Blogs and Articles

What is my rotator cuff?

If you have ever suffered with or known someone who has suffered with shoulder pain, you have probably come across the term ‘rotator cuff’ and have been made aware it is the probable cause to your/their pain. Whether this is because you have strained it, torn it, or irritated it, it is a lot of peoples first call, as rotator cuff injuries are so common. But what makes up the rotator cuff?

The rotator cuff is made up of four muscles:

1. Supraspinatus – sits at the top of the shoulder blade (scapular) aiding us in abduction, flexion movements and stabilizes the shoulder.
2. Infraspinatus – this is found under the supraspinatus, attached to the scapular, and helps with external rotation of the shoulder and stabilization
3. Subscapularis – this muscle sits at the front of the scapular and allows internal rotation of the shoulder and stabilization.
4. Teres minor – this is attached to the lateral border of the scapular and supports adduction, extension, and external rotation movements of the shoulder. Also, provides shoulder stability.

Now, as you have probably realised, they all aid shoulder stability, whilst aiding all vectors of movement available in the shoulder. Therefore, they are constantly used day in and day out to complete tasks, whether this is reaching for something out of the cupboard, opening a door, putting on a jacket, carrying bags, etc. So, it is no surprise that they become strained.

Out of the 4 muscles, supraspinatus amounts to 75% of all rotator cuff strains, followed in second by infraspinatus which is at 15%.

How do we stop these muscles from being strained you may ask. Well, there is a very simple solution. All we have to do is train them. Do exercises to help increase the tone of the muscles, making them stronger, more versatile, and more resistant to straining. These exercises can be done at home, at work, anywhere. If you want to know what exercises to do and what would be best suited for you, you can always contact and see you local Osteopath/healthcare professional who can advise you, making sure you are doing them correctly and safely.

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Is squatting causing my knee pain?

In the last decade there has been a major increase in the number of people going to the gym and partaking in weightlifting exercise. Weightlifting natural places your body under excess pressure, increasing the load through our bones, our muscles, and our joints. The benefits of which are increased bone density, joint congruity and builds tone and strength within the muscles. However, weightlifting comes with its risks, especially if our techniques during specific exercises and movements are wrong. And one that I am seeing more and more of is knee pain over the kneecap (patella) following SQUATS!

When squats are done correctly, they are a brilliant exercise in helping to develop quadricep, hamstring, gluteal and core strength, all this aiding joint stability in the knees and ankles which can help slow down joint degeneration (osteo-arthritis) in the future. However, when done wrong it can cause joint pains and muscle imbalances. These muscle imbalances can be the cause of knee pain when or following squatting.

The key when squatting is making sure your feet are shoulder-width apart, toes pointed slightly out. Initiate the movement by bending at the hips and knees simultaneously, keeping chest up and spine neutral. Lower until thighs are parallel to the ground (knees at 90 degrees), ensuring knees don’t extend beyond toes and then Push through heels to stand. However, a common mistake is when people allow their knees to come inwards when squatting, this resulting in disengagement of their gluteal muscles, increasing pressure through the quadriceps and increasing pressure through the medial aspect of the knee and patella tendon. This can lead to weak glutes and pain over the knee cap.

Your quadriceps are made of four muscles, and commonly it is the outer muscles of the quadriceps (vastas lateralis and rectus femoris) that work the hardest, and when the squatting technique is wrong, they work even harder, resulting in muscle imbalances within the quadriceps alone. The medial muscles of the quads the VMOs (vastus medialis obliques) are weaker. This becomes a major problem as all the quadriceps attach into the same tendon over the kneecap (patella tendon). If the quadriceps are stronger and tighter on one side more than the other this will pull your knee cap off to one side more, taking it away from the smooth soft cartilage and onto a bonier surface of the joint. This is what causes the pain at the front of the knee but can also increase risk of patella (kneecap) dislocation.

So, how do we fix this? First, make sure you correct you squatting technique as shown above and makes sure when squatting your knees do not come inwards but stay in line with your toes. Secondly, start incorporating quadricep stretching and  VMO strengthening into your routine to balance out your quadriceps and improve patella-femoral gliding.

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Working from home: 3 ways to improve your posture

With the increase of those working remotely, where the home doubles as the office, maintaining a healthy sitting posture is essential. Poor posture can lead to a myriad of issues, from back pain to decreased productivity. Here are three practical strategies you can implement easily into your home office:

1. Let’s get ergonomic:

To help maintain a more functional posture, your chair needs to support the natural curve of your spine and allow your feet to rest flat on the floor. Ideally this would be an office chair with lumbar support, but rolling a cushion, blanket, or jumper up and placing it behind your lower back when seated can also help alleviate muscular strain. Consider using a monitor riser to elevate your screen to your eye level to reduce strain on your neck and shoulders. If you don’t want to use a monitor riser, use a stack of books which will also do the job.

2. Regular breaks and general movement is essential:

Fight off those negative effects of prolonged sitting by incorporating regular breaks into your workday. Stand up, stretch, and move around every 20 to 30 minutes. Perform simple stretches and exercises such as shoulder rolls, neck rotations, and knee hugs to alleviate postural muscle tension. Additionally, integrate short walks into your breaks to keep your body moving.

3. Be mindful of your posture:

Practicing mindfulness is a fantastic way to maintain good posture throughout the day. Be conscious of your body’s alignment, keeping your shoulders relaxed, your spine upright, and your head in line with your spine. Avoid slouching, as this can strain your postural muscles. You can set alarms or use a posture reminder app to prompt you to assess your sitting position periodically. Over time mindful posture awareness will become second nature.

Basically, having good posture will reduce both physical and mental strain throughout your work day… doesn’t that sound like bliss.

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Repetitive Strain – Carpal Tunnel Syndrome

Carpal tunnel is a common neurological disorder that occurs in the wrist, effecting the hand. It currently affects around 3 to 6 percent of the UK adult population currently. With the number of people working from home and behind desks (without the necessary ergonomic set up) for prolonged periods of time it is predicted that the number of cases of Carpal tunnel syndrome will continue to rise. Therefore, it is important we become aware of what it is and how we can prevent it from happening to us.

You may be asking ‘how do I know if I have carpal tunnel? And what causes it?’

Carpal tunnel occurs when our median nerve becomes compressed as it enters our hand through the wrist (on the palmer side of the hand) underneath our carpal tunnel (a layer of connective tissue). The carpal tunnel also allows passage of a variety of tendons that allow wrist and finger flexion, and it is these structures that can compress the median nerve. When the nerve becomes compressed it can cause a change of sensation such as pins and needles, and numbness, with potential pain and weakness to the thumb, index and middle finger. In chronic cases where carpal tunnel has not been addressed it can lead to muscle wasting to occur in the hand.

Carpal tunnel is usually due to a variety of factors such as:

• Repetitive strain – use of vibrating tools, mouse and keyboard, etc.
• Trauma – direct impact or repetitive impact to the wrist
• Rheumatoid arthritis and/or arthritic diseases
• Women are 3 times for likely to develop carpal tunnel than men.
• Mechanical restrictions in the wrist
• Pregnancy and menopause
• Increased age

Now, carpal tunnel can be managed at home through self-care, but this can take months! The best course of action is to get it examined and looked at by a professional such as ourselves (Osteopath). Here we will carry out a variety of tests to not only see if it is carpal tunnel but further what might be causing it. Following this we will be able to suggest treatment methods, stretches and exercises, and other advice on how to further care and help restore the wrist back to normal.

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Osteopathy for Ankle Injuries

‘What can an Osteopath do to help my ankle injury?’ It is a common misconception that Osteopaths just specialise in treating the spine, however, as Osteopaths we are specialised in treating the whole body, head to toe.

Over the years that I have spent working in an Osteopathic practice I have seen a lot of ankle injuries, both acute (within a week of the injury) and chronic (weeks, months, years after the initial on set). One thing that is evident with all ankle injuries is that there is a severe lack of rehabilitation taking place following the injury, as a result this can increase the risk of reoccurrence by 50%. This is not a pretty looking statistic and as we use our ankles everyday it is crucial we keep them strong and most importantly functional, so why are we not doing this?

You are probably wondering ‘what is the most common ankle injury?’ Well, the most common injury is an ankle inversion sprain otherwise referred to as a rolled ankle. These can happen from walking on uneven ground, playing sports i.e. football, stepping off of a curb, etc. This injury can vary from a minor strain (strain on the ligaments, muscle irritation and mild swelling) to major strain (ruptured ligaments, loss of stability, pain, swelling, bruising, etc.). Most of us have experienced these at a mild level at some point in our life and have just rested, and waited for the ankle to improve. Those who have suffered a more severe case have also rested and allowed it to heal naturally, but how many can say they have rehabilitated their ankle properly and correctly? When we do ignore our rehabilitations, our ligaments will lose their supportive and stable function resulting in loss of balance and increased risk of re-injury. Furthermore, muscles helping ankle mobility and stability will remain weak, strained and have reduced tone, again increasing risk of re-injury but also affect areas higher up i.e. the knees, the hips, the low back, as we will have to compensate for these weaknesses.

And this is where Osteopathy comes in! As Osteopaths we can assess ankle and foot mobility, muscle strength/tone and proprioceptive balance in the ankle and take this information to develop a treatment plan and a progressive rehabilitation plan to strengthen the ankle both muscular and ligamentous, improve balance and general ankle mobility. So, what are you waiting for?