What can I do about my shoulder pain? By Dr. Scott Glidden, DC

What can I do about my shoulder pain?
By Dr. Scott Glidden, DC

Shoulder pain and dysfunction can reveal itself in many forms: sharp pain, a pinch, ache, and much more. Regardless of how it feels, it can be a debilitating injury. It can affect your work, sleep, and how you enjoy your free time with friends and family. How does it happen?

How did my shoulder pain start?

Unless there was an "event" that caused your shoulder pain, most shoulder pain is the result of a slowly developing chronic injury. This occurs when a motion is repeated over and over again, especially with force.  The symptoms will be worse with motions that are more forceful or require greater range of motion.  This is where we see common shoulder injuries in tennis—with the overhead serve. It can occur during any shot, but the overhead serve requires the greatest amount of function of the shoulder.  The muscles that move and stabilize your shoulder all have to stretch out when your arm is overhead.  As they become more dysfunctional, they will lose more and more range of motion and strength.  Eventually instead of stretching out, the muscles will actually cause irreversible damage to the shoulder.  The affected muscles will cause the top of your rotator cuff to work harder, causing it to degenerate or tear.  Instead of stretching, these muscles will compress the joint space in the shoulder causing cartilage damage and an acceleration of arthritis. It might just feel like a “pinch” at your shoulder, but there is so much more than that going on in the shoulder!

How did this happen?

If your problem is from a chronic process, the root of your problem is most likely adhesion. It is the most common, under-diagnosed, and fixable condition in musculoskeletal health. Adhesion occurs when you use a muscle or ligament more than it is prepared to, resulting in an excess of inflammation.  When this happens, adhesion will develop on the overused structures. Adhesion is like glue and when it sticks to things it limits their range of motion, saps their strength, and makes symptoms more and more likely. Your body can handle a little bit of adhesion but when it is allowed to build up is when the trouble starts.

This is healthy shoulder range of motion: both arms easily touching the head, covering the ears with no tension or discomfort

How do I fix my shoulder?

Adhesion is very difficult to fix, but with expert care it can be removed and the shoulder can become pain free again.  Is adhesion the ONLY thing that causes pain? Absolutely not! There can be rotator cuff tears, labral tears, separated shoulders, cartilage damage, or arthritis that can complicate shoulder problems.  A proper diagnosis can rule these problems in or out with a thorough exam and history. One thing is for sure: an adhesion free shoulder will take pressure off of the joint, slow degeneration, decrease pain and increase function.

At our office, we use Manual Adhesion Release to reduce adhesion.  MAR is one the most effective treatments for adhesion and we use pre and post-treatment assessments to determine exactly how much improvement each treatment achieved. Unless you measure effectiveness, how does the doctor know if the treatment is working? If the doctor doesn't measure function, the doctor has no clue if when they discharge you the pain will stay away.  A pain free shoulder can be one workout away from pain again. Good function=healthy shoulder.

Dr. Scott Glidden is a soft-tissue specialist in Milwaukee,WI. His practice focus is chronic unresolved muscle, nerve, and joint problems. You can find more information on him and his practice at selectspineandsport.com.

Shannon Yee and Kelly Keegan - Making life friends through their local league.

Shannon Yee backhand

We caught up with Shannon Yee and Kelly Keegan out TennisMinneapolis.com | Twin City Tennis League. They have both developed some great friendships in the league.  Shannon won her first ever championship during the Summer Season. Kelly is a two time champion. Photos were taken by Shannon's friend Xi Chen.   We are looking forward to Shannon and Kelly joining us on Nov. 30th in Miami for the 10th annual East Coast National Championship.

- Story updated 11/13/18 adding in Kelly Keegan's comments.

What do you like most about the league?

Shannon:  Flexible location and schedule, the opportunity of playing different lady with different level and styles, the opportunity of playing with the favorite opponent multiple times. 

Kelly:  I love that the league has all levels of players, that the schedule is flexible for those of us who are unable to dedicate a specific time and day each week, and most of all, I really enjoy the fun people I have met! I have made friends through this program and am so glad I joined.

Kelly hanging with Shannon

Tell us about your most memorable match(es)

Shannon:  I call my friend Kelly an "emotional" player.  Because on a good day, she will serve big, make opponent move like a dog, she's consistent on the base line, and approaches net, do all the tricks that only advanced player would do. On occasions, she rips out this scary overhead smash.  When I first played Kelly, I felt the only way I can get a game out of her is counting on the mercy that she might have an off day, which appeared to be the case.

 

On Sept. 8^th, Kelly and I played the summer season championship against each other; it was a sunny day with a little autumn wind.  Like always Kelly started strong with very powerful serve, long deep baseline shot, sharp angles,  some aces.  I was pushed in defensive mood and struggle to hanging there, game is so close that our score walks like climbing stairs  1-1, 2-2, 3-3, 4-4 .. all the way to 6-6.  It was so long that 2 hours has passed and the wind became a little stronger, we feel we'll be on court forever .. Instead of full set, we decided to change to 10-games pro-set so we can eventually finish.  Kelly and I took a water break, 2 hours of non-stop run has consumed us pretty badly.

The wind was blowing even stronger after our water break, Kelly started to lose her concentration after we came to 7-7.  As a pusher I was exhausted and all I have is energy to give the ball back to her court .. Kelly’s aggressive nature showcases at that point she starts to hit very hard, too hard just slightly over the baseline, she gets to the net, and that little timing off caused by wind and exhaust made her miss, anxiety and a desire to make a quick win somewhat did the opposite.  Another hour later, we finished at 10-7, total of 3 hours for a 10-games match!!  I have to admit that tennis is such a thing that combines skill, physical and mental strength, strategy, and honestly some unpredictable good or bad luck.  In the end we were both glad to finally get over the longest match.

Kelly: The most memorable matches of mine are the league championships I've played, both won and lost. That and the matches that have been so close. Once Shannon and I played a match for two hours and we had to stop when it was dark at 6-6 in the first set. 

Julianne S.

Who are your favorite rivals in the league? Why?

Shannon:  Julia Ann for sure.  She is a USTA rated 4.0 player, super athletic, serious and passionate about tennis.  She brings the best of me and I feel each time I play her I get slightly better.

Kelly: Shannon Yee is my favorite for sure! She and I are closely matched, she is a delight and has the best quips.

Do you have any other interesting comments about your experiences with the league?

Shannon: The friend I made from Tennis Minneapolis is the best, it is so much easier to build friendships among people with similar interest.

Kelly:   I was nervous to join because I thought I would be outmatched and not very good. Instead, I have seen my game improve and the league has provided me a source of pride - not only for my play, but the fact that had the courage to put myself out there.

Why doesn’t my elbow feel better after rest? - Dr. Scott Glidden

Why doesn’t my elbow feel better after rest?

By Dr. Scott Glidden, DC

Lateral epicondylitis, or tennis elbow, is one of the most common injuries experienced among tennis players. What might start as an ache or a “twinge” at the outer elbow eventually grows into persistent pain. Rest, straps, cortisone, dry needling, and stretching are all commonly recommended treatments that may work for a bit, but then the symptoms come right back in days or weeks. Why doesn’t anything help?

What exactly is going on?

When looking at this problem, you need to consider a few things:

-What is under the spot that hurts?

-Where do the things under that spot go?

When it comes to an overuse injury like tennis elbow, its often either the muscles that rotate the forearm or those that extend the wrist and fingers at fault. If a muscle is used more than it is trained to do, your body’s response to that use is adhesion.  Adhesion is a glue-like substance that sticks to overused muscles and ligaments in order to stabilize them so they don’t tear.  Unfortunately, adhesion also limits strength and range of motion as well. You will slowly lose strength and endurance as well as become more symptomatic with continued use.  “No pain no gain” does not apply here!

What is the fix?

The first thing I do with my patients with this problem is I have them grab my wrist and try to twist my forearm in both directions like a door knob. When the twisting is resisted, the effected muscles are challenged—reproducing the pain if it is indeed tennis elbow. If that test confirms it, finding an expert in finding and fixing adhesion is your best bet to eliminating the problem.  Once resolved the muscles will stay healthy as long as you maintain a healthy load.  Typing and texting use the same muscles, so keeping this in mind for proper load is key for avoiding injury. You can’t work at a computer all day and expect to be as prepared as you would on the weekend. If the pain isn’t reproduced or isn’t better with rest you should seek an orthopedic specialist for the problem since it likely isn’t a muscle or ligament problem.

Dr. Scott Glidden is a soft-tissue specialist in Milwaukee,WI. His practice focus is chronic unresolved muscle, nerve, and joint problems. You can find more information on him and his practice at selectspineandsport.com.