Herniated Disc

3 Reasons You’re at Risk of a Herniated Disc

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A herniated disc can occur in any part of our spine. However, we often see it happening in the lower back.

This condition has also been known as a bulging, protruding, or ruptured disc. 80% of people will experience lower back pain at one point in their life – and for some this may be from a herniated disc.

Anyone can develop a herniated disc, but certain factors may increase that risk.

Here are three reasons you might be at a greater risk of developing a herniated disc:

1. You’re sitting For Long Periods

When we sit for too long, the burden of our weight is placed abnormally on our spine. This can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution?

Limit your sitting to half-hour periods. Have a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. If you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. I give this advice to every single client I have who comes to me with back problems. It’s one of the easiest ways for the average person to prevent a debilitating back problem over the long term.

2. You’re bending too much

Did you know that the average person bends or flexes forward between three and five thousand times per day?

That’s a lot of bending over time and eventually something will give – and it tends to be a disc in your lower back. Our spines crave balance, but unfortunately, our modern-day lives are designed to have us bending forward more than we should. Sitting in front of a computer, putting shoes and socks on, driving, house and yard work, even brushing our teeth are all daily activities that involve bending forward in some way.

To combat this, we need to make a concerted effort to extend instead of bend. A really simple exercise you can do every day is to stand and extend your spine. Place your hands on your lower back for support and then arch back as far as you can go. Repeat this 10 times, at least once per day. If you’ve never arched your back like this before, it may feel stiff or even hurt a little at first. But with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.

3. Your Age

Age is one of the most significant risk factors for developing back problems.

As we age, our muscles naturally weaken, including those in our back. This can make it harder for us to support our spine and maintain good posture.

Making sure that you are maintaining a proper nutritional diet is very important. It will aid in avoiding injuries like a herniated disc. When our bodies are supplied with the vitamins and minerals they need – your bones and supportive structures are supported to work at their best.

As we get older, we may become less active, which can lead to unwanted weight gain and weaker muscles. This can cause a strain on our back and increase the chances of having a herniated disc. It is generally recommended to be active for around 150 minutes per week. Staying mobile and strong will delay the wear and tear on our bodies as we age.

The good news is – the majority of herniated discs can be completely resolved without surgery.

Are you local to Portsmouth, NH and looking to get help with your pain NOW? CLICK HERE to request a Free Discovery Session with one of my Specialists. They’ll ask you all about what’s been going on – and figure out if we would be a good fit to help.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

Hip Pain

Hip pain not going away? Three Reasons Why.

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Hip pain is not nearly as common as knee or back pain, but it still impacts much of the population and it can be quite debilitating – especially when it doesn’t go away.

People routinely report hip pain in the side of their hip and in their groin. They may even complain that it radiates into their back and down their thigh. When this goes unresolved, it impacts your ability to walk, play golf, squat, bear weight on one leg, and even sleep through the night.

The big question, though, is why does it go away from some and persist for others?

If your hip pain isn’t going away – here are three reasons why:

1. You need a hip replacement

This is probably the most legitimate reason your hip pain isn’t going away. Your hip joint has become so arthritic and worn down that it’s time to get a new one.

But here’s the thing to keep in mind, whether or not you need a hip replacement should not be decided by your X-ray – it should be decided by your symptoms. Far too many people rely on the “bone-on-bone” diagnosis from imaging to be the determining factor. But there are hundreds of people walking around with fully functioning hips that have bone-on-bone and don’t need joint replacements yet.

When you need a new hip, the presentation is typically constant, unrelenting pain along with severely restricted mobility. In these instances, getting a new hip is going to be life changing and it should have a significant impact on your hip pain.

2. You’ve been mis-diagnosed

This is the most common reason why hip pain doesn’t go away. Just about everyone I see in my office with hip pain tells me they’ve been diagnosed with “hip bursitis”, when in reality, only 15% of women and 8% of women have true hip bursitis.

Hip bursitis occurs when you have inflammation of the bursa on the side of your hip. It’s typically caused by blunt trauma to your hip, or overuse/imbalance of the musculature there. It’s actually extremely easy to resolve so if your hip pain is persisting, this is likely not the reason.

The other common mis-diagnosis I see is that your hip problem is actually coming from your lower back. If you’ve got radiating pain into your thigh, you must always rule out that it’s not coming from your spine. Because if it is – and you don’t address it – your pain will never go away.

3. You’ve got the wrong treatment approach

If you don’t need a hip replacement, and you’ve got the right diagnosis, your hip pain should go away. If not, then we need to consider the treatment approach.

The most common mistake I see with hip pain treatment is implementing strengthening and stabilization exercises way too soon. The hip joint is one of the most mobile joints in our bodies. Because of that, it can be hard to detect when you’ve got some restrictions there. Having optimized mobility in your hip joint is paramount.

Without good, adequate mobility, your muscles will struggle to function as well as they could, and this can impact strength. I have a saying in my office: “mobility before stability”. And it’s for a good reason. If you don’t check mobility first, you risk strengthening and stabilizing around a joint that isn’t moving as well as it could. This could be a reason why your pain isn’t going away.

If you’ve got hip pain that isn’t going away, I hope this article has given you some food for thought.

Approximately 70-80% of all musculoskeletal problems, including hip pain, can be resolved naturally and without relying on pills, procedures, or surgery.

If you’re not having success with getting rid of your hip pain, then it’s important to question what you’re doing and consider that something has been missed. You deserve to live an active and mobile lifestyle doing all the activities you love.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists. Tell them about your hip pain and they’ll get you on a treatment plan right away – at the very least you’ll leave with some helpful tips moving forward.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Staying Active

5 Tips to Stay Active and Avoid Injury in Your 50’s

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I work with a lot of clients in their 50’s and beyond. Staying active over 50 is a big priority for them as they age. An injury can significantly derail this plan, especially as we age, since recovery just isn’t as easy.

Here are five of my top tips when speaking to folks over the age of 50 for staying active and mobile, avoid injuries, and continue doing everything they love:

1. Keep Moving

You’ll often hear me say: “You don’t get stiff because you get old, you get old because you get stiff”.One of the best ways to stay active and mobile as you age is to keep moving. Well what if you have something like arthritis? Remember that arthritis is normal. It happens to everyone as they age and it’s rarely a reason to stop doing your favorite activities.

In fact, research has shown that activities like running, when done consistently and with proper form, actually prevents knee arthritis. Arthritis worsens when you don’t move. And common “injuries” such as meniscal tears and bulging discs are more likely to occur in arthritic joints. But the more active you stay, the less likely you are to be impacted by ailments such as these, and the better your joints will feel. Happy joints will motivate you into staying active.

2. Maintain a Healthy Diet

Both osteoporosis and heart health become bigger concerns as we age, and what you eat can have a direct and positive influence. With osteoporosis, your risk of injury, especially from a fall, becomes greater. Greens like kale, spinach, and arugula are awesome for your bones, along with citrus fruits, fish, and nuts. These foods help your bones stay strong and durable.

According to Health magazine, “The risk of a heart attack climbs for men after age 45 and for women after age 55.” As you enter middle-age, increasing the presence of foods like unsalted nuts, unprocessed oatmeal, raisins, blueberries, and even dark chocolate (over 70% cacao) can help keep your heart healthy. Before making any drastic changes to your diet, especially if you’ve got comorbidities such as diabetes or kidney disease, you’ll want to check with your doctor or dietician. But otherwise, paying attention to your diet can have a big impact on how healthy you keep your heart and bones, which will motivate you in staying active and mobile.

3. Work on Your Balance

Balance is one of the first things to go as a person gets older, and it’s one of the most crucial factors in fall prevention. Slips and falls due to poor balance can lead to broken bones and fractures, which become more common and harder to recover from as you age. But if you’re intentional about improving your balance when you exercise, it’s not too late to improve it.

While there are many great balance-exercises you can do at home, I always recommend incorporating balance strategies with movement and activity. Because rarely do we fall when just standing still. Try standing on one leg when you brush your teeth, place one foot up on a stool when washing dishes, walk around on your toes and heels during commercials. These are really easy strategies to incorporate into your daily living. And of course, activities like walking regularly, Thai Chi and Yoga are also great to promote good balance – while also keeping you active.

4. Strengthen Your Core

Having a strong core is beneficial at any age, but especially as you get older. Strong abs, hips and buttocks (all part of your core) help you to sit and stand more upright, prevent back and neck pain, and will help you feel stronger and more confident in just about everything that you do.

One word of caution, however, when it comes to core training is to pay special attention to your form and posture. Ironic, right? Since core training is supposed to help those things… But I can’t tell you how often I see folks (especially over 50) begin a new core training program and then call us 4-6 weeks later because they’ve suddenly hurt their back.

If you’re over the age of 50 – and you haven’t exercised in a while – I highly recommend engaging the help of a qualified professional who can guide you through exercises that are appropriate for your fitness level as well as keep a close eye on your form and technique when crunching those abs and working those planks.

5. Educate Yourself

Knowledge is power, and lack of it, is one of the biggest reasons I see people decreasing their activity levels as they age and getting injured.

People think that ailments like arthritis, bulging discs, or a torn meniscus are reasons to decrease or cease certain activities. Not true. Most of the things I just mentioned are normal occurrences as we age, and having them show up on an Xray or MRI is not a reason to change something you’ve been successfully doing for years.

Staying active and mobile actually helps these problems. If you’ve got pain, that’s a different story.

Talk to an expert who can help you figure out what’s going on, so that you can quickly get back to your activities and not make your pain worse.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Tendonisis

Tendonitis vs. Tendinosis – The BIG difference and why it matters

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If you’ve ever suffered from tendonitis or tendinosis – then you know that it can last anywhere from a few weeks to several months!

Tendonitis is an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon. Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon that involves deterioration of collagen, a structural protein in your tendon.

While the two conditions sound very similar and are often used interchangeably, they couldn’t be more different. When tendonitis isn’t caught early enough or treated properly it can turn into tendinosis. The treatment for acute tendonitis is very different from chronic tendinosis.

Let me explain…

Tendonitis is an acute condition. The best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. From there, you want to figure out what caused the tendonitis to occur in the first place and address that.

Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendonitis!

The most common areas for tendonitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle).

When you don’t manage tendonitis properly, and it goes on longer than a few months, it can result in tendinosis. Tendinosis is a very different condition where the fibers in your tendon actually start to break down. The first thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you. I can’t tell you how many times I’ve spoken to people still doing this 6-8 months later…

Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers in order to resolve tendinosis and get your tendon functioning properly again.

Passive treatments like ice, rest, and medicine will not help tendinosis. They might help to relieve any pain you’re having from overdoing it or under-treating it… but the tendinosis will continue to progress. Unresolved tendinosis leads to progressive weakening of your tendon over time – making it easily susceptible to full blown tears. This is how so many folks tear their Achilles or rotator cuff, for example, “out of nowhere”.

Once I speak with them, they often report that over the years they had recurring bouts of tendonitis in that area. In other words, their tendonitis wasn’t managed properly and it led to chronic tendinosis. Making them an easy target for a torn tendon.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

You have to re-organize those fibers so your tendon can work properly again!

Sounds easy, right? Well technically it is, but the biggest problem is that this process takes time – up to 9 months in many cases. And most patients I come across simply don’t have the patience for this. Or they simply aren’t told about it.

The other issue is that if you’re expecting an insurance company to cover your treatment – they typically don’t want you in physical therapy for more than 6-12 weeks at a time. This is not long enough to properly treat tendinosis.

The only way to re-organize those tendons is to put stress on them – and over a period of time. You have to put just the right amount of stress to cause a little bit of pain. However, not so much stress that your tendon gets inflamed again. A properly trained physical therapist that is well-versed in tendinosis will know how to do this.

You basically have to retrain the fibers to withstand force again – and this process takes time. The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love as if nothing ever happened!

If you’re confused after reading this don’t worry. So is half the medical community.

The take home points to remember are these:

Tendonitis involves pain and inflammation, there is no damage to your tendon, and it only lasts about 4-6 weeks. Treatment for this should involve passive modalities like ice and rest. The focus should be on what causes the tendon to get irritated innitially.

But if problems in your tendon have gone on longer than 3 months, you MUST suspect tendinosis. This no longer involves inflammation but instead, a breakdown of your tendon.

Passive treatments will NOT work and could actually prolong your problem – so stop icing and resting.

To get rid of tendinosis, it requires carefully prescribed loading strategies. These will properly re-organize the tendon so that it can be strong again! This is extremely challenging to do on your own, so we recommend working with an expert who is well-versed in this diagnosis.

Luckily – we’ve introduced a brand new treatment modality in our office. It accelerates the healing of soft tissue and tendon injuries.

It’s called Shockwave Therapy and we are currently accepting new patients for this service. If you’re already a client – you will get this service at no charge. Just ask your specialist next time you’re in and see if you’d be a good fit for this treatment.

But if you’re not a current client – and are currently suffering from something like plantar fasciitis, tendonitis, or some other soft tissue strain or injury – you could be perfect for this treatment! Studies have shown about 70% reduction in symptoms in as little as 6 sessions.

While this won’t completely “fix” your tendon or soft tissue problem – it can have a significant reduction on your pain which will allow you to more easily do the work that WILL fix your problem.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].