Shoulder Bursitis: How To Treat and Prevent

Bursitis in general means inflammation of the bursa, which is one of the layers of soft tissue that surrounds a joint. It can occur in almost any of your large joints. It is important to have a specific diagnosis of which bursa is inflamed.

Bursitis in the shoulder is technically diagnosed as subacromial bursitis. Shoulder pain can come from many sources, such as impingement syndrome, rotator cuff tendinitis, rotator cuff tear, frozen shoulder, muscle strain, Glenohumeral joint instability, various types of arthritis, and the list goes on. Therefore, it is not easy to develop a diagnosis unless you see an orthopedic/shoulder specialist and/or have an x-ray/MRI performed.

The first thing to know about treating bursitis (and most other inflammatory shoulder problems) is to identify and decrease the movements, positions and activities that exacerbate your symptoms. For example, you may need to stop sleeping on your right side for a few weeks-months. Or you may need to modify the position of your computer mouse. You may need to eliminate certain shoulder exercises in your workout routines. Switch your purse to the opposite shoulder or clean it out to make it lighter. Listen to your body in order to find out what aggravates your pain; then modify those things in order to function with less pain. This is called POSITIONAL AVOIDANCE.

Secondly, you may need MEDICATION. Consult your physician, who will likely prescribe an anti-inflammatory medicine. Your primary care physician will refer you as needed for imaging tests and/or specialist visits. It is important to comply with doctors' orders in order to know if the prescribed treatments are effective.

Any of your doctors (primary or specialist) may refer you for PHYSICAL THERAPY (or Occupational Therapy) if indicated.  Physical Therapy for your shoulder may include exercises, hands-on techniques, pain-relieving modalities, education, postural corrections and other interventions aimed at decreasing your pain and restoring full function of your shoulder.

ICE can also be an effective adjunct to your symptom-management routine. Put a bag of ice or frozen veggies in a T-shirt or pillowcase placed over the location of your pain. Do this for 10-15 minutes, >2x/day.

POSTURE plays a bigger role in shoulder pain that you may realize, so check this area to see how you measure up. Do you slump whenever you sit? What is your posture while working? Is there a posture you stay in for a long period of time each day that aggravates your shoulder pain? Upright posture places all your joints in proper alignment and maximizes their mobility. Try to avoid having your shoulders rounded forward. Sit or stand up tall, with your shoulders back (they should be lined up vertically with your ears).

Lastly, work to improve your BODY MECHANICS during all daily tasks. You should have an ergonomic work station. You may need to modify your computer chair, the placement of your keyboard/mouse, the amount of back support in your recliner chair, your lifting techniques, the placement of heavy objects in your home or garage, etc. The idea of body mechanics is to use your body to its advantage instead of straining your joints by doing difficult tasks incorrectly. Use large muscle groups to do harder work. Use proper lifting and reaching techniques. To prevent shoulder pain, avoid lifting heavy objects overhead. If you are carrying something heavy, hold it with both hands and keep it close to your body. Be sure your shoulders are relaxed (not shrugged up) while you are typing. Turn your thumbs up whenever you reach above shoulder height.

How To Avoid Holiday Weight Gain

With Thanksgiving this week, the season of holiday weight gain is heavy upon us. So how can you avoid gaining weight until the new year arrives? This is especially important if you have been losing weight this past year or are working hard to maintain the weight loss you have achieved.

1. Use your holiday time off to do some additional exercise. Don't just lounge before and after holiday meals but do some exercise or at least something active!
2. Limit your portions during larger holiday meals. Stick to 1 medium plateful and 1 small dessert.
3. Choose calories carefully. Be picky about which foods you really like and are willing to indulge on. Skip the others.
4. Limit your desserts. Try 1 slice of pie instead of 1 of each. Or have a small sliver of each, if you like to try the varieties.
5. Eat more vegetables and fewer carbs. And remember that veggies can taste good outside of casseroles and without bacon. They just need the right seasoning.
6. Stop eating when you are satisfied. Don't eat again until you are hungry.
7. Be sure your between-meal snacks are small and healthy. Choose the fruit or veggie tray instead of the cheese/pepperoni/crackers.
8. Drink more water and fewer calorie-filled beverages.
9. Remember that a healthy lifestyle does not have to stop during the holidays. Maintain the same healthy habits that you have been practicing.
10. Shop in stores instead of online.
11. Don't lie down if you can sit. Don't sit if you can stand. Don't stand if you can walk. Don't walk if you can run. Remember that some people are unable to do these things and they would give anything to be able to walk or run again. Don't take your mobility for granted.

IT Band Pain: How To Treat and Prevent

The IT Band (iliotibial band or ITB) is a band of muscle tissue that runs from the outside of your hip/pelvis down to the outside of your knee. It is not a very well-known muscle, so it can be easily neglected, especially by athletes. If it gets strained or injured, it usually causes pain on the outside or lateral part of the knee. This occurs most frequently among runners or athletes whose sport requires excessive running. You are at higher risk for IT band injury if you are new to running or if you are increasing your distances too quickly.

If you do any lower body flexibility exercise, which muscles do you stretch? Probably your hamstrings and calf muscles. Possibly your hip flexors, quads or various buttocks muscles. But have you ever stretched your IT band? It is not realistic to stretch every muscle group in the body daily, so first try to identify a few target areas. If you have IT band pain or have in the past, then be sure to include ITB stretching in your daily routine. The following stretch is one of the easiest ways to stretch your IT band regularly, as it requires no equipment and is done in standing.

The picture below demonstrates stretching of the right IT band. Hold the position for at least 20 seconds. Repeat 3-4 times. This should be done several times daily. You may need to stand next to a wall for arm support and to push into a deeper stretch (the wall would be on your right side for stretching your right ITB). If you are a runner or athlete, be sure to include this in your workout stretching routines. Warm up your legs for 3-5 minutes before stretching by doing some light cardio exercise. Be sure to stretch again after your workout, especially if you are recently having ITB pain.

Remember that prevention is easier than treatment! So in addition to stretching your IT bands, include sufficient warmups to your workouts, wear proper shoes, consult your physician before starting an exercise regimen, carefully progress your exercise intensity, and do not work out through an injury. If you have ITB Syndrome, you may also want to use ice, prescribed medications, massage, more ITB stretching, leg strengthening, and Physical Therapy. 

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Healthy Game Day Menu

Here are some ideas for your next tailgating party, to replace the usual wings, pizza and other junk foods.

1. Shrimp cocktail
2. Bruschetta (diced tomatoes with olive oil and Italian spices, served on fresh bread)
3. Guacamole dip, served with wheat crackers
4. Spinach and artichoke dip, served with fresh veggies
5. Hummus, served with baked pita chips
6. Fruit salad or sliced fruit with yogurt dip
7. Turkey sliders (made with ground turkey), served on miniature wheat buns
8. Sub sandwiches (such as turkey breast, chicken breast or tuna)
9. Vegetarian quesadillas (with pinto beans, refried beans and/or sauteed vegetables)
10. Trail mix (with various nuts and dried fruits)

Physical Therapists in Columbia, SC

This is not a comprehensive list of Physical Therapy clinics, but it may help you get started. If you need Physical Therapy, it is good to know a list of therapy offices and their locations, as well as their specialty areas. Your referring doctor can also provide you with a list of nearby PTs.

Columbia Rehab (NE Cola, downtown, West Columbia, Irmo): outpatient orthopedic rehab, dry needling, TMJ

Blythewood Physical Therapy: outpatient orthopedic rehab, pediatric rehab

Total Rehab Services (Two Notch Rd near Sesquicentennial Park in NE Cola): specializes in Aquatic Physical Therapy, Pediatric Physical, Occupational and Speech Therapy

Carolina Therapy Solutions: NE Columbia: specializes in Spine Rehab

Lexington Physical Therapy (Lexington): outpatient orthopedic rehab

Drayer Physical Therapy (NE Columbia, downtown, Irmo): outpatient orthopedic rehab

Abundant Life Physical Therapy (Lake Carolina in NE Cola/Blythewood): Pediatric Physical Therapy

Carolina Physical Therapy/Sports Medicine: outpatient orthopedic rehab

Healthquest Physical Therapy (Lexington): Aquatic Physical Therapy, outpatient orthopedic rehab

Palmetto Health Richland Outpatient Pediatric Rehab (on Richland Campus, downtown): PT, OT, Speech for pediatrics

Palmetto Health Baptist Outpatient Adult Rehab (on Baptist Campus, downtown): outpatient orthopedic rehab

Sigurd Center (W. Cola): specializes in Neurological Rehab

HealthSouth Outpatient Rehab (near Palmetto Health Richland): specializes in Neurological Rehab, outpatient orthopedic rehab

Veterans Affairs Outpatient Rehab (Garner's Ferry Rd): outpatient Physical Therapy, Occupational Therapy

Please make corrections in the comments section below for changes in names, locations or specialties.

Panera Bread: A Healthy Review

One of the restaurants we frequent at the Village at Sandhills is Panera Bread for a few reasons. The first thing that draws us is the kid-friendly environment/menu since we have two young children and a third one on the way! So what do I recommend there?

1. Broccoli cheddar soup. This may not be the healthiest soup on the menu, but it is the best-tasting. It is one of the best broccoli cheese soups I have tasted anywhere. And my husband (who does not eat broccoli) loves it! He never orders a different soup for his "You Pick 2" meal.  And every time I choose something different, I always end up admitting that his soup is better. Tonight I actually ordered the new Sonoma Chicken Stew (for a taste test), but it is not nearly as good as the broccoli cheddar. That being said, if you like chicken pot pie, you will enjoy the Sonoma stew.
2. Garden vegetable with pesto soup. It is vegetarian yet has protein (with white beans), and of course is full of a wide variety of vegetables in a tomato-based broth.
3. Black bean soup or creamy tomato soup. I have not actually tried these recently, but the descriptions look good, and they are vegetarian dishes. If you really want to be extra-healthy, order your bowl of soup with a side of an apple (choices are bread, chips or apple). But to be honest, I really recommend the bread there (French baguette) unless you are on a no-carb diet.
4. Salads. There are a ton of salad options, but I never actually order salads there because many years ago, when I also was pregnant, I found a dead fly at the bottom of my salad. Usually I do not get emotionally traumatized by food, but it has been 4 years and I still have not recovered. However, the salads always look good when I see other customers enjoying them, and they are pretty big.
5. A lean-meat sandwich on whole grain bread. The turkey they serve is thick-cut and tastes more like fresh-roasted turkey than lunch meat. There are a range of healthy breads to choose from, so select something like whole wheat or rye.

Is Your Bed Causing Your Back Pain?

You have seen the ads for sleep number beds, promising that you will sleep better. But how do you know when to replace your present mattress? There is actually not one right answer, but here are some guidelines that may help to determine if your bed is causing or aggravating your back pain.

1. What is the present age/condition of your mattress set? If it is over 10 years old, likely you may need to replace it soon. If it is 2-4 years old, it is probably still in good condition. Of course this depends on the quality of the mattress, how much it has been used, and if it has been rotated/flipped regularly. If you bought it firm, does it still feel firm? Does your medium or soft mattress feel too soft?

2. What position is your spine in when you lie down on your bed? How far do you sink into the mattress? Can you get your back into its straight alignment in your sleep position of choice or is bent/twisted in one direction? A bed that is too soft makes it more difficult to sleep with a neutral back posture because the middle of your body will sink down more than your upper body and legs (especially if you lie on your side or tummy).

3. Do you sleep better on the couch, the recliner, the floor or another bed? That is a sure sign that you should find a different mattress. Traditionally, individuals with back pain prefer a firm mattress and have increased pain if they sleep too long (>7-8 hours).

4. Do you have more back pain when you first wake up than the rest of the day? There may be an easy solution, such as modifying your sleep position, changing your mattress or using additional pillows (body pillow or adding a pillow between your legs for improved spine alignment). The best way to achieve proper sleeping posture is to lie on your side with a pillow between your knees and to keep your back in a straight position (not rounded up into fetal position). Lying flat on your back is also appropriate for most individuals, as the spine is kept in a straight position (you may also put a pillow under your knees for more comfort). Sleeping on your tummy is not usually recommended.

Your sleeping posture is more important than you may realize because it places your spine in a potentially bad position for so many hours every night. So the next time you are mattress shopping, I recommend spending some nights sleeping on various types of beds, whether at hotels or friends' guest rooms. That way you don't spend the money on a mattress that you end up hating for the next 10 years.

Finally, if you have increased back pain during the night that is not present during the day and worsens every night (wakes you up), please consult your physician immediately, as this can be a sign of a more serious problem.