Back Pain

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

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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].

Man getting knee pain treatment

Four Reasons Your Knee Pain isn’t Going Away

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Approximately 25% of adults suffer from chronic knee pain and for many, they don’t have a clear reason or diagnosis as to why. They’ve been told to accept that their knee pain is due to arthritis, age, or wear and tear. So why then, are some people able to get rid of their pain with proper knee pain treatment while others continue to suffer? It starts with the correct diagnosis. And for many chronic knee pain sufferers, this is the problem.

Here are four reasons why your knee pain might not be going away:

 

1. Mobility Before Stability

I’m a firm believer in this concept.

Our joints function better when they have full and free mobility. With knees in particular, everyone tends to focus on how well a knee is bending, but a lot of people miss when a knee isn’t fully straightening. Most knees have a certain amount of what we call hyperextension.

For example, your knee might look and feel straight, but if it’s naturally capable of “over-straightening”, and you don’t restore that completely, your knee will have problems.

I see it all the time, especially in folks who’ve had previous knee surgeries. If their full knee motion wasn’t restored properly during rehab, or perhaps they didn’t have any rehab at all (common practice now after most arthroscopic knee surgeries), knee pain will persist, and won’t go away no matter how much you strengthen it.

This isn’t something that can be seen on an Xray or MRI. Only a trained expert who knows how to look for this will be able to detect it, teach you how to restore it, and finally help you get rid of your chronic knee pain.

2. It’s Really a Back Problem

When the source of your pain is truly coming from your knee, it tends to be pretty specific and very localized to the knee joint itself. But if your pain tends to move around your knee, or perhaps travel up and down your leg, there’s a good chance your knee pain is coming from your back.

A recent study found that 40% of all extremity pain (including knees) comes from a source in your spine – even when you don’t have any back pain.

How does this happen? Typically it’s due to an irritated nerve that sends pain primarily to your knee and nowhere else. If you’ve been treating your knee for months and it’s either not going away or perhaps getting worse, consider that your knee problem is not a knee problem. Get your spine checked by a proper movement/mechanical therapist who can screen for this and figure it out.

3. Poor Core Strength

Your abdominals, low back muscles, hips, and glutes all make up what we call your “powerhouse” or core.

We all know that a strong core is important to help prevent back pain. But, it’s equally important for healthy knees. If your core is weak, or doesn’t activate properly, it will have an impact on how fluid your joints will move during activities.

If you aren’t stabilizing yourself well with a strong core, your knees might try to help out by adding stability. Knees aren’t really meant to do this – they are meant to be mobile. But when your body lacks stability, your joints stiffen up in response, which can cause knee pain over time or aggravate arthritis that’s already there.

If your knees chronically ache – especially during activities – this could be why. You can treat your knees all you want, but if you don’t also address the deficits in your core, your knees will continue to hurt.

4. Stiff Ankles

When your ankles are stiff it will have an impact on your knees.

Do one or both of your ankles lack mobility during certain activities? Especially running, hiking, and squatting?  Your knees may strain themselves trying to help out and compensate.

Over time, this pattern will lead to knee pain. Do you notice a lot of stiffness in the front of your ankles? Or pain/fatigue in the front of your lower legs after repetitive walking or running? This could be a sign that the real problem is coming from stiffness in your ankles.

Stop working on your knees and start mobilizing your ankles instead. Your knees should start to feel better in no time. Knee pain can be tricky to figure out – especially if it’s chronic. Arthritis, age, and wear and tear aren’t common reasons for chronic knee pain. But they are definitely reasons that mislead people into thinking they’ve just got “bad knees”.

At least 70% of the time, knee pain can be resolved naturally and with movement – but you must make sure you’ve got the correct diagnosis nailed down first.

Want some help getting rid of YOUR knee pain?

Talk to one of my specialists for free by CLICKING HERE.

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

plantar fasciitis

Your Pain’s Location May Not Be Its Source

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Your Pain’s Location May Not Be Its Source

Pain is a confusing topic. And there’s lots of advice out there on what to do about it.

Should you rest? Should you exercise? Apply heat or ice? Do you see a doctor? Or let it go away on its own? 

Before you can even think about a solution to your pain, you must first accurately determine where it’s coming from. If you have pain in your knee, and it’s coming from your back, for example, the best treatment in the world isn’t going to fix it. Inaccurate diagnosis of pain is one of the biggest reasons why so many people suffer longer than they need to, and why they undergo unnecessary surgeries. You must accurately determine the source of your pain for treatment to be effective. And the location of your pain is not a reliable way to figure out where it’s coming from. 

For example,

I’ve met people who’ve suffered from unrelenting tennis elbow for years, only to find out it was coming from their neck. It’s why all the elbow and arm treatment in the world wasn’t solving their problem. I’ve met people who’ve undergone major knee surgery and it failed – only to find out later they never actually had a knee problem. Their pain was coming from their lower back – it just got missed – or was never even considered.

Isolated extremity pain (knees, elbows, shoulders) is one of the most mis-diagnosed problems in the musculoskeletal world. In a study published in the Journal of Manipulative Therapy, Richard Rosedale, et al found that over 40% of people suffering from isolated extremity pain had a spinal source responsible for their symptoms. In other words, the pain they were feeling in their knee or shoulder was actually coming from their back or neck (respectively).

Confused? I don’t blame you. But more importantly, how do you reliably figure out the source of your pain when it’s not always where you’re feeling it?

As already mentioned, the most common place for this to happen is with extremities.

If you’ve got shoulder, elbow, or knee pain, and you don’t recall having a specific injury to it, you must consider that it could be coming from your spine. There’s a 44% chance that it is. Where this gets really confusing is that typically, when you’ve got isolated knee or shoulder pain that won’t go away, your doctor will order an MRI. And if you’re over 40 years old, the MRI will almost always show “something”. It could be a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

What most people don’t realize is that these findings are quite normal and happen naturally as you age. Just because they show up in your MRI – doesn’t mean they are responsible for your pain. Despite studies showing this to be true, doctors continue to order these tests and rely on them to make important decisions about treatment. It’s how people end up undergoing unnecessary procedures or surgery.

Whenever I meet someone with isolated extremity pain, especially if it came out of nowhere, I always consider that it could be coming from their spine. How can you figure this out? Well, it’s challenging to figure it out on your own. But if you work with a movement specialist who understands this concept – you’ll be able to figure this out accurately. The basic premise is that if you can move your spine in specific directions – repeatedly – and influence the symptoms you feel in your extremity – then there is a very good chance your problem is coming from your spine. Or at the very least, your spine is involved. And whenever your spine is responsible solely or partially for pain elsewhere – and it’s ignored – your problem will persist and likely get worse over time. 

If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source.

That source could be your spine. And if you’re considering some kind of surgery or procedure, you definitely want to rule this out first. Specialized movement exams are one of the most reliable ways to figure this out – studies have proven it. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, look for someone who understands this and can give you a proper movement exam to accurately identify the source of your pain.

Ready to get help with your pain?

Request to speak 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 and writes for Seacoast Media Group.