Motion Stability's Blog


Could Uneven Shoulders Indicate Any Issue? by charlestlee

image source: helloamanda.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Uneven shoulders can be observed in a couple of planes. One of the most common observations is when one shoulder looks higher than the other. This could indicate either a structural, muscular or neural imbalance.

Structurally, the patient may have a leg length discrepancy or a scoliosis that causes the shoulders to be raised on one side.

Muscularly, the shoulder blade or scapula has multiple muscles that stabilize it in position. Muscular imbalances can easily occur that cause certain muscles of the scapula to pull it in a certain direction. For example, in many single arm-dominated sports such as baseball or tennis, the dominate arm tends to over-develop the latissmus dorsi which is your ‘wing’ muscle. With more muscular development it actually pulls the shoulder blade down. In standing postures, most of these athletes will look like their shoulder is lower on the same side. This can create problem for the lowered shoulder, especially when the arm is required to repetitively raise over their head. With the shoulder lowered it takes greater work of the opposing muscles to raise the arm overhead. Over time, it can cause poor shoulder mechanics and lead to injury of the shoulder.

When someone has chronic nerve symptoms in their neck and arm due to a radiculopathy or pinched nerve in their neck, many times you may see that the shoulder on the same side looks elevated. This is due to the adaptation of the muscles to shorten or spasm to elevate the shoulder girdle and allows more room for the nerve to conduct. Patient’s with this pattern often feel tight in their neck and upper shoulder. When they try to stretching the muscles it makes their nerve symptoms worse. This happens because the muscle is not tight but in protective spasm keeping the nerve from being injured further. In this case it is important to treat the nerve first before trying to lower the shoulder girdle.

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What can I do for knee pain? by charlestlee

image source: specialistpainphysio.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Treating knee pain depends on the location and severity of the symptoms. If it is swollen, you should apply cold packs, compress, and elevate it to reduce swelling. You should consider contacting a qualified physician or physical therapist to assess your injury. 

If things are clear for any significant injury – and as swelling calms – determining where the location of knee pain helps guide things you can do to treat it.

Commonly pain is in either behind the knee cap or along the inside border. You may get a diagnosis of chondromalcia patella or patelofemoral pain which indicates that your knee cap is not tracking correctly along its groove. And with this pain, and most other types of knee pain – the pain usually originates from poor lower extremity mechanics, not just at the knee itself but at the hip and foot as well.

You have to look at the knee as a junction between two different stilts, one from above from the hip and femur, and one from below from the ankle/foot and shin. If the hip and/or ankle/foot are do not have the proper strength or flexibility many times the knee suffers increased stress and torque to it.

Exercises are then based on not only getting the knee stronger – but also improving the flexibility/strength of the entire leg.