Hi, I'm Dr. Molly with Your Goals Physical Therapy. Let's talk about carpal tunnel. Carpal tunnel is so common, especially for moms. And if you've just had a kid it’s also common to get carpal tunnel while you're pregnant, but it’s common just from holding your child that you get carpal tunnel. In my case my daughter, after she was born, just loved to be carried. She didn't really like to be put down for any length of time. And so you just spend a whole lot of time caring and of course, you're kind of curled in this position. You're trying to make sure that they're comfortable and you're doing a whole lot of this right. All day. And after a while, I noticed that, you know, my wrist would be a little bit sore and achy. My elbow was getting sore and because you're not sleeping a whole lot, there's not a lot of thought. You just know that you need to take care of your baby. And then that's what you're doing. But when I started to try to reach for things and I was uncoordinated, I would drop things because I didn't really have as good a grip as I thought I did. And then the numbness came and then after the numbness came, the realization that I am giving myself a carpal tunnel on my left side.
Hi, I’m Dr. Molly with Your Goals Physical Therapy. I had somebody stop me the other day and asked me what’s kind of a funny question. But it was very serious for her. She asked me why she walked like a duck and she demonstrated. She walked with her feet turned out. I obviously kind of chuckled because it's a funny way of asking why I walk a certain way. And she was kind of trying to brush it off too. Like, yeah, my kids are kind of messing with me a little bit about how my feet are always turned out. Then she said, I'm secretly a little afraid that they think I look funny or that I look odd when I'm walking. After talking to her for a little bit, there was a little bit more to that.
I'm Dr. Molly with Your Goals Physical Therapy, are you currently trying to decide whether or not you need to have a cortisone shot or go to physical therapy for a shoulder impingement? I'm assuming if you have a diagnosis like shoulder impingement, you went to your doctor because you're having pain with certain motions. You're probably freaking out because it is very scary when it hurts to get dressed, it hurts to sleep. You can't find a comfortable position walking around your arm because it really doesn’t like just hanging. You can have pain putting away dishes, vacuuming, all sorts of things. And it's all the time, especially if it's your right arm and you're right-handed, you have to use your arm all the time so everything reminds you that your shoulder doesn't feel very well. Most of us, we're able to ignore that pain for a while because… “it'll just go away on its own”.
If you've gone to the doctor and the doctor is talking to you about whether or not you need a cortisone shot that's probably a pretty scary place to be because you're thinking the absolute worst. You're afraid that, if this cortisone shot doesn't work, you're going to need surgery. Or there's some other major thing waiting around the corner. That's going to tell you that your shoulder is going to be messed up for a very, very long time. You just want this pain to go away. And so this doctor is offering you a cortisone shot, which based on what the doctor is telling you will get rid of your pain in a couple of days.
But you're also curious what a non-invasive item would be like physical therapy and what would the differences be?
So let me go over that. First, a shoulder impingement, just so that we understand what we're talking about, is the mechanics of your shoulder are not working properly. That means that your arm bone, or your humerus, sits in a very shallow little cave, and your rotator cuff helps keep your arm bone in place, along with some other items. When the rotator cuff works correctly, it pulls your arm bone down enough so that you can clear the little hat that sits over here, it's just called your acromion. If your rotator cuff is not strong enough, or isn't coordinated, it's not recruiting itself properly, then what happens is that the arm bone doesn't depress enough to clear the acromion. Then you get this pinch. You can feel like your arm just doesn't go any farther. Now some people can get it to go farther. There's just a lot of pain for a second. And then you have a little bit more range depending on how long you've been dealing with it. You could have had more motion a few weeks ago. And now you just can't even raise your arm without a huge amount of discomfort. That's what the impingement is. The impingement is when the mechanics are off and it's causing your arm bone to actually hit another bone pinching, your rotator cuff. The negative effects of that over time is eventually you can actually tear your rotator cuff. Those two bones hitting each other will eventually bore a hole through your rotator cuff, possibly requiring surgery intervention later, later on.
The nice thing about cortisone shots is that they get rid of the inflammation, it’s a high powered anti-inflammatory, kind of like an ibuprofen only with a whole lot more strength. And it’s a lot more exact because you're not taking it orally. They're actually going to inject it right into the shoulder joint right where the tissue that needs it the most. Where it hopefully has more bang for its buck. For the people that this works for, which is quite a few it's obviously not a hundred percent, there is some really good benefits.
There are a lot of good benefits to taking a cortisone for getting rid of that inflammation, especially related to pain. Your doctor will, or should, tell you that you can only have so many of them, because what attacks the bad tissue, that's the inflamed and irritated tissue that's causing the pain, will also attack good tissue, which can make your muscle a little bit weak, and more unstable. They won't let you have more but you then a certain amount before they call it quits on giving you cortisone shots. So cortisone shots do an amazing job of getting rid of the inflammation.
So what does physical therapy do and why would you even bother with that if you're going to get rid of your pain? I mentioned the actual definition of the shoulder impingement is that the mechanics in your shoulder are not great.
Guess what physical therapy does? Physical Therapy helps fix and get rid of that mechanical problem. By looking at your posture. By looking at which muscles are not as strong as maybe the opposing muscle, causing a little bit of imbalance. By looking at the flexibility of certain arms and other muscles in your chest, your upper back and your neck. There can be a very evident reason as to what's going on and causing this dysfunction movement in your arm bone. And honestly, this is gonna be something super slight, something that nobody, other than a very trained professional, can figure out. A slight change in where your arm is sitting inside of its joint can make a huge difference because there's not a whole lot of space in there. We're talking millimeters, not centimeters. And so just having a little bit of something off balance and off-kilter can cause a huge amount of pain. Having a specialist, somebody who specializes in shoulder joints, somebody who specializes in how muscles move and how to correct posture and how to look at your workspace. Sometimes it could be something that you're doing at your job that you've been doing for years that just eventually caused a problem.
There can be so many reasons why people have shoulder impingements and they don't have to be devastating and they don't have to last. That's literally what I do all day. I help people fix their posture. I help people figure out, by problem solving, which muscles are affected. Then we restore that proper balance with very specialized exercises and some hands-on techniques that help you properly align your shoulder joint and help you to get the right amount of muscle recruitment, to get everything to work correctly.
Those are the differences between a cortisone shot and physical therapy. If you have any questions about your specific situation and what's going on with your shoulder, feel free to contact me. Either send me a direct message through the site or send me an email. I'll talk to you later.
Are you debating between buying a back brace and going to Physical Therapy. You're looking at these two options because your back is killing you. You're not able to move around your house. You're not able to walk the distance that you want to do. You're not able to stand up, sit down, basically your back is running your whole life. The back pain can be one of those things that just interrupts everything. Anything from standing in the grocery store line to sitting in your car, commuting to work can become very difficult and very painful surprisingly quickly. If you are staring at the aisle and you're like, Hmm, back braces are looking pretty good right now, but “I don't know if they're going to help me”. Then maybe a friend told you about physical therapy, but you know that that's going to be something that you have to commit to. Becoming another thing on your list. So you're trying to figure out what makes the most sense for you.
Hi, I'm Dr. Molly with Your Goals Physical Therapy. Let's talk about whether or not you need to have an MRI before you come into physical therapy. In my opinion, the answer is no. And here's why, so first the difference between physical therapy and a surgeon? So surgeons and, your primary care physician, they use x-rays and MRIs to diagnose structural issues. I mean, I would use it for the same thing, I'm gonna look at the picture and know, okay, this is where some injury has occurred. And, you can make a plan accordingly. Especially, if I was going to go in as a surgeon, then I would need to know exactly what it is that I'm going to be doing surgery on and what it looks like. So I can come up with a game plan. It would be very important for me to at least have a general idea of what I'm going to go in and see. And if things change, once you open somebody up and things change, but at least you had a general idea going in.
Hi, I'm Dr. Molly with Your Goals Physical Therapy. Let's talk about Sciatica. So sciatica is kind of a general term. A lot of people get diagnosed with sciatica, in general, what they're talking about is that they have low back pain that runs down their leg. So they may always have back pain. Like there's a little bit of ache in their low back, then with certain motions or in some cases all the time, they have a burning sensation that runs down one of their legs. When somebody gets diagnosed with sciatica, that can mean that that burning sensation is running from their hip to their knee, or could even go all the way down to their foot. Today I wanted to talk about why it is so important, not to wait years to find the reason for that pain.
Hi, I'm Dr. Molly with Your Goals Physical Therapy. So many people have pain in their shoulders when they try to do a pushup and for a lot of people that ends up being the end of all pushups forever. Because ultimately people end up in one of two camps, you're either in the camp that if an exercise hurts, “I just don't do it.” Or you're in the camp of “I'm going to push all the way through the pain because pain is just weakness” and I can make it through that. I’m a little bit more in the gray area.
Hi, I'm Dr. Molly with Your Goals Physical Therapy. Let's talk about how you properly stretch your Pecs. Most people are familiar with that stretch where you put both arms through the door and then pull through. But one of the things that I've noticed over the years is that there are a few things that are done wrong consistently. So I thought I would go over those things.
Hi, I'm Dr. Molly with your Goals Physical Therapy. If you're about to go in for a shoulder surgery, then you've more than likely been told what you need. You're going to be wearing a sling for some amount of time. Some times for 4 weeks some times for six weeks depending on the surgery. Then you're going to need to ice because of the discomfort. You're going to have your pre-op appointments. You’re going to have post-op appointments. And you're probably planning out how people are going to help you take care of yourself and how you’re going to get from place to place.
Well, I have two tips that I always give people that they should have in their post surgery bag. I thought I would share those today. They're a little bit lighthearted, but who doesn't want to be as comfortable as possible after having shoulder surgery.
Hi, I'm Dr. Molly with Your Goals Physical Therapy. Let's talk about stopping that muscle spasm that happens between your shoulder blades. So the other day I got a frantic phone call from somebody who rolled over in bed, super common roll over in bed, and was woken up instantly. All of a sudden she had a huge muscle spasm that was attacking a nerve and it was sending radiating pain up into her head. Every time she moved her head she had severe pain. She couldn't find a comfortable position. She was stuck. She was waking up every couple of hours because of giant shooting pain from her shoulder blade up to her head. Her head could be up too much. She couldn't lay on her side. It was just miserable. She took ibuprofen, she tried using heat. She tried sitting up in a chair. She tried everything that she could think of but she was just miserable all night. So when she calls me, she wants to know how to make this better. She was throwing out any and all ideas of things she thought she could do at that moment and asking what I thought. I thought it'd be good to make a video and kind of talk, what I told her.
What do you do when you wake up with searing pain that prevents you from being able to move your head or your shoulder throughout your day without dramatic sharp pain?
WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald