Posts tagged weakness
Deep Neck Flexor Weakness Found Predictive of Neck Pain

70% of Americans will experience neck pain symptoms within their lifetimes. The vast majority of these symptoms are secondary to the musculoskeletal system and effectively treated by Physical Therapists. Patient’s who experience multiple episodes of neck pain or have experienced symptoms for a longer duration (> 3 months) often present with weakness in the cervical muscles which support the spine. The deep muscles on the front of our neck (deep cervical flexors) have been shown to play an important role in neck range of motion and function. These muscles have a feed forward mechanism of action in pain free individuals allowing these muscles to contract in anticipation for the upcoming head or neck movement. Conversely, these muscles have been shown to contract late or insufficiently in patients with neck pain.


A recent article in the journal Pain Medicine examined 60 participants with and without chronic neck pain to determine the relationship between proprioception and motor function and chronic neck pain (Arimi et al. 2018). Participants’ joint position error, cervical endurance, muscle size, pain, disability, and fear of movement were assessed by researchers. Consistent with prior research the authors found smaller deep cervical muscle size as well as lower endurance scores in the participants with chronic neck pain. In addition, deep cervical flexor weakness was found to be a significant predictor of chronic neck pain development.

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Hip Weakness Shown To Be A Predictor For Future Ankle Sprains

Ankle sprains are one of the most common sports injuries we encounter in our Boulder Physical Therapy practice.  In our previous blogs we have written on the importance of early interventions such as manual therapy and proprioceptive exercise to help accelerate the recovery after these sprains.  Prior research has shown a higher recurrence rate in athletes who return to play without Physical Therapy, as well as, higher rates of hip weakness in athletes who have sustained an ankle sprain.  Recent research indicates hip weakness also increases the risk of future ankle injury in healthy athletes.

Powers and colleagues examined the leg strength of over 200 competitive soccer players prior to the start of their season (J Athletic Training. 2017).  Athletes were then followed over the season for any incidence of ankle injury.  Twelve percent of all the athletes sustained an ankle sprain with a higher rate of injury found among athletes with hip weakness.  This study highlights the injury risks associated with hip weakness.  Athletes are encouraged to participate in a strength training  program to both improve their performance and reduce their future injury risk.


Shoulder Blade Movement and The Development of Shoulder Pain

Poor movements patterns at the shoulder blade (scapular dyskinesis) is quickly becoming the over pronation of the upper extremity.  Although associated with a number of shoulder diagnoses including rotator cuff tears, tendinopathy, and impingement many questions remain.  We observe these patterns of movement in both strong and weak individuals, as well as, those with and without shoulder pain.  These questions limit our ability to objectively determine this pattern’s causative or correlative role in an individual’s shoulder pain.  In addition, the high rates of scapular dyskinesis in asymptomatic individuals make it difficult to determine if we should intervene in an asymptomatic patient.  A new study highlights the predictive ability of scapular dyskinesis to detect the future onset of shoulder pain in asymptomatic individuals.

A study in the British Journal of Sports Medicine performed a research review on the predictive ability of these movement patterns(Hickey et al. 2017).  The authors reviewed 5 studies of over 400 athletes.  They reported 35% of these asymptomatic patients with dyskinesis reported future episodes of shoulder pain.  This compared with the 25% of athletes without dyskinesis who also reported future shoulder pain.  Thus pain free athletes who present with dyskinesis have a 43% greater risk of shoulder pain than those with good movement patterns. 

To learn more on how to improve your shoulder movement, control, and strength contact your local Physical Therapist.