After some detailed tips and tricks from @fysio.lars on social media, me and @thomasjump63 recently did our first ultrasoundguided lavage of a calcific deposit in a supraspinatustendon. Here is what we did: 1. Injection of 5ml of Lidocain into the bursa. 2. Switching to a 18G needle and entering the Calcification, first trying to just aspirate but nothing came in return so we then started ”pumping” fluid with a syringe containing 4ml of Lidocain and 4ml of NaCl and now the calcium started to flow back into the syringe, we switched two times to syringes containing only NaCl. 3. Did some fenestration of the ”shell” of the deposit. 4. With a new needle we ended the procedure with injecting 1ml of DepoMedrol and 3ml of Lidocain into the bursa. I saw the patient last week, 6 weeks after the procedure and she was improved but not totally painfree. Up until now the patients at our clinic with symptomatic calcific tendonitis (if not improved by physiotherapy or injections) has been treated with arthroscopic removal of the calcium deposit and often subacromial decompression at the same time. Hopefully this can be an alternative for some patients...🤔
⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ACTIVE THORACIC MOBILITY ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ If you have been keeping up with my posts regarding mid-back stiffness, then here’s another one for you ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ The human body is very adaptive! ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ The idea of the weight training (for the majority) is to progressively overload your body with stress that is above what you have previously experienced in an attempt to allow the body to adapt to it. ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ The same logic applies to sitting. If you’re someone who sits all day, you can guarantee your body will adapt and get GREAT at it. And this is how common postural issues arise. ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ Try these mid back (thoracic) exercises to break up your days of sitting, warming up for training or to just get some more thoracic movement in your life. ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ◾1: Active Rotation w/ a Reach To add more tension, add a small pressure against the wall with the reaching hand (my right hand in the video) ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ◾2: Counter Rotation Like exercise 1, to add more tension push the lead knee into the wall when rotating ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ Also, it’s not unusual to find one side stiffer than the other, many individuals will have a more dominant side. ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ ⠀⠀⠀⠀⠀⠀⠀⠀ ⠀⠀⠀⠀ If you cannot reach the wall with the opposite arm when rotating, just move to where you feel the tension and work through that range.
Your knees have to translate forward during a squat (especially when you get deeper). . So many of my clients tell me that someone (most likely an uneducated idiot) told them that their knees shouldn't translate forwards during a squat. This is a complete lie and myth. . Squat effectively with these cues: 1️⃣ Learn how to brace your abdominal wall prior to the squat (especially when lifting heavy- learn how to perform a breath hold to increase intra-abdominal pressure) 2️⃣ Initiate the squat with a hip hinge 3️⃣ Maintain a vertical bar path during your squat so the bar stays over the middle of your foot (if looking side on) 4️⃣ Do NOT let your knees buckle inwards and maintain the inside of the kneecap slightly outside your big toe 5️⃣ Drive up out of the hole with controlled speed (again do NOT let your knees buckle in) 6️⃣ Perform a glute squeeze at the top before starting the next rep 7️⃣ Celebrate squatting like a legend with a celebratory moonwalk
“ Do what you love and you’ll never work a day in your life “ ... A quote we all strive to get to in life, but I have the privilege of doing what I love for a living, and I still work my butt off! I choose to work as much as I do for the experience and my future, but it’s far from easy. Contrary to what people may think/believe working with animals is not always play time and cuddles, with all the ups, there are just as many downs, especially when working with wildlife. Due to #thewoolseyfire we were forced to evacuate our facility and we cared for our patients at another site. Because we had limited resources we found ourselves working harder to make sure all animals got the appropriate care they needed, regardless of the situation at hand. As technicians we strive to keep our patients content and stress-free no matter what the circumstances may be, but some days can be harder than others. Despite the nerve -racking situation, we never lost hope! The truth is, when you love what you do, you work harder to make sure things are done correctly, there are no short cuts, and you literally give it your all! It can be stressful, physically/mentally/emotionally draining, but when you love what you do, it’s all worth it! Thank you for my amazing coworkers for making these last few days seem like nothing was wrong, even when we weren’t sure if we had a building to go back to. Thank you for working crazy hours. And thank you for loving what you do! ❤️