syringe

Shoulder Still Hurting After Your Covid-19 Booster?

Shoulder pain is quite normal after any vaccine.

But prolonged shoulder pain isn’t.

Shoulder injuries related to vaccine administration (otherwise known as “SIRVA”) is a rare, but possible occurrence when you get a vaccine or booster shot. Shoulder injections should enter the deltoid muscle. But SIRVA occurs when a healthcare professional administers the vaccine too high, or too deep into your shoulder.

When not properly administered, your next booster shot could graze your bone or nerve, or even puncture your bursa (a fluid-filled sac that protects your shoulder tendons).

Pain from SIRVA can be really difficult to distinguish from the normal pain that occurs after a shot in your arm. But it’s critical you know what to look for. Because if left untreated, SIRVA can cause prolonged problems in your shoulder over time.

I’ve seen folks end up with entirely preventable rotator cuff tears, bursitis, and tendonitis – all because someone didn’t take their complaints of shoulder pain after getting a Covid shot in their arm seriously enough.

Normal shoulder pain after a Covid vaccine or booster shot:

Mild skin sensitivity and localized shoulder pain is quite normal after a Covid vaccine or booster shot. Some people experience what is now known as “Covid arm” – a mild rash and skin sensitivity that can occur anywhere from a few days to even a week after receiving your shot. You’ll experience skin sensitivity and/or swelling that might look similar to cellulitis.

While annoying, Covid arm is not considered dangerous or threatening.

The symptoms will typically go away after a week or two and in the meantime, talk to your doctor or pharmacist about over the counter or prescription remedies that can address the symptoms of itchiness or swelling.

Localized shoulder pain at the site of your vaccine or booster shot is also normal. The pain you feel is from the mild trauma caused by the needle being inserted into the soft tissue (muscle) of your arm. It often feels like a bruise, and you may experience a little bit of swelling. It will typically go away after 2-3 days. Even though your arm can be quite sore, the important distinction here is that you’ll still have full, normal function of your arm. In other words, despite the soreness, you can still move your arm freely up and down if you had to without restriction.

Your arm soreness will go away with time, but gently massaging the area of pain, and even some easy movement or exercise can help the soreness go away faster.

Abnormal shoulder pain after a Covid vaccine or booster shot:

The symptoms of SIRVA are different, and typically more severe than what I’ve just described above. If not addressed, some of these symptoms could lead to long lasting shoulder problems or compensatory problems elsewhere.

As I’ve already alluded to, one of the main distinctions between “normal” shoulder pain after a vaccination shot and SIRVA is how well your arm functions. If the needle was accidentally inserted into your joint capsule, for example, you will notice limited mobility and possibly limited strength. If unaddressed, symptoms like this can manifest into more serious shoulder problems down the line such as adhesive capsulitis or frozen shoulder.

If the needle was inserted too high or too deeply, and beyond your muscular layer, it could have injured your bursa. This could cause it to become inflamed, turning into shoulder bursitis. Your mobility may or may not be impacted when this happens, but you’ll notice prolonged shoulder pain that doesn’t subside after 2-3 days like it should. Bursitis is actually a really simple injury to treat. But with SIRVA, it’s often dismissed as normal pain after the shot.

When ignored – shoulder bursitis can lead to compensatory movements due to pain – and cause problems later on in places like your neck, shoulder blade or even elbow.

One last common problem we see as a result of SIRVA is rotator cuff tendonitis. Much like bursitis, you may have normal motion in your shoulder, but what you’ll notice with this is again, the pain will persist longer than it should. But unlike bursitis, you’ll also have pain and weakness when you exert force through that tendon – particularly with overhead movements or lifting something with an outstretched arm.

This is also not a complicated injury to rehabilitate, but if not addressed, could turn into a more serious problem such as a rotator cuff tear or chronic tendonosis – conditions that are more difficult to treat.

To recap – your shoulder will hurt after getting a vaccine.

It’s normal. And you may even experience Covid arm. But these symptoms should go away and not remain.

And you should still have normal function of your shoulder, despite the pain.

If you have shoulder pain that persists, and especially if you’re noticing limited mobility, it’s something worth getting checked out. The last thing you want is for these symptoms to go on longer than needed, or turn into compensatory, more complicated problems.

The good news is that even with SIRVA, your shoulder pain can be successfully treated naturally, and without medications or procedures. Don’t let a healthcare professional brush off your concerns and blame your prolonged shoulder pain on your booster shot.

Talk to a musculoskeletal expert who understands this sort of thing and get some help!

CLICK HERE to request a Free Discovery Call with our Client Success Team.

They’ll let you know if we can help – and if you’re a good fit for our services – get you scheduled as soon as possible.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of one of her guide to neck and shoulder pain CLICK HERE or to get in touch, email her at [email protected].

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Nagging pain in your shoulder can be extremely annoying. But when it starts to interfere with things you love to do – you can’t help but wonder – Will a Cortisone Shot Help Your Nagging Shoulder Pain?

When you’ve got dull, nagging shoulder pain that just won’t go away, cortisone shots suddenly seem very attractive. They’re quick, easy, and seemingly harmless – right? Not so fast.

Just because cortisone shots are extremely routine and popular – it doesn’t mean they are the best or right thing to do.

Cortisone shots are typically administered to reduce localized inflammation inside a joint or tendon. In shoulders, it’s very common to use this procedure to reduce pain from arthritis, bursitis, rotator cuff tendonitis, and even frozen shoulders. When inflammation is confirmed to be the root source of your shoulder problem, and it’s not going away with medication, on its own, or with physical therapy – a cortisone shot may be the right course of action.

But what if inflammation is not the root source of your problem? What if inflammation is actually a secondary symptom?

This is where most of the confusion lies in the medical community. While it might not seem like a big deal (pain is pain, right?) – it’s a problem if you keep getting cortisone shots when you don’t actually need them.

Why?

Well overuse of cortisone shots can cause degeneration of your tendons and joint structures. So you only want to get one when you know: 1) it’s going to help and 2) if it’s necessary.

But how do you know? The key is in understanding the source of your pain. With chemical sources of pain, the source is inflammation and a cortisone shot is a good idea. But when it comes to mechanical pain, inflammation may exist but it’s not the source of your shoulder problem. In these cases, cortisone is either not helpful – or worse – it “works” but then masks your problem, sometimes for years.  

Let’s talk about the two sources of Shoulder pain to help you understand.

 

“Chemical Pain”

Chemical pain is the result of your body’s natural inflammatory response to injury. It’s a complex chemical reaction that occurs after tissue damage that involves the releasing of chemicals from your blood and other cells to “flush out” the area and start the healing process.

A good example of this is when you fall and sprain something. The sprain causes temporary tissue damage so your body creates inflammation to heal it. Normally this process only lasts a few days, your pain subsides, and you’re back to normal in no time. But sometimes this inflammatory process lingers longer than it should.

For various reasons the accumulation of toxic chemicals sticks around and the result is constant irritation to the nerves and surrounding tissues. Constant, dull pain, even at rest, that tends to be very sensitive to any and all movement is often a tell-tale sign that you’re dealing with pain that is chemical in nature. In this case, a cortisone injection could be a good course of action for you.

“Mechanical Pain”

Mechanical pain does not need a cortisone shot and it won’t respond well to it. The hallmark sign of mechanical pain is that your pain will come and go based on certain activities, movements, or positions. It’s not constant and throbbing like with chemical pain. Eighty percent of all musculoskeletal problems – including shoulder pain – are mechanical in nature.

Now, the real problem is that whether or not your pain is mechanical, a cortisone shot often does take away your pain. Not only is this confusing – but many people question why they should even be concerned about this. Well – when the pain and inflammation you’re experiencing is secondary – which is often the case with mechanical pain.

 You never actually treat the true source of your shoulder pain when you “cover it up” with a cortisone shot.

For example, you might have an irritated rotator cuff tendon or arthritis that is exacerbated because of poor posture or immobility in your shoulder joint. If you inject cortisone into your tendon or joint, the pain will likely be relieved. But this will only be temporary. It’s only a matter of time before your poor posture and movement habits cause irritation and pain again. This is the vicious cycle I see a lot of folks get themselves into. You risk never fixing the real problem. And irreversible damage to your tendon that might eventually need to be fixed surgically. 

Moral of this story… don’t rush to get a cortisone shot just because you’ve been told you have inflammation.

You must figure out the source of your inflammation first. Cortisone shots are not necessary if your pain is mechanical in nature. And it might actually prolong your problem. If your pain comes and goes, or you have good days and bad days, this is a classic sign that your pain is likely coming from a mechanical source.

Your best course of action is to work with someone who understands and specializes in this. I’ve seen many cases where getting a cortisone shot provides a false sense of hope, and as a consequence, delays quality treatment that you should be getting instead. 

Are you local to Portsmouth, NH?

Request to speak to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

If you can’t wait for the call  – get our free guide to neck and shoulder pain now. 

This totally free guide – written by leading back pain specialist, physical therapist, and movement expert, Dr. Carrie Jose – reveals seven easy ways (plus a bonus section!) that are PROVEN to help you ease neck and shoulder pain quickly – without pain medication, procedures, or surgery.

Click here to download the guide!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch email her at [email protected] or call 603-605-0402

Neck Pain

Tech neck: What it is and How to Cure it

Tech neck – also known as text neck – is a commonly used term to describe neck pain that results from overuse of various electronic devices. If you’re looking down at your cell phone or iPad too much, or sitting in front of your computer too long – and you feel pain in your neck – you are likely suffering from tech neck.

So what’s the big deal? Is this even a real syndrome?

I’ll be honest. I had my doubts at first. I’ve been a physical therapist for 20 years and when I first heard this term I thought it was a joke. But over the last 12-15 years I’ve seen more and more cases pop up and I can tell you with certainty that tech neck is, indeed, a real problem for people.

Tech neck – when allowed to go unaddressed – can result in headaches, tension into your upper shoulders, or even pain and tingling into your arms and hands.

The good news – it’s not only entirely possible to get rid of it – but you can learn how to prevent it all together.

So what can you do about tech neck? Here are three simple tips:

1. Be mindful of your posture

When you’re constantly looking down or hunching forward – it eventually wreaks havoc on your neck. Being mindful of your posture is not only the number one way to cure tech neck – but it’s the best way to prevent it.

The biggest problem with poor posture is that you don’t know it’s a problem until it’s too late. Postural problems take a lot of time to reveal themselves. The changes in your soft tissue and the wear and tear on your spinal joints that occur from being positioned poorly and repeatedly don’t happen overnight – and you rarely notice them when they are first happening.

Truth be told, “bad posture” on occasion is not bad for you and should not cause you any major problems. Poor posture all the time is where you get in trouble. That’s why simply being mindful of how you’re positioned when using your favorite electronic devices can go a long way.

2. Use headphones

Our spines crave movement but also alignment. But we don’t want alignment at the expense of other joints – namely – our shoulders. It’s not always comfortable to hold your phone or iPad in front of your face – which is what you need to do if you want to maintain optimal neck alignment when using your device. While great for your neck – this position can cause strain and tension in your upper shoulders.

For this reason I highly recommend using headphones. Especially wireless headphones. This allows you to keep your phone or iPad on your desk while freely sitting upright and talking. Headphones also allow you to use the speak to text feature quite easily so you don’t have to strain your thumbs or shoulders when talking to your friends, kids, or grandkids.

3. Interrupt your sitting and standing

Prolonged posture in any form is not great for you. Our bodies – especially our spines – crave movement. We hear a lot about the detrimental effects of sitting all the time – but standing all the time isn’t great either. When it comes to sitting, your lower back tends to hunch over time which forces your neck into that “forward head” posture when you’ve been sitting for more than 20 min or so. When you add an electronic device to the mix the effects are even worse.

Because of this – standing desks have become much more common over the past few years. But I see folks having problems from standing too long also. If you don’t have great core engagement, for example, which is important when you’re standing for prolonged periods, you might hold tension in your jaw or neck to compensate. This can create unwanted tension and stiffness in your neck muscles.

How do you combat all this?

Simply interrupt your position. Try not to stay sitting – or standing – longer than 30 min at one time. Your body – and especially your neck – will thank you.

Recognizing tech neck early is crucial and if you catch it in time – it’s very easy to cure on your own.

The problem is that it’s something that tends to creep up over time and not addressed until it’s too late. If you’re suffering from chronic headaches, or symptoms down your arms or into your hands – the tips I’ve given you here may not be enough to address the problem.

Don’t worry – you can still get help with these symptoms naturally and without pills and procedures – you will likely need some expert help.

Talk to someone who understands posture and the importance of healthy movement in your spine – they are the best people to help you cure and prevent tech neck.

Local to Portsmouth, NH?

Consider talking to one of our specialists free. They’ll let you know if you’re a good fit for what we do and get you on our schedule as quickly as possible! CLICK HERE to request a free Discovery Call with someone from my client success team.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

tendinosis

The Number One Reason your Shoulder Pain isn’t Going Away

Statistics show that shoulder pain impacts approximately 15.4% of men and 24.9% of women. The prevalence of shoulder pain also tends to increase and become more severe as we age, especially for folks in their 50’s.

There are many reasons why we get shoulder pain. It’s the most mobile joint in your body, making it more susceptible to injury. But why – for some – does it seem to just linger and not go away?

The number one reason is mis-diagnosis. Here are a few examples of what that looks like.

  • Your MRI says you have a rotator cuff tear – so you get surgery – yet the pain comes back or doesn’t fully resolve like they told you it would.
  • You’re told you have impingement syndrome – so you get arthroscopic decompression surgery – no success.
  • Perhaps you’ve been told you have tendonitis in your shoulder and need a cortisone shot – followed by physical therapy. Nope, that didn’t work either.

When it comes to shoulder pain, it’s critical that you know for certain the pain in your shoulder is actually coming from your shoulder. If not, you’re going to waste your time fixing the wrong problem and are more likely to get an unnecessary procedure or surgery. 

So – if your shoulder pain isn’t coming from your shoulder – then where is it coming from? 

The most common culprit is your neck or mid-back. In fact, studies have shown that 40% of the time extremity pain (including shoulder pain) comes from a source in your spine – even when you don’t feel any pain in your spine. 

Here are a few key signs and considerations to help you figure out if your shoulder pain has been misdiagnosed:

1. Where is your pain located?

When your pain is coming from your shoulder, the pain will be localized to your shoulder joint. True shoulder pain is felt directly in front of your shoulder, on top of your shoulder, or in a more involved shoulder problem (like a rotator cuff injury) you might feel some achiness down the side of your arm. But it will never go below your elbow. If the pain goes past your elbow and into your forearm or hand, or radiates above your shoulder into your neck (the upper trap area), or if you feel pain deep inside of your shoulder blade into your mid-back – odds are pretty good that you’re dealing with a spine problem and not a shoulder problem. 

2. Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening – it’s likely coming from your neck – and could be due to something like a bulging disc – or a restricted/faulty movement pattern that is irritating nerve roots in your neck. You might feel symptoms in your shoulder, shoulder blade, or even down into your arm. What’s particularly misleading is that it’s entirely possible to feel all these nerve symptoms in your shoulder or arm – and not actually feel anything in your neck. If you’ve got more pain in your arm than you do your shoulder, be sure to get your neck fully checked out. This is a huge area of mis-diagnosis for those suffering with long-standing shoulder pain.

3. How is your posture?

Poor posture can wreak havoc on your shoulder joint – without you even knowing it. If you’ve got a really curved middle back, combined with a “forward head” posture, you’re just setting your shoulder up for failure. Chronic, poor posture will crowd the tendons and structures in your shoulder joint over time. Every time you raise your arm overhead, or try to lift something with an outstretched arm – there will be implications if you’ve got poor posture.

The tricky part about this scenario is that you really will have pain in your shoulder. You’ll have wear and tear of your rotator cuff, and you’re more likely to have degeneration in your shoulder joint that might cause it to feel weak. The confusion here is that the shoulder “problems” are actually symptoms. The real cause is your posture and it’s either been missed or not addressed. The good news is that if you address your posture, most of these “wear and tear” shoulder problems will go away naturally, and you can avoid unnecessary procedures and surgery. This problem flies so under the radar that it’s overlooked all the time.

If you’ve got a true shoulder problem and it’s been diagnosed correctly – it should go away with proper treatment.

If that’s not happening, it’s worth considering that the true source of your shoulder pain has been missed. Start by getting a thorough check of your spine.

Don’t know where to start?

You can request a free Discovery Call with someone from my client success team. They’ll let you know if we can help – tell you if you’re a good fit for what we do – and get you on your way to living pain free. CLICK HERE to request a free Discovery Call.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

Traveling

4 Tips to Avoid Neck and Back Pain When Traveling

4 Tips to Avoid Neck and Back Pain When Traveling

Memorial Day weekend is the “unofficial” start of summer – and AAA estimates that 39.2 million people will travel this weekend. That’s 8.3% more than last year, and it’s going to mean the exacerbation of neck and back pain for a lot of folks out there – especially the over 40 crowd.

So why does traveling wreak such havoc on our spines? 

Road trips, planes and trains typically involve lots of sitting and driving, which necks and backs just don’t like when done frequently and for prolonged periods. You’re typically off your routine when you travel, and sleep on surfaces you’re not accustomed to.  Any one of these things – but especially when combined together – can flare up old patterns of neck and back pain.

The good news is there are lots of things you can do when traveling to ease neck and back pain. Here are 4 of my top tips:

 

1. Use the 30 Min. Rule

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting – often in cramped spaces. Our bodies are made to move continuously throughout the day. Whenever possible, getting out of your seat often is critical for keeping your neck and back healthy and mobile. Motion is lotion. And one of the best things you can do for your neck and back is to interrupt any prolonged posture – especially sitting – once every 30 min. If you’re unable to actually stand for a few seconds, then try arching your back or stretching your arms up over your head while sitting. Do a few neck rolls and chin tucks to stretch your spine. The more you move, the better your spine is going to feel.

2. Use a Lumbar Roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together, when not supported. While it’s perfectly acceptable to sit like this for small increments of time, it will start to cause problems after several hours. Prolonged curvature of your low back puts unwanted stress on the discs, ligaments, and muscles in your spine.

Your neck also responds to this posture by assuming a position we call “forward head”. This can give you headaches, neck pain, and cause extra tension to occur in your mid back and upper shoulders. One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your low back. If you’re driving, the lumbar support in your seat usually isn’t enough. Take a small towel roll, sweatshirt, or pillow and place it at the small of your back any time you’re sitting. You’ll find it’s easier to maintain the natural curves in your spine – and you’ll have a lot less strain on your neck and back.

3. Bring your own pillow

Sleeping on surfaces we’re not accustomed to can not only ruin a vacation but set us up for unwanted neck and back pain. If possible – bring your favorite pillow from home – or ask for extra pillows wherever you’re staying. If a mattress is too firm for you – you can use pillows to cushion areas of your body like hips and shoulders so that you don’t wake up sore. Conversely, if a mattress is too soft, you can use extra pillows to build up the surface under your waist if you’re a side sleeper, under the small of your back if you’re a back sleeper, and under your belly if you’re a stomach sleeper.

Lastly, if a pillow is too fluffy or too flat – your neck will end up paying for it. When you’re sleeping – the goal is to position yourself in a way that allows your spine to stay in neutral alignment. You don’t want your head tilted down or up – it’s the fastest way to stir up an old neck injury or wake up with a tension headache.

4. Extend instead of bend

Did you know that the average person bends or flexes forward between three and five thousand times per day? When you’re traveling – you’re going to be on the upper end of that metric. Our spines crave balance. And because of the disproportionate amount of time we spend bent over – we need to make a concerted effort to move our spines in the opposite direction. When you’re traveling – look for opportunities to be upright and mobile.

Walking is an excellent, therapeutic activity for your spine – plus – it’s a great way to see the sights wherever you’re going. When you’re practicing the 30 min rule, give your back and neck a nice stretch backwards each time you stand to interrupt your sitting. But probably more important than what you do during travel is what you do when you’re back home. Be cautious when jumping back into your typical gym or exercise routine. All the sitting and bending that comes with travel makes your spine vulnerable for injury. It’s very common to get injured a week or two after you’re home – seemingly “out of nowhere”.

 

Looking for more help with your neck and back pain?

Sign up for a FREE Discovery Session today to speak with my client success team to see if we can help you get rid of your neck and back pain for good.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

Are your Back MRI results reliable? Research says otherwise.

Are your Back MRI results reliable? Research says otherwise.

Whenever pain flares up – one of the most popular questions and concerns I get from clients is whether or not they need an MRI. When you have persistent pain that won’t go away, or shooting pain or numbness down your arm or leg, it’s scary. It makes sense to get a look inside with an MRI, right?

Not necessarily.

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. But what we now know from research is that all those findings on an MRI don’t always correlate with what’s actually causing your pain.

One notable study was the Lancet series – three published papers that investigated how MRI findings related to the treatment of back pain. Martin Underwood, MD, co-author of the Lancet series, and professor at Warwick Medical School, is quoted in The Guardian saying: “If you get into the business of treating disc degeneration because it has shown up on an MRI, the likelihood is that, in most of those people, it is not contributing to their back pain.”

Let me explain.

When it comes to back problems – or joint problems in general – what most people don’t realize is that 70-80% of all spine and musculoskeletal problems are what we call “mechanical” in nature.

That means your pain has to do with the way you move, bad postural habits learned over the years, or muscular and joint imbalances like weakness and poor flexibility. Many of these mechanical “wear and tear” problems don’t show up until your 40’s, 50’s or 60’s – which coincidentally is also the time that things like disc degeneration and other age-related changes show up on an MRI.

What it’s important to understand is that disc degeneration, arthritis, and bulging discs are ALL a normal part of aging, but they often get blamed for problems they don’t actually cause. In other words, the source of your pain is often a movement dysfunction learned and repeated over time that is irritating you – not the age-related changes themselves. The best way to figure out if your problem is movement-related vs structure-related is… well… with a movement assessment… NOT an MRI.

So how does movement testing work and why is it more reliable than an MRI? 

This is a great question and not one that is easily explained… but I’m going to try!

When your back, neck or joint pain is mechanical in nature – one of the most important things to look at and pay attention to is how your pain behaves. Not necessarily where it’s located. With pain – the most important thing to determine is how it reacts against certain triggers and with different activities.

Does your pain come and go? Do you have good days and bad days? Can you change positions and influence your pain?

When your pain is variable, it’s the most reliable sign that your pain is “mechanical” in nature. It also means you don’t need surgery or any kind of procedure to fix it. In fact, a procedure or surgery could leave you feeling worse off than before. Let’s say you “cut out” the structure – or inject it to make it numb – your movement problem hasn’t gone away and it’s only a matter of time before it starts aggravating something else.

Take home point… MRI’s are a super powerful and amazing diagnostic tool – but their results when it comes to diagnosing neck, back, or joint pain MUST be taken with a grain of salt – and should absolutely be coupled with an expert mechanical joint evaluation before you decide on a treatment plan.

Because if you are dealing with chronic, long-standing aches and pains that have come and gone over the years – or have recently gotten worse – there is a 70-80% chance that it is a mechanical problem finally catching up to you and not a structural problem.

Figure out the root source of your neck, back, or joint pain by seeing a movement expert who specializes in mechanical pain FIRST. Because when you automatically assume that you need an MRI first, and you base your whole treatment plan off of those results – you can end up down a rabbit hole of unnecessary medical procedures or surgery that ultimately won’t give you the long-term relief you’re looking for.

 

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.

 

 

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Shoulder Injuries after Vaccination? What to look for

Shoulder injuries related to vaccine administration (otherwise known as “SIRVA”) is a rare, but possible occurrence when you get any vaccine.

SIRVA happens when a vaccine is injected into the capsule of your shoulder joint instead of your deltoid muscle. It can also occur if the needle being used is not the correct length for you, or if it’s administered too high or too deeply into your muscle. SIRVA is essentially a shoulder injury that occurs due to an improperly administered vaccine – not from the vaccine itself.

Now, it should be noted that this condition is very rare. However, due to the sheer volume of vaccines being administered right now – we have seen a slight uptick in unresolved shoulder problems here in our office. Anywhere from weeks to months after vaccination. For most, the shoulder pain is very mild and it goes away on its own. But for a select few, their shoulder pain has persisted and manifested into a more severe problem. This could be a sign you have SIRVA.

Since the signs and symptoms don’t show up right away, I thought it would be helpful to go over with you what is considered “normal” versus not normal shoulder pain after you get a vaccine.

You’ve likely heard of the “Moderna arm” by now. This is a mild skin irritation specifically related to the Moderna vaccine for COVID-19 that typically involves a mild rash and skin sensitivity after your second shot. It usually lasts about 3-5 days and can be easily treated with topical anti-inflammatories. Moderna arm is not considered to be anything serious, and although it’s not normal to experience this after most traditional vaccines, it is considered a common reaction to the Moderna vaccine. If you’ve recently had your second Moderna shot and are experiencing what you think could be Moderna arm, speak with your doctor or dermatologist if symptoms continue to persist past 5 days, just to make sure there isn’t something else going on.

Localized shoulder pain at the site of your vaccine injection is also normal.

We see this with any type of injection or vaccine into your arm, not just with Covid vaccines. The pain you feel is from the mild trauma caused by the needle being inserted into the soft tissue (muscle) of your arm. It often feels like a bruise, and you may experience a little bit of swelling. It will typically go away after 2-3 days. Even though your arm can be quite sore, the important distinction here is that you’ll still have full, normal function of your arm. In other words, despite the soreness, you can still move your arm freely up and down if you had to without restriction. Your arm soreness will go away with time, but gently massaging the area of pain, and even some easy movement or exercise can help the soreness go away a little faster. 

The symptoms of SIRVA are different, and typically more severe than what I’ve just described above.

If not addressed, some of these symptoms could lead to long lasting shoulder problems. As I alluded to above, one of the main distinctions between “normal” shoulder pain after vaccination and SIRVA is how well your arm functions.

If the needle was accidentally inserted into your joint capsule, for example, you will notice limited mobility and possibly limited strength. When left unaddressed, symptoms like this can manifest into more serious shoulder problems down the line, such as adhesive capsulitis or frozen shoulder.

If the needle was inserted too high or too deeply, you can end up with shoulder bursitis, which means the needle was inserted beyond your muscular layer and directly into the bursa (a cushiony fluid-filled sack), causing it to become inflamed. Your mobility may or may not be impacted when this happens, but what you’ll notice is that your shoulder pain will take a lot longer than 2-3 days to subside. Bursitis is actually a really simple injury to treat, but where I see most things go wrong is that you can end up with compensatory problems in places like your neck, shoulder blade or elbow the longer it is allowed to persist.

The last thing you might see from an improperly injected needle is rotator cuff tendonitis. What you’ll notice with this is that you’ll likely have full mobility in your shoulder, but it will be very painful and weak to exert force in your arm.  Much like bursitis, this is not a complicated injury to rehabilitate, but if not rehabilitated properly, it leads to other problems that do become more difficult to treat down the line.

So to summarize, your shoulder WILL hurt after getting a vaccine.

And with the Moderna vaccine in particular, you may notice some skin sensitivity, mild swelling, and even a rash.

But these symptoms should go away after a few days.

If you have shoulder pain that persists, and especially if you’re noticing limited mobility, it’s something worth getting checked out.  The last thing you want is for these symptoms to go on longer than needed, or turn into compensatory, long lasting problems. The good news is that even with SIRVA, these problems and symptoms can be successfully treated naturally, and without medications or procedures. We’ve been successfully helping people right here in our office. If you’re worried about a potential shoulder problem after the vaccine and not sure where to turn – reach out. You can schedule a FREE Discovery Session with one of our specialists right here!

 

Neck stretches

Why Your Neck Stretches Aren’t Working

Do you suffer from chronic neck pain and ever wonder…

Why don’t my neck stretches work?

Even though you’ve Googled and YouTubed them about a hundred times…

There are a few reasons why stretching your neck might not be doing anything to help get rid of your neck pain.

  1. Your technique could be off
  2. You could be doing the wrong stretch
  3. It could be that you just shouldn’t be stretching your neck at all!

Let’s go over the different reasons why your neck stretches might not be working… and most importantly… what you can do about it.

1. You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into the stretch. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work.

Some people (myself included) respond better to “moving stretches”. This is where instead of holding one static position for a prolonged period – you repeatedly move through one or several end-range stretches. Neck rolls are a great example of this.

If your neck stretches haven’t been working, try adjusting the way you’ve been stretching… if it works… then you were likely just using the wrong technique.

2. You’re doing the wrong type of stretch.

This one could be a little tougher to figure out on your own. There is a difference between corrective neck stretching and stretching to feel good.

For example, let’s say your neck is tightening up because you’ve been under a lot of stress or you just did a lot of activity that impacts your neck. Generic neck stretches such as bringing your chin to your chest, or pulling your chin to the opposite shoulder (known as an “upper trap stretch”) may be all you need.

In fact, I do stretches like this regularly because I’m constantly leaning over to help patients. I stretch my neck to PREVENT it from having problems and because it feels good.

But let’s say you already have a neck problem, or you have pain or numbness running down your arm.

In these instances, generic neck stretching could make you worse.

You likely need corrective stretches, like what we prescribe for patients in our office.

Corrective stretches are specifically prescribed to address your particular problem in your neck – and are very different from the generalized stretches that are designed to feel good and relieve tension.

If you think you might need corrective stretches for your neck – DO NOT google them – you must see a specialist and have them prescribed to you.

3. You shouldn’t be stretching your neck at all!

This is a very common problem we see… folks come in with complaints of chronic tightness and discomfort in their neck and no matter how often they stretch or massage, it doesn’t go away.

Did you know that chronic neck tightness can be a sign of a weak core?

It’s quite common – and if that is the case for you – no amount of stretching will help – and could even aggravate your problem!

The deep, stabilizing muscles of your neck are connected by fascia to the deep muscles of your core. If your deep core is not working properly, then your neck will often kick in and try to help.

Ever notice that your neck is always sore or tight after a good ab workout?

This could be a sign that your neck is compensating for your core.

Stop stretching your neck, learn how to strengthen your core the right way, and see a specialist who can help you.

In our office, our team of specialists work alongside our Pilates instructors to help folks improve their core strength from the inside out – so that their necks and backs stop getting involved.

If you’re dealing with chronic neck problems that aren’t’ responding to stretching…

There’s a good chance you could be not stretching correctly, the stretches aren’t right for you, or you’ve completely missed the root cause of your neck pain and you shouldn’t be stretching at all!

Want to work with our team of specialists and finally get some help for your neck problem?

CLICK HERE to request a free Discovery Session with one of our specialists.

They’ll set up a time to talk to you about what’s going on with your neck. If you’re a good fit for what we do, then they will help you get started!

This is only for people serious about getting help…

And for those that are finally ready for a long-term solution to their pain – one that will put an end to constantly relying on pain pills – and help you avoid expensive procedures and risky surgery.

Request a Discovery Session here.

The Location of Your Pain may NOT be its Source…

One of the most confusing topics we deal with in our practice is pain. And there’s lots of advice out there on what to do about it…

Should you rest or move? Apply heat or ice? See a doctor or let it go away on its own?

Before you can even think about a solution to your pain, you must first accurately determine where it’s coming from. If you have pain in your knee, but it’s actually coming from your back, the best knee treatment in the world is not going to fix it.

Inaccurate diagnosis of pain is a BIG reason why so many people suffer longer than they need to, and undergo unnecessary surgeries.

You must accurately determine the source of your pain for treatment to be effective, and the location of your pain alone is not a reliable way to do that.

For example, I’ve seen people in my office with what they think is unrelenting tennis elbow, only to find out it was actually a problem in their neck causing it. I’ve seen people disappointed after a failed knee surgery, because the problem was never in their knee and actually coming from their back.

Isolated extremity pain (knees, elbows, shoulders) is one of the most misdiagnosed problems we see in our office.

A recent study by Richard Rosedale, et al. in the Journal of Manipulative Therapy investigated this – and it was found that over 40% of people suffering from isolated extremity pain actually had a spinal source of symptoms.

In other words, their extremity pain was actually coming from their neck or back.

I can’t tell you how many times we’ve seen folks with unexplained shoulder pain lasting months or years get better as soon as we begin treating their neck, even though they never had neck pain.

Same for knees…

It’s possible to have knee pain that is caused by your back, without ever hurting your back!

Confused? I don’t blame you.

But more importantly, how do you figure out the source of your pain when it’s not always where you’re feeling it?

As already mentioned, the most common place for this to happen is with extremities. If you’ve got shoulder, elbow, knee or foot pain – and you don’t ever recall a specific injury to it – you MUST consider that it could be coming from your spine.

There’s a 44% chance that it is!

Where this gets really confusing is that typically your doctor will order an MRI when you’ve got isolated knee or shoulder pain that won’t go away. And if you’re over 40 years old, the MRI will almost always show “something” – a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

Remember that these are normal signs of aging in everyone, and may not be the cause of your pain.

If you haven’t already had your spine checked properly as a possible source, you can’t rely on these findings (or the location of your pain) as an accurate diagnosis. That is how people end up having surgeries they don’t really need.

Whenever someone comes into our office with isolated extremity pain, we don’t even look at it without an exam of their neck and back first.

By moving your spine repeatedly, and in certain directions, we can often produce – or take away – the pain you’re feeling in your knee or shoulder.

Why?

Because if the pain in your extremity is caused by a pinched or aggravated nerve, moving your spine around is going to influence that, and tell us where the source really is.

An MRI and X-ray won’t be able to determine this for you with certainty – because sometimes your nerve only gets irritated when you move a certain way – or when you’re in a certain position. Since MRI’s and X-rays can’t see what’s going on while you’re moving, you can’t rely on those tests alone to tell you exactly where your pain is coming from.

If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source.

That source could be your spine.

And if you’re considering some kind of surgery or procedure, you definitely want to rule that out first.

Specialized movement exams like we do in our office are one of the most reliable ways to figure this out. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, CLICK HERE to request a Free Discovery Session with one of our specialists.