Robin Holland, Author at Siphox Health

Shoulder Pain While Sleeping

Robin Holland — Mon, 04 Apr 2022 08:59:17 +0000

Shoulder pain while sleeping is very common and can significantly impact your daily life. If the pain is severe enough to keep you awake, the knock-on effects can cause all of the same problems that you would associate with insomnia. Ironically, if the shoulder pain stops you from sleeping consistently night after night, this can lead to poor healing and more pain overall. Sleep is when our bodies repair damage and when most of the healing process occurs, so if you miss out on this vital time, then you can get stuck in a vicious cycle of more tissue damage, more pain and less sleep.

Shoulder pain while sleeping is unfortunately one of the most common complaints from anyone suffering shoulder problems. All of the common causes of shoulder pain can lead to pain at night, including shoulder impingement syndrome, rotator cuff tears, tendinosis, and bursitis. Should pain while sleeping can even be down to your sleeping position. To make matters worse, you have very little control over your body and joint positions while you sleep, so it can be one of the hardest problems to treat.

What causes sore shoulders to hurt so much at night?

Most shoulder problems will come with some level of inflammation, stiffness and weakness, which are the main drivers of pain during the day. All of these problems are exacerbated at night. Inflammation increases when the joint is in a prolonged static position. Most people tend to sleep with their shoulder in an inwardly rotated position, which increases the pressure on irritated structures within the joint. Blood flow to the area is slightly reduced, thus making the soft tissues stiffer and therefore more painful. Furthermore, muscle activation reduces at night, which means if there is underlying weakness already present, then the level of support around the joint will decrease even further.

So how can you reduce the night pain and finally get some much-needed rest? Unfortunately, since we have very little control over these causes of increased night pain, it’s very difficult to tackle night pain in isolation. You need to treat the root cause of the pain during the day, so that the body can heal the damaged structures and calm down inflammation levels.

Shoulder pain assessment

Getting your shoulder pain assessed by a qualified physiotherapist can be the best way to start the recovery process. Your physio will be able to identify the cause of pain and provide an individualised treatment plan. Rehabilitation typically starts with stretches and range of motion exercises to alleviate stiffness and lack of movement. Once you start to get some movement back in your shoulder, your physio will guide you through some strengthening exercises to tackle any weakness in the joint. Weakness in the muscles surrounding the joint causes strain on the joint, ligaments and tendons, which then causes inflammation and pain. By improving the strength and muscular function, you will be able to off load the irritated structures, thus allowing the body to heal.

Once the shoulder is functioning better during the day, night pain will naturally settle.

In the meantime, while you work on improving your shoulder health during the day, here are a few tips to help control pain while sleeping:

Avoid sleeping on the affected side. Try sleeping on the other side or your back. If you find yourself waking up on the sore shoulder, try putting pillows next to that shoulder to stop you from rolling onto it.
Use pillows for support. Try lying on your back and putting a pillow under the shoulder to off-load the joint. Alternatively, lay on the unaffected side and prop your sore arm on a couple of pillows so that it will rest in a neutral position.
Know your limits. Avoid overdoing things during the day so that you do not further irritate the joint and increase inflammation levels.
Use heat or ice. While hot or cold won’t ultimately get the pain better, they can provide good temporary relief to help you get some rest.
Commit to your rehab plan! The exercises your physio has given you have more benefits than just strength and flexibility gains. The act of doing the exercises increases cellular activity in the area, which in turn increases blood flow to the area, promotes the healing process, and even encourages the body to release our natural opioid substance that reduce pain.

The most important thing is that you don’t just suffer! The vast majority of shoulder pain can be treated. Seek help as soon as possible so you can kick start your recovery and get back to sleep.

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Why most patients fail to complete their rehab

Robin Holland — Tue, 25 Jan 2022 19:09:57 +0000

Why most patients fail to complete their rehab

Patients recovering from shoulder injury or surgery will be given a range of physiotherapy exercises to get their shoulders back to full functioning. While the exercises given will vary depending on the particular injury or surgery, the goal is the same – to get you back to doing your daily activities easily and without pain. Unfortunately, up to 70% of patients fail to complete their rehab plans [3].

Some patients report that, once they have enough range of motion to complete all of their daily activities, there is little incentive to carry on with tedious rehab exercises. We all have busy lives, with numerous work, family and life commitments. If you struggle to lift your arm enough to get your shirt on in the morning, then you will easily remember to do your exercises. However, once you can use your shoulder without thinking about it, maybe you start to forget your daily exercise program. Or maybe your exercise plan simply starts to slip down the priority list. Getting to the office 5 minutes early to clear your inbox or even playing with your child for 10 minutes before dashing off to catch the train might seem more important.

Consequences of not completing your rehabilitation

However, failing to complete your rehabilitation can have a lasting impact. For example, if you are recovering from a frozen shoulder, you will likely struggle to regain your full range of external rotation. Let’s say you have been diligently doing your rehab exercises, and now have about 70% of your range of external rotation compared with your other arm. With this amount of movement, and with the pain mostly gone, you can generally do everything you need to do in life. However, because of the remaining stiffness, you often have to compensate for your movement patterns. You might end up regularly twisting your back to make up for the fact that your shoulder won’t go any further. Eventually, you could end up with back pain from the repetitive, unnatural movement.

Mental health and social impacts of not fully recovering

Furthermore, it’s not just your physical health that suffers from chronic shoulder problems. Mental health can also quickly suffer when shoulder stiffness sets in. Consider this scenario – imagine you attend a badminton club twice weekly. This helps you stay fit, but your badminton partners are also good friends. You all have busy work schedules, so your bi-weekly matches are your time to socialise. Unfortunately, you were forced to take a break from badminton due to a frozen shoulder. A few months later, you have been progressing well with your shoulder rehabilitation, but you still struggle to get enough strength and range of motion to use the racquet. You continually have to delay your return to your matches, and eventually have to cancel your badminton membership. This means you no longer have that bi-weekly time with your friends. Sure, they do their best to keep in touch, but with your busy work schedules, you no longer have the opportunity for meaningful contact. We all know that friendships are vital for our mental well-being, so you can now see how easily losing your shoulder range of motion can leave your mental health suffering.

How measuring your range of motion can help you stick to your rehab plan and reach your goals

One of the main reasons patients fail to stick with their physiotherapy exercises is that progress is too slow. Your therapist may tell you that your shoulder is moving better, but if you can’t see or feel any improvement for yourself, you will probably start to feel discouraged. You may even feel that the exercises are not working. Also, as previously discussed, you might start to feel that the time spent on rehab is no longer worthwhile.

Regularly measuring your range of motion is an incredibly simple but effective way to visualise your improvements. When you can see small improvements each week, then you know you are on the right track.

Of course, there are many factors that will contribute to the success of your shoulder rehabilitation, but as you can see, regularly monitoring your range of motion is a vital part of the journey. If you are consistent with your rehabilitation plan, but are not identifying any increased range, you will know that a new course of action is needed. However, if you are regularly seeing improvements, then use this data to help encourage you to continue your rehab, even if it seems boring!

Injured shoulder?

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References:

Correlates of compliance in physical therapy – https://pubmed.ncbi.nlm.nih.gov/8234458/

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Why you should measure shoulder range of motion

Robin Holland — Tue, 25 Jan 2022 12:17:11 +0000

Why you should measure shoulder range of motion

The shoulder has the highest range of motion of all the joints in the human body
We rely on it for many movements in our day to day activities, but often take it for granted
Reduction in your shoulder range of motion can have big impacts on your physical and mental health
Slow progress is one of the biggest reasons people don’t complete rehab for their shoulder injuries
Using data to track recovery helps you ensure you are on the right treatment plan
Measuring range of motion will show that you are progressing in recovery and encourages you to reach your goals

Our shoulders are capable of an impressive range of motion (ROM). Through its various anatomical positions, a healthy shoulder can in fact complete a full circle – technically called circumduction. We rely on this range of motion for many of our daily activities, such as reaching something off a high shelf, grabbing a needed paper off the desk behind you, and even just getting dressed in the morning. When everything is working as it should, we use our full range of motion without even thinking about it.

Why shoulder ROM is important in detecting early signs of injury

When pain or injury strikes the shoulder, a loss of range of motion is often the first indication that something is not quite right. Maybe you struggle to get your arm behind you when getting your coat on. Perhaps you fell onto your arm and now can’t lift it above shoulder height. A loss of shoulder range of motion can have profound impacts on a person’s day-to-day life and should never be ignored.

Adhesive Capsulitis (Frozen Shoulder)

Take for instance Adhesive Capsulitis, more commonly referred to as Frozen Shoulder. While pain is often one of the first symptoms, stiffness and decreased range of motion are the hallmark signs of the disease. Specifically, a loss of range of motion into external rotation, or rotating your arm outwards (example below), is the key diagnostic indicator for frozen shoulder [1]. It’s common for patients with frozen shoulder to quickly lose almost all external rotation.

If you are suffering shoulder pain, monitoring your range of motion can therefore help your health care providers identify the cause of your shoulder pain. In the case of frozen shoulder, if your shoulder won’t rotate outwards at all, then it’s highly likely you have frozen shoulder. An accurate diagnosis will then allow medical staff to provide the most appropriate therapy, helping improve your chances of a full recovery.

Acute shoulder injuries – impact & trauma

Monitoring range of motion can also be a vital part of diagnosing an acute shoulder injury. Say, for example, you fell off your bike and landed on your shoulder. You generally came out of the accident alright, but you’re struggling to move your shoulder. When you lift your arm up to the side, you can only manage about 30 degrees before you’re struck with severe pain. Not only is it painful to try to lift your arm, but it feels like you simply can’t. This lack of range could indicate that you have torn your rotator cuff.

Active vs Passive Range of Motion

A key diagnostic factor of rotator cuff tears is a difference between active and passive range of motion [2].

Active range of motion is how high you can lift your arm normally.

Passive range of motion is how far someone else could move your arm when it is relaxed.

Rotator Cuff Tear

A quick test of your active versus passive range of motion would indicate the possibility of a rotator cuff tear. While you are unable to lift your arm, you ask your friend to check your passive range. Your friend lifts your arm easily, and you only feel minor pain. The outcome of this quick test can aid your doctor or physiotherapist in identifying that further tests and treatments are likely needed for your rotator cuff.

Why shoulder ROM is important during recovery

Measuring your range of motion at the start of rehabilitation is the first thing your physiotherapist will do.

Where measuring shoulder range of motion really becomes important is during recovery. If you are recovering from a shoulder injury or surgery, trying to regain your range of motion is often the first hurdle. In fact, measuring your range of motion at the start of rehabilitation is the first thing your physiotherapist will do.

The first measurement gives you a baseline to work from. The first test will help identify appropriate treatment plans. For example, if you only have a few degrees of shoulder movement, then you will need to start with very basic exercises, whereas if you have about half of your normal range, you may be able to progress to medium-level exercises pretty quickly. Most importantly, measuring range of motion will help you identify if your treatment plan is working. If you are consistently sticking to your exercise plan and advice from your therapist, then you should see a gradual increase in your range of movement. However, there is never a one-size-fits-all approach for rehabilitation. So, regularly monitoring your range of motion is critical to identify problems with your treatment plan.

If you are not noticing improvements in your range, you know that you and your therapist need to make changes in your exercise prescription. The sooner that problems are identified, the sooner you can get back onto the right track!

Download Siphox Health on iOS

References:

The external rotation test in the diagnosis of adhesive capsulitis-https://pubmed.ncbi.nlm.nih.gov/20506951/
Rotator Cuff Tears – https://www.physio-pedia.com/Rotator_Cuff_Tears

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Up your mobility in 2022 – 9 tips from a physiotherapist

Robin Holland — Mon, 24 Jan 2022 13:36:00 +0000

Up your mobility in 2022

New year, new goals. So many people start the new year with great intentions of improving their fitness. As the days and weeks slip past, though, our busy lives often get in the way. That daily gym session you committed yourself to becomes biweekly, then only once a week, and suddenly you can’t remember the last time you went to the gym.

We all know that keeping fit and active is the key to good health. So, how do you stick to your fitness goals while maintaining all of your work, life and family commitments?

The good news is you don’t need a gym membership or an hour-long sweat-session to get healthy. In fact, you can reap all of the health benefits of a full workout by simply sneaking in short bouts of activity throughout the day. Here are some tips to help you get more active.

1. Start stretching

One of the best ways to start increasing your activity is by adding some simple stretches throughout the day. Spend a few minutes loosening your back when you get out of bed. Stretch your shoulders and neck at your desk throughout your work day, and lengthen out your hips after you’ve been sitting for a while.

2. Walk whenever possible

Walking is free, easy to do and offers a host of health benefits. Carving out just 5-10 minutes of time for a quick walk a couple of times can really add up. Try going for a short, brisk walk during your lunch break. Take your partner, kids or friends for a walk. Walk to the shops or work if you can. You could even try scheduling a walking meeting with your colleagues. The possibilities are endless!

3. Change up your commute

Don’t underestimate the potential value of your commute time! Adding exercise to your commute can be a really efficient way to sneak in more activity for time-crunched workers. Could you walk or cycle instead of driving? Can you park your car a few blocks away from the office and walk the rest of the way? Even taking public transport can help, as this forces you to walk and stand more than just sitting in the car.

4. Take the stairs

You have probably heard this suggestion before, but it really is a super effective strategy. Climbing the stairs uses all of your core and leg muscles, which means you strengthen these important muscles while getting where you need to go. Furthermore, you’ll get your heart rate up at the same time!

5. Plan active dates with friends and family

Instead of meeting friends at the pub or chilling out with your family in front of the TV, turn your social time into active time. Invite everyone outside to play frisbee or kick a football around. Take the family swimming or cycling, or invite your friends to join a sports club with you.

6. Incorporate regular desk breaks and desk exercises

We all know that sitting too long is bad for us. Unfortunately, though, many of us are required to spend long hours in front of a computer. Adding in a few minutes of activity every hour can help combat the effects of sitting by firing up your muscles and getting your body moving. Ideally you should move at least every half hour when at your desk. This doesn’t have to cut into your work time, though. Even just simply standing up and stretching for a couple of minutes can help.

Another option is to build in a few desk exercises once or twice a day. Try this quick 5-minute routine for a great health boost in minimum time:

Stand up and sit down off your chair 10 times
Holding on to the back of your chair, push up onto your toes 10 times
Perform arm circles, 10 times forwards and 10 times backwards
Do 10 push-ups against the wall or your desk
Sitting upright on the edge of your chair, cross your arms over your chest and rotate your upper body side to side, 10 times each way

7. Do more housework

Sure, no one likes doing chores, but cleaning the house really does get you moving. Put on some music, push your vacuum cleaner and scrub the floors with vigour. Before you know it, your house will be clean and your heart and muscles will be pumping! According to WebMD, mowing the lawn can even burn as many calories as cycling.

8. Learn to love gardening

Great news for those of you who spend their time planting and raking! According to the American Heart Association, gardening is considered moderate physical activity and can be a great way to meet your physical activity requirements. Gardening can be a full-body workout that builds your endurance, strength, balance and flexibility. Depending on the activity, you can work all of your major muscle groups, including legs, glutes, back, core, arms and shoulders.

9. Get dancing

Ok, so you may feel a little silly at first, but in the privacy of your living room or bedroom, who cares?! Simply put on your favourite tunes and get moving; no fancy equipment needed. Dancing is a great way to get your heart rate up, improve your strength and balance, and burn calories. If you want some help to get started, you can try a dance workout video or join a class. Once you find your groove, you can dance the night away for some serious health benefits.

Mobility check? Our sedentary lives impacts our mobility. Powered by A.I, our app allows you to measure your shoulder range of motion from your own home. Download Siphox Health on the App Store to assess your shoulder mobility.

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