Shoulder Instability

The shoulder joint is the most mobile joint in the body. This makes sense because we need to be able to reach overhead, reach in front of our bodies, reach behind our heads and reach behind our backs as part of our everyday function. Because it needs to be able to move in so many directions, the shoulder joint does not have a high degree of stability. Why does this matter?

The shoulder joint is one of the most dislocated joints in the body. To understand why, let’s talk about the anatomy of the shoulder.  When thinking of the shape of the shoulder and its ‘socket’, it is helpful to compare it to a golf ball sitting on a tee. The golf ball is much larger than the tee that it sets on. This is also true of the shoulder joint. The head of the arm bone (humerus) sits a small concavity called the glenoid. In our comparison, the humeral head is the golf ball and the glenoid is the tee. It does not take much force at all to knock the golf ball from its tee, right? Thankfully, the shoulder has some additional stabilizing structures to keep us from dislocating so easily:

1. The labrum is a ring-like structure on the periphery of the glenoid that deepens the ‘socket’ and acts like a suction cup to keep the humerus in place.

2. The capsule is the name given to the connective tissue/fascia that surrounds and envelops the shoulder joint (much like Saran-wrap).

3. Ligaments of the shoulder connect the humerus to the scapula and provide stability.

Injury to any of these built-in stabilizing features of the shoulder can create increased undesired motion of the humerus, or instability, resulting in pain and dysfunction.  When the static stabilizing features of the shoulder are compromised, the dynamic stabilizers become increasingly important. Dynamic stabilizers of the shoulder (i.e. the rotator cuff) are muscles that contract in a fashion to keep the humerus centered in the glenoid when using the arm.

It makes sense that injury to the labrum, the joint capsule or the ligaments of the shoulder can cause instability, but not all instability is traumatic. Some individuals are just more lax than others. We’ve all seen someone who is ‘double-jointed’ and can bend their bodies in ways that we never thought possible. Individuals who perform repetitive motions in extremes of ranges of motion (such as baseball pitchers) can also stretch ligaments or portions of the capsule without traumatic injury and develop atraumatic instability.

How does Physical Therapy Help?

If instability is not corrected, it can lead to further injury down the road. Your physical therapist will perform a thorough evaluation of your shoulder motion, strength, and function, and prescribe a plan of care designed to restore stability. This plan of care will differ based on whether the instability is traumatic or atraumatic.

Getting back into the Gym during COVID

by Karen Maldonado, Certified Personal Trainer

2020 has thrown quite the curveball into all our lives. Now that the country is slowly opening back up, gyms are starting to open their doors too. What can you do to get back into the gym safely to reach those goals?

1. Ease into your workout routine - With stay at home orders in place and months out of the gym, your body may be feeling stiff and weak. You will want to focus on warming up and stretching. Attempting to start where you last left off months ago can leave you open for injury. Start slow and build up your strength and endurance. It may seem like a drag to start over, but your body will thank you in the long run.

2. Disinfecting equipment - Wiping down equipment after each use is common practice in the gym. This will help keep you and everyone else safe. For extra precautions, consider wiping down beforehand. Make sure the staff are taking proper precautions to keep you safe by cleaning the facilities regularly.

3. Social Distancing - The CDC suggests keeping 6 feet of distance from others. Some gyms may require the use of face masks as well. D

4. Don't touch your face! - Keep a towel handy to wipe any sweat. When you're done with your workout, remember to wash your hands.

5. Stay at home if you're sick! For the sake of your health and the health of others, just stay home. Talk to your doctor about when it would be safe to return to the gym.

Whenever you're ready to head to the gym again, keep these tips in mind. Exercise is important for your health! Keep yourself, and everyone around you healthy.

You're Invited to our Ribbon Cutting Ceremony!

Please join us October 6, 2020 at 5pm for our Ribbon Cutting Ceremony at our new Ahwatukee Foothills location!

Pritchette Physical Therapy and Sports Performance has provided physical therapy, personal training, sports performance, and massage therapy services to Ahwatukee since 2009. Our focus on customer service and helping our patients and clients get results has lead to us being awarded a Best of Ahwatukee in multiple categories (Best Place for Physical, Best Place for Massage, Best Place for Customer Service, and Best New Business). In an effort to better serve our Foothills/Club West community we decided on a 2nd location in the Ahwatukee Foothills at 1331 E. Chandler Blvd. #102-103. Located at the intersection of Chandler Blvd. and Desert Foothills Parkway, we have placed ourselves in the heart of the Ahwatukee Foothills.

We are excited to show you our new facility and will be providing light refreshments for the ceremony. Please RSVP below!

What is Cranial Sacral Therapy?

Cranial sacral therapy is a type of massage therapy that relieves compression in the bones of the head, sacrum, and spinal column.

Cranial Sacral Therapy uses gentle pressure on the head, neck, and back to relieve the stress and pain caused by compression. This helps reset the Cranial Rhythm.

The Cranial Rhythm is an echo that pulses from your brain down your entire body. Emotional and physical trauma can disrupt this Rhythm. In a session, holds are placed onto your head that cause the body and mind to reset for an hour and feel like you just took a nap. The effects last for 48 hours making you feel like you had a great night’s sleep the night after the session.

This is just one of the massage modalities that are practiced by our massage therapy team. Contact our office at 480-785-5415 to speak with one of our massage therapists about what massage therapy modality will work with you.

What is Functional Range Conditioning?

Functional Range Conditioning (FRC) can be thought of as a system of strength training for the joints. First the joint range of motion is assessed, then workspace within the joint capsule is addressed, and then strength training of the joint and involved soft tissue, (muscles, ligaments, tendons, etc), is done through different techniques.

If you are a physical therapy client and have been cleared by your therapist, FRC is the perfect next step. Functional Range Conditioning work can now take you to the next level of strengthening the injured area, by increasing stability, and closing the gap between passive range of motion and active range of motion, which is where most injuries occur.

FRC is also the perfect adjunct training for any activity, whether it be weight lifting, CrossFit, martial arts, or any sport. Through FRC assessment, we will find where your weak spots are and how your body compensates. From there we will work together to improve joint function, tissue strength, and range of motion. For example, if you are engaging in a sport or exercise that requires you to have power in shoulder extension, like overhead press or a tennis serve for example, but you don’t have the active range of motion in your shoulder to perform this move, your body is going to find some other place to move from to give you that range. This is not good for the joint.

Whatever sport or activity you are in, Functional Range Conditioning can help increase your performance, and prevent/decrease injury. If you are just beginning, or returning to exercise, FRC is the safest way to begin and can be done by anyone at any fitness level. Much of the work is done through isometric contractions, which is not only the strongest way to train and the best way to increase active range of motion (mobility), but is also the safest, as there is no shearing of the joint or soft tissues. Tanya Paty, is our certified Functional Range Conditioning specialist and is available to help you improve your joint performance. Contact her at 480-785-5415 or email her at T.Paty@pritchettept.com