WHAT IS A "FROZEN SHOULDER"?

A Frozen Shoulder has nothing to do with either the temperature of the shoulder – or sitting in a draught. Although there are a number of conditions referred to as a frozen shoulder its true condition is a painful inflammation of a Bursa. A small sinovial fluid filled sac situated in the actual “socket” of the shoulder joint. This is the main problem but it may start a multitude of other conditions. What happens is that because of the inflammation the arm and shoulder are not moved thereby creating a state of atonement and stiffness in the muscles (known as the “Rotator Cuff muscles.) Because these muscles are not being used they become immovable causing even more pain. The treatment for this is to massage the Rotator Cuff muscles to bring some mobility into the area. Quite a lot of GENTLE mobilisation, a little ultra – sound to get deep into the joint and ease the Bursa. Also a little Manual Lymph Drainage although it can take some time (depending on the patient and the age of the problem) good results can be achieved from this treatment, although results vary from patient to patient. Also how much the patient is prepared to work at it on their own time each day.

WHAT ARE FALLEN ARCHES?

In the foot there are four arches. These are to give the foot a springing lever for walking etc. The medial arch runs on the inside of the foot. The transverse arch is at the front of the foot going across from the big toe pad to the little toe. The lateral arch is a very small arc running along the outside of the foot. The fourth arch is situated in front of the heel bone. A fallen arch occurs when the ligaments and muscles holding the bones in the correct position weaken or are damaged allowing the arch to collapse. Bone breakage may also cause this to happen but it is more likely to be a muscular problem with bad posture or incorrect high heels or tight fitting shoes, as well as having to stand in one position for long periods. The treatment for this condition is some very deep massage to stimulate the muscles into a state of tone. This is to help strengthen them enough to hold the bones in the natural formation Ultrasound may also be of benefit along with some thick felt padding fitted in certain places on the foot. Certain exercises, to help maintain the natural arch will also be given.

WHAT IS A TICKLE?


As unusual as it may seem a tickle is a reaction to pain. That is why you cannot tickle yourself (you know that you will not hurt yourself). Someone very close to you finds it hard to tickle you but a complete stranger would be able to Double you up. There is also what I call an intention factor, if you know someone wants to tickle you then you automatically prepare yourself to be tickled and tense up and are tickled if you relaxed first then no tickling would ensue. This is supposed to be a reflex action to say I can laugh this off you are not causing me any problems the area you are touching is not a tender point and I do not fear you. Sometimes there is an involuntary feeling, because you know someone wants to make you laugh you will laugh at the thought or approach of the tickler coming close.

ARE THERE ANY EXERCISES THAT I CAN DO?


As mentioned in the BELPER BACK CHAT No.2. swimming is a very good exercise. The first thing I say to patients is do you exercise regularly before the injury.If the answer is no, I then ask Why do you want to now you have a problem?- especially if there is a bone joint misalignment the Ligament fibres holding the joint together may have ripped slightly. As these will now be weaker any extra weight on them may cause the joint to be pulled out of alignment again. Therefore I believe (unlike some Physiotherapists ) that exercises should only be commenced after the injury has been allowed a short rest after which it may be able to withstand the riggers and trauma of exercising once again. As regards the actual exercises I generally recommend the Pilate's method, I find that both videos and books are excellent ways to slowly easily and GENTLY stretch and move the body back into a natural movement exercise regime. The first thing is to warm up gradually for 5 -6 minutes. Once the muscles are warm then do some slow gentle (NOT bouncy) stretching. Remember that if you exercise the leg muscles first, when you move onto the arm muscles they will have cooled down, so that they will need warming up and stretching first and visa versa. It is as important to warm down as it is to warm up. One way is to do the same exercises as when training but only at a fraction of the pace / weight for about 7 -8 minutes. Also after a good workout drink plenty of liquids (but not alcohol as this dehydrates the body).