Shoulder Blades Sticking Out? Is it Bad?- Ask a Physio

What is scapula winging?

Scapula winging is when the borders of the scapula (shoulder blade) stick out away from the ribcage. Normally the scapula is meant to lie flat against the rib-cage. Scapula winging usually results from muscle imbalances of the muscles attaching to the scapula. Imbalances commonly occur between the pectoralis minor, upper trapezius, lower trapezius and serratus anterior muscles.

Consequences of scapula winging:

Scapula winging can result in inefficient movement of the glenohumeral (shoulder) joint. The scapula and shoulder joint are connected. If the resting position and movements of the scapula are not in optimum position, it can lead to restricted movements of the shoulder joint. This in turn can lead to impingement of the rotator cuff tendons and associated pain and dysfunction.

 

Weakness of the cervicothoracic postural muscles and subsequent scapula winging can also lead cause increased tension and pain in the muscles between the shoulder blades and the muscles attaching from the scapula to the neck. This in turn can lead to joint stiffness and potentially tension-headaches in more severe cases.

How can Capital Physiotherapy help reduce scapula winging?

After thorough assessment to determine which muscles are contributing to the winging scapula, our physiotherapists may use a variety of different treatment to try and relieve symptoms associated with scapula winging and reduce the winging itself.

 

 

Treatment options include:

  • Postural education and correction
  • Postural taping
  • Massage to relieve tension of tight muscles
  • Dry needling to relieve muscle pain and tightness
  • Muscle strengthening and re-training to correct muscle-imbalances causing the winging
  • EMG activation prior to strengthening to help activate muscles that have difficulty firing due to altered neuromuscular activation patterns

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HOW TO FIX GROIN/HIP PAIN? TIGHT HIP FLEXOR!

HIP FLEXOR TIGHTNESS

The role of the hip flexors:

The hip flexor muscles include the iliacus and psoas major. Together these muscles act to lift the thigh up closer to the abdomen, which is the movement known as hip flexion. Excessive tightness of the hip flexor muscles is more likely to occur in certain people. It can lead to biomechanical abnormalities and be a source of pain.

 

 

 

 

 

 

 

 

People that are more prone to hip flexor tightness:

People that have occupations that involve prolonged periods of sitting are prone to hip flexor tightness as the hips are in a sustained flexed position during sitting. People that engage in regular exercise such as running and cycling are also more prone to tight hip flexors. Sportspeople playing kicking sports such as soccer and football are also more likely to experience excessive flexor tightness as the kicking motion involves repetitive hip flexion movements.

The consequences of tight hip flexors:

Tight hip flexors can be a local source of pain around the hip joint which can be present during prolonged periods of sitting or during sporting activities that utilise the hip flexor muscles. Excessive tightness of the hip flexors can change lumbo-pelvic posture as it pulls the pelvis into an anteriorly tilted position. Increased anterior pelvic tilt increases the curve within the lumbar spine (lordosis) which in turn can cause the facet joint of the lumbar spine to be compressed more and tighten up surrounding back extensor muscles such as the erector spinae; this can lead to associated lower back pain.

Tight hip flexors and altered alignment of the pelvis can also lead to over-activity of the hip flexor muscles and altered neuromuscular activity of the gluteal and core muscles which can further be a source of hip pain.

What can we do to reduce hip flexor tightness?

Our experienced physiotherapists at Capital Physiotherapy can help to reduce hip flexor tightness and associated aches and pains through various treatment options which include:

  • Massage and trigger point release
  • Gluteal and core strengthening to improve lumbo-pelvic stability
  • Neuromuscular training
  • Stretches

What can you do to reduce hip flexor tightness?

To manage tight hip flexors stretch the hip flexors daily, try and stand up every 30-60 minutes to avoid sitting for prolonged periods.

Drop down into lunge position. Tilt pelvis backwards to activate glutes. Then lean forward at the hips, keeping the back in a neutral position. A stretch should be felt near the groin/front of the thigh. Hold for 30 seconds. Repeat up to 4 times a day. Stretch at least once a day.

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What people don’t tell you about PLANK/PUSH UP/SQUAT

Correct Exercise Technique

Correct technique is crucial to ensuring the correct muscles are recruited during specific exercises. Poor technique leads to increased risk of injuries.

Correct Squat Technique:

  • Straight back
  • Knees behind the toes
  • Stick the bottom out
  • Keep heels on the ground

Common mistakes performing squats:

  • Not sticking the bottom out far enough
  • Arching the lower back
  • Slouching the upper back
  • Knees going over the toes
  • Heels coming off the ground
  • Weight on the toes rather than the heels

Correct push-up technique:

  • The head, back and bottom are aligned to form a straight line
  • When going down towards the ground, the chest should move forwards so that it lies in front of the shoulders
  • The shoulder blades should be stabilised before descending so that they don’t stick out relative to the upper back

Common mistakes performing push-ups:

  • Arching the lower back
  • Dropping the head down towards the ground
  • Shoulder blades sticking out
  • Chest going straight towards the ground rather than moving forward as the body descends

Correct plank technique:

  • Head, back and glutes should be aligned to form a horizontal line
  • Glutes and core should be engaged
  • Shoulder blades should be in line with the upper back

Common mistakes performing planks:

  • Arching the lower back
  • Head/neck drop down towards the ground
  • Shoulder blades sticking out

At Capital Physiotherapy, our physiotherapists can create a personalised workout program just for you. Capital Physiotherapy will tailor to individual needs and wants. We will make sure that the program is challenging yet safe to do.

All our therapist are highly trained, prevention is always better than cure! Get fit? Start today 🙂
Hope that through this video, viewer can gain a better understanding on tips to improve your exercise technique. If you like our video please do like, subscribe and share 🙂

5 Steps to Fixing Tennis Elbow Pain

Tennis Elbow/Lateral Epicondylitis

One of the most common causes of elbow pain is the dreaded tennis elbow or, as it’s formally known, Lateral Epicondylitis. Tennis elbow affects predominantly the wrist and finger extensors that is located on the outside part of your forearm; specifically the Extensor Carpi Radialis Brevis and Longus). These muscles originates from the small bone bump on the outside of your elbow, and attaches to different parts of your hands.

The usual cause of a tennis elbow is usually due to a repetitive movement; specifically gripping activities. This is the reason why it’s called tennis elbow, this involves gripping a racquet. However, there usually is an issue with the person’s hitting technique. A common mistake is to use wrist extension to hit the ball. Your physio at Capital Physiotherapy can assess you in this regard.

Other common ways you can get tennis elbow are: prolonged computer work (typing), home renovations (hammering, painting) as well as carrying/lifting objects. In some cases, tennis elbow may also be as a result of some neck issues, including stiffness and nerve root irritation.

As you can see, it is important that you seek professional help when you have elbow pain. Inappropriate care will result in worsening of your symptoms as well as delayed healing. This may result in you requiring corticosteroid injections.

Your physio at Capital Physiotherapy is well equipped to look after you. They will spend the time that it takes to ensure you are cared for and get the results you need. They will make sure all contributing factors are considered and assessed. A thorough assessment is required so that you receive the correct treatment to get you back to your activities quickly!

Hope that through this video, viewer can gain a better understanding on tips to help with your tennis elbow pain. If you like our video please do like, subscribe and share 🙂

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A Beginner’s Guide to Getting Fit and Healthy (Nutrition)

Successfully fit people are successful not because of good luck, birth order, or family heritage but because they have adopted the right habits. They do things differently than the rest.

To be a successful person, you must adopt the habits of success.

This Video will teach any beginners who are starting to get fit and wanting to stay healthy.

Being healthy is not a destination it’s a way of living.

Eating a balanced diet is vital for good health and wellbeing. Food provides our bodies with the energy, protein, essential fats, vitamins and minerals to live, grow and function properly. We need a wide variety of different foods to provide the right amounts of nutrients for good health.

For any one who is beginning to exercise and change their diet to a healthier diet, they need to understand the amount of Carbs, Protein , Fat intake to consume daily. We are here to try to make it as simple as possible for beginners.

Protein:

1 gram of protein per pound of body weight (2.2 g/kg of BW) per day has been a bodybuilding rule of thumb for decades. Higher levels of protein intake, usually in the range of 1.2 – 1.5 grams per pound of body weight (2.6 – 3.3 g/kg BW) per day, are commonly recommended when “cutting” to lose fat.

Carbohydrate:

A low GI diet has commonly been promoted as an effective way to help lose weight by controlling blood sugars and appetite. When high and low GI diets are compared head-to-head, however, scientific evidence has shown that there is little additional benefit for weight loss of a low GI diet over a similar diet of nutrient composition that is high GI.

While GI can be a useful guide in planning a diet and controlling blood sugar levels, it should not be the only consideration. Both the serving size of foods and the nutritional quality of the diet are just as important to consider.

Low-GI foods are those with GI scores of 55 and under;
Medium-GI foods have assigned scores between 56 and 69;
High GIs are considered 70 and above.

Fat:

Like carbohydrates and protein, fat is an essential nutrient. This means that your body requires it for key functions, such as absorbing the fat-soluble vitamins A, D, E, and K.

Good fats

Monounsaturated fatty acids (MUFAs)
Found in plant foods like nuts, avocados, olive oil, and canola oil, and in poultry

MUFAs can actually lower cholesterol levels, and, in doing so, your risk of heart disease.

Polyunsaturated fatty acids (PUFAs)
Found in fatty fish such as salmon and mackerel, and corn and soybean oils

Like MUFAs, PUFAs have been shown to improve cholesterol levels and reduce heart disease risk.

Saturated fat (In Moderation)
Found in meat and dairy products such as cheese, butter, and milk

While some experts say there’s no downside to cutting out saturated fats, others believe keeping them in the mix helps us avoid getting too many bad-for-you refined carbohydrates instead. Bottom line: You don’t need to ban them. Just make sure most of your fat intake is unsaturated, eat red meat only once or twice a week, and use olive oil instead of butter when possible.

Bad fat

Trans fat
Found in some fried foods, shortening, and packaged snacks like crackers and desserts

Research has found that artificial trans fats raise LDL cholesterol and lower HDL cholesterol—and a high LDL/low HDL combination can increase your risk of heart attack and stroke.

All in all, the important key to take home is to ‘”eat clean” which means, eating whole, unprocessed Foods. Whole foods are those in their natural, unaltered state, such as fresh fruits and vegetables, raw nuts and seeds, eggs, poultry such as chicken and turkey, red meat, fish and seafood. Is the healthiest options for anyone.

Hope that through this video, viewer can gain a better understanding on the importance of healthy eating and importance of clean and whole food to stay fit and healthy. If you like our video please do like, subscribe and share 🙂

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5 Key Areas That Runners Need to Train

The physiotherapists at Capital Physiotherapy believe that in order to be able to run efficiently with improved performance and reduce risk of injuries, the following 5 factors need to be incorporated into your regular weekly training routine.

Length of the hip flexor muscles

The hip flexor muscles can become very tight with regular running. This can lead to pain at the front of the hip and tilting the pelvis forward which can then lead to jarring of the joints of the lower back whilst running. Tight hip flexors can also lead to reduced hip extension during running which reduces efficiency of running technique. To prevent hip flexor tightness, runners should stretch the hip flexors daily and after exercise.

Strength/control of the intrinsic foot muscles

The small (intrinsic) muscles of the foot are responsible for helping the balance and stability of the foot during running. If these muscles are weak then the larger muscles around the ankles and calves can become overworked to try and stabilise the foot. Overworked muscles risk becoming tight and injured and can lead to injuries in other areas of the body, which is why it is important to ensure the small muscles of the foot are strong.

Exercises for the intrinsic foot muscles include:

Toe swapping and Doming

Control/strength of the gluteal muscles

The gluteal muscles are responsible for stabilising the hip during activities where one leg is lifted off the ground, which occurs during running. Weakness or incorrect activation of the gluteal can lead to increased stress on other areas of the lower limbs which can lead to pain and risk of injury. It is therefore important to incorporate regular gluteal strengthening exercises into your workout regime. Exercises that work the gluteal muscles include bridges, clams, squats, crab-walking and hip-abduction exercises.

Core control

The core muscles lie deep behind the rectus abdominus muscle. It acts to stabilise and protect the spine during movement. Core strength is critical for running as it helps to prevent injury to the spine and other areas of the body that may be overloaded when core strength is inadequate. Core exercises need to be performed at least 2-3 times a week to maintain core strength and endurance. Correct technique is critical for core exercises.

Other Running videos:

Principles of Natural Running with Dr. Mark Cucuzzella

Different type of running style

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Stretches For The Office Warriors

Sitting for several hours a day working away at a desk can lead to adverse effects on the body. The human body is not designed to withstand seated postures for more than an hour at a time. When seated for extended periods of time, muscles around the hips, spine and legs can become tight as they are in stationary positions and not being utilised through active movements. Muscles in the wrists can also become tight if the hands and wrists are constantly being used for activities such as typing. Muscle tightness can progressively get worse over time and lead to aches and pains. These aches and pains can then result in reduced activation the muscles which can lead to reduced muscle strength and subsequent movement impairments.

It is important to manage muscle tightness in order to prevent and/or reduce associated pain and movement limitations. At Capital Physiotherapy our physiotherapists can help reduce the aches and pains in the office-worker through targeted treatment strategies. Our physiotherapists also emphasise the importance of self-management of reducing tightness through regular stretching in the workplace. Capital physiotherapy have devised a series of stretches that can be performed regularly in the workplace to reduce muscle tightness and discomfort. Our physiotherapists recommend stretching every hour or two, holding each stretch for 30 seconds.

Watch our previous Video on
5 quick and easy way to make your work station more ergonomic

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By Leah Christoforou

 

5 Quick and Easy Ways to Improve Your Workdesk Ergonomic

Ergonomics

How posture affects the spine

In a person that sits with normal posture, the curvatures of the spine assume an “S-shape.” This allows even distribution of body weight loads throughout the spine. Over-time with prolonged sitting, the postural muscles of the back can fatigue leading to the adoption of poor posture. In a person with sitting posture the natural curvatures of the spine can become “C-shaped which leads to an abnormal distribution of body-weight loads on the spine. In particular, excessive stress is placed on the lower back, neck and upper thoracic areas which can lead to symptoms such as pain and stiffness.

 

 

 

 

 

 

Good posture: S-shaped spine             Poor posture: C-shaped spine

What is ergonomics?

Ergonomics utilises sciences such as anatomy, physiology and engineering to design tools that allow people to work more safely and comfortably in their work environments to help reduce the risk of poor health outcomes and improve performance.

How can Capital Physiotherapy implement ergonomics to help you?

Capital Physiotherapy can incorporate ergonomics into their physiotherapy assessment and treatment to help improve posture in the workplace and thus reduce symptoms associated with poor sitting posture. Our physiotherapists can provide advice about alterations to the workplace environment to improve aspects such as desk height, chair set-up and positioning of desk items to aid the adoption of good posture. At Capital physiotherapy, we can also determine which muscles and joints are affected by poor posture and provide treatment to reduce symptoms associated with muscle tightness, joint stiffness, muscle weakness and altered muscle activation.

Some of our treatments may include:

  • Taping
  • Massage
  • Muscle activation, strengthening and stretching exercises
  • Dry needling
  • Hands-on manual therapy
  • Education about posture

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Posted by Capital Physio -Leah Christoforou

Education Epi 3 – Pregnancy Back Pain (When should mother start to worry?)

Sacroiliac Joint Pain (SIJ pain) is pain felt at or near the sacroiliac joints of your pelvis as a result of sacroiliac joint dysfunction. These are joints located at the 2 dimples of the lower back. The pain often feels deep within your lower back and can occur on one or both sides of your back. In some cases, pain radiates down to the buttock and the back of the thigh.

While pain may begin at any time during pregnancy, SIJ pain on average begins in the 18th week of pregnancy and becomes more intense as the pregnancy progresses. The pain usually spontaneously resolves within 3 months post delivery. But in some cases it can become chronic and disabling.

This video will educate mother-to-be on SIJ pain, when and how it happen and what should be done to treat this issue.

For further help please visit our main page at www.capitalphysiotherapy.com.au

If you do suffer from back pain I highly suggest you seek professional help ASAP.
At Capital physiotherapy we can accurately diagnose your pain and give you tips and strategies to help make your preganancy journey a smooth and painfree experience.

How Does it Feel?

People with SIJ dysfunction may experience:

  • Pain that may be sharp, stabbing or dull, localized to 1 side of the pelvis/low back, groin, or tailbone.
  • Pain that may radiate down to the knee.
  • Pain with movements, such as standing up from a sitting position, turning in bed, or bending/twisting.
  • Muscle tightness and tenderness in the hip/buttock region.
  • Pain with walking, standing, and prolonged sitting.
  • Pain that is worse when standing and walking, and eases when sitting or lying down.

How Can a Capital Physio Help?

At Capital Physiotherapy, your physiotherapist will design a targeted treatment program based on your evaluation and your goals for a safe return to sport or daily activities. Treatment may include:

  • Hands on therapy, includes soft tissue release or massage for tight and sore muscle groups. Hands on therapy are used to correct pelvic/SIJ alignment. Joint mobilizations/manual therapy uses gentle movements to improve mobility of the hip, SIJ, and low back.
  • Stretches exercises. Stretching exercises may be prescribed to improve the flexibility of tight muscles. They may also help to improve movement in the spine and lower extremities, and help decrease stress at the sacroiliac joint during daily activities.
  • Specific Strengthening exercises. Strengthening helps to improve the stability of the sacroiliac and spinal joints, which helps to reduce ligament strain and pain.These exercises are focused on weak muscles, including the lower abdominal, pelvic floor, and buttocks muscles.
  • Taping/ Bracing. Depending on our assessment, our physiotherapist may also recommend bracing/ taping your sacroiliac joint. It is used to provide stability during daily activities as your strength returns, and flexibility improves. This modality is especially helpful for pregnant women.

All treatments prescribed by the physical therapist will be based on your specific case.

If you do suffer from back pain I highly suggest you seek professional help ASAP.
At Capital physiotherapy we can accurately diagnose your pain and give you tips and strategies to help make your preganancy journey a smooth and painfree experience.

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You Need To Watch This If You Are Suffering From Shoulder Pain

Shoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. Overhead activity of the shoulder, especially repeated activity, is a risk factor for shoulder impingement syndrome. Examples include: painting, lifting, swimming, tennis, and other overhead sports. Other risk factors include bone and joint abnormalities.

With impingement syndrome, pain is persistent and affects everyday activities. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, may cause pain.

Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons(tendinitis) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to thin and tear.

For more information, book an appointment with one of our physiotherapists for a more tailored recovery program that suits you best.

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