Thursday, May 18, 2017

Common Conditions Of The Shoulder Joint

By Dr. John A. Papa, DC, FCCPOR(C)
 
The shoulder is one of the largest and most complex joints in the body.  It is anatomically designed to allow for an individual to perform a wide range of movements and activities.  This versatility, along with the high physical demands placed on a shoulder can also make it vulnerable to breakdown and injury.
 
Listed below are some of the conditions that commonly cause shoulder problems:
·        Osteoarthritis: Results from the protective layers of cartilage in the shoulder becoming worn over a period of time, leading to change in the composition of the bone underneath the cartilage. This process may also be related to previous injury/trauma to the shoulder joint.
 
·        Frozen Shoulder:  Also known as adhesive capsulitis, this condition is a painful and persistent stiffness in the shoulder.  It is believed to be caused by thickening, swelling, and tightening of the flexible tissue that surrounds the joint.  Symptoms can vary greatly and can last anywhere from several months to several years.
 
·        Rotator Cuff and Soft Tissue Injuries:  The rotator cuff is a group of muscles and tendons that provide stability and rotational movements of the shoulder joint in a balanced fashion.  Other shoulder muscles are responsible for different ranges of motion of the upper arm (humerus) and proper positioning and movement of the shoulder blade (scapula) along the ribcage.  An injury can occur to any of these muscles which can lead to shoulder problems.

·        Mechanical Conditions:  Scapular dyskinesis is a mechanical term used to describe irregular movement of the shoulder blade.  It can be an early sign that a shoulder problem may develop, or it may already be accompanied by pain or dysfunction in the shoulder.  A mechanical change in shoulder blade movement can be associated with a variety of problems including an internal pinching of soft-tissue structures (impingement), irritation of the cushioning bursa (bursitis), or a feeling of the shoulder dislocating with certain movements (instability).

·       Traumatic Injuries:  Vigorous lifting, pushing, and pulling activities, or a fall onto or blow to the shoulder can result in ligament sprains or muscle strains.  More significant injuries can result in shoulder dislocations and separations, rotator cuff and soft tissue tears, cartilage labral tears, and fracture.

Balanced and stable movements are key to a healthy shoulder.  If this does not occur, there is potential for many shoulder problems to exist simultaneously at any given time.  For example, an individual may strain their shoulder from heavy lifting.  The shoulder strain may be causing pain, but it can also be accompanied by pain and weakness from impingement and bursitis that may arise from the irregular movement pattern of the shoulder.  Therefore, it is important that a proper evaluation is performed to best guide the treatment of shoulder conditions.

If you suffer from a shoulder problem that is limiting your daily functioning, contact a qualified health professional who can prescribe appropriate therapy, rehabilitation, and self-management strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Wednesday, May 10, 2017

Solutions For Overcoming Poor Sitting Posture

By Dr. John A. Papa, DC, FCCPOR(C)

An ideal posture allows an individual to maintain an efficient, strong, and balanced position while interacting and adapting to their physical environment.  Good postural habits can help decrease abnormal and excessive physical strain on the body, thereby minimizing the chance of injury.
 
Unfortunately, modern technology has significantly influenced our daily postural habits, which has resulted in having people sit more often and for longer periods of time.  Individuals exposed to these sitting positions may adopt a poor posture that includes losing the natural hollow of the low back, rounding or slouching of the upper back and shoulders, and a forward head poking position.
 
Less than ideal posture puts cumulative compression, stretch, and shear forces on the body.  The cumulative effects of sitting are often offset by the body’s ability to compensate.  However, even in the absence of pain, these compensatory changes may begin a vicious cycle of unbalanced motion, muscle and joint stress, and secondary areas of discomfort.  As a result, the physical consequences of chronic poor posture can lead to symptoms such as muscle and joint stiffness, nerve pain, headaches, shoulder pain, neck pain, upper and lower back pain.
 
Listed below are some potential solutions that can minimize the chance of postural injury, specifically as it pertains to the sitting position:
 
1.    Pay attention to how you sit by making sure weight is evenly distributed in your seat, your shoulders are not rounding forward, and you are not slouching.  Your head should be resting on your torso and not poking forward.

2.    Take a break from sitting with 10 to 30 second stretch or posture breaks every 20 to 40 minutes.  Some activities such as computer work, talking on the phone, and business meetings can also be done while standing.

3.    The use of a properly designed workstation (i.e. adjustable chair and desk), along with ergonomic tools and assistive devices (i.e. speakerphones, foot stools, lumbar supports) can help maintain mechanically advantageous positions while working in a seated position.

4.    Avoid unnatural positions such as looking down, awkward twisting, or slouching for long periods of time as this can cause unnecessary strain.  A simple solution may be to bring your smartphone, tablet, or book closer to eye level, or adjusting your seat position to help you maintain a more natural/neutral position.

5.    Engaging in regular physical activity and exercise can keep your body strong and help overcome the effects of cumulative strain associated with poor posture.  Exercise activities can include general cardiovascular conditioning, along with postural, stretching and strengthening exercises for the neck, shoulders, upper and lower back regions.

Prolonged sitting and poor posture can undeniably cause real physical change and breakdown in the body.  If you have ongoing pain as a result of postural strain, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Friday, May 5, 2017

What Does It Mean To Have Degenerative Joint Changes?

By Dr. John A. Papa, DC, FCCPOR(C)

Have you had a joint problem and been told that you have "degeneration" or "degenerative changes"?  What exactly does this mean?  Is this something that can be fixed?  Let's take a closer look at two common types of degenerative changes and some potential management strategies that can be employed.
 
1.    Degenerative Joint Disease (DJD) is also known as osteoarthritis, and is the most common form of arthritis.  Weight-bearing joints such as the hips and knees are most commonly affected, but DJD can affect any area of the body, including the hands, neck, and low back.
 
Most joints in our body have smooth cartilage surfaces that glide against each other, which allow two or more opposing bones to move freely and perform a specific set of movements.  A joint becomes "degenerated" or arthritic when there is wearing down of these cartilage surfaces, and a change in the composition of the bone underneath the cartilage occurs.  An arthritic joint does not mechanically function like it is supposed to.  This may result in a number of symptoms including:  muscle tightness and weakness, joint pain and stiffness, decreased ranges of motion, creaking in the joints, swelling, inflammation, and joint thickening (i.e. finger nodules, bunions).
 
2.    Degenerative Disc Disease (DDD) specifically affects the spinal discs between each vertebrae and is also considered an arthritic disorder.  Spinal discs allow for some movement between vertebrae, and they also absorb compressive, tensile, and shearing loads with everyday activities.
      The centre of the disc, called the nucleus pulposis, is jelly-like and mostly made up of water. The outside of the disc, called the annulus fibrosis, is tough and thick and contains the nucleus pulposis.  Over time, the water content of the spinal disc diminishes, causing it to dry out and become fibrotic (tough and brittle).  As the disc becomes fibrotic it can develop tears.  This breakdown can result in disc herniations, the development of bony spurs, and sciatica.
 
Risk factors/causes for DJD and DDD are typically multi-factorial, meaning that there is usually no single cause, but rather a combination of several different factors.  These risk factors/causes may include but are not limited to: advancing age, genetic predisposition, mechanical overload from occupational and recreational activities, direct injury to the affected region, cigarette smoking, lack of exercise, and being overweight or obese.
 
Degenerative changes can result in debilitating symptoms for some individuals and can be managed a number of ways.  Maintaining an ideal body weight through a healthy diet and regular exercise consisting of strength, flexibility, and endurance training can reduce the risk of pain and subsequent disability.  Treatment from licensed health professionals who utilize manual mobilization therapies, soft tissue therapy, electrotherapy, acupuncture, exercise and rehabilitation strategies can also significantly help to decrease pain by restoring normal muscle and joint motion, and promote healing of arthritic or injured areas.
 
In the event that you suffer from degenerative joint changes, you should contact a licensed health professional who deals in the diagnosis and treatment of these conditions.  For more information, visit www.nhwc.ca.
 
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Monday, May 1, 2017

Taking Care Of Your Feet

By Dr. John A. Papa, DC, FCCPOR(C)

The feet are an individual’s contact points with the ground, so how they support the rest of the body is critical.  Our feet have nearly 100 individual working parts, which all have to function together when we stand, walk, run and jump to provide proper stability and balance.
 
When a small problem develops in our feet, the subtle changes in the way we move can cause a chain reaction of adjustments in our posture and walking mechanics.  This can lead to symptoms such as: localized foot pain, arch and heel pain, along with ankle, knee, hip, and back pain.
 
Protecting your feet and choosing proper footwear can go a long way in preventing injury and pain.  Below are some helpful tips that can ensure your feet are protected and functioning to the best of their ability.
 
·        Choose footwear that is appropriate for your foot type.  For example, people with low arches, called pronators, will need a shoe that provides some degree of stability.  A shoe with good cushioning is important for people with high arches, called supinators.
 
·        Select a footwear store with knowledgeable staff who can provide advice on the shoe that best suits your activity, body structure and type of foot.  Shop in the afternoon or evening, as your feet tend to accumulate fluid and swell throughout the day.  What may have been comfortable earlier in the day could now feel tight later in the day.
 
·        Remember that not all shoes are created equally.  The same shoe sizes can have different fits depending on the manufacturer.  Be sure to try several sizes to find the most comfortable shoe.
 
·        Avoid buying shoes that you feel need a break-in period.  Shoes should be comfortable from the first time you put them on.
 
·        Don't cheap out on your shoes!  Better quality shoes may cost more but will pay off in terms of support and sturdiness.  A mid-priced shoe may offer the best value.
 
·        Do not hesitate to replace footwear after excessive wear as it may not be providing you with proper support and stability.
 
·        Consider custom orthotics to help support your feet.  Orthotics are mechanical aids that fit into your shoes as comfortably as an insole and work on your feet much like glasses work on your eyes – they decrease stress and strain on your body by bringing your feet into proper alignment.  This helps rebalance your feet and reduces pain and discomfort by enhancing your body’s natural movements.
 
·        Remember to exercise regularly and try to maintain a healthy weight.  Extra weight adds extra stress on your feet, knees, hips, and back.
 
In the event that you suffer a muscle or joint injury related to your feet that does not subside, you should contact a licensed health professional.  For more information, visit www.nhwc.ca.
 
This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.