GARDENING WOES... WHAT'S BUGGING YOU?

Linda Morgan, BSc(PT), CAFCI, MCPA

Gardening and landscaping: what a wonderful opportunity to enjoy both the great outdoors and engage in healthy physical activity! Gardening and landscaping can result in improved muscular flexibility and strength - not to mention excellent cardio-vascular benefits with sustained activity levels.

As gardening and landscaping require use of the arms and shoulders - cutting grass, trimming trees and shrubs, transplanting flowers, watering, weeding the garden, and finally, to admiring your beautiful flowers, harvesting the garden or completing that amazing landscaping project. All in all, our shoulders get a huge workout - which can result in improved muscular strength and flexibility. But what happens if we use our shoulders too much during a repetitive activity (like weeding an entire flower or vegetable garden), or by lifting a heavy object...?

Rotator cuff tendonitis, rotator cuff strains, and impingement syndrome can develop after repetitive use of the shoulder or after heavy lifting. The "rotator cuff" is a group of muscles that contribute to fine-tuning movement of the shoulder. Similar to other muscle groups in our body, the rotator cuff is susceptible to inflammation (tendonitis) and strain.

Some of the common signs and symptoms of rotator cuff tendonitis, rotator cuff strains, and shoulder impingement syndrome include:

• loss of range of motion - for example, having difficulty lifting your arm overhead, or having difficulty with reaching your arm behind your back.
• feeling pain or discomfort over the shoulder region while lifting your arm.
• tenderness and swelling of the shoulder.
• decreased strength of the shoulder.
• soreness with trying to lie on the affected shoulder while sleeping.

Physical Therapy assessment and treatment of rotator cuff tendonitis, strains and impingement syndrome can include some of the following management strategies:

• a detailed assessment of the arm and spine to ensure an accurate diagnosis, as well as a referral to your medical doctor if appropriate for further review.
• a detailed assessment of your muscle strength, flexibility, range of motion (mobility), and posture.
• use of modalities to decrease pain and inflammation, to improve muscle strength, and to improve circulation. Modalities may include: acupuncture, ultrasound (using sound waves), electrical current, TENS machines, electrical muscle stimulation to improve recruitment of weakened muscles, interferential machine (IFC), and laser.
• soft tissue mobilizations and joint mobilizations may be used to improve the mobility of stiff joints and to improve the flexibility of certain muscle groups.
• specific exercise prescription to improve muscular strength and flexibility to restore proper muscle balances and improve postural alignment. Normal movement of the shoulder relies on the co-ordination of many muscles that move our shoulder and shoulder blade (scapula). To restore normal movement patterns of the arm, Physical Therapists prescribe specific exercises to improve the strength and flexibility of the muscles of the shoulder and shoulder blade.
• education regarding proper body mechanics (using your body safely and efficiently).
• education regarding your work space design (reviewing ergonomics).
• education regarding use of heat/cold at home, and appropriate sleeping positions to avoid strain to the shoulder and spine.