Shoulder Surgery: Diagnostic Aids

Shoulder surgery is not something to be taken lightly. When it comes to intrusive surgeries of this kind, most primary care practitioners realise that it is essential to approach initial treatment very conservatively. The shoulder is the joint where adequate steroid injection techniques can be most helpful- more than any other structure in the body. The diagnosis of the cause of shoulder pain can be greatly simplified by taking into account certain fundamental principles. For example, the age and gender of the person complaining of discomfort provides a very important guideline. Some types of shoulder pain and disorders occur frequently in certain age groups and gender combinations. Listed below you’ll find a series of commonly occurring shoulder maladies as well as the groups it generally tends to affect. Used in combination with pain location, these parameters can be quite useful in making a diagnosis after a clinical examination.Commonly occurring shoulder maladies:1. Thoracic Outlet Syndrome (young females aged 14 to 20)2. Shoulder instability due to previous dislocations (young athlectic boys aged 14 to 21 participating in sport). In this instance there is often a prior injury where the shoulder was dislocated the first time.3. Shoulder instability or Os-acromiale (young physically active males and females aged 18 to 30 years old)4. Rotator Cuff Impingement Syndrome (males and females 40 years and older)5. Frozen shoulder (females 45 to 55 years old)6. Calcific Tendonitis (females and males 40 to 60 years old)7. AC joint pain (active sporting males between the ages of 35 to 55 who complain of pain on top of the shoulder)8. Rotator Cuff Tears (males and females 50 years and older)9. Osteoarthritis of the shoulder (males and females aged 60 years and older)The above information relates conditions that commonly occur in certain gender and age groups which tend to request shoulder reconstruction surgeries. Additional factors that may help in making a diagnosis includes both the nature and localisation of the pain.Localisation of the pain: 1. Pain on top of the shoulder may be caused by acromio-clavicular joint problems. 2. Pain in the shoulder and outside of the upper arm could be following the pattern of Rotator Cuff problems that include rotator cuff impingement, tendonitis, calcific tendonitis and rotator cuff tearing. 3. Pain at the back of the shoulder usually indicates arthritis. 4. Pain in the neck and upper part of the shoulder may be caused by a referred problem from the neck. 5. Pain in the neck or shoulder that radiates down the arm and into the hand could be linked to neurological complications like thoracic outlet syndrome or disc problems in the neck. 6. Night pain occurs with most shoulder problems. Shoulder instability does not commonly affect sleep but most other conditions do when a person lies down at night. The reason is that any inflammation that might be present is worse when the position of the shoulder is lower due to the pressure effect of gravity. 7. Constant or intermittent pain: Most mechanical reasons for pain (e.g. rotator cuff tears) mostly cause discomfort only with certain movements e.g. lifting the arm. On the contrary, certain conditions cause constant pain unrelated to movement – these would indicate nerve conditions like thoracic outlet syndrome.Severity of the pain:Acute “blinding” pain usually occurs when calcium is absorbed by a person who suffers from calcific tendonitis. Other conditions may cause intermittent pain depending on the position of their arm and the activity being performed. If the pain is constant and runs from the neck down to the shoulder and hand, it is most likely from a nerve problem in the neck or thoracic outlet. If the pain is more mechanical and occurs during movement only it would suggest a damaged structure in the shoulder.As previously stated, shoulder reconstruction is something that has to be considered very carefully. With the use of these diagnostic guidelines primary care physicians will be able to make a more accurate diagnoses and research the most effective treatment available. Invasive shoulder surgery can offer great relief for patients suffering from debilitating pain but non-invasive treatment should always be considered first.

Introduction About Lung Cancer

Lung Cancer is the most customary and lethal of the cancers that one can be diagnosed with; however there are also operative treatments for patients anguish from lung menace. Most bags of lung bane are smoking allied, but not all smokers will arise this form of the sect degenerative disease. It is a good idea to renounce smoking if you are, and even the occasional cigar could intensify your chances of getting connected bane. This is why it is also especially unsafe to smoke near children and babies, because among the other harmful things, this can play a colossal function in their development of blight one day. There are many different types of lung cancers. These are Epidermold carcinoma or Squamous cubicle carcinoma which is most familiar in men and attacks the bronchial tube lining. Then there is Adenocarcinoma blight allied to lungs which forms in the mucus glands and occurs mostly in females and in non smokers. Bronchioalveolar carcinoma is an unusual part of Adenocarcinoma melanoma, forms near the air sacs in the lung and is exposed to be responding more effectively to the newer clinical worry treatments. Other types of lung menace are the Large sect undifferentiated carcinomas which strike on the appear edges of the lungs faster to the surface. The mode spreads more rapidly than the others and has regularly done so by the time it is even diagnosed. Small chamber connected scourge is caused more often than not by smoking and accounts for 20 percent of all gear of the disease. The cells inception off small but rapidly grow into large tumors. Lung melanoma could be painless to miss as the symptom crop as habitual flu like symptoms and habitual illnesses like bronchitis and pneumonia. You could have an irritating cough and some chest, back and shoulder pain. If you notice any blood in the sputum or a change in its incline then it will be prudent to have it checkered. Other symptoms could compose dumpiness of breath or very tough breathing. The symptoms of such nature of tumor do not have to be only respiratory related. You might have demise of, or no passion, weariness, combined and president aches, bulge in the face or spit and rapid credence passing. More unadorned symptoms of lung bane can include peculiar lapses in memory and fitting tremulous on your feet. There are many therapies and treatments, including some clinical trials, so if you are diagnosed, talk to your practitioner about these options

When I was nine years old my father suffered a “nervous breakdown”, whatever that was. The term is no longer in vogue. Too vague. He was sick in every part of his body. When one part healed another part hurt. He thought he was dying.

We moved from the city to a country farm. We didn’t have a telephone because he couldn’t stand the ringing of a phone. His doctor finally told him he needed to see a psychiatrist. That shocked him into reading everything he could to heal himself. It took him seven years.

During that difficult time my mother suffered chronic back pain.

I suffered chronic shoulder pain relieved by daily use of a Chi machine until I had both shoulders replaced.

I’m sure you know someone who suffers chronic pain. It’s no fun.

Here are excerpts from a fascinating lecture presented at the 14th annual meeting of the AmericanAssociation of Orthopaedic Medicine, Tempe Arizona Feb.21, 1997

The title:

Psychological Factors in Chronic Pain: An Introduction to Psychosomatic Pain Management by Dr. Dietrich Klinghardt, M.D., PhD

“Most pain treating physicians have a vague notion, that there may be a psychological component contributing to the severity of chronic pain. The International Association for the Study of Pain defined pain as ‘an unpleasant sensory and emotional experience associated with the actual or potential tissue damage’.

“The well respected British neurologist and researcher Barry Wyke demonstrated, that the neurological signal from a painful stimulus travels from the receptors in the periphery to the thalamus, where the message is split: one pathway goes up to the sensory cortex, telling the patient where the pain is and what particular sensation it causes (warm, pulling, pressing etc.). The other pathway goes to the frontal lobe, which is now accepted as being partially part of the limbic system. Stimulation of this area gives the patient the emotional experience that goes along with having pain (”it makes me sick, hopeless …I feel terrible …I am afraid ..etc.).

“Patients, that had their frontal lobes removed, can still tell pain, but there is no suffering whatsoever that goes along with the experience. It is really the “psychological” component, that has earned chronic pain the attention it is given in modern medicine. Why then are we not focusing our attention on the ways in which we can help patients in this area? Why are most of us still trying to “fix” pain with all the invasive procedural approaches available today? Why not develop a psychological intervention, that treats the emotional part of chronic pain and leave the rest alone?

“One of the main reasons I found for this dilemma can be explained quite simply: Medicine is a science, that has clearly come into it’s adulthood. Many safe injection procedures and other technical approaches are available today. These are teachable, learnable and reproducible. Psychology however is a young science with many diverting opinions ,each exploring different personality models, being based in often contradictory philosophies.

“In 1992 the San Francisco Spine Institute published a paper in Spine Magazine. 100 adults with MRI proven severe lumbar disc herniations were preoperatively interviewed regarding five possible traumatic situations in their respective childhood:

1. Physical abuse

2. Sexual abuse

3. Emotional neglect/ abandonment

4. Loss of one or both parents (divorce, death etc.)

5. drug abuse at home (alcohol, prescription drugs etc.)

The patients were assigned to 3 different groups:

1. None of these risk factors

2. One or two risk factors

3. Three or more

The long term postoperative success was as follows:

1. 95% excellent improvement

2. 73% improvement

3. 15%improvement

“What does this mean? The result of surgery and postoperative pain have little to do with the surgical procedure itself but largely depend on factors that date back to the childhood of the patient. It can be easily extrapolated from this study, that the same is true for many or all of the other procedures used in pain management, including osteopathic manipulation, prolotherapy and others. A follow-up study demonstrated, that brief targeted psychotherapy that addresses these specific issues, could improve the postsurgical results dramatically in groups B and C. Pelletier showed, that patients, who had a”severe”childhood, but matured through the process of good psychotherapy, ended up having a higher life-expectancy than people, that had a “happy” childhood.

“Another study, conducted by several AAOM affiliated physicians (Klein, Eek, Dorman et al) pointed indirectly in the same direction as the Spine Institute study: Patients were examined regarding the severity of their MRI findings before undergoing prolotherapy treatment. There was no correlation between outcome and the severity of the lesion: patients with severe pathology had the same success rate as the group with no demonstrable pathology, i.e. some patients with no demonstrable pathology did not improve with prolotherapy, others with severe pathology did improve. This study did not look at the probable underlying psychological problems even though I would dare to say, that just as in spinal surgery the outcome of the treatment was determined by the same 5 psychological factors, not by the severity of the lesion.”

###

With recognition of psychological factors in chronic pain and illness that travels the body, medical doctors now studying the neurological pathways of chronic pain are recommending treatment rather than prescription drugs. No longer is there shame that the subconscious mind can be the source of pain.

Don’t take seven years to get well.

  Many women with extremely large breasts experience serious complications in their daily lives. Fortunately, this problem is correctable. If you suffer from this condition, you might want to consider surgery to reduce the size of your breasts. Ideal Candidates for Breast Reduction Surgery You are a candidate for breast reduction if you experience the following symptoms as a result of your large breasts: · Chronic back, neck, or shoulder pain · Posture issues · Skin rash under your breasts · Indentations in your shoulders from bra straps · Restricted ability to engage in physical activity · Low self-esteem Diabetes, circulation issues, heart and lung disease, and smoking can cause complications with the procedure. Make sure your doctor knows your medical history to help determine if breast surgery is right for you. Breast reduction is generally done after age 20, when your breasts are completely developed. If you are planning on having children, you might want to think about waiting to have this procedure until after you’ve given birth. This surgery frequently causes problems with breast feeding. Also, changes to breasts during pregnancy can affect the results of the surgery. Preparing for Breast Reduction Surgery You need to be very specific when telling your doctor what you want done to your breasts. This will help ensure that your doctor can most effectively meet your expectations. It is a good idea to have a mammogram before surgery, especially if you’ve never had one. If you are a smoker, you’ll need to stop for awhile before surgery and during your recovery period. Smoking inhibits blood flow and can lead to complications in the healing process. The Breast Reduction Procedure The surgery usually takes 3-4 hours, and you will be given a general anesthesia before the procedure. Generally, the surgeon will make three incisions: one around the areola, one down the breast, and one in the crease beneath the breast. In most cases, the nipple and areola will stay connected to the breast, but in situations where breasts are extremely large, the surgeon might have to physically remove the nipple and areola, reattaching them in a higher place. This will cause you to lose sensation and the ability to breast feed. In these cases, the loss of sensation is usually permanent. The Recovery Period After surgery, your breasts will be swollen, bruised, and sore. The pain might last up to a month. It could take six months before your breasts achieve their new shape. Right after surgery, you will probably have decreased sensation in your nipples and areolae. Sensation will eventually return, but the time frame varies from person to person. It can take anywhere from a few weeks to a year to regain full sensation. You can generally return to normal physical activity within a few weeks. However, you should avoid heavy lifting for awhile. You won’t be able to engage in any kind of sexual activity for at least a week after surgery. Risks and Complications As with any major surgery, there will be risks and potential complications. The following side effects are common after breast reduction surgery: · Loss of sensation to nipples and areolae · Permanent scarring · Inability to breast feed · Asymmetry in size and shape of breasts

Shoulder pain can strike anyone at any time. Whether you’re a javelin-throwing athlete, a weight-lifting gym bunny or a mom picking up a hefty toddler at the wrong angle, no-one is immune from the possibility of straining or damaging this vital, complex area of the body, with its joints, ligaments, tendons, muscles and nerves all capable of succumbing to the stresses placed on them.

There are two basic degrees of shoulder pain – acute or chronic. Acute shoulder pain has a sudden onset and lasts temporarily, for example when a muscle is strained.

Chronic shoulder pain may come on more gradually but persists for an indefinite amount of time. Acute pain can develop into chronic pain, especially if not treated correctly at the time of onset.

Shoulder pain should never be ignored as early treatment is the best way to avoid prolonged problems, while occasionally pain can indicate a more serious condition.

Some of the more common causes of shoulder pain include:

Tendonitis – tiny tears in the tendon causes the area to become inflamed, often related to sport activities or work-related strain

Rotator Cuff Shoulder Pain – can be caused by the natural aging process, this affects the rotator cuff which is the group of muscles and tendons that provide the shoulder with its circular motion

Bursitis – the bursa are small, slippery sacs which reduce friction between these soft tissue and bone. If the bursa becomes inflamed due to repetitive motion, for example in manual labor or similar routine jobs, bursitis can result.

Arthritis – most commonly found at the site of an old injury.

Shoulder Pain Treatments

The importance of early diagnosis cannot be stressed enough. The sooner the correct treatment is begun, the sooner the pain can be alleviated and managed, and the chances of further problems are enormously reduced.

The types of shoulder treatments available include surgery, allopathic, and alternative therapies.

Allopathic Shoulder Pain Treatment

Depending on the severity of your pain, and its causes, Pharmaceutical treatments for shoulder pain can be obtained over-the-counter, such as aspirin, or with a doctor’s prescription. Your doctor will be able to recommend the right kind of medication depending on his diagnosis. For example, some conditions do not respond to anti-inflammatories while others respond extremely well. Do not try and guess, ask your medical practitioner.

Remember that many drugs carry the risk of side effects which can be quite severe, such as heart disease, digestive disorders, ulcers and liver damage. This is especially true with long-term use. Make sure you are aware of the risks and discuss alternatives with your doctor if you are unhappy with his proposed medication.

Also keep in mind the risk of addiction with certain long-term medications.

It is important to understand that medicines usually manage pain rather than cure the cause. This is especially true of degenerative conditions.

Physical Therapy

Physical Therapy is often prescribed along with medication to alleviate shoulder pain. A wide variety of treatments from heat therapy to massage are offered by registered physiotherapists, with a wide range of success being reported, from excellent to fair. Physiotherapy is most helpful in treating shoulder pain so as to prevent frozen shoulder, when the patient stops using the shoulder due to pain and then the muscles seize up, compounding the problem.

Alternative Therapies

For those patients who prefer a more natural approach there is a wide range of alternative treatments available for shoulder pain. These methods of treating shoulder pain are generally more conservative than the standard medical approach, and often just as, if not more, effective.

You can choose from Acupuncture, Chiropractic Massage Therapy and Naprapathy. Check that the practitioners are registered and properly qualified. Many doctors now happily refer their patients to alternative professionals themselves.

Shoulder Pain Surgery

If all else fails you may be faced with the option of surgery. This should always be a last resort, as the results are not guaranteed. Surgery offers limited relief for certain conditions. Also, there are some risks to be taken into consideration. Discuss all your options with your surgeon before making the decision to go ahead with this option.

Another article about the bench press you ask? Whether you agree or not the barbell bench press is one of the most highly regarded weight room exercises period. Have you heard this conversation in the gym lately? “So how much weight can you use for preacher curls?” “I’m moving some heavy weight, how much can you use for kickbacks?” “I’ve been struggling on those and I have a kickback meet coming up in a few months!” I’ll take a wild guess and say this conversation has never and will never take place. The truth is the vast majority of individuals measure their strength and even their manhood based on how much they can bench. You could be at the gym, or even at a bar having a beer but when the topic of working out comes up people are almost certain to ask the infamous question, “How much you bench?” If you don’t care how strong you are then I don’t know why you’re lifting weights anyway. The bench press is a benchmark of your strength plain and simple. Back to the conversation we didn’t hear at the gym. What our friends above should have been asking each other isn’t how much weight they use when doing kickbacks but rather how much weight they use when they’re performing a lower pulley external rotation exercise. Did I lose you there? I know, I know we declared the bench press is the true measure of our strength not all these isolation and stabilizer exercises right? This is true, but have you ever heard the expression, you’re only as strong as your weakest link? When you bench press there are four tiny muscles that play a major role in whether your bench press takes off or if you’re going to suffer from a bench press blowout. Build these muscles up and you can dramatically decrease the chance of blowing out your shoulder. If you’re benching heavy weight and not paying attention to these muscles you run the risk of muscular imbalances, shoulder pain, and getting stuck in a serious plateau. When bench pressing it essential to have stability and strength in the shoulder. The four relatively small muscles predominantly responsible for stabilizing the shoulder - teres minor, infraspinatous, supraspinatous and sucscapularous - are known collectively as the ‘rotator cuff’. When these muscles contract they pull on the rotator cuff tendon, causing the shoulder to rotate. While bench pressing you may experience some rotator or shoulder pain, during part of the movement. This is likely due to weak muscles in this area. Weak muscles are often but not always the cause of rotator cuff impingement syndrome and associated rotator cuff tears. If you have the rotator cuff strength of a little girl, your body has no choice but to limit the amount of weight you can stabilize and move to prevent injury. It’s not uncommon to see an individual break through a bench press sticking point simply by incorporating direct rotator cuff training. OK maybe now I have your attention. So how do you make sure your rotator cuff isn’t the weak link in your bench press? Or even more importantly how will you prevent a bench press blowout where you damage the rotator cuff? Like we discussed you need to strengthen the muscles, so let’s take a look at this workout routine. Remember if you already have an injury you should not use this routine as a rehab program but rather visit a sports medicine physician. If you want to prevent a future injury and break past a bench press sticking point then follow this routine twice a week. If you’re not in pain now, that’s an even better reason to follow my advice. Trust me if you have a nagging injury you’re not going to be growing or getting any stronger. Train smart, so that you can hit the weight hard when you do bench. The first thing you need to do is stretch the muscles you are about to train. Make sure you have warmed up for a good five minutes on the bike or treadmill before you start stretching. This will help you acquire greater flexibility. You already know stretching is important so just do it. You don’t need any equipment for this stretch. You can do it one arm at a time or with both arms at the same time. Extend your arms out from the torso at a right angle. Now bend your elbows at a 90-degree angle. Place your forearms on the frame of the doorway and lean forward. You will feel the stretch in your pecs and the back of your shoulders. Hold the stretch for 20-30 seconds. Next I want you to hang from a pull up bar for 20-30 seconds. This isn’t a grip strength test so no you don’t have to hang on for the full 30 seconds. Cuban Press Rotation Grab an EZ Curl bar and perform a wide grip upright row until the bar is a few inches below your collar bone. Now keep your elbows stationary while you externally rotate the bar as if you were trying to tap your forehead. Next you will press the bar overhead. Lower the weight along the same plane and repeat for ten reps. You will not be able to use the same weight you use for standard overhead presses due to the external rotation. This exercise won’t build your ego right now, but you’ll be thanking me when your bench press increases. Cable External Rotation Raise the pulley until it is even with your elbow. You’ll be standing sideways next to the weight stack so if your right hand is holding the handle, your left foot should be closest to the weight stack. Grasp the cable attachment with your far arm while keeping your elbow close to your side and forearm across your stomach. Your palm should be facing in. Pull cable attachment away from body by externally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm. Cable Internal Rotation Again raise the pulley until it is even with elbow. You’ll be standing sideways next to the weight stack but this time if your right hand is holding the handle your right foot should be closest to the weight stack. Grasp the cable attachment with the closest arm. Keep your elbow close to your side with your palm facing in. Pull the cable attachment across your body by internally rotating your shoulder. Return and repeat. Turn around and continue with opposite arm. 90-Degree Dumbbell External Rotation To finish off the infraspinatus, hold a dumbbell in each hand, and perform a lateral raise to 90-degrees while keeping the elbows bent at 90-degrees. Once your upper arms are parallel to the floor, externally rotate your arm so that your forearms are perpendicular to the floor. It will look like starting point of a dumbbell military press. Now lower and repeat. Remember to use light weight. The infraspinatus is a tiny muscle so it can’t handle a heavy load. The shoulder horn is a great piece of equipment that keeps your arms in place while you perform this motion. Do three sets of ten repetitions for each exercise. Perform the routine once a week in conjunction with your current workout. This is important so listen up. The last thing you want to do is pre-exhaust your rotator cuff before training the bench press. Never do this workout prior to a heavy bench press or shoulders session or you run an even greater risk of aggravating the area. You can give these exercises a try at the end of your workout, but be sure you always give your rotator cuff muscles 48-hours rest after a workout before training chest or shoulders. Points To Remember: The muscles of the rotator cuff are very small. Even if you’re pushing five bills on the bench press you’ll still be using five-pound dumbbells for many rotator cuff exercises. So leave your ego at the door! Avoid lat pulldowns and military presses behind the head as they place the shoulder in a poor biomechanical position which enourages impingement. Training your rotator cuff muscles can help you avoid pain, prevent future injuries, and fix muscular imbalances. It’s not uncommon for a trainee to add 20+ pounds to their bench press simply by strengthening the rotator cuff muscles. Never perform a rotator cuff routine prior to bench pressing or overhead pressing movements. If you feel serious pain in your shoulder it may be too late. Go see a sports medicine physician. We all know people who were really into bodybuilding/powerlifting and looked forward to bench pressing only to eventually drop out after a few years of hardcore training. Why? In many cases nagging injuries especially those of the shoulder, simply took the fun out of it. This doesn’t have to happen to you so you’re ahead of the game. The best thing you can do to keep your shoulders healthy, and make sure your bench press continues to improve is strengthen your rotator cuff muscles so that they will never be your weakest link! After all your bench press will be going nowhere fast if you’re injured. Pick up the girlie weights for a few sets once a week so you’ll experience a bench press blastoff instead of a bench press blowout. Mike Westerdal is the owner of http://www.criticalbench.com. Visit his site to receive two free PDF reports entitled, “31 Days To Bigger Arms” and “Boosting Testosterone Levels for Big Muscle Gains.”

Yoga and Back Pain
by jainish

Introduction

Lower back pain injuries are associated with lifting, twisting, bending, reaching, pulling and pushing actions. In order to help prevent back pain injuries, people should: Engage in exercises that don’t jolt or strain the back, maintain correct posture, lift objects properly. Low back pain injuries create tug-of-wars with opposing and attachments of bone, ligament, tendon, and muscle.

Doctors also report that men complain of exercise and sports-related back pain injuries more often than women and the two genders identify different activities as the source of their discomfort. This is important because with greater strength and flexibility, not only can current episodes of pain be reduced, but it also helps to prevent further bouts of back pain injuries.

Pain

Pain from an injury may be sudden and severe. Pain from the lower back can affect anywhere in the lower limb. Pain typically felt in lower back, and from time to time one sided. Pain in the back may occur in any region from the base of the skull to the hips. Nearly all adults suffer at least one back-pain episode during their lives. In fact, nurses rank second in back-pain injuries among all professions. Our areas of specialty include: -Neck pain, Back pain, headaches, sciatica, migraine, shoulder pain, foot pain, whiplash, sports injuries.

Conditions which have responded successfully under our care are the entire above plus more. Many patients have been able to avoid undergoing surgery or prolonged exposure to medication by attending yoga classes and regular practice.

Although we concentrate on back and neck pain relief, many people suffer both neck and lower back pain. Areas of back strain are ordinary and we offer some suggestion for back pain release from simple correction in your every day activities, to posture alteration and a number of devices that are easy to use and can actually help.

A local area of muscle strain is very prevalent among back pain sufferers, and is seen in up to 85% of chronic pain patients. The strength of pain can alter from day to day and is characteristically made worse and maintained in a chronic state by poor posture, repetitive motions, stress, lack of sleep and even nutritional imbalances.

Injury

Our body movements usually do not cause problems, but it’s not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Severe back injuries may result from car accidents, falls from significant heights, direct blows to the back or the top of the head, a high-energy fall onto the buttocks, or a penetrating injury such as a stab wound.

Shoulder surgery is not something to be taken lightly. When it comes to intrusive surgeries of this kind, most primary care practitioners realise that it is important to approach initial treatment very conservatively. The shoulder is the joint where adequate steroid injection techniques can be most helpful- more than any other structure in the body.

The diagnosis of the cause of shoulder pain can be greatly simplified by bearing in mind certain fundamental principles. For example, the age and gender of the person complaining of discomfort provides a very important guideline. Some types of shoulder pain and disorders occur frequently in certain age groups and gender combinations. Listed below you’ll find a series of commonly occurring shoulder maladies as well as the groups it generally tends to affect. Used in combination with pain location, these parameters can be quite useful in making a diagnosis after a clinical examination.

Commonly occurring shoulder maladies:
1. Thoracic Outlet Syndrome (young females aged 14 to 20)
2. Shoulder instability due to previous dislocations (young athlectic males aged 14 to 21 participating in sport). In this instance there is often a previous injury where the shoulder was dislocated the first time.
3. Shoulder instability or Os-acromiale (young physically active males and females aged 18 to 30 years old)
4. Rotator Cuff Impingement Syndrome (males and females 40 years and older)
5. Adhesive Capsulitis (females 45 to 55 years old)
6. Calcific Tendonitis (females and males 40 to 60 years old)
7. AC joint pain (active sporting males between the ages of 35 to 55 who complain of pain on top of the shoulder)
8. Rotator Cuff Tears (males and females 50 years and older)
9. Osteoarthritis of the shoulder (males and females aged 60 years and older)

The above information relates conditions that commonly occur in certain gender and age groups which tend to request shoulder reconstruction surgeries. Further factors that may help in making a diagnosis includes both the nature and localisation of the pain.

Localisation of the pain: 1. Pain on top of the shoulder may be caused by acromio-clavicular joint problems. 2. Pain in the shoulder and outside of the upper arm could be following the pattern of Rotator Cuff problems that include rotator cuff impingement, tendonitis, calcific tendonitis and rotator cuff tearing. 3. Pain at the back of the shoulder most probably indicates arthritis. 4. Pain in the neck and upper part of the shoulder may be caused by a referred problem from the neck. 5. Pain in the neck or shoulder that radiates down the arm and into the hand could be linked to neurological complications like thoracic outlet syndrome or disc problems in the neck. 6. Night pain occurs with most shoulder problems. Shoulder instability does not usually affect sleep but most other conditions do when a person lies down at night. The reason is that any inflammation that might be present is worse when the position of the shoulder is lower due to the pressure effect of gravity. 7. Constant or sporadic pain: Most mechanical reasons for pain (e.g. rotator cuff tears) mostly cause discomfort only with certain movements e.g. lifting the arm. On the contrary, certain conditions cause constant pain unrelated to movement – these would indicate nerve conditions like thoracic outlet syndrome.

Severity of the pain:
Acute “blinding” pain usually occurs when calcium is absorbed by a person who suffers from calcific tendonitis. Other conditions may cause sporadic pain depending on the position of their arm and the activity being performed. If the pain is constant and runs from the neck down to the shoulder and hand, it is most likely from a nerve problem in the neck or thoracic outlet. If the pain is more mechanical and occurs during movement only it would suggest a damaged structure in the shoulder.

As previously stated, shoulder reconstruction is something that has to be considered very carefully. With the use of these diagnostic aids primary care physicians will be able to make a more accurate diagnoses and research the most effective treatment available. Invasive shoulder surgery can offer great relief for patients suffering from debilitating pain but non-invasive treatment should always be considered first.

Janine has been considering www.shoulderinstitute.co.za/ “>shoulder surgery and came across some interesting www.shoulderinstitute.co.za/”>shoulder replacement surgery websites.

It’s funny how you don’t notice a certain part of your body until it starts giving you problems. Imagine this, you use your arms everyday and connected to your arm is your shoulder which mostly moves with your arm.

Now all of a sudden somewhere along the line you hurt your shoulder. You’re not exactly sure when or why, but something is different. A nagging pain is nibbling on your nerves and you can barely pick up your fork to take a bite of your supper.

Sounds familiar?

We only notice that we can’t be without the functionality of a certain part of our body as soon as that part of our body starts acting up.

When it comes to the subject of shoulder problems, many a person will tell you about the pain and suffering that their shoulder problem caused them. According to research it seems that shoulder problems are common in the general population, with up to 47% of adults complaining about their shoulder/s.

Before going for surgery, many will go to specialists to help them sort out the problem. Effective methods used to help alleviate shoulder pain include anti-inflammatory medications or pain medications, cortisone injections are also popular and of course physical therapy.

One of the very common treatments for shoulder pain is therapeutic exercise. In contrast to this, shoulder pain can actually be caused when hurting oneself while doing gym exercises.

A relatively normal activity for many people, which in actual fact has the ability to be responsible for your shoulder problems or aggravate an already existing shoulder problem.

Thus, certain exercises are beneficial to the shoulder, but there are others which may place the shoulder at risk for injuries and pain.

Following are four gym exercises that you should watch out for- they might just be the cause for your shoulder problems:

1. Bench press: There may be an association between bench press and arthritis of the shoulder due to the fact that the shoulder is loaded with compression. The shoulder is strictly speaking a hanging joint. Such heavy loading may cause early wear of the cartilage.

2. Acromio-clavicular (AC) joint: AC joint (the joint between the collar bone and the shoulder bone on top of the shoulder) is also referred to as weight lifters shoulder. Lifting heavy weights may lead to wear of this joint but the incident is so low that one probably should not be too concerned about this.

3. Overhead exercises like military press: Military press loads the rotator cuff in a disadvantageous position and can lead to rotator cuff injuries. There are other exercises with equal benefits and less risk eg. lateral raises, horizontal row, etc.

4. Contagious exercises: One of the top exercises is seated rowing. When the weight is pulled back it also squeezes the shoulder blades together – this does not only exercise the rotator cuff muscles but also the stabilisers of the shoulder blades.

As mentioned above, contrasting to these four exercises, there are therapeutic exercises that will help treat your shoulder problems. Therapeutic exercises usually consist out of motion, strengthening and conditioning exercises.

Isn’t it ironic how the same thing, exercise, can either heal or harm you? So next time you go to the gym, be sure to watch out for potentially harmful exercises.

Dee works with the Cape Shoulder Institute where they are dedicated to the treatment of shoulder problems which are managed both conservatively and surgically. They treat all forms of shoulder problems even those caused by gym exercise.

There are times when we deal with specific types of pain that seem different than other pains we’ve dealt with in the past, and one type of pain that can occur is liver pain. Sure, we all deal with aches and pains, but there are some pains, such as liver pain, that just have a certain feel which lets us know that something is not right. So, if you’re having some pain in the area of your liver, you may be wondering if your liver is really your problem. Well, let’s take a closer look at liver pain, where it occurs, how it feels, and the things that can cause it.

Where Liver Pain Can OccurWhen it comes to liver pain, it usually occurs in the right side of the body, and most of the time this occurs right beneath the rib cage and on up as well. In some cases though, this pain can radiate into the right shoulder as well. Breathing can begin to feel quite painful as can coughing. Many people feel as if they have cramping that is occurring underneath their rib cage and it often feels full and swollen there as well.

How it FeelsUnfortunately many people don’t seem to think that liver pain really exists, but the pain is very real. In some cases this pain can feel as if your liver is not fitting where it should or like there is a large object lodged between your ribs. In some cases there can be severe back pain that occurs as well. Often the pain feels like a dull ach, and it usually is not a sharp or sudden pain.

Causes of Liver PainThere are a variety of different causes of liver pain, and usually these causes are identified when other symptoms can be identified as well. Some of the other symptoms that can go along with liver pain can include swollen testes, problems with breathing, itching, fatigue, shoulder pain, and eating difficulties. While there are many things that can cause this pain, the toxins and pollutants of the environment today are often to blame due to chemical overload of your body.

When to See Your DoctorSo, you may be wondering when it is time to see your doctor about this pain. Well, if things become more than a low grade ache and you deal with the liver pain for more than a couple days, then it may be time to see your doctor and have some tests done to figure out what the problem could be so you can get the treatment you need.

Balva Rudick is the Editor and Publisher of Article Click. For more FREE articles for your ezine and websites visit - www.articleclick.com