Rest is best, right?  Well, it's a bit more complicated than that.  Of course there are times where rest can help resolve some muscle soreness, especially if you have been training high volumes with your lifts or if you have significantly increased your mileage with running.  We'd also be remiss not to mention proper sleep and recovery.  

Still, rest alone isn't the answer to everything and often times leads people down a path of prolonged recovery and time spent away from doing what they love. 

Over the years we have seen this time and again.  That's why we've put together this list of five injuries that likely won't resolve with rest alone as well as a couple of tips for how to get started resolving them, so that if these issues arise you know exactly what to do to get back to training. 

Here are the five injuries that likely will not be resolved with rest alone, along with a couple of tips for how to get started resolving them. 

1. Back Pain With Deadlifts
Back pain during deadlifts can come from one of three things (or a combination of all three). These three things are 1) you lack trunk stability, 2) you lack hip extension strength, or 3) you lack hip extension mobility.  The combination of these things can cause you to overextend your low back during the lock out instead of extending through your hips at the top. This back and forth motion couple with a loaded spine with cause your brain to throw up a red flag and give you a "check engine soon" light known as low back pain. 

You're probably saying "but what should I work on to turn off that warning light?"
​
- Answer 1: Improve your ability to keep your trunk stable.  Think "ribs down" when lifting. 


-Answer 2: Work on improving your hip extension mobility and then hit the save button and lock it in by following it up with something like a single leg glute bridge. 

2. Hip Pain With Squats
Pain in the front of your hips or a "pinching" sensation is very common.  This can happen for multiple reasons but more than likely your hips are just running out of room when you go down in your squat. 

"What should I work on?"
​
 -Answer 1: Improve your ability to keep your trunk stable.  Again, think "ribs down" when lifting. This will put your pelvis in a better position which will help to increase depth in your squat. 

 -Answer 2: Improve your hip flexion mobility.  This is the ability for you to move your knee toward your chest.  If you get a "pinching" feeling by laying on your back and bringing your knee to your chest, then this is for you:

3. Knee Pain With Running
There are a couple of reasons you may be feeling pain in your knee while running.  The things that seem to pop up repeatedly in our clinic are limited hip mobility, poor hip control, and a hard landing during foot strike. 

"What should I work on?"

 -Answer 1: Improve your hip mobility as well as stability.  This will not only allow you to move through the full range of motion during your stride but will help to keep less tension on your quadriceps which can pull on the knee (the quad tendon crosses over the knee) and cause knee pain. (See Hip Extension Mobility Video Above)

 -Answer 2: Work on landing softer.  Think about "landing like a ninja."  Your heel will make contact with the ground but ideally it should not be the first point of contact.  One drill to improve this is to try running barefoot on the grass, then put your shoes on and run the same way you were when you were barefoot.  Some people will opt to just run barefoot or in minimalist shoes, too. 

4. Shoulder Pain With Pull-ups
A common complaint with pull-ups is a "pinching" feeling or pain in the shoulders with pull-ups.  If this is the case for you, you likely are having some difficulty with overhead mobility and/or stability.  When movements like the overhead press, the humerus (arm bone) needs to be able to sit back.  If it isn't able to , it will run into the front part of the shoulder blade (aka acromion) which can cause pain when you repeatedly move into this position. 

"What should I work on?" 
​
 -Answer 1: Work on improving your shoulder flexion mobility. The is the ability to move your arm straight in front of you to the overhead position. 

​5. Shoulder Pain With Pressing
Last but not least is another very common complaint.  If you are having pain with a pressing motion such as the bench press, push-up or overhead press, it could very well be from a lack of shoulder stability.  This simply means that you are having difficulty controlling your shoulder blade when you press a barbell or kettlebell.

"What should I work on?"

 -Answer 1: If you are having most of your issues during an overhead press I would start by working on overhead mobility.  (See Overhead Band Opener Video Above)

 -Answer 2: Practice stabilizing your shoulder blades and creating torque through your shoulder when pressing. By doing this, you will create a stable platform from which you can press both more efficiently and effectively. 


Now, as we mentioned earlier there are times when rest is important and as we know recovery is just as important for you as your actual training is.  However, if you are training movements with poor mechanics, there is no amount of rest that is going to fix that issue.

If you have been dealing with stiffness or pain for weeks, months or even years and you haven't been able to solve the problem on your own then it is time to give us a call.  We help active people just like you every day to continue their training without pain or limitations. 

Want to work with Kaizen?  Here's how:

Step 1:  Book A ​Discovery Call
​​Book a free 30-minute discovery call. We’ll ask you a few questions and listen to your needs, goals, and pain points.

WHAT IS BODY TEMPERING?
Body tempering (BT), a form of soft tissue mobilization developed by Donnie Thompson in 2014, is performed by placing heavily weighted cylinders across muscles, tendons, ligaments and fascia. As a result, this can help prepare the muscle for activity and improve muscle recovery. Think of it as foam rolling on steroids.

Now, I'm sure there are many that will read this and argue that foam rolling is a waste of time but there is quite a bit of research that supports the use of foam rolling to help create temporary improvement in mobility.  Because of the fact that the results people see from foam rolling are temporary and don't create long-term chances, many will say that we should stop using this modality in our training. However, we can use these temporary changes to our advantage as a part of a bigger mobility plan. 

DOES IT WORK?

I wouldn't be writing this if it didn't ;) . Just like foam rolling, scraping (aka Graston Technique, instrument assisted soft tissue mobilization or IASTM, etc.), BT does a great job of improving mobility. It has quickly become my favorite way of performing soft tissue mobilization, and my patients have loved it. Our patients that have tried BT will also tell you that foam rolling doesn’t even compare to the feeling of BT. When performed properly, body tempering is more intense than foam rolling without being more painful.
​
How do we accomplish more intensity without pain? By utilizing different loads based on the body part that we are working on so that the athlete feels significant pressure without being painful. From there, we simply temper that muscle, joint, or area for 1-2 minutes.

Because most BT devices are weighted (anywhere from 22 – 200 lbs.), you would think this would be painful, but the large surface area of the cylinders disperses the pressure across the muscle. Contrast this with other soft tissues modalities using smaller tools or a therapist hands that have a much smaller surface area and can lead to discomfort and pain.

The pec minor is a great example of a muscle where hands-on work is often a bit painful for patients. However, when we temper it for 30 seconds with a larger device our patients don’t report pain but we are able to quickly notice that the pec minor relaxes and the shoulders drop back.

For more information on how body tempering works, check out this article for a detailed description of the proposed mechanisms. 

www.roguefitness.com/rogue-dt-tempering-roller​

If body tempering is something you would like to try, we have many different affordable options for you.  Choose from single sessions at 30 minutes, 45 minutes, or 60 minute sessions and if you buy five sessions you'll save even more!

References:
Body Tempering. (2018, November 3). Body Tempering. BodyTempering.Com. https://bodytempering.com/body-tempering/

Coop. (2019, February 26). Rogue DT Tempering Roller Review: Body Tempering Device for the Masses. Garage Gym Reviews. https://www.garagegymreviews.com/rogue-dt-tempering-roller-review

​Dunning, J. (2019, April 5). Body Tempering for Myofascial Pain & Performance Enhancement: Proposed Mechanisms. OSTEOPRACTIC. https://osteopractor.wordpress.com/2019/04/05/body-tempering-for-myofascial-pain-performance-enhancement-proposed-mechanisms/

Long, Z. (2020, April 28). An Intro to Body Tempering. The Barbell Physio. https://thebarbellphysio.com/an-intro-to-body-tempering/

M&F Editors. (2015, November 2). Body Tempering to Improve Physical Performance. Muscle & Fitness. https://www.muscleandfitness.com/workouts/workout-tips/body-tempering-improve-physical-performance/

Rogue. (2020, December 31). Rogue DT Tempering Roller. Rogue Fitness. https://www.roguefitness.com/rogue-dt-tempering-roller

This screening tool has a very high negative predictive value which means that if you CAN take 4 steps AND you DO NOT have tenderness in those specific areas, it almost certainly means YOU DO NOT HAVE AN ANKLE FRACTURE and thus you do not need to get an x-ray.
​
Now, if you CAN NOT take 4 steps or DO have tenderness in those areas, that does not necessarily mean that you do have a fracture, it just means you should see your physician and get an x-ray.

The specificity (ability of the test to determine if someone has a fracture) of the Ottawa ankle rules is low. It is simply a SCREENING test to RULE OUT if someone has an ankle fracture, not to RULE IN if you do indeed have an ankle fracture. 

ANKLE X-RAY SCREENING QUESTIONS

1. Can you take 4 steps (its okay if need to limp)? NO? –> GET AN XRAY
2. Do you have tenderness/pain around your medial or lateral malleoli (the little bone bumps on either side of your ankle)? Specifically the back side of the bones? YES? –> GET AN XRAY
3. Do you have tenderness/pain around the base of the 5th metatarsal (bump on the lateral/outside portion of your foot; halfway between your heel and your little toe)? YES? –> GET AN XRAY
4. Do you have tenderness/pain around the navicular bone (bump on the medial/inside portion of your foot?) YES> –> GET AN XRAY

References:

Bachmann, L. M., Kolb, E., Koller, M. T., Steurer, J., & ter Riet, G. (2003). Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ (Clinical research ed.), 326(7386), 417. https://doi.org/10.1136/bmj.326.7386.417

Physiopedia. (n.d.). Ottawa Ankle Rules. Retrieved August 4, 2020, from https://www.physio-pedia.com/Ottawa_Ankle_Rules
​
Lau, M. (2020, February 1). Do I Need an X-Ray After an Ankle Sprain? 𝙏𝙝𝙚 𝙋𝙧𝙚𝙝𝙖𝙗 𝙂𝙪𝙮𝙨 | Online Physical Therapy. https://theprehabguys.com/x-ray-after-an-ankle-sprain/

Medical Disclaimer:
This website does not provide medical advice and does not direct that you undertake any specific exercise or training/rehabilitation regimen.  Consult with a physician before undertaking any information found on this website. All visitors to this site must consent to the Terms of Use & Privacy Policy

Movement is Medicine
 
Hi guys, just wanted to check in and see how everyone is doing! We all know these are challenging times so we wanted to shed some positive light on the situation.
 
In case you don’t know us outside the practice, I’m Deana, Bryan’s wife and together we have two boys. Jack is five and Henry is two. We also have another baby boy on the way, he is due in early July.
 
Just like all of you, this pandemic has affected our family and our business both personally and financially. Bryan is now at home full time with the boys, running his practice via telehealth for the time being, while I work as a nurse in a local hospital Monday through Friday. We are so grateful for technology and the fact that we’re living in this time period that allows so much innovation and opportunity, from our home!
 
I wanted to share some of the positive things we’ve seen over the last few weeks.
 
This common enemy throughout the world, this virus, has brought us all closer together. We can now clearly see that we are all more alike than different. No one is immune to this virus nor the circumstances that might come of it. Throughout the ENTIRE world, I realize it’s somber, but this is a pretty amazing revelation.
 
We have lived in the Midwest most of our lives and in the last few weeks I have seen more neighbors out for walks, bike rides, and playing in their front yard than I ever have!

Challenges make us stronger. They make us more resilient. Challenges enable growth.
 
Focus on what you CAN control. Chances are you’re stuck at home. Possibly with children. While we know its super challenging especially with little ones, get moving! Those babies are watching you and feeding off your energy. If you’re stressed, move your body. Movement is medicine! If you don’t know where to start or have history of pain or any injury, send us your questions.
 
Nope, we can’t fix the economy right now. Nope, we can’t cure this virus overnight.
 
However, we can focus on our health and our family that is sitting right in front of us. We have gotten to spend more consistent, quality time with our boys in the last few weeks than we have since they were newborns (it sounds sad to say, but that’s the reality of full time working parents). They’re loving it and although it’s sometimes stressful and exhausting, it is such a blessing. We have enjoyed going on more walks, practicing yoga as a family (thanks YouTube), playing more games, and doing more puzzles. We can control how much screen time we are all exposed to every day. Set some goals. Read some books. Do what makes you feel good!

Two simple reasons:

1. In order to spend more time one-on-one: provider and patient.
2. Because cutting out the middleman means decreased overhead and the ability to run a practice focused on ONE thing, the patient.

This takes us back to the simple life. Up until the 1950s, this was the traditional model. We want to care for patients the best way we know how. This involves spending time, face to face, listening, assessing, planning, and implementing based on your concerns and your goals. Providing this care as an in-network provider would be tricky. It would require much sacrifice, especially when it comes to time spent documenting, coding, and billing. These things do not impact your care directly and will not help you get better. These are the things that our healthcare system currently has wrong (at no fault of the providers, just a faulty system, unfortunately). In short, billing insurance requires staff to maintain the transactions with the middleman, it means decreased reimbursement (which varies depending on the insurance company), leading to the increased need to get patients in and out of the door, which requires hiring more staff to care for those patients and increased overhead… and, you get the picture.

Seeing a cash-based physical therapist, out-of-network can save you money and more importantly, your time! At Kaizen, that means we dedicate each entire one-hour session just on you to address your concerns and develop a customized treatment plan.

We want you to know that being an out-of-network provider is not a decision we came to quickly or easily. We debated the option to go in-network for the entire first year we were a distinguished company. However, in the end, we conclude it’s just not for us. Here’s another reason why. Insurance companies can be very restrictive. In-network PT is typically limited to “treating one body part,” while Kaizen is able to consider the patient as a whole person. We are not big on limitations – neither are you, which is why you’re here. In our experience, third-party payers pressure for immediate diagnoses, then insist on confining treatments, and simply put, interfere with the therapy we want to provide. This often hurts the patient’s progress and hinders our ability to reach his or her goals.

Out-of-pocket expenses over the course of physical therapy will often be less expensive for patients like you with a cash-based model than through a traditional physical therapy practice. Let’s do some simple math. While it’s hard to use exact figures because everyone’s insurance plans are different, the outcomes are typically the same.

If we take the “standard” protocol in an insurance-based model for a torn rotator cuff in a healthy individual (25-35), the patient will typically need 4-6 months of rehab requiring passive and active PT (~2x per week) according to the US National Library of Medicine. You may also have to worry about meeting your deductible and paying a co-pay at each visit. If you have a $50 copay for specialty care this might end up costing you up to $2,400 in copays or $3,000 if that’s your individual out-of-network deductible.

​In our model we typically see the patient 1x a week and give them an extensive home program so he or she can begin working on the treatment plan at home. We also see our patient on average 6-10x during a plan of care and quickly go from rehabilitation to working on performance and prevention. Our ten-visit package is $1,800.

At the end of 6-months cash-based is often more affordable and less of a time investment. This also doesn’t account for the intangibles around enjoying a dynamic, individualized care plan and relationship built with your Kaizen PT.

We totally get it, we want to feel like we utilized the insurance plan we spend thousands of dollars on every year too. The thing is, health insurance was never intended to pay for our every health concern. It’s insurance, there if we need it in case of catastrophic events.

It’s worth mentioning here that the “cash-based model” is able to accept other forms of payment including credit/debit cards, checks, and even flexible spending or health savings account if your plan allows it. Most insurance companies, with the exception of Medicare, Medicaid and some HMOs, will provide reimbursement for specialty services received “out of network” (given your deductible has been met). We can help you with this process. Don’t be restricted by your current health insurance policy. Ask questions. Advocate for your healthcare.

Many people seeking cash-based care have high-deductible insurance plans. It makes sense to seek out cash-based providers when your deductible is $3,000 per person or $12,000 per family. You have more options and are able to choose a practitioner that fits your needs and values. Personalized care!

Have questions or want to learn more? Give us a call at 515-339-2906 or fill out a contact request here https://www.kaizenhealthandwellness.com/contactus.html

Sleep is easily the most underrated aspect of health and is often times an overlooked component in both the fitness and healthcare industries.  Lately, however, the importance and benefits of sleep are becoming more mainstream and it has even been called the greatest performance enhancer with the ability to improve your performance by 30%.  That's huge!

One thing we are also seeing is that it's not just MORE sleep that people need but actually sleep QUALITY.  We should all be aiming for 7-9 hours of sleep per night but if you are tossing and turning all night and not getting quality sleep then it doesn't matter how long you are in bed.

Sleep quality and sleep density are what we should be aiming to improve.  But how do we do that?  Luckily there are some quick and simple things that you can do tonight to help get your sleep on track.

The first thing we need to do is set up a routine just like you do with your kids.  You know, bath time, pajamas, tuck them in, read them a book.  All of these things trigger a response in their brains telling them it is time to calm down and get ready for bed.  It's the same thing with us, it's just going to look a little different. 

As a part of this, we need to make sure our exercise, stress and nutrition are all on point as well. As such, caffeine and alcohol both affect sleep quality.  Caffeine is a stimulant and will keep use awake, tossing and turning.  Alcohol is a depressant and while people have often used this as a sleep aid, studies have shown that it actually keeps us out of the important REM sleep cycles.  So we aren't getting the deep, restorative sleep that we truly need. 

Our routine is going to start with 8-10 minutes of soft tissue work.  Take a foam roller or lacrosse ball and start rolling - it doesn't matter where (quads, back, hamstrings, calves, etc).  The reason we are doing this is because it provokes a parasympathetic response in us. This is the rest and digest mode of our autonomic nervous system (the opposite of sympathetic aka fight or flight). This is going to prime us and get us ready to fully relax.

Next up is all about sleep hygiene.  We want our room to be cold!  We are talking between 62-68 degrees F. You can also you a cooling mattress pad such as this.  There are a ton out there so read some reviews and pick one for yourself.  

We also want our room dark! Too much exposure to light before bed has been linked to things like sleep apnea and depression and affects our circadian rhythm.  One of the best ways to make sure the room is dark is to get black out curtains.  If you don't have those or don't want to spend the money, get an eye mask! Bonus: you can take an eye mask with you when you travel!  A white noise machine or ear plugs can also create a nice environment to help you sleep as well. We have a couple of these and even take them with us when we travel now, too.  The key with all of this is to set up a repeatable pattern that you can do every single night. Just like the bed time routine you have with your kids.

Another way to prepare your body for sleep is to reduce your core body temperature.  A great way to do this is by taking a warm bath.  This will increase your peripheral blood blow (aka in your arms and legs) and thus decrease your core temperature. This is why you feel sleepy after a warm bath.

Tart cherry juice has also been shown to naturally increase the level of melatonin in your body. All it takes is 1 ounce, 2 times per day.

Now onto what will probably be the hardest for everyone. NO technology in the bedroom! This means no television, no iPad/tablet, and NO cell phone!  If you have to have your phone in the bedroom, turn it on night mode and turn it upside down.  I would also recommend a red alarm clock in the room but also turn it upside down so the light isn't disrupting.  Turn off all screens at least an hour before bed and do yourself a favor and get a blue light blocker screen protector or glasses.  Blue light has been shown to affect serotonin levels and leads to poor sleep quality.

As mentioned before, try to create a routine and do it nightly.  This goes for when you are at home but also when you are traveling.  A great example of this is the British professional cyclists.  They noticed that sleeping on different mattresses during their travels was affecting their performance so they started traveling with their own mattresses.  I get that this likely isn't feasible for most of us but we can control certain aspects of our environment such as a pillow, pillow case, sound machine/ear plugs, and a face mask.

Master your sleep routine and watch your performance sky rocket! 

Check out the interview below with Dr. Matthew Walker, a neuroscientist who studies sleep:

The ability to move your arm in space and reach for objects is crucial for quality of life.  Without it we are limited in the things that we can do - both for work and fun.  Anyone who has had a shoulder injury or surgery can attest to this.  

If you have pain when raising your arm above shoulder height, laying on your side, or even when lifting overhead, these 5 exercises are for you.  The best part is that you can do them at home and they don't take a ton of time. 

1. Thoracic extension

This is an area that most people ignore and can really limit the effectiveness of the rest of your routine. The thoracic spine, or mid-back, is extremely important when it comes to the ability to raise you arm overhead.  The thoracic spine HAS to extend (bend backwards) to allow for full shoulder flexion.  Without it, your shoulder flexion is limited and can become painful.  With this exercise I am using a foam roll but you can get the same effect with a rolled up towel.

​2. Active Release

The next technique utilizes a ball (it can be a tennis ball, lacrosse ball, etc), applying direct pressure on a muscle, and some arm movements to "release" or loosen up the tight muscles.  A lot of people tend to carry their stress in their neck and shoulders and the muscles surrounding these areas can become very tense and tight.  These are some great techniques to quickly loosen up these muscles. 

3. Shoulder Internal Rotation Opener

A common finding after a shoulder injury or even surgery is a lack of internal rotation.  This can cause several issues and can make it difficult to do things like scratch your back, put on a bra, etc.  It can also limit different lifts such as the high pull, where your shoulder is in an internally rotated position. By using a band we can get a great "extra" stretch that will make a big difference.

4. Overhead Band Opener

Another common finding (maybe the most prevalent) is a lack of shoulder flexion, or the ability to raise your arm up in front of you. As I mentioned with the first exercise, this can be from several things such as a lack of thoracic extension, but it can also stem from tight tissues in the shoulder itself such as muscles or even the joint capsule.  This is one of my go-to exercises to help people obtain end-range flexion.

5. Thoracic Prayer Stretch

While it isn't often associated with the shoulder the latissimus dorsi, or "lat" for short, goes from your lower back all the way up to the front of your shoulder.  If this muscle become tight, it can limit your ability to reach over head and externally rotate your arm.  The thoracic prayer stretch not only helps stretch the lat out but it also works on thoracic extension at the same time. 

Buzzing, tingling, numbness and pain in your arm and hand can be very worrisome, especially if you have never experienced this before and don't know what is causing it. 

A common cause for these symptoms is thoracic outlet syndrome (TOS). TOS can be caused from either a compression of the neural and/or vascular structures that pass through the thoracic outlet. We are going to focus on the neural component today as that is the most common, but just know that if your hand is turning blue and is cold you should probably get that looked at. 

So, what is the thoracic outlet?  The thoracic outlet is defined by the space bordered by your first rib, your clavicle (collar bone) and the superior border of your scapula (aka the top of your shoulder blade). The outlet passage is further defined by the interscalene interval, which is a triangle formed by the scalene muscles.

As you can see, there is a lot going on in this little area and multiple points at which the nerves and blood vessels can become compressed.  Common sites of compression include between the scalene muscles, between the first rib (or presence of a cervical first rib), the clavicle and subclavius muscle, or at the coracoid process and pectoralis minor. 

You can also have multiple points of compression of peripheral nerves (nerves in your arm) between the cervical spine and your hand, in addition to the thoracic outlet.  This is called double crush syndrome or multiple crush syndrome, depending on home many sites of compression there are. This means you could potentially have TOS, and ulnar nerve compression, and carpal tunnel syndrome, for example. 

So now that we know a little bit of background of TOS, how do you know if you have it?

Symptoms can vary widely depending on what is compressed and where the compression is.  The most common complaint is typically diffuse arm and shoulder pain, especially when the arm is raised above shoulder height. 

Another common complaint is tingling, numbness or an "electric shock" in the shoulder and down the arm.  These symptoms can also occur in the neck and jaw as well.

Does this sound like you?  Schedule an appointment with us today!

Causes of TOS are typically divided into four main causes and can sometimes be interrelated:

1. Congenital abnormalities: which include bony or muscular changes (e.g. cervical first rib, anterior scalene or sickle-shaped middle scalene).
2. Post-traumatic causes: this can be macro trauma such as a car accident or micro trauma such as a muscle strain of the scapular stabilizers (see my last blog for details on that).
3. “Functional” or acquired: this is from repetitive movements or prolonged postures (e.g. sitting in one position for too long).
4. Other acquired causes: These are rare but must be systematically considered as well.  These include tumors  hyperostosis, osteomyelitis, etc. The diagnosis for these is made by your physician and is based on clinical examination and medical imaging (CT and MRI).

So how is TOS diagnosed?

TOS is a clinical diagnosis which means that it is made almost entirely from a subjective history and a physical examination. 

​The examination will include different tests such as a visual inspection of the shoulder and spine; active and passive range of motion of the cervical and thoracic spine as well as the shoulder, elbow and wrist; palpation of different structures; a thorough neurological examination that looks at deep tendon reflexes as well as any sensory or motor deficits; breathing pattern; assessment of the first rib and clavicle; position and movement of the scapula as well as the strength of surrounding muscles; other tests are also performed to rule out any coexisting pathologies such as a peripheral nerve entrapment or cervical radiculopathy. 

While all of this can seem daunting and scary, the good news is that in most cases TOS can be treated successfully with physical therapy. In rare cases surgery may be indicated if symptoms are progressing or if they are unresponsive to therapy.

Physical therapy treatment of TOS can include correction of any postural abnormalities of the spine and shoulder girdle, strengthening of the scapular stabilizers (i.e. serratus anterior, rhomboids, middle/lower trapezius and rotator cuff muscles), stretching of any short and tight muscles (typically on the front of the shoulder such as the pectoralis minor), as well as mobilization and manual therapy to the shoulder complex as well as the first and second ribs. 

Here are some great exercises that help with thoracic outlet syndrome:

There is one thing that I see over and over again with people that have shoulder pain. It’s one of those things that is so prevalent that you can pinpoint it (with pretty good accuracy) before even looking directly for it.

So what is it?  Lower trapezius weakness.

The trapezius (or trap for short) is a very large muscle as a whole but when you break it down into its component parts, the lower trap is actually pretty small in comparison.  But don’t let that fool you because this is an extremely important muscle when it comes to shoulder health.

Not only does it help with proper motion of the scapula, it also helps with stability.
And without a proper ratio of mobility and stability, you start to see some issues pop up.

With weakness, we see the scapula (shoulder blade) start to ride upward and tilt forward which depresses or lowers the coracoid process.  The coracoid is a small bone that sits on the front of your shoulder and is attached to the scapula. Several muscles and ligaments attach to this bone including the pectoralis minor, coracobrachialis, and short head of the biceps brachii.  The ligaments that attach here are the coracocalvicular, coracohumeral, and coracoacromial and transverse scapular ligaments.  Long story short, this is an important part of the shoulder.

When the lower trap is weak and we get elevation and a forward tilt of the scapula, the muscles on the front can get in a short and tight position.  We see this a lot, especially in people that sit at a desk for extended period of time. 

All of this together can lead to a problem called scapular dyskinesia and is often times accompanied with scapular winging, or an outward tilt of the shoulder blades. When this happens, people often times get pain in the front or side of their shoulder, especially when reaching or lifting overhead. 

Shoulder pain can be frustrating and stressful, especially if you have seen other providers in the past and only had temporary relief or even if you have been told to stop doing things. If this sounds like you, know that there is hope and you aren't doomed to have shoulder pain for the rest of your life.  The shoulder is complex and you need an expert that knows the shoulder and can work with you to develop a plan that fits your unique needs and goals.  

Here at Kaizen, we have worked with hundreds of patients just like you who have had shoulder pain and are concerned, frustrated and don't know what to do.  We utilize the Kaizen 3 step process:

The Kaizen 3 Step Process
Step 1: Find The Source and Relieve Your Pain
Step 2: Fix The Root Cause Of ​The Problem
Step 3: ​TeachYou How To Keep It From Coming Back!

We offer 60 minute sessions, working one-on-one with Dr. Ladd to determine your problems, set goals and develop a personalized plan of care.  This hassle-free process reduces the number of needed appointments, saves you time and saves you money. 

It's time to get you back in the game and keep you there.

Give us a call at 515-339-2906 or fill out a contact request at the link below: