BST Clinic

26/01/2022

04/01/2022

Technique Tuesday> Treating Frozen Shoulder and Adhesive Capsulitis

The term frozen shoulder has been around since the early 1930s, but research by Drs. Andrew and Robert Neviaser found that a stiff, painful glenohumeral joint doesn’t necessarily mean the shoulder is “frozen.” According to these authors, frozen shoulder and adhesive capsulitis are not the same thing. Since many manual and movement therapists (myself included) lump these two conditions together, let’s take a closer look at what some believe makes them different. On the famed Cleveland Clinic orthopedic hospital website they say: “Frozen shoulder is a general term used to describe any shoulder that is stiff. Adhesive capsulitis is a very specific term for a condition that involves the spontaneous, gradual onset of shoulder stiffness and pain caused by tightening of the joint capsule.”

When osteoarthritis attacks the body’s shoulders, hips, knees or intervertebral joints, lubricating fluids breakdown, the articular cartilage wears away, and, in time, a bone-on-bone adhesion may develop. This is typically what makes arthritis so painful and debilitating. Although Myoskeletal mobilizations don’t actually add synovial fluid or hyaluronic acid to joints, they certainly disperse the existing fluids allowing for increased joint play and joint centration, and that can be very therapeutic.
The problem seems to be that some consider frozen shoulder... https://mailchi.mp/freedomfrompain/treating-frozen-shoulder-adhesive-capsulitis-159634

29/09/2021

Click here for more information and to read an article about how to treat low back pain by addressing the hip joint.

23/01/2021

🔈 WHY ARE THE PSOAS MUSCLES CONSTANTLY CONTRACTED DURING PROLONGED PERIODS OF STRESS?

Whether you run, bike, dance, practice yoga, or just hang out on your couch, your psoas muscles are involved. That’s because your psoas muscles are the primary connectors between your torso and your legs. They affect your posture and help to stabilise your spine.

The psoas muscles are made of both slow and fast twitching muscles. Because they are major flexors, weak psoas muscles can cause many of the surrounding muscles to compensate and become overused. That is why a tight or overstretched psoas muscle could be the cause of many or your aches and pains, including low back and pelvic pain.

👩‍🔬 ANATOMY

Structurally, your psoas muscles are the deepest muscles in your core. They attach from your 12th thoracic vertebrae to your 5 lumbar vertebrae, through your pelvis and then finally attach to your femurs. In fact, they are the only muscles that connect your spine to your legs.

Your psoas muscles allow you to bend your hips and legs towards your chest, for example when you are going up stairs. They also help to move your leg forward when you walk or run.

Your psoas muscles are the muscles that flex your trunk forward when bend over to pick up something from the floor. They also stabilize your trunk and spine during movement and sitting.

👩‍🔬 THE PSOAS AND FIGHT OR FLIGHT RESPONSE

The psoas muscles support your internal organs and work like hydraulic pumps allowing blood and lymph to be pushed in and out of your cells.

Your psoas muscles are vital not only to your structural well-being, but also to your psychological well-being because of their connection to your breath.

Here’s why: there are two tendons for the diaphragm (called the crura) that extend down and connect to the spine alongside where the psoas muscles attach. One of the ligaments (the medial arcuate) wraps around the top of each psoas. Also, the diaphragm and the psoas muscles are connected through fascia that also connects the other hip muscles.

These connections between the psoas muscle and the diaphragm literally connect your ability to walk and breathe, and also how you respond to fear and excitement. That’s because, when you are startled or under stress, your psoas contracts.

In other words, your psoas has a direct influence on your fight or flight response!

During prolonged periods of stress, your psoas is constantly contracted. The same contraction occurs when you:

➡️ sit for long periods of time
➡️ engage in excessive running or walking
➡️ sleep in the fetal position
➡️ do a lot of sit-ups

💡 Here are some tips for getting your psoas back in balance:

✔️ Avoid sitting for extended periods
✔️ Add support to your car seat
✔️ Try Resistance Flexibility exercises
✔️ Get a professional massage
✔️ Release stress and past traumas
✔️ Stretch

💡 HOW TO STRETCH

Roller Psoas Stretch
Use a foam roller for this passive, relaxing stretch that lengthens your psoas, one of your deep hip flexors.

1. Place the roller perpendicular to your spine and lie with your sacrum (the back of your pelvis) — not your spine — on the roller.
2. Pull your left knee toward your chest, keeping your right heel on the ground. You should feel a stretch on the front of your right hip.
3. To increase the stretch, reach your right arm over your head and open your left knee slightly out to the left.
Hold for 30 seconds, then switch legs. Repeat as needed.

23/12/2020

🔈 RELATIONSHIP OF SCIATIC NERVE TO PIRIFORMIS

(A) The sciatic nerve usually emerges from the greater sciatic foramen inferior to the piriformis.
(B) In 12.2% of 640 limbs studied by Dr. J. C. B. Grant, the sciatic nerve divided before exiting the greater sciatic foramen; the common fibular division (yellow) passed through the piriformis.
(C) In 0.5% of cases, the common fibular division passed superior to the muscles where it is especially vulnerable to injury during intragluteal injections.

18/12/2020

🔈 THE FIVE JOINTS OF THE SHOULDER

Right shoulder, anterior view. A total of five joints contribute to the wide range of arm motions at the shoulder joint. There are three true shoulder joints and two functional articulations:

✅ True joints:
1. Sternoclavicular joint
2. Acromioclavicular joint
3. Glenohumeral joint

✅ Functional articulations:

4. Subacromial space: a space lined with bursae (subacromial and subdeltoid bursae) that allows gliding between the acromion and the rotator cuff (muscular cuff of the glenohumeral joint, consisting of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, which press the head of the humerus into the glenoid cavity.
5. Scapulothoracic joint: loose connective tissue between the subscapularis and serratus anterior muscles that allows gliding of the scapula on the chest wall.

Besides the true joints and functional articulations, the two ligamentous attachments between the clavicle and first rib (costoclavicular ligament) and between the clavicle and coracoid process (coracoclavicular ligament) contribute to the mobility of the upper limb. All of these structures together comprise a functional unit, and free mobility in all the joints is necessary to achieve a full range of motion.

This expansive mobility is gained at the cost of stability, however. Since the shoulder has a loose capsule and weak reinforcing ligaments, it must rely on the stabilizing effect of the rotator cuff tendons. As the upper limb changed in mammalian evolution from an organ of support to one of manipulation, the soft tissues and their pathology assumed increasing importance. As a result, a large percentage of shoulder disorders involve the soft tissues.

Would you like to find out more about human anatomy, physiology and pathology? Stay tuned and make sure you turned on notification on Healthy Street and see all posts and updates.

10/12/2020

🔈 A GREAT PICTURE TO HELP YOU REMEMBER FOREARM SUPERFICIAL MUSCLES

07/08/2020

🔈 THE TRICK TO HAMSTRING REHAB

After poring over decades of research, a team of scientists in Australia believes it has pinpointed the missing link in hamstring injury rehabilitation: neuromuscular training.

Neuromuscular training involves reactivating communication between neurons (nerve cells) and muscles. In the case of hamstring injuries, that can be done by performing heavy resistance training exercises like Nordic hamstring curls or stiff-leg deadlifts, according to Antony Shield, Ph.D., one of the paper’s authors and a professor at Queensland University of Technology, School of Exercise and Nutrition Sciences.

The researchers were interested in hamstring injuries because of their frequent reoccurrence in sports that involve fast running—soccer, football, rugby, cricket, and track and field. The review, published in the Journal of Electromyography and Kinesiology, didn’t include distance runners, but Shield believes that, while hamstring injuries in distance runners tend to be less frequent and less severe, the paper’s conclusion is applicable because the rehabilitation practices are the same.

When the hamstring is strained, the normal signals between neurons and muscle shut down. This “neuromuscular inhibition” limits normal muscles’ function and the effectiveness of strength and stretching rehabilitation. Over time, the injured muscle atrophies, strength imbalances increase, and the angle of peak torque changes (i.e., the knee becomes less stable).

These “maladaptations” are long-lasting and raise the risk of injuring the area again.

“We have evidence for reduced activation many months after return to sport,” Shield told Runner’s World Newswire via email. “We have more recent data (as yet unpublished) that athletes use their previously injured biceps femoris [a hamstring muscle] about half as much on the injured side as the uninjured side when doing a Nordic hamstring curl. This data is, on average, 10 months after injury, so the change appears pretty permanent.”

Physical therapists likely avoid exercises such as Nordic hamstring curls owing to the high forces generated by the move.

But if athletes re-establish pathways between nerves and muscle, they may be better able to restore full muscle strength and function to the hamstring and reduce their chances of getting injured again, the researchers suggest.

Shield notes that many injuries result in neuromuscular inhibition. The concept isn’t new or radical, he says, it just hasn’t been adequately addressed.

Additionally, neuromuscular training isn’t a “magic solution,” writes Shield, but one of many factors athletes and physical therapists should consider.

Source: Runner's world

13/11/2019

Ever had pain somewhere, but when you try to touch it, you can't quite seem to get to it? This can be referred pain, or a cuteaneous nerve problem, but it can also be dermatomal pain. That's pain on different areas of the skin coming from the spinal nerves.

13/11/2019