Quite regularly, patients present to our clinic (Burlington Sports Therapy) with a stiff, tight, painful neck. Usually, patients attribute this neck pain to countless hours of computer work. These patients often describe their pain “as if the muscles of my neck won’t relax”. Interestingly, some recent research may confirm this description!

Posture and Neck Pain

A recent study published in the journal “Manual Therapy” looked at two different postures and their affect on neck muscle activity. The results found that subjects with a history of chronic neck pain showed altered and increased muscular activity when simply putting their hands on a keyboard. In other words, their neck and shoulder muscles “went crazy” when they simply placed their hands on the keyboard when compared to just placing their hands on their lap.

Neck Pain and Computers

Similar to the results mentioned above, another study published in 2005 found that people with chronic neck pain showed an increased “agitation” of the neck muscles while typing on a keyboard. In other words, these types of studies confirm the fact that typing on a keyboard and sitting at your computer is not really helpful for your neck pain. So what do we do?

Computer Desk Ergonomics

Before you seek any treatment for your neck pain, it is important to ensure that your work-station is ergonomically correct. That means, your work-station should be set up in a way that allows good posture. Although treatment for your neck pain can be very effective, your pain will likely return if you go back to your poor workstation and return to your daily habit of poor posture.

Tips For Setting up Your Computer Desk

To start with, ensure that your computer monitor is straight in front of you, instead of at an angle to your chair. Your chair height should allow your forearms to rest on the desk, without having to “shrug” when sitting. In general, your eyes should be at the level of the top of your computer monitor. With respect to your lower back, you should maintain a good curve in your lower back (lordosis) while sitting. This will assist your neck and mid-back in good posture. Pacing is very important. That means, sitting at the desk for hours on end will more than likely result in some form of dysfunction. Get up and walk around as often as possible to avoid prolonged strain of neck muscles.

Graston Treatment Burlington

Treatment for Neck and Shoulder Pain

It’s quite common for patients to come to our clinic wanting treatment on their trapezius, neck and shoulder area. They also commonly complain of pain around the shoulder blade. There are various methods for treating these areas of muscular pain. Our clinic offers chiropractic, physiotherapy, laser therapy, athletic therapy, massage therapy and acupuncture as treatment options. Personally, I have found that a combination of Graston and Active Release is what gets the job done. Above this paragraph is a picture of Graston on the area of the trapezius, which tends to be a common area of pain and dysfunction. For more information, please call our clinic at 905.220.7858 or email us at info@burlingtonsportstherapy.com.

References
Szeto G, Straker L, O’Sullivan P. A comparison of symptomatic and asymptomatic office workers performing monotonous keyboard work-1: neck and shoulder muscle recruitment patterns. Manual Therapy 2005; 10: 270-280.
Szato G, Straker L, O’Sullivan P. Neck-shoulder muscle activity in general and task specific resting postures of symptomatic computer users with chronic neck pain. Manual Therapy 2009; 14: 338-345.
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Quite often patients present to our clinic with what they describe as a “pinched nerve”.  Their symptoms can include pain, numbness, weakness, and sensations of tingling, pins and needles, feeling like an arm or leg is asleep or a dull achy throb.  These entrapments can occur almost anywhere there is a nerve.  Common areas include the neck, arms, lower back and legs.  Diagnosis can sometimes be tricky, since the symptoms don’t always occur where the nerve is being compressed.  To understand how nerve entrapments work, it is important to have a basic understanding of the anatomy…

Burlington Ontario Chiropractic and A Pinched Nerve

Anatomy of a Pinched Nerve

In simple terms, the brain descends into the spinal cord which has nerves that branch off at every spinal level.  These nerves course between and through various structures as they head toward their destination. Entrapment can occur at the spine or closer to the destination, compressed by various tissues such as muscles, fascia or ligaments.  One of the most common examples of a nerve entrapment is what is often referred to as “sciatica” or sciatic nerve pain. 

Sciatica – What is it?

Sciatica is a frequently used term describing irritation or “pinching” of a nerve that is present in the back of the thigh and leg.  Quite often, after the nerves have exited the spinal canal they can be compressed by the spinal disc.  A proper diagnosis is crucial in this situation since a small percentage of the population can get compression of the sciatic nerve by a muscle in the gluteal region known as the piriformis, instead of the lumbar disc. 

Piriformis Syndrome – What is it?

Piriformis syndrome can mimic lumbar disc herniation and sciatica.  Both of these conditions involve nerve compression and although their symptoms are similar, a treatment won’t be successful if it isn’t directed at the correct location.  For example, treatment of piriformis syndrome might involve techniques that stretch the muscle, whereas the treatment for lumbar spine nerve compression might avoid those same stretches. 

Carpal Tunnel Syndrome – What is it? 

Another common nerve entrapment involves the median nerve.  The median nerve is a nerve in the arm that travels from the area of the shoulder down to the hand.  The most talked about site of entrapment for the median nerve is at the carpal tunnel, producing numbness, tingling, pain and weakness into the hands and fingers.  These symptoms can also be reproduced with compression of the nerve roots at the neck.  Again, two conditions with similar symptoms yet the nerve compression occurs at different locations.

Treatment for a Pinched Nerve

There are various treatment approaches for nerve compression. Our clinic employs chiropractors and physiotherapists who both use a combination of manual treatments and home exercise. One treatment approach that we frequently use with nerve entrapment injuries is Active Release Technique. Active Release Technique is a popular method of breaking down dysfunctional scar tissue and thereby releasing pressure on nerves. In fact, our Active Release Practitioners have taken specific courses in nerve entrapment treatment. Unsure what is right for you? Give us a call at 905.220.7858 or email us at info@burlingtonsportstherapy.com. We can help!

References
McCrory P, Bell S, Bradshaw C. Nerve entrapments of the lower leg, ankle and foot in sport. Sports Med 2002; 32(6): 371-391.
McCrory P, Bell S. Nerve entrapment syndromes as a cause of pain in the hip, groin and buttock. Sports Med 1999; 27(4): 261-274.
Schoen, DC. Upper extremity nerve entrapments. Orthopedic Nursing 2002; 21(2): 15-32.
Leahy M. Active Release Techniques Peripheral Long Tract Nerve Release – Course Manual. 2005.

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If you’re looking for physiotherapy in Burlington Ontario, look no further! 

Burlington Sports Therapy – A bit about us…

Our clinic (Burlington Sports Therapy) is a Burlington Ontario physiotherapy clinic that offers many different treatment approaches for patients.  We have traditional approaches to physio (such as interferential current and ultrasound) as well as more modern approaches to physical therapy like Active Release and Graston technique.  Please take the time to look around on our website and learn about our different services…we’re sure to have a treatment approach that is right for you!   Want to know about our philosophy for treatment?  Click here!  

Physiotherapy Patients – Important Information

You do not need to be an athlete to be treated at our clinic.  Our Burlington Physiotherapy clinic caters to patients of all abilities and we treat various physical injuries, not just those related to sports.  Many of our patients are unaware that we also accept motor vehicle injuries and wsib (workplace) injuries.  For more information about our physiotherapist, please review her bio…Beth Slack - Physiotherapist, Burlington Ontario.

Active Release Technique at Burlington Sports Therapy

Many patients contact our clinic looking for Active Release Technique and Graston Technique.  Popular within sports medicine, the majority of professional sports organizations in North America have active release practitioners on staff.  It is a hands-on soft tissue release technique designed to break down scar tissue in dysfunctional muscles, ligaments and tendons.  If you have a sports injury and are looking for a sports medicine clinic in Burlington Ontario, please give us a call.  For more information about Active Release Technique please click here. 

Graston Technique at Burlington Sports Therapy

Graston Technique is also frequently used by sports therapists for various sports injuries.  This technique involves the use of stainless steel instruments that are great for targeting scar tissue in dysfuctional muscles, tendons, fascia and ligaments.  For more information, click here.

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The supraspinatus, infraspinatus, teres minor and subscapularis muscles are often referred to as the rotator cuff muscles. Injury to the rotator cuff musculature is one of the more common conditions affecting the shoulder, ranging from mild strains to complete tendon rupture.

Symptoms of Supraspinatus Tear

Rotator cuff injury (including rotator cuff tear) can cause significant pain, weakness and reduced range of motion. Quite often, it causes difficulty with common daily tasks like putting your arm in a coat sleeve, putting your seat-belt on or reaching in the back seat of your car. Of course, there are many different conditions affecting the shoulder that can make these daily activities difficult and painful, so it is important to have this condition properly diagnosed.

Diagnosing Shoulder Pain

Soft tissue imaging (like diagnostic ultrasound or magnetic resonance imaging) is the optimal way to diagnose rotator cuff tears. Unfortunately, there is often a waiting list for these diagnostic tests so the preliminary diagnosis is made clinically in your health practitioner’s office. This is not always a simple step, since the commonly used clinical tests are not always easy to interpret. According to the scientific literature, there does not seem to be a reliable correlation between symptoms and tearing of the rotator cuff muscles. In other words, studies have found that many patients with minimal pain and normal function of the shoulder often have imaging results indicating partial thickness tear of the supraspinatus or full thickness tear of the supraspinatus.

Rotator Cuff Treatment

Consulting with a knowledgeable and skillful diagnostician can eliminate wasted time by deciphering which tissue is likely damaged and focusing treatment on the appropriate structures as quickly as possible.  That’s the first step as it helps to determine what avenue of treatment is best.  For some, surgery is necessary.  For most, conservative treatment like physiotherapy or chiropractic is the best choice.  What is right for you?  There are many factors to consider and we can assist you with that process.  For example, a recent injury might benefit from laser therapy or gentle exercises with our physiotherapist.  For others with more chronic rotator cuff injury (like supraspinatus tendinosis or tendinopathy) active release or graston technique with one of our chiropractors would be the best treatment.  Unsure?  Give us a call or send us an email…we can help you!  905.220.7858  email - info@burlingtonsportstherapy.com

References

Ainsworth R, Lewis JS. Exercise therapy for the conservative management of full thickness tears of the rotator cuff: a systematic review. British Journal of Sports Medicine 2007; 41: 200-210.

Uhthoff HK, Sarkar K. An algorithm for shoulder pain caused by soft-tissue disorders. Clin Orthop Relat Res 1990; 254: 121-127.

Frost P, Andersen JH et al. Is supraspinatus pathology as defined by magnetic resonance imaging associated with clinical sign of shoulder impingement? Journal Shoulder Elbow Surgery 1999; 8(6): 565-568.

Schibany N, Zehetgruber H, Kainberger F et al. Rotator cuff tears in asymptomatic individuals: a clinical and ultrasonographic screening study. Eur J. Radiol; 2004; 51(3): 263-268.

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Osteoarthritis in the knee is the most common condition affecting synovial joints.  When this type of arthritis is present, it usually involves degeneration and destruction of the various joint structures, especially the cartilage. 

Knee Arthritis Symptoms

Symptoms of osteoarthritis in the knee often include pain with weight bearing, swelling, locking and crepitus (clicking and popping in the joint).  It is different for everyone.  For some people, prolonged weight bearing increases the pain in a joint.  For others, their primary complaint is stiffness and soreness after being still (like waking in the morning or getting up from prolonged sitting). 

Treatment for Knee Arthritis 

There are many different treatment options available for osteoarthritis in the knee, depending on the stage of arthritic change.  Of course, nothing can reverse the degeneration that has occurred, but slowing the degenerative process and keeping the joint healthy is the best way to delay a joint replacement and allow a person with arthritis in the knee to be able to participate in the activities they like to do. 

Living with Osteoarthritis

According to a 2008 systematic review published in the journal Physical Therapy, there is high quality evidence supporting exercise and weight reduction for managing osteoarthritis in the knee.  At our clinic, we combine this approach with the use of low-level laser therapy.  Numerous studies have advocated the use of low-level laser therapy as a means of reducing pain in arthritic knees. 

Physiotherapy for Knee Arthritis

Unfortunately, there is low quality evidence to support the usefulness of therapeutic ultrasound, bracing or thermotherapy (three approaches that are frequently used in physiotherapy).  As mentioned above, our clinic tends to utilize laser therapy, safe strengthening and activity selection that keeps the joint asymptomatic.  This service can be provided by either our physiotherapists or our chiropractors. 

Are There Other Ways to Treat Arthritis?

Yes.  The goal of managing osteoarthritis in the knee is to slow the degenerative process and keep the joint healthy.  There are many different ways to do this, each with varying levels of evidence to support them and therein with variable success rates.  Everyone is different and what works for one person might not work as well for another.  Glucosamine, acupuncture, synovial injections, orthotics and surgery are also common treatment approaches for knee arthritis.  Consulting with a knowledgeable health care practitioner is a great first step in choosing the appropriate treatment strategy for you! 

For more information – 905.220.7858   email – info@burlingtonsportstherapy.com

References

Bjordal JM, Couppe C, Chow RT et al. A systematic review of low-level laser therapy with location-specific doses for pain from chronic joint disorders. Aust J Physiotherapy 2003; (4).

Brosseau L, Gam A, Harman K et al. Low level laser therapy (classes I, II and III) for treating osteoarthritis (Cochrane Review). The Cochrane Collaboration 2004; 3.

Jamtvedt G, Dahm KT, Christie A et al. Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Physical Therapy 2008; 88(1): 123-136.

Lopez AD, Murray CCJL. The global burden of disease, 1990-2020. Nat Med. 1998; 4: 1241-1243.

Disclaimer
The purpose of this blog is to educate patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. Appropriate practitioners include (but are not limited to) chiropractors and physiotherapists. This information is not intended to diagnose or treat your condition. Our Burlington Chiropractic Clinics, Burlington Physiotherapy Clinics, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site. Should you have any further questions about these topics please contact our Burlington Chiropractic Clinics or Burlington Physiotherapy Clinics.