotherapist of Physiotherapy Assistant, check out this link.

After Physiotherapists graduate

After graduating, registered physiotherapists will choose to specialize in a certain area. All the Mississauga Registered Physiotherapists at Physionow are orthopedic therapists. This means that they are experts in examining how bones, joints and muscles work. When you arrive for an assessment, they will look at specific movement patterns and strength to determine the best possible treatment program for you. As everyone has different goals, and different injuries, each program is created individually with your needs in mind.

Some of our Mississauga Registered Physiotherapists have secondary specialities including sports, vertigo, acupuncture and sports taping. A sports therapist has extra training to maximize performance including fitness protocols, concussion treatment and nutrition. Acupuncture treatment can be very effective for certain types of injuries such as Tennis elbow, Golfers elbow or Rotator cuff pain. Sports Taping can reduce the load on injured muscles to allow proper healing. Vertigo treatment focuses on reducing dizziness and nausea caused by inner ear and eye problems.

If you have any questions or are wondering if we could help you, please feel free to call our office and ask to see one of our highly skilled Registered Physiotherapists Mississauga.