A Scaffolders Shoulder – How the body compensates for increased stress
Here we have a photograph of a middle aged Plymouth Scaffolder (who wishes to remain anonymous!) He has developed to large fat pads in the acromio-clavicular area of his left shoulder in response to the increased stress of carrying scaffolding on his left shoulder for all of his working life. The enlarged fat pads (bursae) do not cause any pain and reduce the stresses on his shoulder when lifting.
We regularly treat Tendinitis in our central Peverell Chiropractic Clinic. The Knee, ankle, elbow in fact most joints can have an associated tendinitis, Achilles tendonitis refers to the inflammation of the Achilles tendon. The Achilles tendon is the largest, thickest and strongest tendon in the body. It measures about six inches in length and it joins the calf muscles, the soleus and gastrocnemius to the rear of the heel bone.
Tendinitis of the Achilles tendon, generally caused by overuse of the affected limb, overuse of both the tendons and muscles of the limb is common among people training under less than ideal conditions. Injuries of the Achilles tendon may begin gradually and maybe fairly well progressed before the pain is felt or they may occur because of an overexertion injury, for example running much further than normal or altering your running routine, for eg. running over a more hilly course than you are used to. Non sporting incidences are often related to footwear, for example wearing flip flops on holiday when you are used to wearing a slight heel, or walking barefoot along the beach for a few miles, a rare event in the UK with the weather the way it has been in the last few years!. Tightness of the calf muscles may be a precipitating factor so this condition may occur a few weeks after beginning a fitness routine if you have not exercised for a long time. Very occassionally a very mild Sciatica (an irritation of the Sciatic nerve) may precipitate a tendinitis as the calf muscles may tighten because of the increased firing of the nerves supplying them.
The principles of our treatment of Tendinitis injuries
We use a multifactorial approach to treatment in our clinic as we find that this provides more effective results.
Tendinitis treatments in our clinic consist of of a combination of the following techniques, all of which are helpful but need to be used in conjunction with each other.
- Inflammation reduction using ice, and medication (if permissible).
- Our Core treatment consisting of Massage, Deep tissue therapy and fascial manipulation to reduce muscle spasm, scar tissue and facilitate fascial and tendon repair and healing.
- Taping the affected area to support the damaged tissues and muscles to speed up recovery.
- Exercise therapy and stretching to strengthen and return the weakened muscles, damaged tendons and connective tissue to their normal state.
Just giving exercises is only a partial treatment as is just taping the affected areas:
As with any tendinitis the inflammation must first be reduced. This is normally apparent a a slight swelling at the base of
the tendon near the heel. This is normally facilitated by regularly icing the area and taking a short course of anti-inflammatory tablets. During this time it is important that the area is correctly taped to support the tendon and prevent excessive stretching. Kinesio taping is ideal for this as it can also be used to help reduce the local inflammation at the tendon/bone junction on the heel (Calcaneous). Advice on footwear as it is helpful for the first few weeks to try and avoid walking barefoot or with heelless shoes as these tend to put excessive tension onto the Achilles tendon.
Deep tissue therapy, fascial release and sports massage are used in our clinic to facilitate healing and repair of the damaged tendon and contracted and tight calf muscles.
The common tendinitis and soft tissue injuries we treat are shown below:
- Achilles Tendinitis
- Tennis Elbow (Lateral epicondylitis)
- Golfers elbow
- Patella tendinitis
- Shoulder rotator cuff injuries
- Runners knee
- Medial ligament injuries of the knee
- Ankle sprains
There are 2 main two main types of exercises you can do to help to relieve your Lower back pain and Sciatica.
(1) Core exercises to strengthen your core muscles.
(2) Mobility exercises to loosen up your spine by mobilising your joints and stretching and relaxing your muscles.
We are focusing on the mobility exercises we give to our patients in this article:
In conjunction with rest and regular weight bearing exercise (short walks) a specific lower back pain mobility exercise routine performed regularly will greatly enhance your recovery from lower back injury, reducing your lower back pain
and helping to prevent future problems by keeping your spine more supple and flexible.
Also doing these exercises every morning before you get out of bed will generally help to keep your spine mobile and loose. REMEMBER these exercises are tried and tested, we have given them to thousands of patients over the last twenty years, many of these patients religously do these exercises every morning because they have noticed a difference: they have less morning back pain and stiffness.
Primary Chiropractic treatment, ie spinal manipulative therapy is highly effective (hence Chiropractic’s popularity) however we can enhance our patient’s recovery by also providing advice, soft tissue therapy, mobility exercises and core exercises. A lot of chiropractors do use other modalities/treatments as an adjunct to their spinal manipulative therapy. At Peverell Chiropractic Clinic we have found that using a multi-factorial approach to treatment particularly with more serious and more chronic back pain cases does produce slightly better results.
These simple exercises have been designed to gently mobilize the spine aiding it’s return to normal function without
putting undue stress on the joints and tissues.
If you have lower back pain and/or sciatica perform the exercises at least 4X per day (or as directed). Always do them before you get out of bed to mobilise your spine and loosen it up before you actually put any stress on it when standing
up and weight bearing, then do them every few hours through theday. After the first 2-3 days as the acute back pain diminishes spend more time on your feet, taking regular 5 – 10 minute walks, this will aid in returning your spinal joints and muscles back to normal function.
Perform the exercises in numerical order. Only do the exercises to about 70% of full motion so as not to overstretch the damaged tissues but to gradually restore normal function by: relaxing tight muscles, stretching and strengthening weak muscles, relieving joint inflammation and swelling, increasing bloodflow to aid healing, and reducing joint stiffness. Peverell Chiropractic Clinic 2012.
Do the exercises rhythmically and if any exercise causes discomfort DO NOT CONTINUE WITH IT until your injury has recovered more fully.