The infraspinatus muscle is one of the muscles that makes up the rotator cuff. It originates on the infraspinous fossa of the scapula, and inserts on the middle facet of the greater tubercle of the humerus. It functions to externally rotate the humerus and to stabilize the head of the humerus in the glenoid cavity during upward movement of the arm. Trigger points in this muscle refer pain deep into the anterior shoulder joint and down the anterior arm. Trigger points near the lower medial border refer pain into the rhomboids. This muscle is often injured during throwing motions.
lifestyle
Is there an actual cure all?
No; but exercise seems to be as close as we will ever get!
Some of you may have heard about how a modified form of boxing is helping patients with Parkinson’s disease (PD). If you haven’t, it’s been observed that people with Parkinson’s disease (PD) who engage in this boxing-like exercise routine can enhance their quality of life and even build impressive gains in posture, strength, flexibility, and speed. Proponents of the program report that regardless the degree of severity of PD, participants have a happier, healthier, and higher quality of life.
But must it be boxing? Maybe not. A report presented at the International Congress of Parkinson’s Disease and Movement Disorders in San Diego in June 2015 found that patients with Parkinson’s disease who began regular exercise early into the PD process had a much slower decline in their quality of life when compared with those who started exercising later. The researchers found just 2.5 hours per week of exercise is needed to improve quality of life scores. According to the report, it didn’t matter what exercise the participants did — simply getting up and moving for a total of 2.5 hours/week was reportedly enough (that’s only 20-25 minutes / day)!
Looking beyond Parkinson’s, other chronic conditions also benefit from adding exercise into a person’s lifestyle. Studies show that regular exercise as simple as walking helps reduce one’s risk for memory loss, and it slows down functional decline in the elderly. Incorporating aerobic exercise into one’s lifestyle can also improve reaction time in people at ALL AGES. Exercise has also been shown to improve both physical and emotional well-being in those afflicted with Alzheimer’s disease with as little as 60 minutes/week of moderate exercise! Patients with multiple sclerosis (MS) have also reported less stiffness and less muscle wasting when using exercise machines, aquatic exercise, and/or walking.
Research has shown just 30 minutes of brisk exercise three times a week can help reduce depressive symptoms in patients with mild-to-moderate depression. In a study involving teenagers, those who engaged in sports reported a greater level of well-being than their sedentary peers, and the more vigorous the exercise, the better their emotion health! In kids 8-12 years old, physical inactivity is strongly linked to depression.
Even anxiety, stress, and depression associated with menopause are less severe in those who exercise! So LET’S ALL GET OUT THERE AND EXERCISE!!!
What is Scoliosis?
Your spine is made up of 24 bones that stack on top of each other- normally in a straight line. “Scoliosis” means that your spine is curving from side to side, rather than being straight. Scoliosis affects between 1-3% of the population. Scoliosis may begin at any time between birth and adulthood but is most common during times that your skeleton is growing rapidly. Most cases of scoliosis begin between the ages of 13 and 18. Researchers are not completely certain why some people develop scoliosis, but they have found that the problem tends to run in families.
The curve of your scoliosis may be measured with an x-ray. Although some curves get worse, most do not. In fact, only ¼ of all adolescent idiopathic scoliosis curves will progress. Small curves in mature patients have a low risk of progression (2%), while large curves in younger patients progress more frequently. (70%) Curve progression is more common in girls, especially those with larger curves (greater than 20 degrees). Your doctor may need to monitor your scoliosis for progression by performing x-rays every 6-18 months.
Scoliosis may cause your shoulders, hips, or waist to be unlevel. Most curves are classified as “right thoracic”, which means that the peak of your curve protrudes toward the right. This is often accompanied by a forward rotation of your right shoulder and “winging” of your right shoulder blade. Many patients have a secondary curve in their lower spine that helps to balance their body. The majority of patients with mild to moderate scoliosis have no symptoms, but approximately ¼ report back pain. Unfortunately, scoliosis increases your risk of developing back pain later in life.
The primary goal of treatment is to stop curve progression. While many cases can be slowed or even reversed through appropriate management, it is important to recognize that others may progress in spite of the best care. Conservative care, including spinal manipulation (like the type provided in our office) has been shown to help some patients with scoliosis. Exercise is another effective treatment for scoliosis. It is important that you clearly understand your home exercise program and that you perform it consistently.
Patients with larger curves (30-40 degrees), or those who are at high risk for progression may benefit from wearing a brace. Braces have been shown to decrease the need for surgery in about three out of four patients. Fortunately, less than 0.3% of all scoliosis cases will ever require surgery.
You should avoid carrying heavy back packs and consider switching to a wheeled version, if necessary. Sports and exercise will not worsen most cases of scoliosis, and you should continue to participate in the things you enjoy unless directed otherwise by your doctor. The diagnosis of scoliosis is always discouraging, but you must focus on what it is really most important. Be confident in who you are! Don’t let something like a curved spine (or any other medical condition) define you as a person.
Exercise Tip Of The Month
Women are often afraid to lift weights for fear they will look too “bulky”, but actually
that’s not what happens.
Women can and should do weight lifting exercises if they want to shed body fat and achieve a toned physique. Strength training 30 to 40 minutes twice a week for 4 months, could increase an average woman’s resting metabolism by 100 calories a day, meaning you’ll be burning calories even when you’re not exercising.
Trigger points in the triceps muscle.
The tricep muscle is named for its three heads long, medial, and lateral. The long head originates on the infraglenoid tubercle, the medial head on the posterior humerus, and the lateral head on the posterior humerus as well. They join together to insert on the Olecranon process of the ulna. The triceps function to extend the elbow. Strong extension under resistance can cause trigger points to form. Pain referred from triceps trigger points can be felt in the posterior shoulder and down the posterior forearm, as well as in in the olecranon process and the lateral epicondyle which can cause “tennis elbow” pain.
My knee hurts; I must have bad knees….
Due to bipedal locomotion (walking around on two legs), foot and ankle problems have the potential to affect EVERYTHING above the feet—even the knees!
When analyzing the way we walk (also known as our gait), we find when the heel strike takes place, the heel and foot motion causes “supination” or the rolling OUT of the ankle. As the unloaded leg begins to swing forwards, there is a quick transition to pronation where the heel and ankle roll inwards and the medial longitudinal arch (MLA) of the foot flattens and pronates NORMALLY!
During the transition from supination to pronation, the flattening of the MLA acts like a spring to propel us forwards followed by the “toe off”, the last phase, as we push off with our big toe and the cycle starts with the other leg. However, if you watch people walk from behind, you will see MANY ankles roll inwards too much. This is call “hyperpronation” and that is NOT NORMAL!
So at what point does this normal pronation become hyperpronation? The answer is NOT black and white, as there is no specific “cut-off” point but rather, a range of abnormal. Hence, we use the terms mild, moderate, and severe hyperpronation to describe the variance or the degrees of abnormality. Hyperpronation can lead to the development of bunions and foot/ankle instability that can cause and/or contribute to knee, hip, pelvis, and spinal problems—even neck and head complaints can result (the “domino effect”)!
One study looked at the incidence of hyperpronation in 50 subjects who had an anterior cruciate ligament (ACL) rupture vs. 50 without a history of knee / ACL injury. They found the ACL-injured subjects had greater pronation than the noninjured subjects suggesting that the presence of hyperpronation increases the risk of ACL injury.
Doctors of chiropractic are trained to evaluate and treat knee conditions of all kinds. Often this may include prescribing exercises or utilizing foot orthotics in an effort to restore the biomechanics of the foot, which can have positive effects not only on the knees but also further up the body.
Work Station Ergonomics Advice
When dealing with Upper Crossed Syndrome the ergonomics of your workstation should be at the from of mind. Some workstation ergonomics advice is as follows:
✓ Maintain proper body position and alignment while sitting at your desk – Hips, knees and elbows at 90 degrees, shoulders relaxed, feet flat on floor or footrest.
✓ Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge.
✓ Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
✓ Monitors should be visible without leaning or straining and the top line of type should be 15 degrees below eye level.
✓ Use a lumber roll for lower back support.
✓ Avoid sitting on anything that would create an imbalance or uneven pressure (like your wallet).
✓ Take a 10-second break every 20 minutes: Micro activities include: standing, walking, or moving your head in a “plus sign” fashion.
✓ Periodically, perform the “Brugger relief position” -Position your body at the chair’s edge, feet pointed outward. Weight should be on your legs and your abdomen should be relaxed. Tilt your pelvis forward, lift your sternum, arch your back, drop your arms, and roll out your palms while squeezing your shoulders together. Take a few deep cleansing breaths.
Addressing these areas will help reduce your symptoms, make your care more effective and the duration of pain decrease. If you need help with ergonomics or want more information, please contact us at info@aberdeenchiropratcic.com
Chronic Lumbar Disc Pain
Your low back consists of 5 individual vertebrae stacked on top of each other. Flexible cushions called “discs” live between each set of vertebrae. A disc is made up of two basic components. The inner disc, called the “nucleus”, is like a ball of jelly about the size of a marble. This jelly is held in place by the outer part of the disc called the “annulus”, which is a tough ligament that wraps around the inner nucleus much like a ribbon wrapping around your finger.
Your low back relies on discs and other ligaments for support. “Discogenic Low Back Pain” develops when these tissues are placed under excessive stress, much like a rope that frays when it is stretched beyond its normal capacity. Most commonly, disc pain is not the result of any single event, but rather from repeated overloading. Your lumbar discs generally manage small isolated stressors quite well, but repetitive challenges lead to injury in much the same way that constantly bending a piece of copper wire will cause it to break. Examples of these stressors include: bad postures, sedentary lifestyles, poor fitting workstations, repetitive movements, improper lifting, or being overweight.
Approximately one third of adults will experience pain from a lumbar disc at some point in their lifetime. The condition is more common in men. Most lumbar disc problems occur at one of the two lowest discs- L5 or L4. Smokers and people who are generally inactive have a higher risk of lumbar disc problems. Certain occupations may place you at a greater risk, especially if you spend extended periods of time sitting or driving. People who are tall or overweight have increased risk of disc problems.
Symptoms from disc pain may begin abruptly but more commonly develop gradually. Symptoms may range from dull discomfort to surprisingly debilitating pain that becomes sharper when you move. Rest may relieve your symptoms but often leads to stiffness. The pain is generally centered in your lower back but can spread towards your hips or thighs. Be sure to tell your doctor if your pain extends beyond your knee, or if you have weakness in your lower extremities or a fever.
Repeated injuries cause your normal healthy elastic tissue to be replaced with less elastic “scar tissue.” Over time, discs may dehydrate and thin. This process can lead to ongoing pain and even arthritis. Patients who elect to forego treatment and “just deal with it” develop chronic low back pain more than 60% of the time. Seeking early and appropriate treatment like the type provided in our office is critical.
Depending on the severity of your injury, you may need to limit your activity for a while, especially bending, twisting, and lifting, or movements that cause pain. Bed rest is not in your best interest. You should remain active and return to normal activities as your symptoms allow. Light aerobic exercise (i.e. walking, swimming, etc) has been shown to help back pain sufferers. The short-term use of a lumbar support belt may be helpful. Sitting makes your back temporarily more vulnerable to sprains and strains from sudden or unexpected movements. Be sure to take “micro breaks” from workstations for 10 seconds every 20 minutes.
Pathophysiology of trigger points.
A large number of factors have been identified as causes of trigger point activation. These include acute or chronic overload of muscle tissue, disease, psychological distress, systemic inflammation, homeostatic imbalances, direct trauma, radiculopathy, infections, and lifestyle choices such as smoking. Trigger points form as a local contraction of muscle fibres in a muscle or bundle of muscle fibres. These can pull on ligaments and tendons associated with the muscle which can cause pain to be felt deep inside a joint. It is theorized that trigger points form from excessive release of acetylcholine causing sustained depolarization of muscle fibres. Trigger points present an abnormal biochemical composition with elevated levels of acetylcholine, noradrenaline and serotonin and a lower ph. The contracted fibres in a trigger point constricts blood supply to the area creating an energy crisis in the tissue that results in the production of sensitizing substances that interact with pain receptors producing pain. When trigger points are present in a muscle there is often pain and weakness in the associated structures. These pain patterns follow specific nerve pathways that have been well mapped to allow for accurate diagnosis or the causative pain factor.
Diagnosis of trigger points.
Diagnosis of trigger points typically takes into account symptoms, pain patterns, and manual palpation. When palpating the therapist will feel for a taut band of muscle with a hard nodule within it. Often a local twitch response will be elicited by running a finger perpendicular to the muscle fibres direction. Pressure applied to the trigger point will often reproduce the pain complaint of the patient and the referral pattern of the trigger point. Often there is a heat differential in the local area of the trigger point. 
Aberdeen Chiropractic 