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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Essential Stretches For Runners and Cyclists

Stretches and foam rolling to maintain muscles length is crucial to optimise performance.

When our muscles is too tight, it is impossible to contract your muscles to create force and power to run or cycle. It is vital that all cyclist and runners have a regular stretch and foam rolling routine to help keep their lower leg muscles loose and injury free.

In Capital Physiotherapy, we have created a simple and easy to follow stretch/ foam rolling routine that we gave to all our runners and cyclist clients. This routine when done on a regular basis have shown significant improvement to their performance.

Studies have shown that foam rolling after exercises can significantly increase joint range of motion and reduce muscles soreness after a intense workout.

Feeling tight is related to muscle tone, while actually being tight is related to your muscle tissues physically becoming shorter.

In this video we like to show all viewer on how to stretch all 6 muscles group that are vital for activities such as running and cycling. These muscles are mainly lower leg muscles such as the:
1) Calves muscles
2) Shin muscles
3) Quads muscles
4) IT band
5) Gluteals muscles (glute muscles)
6) Hamstring muscles

Hope that through this video, viewer can gain a better understanding on the importance of regular stretches and foam rolling to prevent potential injuries and allowing them the keep up with the activities that they love doing 🙂

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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

 

The Proper Lunge Technique

Last week, we wrote about squat technique. Lunges, like squats are one of the best exercises you can do in the gym too. It’s another exercise that can effectively work on more than one area of your body. An effective exercise means your body will gain the most out of it, so you can reach your goal quicker! However, just like an improperly done squat, the wrong technique will cause you injury and future issues in the knees. It is important that you scrutinise your technique and concentrate on the quality of your lunge.

Not only are lunges great for your body, but they are easily done anywhere you’d like to exercise. You may see lunges done out in the park during boot camps (*shivers*). You may also see them done in the gym; you can be creative and use the different weights and bars to increase the intensity of your lunge routine. We personally like to do the lunge at the comfort of our own home. It’s an easy exercise that your body will thank you for!

The most important factor while doing lunges are to make sure your knees are positioned correctly throughout the movement. This means:

  • Your knees do not move past your toes at the front
  • Your knees do not move rotate inwards
  • You keep your body nice and upright

By making sure you follow the above rules, you reduce the chance of any wear and tear around your knee caps as well as reducing any issues that arise due to improper technique. By having your knees moving in the correct way, your knee caps are able to distribute the force much more evenly around its surface area; this reduces stress building up on only one area of the knee cap.

In addition, by doing the exercise correctly, you will gain the most out of your lunge. Correct technique allows your muscles to function at its most effective; which means you can progress yourself and get stronger quicker!

Make sure you have a chat with one of our physios to get the most out of your routine!

The Proper Squat Technique

Squats are one of the best exercises you can do in the gym (or at home!). This is because it is one of the few exercises that works multiple areas of your body. This makes it an efficient exercise to make you stronger quicker! However, when done incorrectly, squatting can cause a lot of issues to your knees. Improper technique results in imbalanced pressures around your knee cap, which will accelerate wear and tear.

Not only are squats great for your body, but they are easily done anywhere you’d like to exercise. While the gym is a great place, as you can use different bars with weights to challenge yourself. However, you can do squats at home or even at the park! The best exercises are the ones you can do anywhere. This means you won’t skip your exercise day and get the most out of it!

The most important factor while doing squats are to make sure your knees are positioned correctly throughout the movement. This means:

  • Your knees do not move past your toes at the front
  • Your knees do not move rotate inwards

By making sure you do not do the above, you reduce the chance of any wear and tear around your knee cap as well as reducing any issues that arise due to improper technique. By having your knees moving in the correct way, your knee caps are able to distribute the force much more evenly around its surface area; this reduces stress building up on only one area of the knee cap.

In addition, by doing the exercise correctly, you will gain the most out of your squat. Correct technique allows your muscles to function at its most effective; which means you can progress yourself and get stronger quicker!

Strength and Conditioning

The deadlift

The deadlift is both the best and worst exercise for your back. This depends entirely on your technique.

If you deadlift correctly, you will build an extremely strong core and posterior chain. The posterior chain is simply the backside of your body and its primary muscles include the lower back, gluteus maximus (glutes), hamstrings, and calves The posterior chain is often neglected by the average gym goer however it is probably the most important.

Benefits of the deadlift in no particular order include the following:
1 – Development of power and strength for sports
2 – Prevents injury if done correctly
3 – Increased muscle mass
4 – Increased fat burning: By increasing muscle mass your metabolic rate increases.
5 – Better posture: Deadlifting strengthens your core and as stated earlier your posterior chain which is responsible for keeping you upright/erect.
6 – Improved grip strength
7 – Increased hormone production – Testosterone increases muscle growth and improves muscle repair while growth hormone, which is produced by your pituitary gland, promotes tissue healing, bone strength, muscle growth and fat loss.
8 – Improves cardio respiratory fitness.

In my professional opinion everyone who intends to deadlift (and they should) needs to have proper coaching/form to help avoid injury at all costs. In the long run you will not only avoid those injuries but will lift heavier and get more out of your workout. So make sure you invest in a good personal trainer/physiotherapist who has experience in teaching proper technique.

Deadlifting Incorrectly

Deadlifting incorrectly can result in many different injuries. These injuries include but are not limited to the following: Disc prolapses , Facet joint injuries, muscle strains.

Disc prolapse: When the centre of the intervertebral disc (a jelly like substances) pushes through the fibrous outer ring and can push on nerves or surrounding tissue. This can cause debilitating pain and neurologic symptoms.

Facet joint injury: Each vertebra connects with the vertebra above and below via two types of joints: the facet joints on either side of the spine and the intervertebral discs centrally. During certain movements of the spine stretching or compressive forces are put on these joints which in turn can result in injury.

Muscle strains: Muscle strains in the lower back (erector spinae muscles) can happen when load being lifted is too much or improper technique is used.

If you injure yourself deadlifting it is important not to panic/stress. This can make the problem and recovery time a lot worse.

Stop the activity immediately and do not continue any other exercises in the gym as again this can make things a lot worse. Put ice on the affected area as soon as possible. If you are in a lot of pain non-steroidal anti inflammatories such as Nurofen (ibuprofen) or voltaren (diclofenac) may help.

Often people with back injuries believe it is best to rest however it has been found it is best to keep moving if at all possible, so try minimise prolonged sitting and keep yourself moving.
Book yourself in to see a physiotherapist for a professional opinion. They will be able to assess the severity of your injury and guide your rehab process so you are able to get back to the gym as soon as possible and avoid further injury.

Any physical activity can cause injury. Yes, you can hurt your lower back with Deadlifts. But more people hurt their back outside the gym than doing deadlifts. Sitting slouched at work for hours is bad for your lower back. So is picking up something at work by bending over with straight legs and a rounded lower back. Everybody knows somebody who never did deadlifts but hurt his lower back anyway at work or home.