Will Stretching Help My Pain?

If you have ever been in pain, chances are you were told to stretch.  For some of us it helped, others it didn’t.  Why did it work for some, while others stay in pain and are left thinking they just need to stretch more? Could stretching actually make the pain worse?

To understand this topic, we have to talk about some complicated subjects; anatomy, physiology, and kinesiology.  Please don’t run away, we will make it easy for you to understand.

To start lets agree, that as humans, we all have the same parts, and should, therefore, all move the same and respond similar when exposed to common environments.  Let’s also agree that our modern day lifestyle leaves us in poor postures for most of the day.  Be honest with yourself right now and assess your posture.  Is your head forward into your computer or flexed down to your phone trying to read this?  Is your low back rounded and flexed while at your desk right now or on your drive home?  Chances are it probably is, and you’re like this for most of the day without realizing it. These positions are already lengthened or stretched positions, so why isn’t it helping?

We walk a very fine line everyday balancing between what our body was designed to handle, and what we actually put our body through.  We must understand that when we overload or overwork our body either through training, work, or sitting at a desk all day, the body will have to create compensations to better accommodate the stress being placed on the body.  In the initial phases of compensation, the body will feel “weak and tight.”  This serves as a protective role on the body, and is commonly referred to as “protective tension.”

Protective tension serves a purpose to protect the body from injury by providing stability to an unstable area.  While it may feel good to stretch really all that is happening during this time is that a bunch of stretch receptors are getting fired off and overriding the current symptoms.  This is why you may feel better in the short term but relief never lasts more than a few hours. This is also why it can lead to long term pain, as stretching often leads to more cumulative damage in already lengthened tissue!

If we fail to recognize why the protective tension is occurring and continue with our regular activity without modifications, friction, pressure, and tension, will eventually lead to the development of dysfunction in the body.

Having already agreed that as humans we will mostly have the same parts and respond similar given the same situations, we know that in muscles, or where nerves come into contact with muscles, adhesion will ultimately form in structures with continuous overload from repetitive motions or prolonged positions!  Adhesion is the most common pathology found in muscles, but unfortunately, one of the most misdiagnosed conditions in the human body.  I am going to go out on a limb and guess you haven’t heard this term before.  Fortunately, it can be easily fixed!

Overuse Cycle

Adhesion, or scar tissue, when present, acts like glue on the muscle and nerves.  This further leads into the continuous cycle of feeling “tight” but will also start to cause pain and injury.  If left untreated, this relatively easy problem to fix only gets worse and leads to bigger complications down the road.  Weakness, pain, and even tingling, burning, and numbness, when present along a nerve, can all be caused by adhesion.

Adhesion

Stretching, unfortunately, will not fix adhesion.  In order to fix adhesion, adhesion must be broken down through manual therapy by a certified practitioner that is trained to diagnoses and treat adhesion.  When adhesion is removed, the “need” to stretch is removed.  By removing adhesion, the body can then move better, and function better on a day to day basis without the need to stretch!  Stretching can help to prevent adhesion from coming back in the future, and keep you healthier, but will not fix adhesion in the present.

At Thrive Spine and Sport, we are currently the only full body Integrative Diagnosis provider in the state of Iowa.  Integrative Diagnosis providers are trained to find faulty movement patterns, diagnose, and treat adhesion to fix your pain or movement problem! If you are constantly feeling “tight” or having pain, weakness, or numbness and have failed to find anything that has fixed the problem, I invite you to get to the bottom of your problem! Simply fill out the appointment request on this page or call our office at 319-423-0925 today!

Thanks for reading!

 

 

Is It Tendinitis?

Tendinitis and tendinosis. One you’ve probably heard before.  The other, probably not. While they both sound the same, in reality they are worlds apart.

Tendinitis is, by definition, inflammation of a tendon.  Tendinosis on the other hand is defined as chronic tendinitis and implies chronic tendon degeneration without the presence of inflammation. Basically, one is short-term with inflammation, the other long-term, without inflammation, though both are caused typically by overuse.

soccerTendinitis, the most popular diagnosis of the two, usually presents with swelling and tenderness at the sight of pain, often accompanied by stiffness, and less often by weakness. Tendinosis presents most often with stiffness, tenderness to the touch, and weakness–almost identical to tendinitis. Recovery of tendinitis lasts anywhere from days to six weeks, a relatively “quick fix.” Tendinosis recovery can last a few short weeks to a couple months or more depending on the level of degeneration. If left untreated, tendinosis often leads to “tear” injuries.

While both conditions are classically treated with conservative measures, the difference in care is absolutely critical to resolution of the problem. Conservative management stems around rest and anti-inflammatory medication for tendinitis, while conservative management of tendinosis aims to restore tendon regrowth and strength through manual therapy and eccentric exercise.

Both, occur most often in the Achilles tendon (ankle), patellar tendon (knee), proximal hamstring (high hamstring), common extensor tendon (elbow), and the supraspinatus tendon (shoulder).

With both of these problems being so relatively close, while treatment is vastly different, proper diagnosis is vital to the recovery process! So which one do you have? Let’s go to the research.

While tendinitis is the wildly over-popular diagnosis among general practitioners, it may not be the case. Most research coming out on this topic is now showing that at a cellular level, once believed tendinitis actually is, in fact, tendinosis.

According to Almekinders and Temple, “Most currently practicing general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs despite the lack of clinical evidence.”

In light of this, chances are that if you have been diagnosed with tendinitis the diagnosis was incorrect. Furthermore, traditional, conservative treatment, of such, with the use of anti-inflammatories, corticosteroid injections, and/or pain medication may have left you worse off long term even though pain may have dissipated short term (but this conversation is for a different time). These methods were designed to eliminate inflammation, not regrow tendon. As mentioned above, treatment of tendinosis should be aimed at restoring tendon function and strength through manual therapy and eccentric exercise. Drugs will not help! Treatment should also include load management when deemed necessary.

With all this said, while we cannot assume a diagnosis was incorrect, lingering, worsening, or reoccurrence of pain would suggest that it may in fact be tendinosis. It is recommended that treatment plans geared toward tendinitis, in these cases, be reevaluated.

Tendinitis is one of the most commonly diagnosed injuries and all too many struggle to find relief. With the proper diagnosis and treatment plan, it doesn’t have to be that way!

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of musculoskeletal injuries, including tendinitis and tendinosis.  Most patients have seen many different providers before finding relief in our office.  Fill out the appointment request on this page or call our office at 319-423-0925 to set up an appointment today!

Thanks for reading!

What’s Wrong With My Shoulder?

Raise your hand if you struggle with shoulder pain!  Well, at least, raise it as high as you can.

Shoulder pain is one of the most frequently hurt and injured extremities in the body.  If you were to survey 10 of your friends, how many of them would report a shoulder issue?  Seriously think about this for a minute.  While the research can vary greatly with incident rates of shoulder pain, you can expect on average 2-5 to report shoulder pain and problems!  That is an incredible stat right there!

When you look into the mechanics of the shoulder, it is no wonder why pain is so often found there.  The shoulder joint consists of 3 bones, creating 4 joints.  13 muscles are involved in the movement of the shoulder which is responsible for almost 360 degrees of motion.

While there are many different kinds of problems associated with the shoulder (dislocations, fractures, etc), most complications arise from overuse, or repetitive strain injuries over time.  Shoulder pain may start up overnight, but it took weeks, months, even years to get to the point of pain.  Manual labors and athletes alike are no stranger to shoulder pain.

In cases of shoulder pain where overuse, repetitive strain, or previous injuries are present, the shoulder pain is almost always due to a lengthening issue.  The joints have become stiff and the muscles have become tight.  The most frequent cause of this stiffness is from adhesion.

Adhesion is a build up of scar tissue through repetitive motion, prolonged position, or as a result of previous trauma or injury.  Think of adhesion as glue on a muscle.  It binds things together and prevents the muscles from moving correctly.  When the joints and muscle get stiff and tight, it creates friction, pressure, and tension in the area.  This then creates decreased blood flow and sometimes swelling, which promotes the body to lay down scar tissue, or adhesion, to help stabilize the problem area.  Adhesion is one of the most common problems in the human body and fortunately one of the most easily reversible with the right care!

To see if your shoulder pain could be caused from adhesion at-home, there is a very simple test you can do at home.

Stand upright, with your arms and hands to your side.  Raise your arms up to your ears by moving your shoulders in an arc similar to that of a jumping jack.  The bicep should be able to freely touch the ear without any increased tension or pain.  Anything short of this, adhesion is a strong possibility, and may be playing a large part of your shoulder pain.  Regardless of previous injuries, or even surgeries, adhesion needs to be removed.

Stretching and exercises do not correct adhesion unfortunately.  When adhesion is present, it only gets worse without proper treatment, and could lead to bigger issues down the road.

If you are struggling with shoulder pain, try the test right now.  Look in the mirror if you can’t get your arms up to your ears and see how restricted it is.  The further away from the ear you are the more likely you are to suffer a serious injury down the road.

If you are in the Cedar Rapids/Iowa City area and struggling with shoulder pain, call our office today at 319-423-0925 or fill out the appointment request on this page.  If you have any questions feel free to reach out to me at dr.cody@thrivespineandsport.com.

Thanks for reading!