Shoulder instability is when the ball and socket joint is not controlled well.  When the ball is sliding around it’s socket too much it can cause pain and in some cases come out of the socket and dislocate.  Sometimes the ball does not completely dislocate and is only partially out and can feel locked. With a wiggle it often returns to its normal position.  This is called subluxation.

To help improve the shoulder’s stability, the joint is supported by a thickened rim around the socket called a labrum, which deepens the shallow joint.  The capsule around this joint is also reinforced by ligaments which become taught at the end range of all shoulder movements.  When the ligaments become tight they also send important messages to the brain so that it can coordinate how the muscles around the shoulder move.

There are 3 types of shoulder instability.  The most common form of instability is caused by trauma, such as a fall.  The large force causes structural damage to the ligaments and socket rim (labrum).  This can lead to repetitive dislocations in some people.  Shoulder rehabilitation may reduce the chances of this by training the rotator cuff to fully recover and compensate.  In the younger population (below 28 years old) the chances of re-dislocation are much higher and they may require surgery.

The third type is very rare and called “abnormal muscle patterning”.  This is when the big powerful muscles that attach around the shoulder, activate inappropriately and out of sequence.  This causes very large forces that the rotator cuff simply cannot compete with.  This type of instability requires very specialist physiotherapy.  We aim to reteach these muscles to activate in a normal way and rewrite their programming.  Occasionally, the first 2 types of shoulder instability may develop these characteristics and it is important that this is identified early and addressed.

Due to the complex nature and wide spectrum of symptoms of shoulder instability, shoulder surgeons and Physiotherapists work very closely together to manage this condition.

Osteoarthritis occurs when there is damage in and around the joints that the body cannot fully repair. It’s not clear exactly why this happens in some people, although your chances of developing the condition can be influenced by a number of factors, such as your age and weight. Osteoarthritis usually develops in people over 45 years of age, although younger people can also be affected. It is commonly thought that osteoarthritis is an inevitable part of getting older, but this is not quite true. You may in fact be able to reduce your chances of developing the condition by doing regular, gentle exercises and maintaining a healthy weight.

Who’s Affected?

Although OA occurs in people of all ages, osteoarthritis is most common in people older than 65. Common risk factors include increasing age, obesity, previous joint injury, overuse of the joint, weak thigh muscles, and genetics.
Managing osteoarthritis

Osteoarthritis is a long-term condition and can’t be cured, but it doesn’t necessarily get any worse over time and it can sometimes gradually improve. A number of treatments are also available to reduce the symptoms.
Mild symptoms can sometimes be managed with simple measures including regular exercise to ensure the muscles surrounding the joint are in good strength to support the body weight, losing weight if you are overweight, wearing suitable footwear and using special devices to reduce the strain on your joints during your everyday activities.
If your symptoms are more severe, you may need additional treatments such as painkilling medication and a structured exercise plan carried out under the supervision of a physiotherapist.
In a small number of cases, where the above treatments haven’t helped or the damage to the joints is particularly severe, surgery may be carried out to repair, strengthen or replace a damaged joint.

It is a series of 7 movement patterns that look at the basics of human movement. Three are in weight bearing; four are on the floor. Three involve the basic foot positions of sport; two are for flexibility; and two are for stability. For each movement pattern, we are looking for asymmetries between the right and left side or limitations in the ability to perform the pattern. Each pattern is given a score between 0 and 3, with a maximal score of 21, and an average score of 14-16.
Why does this matter and why would I want one?

The key with any exercise program is to get stronger or fitter without causing other problems. But what if that isn’t happening? What if you want to get back to running after a period of time away from it, but you don’t want to hurt yourself? Or what if you keep trying to return to the sport you love, but you keep causing the same injury over and over again or a different injury every time? There is a very good reason for this. You just may not know what it is yet. By using the FMS, we will look at the basics of human movement, and see how well you, as a human, move. You will have certain tests that are really easy for you and possibly others that seem next to impossible. But you are only ever as strong as your weakest link. The FMS will help us identify what this is so that we can help you change it, and thereby, change your outcomes.
Likewise, what if you regularly lift weights in the gym but you never seem to see a difference in your performance, whether that’s in a sport or simply with daily routines? Participating in an FMS can help you identify where your weaknesses are so that you can alter your workouts to address them. Doing what you are good at does not make you better. Doing what is hard until it’s not hard any longer does make you better. If you have limited movement patterns or are working around a pre-existing problem, you will never see the changes you are looking for. An FMS will help you identify where these limitations are and ways to change them. It also gives you objective measurable ways to judge your progress.
An FMS can also identify pain. You should not train on top of pain. Pain changes the way we move in unpredictable ways. Whether you realize it or not, pain causes you to compensate and move in less than efficient patterns. The pain needs to be resolved before a pattern is regularly repeated. This can only cause more problems. Additionally, sometimes, we have pain that resolves, but we don’t necessarily resolve our compensations. Sometimes, we don’t even realize that we ever started to compensate in the first place, so we have no idea that we are moving in an altered way. An FMS can help us to identify patterns that cause pain. An SFMA or a qualified provider can help you to identify sources of pain.
To summarize, the FMS helps us to identify two main things. One, which aspects of movement need to be addressed to have the biggest impact on performance. Performance could be athletic performance, but it doesn’t have to be. It could also be squatting to retrieve items from a low shelf or reaching into an overhead cabinet or any other movement pattern that we use in everyday life. And two, it helps us to determine where a person might break down. It helps us see a potential for injury before that injury occurs, so we can stop the process and prevent it. In participating in an FMS, you will learn one of three things. Either, you are good; keeping doing what you are doing. Or, how to tailor a workout program to better meet your goals. Or lastly, that you have some underlying issues that you would be better off to address before increasing loads or repetitions. Hopefully, this has shed some light on the FMS, in general, and also, some of its benefits.

Benefits of an appropriate warm up will result in an:

• Increased speed of contraction and relaxation of warmed muscles
• Dynamic exercises reduce muscle stiffness
• Greater economy of movement because of lowered viscous resistance within warmed muscles
• Facilitated oxygen utilization by warmed muscles because haemoglobin releases oxygen more readily at higher muscle temperatures
• Facilitated nerve transmission and muscle metabolism at higher temperatures; a specific warm up can facilitate motor unit recruitment required in subsequent all out activity
• Increased blood flow through active tissues as local vascular beds dilate, increasing metabolism and muscle temperatures
• Allows the heart rate get to a workable rate for beginning exercise
• Mentally focused on the training or competition

Cool Down Cooling down after your workout allows for a gradual recovery of heart rate and blood pressure. Cooling down should consist of 5 to 10 minutes jogging/walking to decrease the body temperature and remove waste products from the working muscles. Followed by 10 minutes of static stretching. Static stretches are appropriate to the cool down as they help muscles to relax, realign muscle fibres and re-establish their normal range of movement. These stretches should be held for approximately 10 seconds. An appropriate cool down will

• Aid in the dissipation of waste products – including lactic acid
• Reduce the potential for Daily onset of muscle soreness ( DOMS)
• Reduce the chances of dizziness or fainting caused by the pooling of venous blood at the extremities
• Reduce the level of adrenaline in the blood
• Allows the heart rate to return to its resting rate

•  Sharp, stabbing or dull pain localized to one side of the pelvis, low back, groin, or tailbone
• Pain that may radiate down to the knee
• Pain with movements, such as standing up from sitting, rolling over in bed, or bending or twisting
• Muscle tightness or tenderness in the hip or buttock
• Pain with walking, standing, or prolonged sitting
• Pain that is worse with walking or standing and eases with sitting or lying down

When pain occurs, a physiotherapist can help to resolve the problems. A tailored treatment approach should be devised depending on the woman’s symptoms, her trimester or post-partum status, and her current mobility or motor control limitations.
This treatment might include:

• Manual therapy, which might involve massage of tight muscles, mobilization of stiff joints, or muscle energy technique to improve the alignment of the pelvis, tailbone, or lumbar spine
• Flexibility exercises to decrease the chance that any one muscle group puts undue stress on the pelvis, tailbone, or lumbar spin.
• Strengthening exercises to improve the stability of the pelvic and spinal joints and targets abdominal, pelvic floor, and buttocks muscles
• Education to help the woman understand how she can alter her daily activities to reduce stresses on her low back or pelvis. This may include body mechanics training focusing on proper form with standing, sitting, lifting, or carrying. It may also encompass educating a woman on compensations that she has learned to avoid pain and how to stop making those compensations after her pain is relieved so that these compensations do not cause further problems.

Low back or pelvic pain should never be described as something a woman just needs to endure during pregnancy or after delivery. The earlier a problem is treated, the easier it is to resolve; but it is never too late to address problems that arose due to pregnancy or childbirth. Don’t be afraid to ask for help.

• Causing your body to release chemicals which help lift your mood and make you feel more relaxed.
• Focusing your attention away from issues that make you feel stressed and onto what your body needs to do to run, kick a ball, or swing a racket.
• Helping you release pent-up stress and tension and making you more resilient to pressure.

Getting started Almost any form of physical activity can provide relief from tension or stress. The smallest steps can go a long way to improving your mental well-being, while also helping you look and feel better physically.
~ Good posture Whatever your occupation, it’s important to practice good posture for the tasks you’re expected to do. Bad habits, such as slouching, along with stress and anxiety can affect posture – causing you to hunch your shoulders, for example.
Active travel Travel actively by walking or cycling as part of your journey: •Get off the bus or train one stop earlier and walk the final part of your journey. If you drive, park further away than usual • At train stations and car parks, take the stairs instead of lifts or escalators •Cycling is great for fitness and a good stress reliever – it can also save you money on fares or fuel.
Easy exercise at work Too much time spent sitting at a desk or doing repetitive tasks can contribute to the development of back, neck and arm pain and other health problems. Breaking up your day so that you rotate your time spent doing other tasks, and moving and stretching regularly can help you think more clearly and be more efficient.
✔ Raise concerns with your employers early about any pressures you think are affecting your health. With their support, you might be able to address problems before they have a chance to build up.

Office workers

• A change can be as good as a rest – vary your tasks, stand up to take a phone call, move around every 20 minutes or so.
• Move your neck, arms and shoulders periodically while seated at your desk.
• Sit facing straight ahead, feet flat on the floor (or on a sturdy footrest) and with legs uncrossed.
• Adjust your chair and monitor to find the most comfortable position for your work. As a broad guide, your forearms should be approximately horizontal and your eyes the same height as the top of the monitor.
• Adjust the backrest of your chair so that you can lean back against it comfortably. Make sure your lower back is supported.
• Place your mouse within easy reach and support your forearms on the desk. Keep your wrists in a relaxed, neutral position. Drive the mouse from your shoulder, not your wrist.
• Don’t wedge your phone between your ear and your shoulder. Use a lightweight headset if necessary
• Make sure that at breaks you leave your desk and walk around. At lunchtime try to go out of the office for a walk. This will relax your muscles, stretch your joints and get fresh air into your lungs helping you to work better in the afternoon.
• Use a copy holder if you work from documents.

Manual workers

• Make good use of any equipment designed to help you with strenuous tasks.
• Try splitting loads into manageable sizes, so that you can move them more easily. Minimise the distance you need to carry items by using handling aids, such as a trolley or lift if possible.
• Avoid prolonged or repetitive tasks. If on a production line, ask your supervisor if job rotation is possible, for example, so that you work on a different side or position on the line and use different muscles.
• Use both hands – pick one item with your left hand then one with your right.
• Don’t over stretch to perform a task – move closer.
• Avoid adopting a stooped or flexed posture when working at a bench or table by adjusting its height so that it is level with your waist.
• Make sure your clothes fit well so you can move freely and keep warm – cold muscles don’t extend properly.
• Check machinery regularly. If your equipment works well, it will save you from putting in extra physical effort or improvising technique.
• Take more short breaks rather than one long one – use the time to stretch your arms and legs.
The most important thing you can do to prevent work relevant musculoskeletal disorders is to maintain a good level of physical fitness. Aim to take 30 minutes of exercise outside work at least five days out of seven.