Rotator Cuff Injury

Supraspinatus – The Usual Suspect

Rotator Cuff INJURYWith 4 different muscles of the rotator cuff that perform different actions, you would think that they each have an equal opportunity to be injured and cause problems. That isn’t the cases 80-85% of the time the supraspinatus muscle is the one that is torn or injured. There are many different ways this muscle can be injured:-

  • Local inflammation of the tendon
  • Minor tear from wear and tear
  • Severe tear from fall or sports injury
  • Impingement (pinching from improper posture or incorrect movement)

Shoulder injuries are extremely common in the active and even more sedentary population. They can be dislocations, instability, “frozen shoulder” or fractures. But the most common injury of the shoulder is to the rotator cuff. These injuries can be simple inflammation, minor tears (strains) or complete tears that require surgery.

Common Symptoms of Rotator Cuff Injuries

From time to time we all experience shoulder soreness or pain. It could be from doing more than usual at home, trying a new sport/exercise or even “sleeping wrong”. This type of pain is vague and will go away in a few days. If it doesn’t go away then you should have it looked at.

Rotator cuff injuries can cause pain generally in the shoulder, front or back, and can even go down into the arm. Usually, there will be increased pain with raising the arm, most often in front or to the side.

If the injury is more severe there may also be weakness along with the pain upon lifting or raising your arm. If the injury is very serious, like a complete tear of the tendon, there might be a total inability to lift the arm. These injuries are often diagnosed with the help of diagnostic imaging, such as ultrasound and/or MRI.

Causes of Rotator Cuff Injuries

As with most injuries, there are many causes but the most common are the repetitive overhead activity (sports – tennis, baseball or work -electrician), falls or in the older population, degeneration.

Repetitive overhead activity puts the shoulder in an unstable position and forces the rotator cuff to help stabilize as well as move the shoulder. Without proper balance and muscle control, this can lead to faulty mechanics and puts extra strain on certain muscles of the cuff, ultimately causing wear and eventual injury.

As we age our muscles need more exercise to maintain their strength than when we are younger. Without maintaining this, your muscles are susceptible to degeneration (wear and tear). This usually shows up as a gradually worsening shoulder pain that we “wake up with” one day.

Home Care

It’s very important to keep your shoulders strong and with a few minutes during the week you can prevent future injuries.

Doing some simple resistance exercises, like the ones shown in the picture to the left, can help prevent injury. When you are doing these exercises you are trying to increase your endurance (not power) and therefore it’s more important to work in higher repetitions at low resistance than a few very difficult exercises.

Always warm up before any physical activity to get the blood flowing into the muscles. Simple stretches such as “self-hugs” help to loosen the shoulder muscles.

If you do get an injury, using ice at the beginning of any injury will help inflammation and reduce swelling to allow healing to begin quicker. If it does not go away within a week, consult a healthcare practitioner to have your shoulder properly assessed for the extent of the injury.


Carpal Tunnel Syndrome – What Is It?

What Is It?

Carpal Tunnel Syndrome (CTS) is a common disorder of the wrist and hand. CTS most recognizable features are pain and numbness on the palm side of the wrist and hand. Sufferers may also say their fingers feel swollen. When the condition is more severe, weakness can result causing considerable troubles with simple everyday activities such as brushing your teeth, gripping a glass or cup or even dressing in the morning. Occasionally the pain may travel up the arm. Symptoms are commonly worse in the morning.

What Is Going On?

These symptoms are a result of a nerve(median) becoming compressed as it passes through an opening in the wrist. This compression is most commonly caused by the other structures that are also in this small tunnel. These are the bones of the wrist and the tendons(muscles) that move the fingers and thumb. When these structures become damaged or inflamed, they can put pressure or irritate the median nerve. This nerve starts in the neck and travels down the arm into the hand. Because of this, poor posture or injuries to either the neck or shoulder and upper arm can be linked to this disorder. Other conditions can cause someone to be more prone to developing CTS including pregnancy, arthritis, an old fracture at the wrist, or overuse in repetitive sports/jobs.


What Can Be Done?

Like almost all conditions and disorders the first thing a person can do is be preventive. This starts with taking precautionary measures, especially if you are in a higher risk group as previously discussed. Prevention starts with stretching and being aware of improper posture and form when performing repetitive tasks in either work or play. You want to avoid prolonged positions where your wrist is bent forwards or backward. If this is impossible, take frequent breaks to reduce the stress on your wrist. If you use tools for work or racquets for sport, use large handles to loosen your grip and minimize the amount of force your muscles need to generate.

If you are already afflicted with this disorder, some of these same tactics can be useful but you are best served to be assessed by a healthcare practitioner to determine the severity as certain stretches and exercises can actually make the condition worse. When you are already experiencing pain, priority is to try and reduce the irritating action to allow healing and an ability to fix the problem. If unable to do this, treatment can take longer than normal. Treatment of the disorder is aimed at decreasing pain and inflammation in the carpal tunnel. This can be done by icing, taking medications or using treatments like electrotherapies, acupuncture, massage therapy to reduce symptoms and heal faster. If symptoms are severe, a splint can be wornat night to keep your wrist neutral and reduce stress. If someone has symptoms that are advanced and do not respond to treatment attempts, the last resort is a surgical procedure called a carpal tunnel release where the surgeon will cut the ligament covering the tunnel to release the pressure. As with all surgeries, there are inherent risks of continual symptoms and should only be done as a last resort as it is irreversible!

Potential Treatments

  • Stretching and Exercises
  • Massage Therapy
  • Electrotherapy and Ice/Heat
  • Ultrasound
  • Acupuncture
  • Wrist Splint/Brace
  • Medications (Advil/Ibuprofen)
  • Chiropractic to improve posture
  • Last Resort – Surgical Release

What Can I Do At Work?

One of the major causes of developing carpal tunnel syndrome is having poor posture at your workstation. Having an ergonomic assessment done can be helpful but here are a few simple tips to help alleviate stress on your body:

  • Follow the 90-90 rule! Position your elbows, hips, knees, and ankles in a 90degree position for optimal alignment.
  • Position the top of your computer screen at eye level to prevent eye and neck strain
  • Set the keyboard at a closer distance from you to avoid unnecessary trouble in reaching the keyboard.
  • Place the keyboard in such a manner so that your arms should be parallel to your thighs.
  • Keep your wrists straight, relaxed and in a neutral position in line with your forearm. When typing, the best practice is to keep your wrists floating rather than resting them on a wrist pad. But if you choose to use a wrist pad, rest the heels of your palms and not your palms. If possible, use the wrist pad between typing movements and not during typing.
  • Gently press the keys and do not hold them down for extended periods.
  • Perform back, shoulder, and wrist stretches and shoulder shrugs at least every hour to prevent body strain and stress

Fit in the Core

Starting May 26th, there is going to be FREE open-air fitness every Sunday throughout the summer in downtown Burlington. It takes place in the Civic Square right next to City Hall. Come and join next Sunday!!

We were at the inaugural session of Fit in the Core on Sunday, May 26th and what a start to the event. The weather was perfect and Peter from Peter-Built Fitness Studio lead over 50 people of all ages in a group exercise class. Here are some pictures from the day.

Lower Back Pain

Chiropractic Assessment Luncheon May 2013

We were at MMM group in Thornhill, ON doing chiropractic assessments for the workers over their lunch breaks.

The staff were able to come and talk with us and have a simple assessment for any problems they were having. We answered questions about their general health and gave them advice to help them combat the physical demands of office posture. If you think your company would benefit from having us come in and talking or doing assessments, please contact our office as we would be more than happy too.

Lace Up For Love Run

Lace Up For Love Run May 2013

While is it was not optimal weather for a Mother's Day run, spirits were still warm at this event for a great cause supporting WELLSPRING Birmingham Gilgan House’s New Cancer Exercise Facility; Our team consisted of Dr. Maja Edgar and RMT Amanda Holmes supporting the runners with massages, stretches and answering questions about their health.

Preventing Gardening Injuries

Preventing Gardening Injuries

Time to get outside and work on our yards/gardens. Here are a few tips to help keep the injury imp from striking.

As the weather continues to tease us that warmer days are ahead, people will be dusting off their trowels and reaching for their gardening gloves. Just with any physical activity, you need to prepare and take a few simple precautions to help prevent causing pain or worse, injuries. Before you start doing anything take a few minutes and warm up. Take a brisk walk around your garden/yard to survey what you will be working on. This will raise your body temperature and get your blood pumping into your muscles. Roll your shoulders, rotate your torso slowly, do a few squats with your back straight to prepare you for lifting.

Once you begin, always break down the tasks at hand into smaller more manageable sections. Take frequent breaks as you work and remember, the Hanging Gardens of Babylon weren’t built in a day. When working remember to keep good posture, bending at your knees instead of your waist, avoid twisting or overreaching. Instead, shuffle/move your feet or get closer. If you are using tools, try to use ergonomic, well-designed tools. They should lightweight and long handle. Larger hand grips will also help to reduce the strain on your forearm muscles. If possible, try and change hand soften but only if this doesn’t put you at more risk of injuring yourself (cuts). Use kneeling pads while planting or hand digging.

Halfway through your gardening as well as at the end when you are done, make sure to stretch your muscles. This will help to reduce your soreness the next day. For your legs stretch your hamstrings by placing your heel on a low step with your leg straight. Slowly lean forward at your hips while keeping your back straight.


For your thighs, stand close to a wall for balance. Bring your heel to your buttock and hold. Switch sides. For your lower legs, stand with your hands’ on the wall with your one foot behind the other. Keep your leg straight and make sure your heel is on the ground. In addition, a step closer and bend your knee while still keeping your heel on the ground.


For your forearms and wrists, extend your elbow with your palm facing down and slowly drop your wrist to the floor using your other hand to help stretch. Repeat this stretch by pulling your wrist back towards you.

back muscles

To stretch your back muscles lay flat on your back and bring your knee to your chest and hold. You can do this one leg at a time or bring both at once.

Enjoy the warmer weather and your time in the garden. Winter will be here before you know it.

If you have any questions regarding the material in this newsletter, give us a call or email us at the clinic. In addition, if you would like to have an educational talk at your workplace on ergonomics and posture, proper lifting techniques or injury prevention, let us know. We would be excited to come and share our knowledge on staying healthy.


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