Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Tennis elbow is a condition which is characterized by a sharp pain on the outer portion of the elbow. This condition is also called  lateral epicondylitis  and it occurs when the muscles of the elbow are overused. The symptoms of pain tend to occur near the forearm when you bend your elbow or try to grip an object.

Causes
The elbow joint comprises of muscles which facilitate movement of the wrist, elbows and the fingers. There are tendons present in the elbow which join the muscles and bones, thus regulating the forearm muscles. When the muscles of the elbow are overused, then it can lead to inflammation and tears in the muscles.

This condition is so called as it is usually caused by playing certain sports, primarily tennis. It may also be caused by activities that put repetitive stress on the elbow. If the same pain occurs around the inner portion of the elbow, it is called a  golfer s elbow .

Prevention
The best treatment method to prevent tennis elbow is to strengthen your elbow muscles. You need to follow a regulated strength and stretching program directed at strengthening the muscles of the body, including the elbows.

Here are some tips to prevent tennis elbow:

Try to stay in good shape physically.
Use proper technique when you are carrying out any activity that involves the elbow.
Avoid overstressing the elbow joint with repetitive movements as it can cause injury to the tendon.
The muscles of the shoulder, arm and the upper back should be strengthened to prevent tennis elbow.
For movements that require you to twist your arm or grasp things, you can use a counter force brace to protect your elbow. This brace is worn on the forearm which redistributes pressure on the muscle. A counter force brace is recommended for people who are at an increased risk of tennis elbow.

Tennis Elbow - Tips To Help You Prevent It!

Excessive and persistent pain in the feet as well as the ankle joints could point at the existence of a condition known as flat foot pain. This happens due to the difference between a normal foot and a flat foot. While a normal foot will have an upward arch under the foot, right in the middle, the flat foot does not have such a support. This arch is usually formed by the tendons and ligaments that help in rendering support to the foot as well as stabilising the rest of the body. When these tendons and ligaments become weak, the arch begins to diminish before finally disappearing, which leaves the patient with a flat foot. This can be a painful condition. Let us look at the ways in which it may be cured.

Foot Wear: When you are suffering from this condition, it is important to wear comfortable and supportive foot wear like shoes, sandals and slippers which can support the arch and help in giving stability to the rest of the body. Besides looking for shoes that will provide the right amount of comfort, one can also use additional support like insoles that will help in giving comfort while you are walking, standing or running.
Orthotics: These are tools that can be recommended by your doctor in order to help in minimising the pressure that one feels in the foot. The orthotics usually distributes this pressure by giving much needed additional support to the arch of the foot. These tools also help in realigning the foot s ankle with its bones as well as the joints, which can help in successfully treating this condition to a great extent. They are usually customised as per your exact foot shape and size, as well as the problem you are facing, so that you have plenty of support when you are using your feet for varied activities.
Arch inserts and wraps: If your normal shoes are lacking the arch support that you require for flat feet, then you can also invest in arch inserts and wraps which will reduce the pain and prevent it from reoccurring. Also, these will help you to remain standing or walking for longer periods of time, as they add that extra bit of support to your feet for normal functioning.
Surgery: If the various non surgical treatments do not help you over a period of a few months, then it may be time to speak with your podiatrist or orthopaedic specialist so that you can go in for a surgery that will fix this problem. This kind of surgery will help in stabilising the feet and ankle bones by applying corrective foot support.

Flat Foot Pain - Ways It Can Be Treated!

Knee pain is one of the most common and painful ailments that can limit mobility. Injuries can result in cartilage or meniscal tears or sprains too. Obesity is another reason because of which knee pain is on the rise. Also, regular wear and tear of ligaments and tendons around the knees due to old age is another cause. These days, with reduced physical activities and sedentary lifestyles, the rate at which knees are wearing out has also become accelerated. Whatever the reason, a correct diagnosis followed by prompt treatment can help. Over the years, physiotherapy has been playing an important role in treating knee injuries. Whether to supplement the various drugs to reduce pain and inflammation or to avoid surgery, physiotherapy has helped many and its popularity is growing every day. Here are some ways that physiotherapy can help reduce pain.

Improve flexibility of tendons: The knee cap is an area where there are lot of tendons and ligaments, coordinating to enable movement. Careful exercising can ensure that the flexibility of tendons and ligaments is improved, thereby making your knee movement easier and less painful.
Improves blood supply: As we all know, proper movement requires good blood supply. Exercising with special focus on the knee ensures that blood supply is improved, and thereby the supporting ligaments and tendons function optimally.
Enhances the knee cap function: The knee cap is that portion which joins your thigh bone to your calf bones. This is prone to slip out of place, especially with arthritis and injuries. This can be painful and limit movement to a great degree. Focused exercises aimed at improving knee cap function will ensure that the knee cap has a wider range of function, and does not slip out of its socket easily.
Reduce rigidity: Once you start physiotherapy, you will feel your knees getting more flexible. The rigidity that had set in as a result of injuries and/or old age will also reduce over a period of time.
Slow down the wear and tear: When you start physiotherapy after knee damage, continuing the exercise routine, of course with expert guidance, can reduce the pace at which further damage might happen. A word of caution though. Be sure to consult an experienced physiotherapist before you begin. Exercising in a bad manner can do equal or more harm than the original injury or old age itself.

Knee Pain and Physiotherapy

Frozen shoulder is a condition where the patient encounters continuous shoulder stiffness and pain. It could last for several weeks. Inflammation around the shoulder increases the inability to move or stretch properly. This happens when somebody is recovering from an injury. Frozen shoulder can also occur when somebody is wearing a sling or a cast. It also occurs if someone is recovering from surgery or experiencing joint pain. It may also be experienced as a symptom of thyroid, joint disorders or diabetes.

Some of the causes and risk factors for creating a frozen shoulder are as follows:

    If you are 40 years or older, your chances of a frozen shoulder are higher than others
    Recovering from a damage or surgery
    Hormonal imbalance
    Ladies are more prone to a frozen shoulder
    Cervical disc infection that influences the nerves around the shoulder
    Not moving your arm because of other pain or wounds
    Having a previous medical condition like diabetes or other heart diseases
    Open-heart surgery or spinal surgeries
    Poor diet and unhealthy lifestyle

The most widely recognized symptoms of a frozen shoulder include:

    Stiffness around the shoulder usually happens in one shoulder at a time (not both) and will probably return in the same shoulder. Muscle, joint and bone agony in and around the shoulders or arms may be experienced.
    Restricted scope of movement
    Having difficulty moving and using the shoulders or arms ordinarily, (for example, experiencing difficulty in getting dressed, driving, holding objects before you, and gestures.)

Treatment:

    Stretch the Shoulder: Before beginning shoulder exercises for a frozen shoulder, try to warm up your shoulder by doing a few warm up exercises. This will improve the blood supply in the affected area and avoid future injuries by making your body more comfortable with the motion. The best approach is to extend and warm up the shoulder by applying heat for 10 to 15 minutes, scrubbing down or showering with Epsom salt.
    Non-intrusive treatment: While these activities mentioned above can be easily performed at home, if pain continues and makes it difficult to move around or work ordinarily, see a physiotherapist who can appoint particular activities and can enhance your scope of movement, flexibility and strength.
    Acupuncture: Acupuncture is considered one of the best treatment choices for any joint and nerve related problem. The treatment is based on focusing on the trigger points of the pain and putting pressure on them via needles. The treatment is not painful and is known to produce good results in the long run.
    Dietary Supplements: Various supplements can be taken with the recommendation of a doctor, in order to improve recovery. Alfalfa (horse feed) and turmeric are two of the most regularly recommended elements that relieve swelling and repair the tissue in the shoulder.

Best Remedies for a Frozen Shoulder

A small piece of bone is known as a fragment and it is very common that an avulsion fracture also tends to damage the protrusions of bone to which the tendons attach. This basically means that the tendon or ligament will come away from the bone and it will take a small piece of bone with it. It is sometimes very hard to find out what type of injury you have and this is why knowing the causes and symptoms of an avulsion fracture are very helpful in determining exactly how severe the injury is. 
Here are the causes of an avulsion fracture.
Causes:
Explosive Landing: Athletes who tend to jump or land with great impact tend to get these most commonly. Therefore, it is crucial for your health that if you participate in such sports, you do follow the correct method of jumping.
Explosive Extension: Similar to how an athlete landing ferociously can get an avulsion fracture, someone who is extending the legs very violently and explosively during an exercise can also get an avulsion fracture. This is because the bone getting extended could very well damage the protrusions to which the tendons are attached. 
Symptoms:
These are the two main causes of an avulsion fracture. There are not many symptoms of an avulsion fracture. This is because an avulsion fracture can only be determined by an MRI or by an X-ray scan. Therefore it is nearly impossible to diagnose that you have an avulsion fracture without looking at the results of the tests performed on the part of your body. However, the way you got the fracture and especially the details of it are very good indications of whether you have an avulsion fracture or not.


Causes and Symptoms of Avulsion Fracture

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