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Chesterton Physical Therapy, Inc
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Many patients with no shoulder pain have MRI findings that show tear: Rates of shoulder surgery are increasing, and it may be partially due to MRI results The labrum is a piece of cartilage shaped like a cup that's attached to the rim of the shoulder socket. Its function is to secure the shoulder socket and keep the ball of the joint in place during movement, but this cartilage can tear either from an injury or due to the aging process. The result is called a labral tear, which may or may not cause symptoms depending on how severe it is. Labral tears are difficult to diagnose, and the methods used for evaluation like physical exams and MRIs are not very consistent at identifying the injury. Statistics also show that the rate of surgery for labral tears has been increasing over the past decade-especially in middle-aged patients-and that some of them are not experiencing positive outcomes. While it's not completely clear why this has been occurring, one possible explanation is that more patients are being diagnosed with labral tears on their MRI and then being told to consider surgery. To investigate this matter and develop a better understanding of the connection between MRI results and shoulder symptoms, a study was conducted. Patients with no shoulder pain undergo MRIs Middle-aged individuals between ages 45-60 without any shoulder pain were recruited and invited to participate in the study, which led to 53 of them being accepted. All participants underwent a physical examination and were asked a series of questions regarding the use of their shoulder in work or sports. Then, each participant had an MRI of their shoulder and two radiologists evaluated the results. A radiologist is a medical professional trained to interpret the findings of imaging tests like MRIs and X-rays, and in this case, they were not given any information about the study subjects to increase the reliability of their evaluations. Both radiologists find labral tears in at least half of patients On the whole, results showed that labral tears were fairly common. The first radiologist interpreted 38 (72%) of the MRIs as containing a labral tear, while the second radiologist found labral tears in 29 patients (55%). Further analysis revealed that the two radiologists had a moderate level of reliability between them, and that there was only one area in which their reliability was poor. Avoid having an MRI and see a physical therapist instead These findings show that even in middle-aged patients that have no signs of shoulder pain, labral tears are commonly found on MRIs. The unfortunate result of this fact is that a patient with shoulder pain can be told they have a labral tear and then go on to have surgery to repair it, even though their pain may not be related to the tear. One way to avoid this predicament is to see a physical therapist first for any type of shoulder pain. Physical therapists will usually treat the pain immediately with a comprehensive treatment program and will only prescribe tests like MRIs if they find it to be completely necessary. Following this course will help you work towards getting better right away regardless of what's causing your shoulder pain and by keeping you out of the operating room for a labral tear that may not be related to your pain. -As reported in the January '16 issue of The Orthopaedic Journal of Sports Medicine http://dlvr.it/QbyJv7
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Motivational Monday: -Albert Einstein http://dlvr.it/Qbkr2Y
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Hands-on therapy found to be effective for shoulder pain: Long-term computer use can lead to muscle dysfunction and disorder Approximately 90% of white-collar workers use computers for more than four hours per day. Over time, sitting and working at a computer can lead to a dysfunction of muscle stability and other disorders of the region, which may result in shoulder and neck pain, as well as a decreased threshold for pain. One of the main reasons for shoulder pain is hyperactivity of an upper back muscle called the upper trapezius, which results in decreased control of two other muscles and instability. To treat this muscle instability, several physical therapy interventions may be used, including manual therapy. In manual therapy, the physical therapist performs various manipulations and mobilizations on the painful area in order to bring about tissue changes that will lead to less pain. Manual therapy may, therefore, be helpful for office workers with shoulder pain, and to evaluate this possibility, a study was conducted. Middle-aged office workers with pain serve as the study group Individuals between the ages of 30-40 who had shoulder pain and worked on a computer for more than eight hours a day were invited to participate in the study and screened to determine if they were eligible. This process led to 38 individuals who were accepted, and then randomly assigned to either the manual therapy group or the shoulder stabilization exercise group. Both groups underwent treatment during two 40-minute sessions per week for six weeks. In the manual therapy group, the therapist applied manipulations and mobilizations to various muscles in the back, chest, and neck for three minutes each. In the shoulder stabilization group, patients were instructed to perform a series of stretching and strengthening exercises for muscles in the same area. All patients were assessed before and after undergoing treatment for pressure pain threshold (PPT) of certain muscles, which measures the minimum force applied that causes pain. Manual therapy leads to greater improvements After completing treatment, participants in both groups experienced significant improvements with an increased PPT of several muscles of the upper back; however, the manual therapy group showed greater PPT improvements in these muscles than the shoulder stabilization group. This is likely due to the pain-relieving properties of manual therapy, as it increases blood flow and decreases the activity of muscles in such a way that it changes the length of tissues and results in less pain. These results show that while both shoulder strengthening exercises and manual therapy appear to be effective for office workers with shoulder pain, manual therapy is even more beneficial for improving their threshold for pain. Individuals currently dealing with this type of pain should, therefore, seek out the services of a physical therapist for appropriate treatment. -As reported in the September '16 issue of The Journal of Physical Therapy Science http://dlvr.it/QbRXyC
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Recipe Wednesday - Broccoli with Asian Tofu: Are you looking forward to this healthy and flavorful dish? Click here for this great recipe! http://dlvr.it/QbC3VD
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Shoulder injuries in water polo, learn how to prevent. #SeeAPT1st: Shoulder injuries are most common in water polo, learn how to prevent this. #SeeAPT1st Click Here for the Article http://dlvr.it/QZh9Ld
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Motivational Monday: -Harvey Mackay http://dlvr.it/QZCfWV
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Neck exercise more beneficial than physical activity for whiplash: Persistence of symptoms results from both physical and psychological factors Approximately 50% of people with whiplash-associated disorders (WADs) continue to report neck pain one year after injury, yet despite this prevalence, there is no clear evidence regarding the most effective treatment. Though exercise is considered safe and effective for neck pain, it's efficacy for WADs specifically is unclear, and the same is true for prescribed physical activity (PPA). In addition, since the persistence of symptoms in WAD patients is due to both physical and psychological factors, a behavioral approach may also be beneficial, but this is not clear either. Based on these shortcomings, a randomized-controlled trial (RCT) was conducted to evaluate the long-term effects of neck-specific exercise on WADs. Two-year follow-up performed on earlier RCT The current study was a one- and two-year follow-up on a 2014 RCT. Initially, 216 individuals with grade 2 or 3 whiplash injury were recruited and randomized to the neck-specific exercise (NSE) group, the neck-specific exercise with behavioral approach (NSEB) group or the PPA group, and all interventions spanned 12 weeks. Patients in the NSE group followed a supervised neck-specific exercise program twice a week. At first, this focused on deep cervical muscles, and eventually, more progressive head resistance training was incorporated gradually. The NSEB group received the same treatments plus physical therapist-led behavioral interventions. The PPA group was prescribed general physical activity to be performed independently without any neck-specific exercises. Patients were assessed for pain, disability, functioning and other variables at baseline and then one and two years later. Positive long-term outcomes reached with neck-specific exercises In total, 170 patients (79%) completed the one-year follow-up and 123 (57%) completed the two-year-follow-up. At one year, both neck-specific groups displayed more clinically important improvements in pain, disability, and functioning than the PPA group. At two years, the same was true for disability, and there were also clear trends towards greater improvements in all other outcomes as well. The addition of the behavioral approach did not produce any significant differences. This follow-up RCT suggests that neck-specific exercises can lead to improvements in patients with WADs for one or two years, but additional research is needed to confirm these findings with a different study population, longer follow-up and higher retention rates. -As reported in the March '16 issue of the Journal of Rehabilitation Medicine http://dlvr.it/QYxZSN
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Recipe Wednesday - Heavenly Chicken With Angel Hair Pasta: Sounds like something you can't pass up! Click here for this heavenly recipe! http://dlvr.it/QYj3jx
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16 Tips to Help Prevent Overuse injuries in Softball. #SeeAPT1st: Overuse injuries occur equally in all softball player positions, 16 tips to help prevent most injuries. #SeeAPT1st Click Here for the Article http://dlvr.it/QY9CTF
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What the heck is prehab?: What the heck is prehab? Here is our latest monthly video. http://dlvr.it/QY6bWy
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