A Physical Therapy Expert’s Guide to Enjoying Fall Activities Pain-Free

/in , , , /by

Fall is my favorite season – and I know it is for many of you too.

Crisp air, colorful leaves, pumpkin patches, and cozy outdoor gatherings are some things that come to mind. But there’s also raking leaves, picking apples, chopping wood, and moving heavy things like hay bales or pumpkins. Any of these fall activities can produce unwelcome strain on your body if you’re not careful. 

Here’s a guide to enjoying all that fall has to offer – from a back pain and mechanical pain expert – so you can enjoy fall activities this season while keeping your back and joints pain-free.

1. Rake Leaves with Care

Raking is a quintessential fall activity, but it’s also repetitive and strenuous, which can lead to back pain if done improperly. Here are a few ways to protect yourself:

  • Warm Up First: Just as athletes warm up before a game, you should warm up before raking. Try a brisk 5-10 minute walk around your yard or neighborhood to get your blood flowing, followed by gentle stretches for your back, shoulders, and legs. A few torso twists and arm circles will help loosen up your muscles and prepare them for the repetitive motions of raking.
  • Choose an Ergonomic Rake: Look for a lightweight rake with a long handle that allows you to stand upright. Avoid bending forward too much, and alternate sides regularly to avoid overusing one side of your body.
  • Use Your Legs and Core: When bending to gather or bag leaves, squat using your legs and keep your core engaged. Avoid twisting from your waist, as this puts your spine in a vulnerable position. Instead, pivot your entire body to avoid strain.
  • Take Regular Breaks: Raking for extended periods can tire out your muscles, making you more susceptible to injury. Set a timer for every 20-30 minutes and take a short break to stretch your back and shoulders.

2. Safely Pick Up and Carry Pumpkins

Pumpkin picking is a fall favorite, but carrying heavy or awkwardly shaped pumpkins can strain your back and shoulders if you’re not careful. Here’s how to keep things safe and pain-free:

  • Lift with Your Legs, Not Your Back: When lifting a pumpkin, bend at your knees and use your leg muscles to power the lift. Keep the pumpkin close to your body and avoid twisting as you lift.
  • Use a Cart or Wagon: Many farms and pumpkin patches provide carts—take advantage of them! Use a cart to transport heavier pumpkins and prevent carrying strain.
  • Limit Carrying Distance: If you’re decorating with multiple pumpkins or other fall items, consider limiting the number of trips you make to and from your car or home to avoid repetitive strain.
  • Pro Tip: This advice applies to picking up and carrying anything. Whether it be hay bales, fall decorations, or putting away summer furniture.

3. Use Good Posture when Apple and Pumpkin Picking

Apple orchards and pumpkin patches can be so much fun, but both activities involve a lot of bending, reaching, and lifting. Use these tips to protect your body:

  • Stay Grounded: Instead of overstretching to reach that perfect apple, use a ladder or stool. Overreaching can lead to shoulder and back strains, so play it safe and keep a good base of support as you reach up.
  • Mind Your Posture: When standing or walking for extended periods in the orchard or patch, practice standing tall, with your weight evenly distributed between both feet. This not only helps reduce fatigue but also protects your lower back.
  • Wear Supportive Footwear: If you know you’ll be walking and standing for prolonged periods – you’ll want to have good, supportive shoes. This will go along way in helping your spine and the rest of your joints absorb the load of your body as well as those pumpkins and apples

4. Move Often and Stay Hydrated

All-day outdoor fall activities can wear you out, especially if you’re standing, bending, or lifting frequently. Staying mindful of your body can make a big difference:

  • Take Stretch Breaks: If you’re spending a long day outdoors, make a point to take a stretch break every hour or so. Focus on simple movements that lengthen your spine and open up your chest and shoulders, such as reaching your arms overhead and gently twisting your torso side-to-side.
  • Stay Hydrated: Cooler weather can make you feel less thirsty, but it’s still essential to stay hydrated. Dehydration can lead to muscle stiffness, fatigue, and even unwanted spasms and cramps – increasing the risk of strains.

5. Cool Down After Fall Activities

Once you’ve wrapped up your fall fun, give your body a few minutes to cool down and recover properly. A little bit of post-activity care can go a long way in keeping pain at bay.

  • Gentle Stretching: After raking, decorating, or any heavy lifting, spend five minutes stretching your back, legs, and shoulders. Simple stretches like extending our spine backwards or pulling your knees to your chest can help relieve tension.
  • Mind Your Posture When Resting: After a full day of physical activity, it’s tempting to sink into a couch or recliner, but try to avoid slumping immediately afterward. Instead, sit with a straight back, or go for a light walk. This can help prevent stiffness and reduce the likelihood of soreness.

Enjoy Fall Activities the Pain-Free Way

Fall activities are a great way to enjoy the season and embrace the outdoors, but they don’t have to come with pain and strain. Taking a few preventive measures, such as warming up, being aware of your body, and using proper lifting techniques, can make a significant difference in how you feel afterward. With these tips, you’ll be ready to fully enjoy apple-picking, pumpkin patches, and all the beauty that fall has to offer – with a lot less aches.

That being said, if you try every tip I’ve mentioned and don’t notice any difference in how you feel or tolerate these activities – your problem might need expert help. Reach out so we can help you find a mechanical pain expert in your area who can work with you.

Are you local to Portsmouth, NH? If so, consider speaking to one of my specialists in a Free Discovery Session. This 30-min session is a designed to: 1. Make sure we can help you 2. Make sure you’re a good fit for what we do 3. Make sure we’re a good fit for you. Click here to speak with a specialist.

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, call 603-380-7902, or CLICK HERE to get a free guide for preventing back pain.

Sciatica

Why Cortisone Shots Don’t Work for Sciatica

/in /by

If you’ve ever suffered from sciatica – then you don’t need me to tell you how debilitating the condition can be.

From shooting and searing pain into your buttocks that can run all the way down to your foot – to numbness, tingling and loss of strength… sciatica has the ability to significantly impact your quality of life. What’s worse? It typically comes out of nowhere – making this condition even more frustrating to deal with.

It’s no wonder that a majority of people resort to “quick fixes” like cortisone shots – in hopes it will put an end to their back pain and sciatica suffering. According to the American Academy of Family Physicians (AAFP), epidural steroid injections (a type of cortisone shot) are among the most common interventions for chronic low back pain and sciatica. In a study published in The Spine Journal in 2015 – it was reported that approximately 50% of patients with sciatica opted for cortisone shots for pain relief as part of their treatment plan. 

But just because cortisone shots for sciatica are popular and considered “standard” – it doesn’t mean they are best practice.

First of all – even if a cortisone shot “works” (almost 50% of the time they don’t) – the results are typically temporary.  Only 20-30% of patients have been able to report sustained relief past a few month’s time. Everyone else reports anywhere from a few weeks to 3 months relief. The problem with the majority of people only experiencing temporary relief from cortisone shots in their spine – is that  you risk “chasing the pain” with more cortisone shots (or prescription meds), acceptance of your condition and continued suffering (I call it “bad back syndrome”), or opting for spine surgery, that in most cases, is totally preventable.

OK – statistics aside – why exactly don’t cortisone shots work for sciatica?

The reason cortisone shots don’t work is because they are attacking symptoms instead of the root cause of your sciatica. Cortisone shots are great when you have an out of control inflammatory reaction to an injury. This presentation is distinct and rare. We call it “chemical  pain” and it’s essentially the result of your body’s natural inflammatory process going a bit haywire.

What makes chemical pain distinct from mechanical pain (which accounts for 80% of all sciatica/low back pain) is that most “mechanical” sciatica will come and go throughout the day – and will be better or worse during certain activities and positions. For a simple example – your sciatica may “scream” at you if you’ve been sitting for too long – but will ease up and feel better if you stand up and stretch. This is a classic presentation of mechanical sciatica.

Chemical pain does not behave like that. It literally hurts all the time and the only thing to relieve it is drugs.

And even that is temporary – thus – justifying the more invasive cortisone shot when accurately diagnosed. The tricky thing about mechanical sciatica/low back pain is that it occurs slowly over time and is the result of abnormal stress and strain on your discs and spinal nerves. It’s a “lifestyle” and movement condition at its root – not an inflammatory condition. While the cortisone shot may succeed in temporarily getting rid of the inflammation – it won’t ever get rid of the mechanical cause – which means you’re more likely to prolong the true problem over time. A cortisone shot, at its best, puts a bandaid on your sciatica. And this is the number one reason why so many people end up in a vicious cycle of treatments, and end up getting both unnecessary and preventable spine surgery.

So what should you do for your sciatica instead of a cortisone shot?

First, trust the research and evidence – which says there’s an 80% chance your sciatica has a mechanical root cause – and that the inflammation you’re experiencing is instead – a symptom. Research aside, I can vouch for this over the 22 years I’ve been helping people get rid of sciatica naturally. 

Second, medical doctors (unfortunately) are not trained in recognizing, diagnosing, or even treating mechanical pain. You need a mechanical pain specialist to help diagnose and get rid of mechanical sciatica – if you want it done the right way and for the long term. Plus – the best thing about working with a properly trained mechanical pain expert first – is that it’s fool-proof. If it’s not a mechanical cause – and it indeed is an inflammatory process “gone wrong” inside your spine – they will rule it out quickly – and refer you for a cortisone shot (appropriately).

So here’s the good news…

There’s an 80% chance your back pain or sciatica is a mechanical problem at its source. Which means that when working with the right medical professional(s) – you can successfully get rid of it naturally – and avoid cortisone shots altogether. I’m a huge advocate of natural, DIY treatment approaches whenever possible – because although small – there are real risks associated with invasive procedures like cortisone/epidural injections. And when those adverse reactions occur – they are often irreversible. 

Why not give yourself the shot at a natural approach to your sciatica before diving into an invasive one?

I’m not talking YouTube exercises and Google – I’m talking actually mechanical pain specialists. I know a lot of them. So if you’re struggling to find one in your area – please reach out. I’d love to help.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media group. To get in touch, or grab a seat in her upcoming Masterclass: “Put an end to back pain naturally – without surgery, procedures, or pills – CLICK HERE.

Pain when gardening

Six Ways to Protect your Knees and Back when Gardening

/in , , /by

Gardening is a favorite activity for a lot of folks – and lately I have been hearing many people having knee and back pain when gardening. To add more frustration to this topic, you might not even notice the pain until hours or days afterwards, which can make it challenging to address.

The good news is that there are several things you can do to protect your knees and back while gardening.

Here are 6 of my favorite tips to manage pain when gardening:

1. Warm up first

Before diving into any activity that you know you’ll be doing repetitively and for more than a few hours, it’s a good idea to warm-up. It doesn’t have to be anything crazy or excessive and 10 min is plenty.

Typically, you’ll only be gardening during nice weather. So enjoy it by taking a walk around your neighborhood first. Then do some easy light stretching to lubricate your joints before you begin. It won’t take long but your knees and back will thank you.

2. Avoid bending from the waist

Lifting and carrying heavy bags of soil or plants can put a lot of strain on your back and knees. You really want to make sure you’re using proper posture and body mechanics to avoid problems.

When lifting, be sure to use your legs instead of your back and hold objects close to your body. If you hinge only from your hips, for example, which a lot of people like to do, you will put extra strain on the back of your knees and lower back. Get in the habit of bending your ankles, knees, and hips in unison – kind of like an accordion – so that you build good muscle and body memory and don’t even have to think about it next time you’re gardening or lifting.

3. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back and knees still need a break. Our joints don’t enjoy anything when done repetitively or for prolonged periods, but especially too much bending or sitting on your knees. When you bend too much and too often, the discs in your lower back can get aggravated, and when you’re sitting on your knees, it’s a lot of pressure and can annoy your arthritis.

I recommend setting a timer and giving yourself a break every 30 min to change positions. Simply stand up and get out of the bent or sitting posture. Your back and knees will thank you and you’ll be able to garden for much longer and without risk of injury.

4. Pivot instead of twist

Your lower back and knees aren’t really designed to rotate, they are designed for bending and extending. So if you’re not careful – you can strain these areas with poor twisting and turning mechanics. When you have to rotate, you’ll want to pivot from your pelvis.

What does this look like?

Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and your pelvis in line with your knees and feet – and always move them as a unit. While it’s ok to bend and twist from your waist or legs on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you’re already prone to back or knee pain.

5. Use ergonomic gardening tools

The right gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. Long-handled tools can help reduce the need for bending and stooping, which as already discussed, puts strain on your knees and back when overdone. Another consideration is the weight of your tools. It might be worth the investment to swap out your older, heavier tools for more modern, lightweight alternatives.

When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench and/or knee pads. These tools will make it easier to sustain activities that require prolonged bending or kneeling.

6. Use beds to raise your gardens

Raised garden beds not only look pretty but they are extremely ergonomic. Especially if you suffer from more chronic back and knee problems. Raised garden beds are elevated off the ground. They are easier to maintain and limit the amount of bending you have to do.

Raised garden beds are relatively simple to build and create. Even if you’re not having problems now with gardening, if it’s an activity you love to do, you might want to consider it. Making the investment in raised gardening beds now could go a long way in preventing knee and back problems in your future.

Gardening has so many positive benefits for both your mental and physical health – and the last thing I want is for back or knee pain to get in your way.

If you are experiencing pain when gardening – Give these tips a try.

But if it’s not enough, don’t give up.

Enlist the help of a musculoskeletal pain and movement expert who can help you figure out the source of your problem and provide you with practical solutions so that you can get back to gardening as quickly as possible.

If you are local to Portsmouth, NH – consider speaking to one of my specialists.

It’s a free, no-obligation call where you can tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you.

Click here to speak with a specialist.

Back Pain

5 Reasons Exercise is Hurting Your Back

/in , /by

The research continues to show that the best “treatment” for back pain is exercise.

But what do you do when exercising causes back pain instead of helping?

This is one of the most common frustrations I hear from our clients. The doctor looks at their back and takes an X-ray. He or she only sees something like arthritis or degenerative disc disease. Surgery doesn’t make sense – so the advice is to go exercise – and specifically to strengthen their core.

But when it doesn’t work they are at a loss.

Why would exercise hurt your back when the research overwhelmingly shows that it’s supposed to help?

Here are 5 reasons why exercise is causing your back pain…

1. It’s the wrong type of exercise

The research isn’t wrong about exercising and back pain. It doesn’t always reveal the specifics on the type of exercise that’s being done. For example, walking is considered one of the best activities for back pain sufferers. For the majority it will help significantly. But I also have clients who get worse just walking to their mailbox at the end of the driveway.

What the research is really saying is that movement – not necessarily “exercise” – is what’s really good for back pain – even acute back pain. But you need to make sure it’s the right type of movement for YOUR specific type of back pain. If you get the type of exercise or movement wrong – you’ll feel worse. It’s one reason why exercise will sometimes hurt your back instead of help.

2. Stability training is introduced too soon

Stability training is an important part of back pain recovery – but I often see it introduced too soon. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. You want to make sure you explore that fully and get the spine moving the way it should be before you begin stabilizing or strengthening it.

Every now and then I stabilize first, but it’s rare. More often than not I see that people with long standing back pain are suffering from a mobility problem that was missed. When your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to get irritated. You want to figure that out first before jumping ahead to stability training of your core and spine.

3. Your aren’t activating your core

Knowing how to properly activate your core is different from having good core strength. You can have the strongest abs in the world – but if you don’t use them when they count – your 6-pack abs are useless. Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or performing complicated movements that require good coordination, you’re setting yourself up for injury.

The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. Pilates (when done properly and with a well-trained instructor) can accomplish this quite well. If you’re constantly having back pain every time you exercise or try to strengthen your core, it could be that you lack the ability to activate it when it counts.

4. You aren’t breathing properly

Not breathing properly – or not breathing at all – can significantly impact the effectiveness of your exercise routine and impede your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise, and in order to activate your core properly, you must be able to breathe properly.

Your deep core is made up of four parts: your deep abdominals, your deep back muscles, your pelvic floor, and your diaphragm. Your diaphragm is what controls your breathing. Let’s say you hold your breath when you exercise. When this happens it means your diaphragm isn’t expanding or contracting in the way it needs to for your deep core to be fully functional. Additionally, when your diaphragm doesn’t work like it should, it adds unnecessary strain and work to your back muscles. This is one reason why you might not be able to activate your core properly – and why exercise might be hurting your back.

5. You’re using improper form

The last and most common reason why exercising might be hurting your back is because you aren’t doing it right. There’s a lot of people out there who think posture and form don’t really matter. But they do.

If you’re lifting weights – especially when frequently and repetitively – you want your spine to be in good alignment. It might not hurt the first time you lift with improper for. But it will hurt when you get to your 100th rep. Same goes for body weight exercises. Just because you aren’t adding load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. That’s really where people get in trouble. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture or it’s going to catch up to you and cause you unnecessary back pain.

If exercising is currently hurting your back…

Consider speaking to one of my specialists – they’ll ask you all about what’s been going on – and see if we would be a good fit to help you!

If you’re local toPortsmouth, NH – Click here to book a free discovery visit.

knee pain source

When Knee Pain Doesn’t Go Away – Consider your lower back.

/in , , /by

One of the most important things to get right when it comes to successfully resolving knee pain is to correctly identify the knee pain source.

Is your knee pain actually due to a problem in your knee? Or is the root cause of your knee pain coming from somewhere else in your body?

Rosedale, et al published a study in 2020 that revealed 43% of all isolated extremity pain was coming from the spine. What that means is that you could have nagging knee pain, and no back pain at all, and your knee pain is the result of a lower back problem. I’m not going to get into the technicalities of how this happens. Generally speaking, it’s a mechanical problem in your lower back that causes irritation to nerves or structures that impact your knee – and only your knee.

But how do you know for sure?

One of the biggest clues you’ve missed the root source of your knee pain is that it doesn’t go away after trying everything that “should” help it. Perhaps you’ve tried ice, heat, pain medication, foam rolling, strengthening, and stretching. Even physical therapy – but no matter what – your knee pain just won’t go away. It might get better for a short period, but it always comes back. If the lower back is not considered at this point, then it’s typically when knee doctors get involved. This is great if you’ve actually got a knee problem.

Knee pain that doesn’t respond to conservative treatment should be looked at further. But if your knee pain is a symptom of a problem in your lower back, and it’s missed, you risk having an unnecessary knee procedure or surgery that will only cause you more problems later.

Here’s a quick story about someone this happened to…

I spoke to a client the other day – we’ll call him “David”. He had surgery on his knee to clean out some cartilage and wear and tear from arthritis. They recommended this surgery because he had “failed” regular physical therapy treatment. Nothing else seemed to be resolving his knee pain. It was supposed to be a “quick recovery” and take his pain away because they assumed all his problems were due to arthritis. Well, three months later, Davids knee felt (and functioned) worse than pre-surgery. Now he had back pain to go along with it. To fix the new pain he was having they were recommending even more knee surgery. And now they wanted to do an MRI of his back.

How does something like this happen?

The biggest culprit is over-reliance on imaging to form a diagnosis and treatment plan. Leading you to have the wrong idea of your knee pain source.

If you’re over 50, and you get an X-ray or MRI taken of your knees, there is a 60 to 80% chance they’ll find arthritis and/or meniscus (cartilage) tears. And this will be whether you have knee pain or not. That’s because these are normal changes that occur as you age.

So if you’ve got knee pain, and your doctor wants to do some imaging, there is a very good chance they’ll find one or more of these changes in your knee. They might just blame your knee pain on it without looking at anything else. That’s exactly what happened to David. They blamed knee arthritis for his knee problem when it was actually coming from his lower back.

How do I know?

Luckily for David, he refused the second knee surgery. He went to a mechanical pain expert for diagnosis and treatment, and in 2 months both his knee and back pain were gone.

Do you have knee pain that won’t resolve with typical knee pain treatment? You must consider that it could be coming from your lower back before you undergo any kind of surgery or procedure.

If your knee pain seems to come on slowly or out of nowhere, if you have trouble pinpointing exactly where the pain is, if it moves around and changes from day to day, or if it runs up or down your leg – there is a good chance your knee pain is a symptom of a mechanical problem in your lower back and you should get it looked at.

Herniated Disc

3 Reasons You’re at Risk of a Herniated Disc

/in , /by

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].

Sciatica

Suffering from Sciatica? The Do’s and Dont’s

/in , /by

Four out of five people will experience a debilitating back pain and Sciatica episode at one point during their lives. Sometimes this looks like severe back pain that lasts a few days and eventually goes away on its own.

But for some – especially those that have experienced more than one debilitating back pain episode over the course of their lifetime – they experience searing pain down their leg that may or may not persist over a period of time.

When you experience back pain followed by radiating leg pain – this is known as “sciatica”.

Sometimes the pain will only go to your knee, or be a dull ache in the side of your hip and leg. But other times it can manifest all the way down to your foot and be accompanied by numbness, tingling and a loss of strength.

The good news is that there is plenty you can do on your own to help yourself recover from sciatica naturally. But there’s just as much you can do – unknowingly – to make your situation worse.

Here are some Do’s and Don’ts when it comes to sciatica.

The Dont’s:

1. Avoid resting in bed or on the couch.

While it may feel better in the moment – lying in bed or on the couch will ultimately aggravate your sciatica. Sciatica is caused by pinching or irritation of the nerves in your lower back. When you lie in a slouched posture (such as in bed or on the couch) you will put unwanted pressure on these nerves, thus aggravating your symptoms.

The trickiest part about this is that you typically won’t notice the aggravation when you’re resting. You’ll notice it after the fact when you stand up or try to move around, and mistakenly assume the movement is what’s aggravating you instead of the relaxed posture you were just in.

2. Avoid child’s pose and stretching forward.

This is another big misconception about sciatica because it tends to feel really good when you’re “in the moment” and stretching your back forward. Not always, but often, sciatica is caused by a bulging or herniated disc that is pinching your nerve.

The position of bending forward does temporarily relieve pressure on your nerves – which is why it feels good at first – but it doesn’t last.

Stretching forward also opens up the space between your vertebrae. This can influence the protrusion (bulging) of your disc. If you allow your disc bulge to protrude more onto that nerve – your nerve will become more angry and aggravated – as will your sciatica.

3. Don’t let your MRI decide treatment.

As I mentioned in our first two examples, sciatica often involves bulging discs and irritated nerves. And an MRI will typically confirm this. But here’s the thing – tons of people out there have bulging discs showing up on their MRI’s and no symptoms at all.

What matters is whether or not your bulging disc is interacting negatively with your nerve – and that is typically influenced by poor movement strategies.In other words, if you learn how to move better, you can actually make your bulging disc inconsequential and your sciatica will dissipate.

So you should never let your MRI, alone, determine your treatment protocol when you’re suffering from sciatica. What’s more important is how your sciatica symptoms behave during movement. Research has shown this to be more reliable than imaging alone because it tells us in real time what’s happening to your nerves.

The Do’s:

1. Keep moving.

While it may seem counterintuitive to move when you’ve got pain running down your leg – it’s one of the best things you can do.

Try to stand and walk upright as much as you can and pay close attention to what happens in your leg. If the symptoms in your leg start to subside, then you’ll know that your body is enjoying that particular movement and that it’s helping your sciatica.

But here’s the catch – make sure the relief lasts. Lasting relief (vs temporary) is what we’re looking for and it tells us if the movement you’re doing is a good thing for your sciatica.

2. Watch your Posture.

This may seem trivial – but maintaining good posture is critical when you’re suffering from sciatica. Remember that sciatica typically involves a pinched or irritated nerve – and irritated nerves are highly sensitive to postural changes in your lower back (especially slouched postures).

Whether you’re standing, sitting, or lying down – be sure to maintain a small curve in your lower back to minimize your slouch. This helps to keep pressure off your discs and already aggravated nerves.

3. Talk to a Movement Specialist.

While it’s entirely possible to rid yourself of debilitating sciatica without pain pills, procedures, or surgery, you’ll find it easier to do so under the guidance of a movement specialist who specializes in understanding back pain and sciatica.

Yes – you can get an MRI and go see a surgeon – but they aren’t movement specialists. They are surgical specialists. In order to get rid of your sciatica the natural way (with corrective movement strategies) – you need to work with someone who’s an expert in this.

Have you been dealing with back pain or sciatica? Or do you know someone who is?

If you”re local Portsmouth, NH, and you want help NOW for your back pain – Request a Free Discovery Session from one of my specialists. They’ll tell you if we can help and get you set up on a treatment plan right away!

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].

Back Surgery

Back Surgery: Why it fails and do you need it

/in , /by

Approximately 500,000 Americans undergo back surgery to relieve their pain every year, and according to the Agency for Healthcare Research and Quality (AHTQ), this costs approximately $11 billion annually.

But what if I told you that only 5% of people undergoing back surgery actually need it – and worse – for many folks the pain ends up coming back. The American Society of Anesthesiologists estimates that 20-40% of back surgeries fail. If you’ve had repeated back surgery your risk of failure increases. Failed back surgery is so common that it’s gotten its own name – “Failed Back Surgery Syndrome” – which occurs when you experience continued pain in your neck, back, or limbs following any spine surgery meant to reduce pain.

So why then do we continue spending so much money on back surgery when the majority of people don’t actually need it – and when half the surgeries fail?

Back pain can be excruciating, debilitating, and have a significant impact on your quality of life and happiness.

If you’re in this situation, and told by a well-respected surgeon that surgery is your best option of taking your pain away and getting you back to living your life again, odds are good you will take that opportunity. And most of the time – surgery does take your pain away – initially that is.

But what surgeons don’t tell you is that your pain has a high likelihood of returning.

If you’ve had one “successful surgery” – you assume the next will go the same. But as mentioned above – the more back surgeries you have – the more likely they are to fail – and the vicious cycle begins.

So when should you get back surgery?

If you’ve had an accident or trauma that has resulted in major damage to your spine – you need surgery.

If you have urgent compromise to one of your spinal nerves you also need surgery. But let me preface “urgent”.

Your symptoms will be progressive and severe.

Signs might include problems with your bowel and bladder, sudden and worsening foot drop (loss of strength and ability to lift your foot and toes), walking will be difficult and progressively worsen, and nothing will take your pain away – medication and rest will barely touch your symptoms.

These cases are rare – but do require surgery to quickly decompress your nerve before permanent damage ensues.

But 70-80% of the time, back pain is what we call non-specific or mechanical.

And surgery is not recommended – and rarely works for this type or back pain.

Mechanical back pain can be acute and last for a few days, or can be chronic and come and go. You might have nerve pain with numbness and shooting pain down your leg, but it won’t be urgent like the situation described previously. The pain you feel is typically caused by irritation to soft tissue structures, discs, muscles, and joints. But the root cause of this irritation is from something different – and that is what we need to care about.

It’s why 50% of back surgeries fail.

Let me explain…

When you get an MRI to see “what’s causing” your back pain – it will typically show some form of bulging disc, degenerative discs, or lumbar stenosis. You will likely be told that these findings are what’s causing compression and irritation to your nerves.

They might try injections and medication first, but when that doesn’t work, they’ll recommend surgery. But here’s the catch. These findings show up in 60-80% of all MRI’s when you’re over the age of 50. But not everyone with these “abnormalities” has back pain.

In other words, you can have two people of the same age, with equal-looking MRI’s, and one will have pain while the other doesn’t.

How does that happen?

What research has shown over the years is that what shows up in your images rarely correlates with what’s causing your back pain.It’s why so many back surgeries fail – because we are messing with “abnormal” findings that are in fact – quite normal for your age. So if the structures aren’t the problem – then what is?

Most back pain comes from poor movement habits and lifestyle.

Over time, repeated, unbalanced movements will exacerbate or cause irritation to these structures that are considered “findings”. But you can’t fix your back problem by only addressing where the symptoms are.

You have to address the root cause. This is typically some combination of restoring full and free mobility in your spinal joints and balancing out flexibility and strength. When you move correctly – these structures are no longer bothered – and neither is your back.

I know what you’re thinking – this sounds way too simple and perhaps you’ve already tried physical therapy or something similar and it didn’t work. Sadly, not everyone understands – or even agrees – with the concept of mechanical back pain in the way I’ve just explained it.

But trust me, when you find someone who does, you’ll be amazed at how easy it is to fix your own back. You can then keep the pain gone – without ever having to see the inside an operating room.

Back surgery can be costly – both to your bank account and mental well being.

That’s a lot of money to risk when there’s only a 50% chance of the surgery working. There’s an even better chance that your pain will come back. If there’s a complication of any kind, then you’re looking at more surgeries. This is an almost certain loss in quality of life.

It’s worth it to do your due diligence. Find a movement specialist who understands mechanical back pain and can keep you out of the operating room.

If you’re dealing with back pain now and want to learn more…

We will be talking all about this and more in our upcoming Masterclass for Back Pain & Sciatica Sufferers.

The Masterclass is free – and happening on January 24th from 6-7 pm via zoom. Reserve your seat HERE – spaces are limited – and there’s a limited number of spots left.

Back Pain

Three Reasons Back Pain Sufferers Avoid Exercise (and what you can do)

/in , , /by

80% of the population suffers from what we call “non-specific low back pain”. Low back pain is typically chronic, comes out of nowhere, you have good days and bad days, and it’s not usually due to any recent or major accident or fall. If you’ve got back pain and you’re reading this – odds are pretty good that you suffer from non-specific low back pain. Research shows that exercise is the best treatment for non-specific low back pain.

But what do you do when your back pain keeps you from the thing that’s supposed to help you?

Here are three of the most common reasons I see that keep people with low back pain from exercising – and some tips for what you can do:

1. Fear

Let’s face it – back pain is scary.

This is the number one reason back pain sufferers don’t exercise. Is the pain you’re feeling good or bad? Should you be feeling any pain at all? Pain is confusing. When you experience pain during exercise, it can be difficult to know if it’s normal or a warning sign. For many, the safest thing to do (as they see it) is avoid any exercise or movement altogether until the pain subsides.

The problem is – when you try to resume movement again – the pain comes right back – and then you’re caught in a vicious cycle.

What you need to figure out is which movements are “good” and which movements are “bad” – and the good news is your body is going to tell you. If you hurt a little at first – but feel better the more you do something – and aren’t worse after – you can consider that movement generally safe and be encouraged to keep trying it.

But if you hurt during – and feel worse after – then that’s a sign to stop and back off. Pain is not something to fear – it’s just information. What’s important is how your back pain behaves over a period of time with a certain activity.

Fear of pain comes from not knowing what it is or what to do – but when you figure out how to “speak pain” – the fear goes away and you can have control over your body again.

2. Bulging Discs

Most people who suffer from long-standing low back pain eventually find themselves getting an MRI. And 60-70% of the time, it will show one or more bulging discs.

If you’ve been following me for a while, you know that most people over the age of 40 walk around with bulging discs – and that 65% of them feel no pain at all. In other words, if you’ve got a bulging disc, you can’t be certain it’s the cause of your back pain. Research proves this. And being told you’ve got a bulging disc is not a reason alone to avoid exercise.

Movement is actually one of the best things you can do for a bulging disc.

It may require some customization of your current exercise routine, but a movement specialist can help you with this. Don’t just stop or avoid exercise altogether just because you’ve been told you have a bulging disc. Go back to the rules of pain I mentioned above and let that be your guide instead.

3. You Were Told to Rest

Well-meaning doctors and family members who aren’t up to date on the latest back pain research will advise you to rest every time you experience back pain.

This might be reasonable advice when you’re dealing with an acute (sudden) episode of back pain – but it’s terrible advice for chronic, non-specific low back pain sufferers.

Rest is one of the worst things someone with chronic back pain can do. Since most people don’t have a thorough understanding of this concept, they find themselves in a yo-yo effect.

They rest to “heal” their back pain. When it’s gone they return to exercise – only to hurt their back again. I’ve seen so many people fall victim to this perpetuating cycle and it’s a big reason why so many back pain sufferers just give up on exercise entirely.

If it’s been a long time since you’ve exercised – start with 10 min of daily walking.

Walking is generally known to be one of the best things you can do for back pain. If for some reason walking increases your back pain – then that’s a good reason to see a back pain specialist (ideally one who understands how to heal your back with movement versus pills and procedures).

If you’re suffering from chronic, non-specific low back pain – and you’ve stopped exercising – know that you’re not alone.

This is such a confusing topic and there are so many mixed messages out there about what the “right” and “wrong” thing to do is. Don’t try to go at it alone. Exercise is good for your back, but you may just need a little help and guidance to get there.

Need help with Back Pain now? Are you Local to Portsmouth, NH? CLICK HERE to speak with one of my specialists. We will see what’s been going on with you – and get you on a treatment plan right away.

We will be talking all about Back Pain in our upcoming Masterclass! Its free – via zoom – on September 19th. Reserve your seat here!   Learn how to manage your back pain on your own – and get back to doing the activities that you love – pain free!

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].

Weight Loss

Ignoring Back Pain could Sabotage Your New Year’s Goals

/in , /by

Now that the Holiday’s are behind us – many people start to shift their focus to New Year resolutions.

According to statista.com – the three most popular New Year goals are:

  1. Doing more exercise and improving their fitness
  2. Losing weight
  3. Saving money

Would you be surprised to know that if you are currently suffering from back pain – and you continue to ignore it – it could significantly impact your chances of success at achieving any of these goals?

Let me explain.

Let’s start with doing more exercise and improving fitness…

Most people think that if they start exercising more – especially their core – it will solve their back problem. Not necessarily.

While the research studies show (overwhelmingly) that exercise is one of the best treatments for back pain – what they don’t reveal is that there are typically some key things that must be in place in order for exercise to be effective.

For example, you must have good mobility before you start focusing on stability (or strengthening). If you’ve got a stiff back, general exercise could be all you need, and you’ll notice improvement. But you won’t know until you get going and by then it could be too late.

What if your back is stiff because it’s compensating for something – say a bulging disc or muscle weakness? If that’s the case, and you go all in with an exercise program in January, it’s only a matter of time (usually about 3 months in) before your back becomes worse, forcing you to abort your grand plan for the new year. When stability is there for a compensatory reason, it’s important to figure that out before adding more exercise or strengthening to the mix. This is one way back pain could derail your New Year’s resolution of doing more exercise and improving your fitness.

Say you want to lose weight this New Year.

This is a fabulous goal. And if you’ve got back pain, losing weight will surely help. But once again, it’s critical to understand why you’ve got back pain in the first place.

For example, being overweight is rarely the cause of back pain. A few extra pounds can certainly exacerbate your back problem, but it doesn’t usually cause back pain all on it’s own. The most common causes of back pain are mechanical (movement) problems. In other words – bad movement habits such as sitting all the time, bending and rotating too much, or having terrible posture can all lead to back pain slowly over time.

If you lose weight, but never correct these mechanical/movement problems, your back pain isn’t going to improve. When it comes to the process of losing weight, in addition to watching your diet, more exercise is often incorporated into a weight loss plan. If you’ve got back pain, it’s more than likely due to poor movement habits. More exercise will not address these, and worse, could exacerbate the problem. If your back pain increases, not only will you not want to exercise, but you could be more inclined to sit at home and eat more – completely derailing your New Year’s resolution of losing weight.

Finally – we come to saving money in the New Year!

What on earth could back pain have to do with this?

Well, you’ve probably heard the saying: “If you think wellness is expensive, try illness”. And this couldn’t be truer. When you ignore back pain, it’s only going to get more expensive to address later. As back pain worsens, you’ll have less willpower to bear it, and you’ll be more likely to opt for expensive fixes such as outpatient procedures and surgery. Not to mention the rehab that needs to take place afterwards for an optimal recovery and the expensive tests that need to take place before-hand to ensure you’re ready for surgery.

When you ignore a back problem it’s only a matter of time before it becomes unbearable. And when we’re desperate, we make poor decisions, which often leads to more money spent than necessary. All that money (and more) that you set out to save as part of your New Year’s goals eventually goes to waste. Instead, get in front of your back pain.

For 80% of back pain cases, there is a natural, movement-based solution.

Natural solutions are far less expensive – and much safer long term compared to something like surgery. While the impact of ignoring back pain may seem indirect when it comes to a New Year’s resolution of saving money – it will impact you in some way – at some point – in a monetary way if you don’t address it now.

When you’ve got back pain (or any pain for that matter) that isn’t going away, it’s your body trying to tell you something. Don’t ignore it. It’s only a matter of time before it gets worse and starts to derail more than just your New Year’s goals.

If you want to stop ignoring your back pain and you’re ready for some help – talk to one of my specialists! They’ll let you know if we can help – and if you’re a good fit for what we do. CLICK HERE to request a Free Discovery Session with one of my specialists.

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].