Coming Down the “Stretch”

As the cold autumn weather sets in, and people look to enjoy the outdoors a few last times before winter, the need to warm-up becomes increasingly important. Much as the soil stiffens from the cold winds, so to do our muscles, tendons, and joints. The soft tissues become less pliable, and less efficient, as the body pumps blood to more vital areas of the body. When a muscle, or tendon, is not properly prepared for activity, even the slightest movement can cause an injury (e.g. hiking, raking leaves, trimming trees, etc.).

As a chiropractor, nearly every patient I see has some form of soft tissue injury. These injuries range from strained/pulled hamstrings, partially torn rotator cuffs, and compensatory muscle spasms secondary to an injury elsewhere in the body. Perhaps, one of the most common forms of soft tissue injury is what’s known as a “guarding effect.” When an individual injures themselves, the muscles surrounding the site of injury become very tense in an effort to “splint” the inflamed area. This splinting is intended to limit the individual’s range of motion, stabilizing the injured area and avoiding further pain provocation. The issue, here, is that as the patient adopts this new position they are required to make up that range of motion in another region of the body. A perfect example of this is someone who injures their neck. Rather than turning their head, say with driving, the person is forced to turn their entire upper body. This unnatural movement pattern can then create pain and discomfort in the shoulders, mid back, and other related areas. It is for this reason that all of our patients are given simple at home stretches/exercises to perform in conjugation with their in office treatment plans. Typically, the more compliant a person is with their “homework,” the faster and more favorably they will respond.


While most people presenting to a chiropractic office are in pain, there are those individuals simply looking to live a healthier lifestyle. As the old adage goes, an ounce of prevention is worth a pound of cure. Along these lines, one of the best ways to avoid injury is to maintain good muscle strength, control, and flexibility. The issue here is that many people aren’t quite sure of what exercises and stretches to perform.   While thousands of examples can be found online, in magazines, or learned from a gym buddy, not all advice is created equal (or easily explained). With all of the various forms of stretching out there (static, active, functional, ballistic, PIR, etc.), it can be a daunting task trying to figure out just what type of stretching is best for your specific needs.


Professionally, I have found the combination of dynamic warm-ups and active stretching to be the most effective method of preparing for physical activity. This notion is further supported by recent research showing that traditional static stretches, when performed within an hour of physical activity, actually decreased muscle function and increased the likelihood of injury. A perfect example of static stretching is the old-reliable hamstring stretch in which an individual stands straight legged while trying to bend forward and touch their toes. The main issue here is that the muscles you are trying to stretch are required for pelvic stability while standing. As you bend forward, the posterior leg muscles are forced to undergo an eccentric contraction, where the muscles actually contract while being elongated (people who lift weights know this better as a “negative” exercise). This alone makes this stretch highly ineffective.

To learn a more effective hamstring stretch, for more information on dynamic warm-ups, or to schedule your Free Consultation today, call Full Function Chiropractic at (570) 601-4091.


Shoulder Impingement

When people experience shoulder pain, whether acute or chronic, they often become fearful of the infamous rotator cuff tear.  While rotator cuff tears are a significant injury, and something to be concerned about, they make up only a small potion of all shoulder complaints.  More often than not, the person’s shoulder pain, and often resultant neck pain, can be contributed to what is known as Shoulder Impingement Syndrome.  As the name implies, the soft tissues of the shoulder often become impinged upon/compressed secondary to repetitive stress, muscle weakness, muscle tightness, and poor posture.  These soft tissues include muscle tendons, such as the biceps and supraspinatus (smallest, upper-most rotator cuff muscle), and the sub-acromial bursa ( a small sac of connective tissue/fluid that acts as a shock absorber for the shoulder/collar bone).  Over time, this repetitive impingement leads to inflammation of the tendons and bursa, resulting in tendinitis and bursitis, respectively.  Pain associated with impingement syndrome often develops gradually over a period of time, with the primary focus being towards the front and side of the shoulder joint.  If left untreated, the repetitive irritation may result in fraying and tearing of the underlying tendons (now we have our more serious rotator cuff tear).

shoulder pain

In a typical healthy shoulder the supraspinatus muscle is able to glide freely in an opening between the shoulder blade and collar bone, just beneath the AC-joint.  However, this space is often compromised and becomes more narrow with repetitive activities involving over head or inward movements of the shoulder and arm.  These activities may include, but are not limited to, swimming, throwing, painting, overhead sports, lifting, sleeping on your stomach, excessive computer use, and extended driving.  The shape of your collar bone, or the development of arthritic bone spurs, in specific locations, are also important factors in developing impingement syndrome.  While x-rays may be useful in identifying these risk factors, they are typically unnecessary in diagnosing impingement syndrome; your Doctor of Chiropractic can often make this diagnosis based on history and physical examination alone.


When treating impingement syndrome, or any musculoskeletal injury for that matter, it is important to exhaust all conservative options prior to moving forward with more invasive procedures.  As the shoulder becomes inflamed your body undergoes a compensation process, trying to avoid the pain, in which certain muscles become weak while others go into spasm.  This imbalance further creates aberrant motion of the shoulder joint, shoulder blade, mid-back, and neck.  The first goal of conservative care is to reduce the pain and inflammation, while simultaneously improving range of motion.  This can be accomplished in various methods, including chiropractic adjustments, soft tissue work (including myofascial release and instrument assisted soft tissue mobilization), nutritional support, and focused exercises and stretches.  The main focus of the stretches/exercises should be to avoid aggravating postures in which the shoulders and mid-back round forward, further restricting normal shoulder movements.


As a rule of thumb, the longer an injury takes to develop, the longer it takes for the injury to recover; this also holds true for the individual who simply ignores the pain in hopes that it will clear up on its own.  With this being said, while you cannot expect to fully recover in a matter of days, or weeks, you should see some signs of improvement (e.g. pain reduction, improved range of motion, no longer pain putting on jacket, etc.).  If symptoms persist, despite being treated, your Doctor of Chiropractic may consider referring you for an MRI (to assess for underlying tears), pain management (e.g. pain creams or corticosteroid injections), or to see an orthopedic surgeon.  More invasive forms of treatment, such as cortisone injections, should be reserved for cases that are non-responsive, or extremely painful.  While these injections are effective at reducing inflammation, they do not address the underlying dysfunction responsible for causing the impingement, and carry with them their own set of inherent risks.

Avoiding Snow Shovel Blues

With the winter months upon us, and Jack Frost here to stay, it is inevitable that snow removal is in our future. Everyday common tasks, recreational activities, and basic chores can pose a risk for even the most fit individual if he, or she, has not warmed up properly. Simply going out to shovel after being inactive in bed, on the couch, or using the computer, makes the body susceptible to muscle spasms, strains, sprains, and disc irritation (especially in the lower back).

sbow pain

Just before it snows (or rains) you, or someone you know, may have experienced aches and pains in old injuries of the back, knees, shoulders, hands, etc. This sensation of pain is partially due to the fact that as the weather changes so too does the barometric pressure. Just like water, pressure often travels from areas of high concentration to areas of low concentration. As the pressure around us drops, the pressure in the fluid surrounding our joints attempts to push outward, creating the sensation of pain. This unique pain can be further aggravated (intensified) by simply going out into the cold weather without proper clothing. As a person becomes cold, the blood vessels in their arms and legs constrict to conserve heat for the vital organs (e.g. heart). This decrease in blood results in a decrease in oxygen to the muscles. Without proper amounts of oxygen the muscles become tight and spastic, increasing the likelihood of injury (think “pulled muscle”).

Along with dressing properly, it is essential that anyone working outside perform a thorough warm-up, including light aerobic activities and functional stretches. Light aerobic exercises can include walking, jogging, performing jumping-jacks, stationary biking, and using an elliptical. A functional exercise, also known as a dynamic exercise, is any movement that utilizes multiple muscles, and takes the muscles/underlying joints through their proper ranges of motion. Examples of dynamic exercises include air squats (without weights), lunges, and bringing your elbow towards the opposite knee while marching. Along with properly warming-up, there are various tips to keep in mind to help reduce the chance of injury with shoveling snow. These tips include:

  1. Be prepared – knowing it is going to snow will afford you ample time to wake-up, and shovel snow prior to work/school
  2. Wear multiple layers of clothing to keep your muscles warm and flexible
  3. When shoveling, it is very important to simply push the snow forward, rather than attempt to throw it.
  4. Avoid sudden twisting and turning movements
  5. As is the case when lifting anything, it is always best to lift with your legs rather than your back. Due to the length of the shovel, and the effects of physics, the perceived weight of the snow is much heavier than the actual weight of the snow being lifted
  6. Take frequent rest breaks to decrease the strain on your joints and muscles
  7. Always perform a series of active cool-down stretches following shoveling, or any other winter recreational activity

snow penguin