Want to lose weight in the New Year? Don’t let knee or back pain get in your way.

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If you google “Top 3 New Year’s Resolutions” – you’re sure to find “losing weight” as one of them. While I’m not a dietician or nutritionist, I know that the majority of weight loss has to do with what you eat. However, exercise plays a role too, and that I am an expert in. 

Exercise stimulates endorphins and makes you feel better all around. The better you feel, the easier it will be to stay motivated about your weight loss goal.

Exercise also helps you burn more calories – which certainly isn’t going to hurt your weight loss journey.

But if you’ve got unchecked knee or back pain, not only will you find it challenging to exercise, you are going to be more stressed about it. Stress increases cortisol which interferes with your ability to manage weight. And if you can’t exercise at all because of pain, that will make it even harder to manage stress, never mind your weight. You can see how this vicious cycle from unwanted knee and back pain could completely derail your New Year’s goals.

Here are four tips to help you not let knee or back pain get in the way of your weight loss in the New Year:

1. Mobility Before Stability

Your muscles can’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a joint that isn’t moving at its best, or you’ll encourage compensation. If your nagging back or knee pain is due to inadequate mobility, you’ll run into problems. You will be in more pain if you suddenly increase your exercise or activity level. We saw this happen at the beginning of the pandemic. People started walking and exercising more and we saw a huge influx of unexpected back and knee pain as a result. Their joints weren’t accustomed to moving so much and it highlighted the lack of mobility and compensations. Don’t let the same thing happen to you. Make sure all of your joints, including your spine, can move fully and freely without any pain before you begin a new exercise program.

2. Pace Yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember… the tortoise (not the hare) won the race. It’s important to not beat yourself up if you’re not seeing immediate results. If you’ve been out of shape for a while and doing something completely new, expect to be sore. But if you’re limping around for days or experiencing sharp pain in your back or knee, there is a chance you overdid it or worse case injured yourself.

My general rule of thumb is to monitor your soreness on a scale of 1 – 10. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise they haven’t tried in a while. If you find that your pain level goes above a 5, or persists at that level (or higher) for more than a day, there’s a chance you’re overdoing it and setting yourself up for an unwanted injury. When in doubt, listen to your body. And if you’re not sure what it’s saying – enlist the help of an expert.

3. Stay Hydrated

Most people don’t drink enough water during their regular day, never mind when they increase their activity level. Drinking lots of water has two great benefits: It will give you the extra hydration you need if you’re planning to be more active; and it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day is to begin with 10 oz of water first thing upon waking. And a good rule of thumb when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

4. Get Assessed by a Mechanical Pain Expert

If you’ve got nagging back and knee pain, see a mechanical pain expert before you begin your new exercise routine. Your first thought might be to go see your medical doctor. However, it’s important to understand how different medical professionals assess different problems. Medical doctors are trained to screen your whole body and typically rely on imaging to make their diagnosis. This is a great approach if you’ve had an accident or trauma. Or if you are presenting with what could be a serious pathology. But for 80% of musculoskeletal pain – including knee and back pain – X-rays and MRI’s are overkill.  They put you at risk of being led down a path of unnecessary referrals, treatments, and procedures. They will definitely put you at risk of being told not to exercise at all.

A mechanical pain expert, on the other hand, is trained to assess your pain with movement tests – not imaging. This is going to reveal a much more realistic picture of what you can and can’t do. It will also reveal what movements will make you better or worse. This allows you to go into a new exercise routine with a more informed approach. Also, with a plan to exercise around your pain and make it better.

Is exercising and losing weight is part of your New Year plan? If so, I hope these tips help you go into 2023 with confidence. If you’ve got lingering or unwanted knee or back pain that’s not going away on its own – get it checked.

 

Are you local to Portsmouth, NH? – CLICK HERE to speak with one of my specialists. We will ask you about what’s been going on – and see 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 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].

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5 Tips to Avoid Back Pain when Raking Leaves

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We are in peak leaf-raking season right now in New England. Leaves are everywhere – and the daily sound of leaf blowers in my neighborhood has become somewhat meditative. I love Fall – but I don’t love raking leaves. And raking leaves is even worse when you’re suffering from back pain.

The good news – it’s not as hard as you think to avoid back pain while doing this repetitive, monotonous activity…

Here are 5 tips to help you avoid back pain when you’re raking leaves:

1. Take a walk before you start.

Walking is a really great activity for your back in general, but it’s also a really easy way to warm-up your entire body ahead of an hour or more of repetitive raking. Personally, I love nothing more than taking a walk in the cool, crisp Fall air.

Why not take a quick walk around the block before you get into your raking?

This simple activity will bring blood flow to your arms, legs, and spine – and get all your joints moving and warm ahead of the full body activity that is raking.

2. Stretch every 30 minutes.

The biggest “danger” to your back when it comes to raking leaves is the repetitive nature of it – specifically the frequent bending and rotation of your spine.

Our spines were designed to hold us upright, not to bend and twist over and over again in the same direction. One of the simplest ways to protect your back while raking leaves, or any other repetitive activity, is to take quick and frequent rest periods to stretch. Every 30 min or so, stop what you’re doing, and give yourself a simple stretch backwards. This very simple action can go a long way in avoiding excessive back pain while raking.

3. Bend with your legs and hips.

As mentioned above – one of the worst activities for your lower back is repetitive bending and rotation – which is very easy to do if you’re not paying attention while raking leaves.

One way to avoid this is to use your hips and legs to bend and rotate. Using your legs and hips to bend and get lower to the ground when raking minimizes the bending at your spine – and pivoting at your pelvis to throw the leaves away minimizes the rotation to your spine.

Don’t get me wrong, your back will still likely be sore after taking even when “doing everything right” – but the stress will be significantly less and can help you avoid throwing out your back a day or two later – because yes – this is the timeframe when it will usually occur if you didn’t use good habits while raking your leaves.

4. Engage your core.

You don’t need six-pack abs to prevent back pain while raking leaves, but being mindful of your core can be super beneficial and it certainly won’t hurt you. Most back injuries occur when you least expect it… coughing, sneezing, picking something light off the floor.

These activities are so mindless and automatic that you’re typically not paying attention to what your core might be doing – or not doing. Raking leaves is an equally mindless activity. Each time you pull the rake toward you or lift it, think about drawing your belly in and engaging your abs. This will help keep your spine more supported and stable while raking.

5. Keep moving afterwards.

What you do after raking is equally as important as what you do during to help prevent back pain.

One of the biggest mistakes people make after a repetitive or strenuous activity (like raking) is to slump on the couch or recliner and rest. This is one of the worst things you can do to your spine because it’s more pliable and vulnerable after strenuous activity. When you put yourself in a relaxed and sustained bending position – after all that repetitive bending – it can be the icing on the cake.

You go to stand up and “boom” – there goes your back. I see it all the time. Do yourself a favor and go for another walk after raking to cool down, and be mindful of the posture you rest in after all that hard work.

Hopefully these tips give you a few things to think about before you go raking, and most importantly, avoid unwanted back pain so you can enjoy this beautiful fall season.

Are you local to Portsmouth, NH and looking for help with your back pain?

Consider speaking to one of my specialists.

You can tell us everything thats been going on and we’ll see if we’re fit to help you – and give you all of the information you need to make the best decisions for your health.

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]. 

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Three Ways to Keep your Back from “Going Out”

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Four out of five people will experience a debilitating back pain episode at one point during their lives. For many this will be from a pulled back muscle.

Typically, we put more effort into caring for our backs during those times than when we’re feeling good. But it’s critical that we take good care of our backs all the time, not just when we’re in pain.

The real secret to keeping your back healthy is in your daily habits.

Pulled a Back muscle? Here are three ways to take care of your back on a daily basis. So that you can keep it from “going out”:

 

1. Avoid sitting for prolonged periods.

When we sit for too long, the burden of our weight is placed abnormally on our spine and 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. The curves in your spine matter

We have natural curves in our spine that help us handle stress and loads. Whether sitting or standing, it’s important to maintain these curves. When standing, our spinal curves occur more naturally and are usually easier to maintain. But when we sit, the protective curves in our spine are harder to maintain and often disappear, and you’re often completely unaware it’s happening.

While strong back and abdominal muscles are an important component to maintaining a healthy back, they do very little when it comes to sitting and maintaining those curves, which is a common misconception in the medical and fitness community.

Fortunately, the solution is simpler than you think. Using a lumbar roll every time you sit goes a long way in helping you maintain the natural curves in your spine – and with minimal effort or thought. The good news is you can craft one quite easily on your own using a small towel roll or pillow. Simply place it between the small of your back and the chair and it will help you to maintain the natural lordosis (or curve) of your lower back. Give it a try. You’ll be amazed at how effective this one simple tip is for helping to control and prevent back pain.

(Did you know we have Lumbar Rolls right here in our Portsmouth office? Email [email protected] if you’re local and want to get one)

3. Extend instead of bend.

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 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. If it doesn’t, or becomes troublesome for you, then it’s important to speak with a specialist.

Getting rid of a back problem really isn’t as complicated as you think – and it could be as easy as starting with simple tips like these.

These tips are considered basic “back hygiene” that everyone should consider incorporating into their daily routine. But if you’ve had several back pain episodes year after year, or every few months, these tips may only take you so far and it’s important to enlist the help of an expert.

CLICK HERE to request a FREE Discovery Call with one of my specialists.

Someone from my client success team will call you right away and see if you are a good fit for what we do.

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].

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Failed Back Surgery Syndrome? You’re not alone.

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Back pain impacts approximately 80% of the population. The response to that has been more and more back surgeries being performed each year. However, despite more surgeries being performed, people aren’t having any less back pain. In fact, those that do get back surgery only have success rates of 50%. After a few years, their results are no less successful than those who chose to have conservative interventions. Such as physical therapy and exercise, for the same problem. If you’re experiencing failed back surgery syndrome, you’re not alone.

The American Society of Anesthesiologists estimates that 20-40% of all back surgeries fail. That statistic gets worse for patients who have a second surgery. Estimating that only 30% of second back surgeries are successful. Should you have a 3rd or 4th surgery your success rate plummets. Only 5-15% of 3rd and 4th back surgeries have successful outcomes. Despite these statistics, approximately 500,000 Americans are still undergoing back surgery every year to relieve their pain. The Agency for Healthcare Research and Quality estimates that back surgery costs us $11 billion annually. That’s a lot of money to spend on something that isn’t even guaranteed to work. 

So why are we spending so much money on back surgery when for almost half of these people (and in some cases more), it’s not even successful?

Problem number one is if you’re dealing with debilitating back pain that is impacting your life and happiness. Surgery is often going to be a very attractive option. If you’re told surgery will take away your back pain, why wouldn’t you want to choose this approach?

The second major problem is with the way back pain is typically diagnosed. Nowadays, doctor’s rely on imaging (X-rays or MRI’s) to decide what’s wrong with you and to formulate a treatment plan. They rarely take the time to talk to you about the events that led to your back pain, examine the way you move, or make certain that what shows up in your images is actually responsible for your pain.

For example, if they see a bulging disc and you’ve got coinciding leg pain – they assume that’s the source of your problem and recommend you cut it out. If you’ve got severe degenerative changes or stenosis in your spine, they recommend fusion.

What’s the problem with this approach?

Things like bulging discs and degenerative changes show up in MRI’s and X-rays, and are quite normal. They occur naturally as you age. It’s no coincidence that before the invention of MRI’s – there were far less surgeries being performed. What we do know is that 50% of the time, back surgery fails. Could it be because we are going in and tampering with structures that have nothing to do with the source of our back problem?

Let me explain.

We now know from research that 70-80% of all back pain is considered “mechanical” in nature. Meaning, the root cause or your pain is due to restrictions in your joints. Or restrictions in soft tissue that impact the way you move. This, in turn, can make surrounding structures very angry and lead to pain. Findings such as bulging discs, disc degeneration, and stenosis are all a normal part of aging and there are plenty of people out there who have these exact same findings on their images – yet have no pain at all. That’s because for some, their joints move fully and freely, and these (normal) abnormalities don’t give them any trouble. But for those whose joints do not move well, that bulging disc has a better chance of getting irritated or causing something else (like a nerve) to get irritated.

Removing the disc, or fusing your spine, won’t take away your underlying mechanical movement problem. It will put a temporary band aid over it until the problem either re-occurs – or shows up in another section of your spine – often years later.

Does this help you to understand why so many back surgeries are unsuccessful? 

It’s such a common occurrence they even have a name for it – “Failed Back Surgery Syndrome”.

When your back pain is due to a mechanical problem – such as an underlying movement or mobility issue – surgery will not fix this. Additionally, MRI’s and X-rays can’t accurately diagnose it. When you do have surgery, you end up prolonging your problem further. Because you think that just because your back pain is gone, your problem is gone.

It’s only a matter of time before your pain returns, and it’s usually worse. Plus, your mechanical problem becomes more challenging to address once you’ve had surgery. But the good news is that it’s still possible to address it without a second back surgery. And it’s possible to address debilitating back pain without a first surgery altogether.

So if you’ve got back pain and are considering surgery, definitely think twice and be sure you’ve been fully examined by a mechanical back pain expert first. And if you’ve already had back surgery and it failed, still talk to a mechanical back pain expert. 

Remember that the odds of success for second and third back surgeries are very low. Even after a failed back surgery, it’s still possible to learn how to address back pain on your own and get back to doing everything you love. 

Did you know that we specialize in back pain – and have helped thousands of folks learn how to treat back pain completely on their own?

CLICK HERE to talk to someone from my team – especially if you’re considering back surgery and want to make sure you’ve explored ALL possible alternatives first.

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].

Three Ways You’re Getting Back Pain Treatment Wrong

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If you’re over the age of 40 and reading this, odds are pretty good that you’ve experienced back pain at least once in your life. In fact, four out of five people are impacted by back pain, and for many, it’s a constant back-and-forth year after year. Keep reading to learn three ways you could be getting back pain treatment wrong.

The first thing you need to understand is that back pain is normal. It’s hard to combat the everyday stressors our modern-day lifestyles impose on our spine. We simply weren’t meant to sit for hours each day or be crouched over electronic devices. Rather than have unrealistic expectations about pain-free lifestyles, we should instead be focusing on ways to naturally manage our own back pain.

Now keep in mind, I make a living off helping people recover from debilitating back pain. But that doesn’t mean I want you to suffer. Here are three ways we’re getting back pain treatment wrong.

1. Quick fixes and passive modalities.

Reliance on quick fixes or passive modalities is how most people attempt to treat their back pain. It’s also the number one reason why back pain returns. A passive modality is something that is done to you vs something you actively do on your own. It’s where you walk in somewhere, lie on a table, and receive some kind of treatment. This could be chiropractic care, massage, acupuncture, or even injections and surgery. You have no active role in the process – it’s completely passive.

Now, I’m not saying there is anything wrong with these treatments. They are great for easing symptoms related to back pain – especially tight, spasmatic muscles. (I have back pain myself and get a massage once per month.) But they shouldn’t be used in isolation. They need to be part of a more comprehensive, movement-based approach to addressing back pain at its source. Plus – you’ll find the relief you get from passive modalities is almost always temporary. And when your pain keeps coming back – it’s a sure sign you’re missing something. Don’t get back pain treatment wrong by relying on passive modalities.

2. Letting MRI’s make the decision.

Traditionally, the medical community diagnoses your back pain with images. If you’ve had back pain for a while, and especially if you’ve already tried some physical therapy, doctors will prescribe an MRI to “see what’s going on” inside your spine. The problem is that what shows up in your MRI doesn’t always correlate with what’s causing your back pain. In fact, 60% of the time, what you see on your MRI has nothing to do with the root source of your problem.

For example, your MRI might show a bulging disc in your spine. Well, did you know that bulging discs are normal and occur naturally as you age? You could have two people with the same bulging disc on their MRI and one will have zero back pain.

Why? Because the root cause of back pain is more complicated than your anatomy. Evidence from research tells us that 70-80% of all back pain is primarily caused by restrictions in your mobility – which is influenced by your habits and the way you move – not by what’s going on structurally in your spine.

So if your doctor lets your MRI make the decision, and recommends surgery to cut out a bulging disc that isn’t even the source of your real back problem, you’ve not only wasted a surgery, but wasted even more time not addressing the real cause of your pain. Letting MRI’s dictate your treatment plan is one of the most overlooked ways we’re getting back pain treatment wrong.

3. The wrong exercises.

One of the biggest problems I see when it comes to treating back pain is non-specific, non-prescriptive, generalized exercises that are designed to make you strong and perhaps even target your core – but it’s before the real problem gets addressed.

Almost 90% of the time, back pain is due to immobility in your spinal joints (vertebrae) that causes irritation of surrounding structures in your spine – such as discs, nerves and ligaments. What we know to be true is that these mobility restrictions can be freed up with very specific movements, in very specific directions, using a very specific frequency during the day.

Once the restriction in your spine is free and you’re moving normally, you can do any exercise of your choosing. It’s at this point that strengthening your core, for example, is beneficial. Because a strong core helps prevent future back pain episodes (but it doesn’t cure a current back pain episode).

To figure out which specific move you need to address your back pain will require help from an expert. But the good news is once you know what movement gets rid of your back pain, you can use it time and again to manage it on your own. But generalized exercises, when done too soon, is another big way we’re getting back pain treatment wrong.

If you’ve been suffering from back pain longer than you should, I hope this information helps you figure out where you might have been steered wrong.

It’s worth getting help from a back pain specialist who emphasizes corrective, prescriptive movement as a means to recovery – vs quick fixes, MRI’s, and generalized exercises.

Want help from one of our specialists? Request a Free Discovery Call HERE to see if you’re a good fit for what we do.

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 visit her website at cjphysicaltherapy.com.

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Piriformis syndrome and Sciatica – PT not working?

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I recently polled my readers regarding their most important concerns when it comes to their musculoskeletal health. In other words, what questions were they desperately seeking answers for related to back, neck, knee, hip, shoulder, or ankle pain?

Here is a great question I received from John:

“I’m getting Physical Therapy for lower back pain and sciatica that is said to be from my piriformis. My PT treatment has consisted of various exercises and some massage. Eight sessions in and no change at all. I’m still having pain when sitting or walking a distance. What now?  Do I need an Ultrasound or MRI to see if there is any damage or tear to my piriformis?”

First, John, I’m so sorry to hear you’re still having pain and not seeing any change after a good amount of physical therapy. When it comes to back pain and sciatica, it’s critical that you receive a thorough mechanical and movement examination by your PT before any treatment begins. This should involve repeated testing and retesting of movement and range of motion to determine:

1) where your pain is coming from and

2) what movement patterns trigger and relieve your symptoms

Without this first critical step, you risk missing the root cause of your pain and treating just symptoms. This type of testing is also essential to determine if physical therapy can even resolve your problem. If your physical therapist simply read the prescription from your doctor and dove into generalized treatment protocols – there’s your first problem right there – and it could explain why after 8 sessions you’re seeing no change in your condition.

In your case, it sounds like the massage is intended to treat your symptoms – perhaps your tight, tender piriformis that is believed to be causing your back pain and sciatica. This is perfectly appropriate, however, it’s important to incorporate targeted, therapeutic movement to make the most of what your manual therapy (massage) just did.

In other words, movement is the real “medicine”. Manual therapy is designed to enhance blood flow to and prepare your soft tissue (muscles and ligaments) to be better equipped to tolerate and perform the movement/exercise that is going to have a long-lasting effect.

If the massage and exercise are not done in a specific and targeted way – they aren’t going to have their intended effect. It’s possible this could be happening to you. If you’re not totally clear on what your exercise is for and what the intended effect is – chances are high your exercises haven’t been prescribed to you properly. If you suspect this to be the case, it’s worth your while to try for a different, perhaps more specialized physical therapist before you go jumping into diagnostic tests that could lead you down a rabbit hole of unnecessary procedures or surgery.

Now, let’s assume for a moment that you did receive targeted and high-quality physical therapy treatment and it’s simply not working. This does happen from time to time – but it should only be approximately 20% of the time for the majority of musculoskeletal problems such as back pain and sciatica. And in my opinion, it should be caught well before 8 sessions. In my experience, it takes about 5-6 (quality) PT sessions to figure out if a problem can be resolved with movement and natural means. If not, then a referral to another specialty is necessary.

Are you there yet? I can’t be certain.

But to answer your question about whether or not you need an MRI or Ultrasound… 

If quality, targeted physical therapy has been truly exhausted then yes – either of these diagnostic tests would be the next step in providing valuable information as to what more might be going on.

Ultrasound is a non-invasive diagnostic tool designed to visualize both organs and soft tissue. It could be a good option for examining your piriformis if you are certain that is where your problem is coming from. But piriformis syndrome only accounts for about 30% of all sciatica cases. And typically a tear in your piriformis will not cause pain to radiate down your leg. Most of the time, sciatica is caused by nerve impingement occuring in your lumbar spine (low back). If conservative treatment, like physical therapy, has been fully explored – an MRI could be helpful to see how badly a nerve is being pinched or irritated and whether or not a procedure or surgery is warranted. But in general, the research has shown time and time again that spine surgery is really only successful when you’ve got serious and progressive neurological deficits and symptoms.

In other words, you might have symptoms like foot drop, and your leg is getting weaker and numb by the minute. Otherwise, physical therapy – although it may be slower to work – has equal if not better results compared to surgery and it’s a lot safer.

The caveat, however, is you need to find a good physical therapist.

I hope this helps answer your question. Most importantly – don’t give up hope!

For the next few months I’ll be answering questions like these each week in my articles. If you’ve got your own questions regarding musculoskeletal aches or pains that you want answers for, reach out via the information below.

Local to Portsmouth and feeling frustrated with your current physical therapy treatment just like John?

Reach out – we’d be happy to provide a second opinion. CLICK HERE to request a Free Discovery call 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].

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4 Tips to Avoid Neck and Back Pain When Traveling

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4 Tips to Avoid Neck and Back Pain When Traveling

Memorial Day weekend is the “unofficial” start of summer – and AAA estimates that 39.2 million people will travel this weekend. That’s 8.3% more than last year, and it’s going to mean the exacerbation of neck and back pain for a lot of folks out there – especially the over 40 crowd.

So why does traveling wreak such havoc on our spines? 

Road trips, planes and trains typically involve lots of sitting and driving, which necks and backs just don’t like when done frequently and for prolonged periods. You’re typically off your routine when you travel, and sleep on surfaces you’re not accustomed to.  Any one of these things – but especially when combined together – can flare up old patterns of neck and back pain.

The good news is there are lots of things you can do when traveling to ease neck and back pain. Here are 4 of my top tips:

 

1. Use the 30 Min. Rule

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting – often in cramped spaces. Our bodies are made to move continuously throughout the day. Whenever possible, getting out of your seat often is critical for keeping your neck and back healthy and mobile. Motion is lotion. And one of the best things you can do for your neck and back is to interrupt any prolonged posture – especially sitting – once every 30 min. If you’re unable to actually stand for a few seconds, then try arching your back or stretching your arms up over your head while sitting. Do a few neck rolls and chin tucks to stretch your spine. The more you move, the better your spine is going to feel.

2. Use a Lumbar Roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together, when not supported. While it’s perfectly acceptable to sit like this for small increments of time, it will start to cause problems after several hours. Prolonged curvature of your low back puts unwanted stress on the discs, ligaments, and muscles in your spine.

Your neck also responds to this posture by assuming a position we call “forward head”. This can give you headaches, neck pain, and cause extra tension to occur in your mid back and upper shoulders. One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your low back. If you’re driving, the lumbar support in your seat usually isn’t enough. Take a small towel roll, sweatshirt, or pillow and place it at the small of your back any time you’re sitting. You’ll find it’s easier to maintain the natural curves in your spine – and you’ll have a lot less strain on your neck and back.

3. Bring your own pillow

Sleeping on surfaces we’re not accustomed to can not only ruin a vacation but set us up for unwanted neck and back pain. If possible – bring your favorite pillow from home – or ask for extra pillows wherever you’re staying. If a mattress is too firm for you – you can use pillows to cushion areas of your body like hips and shoulders so that you don’t wake up sore. Conversely, if a mattress is too soft, you can use extra pillows to build up the surface under your waist if you’re a side sleeper, under the small of your back if you’re a back sleeper, and under your belly if you’re a stomach sleeper.

Lastly, if a pillow is too fluffy or too flat – your neck will end up paying for it. When you’re sleeping – the goal is to position yourself in a way that allows your spine to stay in neutral alignment. You don’t want your head tilted down or up – it’s the fastest way to stir up an old neck injury or wake up with a tension headache.

4. Extend instead of bend

Did you know that the average person bends or flexes forward between three and five thousand times per day? When you’re traveling – you’re going to be on the upper end of that metric. Our spines crave balance. And because of the disproportionate amount of time we spend bent over – we need to make a concerted effort to move our spines in the opposite direction. When you’re traveling – look for opportunities to be upright and mobile.

Walking is an excellent, therapeutic activity for your spine – plus – it’s a great way to see the sights wherever you’re going. When you’re practicing the 30 min rule, give your back and neck a nice stretch backwards each time you stand to interrupt your sitting. But probably more important than what you do during travel is what you do when you’re back home. Be cautious when jumping back into your typical gym or exercise routine. All the sitting and bending that comes with travel makes your spine vulnerable for injury. It’s very common to get injured a week or two after you’re home – seemingly “out of nowhere”.

 

Looking for more help with your neck and back pain?

Sign up for a FREE Discovery Session today to speak with my client success team to see if we can help you get rid of your neck and back pain for good.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

golf injuries

Common Golf Injuries and How to Avoid Them

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Most golfers I know won’t let anything stop them from being out on the course – especially here in New England where the golf season is not very long.

But let’s face it, when something hurts, playing 9-holes is just not as fun.

Jack Nicklaus had it right when he said, “Professional golfers condition to play golf; amateur golfers play golf to condition.” That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they’re out of shape, have poor swing mechanics, or don’t adequately warm up.

Here are three common golf injuries and things you can do to avoid them.

Elbow Tendonitis

Tendonitis is characterized as the painful inflammation of a tendon. It’s caused by repetitive movements that overload the tendon, eventually causing it to feel strained and overworked. When it occurs on the inside of your elbow, which is something that happens a lot with golfers, it’s called “golfer’s elbow.” The treatment is ice and rest initially (which means you don’t get to play golf for a while) followed by progressive and proper loading of the tendon to get it back to a healthy state. This whole process, if done properly, takes time… and it can certainly ruin your golf season if it’s not caught early.

What causes elbow tendonitis? We know that technically, it’s inflammation of tendons in your elbow. But what leads to that in the first place? Often weakness in your mid-back and shoulders along with mobility restrictions in your wrists. Your elbow is significantly influenced by what happens above and below it. If your mid-back and shoulder area are weak, the rest of your arm won’t feel supported and your elbow can get overworked. If your wrist is tight and immobile, your elbow will be forced to move more than it should, especially through a golf swing. This will cause extra stress on your tendons and eventually result in tendonitis. The best way to prevent this from happening is to make sure you’ve got adequate mobility in your wrists, and good strength in your mid back and shoulders.

Back Pain

One of the most common ways to hurt your back is with repetitive flexion (bending) and rotation (twisting). Well, what does a round of golf consist of over and over? Repetitive bending and twisting! Every time you swing that golf club, you’re putting your spine through one of its most stressful positions. And if it’s not prepared — it’s going to get injured.

One of the best ways to prepare your spine for a long and healthy golf season is to avoid a lot of sitting and keep it mobile. Sitting for prolonged periods makes your back more susceptible to injury in general, but especially if you’re going to be doing a lot of bending and twisting. Interrupting your sitting frequently during the day is a very easy way to minimize its harmful effects. 

If you lack adequate mobility in your spine, it will feel strained every time you try and swing your club. When you overstress a joint that is stiff, the muscles around it tend to tighten up and spasm in response. It’s important that you take time to optimize and maintain your best spinal mobility for golf season. This will significantly help to decrease the stress that occurs in your spine when you swing in one direction repetitively, and ultimately help you prevent a back injury.

Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints. If you lack adequate mobility or stability in and around your knees, you’re going to have problems. Much like the elbow, the most common source of knee pain I see in my golfers comes from the joints above and below, and not from the knee itself. To keep your knees mobile and healthy and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as stability in your feel and ankles. 

The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees will want to try and help, and they are not designed for this. Your knees need to be loose and free during a golf swing. If not, the muscles and ligaments around your knee joint will take on unwanted stress. 

Another cause of unwanted stress to your knee joint is lack of support from your feet and ankles.

Your knees need a stable foundation if they want to bend and twist without stress. If stability below is lacking, your knees will tighten up in an effort to compensate. Moral of the story: make sure you’ve got mobile knees, a strong core and hips, plus stable feet and ankles, so that knee pain doesn’t derail your golf season.

Hopefully these tips help you understand why golf injuries happen and most importantly, how to prevent them. If you’re feeling stuck and looking for individualized expert help – request a FREE Discovery Session. We look forward to speaking with you!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

Tips to Fix Morning Back Pain

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Morning Back Pain? Things you can do.

One of the most common complaints from chronic back pain sufferers is back pain first thing in the morning.

For some folks it rears its ugly head on occasion and appears out of nowhere – as if they’ve thrown their back out. For others it’s like ground-hog-day – they go to bed feeling great but wake up every morning feeling stiff and achy. 

Why does this happen? Shouldn’t your back feel better after a good night’s sleep?

Back pain impacts people in different ways. Both the location of your pain as well as the time of day you feel your worst can be indicators of where your back pain is coming from and what’s going on.

Some of the most common causes of morning back pain include:

  1. Poor sleeping position
  2. A crappy mattress
  3. Bulging discs

Let’s go through each one and talk about tips to help morning back pain.

1. Poor sleeping position

The sleeping position that aggravates you is going to depend on the underlying cause of your back pain. Sometimes sleeping on your back with legs elevated is what makes your back feel worse in the morning – even if it feels amazing while you’re in this position.  For others, sleeping on their stomach is the thing that wreaks havoc on their spine. 

The most back-friendly position is to sleep on your side. Side-sleeping allows you to put your spine in a neutral position – which is where you get in the least amount of trouble.

It’s really challenging to achieve a neutral spine when you’re on your back or stomach.  If it bothers your hips or shoulders to sleep on your side – I recommend placing a pillow under your waist as well as your head – and if needed – also one between your thighs.

2. A Crappy Mattress

Over the course of my career, I’ve probably been asked at least 1000 times what the best mattress is to sleep on. The answer is “it depends”. Your most important concern should be to find a mattress that you feel comfortable on and that gives you the best night’s sleep. This is different for everyone. Some prefer soft and plush, while others prefer firm and supportive.

But here’s the thing – if you don’t have an underlying back problem then the surface you sleep on will be irrelevant. In most cases, I find that when a mattress aggravates your back, it’s a sign that you’ve got a back problem brewing that needs some attention.

That being said – for those that do suffer from generalized, chronic back pain – a firmer, more supportive mattress is going to be your best bet.

3. Bulging Discs

This is the most common reason I see for morning back pain.

Your vertebral disc has three primary functions:

  1. Absorb shock
  2. Help hold the vertebrae of your spine together
  3. Contribute to the mobility in your spine

The interesting thing about vertebral discs is that they are made up primarily of water.

Over the course of a normal day – and over the course of life – your discs will compress and decrease their water content. At night, your disc literally re-hydrates and can gain up to 17-25 mm of height. While this may be beneficial to someone who’s arthritis is to blame for their back pain, it is not beneficial for someone suffering from a bulging disc.

Remember when I mentioned that your disc is partially responsible for mobility in your spine? When you have a building disc – that bulge restricts your mobility. If it fills up with fluid overnight – you’re going to wake up feeling a lot more restricted and in a lot more pain.

Unfortunately, there is no quick fix I can reveal for you on this one. The best advice I can give you is that if you’re waking up every morning in a lot of pain and you’re afraid to move – there’s a good chance you’re suffering from bulging discs, and you should see someone who can help you with this.

If you’re waking up every morning with back pain…

then hopefully this information helps you have a better understanding as to why it might be happening. Although a crappy mattress could be the reason, I caution you not to default to that. More often than not, there’s an underlying problem in your back that needs to be addressed.

But the good news is that 80% of the time there is a natural, movement-based solution that can address your back pain successfully without relying on pills or procedures.

Are you experiencing back pain and looking to get help without pills or procedures?

Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.

 

 

Why Strengthening Your Core Could Be Hurting Your Back

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As you probably already know, we specialize in back pain and core strengthening via Pilates…

So why on earth then – would we be writing about how strengthening your core could actually be hurting your back instead of helping?

One of the number one reasons people come to see us is because they want to strengthen their core – in hopes that it will put an end to their back pain.

But here’s the thing about core strengthening and back pain…

In most cases, it will make you feel better and possibly even take away your pain. But there are many times when going to core strengthening first is not right for your back, and can actually make it worse.

The biggest misconception I see when it comes to getting rid of back pain is that if the pain is gone – the problem is gone.

NOT TRUE!

And this is where people can get in trouble. If they try to strengthen their core too soon, back pain will come back with a vengeance.

Here are a few ways to tell if strengthening your core could be hurting your back instead of helping…

 

1. You feel stiffer after workouts.

As I mentioned previously, the absence of back pain does not mean you have addressed the root cause of your back problem. This is especially true if you’re prone to “throwing your back out” year after year.

One of the precursors to a full-blown back pain episode is stiffness.

If you find that your spine feels more stiff after your core strengthening routine, it could be a sign that you are aggravating your back instead of helping it. It’s only a matter of time before you wake up one morning stuck in pain and unable to move.

In our office, whenever we transition our clients from back pain treatment to our Pilates program, we teach them how to self-assess and check their spines.

This allows them to know if the core strengthening being done in Pilates is starting to aggravate them for some reason. If their self-assessment reveals a stiffening back, they know how to correct this before it turns into pain, allowing them to quickly get back to strengthening without skipping a beat.

2. Your neck hurts

I’ve spoken about this before, but increased neck pain or tension during or after core workouts is typically a sign that you’re not activating your core properly.

If you’re trying to work your core to recover from back pain, this could be a big problem for you. It’s only a matter of time before your back pain returns.

When you don’t know how to activate your core properly, you aren’t able to properly control pressure and tension in your abdomen. And you likely have difficulty controlling and coordinating your breath. When this happens, you can end up with unwanted pressure in your lower back every time you work those abdominals. This will eventually result in back pain.

This is one of those cases where core strengthening could be the right thing for your back, but you just aren’t doing it at a level that is appropriate for you.

Learning how to activate and build your core strength the right way is important all of the time – but it’s critical when you’re recovering from back pain.

3. Your hamstrings are sore and achy

A good core strengthening program targets more than just your abs. You should be strengthening your hips, glutes, and hamstrings as well.

While it’s normal to have some soreness after a good workout, when it comes to back pain, it’s important that you know the difference between muscle soreness and pain caused by nerve irritation.

Where you feel your pain and how it behaves is one of your best clues.

Let’s say that after a good Pilates session you notice soreness in both of your thighs and hamstrings the next day. This is typically considered “good” soreness. It’s symmetrical, feels better when you stretch, and likely subsides in 2-3 days. The more you work out, the less this soreness seems to occur.

But let’s say you feel an ache or a pull-down only one of your hamstrings after a Pilates class. You stretch and it doesn’t help. It possibly even aggravates your leg. You rest, the pain goes away, but then comes right back after your next workout.

This could be a sign that your core strengthening routine is causing irritation to a nerve in your spine.

If you don’t address the irritation, your leg won’t feel any better and your back will start to hurt as well.

Plus, if you feel pain or soreness anywhere in your body after a workout, it’s important that you learn to recognize the difference between good and bad pain so that you can correct problems before they happen.

Looking for ways to safely strengthen your core?

Our At Home Pilates 101 Get [Your] Back to Health program might be perfect for you, to apply and learn more CLICK HERE! We’d love to have you start your Pilates journey with us.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.