Dr Janet travel coined the term trigger point in 1942 to describe clinical findings with characteristics of pain related a discrete irritable point in muscle or fascia that was not caused by acute trauma, inflammation, degeneration, neoplasm or infection. The painful point can be palpated as a nodule or tight band in the muscle that can produce a local twitch response when stimulated. Palpation of the trigger point reproduces the pain and symptoms of the patient and the pain radiates in a predictable referral pattern specific to the muscle harbouring the trigger point.
fitness
Do I have a cuff tear?
One of the most common causes of shoulder pain is a rotator cuff (RC) tear. To determine just how common this is, one study looked at a population of 683 people regardless of whether or not they had shoulder complaints. There were 229 males and 454 females for a total of 1,366 shoulders. (The participants’ average age was 58 years, ranging from 22 to 87 years old.)
The research team found 20.7% had full thickness rotator cuff tears. Of those with shoulder pain, only 36% had tears found on ultrasound. Of those without shoulder pain, 17% also had tears! Risk factors for an increased for tearing of the rotator cuff include a history of trauma, the dominant arm (ie your right arm if you’re right handed), and increasing age.
In a review of radiologic studies of 2,553 shoulders, researchers found full-thickness rotator cuff tears in 11.75% and partial thickness tears in 18.49% of the subjects for a total of 30.24% having some degree of tearing. In this group, about 40% of tears were found in pain-free shoulders. The researchers concluded that rotator cuff tears are common and frequently asymptomatic.
Both of these studies support the necessity to FIRST consider the patient’s clinical presentation and then correlate that with the imaging results. In other words, the presence of a RC tear on an image (usually MRI or ultrasound) does NOT necessarily mean there is pain (and vise versa)!
So what other things could be causing the shoulder pain? There are many: impingement, tendonitis, bursitis, muscle strain, capsular (and other ligament) sprain, frozen shoulder, and osteoarthritis (the “wearing out” type). Also, rheumatoid arthritis, lupus, polymyalgia rheumatica and other autoimmune types of “arthropathies,” fibromyalgia, a herniated cervical disk, shoulder dislocations, whiplash injuries, and more!
Most importantly, we must NOT forget to include referred pain to the shoulder from an impaired heart (such as coronary heart disease or heart attack), lung, liver, or gall bladder as these problems commonly refer pain to the shoulder and may represent a MEDICAL EMERGENCY!
What to expect with a trigger point massage.
A treatment with Bryan is very user friendly. And, no, you don’t have to remove any clothing. However, bringing a t-shirt and a pair of shorts or sweats is recommended.
The first time you come for a treatment you will be asked to fill out a Client History form. Bryan will go over the information you provide, asking for more detail and discussing the type of pain you are having and its location.
The treatment itself involves locating the Trigger Points in the muscle or soft tissue and applying a deep focused pressure to the Point. This will reproduce the pain and the referral pattern that is characteristic of that pain.
The treatment will be uncomfortable at first, but as the Trigger Points release, the pain will decrease. The pressure will always be adjusted to your tolerance level. If, at any time, you feel too uncomfortable you can ask Bryan to ease off a bit.
Depending on your specific problem, Bryan may also use some stretching and / or range-of-motion techniques, as needed.
After treatment, it is usually recommended that the client apply moist heat to the area treated.
Trigger points in the deltoid muscle.
The deltoid is the the muscle that is most often thought of as the “shoulder.” It is the diamond shaped muscle that caps the shoulder joint. It originates on the clavicle, the acromion, and the spine of the scapula. It inserts on the deltoid tuberosity of the humerus. As a whole unit the deltoid laterally abducts the humerus at the glenohumeral joint. The anterior portion of the delt forward flexes the arm, as well as horizontally flexing the arm across the chest. Since the deltoid is involved in almost all shoulder movements it is especially prone to trigger points. Points in the anterior deltoid refer into the anterior and lateral shoulder. Trigger points in the posterior deltoid refer pain into the posterior shoulder with spillover down the lateral arm. 
Home Gym Essentials
So you want to build your own home gym but you have no idea what kind of equipment to buy. There are two main limiting factors in outfitting a workout area in your house or apartment—space and budget—but with proper planning, you can design an exercise studio perfectly tailored to your needs. Simply start with the essentials, and then branch out to more specialized equipment as you need it. Below are a few of the essentials that can get your started on your home gym journey.
Quality Mats
No matter what your plans are for your home gym a good quality floor mat is key. You can opt for the single mat for stretching and floor work or go shoe hog with an entire flooring system but be sure to go with a high quality, durable product. Rogue Canada has some great products in this (and most) category from floor mats to olympic lifting platforms, as do spots from Fitness Experience to Home Depot.
Suspension Trainer
Maximizing use of space and finding tools with multiple uses are keys when designing your home gym. One of the best pieces of equipment for both those concerns are suspension trainers. The TRX Home2 System is one of the best purchases you can make for your home gym. It includes the latest TRX Suspension Trainer for homes, as well access to the TRX app. (With more than 80 workouts designed by world-class trainers, the app will keep you busy.) While the Home2 System costs less than $200, it is one of the bigger purchases on this list. What makes it worthwhile is that Suspension Training offers a full-body workout that can be modified for any fitness level.
Resistance Bands
Easy to store, easy to use, easy to afford and easy to scale. Resistance bands are a great addition to any home gym. From stands of tubing to elastic loops and heavy resistance with handles, resistance bands come in many shapes and sizes and can be used to add to any fitness routine. Depending on your fitness goals, resistance tubing can be your main source of muscle building or an add oil that enhances lifts. They are a rehab essential as well when working through those nagging injuries that we all get from time to time and a key part of training for pliability as shown in the TB12 method. Every major fitness retailer has dozens of options for you and can help you decide on what you need based on your goals.
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This list is a great start for your home fitness journey but isn’t all inclusive by any means. Everyone’s goals are different, require different levels of equipment and different levels of motivation. The key with any of them is to get committed, get started and get moving!
What evidence do we have of whiplash?
Whiplash, or WAD (Whiplash Associated Disorders), refers to a neck injury where the normal range of motion is exceeded, resulting in injury to the soft-tissues (hopefully with no fractures) in the cervical region. There are a LOT of factors involved that enter into the degree of injury and length of healing time. Let’s take a closer look!
Picture the classic rear-end collision. The incident itself may be over within 300 milliseconds (msec), which is why it’s virtually impossible to brace yourself effectively for the crash as a typical voluntary muscle contraction takes two to three times longer (800-1000 msec) to accomplish.
In the first 50 msec, the force of the rear-end collision pushes the vehicle (and the torso of the body) forwards leaving the head behind so the cervical spine straightens out from its normal “C-shape” (or lordosis). By 75-100 msec, the lower part of the neck extends or becomes more C-shaped while the upper half flexes or moves in an opposite direction creating an “S” shape to the neck. Between 150-200msec, the whole neck hyper extends and the head may hit the head rest IF the headrest is positioned properly. In the last 200-300 msec, the head is propelled forwards into flexion in a “crack the whip” type of motion.
Injury to the neck may occur at various stages of this very fast process, and many factors determine the degree of injury such as a smaller car being hit by a larger car, the impact direction, the position of the head upon impact (worse if turned), if the neck is tall and slender vs. short and muscular, the angle and “springiness” of the seat back and relative position of the headrest, dry vs. wet/slippery pavement, and airbag deployment, just to name a few.
Some other factors that can predict recovery include: limited neck motion, the presence of neurological loss (nerve specific muscle weakness and/or numbness/tingling), high initial pain levels (>5/10 on a 0-10 scale), high disability scores on questionnaires, overly fearful of harming oneself with usual activity and/or work, depressive symptoms, post-traumatic stress, poor coping skills, headaches, back pain, widespread or whole body pain, dizziness, negative expectation of recovery, pending litigation, catastrophizing, age (older is worse), and poor pre-collision health (both mental and physical).
Research shows the best outcomes occur when patients are assured that most people fully recover and when patients stay active and working as much as possible. Studies have shown it’s best to avoid prolonged inactivity and cervical collars unless under a doctor’s orders. It’s also a good idea to gradually introduce exercises aimed at improving range of motion, postural endurance, and motor control provided doing so keeps the patient within reasonable pain boundaries. Chiropractic manipulation restores movement in fixed or stuck joints in the back and neck and has been found to help significantly with neck pain and headaches, particularly for patients involved in motor vehicle collisions. A doctor of chiropractic may also recommend using a cervical pillow, home traction, massage, and other therapies as part of the recovery process.
It is important to be aware that fear of normal activity and not engaging in usual activities and work can delay healing and promote chronic problems and long-term disability. It’s suggested patients avoid opioid medication use due to the addictive problems with such drugs. Ice and anti-inflammatory herbs or nutrients (like ginger, turmeric, and bioflavonoids) are safer options. Your doctor of chiropractic can guide you in this process!
The Bird Dog
Today we are going to look at one of the most effective exercises to protect your lumbar spine from discogenic injury, the bird dog. A great way to work on both posterior chain and rotational stability, the bird dog is safe, effective and simple.
- Get on your hands and knees (four point position) with your knees and hands, hip and shoulders width apart.
- Your back is in neutral position (slightly arched) and your chin must be tucked in.
- Activate your lower abdominals (transversus abdomini) by bringing your belly button inward and by activating your pelvic floor muscles 20 to 30% of maximal contraction.
- Maintain a steady abdominal breathing while you simultaneously lift one leg backwards and the opposite arm overhead keeping your back in neutral position.
- Return to the initial position and repeat with the other leg and arm.
2 sets of 10 reps as part of your regular core/stability routine will have you well on your way to a life-proof low back!
Image and instructions from physiotec.ca
The Best Piece Of Fitness Gear?
For my money I still believe that the classic TRX suspension trainer is the best piece of fitness equipment out there. Easy to use, super effective, safe, compact and scalable. All fitting into a little bag you can throw in your backpack or purse to take with you.
We have kids as young as 7 using it (my kids want to “work out” with us but are too young for weights, kettlebells and treadmills. The TRX is a great way to have them as part of your fitness routine in a safe way) and adults in their 70’s too (both my parents use the TRX to stay strong and limber in the retirement years).
With dozens of exercises and workouts at your disposal online you’ll never get bored and never find it “too easy”.
Check out the original TRX and all their cool accessories here:
Lumbar Spine Stabilization
This is a great way to increase the stability of your lower back.
- Lie with your stomach over a therapeutic ball while stabilizing yourself with your feet and arms and keep your head in line with your body.
- Tighten your abdominal muscles to flatten the spine by pulling your belly button towards your back and hold the contraction throughout the exercise.
- Bend one knee and lift it up towards the ceiling.
- Lower the leg and repeat on the other side.
Our Exercise Of The Month: Dead Bug
Begin lying on your back with your right arm reaching overhead and your left leg flat on the table. Your right knee should be bent 90 degrees and your hip 45 degrees. Place your left wrist beneath your back to prevent your back from flattening against the ground. Slowly begin by raising your left knee and right arm at the same time until your hand touches your knee. Be sure not to lift your head or allow your spine to flatten against the floor. Return to the start position and repeat for three sets of 10 repetitions on each side, twice per day or as directed.
Aberdeen Chiropractic 