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It’s heavy snow Winnipeg, learn about rotator cuff injuries, the winter cold and shovelling

It’s snowing this morning in Winnipeg; the first heavy blast of winter this season. Car accidents, falls and shovelling injuries are inevitable. Beware of your posture, the load, your balance and fitness level before you ‘shovel for hours’. The shoulder, and its supporting rotator cuff group of muscles are highly susceptible to those strains n sprains of high repetition and little prep.

Rotator cuff injuries are common in all sports and can be career enders for athletes likes quarterbacks and pitchers. But even if you’re just throwing snowballs with the kids or working out to stay fit, it’s important to keep the shoulder joint healthy. Here, physiotherapist Chris Bisignano, answers some of the important questions.

Q1: What exactly is the rotator cuff?

“The rotator cuff is a group of muscles, that act almost like a dynamic ligament. It is comprised of four muscles: the supraspinatus, which is the most commonly injured, the infraspinatus, the teres minor, and the subscapularis. The rotator cuff’s functions are to assist with arm movements and provide stability to the glenohumeral [shoulder] joint.”

Q2: Why does the rotator cuff get hurt so often, and what are the common issues?

Most of the exercises we do actually do not specifically target the RC enough to make a difference to its actual strength.

“Up to 67% of the population will have a shoulder problem at some point in their lifetime, and the rotator cuff is most often the source of the pain. The primary reason for rotator cuff pain is that pinching sensation or ‘impingement syndrome,’ which may be the result of rotator cuff tendon inflammation caused by an activity or trauma. Over time, this can lead to a rotator cuff tear. To make matters worse, evidence suggests that most individuals are likely to experience rotator cuff degeneration by age 40 and rotator cuff tearing by age 60. Thus, in many cases, a seemingly normal exercise session or home-repair project may incite shoulder pain.”

Q3: What kinds of moves should I avoid if I want to stay injury free?

Repetitive reaches with even a simple load can isolate alot of force upon the RC. Movements above shoulder become risky when a joint is not supported well, or even unstable because of weakness.

“Many of the more common gym exercises—such as upright rows and lateral deltoid raises—may lead to rotator cuff injuries. Modifying these exercises to keep the end position of the arms or elbows below shoulder height may help prevent injury.”

Q4: How can I tell if I have a rotator cuff injury?

“Many people already have a rotator cuff injury and aren’t aware of it. Unfortunately, evidence suggests that these individuals will eventually develop symptoms. Early on, if you have pain when reaching overhead—pain located at the tip of the shoulder or the outside of the arm, where the lateral deltoid is located—that suggests a rotator cuff injury. Weakness when reaching the arm out to the side is also suggestive of a tear.”

Q5: How can I prevent a rotator cuff injury?

“Three key measures can be taken to reduce the chances of experiencing a rotator cuff injury.

“First, strengthen the external rotators; specifically by tubing or dumbbell exercises that need to be learned from a professional; these will help restore and maintain shoulder stability and may prevent impingement.

“Second, avoid sleeping on your side with your arm positioned overhead.

“Finally, try to achieve muscle balance—that’s key. Many weight-training routines are inherently biased, creating muscle imbalances that may lead to a rotator cuff injury. Try to perform an equal number of ‘pull’ versus ‘push’ exercises. Moreover, try to replace a few sets of shoulder exercises—such as lateral deltoid raises or shoulder presses—with exercises that strengthen both the deltoids and the rotator cuff, such as prone ‘Y’ or ‘T’ exercises.”

Visit yourPhysio or ask your healthcare provider for specific RC education and exercises.

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Even science can provide ‘stats’ on sitting in Winnipeg to prevent neck and back pain, especially those Downtown, Physiotherapy Winnipeg can educate you

No one will stand all day when they have the opportunity to sit. This is because the body works harder when standing than when sitting. However, when we at yourPhysio.com in Winnipeg review work production studies indicate that workers are more efficient when they stand to work. So how do you decide between the two? Consider these general guidelines Winnipeg!

When Standing is preferred:

the task cannot be performed with arms kept comfortably by your sides.

assembling, testing, or repairing larger products (i.e., greater than 6 inches high)

the work area is too large to be comfortably reached when seated. Stand when you must reach more than 15” past the front edge of the workstation. The maximum reach envelope when standing is significantly larger than the corresponding reach envelope when sitting for both men and women (Sengupta & Das, 2000).

you work in more than one workspace to perform job duties and must move around frequently.
the work task lasts less than 5 minutes.

dealing with heavy objects weighting more than 10 pounds. In general, more strength can be exerted while standing (Mital & Faard, 1990) Stand when you need to maximize grip forces (Catovic, Catovic, Kraljevic & Muftic, 1991) or complete static or dynamic lifts (Yates, & Karwowksi, 1992).the work surface does not allow the worker to comfortably position legs under the surface because of an obstruction (i.e. working on a conveyor or a progressive assembly line, working in a kitchen, using a workstation with a drawer located underneath the work surface or a wide front beam, working at a retail counter, or using specialized equipment)

tasks require frequent application of downward pressures (loading bags, inserting screws)

Jobs that are most appropriately done standing include construction workers, highway flaggers, medical personnel, painters, electricians, plumbers, loggers, firefighters, plant inspectors, and maintenance personnel.

When Sitting is preferred:

Better when visually intensive or precise work is required, the activity is of a repetitive nature; longer tasks are completed (greater than 5 minutes), and when everything can be placed within easy reach. Sitting is not appropriate when heavy objects must be handled or long reaches are required.

However, prolonged sitting has been associated with a high incidence of back complaints (Mandal, 1981), increased spinal muscular activity and intradiscal pressure (Grandjean and Hunting, 1977; Lindh, 1989). Other problems reported include discomfort in the lower extremities (Westgaard and Winkel, 1996) and increased muscle loading of the neck and shoulder muscles when sitting with the forearms unsupported as compared to standing with the forearms unsupported (Aaras et al., 1997; Lannersten and Harms-Ringdahl, 1990).

To summarize the literature, neither static standing nor sitting is recommended. Take note of ‘static’ versus ‘dynamic’ Winnipeg, learn to balance each through your day.

Each position has its advantages and disadvantages. Research indicates that constrained sitting or constrained standing are risk factors and that alternating work postures may be preferable. Alternation between two postures allows for increased rest intervals of specific body parts, and reduced potential for risk factors commonly associated with MSD development.

Ideally, provide workers with a workstation and job tasks that allow frequent changes of working posture, including sitting, standing, and walking. If either sitting or standing is feasible but only one possible, sitting in a properly designed chair is preferable.