Human Performance and Rehabilitation Centers, Inc.

Shoulder pain: Addressing rotator cuff issues early pays off

The shoulder is a key player in everyday life. When it’s not functioning properly you can feel pain while carrying out basic functions, including putting on a jacket, or reaching into the back seat of the car. These are hallmark signs of a rotator cuff issue. Untreated, this condition can become a much bigger problem.

The rotator cuff is the group of muscles and tendons that hold the shoulder joint in place and allow the arm and shoulder to move. Age, injury and overuse are all causes for rotator cuff disease. The muscles or tendons can become inflamed, frayed or torn resulting in pain and limited mobility and strength. If this sounds familiar, it’s important to be evaluated by your doctor early. Physical therapy is an effective way to improve low grade rotator cuff injury and avoid surgery.

When a patient comes in with a low-grade rotator cuff injury, we begin by using manual evaluation techniques on the shoulder joint to discover the level of strength and flexibility. There are four main muscles in the rotator cuff that act as a cohesive unit. When one is injured, others get out of balance. A patient has probably developed a habit of avoiding certain movements without even realizing it, while overcompensating with other muscles. Part of our strategy is to find out where these imbalances are so we can rebuild strength and flexibility in muscles experiencing pain or weakness.

Once we determine this, we can begin appropriate stretching and strengthening exercises. We also develop a tailored home program so that a patient can continue therapy daily. Multiple studies have shown that a quality home program is a big factor in helping patients achieve good results.

We educate patients thoroughly about the frequency and duration of the home exercises we want them to accomplish. We send home diagrams with written instructions and we can email videos of exercises to reinforce what we’ve done in the clinic. Usually, patients with low-grade rotator cuff injury see results in four to six weeks.

For minor to moderate shoulder pain, try these exercises at home.


Untying the knot: Myofascial trigger point therapy an effective tool for resolving tension

We’ve all felt them — those tight spots in the neck, shoulders and back that make you feel sore and stiff. You might call them knots, but they’re referred to as myofascial trigger points, and they require a specific type of physical therapy. Performed correctly, myofascial trigger point therapy can help inactivate the trigger point, relax the hardened bands of muscle tissue, and restore strength and flexibility.

Normal muscle contractions operate through a series of events involving nerve conduction and the sliding of protein filaments (myosin and actin) that contract the muscle cells and change the length and shape of the muscle cells. The message to contract a muscle is relayed from the brain to the spinal cord and then out into the muscle cells. The muscle cell is composed of many fibers, fibrils and filaments. Trigger points form when the protein filaments are unable to slide past each other and allow the muscle to return to its normal resting length. These hardened bands can compress the underlying tissue, blood vessels and nerves, leading to pain, weakness, and stiffness

The weakness results because the muscle fibers are already too busy being knotted up they cannot overlap any further to generate more power.  A therapist with good palpation skills will palpate the body in search of the trigger point, based on the client’s complaints of pain reported in the initial exam. The tissue will feel like a hardened knot (rock) or taut band(rope). The spot will be painful on compression and can cause referred pain, or pain that shows up in the body in a distant location.

Trigger points are brought on by a number of factors. While they can be caused by injury or trauma, most often, they build gradually over time.

Culprits include:

  • Static postures, such as sitting behind a desk all day
  • Repetitive motion, including working behind a computer or on an assembly line
  • High velocity movements associated with sports like swimming, golf, tennis or baseball
  • Muscle overload or strain resulting from lifting something too heavy or an abrupt increase in exercise
  • “Weekend Warrior” activities or extreme exercise on weekends
  • Past sports injuries

A physical therapist trained in myofascial trigger point therapy will palpate the muscle until he or she locates the tight muscular band. The therapist should also use the location of the referred pain to help trace the origin, since the body contains a network of established referred pain patterns. Then, using a variety of manual therapy techniques, the therapist will help each trigger point release its contracted state. Dry needling (link to HPRC blog) may also be used to release the taut bands.

The length of time it takes to ease a trigger point depends on a number of factors. The therapist will address any factors (mechanical, medical, psychological) that led to the pain initially or are continuing to make the trigger points worse during the course of rehabilitation. Patients can continue the work we accomplish in therapy sessions through at home exercises, including applying pressure with tennis or racquet balls or Foam Rollers, and frequent stretching of the affected muscles following pressure release work.  Trigger points can be successfully resolved with adequate Myofascial release, proper stretching, muscular retraining and activity modification. It is wise to seek out a physical therapist who specializes in manual therapy, specifically Myofascial Release and/or dry needling techniques to help untie those knots.

My Aching Back: Using Physical Therapy to Address Low Back Pain

If you’ve experienced low back pain, you’re not alone. According to the National Institute of Neurological Disorders and Strokes, about 80% of American adults – both men and women – will experience low back pain at some point in their lives. For many patients, physical therapy is an effective tool in improving low back pain and restoring strength and function.

The low back, or lumbar region, is an incredibly important part of the body. Comprised of five vertebrae, the low back supports the weight of the upper body as we go about our daily lives. Multiple components have to work together for the low back to function properly. Soft cushions or discs between the vertebrae act like shock absorbers as we walk, lift, run and jump. Ligaments hold the vertebrae in place. Tendons attach the muscles to the spinal column. Finally, dozens of pairs of nerves are embedded in the spinal cord. Each of these parts works in tandem, so when something is compromised, we feel pain.

No two patients experiencing lower back pain are the built exactly the same, which is why a physical therapy setting can be so effective in addressing a patient’s issues and body mechanics. Our goal is to restore normal physiological motion in the low back through tested hands-on therapy technques that zero in on each joint. In many cases, this mechanical approach is a much more effective – and certainly less invasive – than surgery.

Some of the patients we see experience pain due to spinal stenosis, or the narrowing of spaces in the spine. This is usually caused by age, normal wear-and-tear or arthritis. As joints harder and narrow over time, they can encroach on the nerves that are rooted there. When that happens, the nerves become compressed. We use techniques including traction modalities, manual therapy, joint manipulations and extension exercises both in the clinic and at home.  These therapies help give the nerves more room to function and can help reduce pain in our patients.

Learn how maintaining good posture can help alleviate back pain.

Physical Therapy at the gym: HPRC Physical Therapy opens satellite inside MÜV Fitness

Imagine the convenience of an experienced physical therapist on site in the gym where you work out. Suddenly, you’ve got the potential to expand your body’s movement and function and to protect it against injury. You don’t have to imagine it in Columbia, where HPRC Physical Therapy has launched a new partnership with MÜV Fitness.

HPRC physical therapists experienced in sports medicine are accepting new patients at our recently open satellite location at MÜV Fitness on Forest Drive. HPRC Physical Therapy took this step in order to bring physical therapy services directly to active adults.

According to WebMD, adults can sustain a workout injury no matter how in shape they are, and the most common injuries include shoulder and knee strain, tendonitis, sprain, dislocation and shin splints. Working with a physical therapist can help ensure you’re exercising not just for general health, but for joint and musculoskeletal health as well. In fact, nothing is more important to keep you in the gym or on the trail long term. Guarding against injury is an important investment that will ultimately save you time, pain and money.

Do you need to see a doctor before visiting an HPRC physical therapist at MÜV? Absolutely not. Thanks to direct access (available to varying degrees in all 50 states), individuals can see an HPRC physical therapist at MÜV Fitness without having to get a doctor referral. So if you experience pain while working out, if you want a physical therapist to help you prepare for an athletic event or if you have existing aches and pains, you can access an onsite physical therapist at MÜV without hesitation. These services are available to both members and non-members of the gym.

The benefits of physical therapy don’t stop with the last session. You will take with you new knowledge on how to stretch properly, warm up, cool down and move your body correctly in any fitness setting.

Founded in Columbus, Georgia in 1955, HPRC has been providing physical therapy services to the Columbia community since 1988.

To make an appointment, please fill out the screening form at or call (803) 939-2213.

Child’s Play: What you need to know about pediatric physical therapy

Lots of issues bring children to a pediatric physical therapist, from developmental delays to “head tilt” (torticollis) to a diagnosis of Cerebral Palsy or Down Syndrome. Pediatric physical therapists play a part in enabling children to live full lives by helping them build strength and balance. Here’s what parents and caregivers should look for in a productive pediatric physical therapy experience. [Read more]

The basic principles of physical therapy are applied consistently to people of all ages, but treating kids requires a special approach. To an adult, a PT might say, “give me 3 sets of 10 reps of this leg strengthening exercise,” but to a child, that doesn’t sound like much fun. Trained pediatric physical therapists know how to create an evidence-based plan of care that is both effective and engaging to a young person.

We begin by carefully evaluating our patients’ neuromuscular function, and we ask parents about how their child is getting along in his or her daily environments. Depending on the patient’s age, mobility and condition, we design a treatment plan that could include neuro-, ortho- aquatic or hippo therapy and other best practices.

On site, we use equipment and activities that look like fun, but that are actually proven strategies for achieving treatment goals. We might use therapy balls, platform swings, adaptive bikes, a jungle gym or a Wii. We might play basketball or kickball. We might place a child in front of a mirror and play tic-tac-toe with a dry erase marker as they balance on one foot. Each activity is an intervention proven to help pediatric strength, mobility and balance.

Sometimes children are scared and it’s hard to keep their attention. In such cases, we might invite a parent to act as lead therapist while we provide direction. Parents play a primary role in their child’s ongoing development, so this helps educate them as well.

In fact, a home therapy program is crucial to success. A good pediatric physical therapist will ask about a child’s living situation and daily routine and will adapt a treatment plan accordingly. A comprehensive plan of care will help pediatric patients improve their long term motor development, confidence and independence.


Our Pediatric therapists offer a range of services. Learn more about how they can maximize your child’s abilities, while minimizing the negative effects of their impairments.