MRIs can be very good at detecting certain “problems” in and around the spine. MRI demonstrated high sensitivity for spinal soft tissue injuries. However, MRI showed a definite trend to overestimate interspinous ligament, intervertebral disc, and paraspinal muscle injuries .
Don’t get too wrapped up in googling the vocab words above. Here’s part of the problem with the above information. If the doctor is trying to appease the patient by ordering the MRI or the patient has demanded one, they will find something.
Whether that something is the actual problem is another discussion completely.
At some point you are going to deal some sort of an injury. Maybe you are already have. Maybe you are dealing with something right now.
I am going to walk you through some different ideas as you approach different scenarios or pain and rehabbing injuries.
There are going to be 6 parts to this post, with each part having its own video.
General guidelines for rehabbing injuries.
Your post-surgery home exercise program.
The idea of layers. Fixing one problem often reveals another one.
Modify your approach to sets and reps.
These ideas work best for chronic shoulder pain. If you recently hurt your shoulder, I would not start messing with these strategies unless you have been evaluated and they are indicated for your rehab.
All of the strategies will have multiple videos to help guide you through the process. These are strategies I have used with both clients and patients to not just manage but ultimately resolve their shoulder pain.
I am going to go over each in more detail, but the 5 strategies are:
Thoracic mobility - if the t-spine lacks mobility the shoulder and neck try to compensate.
Assisted range of motion (ROM) - if your ROM is limited, use something to help assess and improve your ability to move the shoulder and arm.
Supine exercises - this position helps utilize improved thoracic mobility, supports the body and makes controlling shoulder movements easier.
Rows - rows are shoulder-friendly and most people do not do enough of them - especially those who have shoulder pain.
Isometrics - learning how you can engage the muscles around the shoulder is key to managing pain. These are way harder than they look.
Low back tightness is common. Feeling some tightness in the low back is not uncommon. The reasons why the back can be tight are numerous. Most do not even involve the low back itself.
Other problems in the body (weakness, tightness and poor mechanics when moving) tend to manifest as low back pain. Sneaky sneaky.
Because of this, stretching the low back directly is often not the solution.
Decreased shoulder range of motion.
Decreased neck range of motion.
Numbness and/or tingling in the arm or hand.
Any of these issues can have an origin within your thoracic spine. In case you are not familiar, the thoracic spine is that fancy piece of real estate between the neck and the low back.
Let’s keep the holiday train rolling along. In Part 1, we discussed just getting moving more using dynamic warm-ups.
In Part 2, we are going to look at a bunch of different stretches that you can utilize to avoid ending up a complete ball of stress and knots come January.
Rows, pulldowns, pull-ups, and other movements that initiate movement through the scapula should make up a good amount of your upper body exercises in your program.
Rows and other horizontal pulling movements should outnumber both pressing movements and vertical pulling movements.
Stand in front of a bar (or another surface that is stable and will not move - kitchen counters also work great for this).
Walk the feet back, perform a hip hinge and pivot forward until you feel so resistance to the movement in the thoracic spine. Hold this position for 5-6 seconds. Repeat as needed.
NOTE: this may cause the back to crack. Not getting a crack in the back does not mean the movement was ineffective.
Mobilizing the first rib is not something many people know about which is unfortunate. The first rib is right under your collarbone and can be elevated which causes all sorts of issues for the neck and shoulder(s). Check out the video to see how to mobilize the fist rib.
When I first started as a Physical Therapist, I used to get nervous any time one of my patients came in with any neck diagnosis.
I mean, its the neck. I could snap their spinal cord and the person would never be the same after that.
Now, that is not true at all, but that is what I thought. What a weirdo.
Once I worked with some of these patients, I started to realize there were commonalities to most of my patients. Once we fixed a few underlying issues, they got better.
Almost 100% of them.
After awhile, I started to look forward to treating any neck issue because the outcomes I was getting were so good.
The fact of the matter is, pain can bring each one of these situations to a grinding halt. Even worse, if the pain is left unchecked it usually gets worse and can even cause pain in different parts of the body.
It is not uncommon for a right ankle or knee issue to cause pain in the low back or the opposite hip and knee. I will explain how at a later date. The short answer as to how this happens is that everything is connected.
If you have been through a certain experience, you will undoubtedly have some practical advice to share with someone going through the same situation.
That experience allows you to speak with a voice that resonates greater than someone who lacks this experience.
I work with people all the time that have injuries and associated pain and other symptoms. I have become very skilled at helping these people, even though, I have suffered only minor injuries to this point in my life.
If you truly want to understand someone's situation, walk a mile in their shoes, right?
It seems simple enough. If you have muscle tightness, the remedy is to stretch said muscles.
Simple. Easy. Done deal. Moving on.
Not so fast.
There may be a better way. An approach that, on the surface, seems ludicrous and absurd.
No disrespect for these health care professionals, but their evaluations skills are average at best. And, they often do not have the time to truly evaluate someone even if there skills are not subpar.
And, treating pain with meds only attempts to deal with your symptoms. It DOES NOT deal with the underlying problem that is causing the pain.