What type of frozen shoulder are you?

The Frozen Shoulder, or Adhesive Capsulitis, is a unusual condition in that the cause is rarely known. It does occur more commonly in women over the age of 40 in the non-dominant arm. This article, Frozen Shoulder: Evidence and a Proposed Model Guiding Rehabilitation, is very interesting in how it rates different types of frozen shoulders. It does report that you do have to push through with rehab unless you want surgery. But with surgery comes more rehab!

So my recommendation if you have mild to moderate pain, try therapy first for several weeks. Push hard in therapy and at home. If you still feel "Frozen" then injections or manipulation may be the next step.

Let me know what you think if you have personal experience with this condition.

Surviving Rehab

The New York Times published this article, "Physical Therapy and the Camaraderie of Healing" February 17th 2009. It is about how healing from surgery is more than just healing the scars on the outside. It is about how we, physical therapists, are the ones who can take the time to supply the details and push you through the rehab and healing process. And, over time, how we the physical therapists and patients are able to build a strong relationship that goes beyond the clinic. It is a very well written and an enjoyable read.

Have Patience

Knee pain with running?

Thoughts of Dr. Jo:

The theme in this post is knee pain with running. I want to share with you some valuable information from two studies that discuss the root of knee pain in runners.

Article 1*: Differences in Hip Kinematics, Muscle Strength, and Muscle Activation Between Subjects With and Without Patellofemoral Pain

Article 2*: Proximal and Distal Influences on Hip and Knee Kinematics in Runners With Patellofemoral Pain During a Prolonged Run
*link will take you to a site to read abstracts. Purchase or membership is required for full article.

Both articles show that knee pain does not always come from dysfunction in the knee. It is important to look at the whole body to see where the movement disorder exists. These articles show that there is reason to believe that knee pain can come from weakness in the hips.

These two articles confirm the issues I see regularly in my patients who are runners. Runners tend to focus on the knee pain by using braces and strengthening the muscles around the knee. They occasionally neglect to consider how important a role the hip muscles play in controlling the whole leg.

It is important to remember that the hip is a multi-planar joint. If the muscles surrounding the hip do not stabilize then the femur would not be properly aligned. With the femur not properly aligned the knee becomes affected.

Overall message: Pain in one joint could be caused by dysfunction from another.

My advice: When starting a new activity, from general exercise to running for pleasure to training for a marathon, be aware of the importance of strengthening more than one specific muscle group. It is best to seek out a physical therapist to check your movement alignment, muscle balance and posture.

Happy Running!

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