Tag Archives: physical therapy traverse city

Headaches and TMJ Pain: Elite PT Newsletter Sept. 2018

This month I want to talk a bit about treating chronic headaches and temporomandibular joint pain (TMJ – aka the jaw).

But first I want to use this opportunity to remind you that we do free screenings for high school athletes with nagging injuries.  Sprains and strains as well as aches/pains that just don’t get better or go away with time are a perfect example of the kinds of injuries that we could help with.

If you’re son or daughter has a more severe injury then you should consult with your physician first.

I’m available most Tuesday afternoons after 1pm.  Appointments typically run about 30 minute – within that time I can give you a diagnosis and get your athlete started on the path to recovery.  Other days and times may be an option, it just depends on our availability.  Just call us at 231 421-5805 if you have questions or to schedule a free screening.

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In other news….

Anniversaries this month:

Allie Hoyt PT/Athletic Trainer -1 year

Allie Hoyt DPT, ATC
 

 

 

 

 

 

 

Jesie Bott ATC/Massage Therapist- 5 years

Jesie Bott ATC, LMT

 

 

 

 

 

 

Jesie and Allie have been wonderful employees and we’re blessed to have them practicing at Elite Physical Therapy.

They are also a big part of the reason why we have just passed our 7th year in business.  I’m convinced we’ve done so well over the years because of our employees and their love for our patients and desire to help them achieve their recovery goals.
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Headaches and TMJ Pain

These may not be the first things that pop into your head when you think of what a physical therapist would treat but we do see folks with both of these conditions.

Headaches and migraines can sometimes be the result of pain being referred from muscles in the neck up into the head.  It’s way more common than you might think.  The pictures below show the common referral patterns from our neck muscles.

Upper Trapezius

Upper Trap Trigger Points - headaches
 

 

 

 

 

 

 

Suboccipitals

Suboccipital Trigger Points - headaches

 

 

 

 

 

Sternocleidomastoid

Sternocleidomastoid Trigger Points - headaches
 

 

 

 

Long hours staring at a computer screen or hunched over a desk can strain these muscles causing pain.  Often times the muscle itself just feels tight but it projects the pain elsewhere – in this case into your head and/or face.

Luckily its pretty easy for us to determine if this is the cause of your neck pain or headaches. And if that’s the case these muscles can be treated with a number of manual techniques such as Trigger Point Dry Needling and Graston Technique.

  •  click on Dry Needling or Graston Technique above to see video demonstrations

Many people can also have symptoms in the their jaw, or temporomandibular joint (TMJ), which are common with everyday activities like chewing and talking.  The pain can be local to the joint itself and/or the muscles around the joint can refer pain into the head or face.  Check out the pictures below:

Temporalis Muscle

Temporalis Trigger Points - Headaches

 

 

 

 

 

 

 

 

Masseter Muscle

Masseter trigger points - headaches

 

 

 

 

 

 

 

 

TMJ symptoms can also be treated with physical therapy techniques including the manual therapy techniques I mentioned above.  It might sound crazy using needles to treat these muscles but over the past month we’ve had 2 clients that achieved complete pain relief with 1-2 treatment sessions.

There is still a bit of work to do in regards to improving the function of the jaw and neck to be sure the symptoms don’t come back but treating the muscles can be a very beneficial strategy.

If you suffer from chronic headaches or TMJ symptoms give us a call and we can discuss if physical therapy would be appropriate (231 421-5805).
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That’s it for this month.  Talk to you again in October!

Joe Heiler PT
Joe@elitepttc.com
231 421-5805

Elite PT Newsletter May 2018 – Running Injuries Part 2 – Knee Pain

This month’s newsletter focus is on knee pain.  Things have been getting busier here with summer just around the corner and lots of runners prepping for races.

One thing we’ve definitely noticed with our runners is that prevention is key.  They’re coming in sooner, once they can tell something is not quite right, rather than waiting weeks or months for it to just go away on its own.  Because of that we’ve seen two trends:

1)  They are recovering much quicker than in the past
2)  They’re completing their races – most we’ve checked in on have run faster than in previous races.

So on that note let’s continue with our series on running injuries – this month focusing on knee injuries.

***Just a quick note for you non-runners out there – these injuries are very common in all sports and even in non-athletes so if you have knee pain you will still want to check this out!

The most common knee injuries in runners are:

1)  Patello Femoral Pain (front of the knee)
2)  Distal IT Band Syndrome, a.k.a. Runners Knee (outside of the knee)
3)  Patellar Tendinosis (just below the knee cap)

Last month we talked about improving mobility and stability of the foot and ankle – which will also help to relieve strain on the knee joints so if you have knee pain go back and read that article here:  http://www.elitepttc.com/elite-pt-newsletter-april-2018-common-running-injuries-part-i-foot-and-ankle/

This month I want to focus on a couple of the muscles that are notorious for causing knee pain, and what you can do about them. Check out the pictures below:

Rectus Femoris Trigger Points and Pain Referral Pattern

RF Trigger Point Knee Pain

Vastus Lateralis Trigger Points and Pain Referral Pattern
 

VL Trigger Points Knee Pain
The ‘X’ is the location of common trigger points (tight irritable bands of muscle) and the reddened area is that trigger point’s pain referral pattern.  From the pictures you can see how irritation within the big quadricep muscles can cause pain all the way down to the knee.

The quadricep group frequently gets overworked with running which can cause these hyper-irritable bands of tissue in the first place.  As a result the muscle tissues feel tighter and become less flexible.  This creates a vicious cycle over time and ultimately these tissues can refer pain down to the front or side of the knee mimicking the conditions I listed above.

Luckily these trigger points are usually easy to identify and treat with manual therapy techniques such as Graston Technique and Dry Needling.  Following up with corrective exercises can ensure that these irritable areas don’t flare back up after being treated.  On top of that, most of our clients can manage this in the future doing their own soft tissue work using foam rollers and massage sticks, and warming up properly.

Check out the video below if you’d like to see how we dry needle and treat that outer thigh muscle:

***This video was originally created for physical therapists and posted on SportsRehabExpert.com so there is quite a bit of medical lingo but you’ll get the drift.  Be sure to check out how much better Lydia’s leg moves after the treatment. 

Last year one of our Kingsley athletes was diagnosed with IT Band Syndrome and was experiencing significant pain on the outside of the knee.  His knee had actually buckled on a number of occasions while trying to sprint.

He presented with almost identical range of motion at the hip as Lydia in the video above.  One treatment of dry needling followed by a couple corrective exercises and he was able to return to running the next day without pain.

I can’t guarantee it will always work that fast but sometimes it does (helps to be 16 too!)

SPECIAL OFFER – if you’ve been struggling with knee pain and you’re not sure what to do about it then give us a call for a free screening.  We can quickly identify the cause of the problem and guide you down the right treatment path.  231 421-5805.

Until next time…

Joe Heiler PT
Joe@elitepttc.com
231 421-5805

Elite PT October Newsletter – Therapist Spotlight: Lydia Case

I can’t believe another month has flown by and it’s time for another newsletter.

Here is what you’ll find in this month’s issue:

  • Therapist Spotlight:  Lydia Case ATC
  • Back Pain and Sciatica Workshop has been moved to November 4th
  • Sports Medicine Clinic for High School and College athletes

Therapist Spotlight
Lydia Case joined Elite Physical Therapy back in July of 2015 and has been an invaluable part of our team ever since.  She works full time in the clinic plus during the school year she goes out to Kingsley High School two afternoons per week. She has been the athletic trainer at Kingsley for 11 years now.

Lydia has been practicing Athletic Training since 2006 in physical therapy and high school settings. She received her Bachelor’s degree from Northern Michigan University, where she had experience working with the Men’s football and hockey teams. Before transferring to NMU Lydia ran track & field at Aquinas College, but also worked with the Women’s volleyball and Men’s basketball teams at Aquinas. Lydia is a certified Kinesio Taping Practioner(CKTP). She believes that every patient and athlete is unique and that their treatment and workouts should be tailored specifically for their individual needs in order to achieve their best outcome.

1)  What got you interested in athletic training?

My love for sports is what initially got me interested in athletic training- I thought what a great fit- you work with athletes out in the field and can also work with the general public in a PT clinic- NO day is ever the SAME.

2)  What do you like best about being an athletic trainer?

I get excited about helping people and seeing how each patient/athlete is unique. I have worked with people from ages 3 to 98 and everything in between and have so much fun because everyone is so different as well as their injury.  I find it so rewarding to help someone accomplish their goals.

3)  What do you do for fun other than just work at Elite?

I enjoy spending time with my family – we love to be outside especially tubing down the Boardman River, taking our dog Gus for a walk in the woods, and riding 4-wheelers. I also like to play games, mostly card games like euchre. I also enjoy running with my friends and have completed 5 half-marathons, but prefer to run the 10k distance. I have been married to my husband Dave for 11 years and have two kids, Delaney (8) and Owen (5).

Testimonial:

“When I first came to Elite PT I was devastated because I had a running injury that literally prevented me from doing anything.  I was going from exercising 6 days a week, running 3-4 days per week, to barely being able to walk!

I felt like Lydia and Kristy were as excited as I was to get started with strengthening exercises.  I experienced such relief from my treatment, and the exercise plans they put in place for me helped support rebuilding my strength.

I felt like I had my own cheering squad every step of the way.  I am now back to my regular exercise program!”  – L.T. Traverse City

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Back Pain and Sciatica Workshop moved to November 4th!

We will be hosting our first workshop on back pain and sciatica on Saturday November 4th from 10 – 11am.  If you know someone who has been suffering from back pain and/or sciatica then be sure to let them know about this workshop!

Lower back pain is a huge problem in this country, but unfortunately most people feel like there is no ‘cure’ and they just have to live with it.  Check out this short video for more information on the workshop and to listen to how this is one of the biggest ‘myths’ in the health care industry.

The workshop is technically for those who have not been clients of ours in the past.  Past clients receiving this newsletter are welcome to call us with questions ANYTIME!  We are more than happy to answer any questions you may have and set up a time to get you in for a free screen if that is what is necessary.

Like I said, call us anytime!  231 421-5805
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NEW Sports Medicine Clinic Tuesday Afternoons

Many schools in our area don’t have access to athletic training services or team doctors at their games, so many young athletes with injuries don’t get the medical care they need.  We currently provide the athletic training services at Kingsley High School which has been extremely beneficial for our athletes.  The goal is to treat them early to keep them playing and also to keep them from more serious problems and costly treatment down the road.

Unfortunately, we can’t be everywhere, so on Tuesday afternoons we’ll be offering free screenings to athletes with nagging injuries affecting their performance or keeping them from playing altogether.  We can diagnose the injury and get the athlete started down the road to recovery.  Athletes with more serious injuries should see their family physician!

Appointments will be available between 3 – 5pm.  Parents should call to make the appointment as we will need your contact information and at least verbal permission to examine your child. We prefer that a parent be able to make the appointment especially if the athlete is under 18 years of age.

Give us a call at 231 421-5805 to schedule a time.

See you next month!

Joe Heiler PT

Solving Lower Back Pain – Find the Pain Relieving Direction

Just a reminder we’ll be hosting a Back Pain and Sciatica workshop November 4th from 10-11am.  If you are suffering from lower back pain and/or symptoms that go down your leg then this is for you!

One of the topics we will be covering is what we call finding a directional preference.  Many folks with lower back pain, including symptoms down one or both legs, will have a direction that their back prefers to move in.  It could be flexion (forward bending) or extension (backward bending).  Finding a definite preference can often lead to a significant reduction in symptoms on day 1.

What is also true on many occasions is that moving in the opposite direction will make their symptoms worse.  So avoiding activities that increase pain, or just adapting them to avoid certain movements, can also reduce symptoms quickly.

Check out the new video for more information including a mini-case study on how it can work.

At Elite PT we are trained to determine if there is a directional preference and then how to best take advantage of that for a quicker recovery.  This is just one strategy that we will discuss at our Back Pain and Sciatica Workshop.  For more information or to sign up just give us a call at 231 421-5805.

 

Elite PT July 2017 Newsletter: Lower Back Pain, Employee Spotlight – Jesie Bott, Exercise Tips and more…

Hope you’re having a great summer and surviving the craziness that is northern Michigan in July.

This months newsletter features:

  • Employee Spotlight – Jesie Bott
  • Lower Back Pain – 80% of us are going to have it!
  • Exercise Tip of the Month

Employee Spotlight
Jessica “Jesie” Bott was our very first employee starting back in 2012.  She took a bit of a hiatus after giving birth to her daughter but she’s been back a couple years now and we love having her around as much as possible.  Jesie home schools her two children and works Fridays during the school year but in the summer we’re blessed to have her 2.5 days per week.  She’s got a ton of energy and really loves to get to know her patients and clients.  She does a great job for us here at Elite Physical Therapy so we wanted to tell her story.

Jesie is an Athletic Trainer and licensed massage therapist, graduating from Grand Valley State University in 2005.  Jesie has worked in the outpatient orthopedic setting since graduation, and also worked as the athletic trainer at Kingsley High School for 5 years.  Jesie is a Graston Technique Certified Clinician, and trained through Functional Movement Systems giving her the ability to critically analyze a person’s movement ability and develop exercise programs that really work!

Why did you become an ATC/LMT?
“I had an inclination toward sports and health and wanted a career that kept me physically active and challenged me mentally.  Athletic training was a perfect fit!”

What do you enjoy most about the job?
“What I truly like best about my job is helping people feel better. I’m passionate about it.  I want to see people get results and I’m happy to be a part of that.  At Elite, I enjoy the one on one experience with each patient as well as having the freedom and ability to use my knowledge and creativity to problem solve and do everything I can to help someone feel better.”

What do you do for fun?
“Other than working at Elite….:)  I enjoy spending quality time with my family.  We love to be outdoors, camping, playing in the water and playing with our sweet puppy.”

Jesie has been married to David Bott for 13 years and have two great kids – Chase and Clare.  Jesie also owns Freedom Massage Therapy and currently sees clients at Elite PT on Tuesdays and Fridays. You can call her at 231 357-0151 for more details.

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Did you know that lower back pain will affect at least 80% of us at least once in our lifetimes.  Depending on the research article, once you’ve had a back pain episode, chances are between 60-80% that you’ll have recurring episodes beyond that.  Not great odds at all.

Here at Elite PT, lower back pain is the most common diagnosis that we treat.  There are numerous causes of lower back pain – some easier to fix than others, but it’s our job to figure that out.

One of the more common causes is Spinal Stenosis.  Stenosis literally means ‘narrowing’ and in this case the narrowing can cause compression and irritation to the nerves that leave the spinal cord and go out to the lower back, hips, and legs.  This causes pain across the lower back and can also produce symptoms into one or both legs.

spinal stenosis

How do you know that you may have Spinal Stenosis?

  • 50+ years old
  • Standing and walking increase symptoms
  • Sitting and lying down relieve symptoms
  • Leaning on the cart at the grocery store allows you to walk with less back pain

Spinal stenosis, like most types of lower back pain, is something that can absolutely be treated in physical therapy.  Certain muscles being ‘tight’ can create more compression and narrowing and therefore must be address using soft tissue techniques like massage, Graston Technique and dry needling.  Exercises must also be incorporated to stretch those tight muscles and improve how our joints move around the back and hips.

Other muscles tend to be ‘weak’, specifically the abdominals and glutes.  When strong and working with the right timing these muscles can reduce damaging forces across the spine.

A comprehensive physical therapy program that addresses all these factors can be extremely beneficial.

Here is what one of our former clients with spinal stenosis had to say:

Patient Testimonial
“I came to Elite taking medication to numb the pain in my back and legs so I could make it through the day.  Thanks to Jesie I have no more pain and know how to strengthen the muscles to help prevent the pain from returning.  She is a great therapist and I will use her again in the future if the need arises.”
– D.B. from Traverse City

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Exercise Tip of the Week

Child’s Pose is a common yoga pose that produces flexion through the hips and spine.  For someone with spinal stenosis this movement frequently decreases or eliminates the person’s symptoms.  If it relieves your pain, then do it whenever you need relief!

Child's Pose

Try to sit back on your heels – unfortunately my knees don’t bend that far!

In the bottom position, take 4 breaths in through the nose and out through the mouth.  Breathing in this manner decreases tone through the back muscles and also calms the nervous system bringing further relief.

For those with knee pain who can’t perform this exercise, try the seated floor press below.  It’s basically the same movement but with more body weight (usually fine but can be too much if you’re really sore).  Use the same breathing technique but be sure to put your hands on your knees to push yourself back up when you’re done.  This just takes some extra pressure off your back.
Seated Floor Press

You may find these simple exercises can make a huge difference in how you feel and how long you can be on your feet throughout the day.  If so, just keep doing them and you may just be able to keep yourself out of pain.

If you have all the signs and can only get temporary relief with the exercises then you probably would benefit from physical therapy.  Call us if you have questions (231 421-5805) and we could tell you if PT is for you.
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Have a great month of July with hopefully more warm weather to come.

We can be reached at 231 421-5805 or through email:  Joe@elitepttc.com if you have questions or if you just want to let us know how you’re doing.

Back Pain and Sciatica – Part 2

Last month I posted a case study showing how we treat back pain and associated ‘sciatica’ like symptoms here at Elite Physical Therapy in Traverse City.  You can find that article here:  http://www.elitepttc.com/back-pain-and-sciatica-physical-therapy-treatments/

This month’s case study is a little different in that the presentation and location of the pain were quite different but it still comes down to playing detective to determine where the patient’s symptoms are really coming from.  Before we get started here, I’m re-posting the picture of the dermatomes of the body (basically the sensory distribution of the nerves from the spine) so be sure to check that out.  Pretty cool how we were created for sure!Dermatomes

Case Study #2

The patient in this case presented to our clinic with pain shooting into the front of his hip and groin as well as down the front and side of his thigh.  He also reported minor back pain but it was nothing compared to the pain in his leg.  The patient reported having this pain on and off over the past couple years especially when exercising but recently it was much more constant and severe.  In the past he had been diagnosed with IT Band syndrome (pain laterally in the hip and thigh might make you think that), and more recently with a hip flexor strain (could also make sense now that he was having more pain into the front of the hip and groin).

Exam

  • minimal tenderness to the ‘hip flexor’ muscles anteriorly, slight weakness with manual muscle testing but no pain (probably not a hip flexor strain).
  • moderate tenderness and active trigger points in the lateral hip musculature that referred pain down the lateral thigh to the knee (could be part of IT Band syndrome).
  • springing of the lumbar vertebrae at L2 and L3 reproduced the typical symptoms  he felt into his anterior hip/groin as well as lateral thigh (Bingo!)

Treatment

Dry needling was performed at the levels of L2 and L3 along with electric stimulation for 10 minutes, and followed up with Graston Technique (GT) to decrease tone and improve mobility of the superficial fascia and muscles of the mid and lower back.

A couple exercises were given to maintain, and hopefully even improve, the mobility gained through the spine and hips as a result of the dry needling and GT.

Results

The patient reported a significant decrease in the anterior hip and groin symptoms as well as a moderate improvement in lateral hip and thigh symptoms.

During the second treatment session I decided to treat the muscles of the lateral hip as well since they also referred pain into the lateral thigh.  This was done with by dry needling + e-stim just like we had done in the low back.

By the third treatment session a few days later the patient was reporting a significant reduction in lateral hip and thigh symptoms as well.

Final Thoughts

It took a few more treatments to completely resolve this patient’s symptoms but it’s nice to see an immediate decrease in symptoms to know that you are treating the right areas.  With a thorough evaluation process it wasn’t hard to figure out that the patient’s symptoms were primarily coming from his spine which was quite a different diagnosis than what was previously thought.

A little detective work plus effective treatment tools like dry needling and Graston Technique can make a huge difference in patient outcomes especially in these ‘sciatica’ cases.  If you have similar types of symptoms or pain that just doesn’t ever seem to get better then give us a call!  If you have any questions feel free to email me:  joe@elitepttc.com

Exercise of the Week – Wall Slides for Shoulder Pain

At Elite Physical Therapy we know that shoulder pain and rotator cuff dysfunction is often the result of multiple factors such as poor scapular stability, loss of cervical and/or thoracic mobility, and poor trunk stability just to name a few.  Wall slides are one of those exercises that will address each of these areas of concern in one shot.

I’ve featured wall slides here in the past with the back up against the wall, but in this version there isn’t the input for the wall to correct posture and there is more of a focus on scapular upward rotation.

  • Posture – get tall and press away from the wall. You’ll notice in the video how this even assists with a bit of cervical retraction.
  • keep the forearms vertical to keep the posterior rotator cuff and scapular stabilizers engaged – this will be much more difficult with the band.
  • only go as far as the forearms can stay on the wall – this forces you to work through the lats and stiff upper back muscles.

You should feel a lot of muscle activation in the back of the shoulders and between the shoulder blades.  At no time should you have shoulder pain.  If so, this exercise may not be appropriate and probably a good time to have your physical therapist or physician take a look.

Any questions feel free to email me:  joe@elitepttc.com or call 231 421-5805.

Originally posted on SportsRehabExpert.com

Trigger Points and Shoulder Pain – Part II

originally posted on SportsRehabExpert.com

Joe Heiler PT

Shoulder pain is such a common diagnosis that we’ll see here at Elite Physical Therapy, and there are a number of structures that can be pain generators to the shoulder and arm. Last month I talked about trigger points in the posterior rotator cuff (Infraspinatous and Teres Minor) along with their common referral patterns. Another common shoulder muscle to find active trigger points is the supraspinatous. Active trigger points in this muscles can refer pain to the deltoid and down the lateral aspect of the arm.

Check out the typical trigger points and referral patterns below:

Supraspinatous Trigger Point Referral

Check out the video below for a demonstration of dry needling to the supraspinatous:

Case study:

Feel free to check out this case study but it was originally written for physical therapists and chiropractors. Ultimately the point is that a combination of dry needling and soft tissue mobilization, in addition to corrective exercises, can significantly decrease pain while improving range of motion and movement.

Current patient of mine presents with lateral arm pain of 3 months duration. No known cause of injury but diagnosed with tricep injury/tear.

Pre-Treatment

SFMA dysfunctional non-painful patterns:

  • all cervical patterns (mobility)
  • R shoulder medial rotation extension (mobility) – FN to the L
  • MS rotation R (motor control deficit) – FN to the L.

    SFMA dysfunctional painful patterns:

  • R shoulder lateral rotation flexion
  • MS extension (R UE pain)

    Special tests:

  • Hawkins + on the R
  • Passive shoulder IR 20 deg.

    Palpation:

  • Tenderness with palpation of both trigger point in the supraspinatous with referral of pain down the lateral upper extremity to the wrist (indicates that is the pain he gets into the upper arm)

    Treatment on Day 1 consisted of Functional Dry Needling to the supraspinatous (x2) with electrical stimulation followed by more superficial Graston technique to the R upper trap, supraspinatous, infraspinatous, and teres minor along with light strumming at the supraspinatous insertion. Corrective exercise included 3pt. thoracic rotation (UE positioned in internal rotation – hand behind the back) with manual assist to hold/relax work until pt. was able to control the full available range.

    Post-Treatment

    Functional Non-Painful patterns:

  • R shoulder medial rotation extension
  • MS rotation B

    SFMA dysfunctional non-painful patterns:

  • all cervical patterns (mobility)

    SFMA dysfunctional painful patterns :

  • R shoulder lateral rotation flexion
  • MS extension (R UE pain)

    ***both are still painful although intensity has decreased while motion has increased***

    Special tests:

  • Hawkins + on the R but much less intense
  • Passive shoulder IR 50 deg.
  • Graston Technique – Treating the Painful Shoulder

    Here is the video I promised using Graston Technique to treat soft tissue dysfunction in the posterior shoulder girdle using and in particular the trigger points that can refer pain to the front of the shoulder and down the arm.

    If you haven’t read the previous article discussing why we would want to treat this area, you can check that out here:  http://www.elitepttc.com/blog/trigger-points-and-shoulder-pain/

    If you have any questions concerning Graston Technique, Dry Needling, or shoulder pain please contact us at 231 421-5805 or Joe@elitepttc.com

    Trigger Points and Shoulder Pain

    There are a number of manual therapy techniques we use here at Elite Physical Therapy and Sports Performance, including Graston Technique and Trigger Point Dry Needling, to address muscular pain.  What many people don’t realize is that taut bands of hyperirritable muscle (a.k.a. trigger points) can cause local and referred pain.

    This article is one I wrote for SportsRehabExpert.com awhile back showing how trigger points in the back of the shoulder, specifically the muscles of the posterior rotator cuff, can refer pain to the front of the shoulder and down the arm.

    If you have shoulder pain that has not responded to other types of treatment, then check out this article and please contact us with any questions you may have!

    Manual Therapy Technique of the Week – Treating the Infraspinatous and Teres Minor 

    Joe Heiler PT

    I’ve become much more familiar with trigger point referral patterns and treating these out the past couple years since taking the Kinetacore Functional Dry Needling course.  A couple of the more common trigger points I end up dry needling and/or using Graston Technique to treat in the shoulder are the infraspinatous and teres minor.  Active trigger points in these muscles can refer pain to the anterior and middle shoulder, and on occasion will also refer pain down the arm.

    Check out the typical trigger points and referral patterns below:

    Infraspinatous Trigger Points and Pain Referral Pattern

    Infraspinatous Trigger Points and Pain Referral Pattern

    Teres Minor Trigger Point and Pain Referral Pattern

    Teres Minor Trigger Point and Pain Referral Pattern

     

    Case Study

    Current patient of mine presented with R shoulder and scapular pain of 2 year duration.  MS rotation limited to 50% bilaterally (DP) and R shoulder medial rotation extension (MRE) reach only to L4 (DP).  Palpation of the infraspinatous trigger point (most superior and lateral) referred significant pain to the anterior shoulder and slightly down the lateral arm reproducing her typical pain.  The teres minor trigger point referred pain to the middle deltoid area.

    Post trigger point dry needling of these trigger points the patient’s MS rotation improved to 90% (dysfunctional still but non-painful) and R shoulder MRE to T9 (still DP but much less pain).

    It’s not always this dramatic but this is also not the first time I’ve seen the great results like this.

    I’ll get a video up soon showing how we use Graston Technique to treat the posterior shoulder to reduce this type of pain and improve shoulder function.

    In the meantime feel free to contact us with any questions:  231 421-5805 or Joe@elitepttc.com