Author: Dr. Wade Rinehart

As the dog days of summer are upon us, many of you are finding relief and a way to beat the heat in the joys of swimming. Whether you are a novice swimmer that enjoys time in the water, or an elite swimmer that swims for a local swim team or training for your next Triathlon, you most likely have experienced some sort of shoulder pain. Research shows that 94% of elite swimmers experience some sort of shoulder pain or “Swimmer’s Shoulder.” I have recently teamed up with a local NCAA competitive swimmer to take a look into the world of swimming and the injuries that come along with the demands of the sport. Attached to this blog is a link to a research paper that goes into great detail the biomechanical dysfunctions that produce shoulder pain and how to prevent such injuries. If you or your loved ones are having any shoulder pain that may be related to “Swimmer’s Shoulder” come in and see one of our Doctors of Physical Therapy for a complete evaluation and plan of care to get you back into the water pain free.

Brannon Chester, DPT
Doctor of Physical Therapy

Jamie McDonald
NCAA Swimmer, University of West Florida

Swimmer dysfunction research paper.

A common phrase that people use to describe their pain or injury is, “Oh it’s just a little tendonitis, it will go away soon.” Chronic tendonitis without treatment could ultimately lead to a complete rupture of the tendon sidelining you from any activity for months. In the past 10 years there has been substantial research into tendon pathology and the term “tendinopathy” has replaced the old term “tendonitis” as a result of the research and we now have a better understanding of the pathophysiological mechanisms. Through study and research, it has been concluded that there are 3 stages to tendinopathy: 1) reactive tendinopathy 2) tendon dysrepair and 3) degenerative tendinopathy.

Reactive tendinopathy is the early stage of tendon dysfunction and is a short-term adaptive thickening in attempt to reduce the stress placed upon the tendon. In this stage, the tendon can revert back to normal structure if overload is reduced or sufficient time is given between loading. Tendon dysrepair, there is greater matrix (tissue composition) breakdown of the tendon. We see this in all ages of patients and activity levels. In this stage, the tendon appears thickened with more localized changes. Degenerative tendinopathy is the last and most dangerous stage of tendon dysfunction. There is greater matrix and cell breakdown, with even some areas of cell death in this particular stage. If gone unchecked, this stage can inevitably lead to rupture.

Due to the fact that tendonitis/tendinopathy is an overuse injury, the best course of action is to decrease the stress and overloading of the tendon. In other words, REST. Also, through specific treatment interventions including soft tissue mobilization, eccentric strengthening, and evaluating the ultimate cause of the tendon dysfunction, we can prevent any further damage done to the tendon. If you are experiencing any sort of joint pain or “tendonitis” pain, come in and see one of our Doctors of Physical Therapy for a thorough evaluation to determine the best course of treatment for your particular injury.

Brannon Chester, DPT
Doctor of Physical Therapy

Tennis elbow is a common catchall phrase for inflammatory disorders of the elbow. However, most of the time it doesn’t have anything to do with playing tennis. Tennis elbow (lateral epicondylitis) is an overuse/strain disorder caused by repetitive contraction of the muscles of the forearm and wrist. In addition to racquet sports, activities such as painting, using a screwdriver or a knife for food preparation can all cause inflammation and pain in the elbow. Conservative treatment would begin with resting the upper extremity, using ice on the affected area and over the counter NSAIds (Advil, Aleve). There are cases where chronic imflammation of the elbow can lead to adhesions or scar tissue to form around the joint which can result in nagging pain or even disability. If this is a condition you may be dealing with that hasn’t responded to conservative treatments, come see us at First Choice Physical Therapy where our therapists can design a treatment program to get you felling better soon.

Have you ever suffered from constant headaches that start in the back of your neck and end up feeling like the pain is right behind your eye? What about after a long day at work, do you ever have a dull headache that will not go away until you lay down and try to “relax” with little to no relief? This type of headache is referred to as a “tension headache” and originates in the deep muscles of your neck that attach at the bottom of your head and can result in intense headaches. Due to poor posture, along with myofascial restrictions and cervical immobility, tension headaches are very difficult to relieve with home remedies. If you are suffering from headaches and want to do something about them, come in for an evaluation by one of our Doctors of Physical Therapy to decrease your pain and get rid of that headache once and for all.

Brannon Chester, DPT
Doctor of Physical Therapy