Sunday, 23 August 2015


August 23rd 2015
If you are experiencing shoulder pain it could be caused frozen shoulder. Find out how to recognise frozen shoulder symptoms and what the treatment options are with our useful guide.
Shoulder painFrozen shoulder syndrome occurs when ligaments around the shoulder joint swell and stiffen
If you're over 50, it's quite likely you know of someone who's had frozen shoulder – and that’s because, according to a survey,* 72% of patients are over the age of 50.
Frozen shoulder syndrome, or adhesive capsulitis as it’s medically termed, occurs when ligaments around the shoulder joint swell and stiffen to such an extent that normal healing doesn't take place. This makes it difficult to move the shoulder, making everyday activities such as getting dressed or reaching for a cup from a shelf painful. As the condition progresses, the stiffness may continue to the point where range of motion can be severely limited.
Research has shown that diabetes patients are more than twice as likely to suffer with condition, and other risk factors include recent surgery, having a stroke, overactive or underactive thyroid and heart disease.
If you suspect that you have frozen shoulder, see your GP for a diagnosis. Your doctor should also rule out shoulder arthritis via a scan or X-ray, as it produces similar symptoms. With frozen shoulder the surfaces of your shoulder joint are normal and motion is limited because the tissues surrounding the joint have become tight, preventing you from moving your arm and shoulder as you usually would. With shoulder arthritis the joint surface is damaged.

Possible causes of frozen shoulder

Because frozen shoulder is a catch-all term, one person's symptoms and causes might be slightly different from another's, making it difficult to say what has caused the problem.
Frozen shoulder does, however, seem linked to certain activities. For example, any activity that involves you having to rotate your arm, such as freestyle swimming or throwing a ball overarm (for cricket, for example). Also, overhead weight lifting and sudden stress to the shoulder muscles via injury.
It's thought that frozen shoulder is caused by inflammation in the joint - this inflammation could arise after an injury but also as a side effect of other illnesses, such as diabetes, a known risk factor for frozen shoulder.

Early symptoms of frozen shoulder

  • A feeling of pain and tightness in the shoulder area.
  • A feeling of tightness especially when putting the arm up and back, as you would do it you were throwing a ball overarm.
  • Pain on the back of the wrist. (This specifically relates to frozen shoulder caused by subscapularis trigger points.)
  • As time goes on, the symptoms will worsen although the pain may be reduced.

Thursday, 6 August 2015

Rehabilitation and Strength work post knee injury/op

Restoration Of Functional Muscle Strength After Knee Injury Or Surgery

Functional muscle strength refers to whole limb force expression during multi-joint, multi-muscle group movements specific to a person’s unique activity or purpose. 

With regard to the lower limb, force production predominantly occurs in a closed kinetic chain (CKC), and functional muscle strength of the lower limb is expressed during the concentric phase of CKC activities such as sit-to-stand, stair ascent, and taking off from a jump. Conversely, force absorption also predominantly occurs in a CKC, and so functional muscle strength of the lower limb is also expressed during the eccentric phase of stand-to-sit, stair descent, and landing from a jump. 

Relative to the simple functional observations just described, it is not surprising that CKC muscle performance tests such as one repetition maximum (1RM) squat or leg press demonstrate a stronger relationship to lower limb function defined by hopping, jumping, and running tasks than open kinetic chain (OKC) muscle performance tests such as a 1RM knee extension. This, in turn, indicates that CKC training methods (e.g. squats) should eventually be the dominant method of strength training if enhanced performance in hopping, jumping, and running tasks is desired. 

Soon after knee injury or surgery, however, OKC strength training should first be used as the dominant training method in order to reverse isolated knee muscle weakness and prepare the knee for functional training, after which CKC strength training should become the dominant training method to optimize whole lower limb function. Thus, both OKC and CKC training methods should be used throughout the rehabilitation process. The key is to implement the correct training method at the correct time. 

Here are some links for you that look at some of the above further: 






Nicholas Clark. 
Knee Consultant Physiotherapist. 
SKS Group Moderator. 

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