2006-11-24 / Columnists

Eye On Physical Therapy

Commentary By Dr. Tim Rohrs, DPT

The past few Eye on PT columns have focused on tissue healing. Giving the body the opportunity to heal and maintaining strength flexibility and mobility have all been goals of physical therapy so far. The last and final component to therapy is future prevention of the same incident.

If the injury had a clear onset such as a fall, car accident, or sport injury, the prevention of injury is much easier; not to let a reoccurrence of the same injury. Too many times the injury is unclear. "It just started one day." "I had a twinge of pain and it got progressively worse." In these instances on what do we blame the pain and injury? Some bio mechanical deviation is often to blame. Poor postural habits over the years can play a big role. One often sees little old ladies with "Dowager's Humps" and rounded shoulders. These take years to develop and may be pain free until they reach the point where it is noticeable to everyone else. This aberrant posture throws off the mechanics of both the head and neck causing headaches and neck pain, mid back pain as well as shoulder dysfunction pain and possible rotator cuff tears.

In addition to poor posture, the way we sleep can affect the way our muscles and joints function. Sleeping for eight hours a night in a dominant position, meaning the one position we return to often during sleep, can cause joint dysfunction over time. For myself, I started to sleep on my left side with my left arm overhead and my head resting on my arm. After doing that for about two months I started to develop left shoulder pain. I had no idea what caused the pain but it started to be painful to lift things heavier than five pounds shoulder height. Then I started to get numbness and tingling in my left hand while working on patient's backs and necks. I started to do some rotator cuff strengthening exercises. The pain was a little less after two weeks but the numbness and tingling was still there. I then noticed that the pain was more noticeable in the shoulder when I assumed that position in bed at night. I made a conscious effort to keep my left arm down at my side at night. Within two weeks the pain and numbness and tingling was gone.

Finally, another cause of pain and injury is repetitive stress. Some may have heard of this before. This is from doing a certain activity day after day such as using a keyboard or mouse for eight hours a day. When this is the onset of pain, a careful examination of the work site for proper ergonomics is needed. Often a small change in the position of monitor, keyboards, chair etc. is all that is needed to relieve the stress and allow healing to take place.

To make the most of your course of physical therapy treatments, tell your therapist everything. Talk about all the activities that cause pain, what makes it feel better and what makes it worse, when it started. The more your therapist knows, the better the chance to be a successful detective and make the appropriate changes.

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