Common Golf Injuries and How to Avoid Them

Golf season is officially here in New England. And there is nothing worse than an unexpected injury ruining your season.

Just this week, we’ve had some of our regular clients requesting extra “tune-up” sessions — just to make sure their body is ready for golf. After working with us for a while, they know that preventing injuries is far easier than rehabilitating injuries. And the last thing they want is for any kind of pain or injury to get in the way of what can often be a very short golf season around here.

With that said, I thought I’d go over with you some of the most common golf injuries we see and how 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 to understand why golf injuries happen and most importantly, how to prevent them. If you’re feeling stuck and looking for individualized expert help – sign up for a FREE Discovery Session right here. We’re happy to help!

Could your Hamstring Strain Actually be a Back Problem?

Have you ever strained your hamstring but the pain just doesn’t go away?

It’s been months since you first started hurting, you can’t actually remember how you injured it (it just started aching one day), you’ve been stretching and massaging it diligently, yet your hamstring still hurts.

This happened to a recent client of ours (“Sandy”).

Sandy was a runner and regular gym goer, who one day noticed an ache in her hamstring. She assumed she had just overdone it working out. She rested it a few days and the pain went away, but when she tried to get back to running she couldn’t. Her hamstring pain came right back. Thinking she hadn’t let it heal enough, she went back to resting it, but this time, decided to add some massage and stretching to her routine. 

A few weeks later… you guessed it… Sandy still couldn’t run.

She also noticed the pain in her hamstring started to feel “different.” It was becoming more deep and achy and started to hurt all the time instead of only when she tried to exert it. It even hurt when she sat for too long. She still couldn’t run and was starting to get worried. Her doctor told her it was just a “strain” and that she had to let it heal. The problem was that it wasn’t healing. Several months had now gone by and she was running out of exercises and stretches to try that would “let it heal.”

Luckily, Sandy attended our recent back pain and sciatica class and realized that the pain in her hamstring might not be a strain at all. 

And her instincts were right! Let me explain.

When you truly strain a muscle, it means you have done damage to your muscle tissue. Although it’s possible to have chronic problems from a strain that isn’t rehabilitated properly, strains typically do in fact heal. Once the inflammation from the tissue damage goes away, and you start doing the proper stretching and strengthening, your muscle eventually gets back to normal. Until a muscle strain is fully healed, it will typically be aggravated if you accidentally over-stretch it or exert it. But you usually don’t feel anything when you’re resting the muscle. In Sandy’s case, her hamstring was starting to feel worse when she was resting — the longer she sat, the worse she felt. Your hamstring is completely relaxed when you are sitting, so something wasn’t adding up.

This was the first sign we were likely dealing with something other than a “hamstring strain.” The second sign was that we could take her pain away by moving her back! Yes, you heard that right.

By moving and stretching her back in a specific way, we were able to significantly relieve the pain in her hamstring.

The reason her hamstring was actually hurting was because a nerve had been aggravated in her back. The nerve was causing pain to radiate into her thigh. That’s why it hurt when she sat for too long and it’s why she couldn’t tolerate any running. Sitting puts more stretch and pressure on the nerves in your back, and running puts a lot of compression through your back. Generally speaking, nerves don’t like to be stretched, especially aggravated nerves, and they don’t like to be compressed if they are aggravated either. By stretching her back in a very specific way, we were able to relieve the pressure from the nerve that was giving Sandy her “hamstring strain.” This confirmed that she was indeed having a back problem.

Has anything like this ever happened to you?

If you’ve got pain anywhere in your buttocks, hip, thigh, or leg that isn’t going away — especially if you’ve done your due diligence and tried all the “right things” — it’s possible you could have a back problem causing this pain instead. These types of back problems are easily missed if you don’t know how to accurately assess them and it won’t be picked up by an MRI or X-ray. The best way to figure this out is through specialized movement testing, like we did with Sandy. 

We talked all about this in our recent back pain and sciatica class. If you want access to the recording, just call our office: 603-380-7902. If you want to take the next step and meet us in person — you can schedule a FREE Discovery Session with one of our specialists right here

The Location of Your Pain may NOT be its Source…

One of the most confusing topics we deal with in our practice is pain. And there’s lots of advice out there on what to do about it…

Should you rest or move? Apply heat or ice? 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, but it’s actually coming from your back, the best knee treatment in the world is not going to fix it.

Inaccurate diagnosis of pain is a BIG reason why so many people suffer longer than they need to, and undergo unnecessary surgeries.

You must accurately determine the source of your pain for treatment to be effective, and the location of your pain alone is not a reliable way to do that.

For example, I’ve seen people in my office with what they think is unrelenting tennis elbow, only to find out it was actually a problem in their neck causing it. I’ve seen people disappointed after a failed knee surgery, because the problem was never in their knee and actually coming from their back.

Isolated extremity pain (knees, elbows, shoulders) is one of the most misdiagnosed problems we see in our office.

A recent study by Richard Rosedale, et al. in the Journal of Manipulative Therapy investigated this – and it was found that over 40% of people suffering from isolated extremity pain actually had a spinal source of symptoms.

In other words, their extremity pain was actually coming from their neck or back.

I can’t tell you how many times we’ve seen folks with unexplained shoulder pain lasting months or years get better as soon as we begin treating their neck, even though they never had neck pain.

Same for knees…

It’s possible to have knee pain that is caused by your back, without ever hurting your back!

Confused? I don’t blame you.

But more importantly, how do you 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, knee or foot pain – and you don’t ever recall 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 your doctor will order an MRI when you’ve got isolated knee or shoulder pain that won’t go away. And if you’re over 40 years old, the MRI will almost always show “something” – a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

Remember that these are normal signs of aging in everyone, and may not be the cause of your pain.

If you haven’t already had your spine checked properly as a possible source, you can’t rely on these findings (or the location of your pain) as an accurate diagnosis. That is how people end up having surgeries they don’t really need.

Whenever someone comes into our office with isolated extremity pain, we don’t even look at it without an exam of their neck and back first.

By moving your spine repeatedly, and in certain directions, we can often produce – or take away – the pain you’re feeling in your knee or shoulder.

Why?

Because if the pain in your extremity is caused by a pinched or aggravated nerve, moving your spine around is going to influence that, and tell us where the source really is.

An MRI and X-ray won’t be able to determine this for you with certainty – because sometimes your nerve only gets irritated when you move a certain way – or when you’re in a certain position. Since MRI’s and X-rays can’t see what’s going on while you’re moving, you can’t rely on those tests alone to tell you exactly where your pain is coming from.

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 that out first.

Specialized movement exams like we do in our office are one of the most reliable ways to figure this out. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, CLICK HERE to request a Free Discovery Session with one of our specialists.

How to Keep Knee or Back Pain from Derailing your New Year’s Goals

More than ever right now, people are excited to move on from the strange year that was 2020. And for many, one of the ways to get on with 2021 as fast as possible is to focus on some New Year’s goals! The most popular goals for the New Year continue to revolve around weight loss and exercise. But here is one thing that can get in your way when pursuing those goals… unresolved back or knee pain. So many people make the mistake of thinking that exercise or weight loss alone, is going to “cure” their nagging pain. But that’s not always the case. 

Here are some top tips and advice I give all my clients around this time of year to help you get the most out of your health and fitness goals for 2021, and NOT let something like back or knee pain get in your way…

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 (and 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.

Pace yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember, the tortoise won the race, not the hare. 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.

My general rule of thumb is to monitor your soreness on a scale of one to ten. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise we haven’t tried in a while. If you find that your pain level goes above a six, 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 to you, enlist the help of experts like us!

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. A good place to start when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

Get assessed by a movement expert

If you’ve already got some nagging back and knee pain, do yourself a favor and get assessed by a movement expert FIRST, before you begin your new exercise routine or New Year’s goal. Your first thought might be to go see your medical doctor, which of course isn’t a bad idea, but it’s important you understand how different medical professionals look at you when you have knee or back pain.

Medical doctors are trained to screen your whole body and spot for serious problems. If you see them for musculoskeletal pain, they will typically take X-rays and MRI’s to make sure there are no broken bones or serious pathologies. They do not have extensive training to assess how your pain behaves during movement or exercise, which is the majority of people’s problems. That’s where we come in.

A specialty practice like ours will be able to assess your movement in detail, through various movement tests, which will tell a much better story about how your pain may or may not impact the new exercise or weight loss program you’re about to start. Plus, once we know how your pain behaves, what the triggering patterns are, we can also teach you how to control it – so that you don’t have to let nagging back or knee pain derail your 2021!

I hope your New Year is off to an amazing start, and if you want to ensure that back or knee pain doesn’t get in the way of that, reach out for a FREE 30 minute Discovery Session. We would love to talk with you about your goals and be part of your support team as we all launch into 2021!

 

 

Considering Back Surgery? Read this First

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. The worst part — it turns out only 5 percent of these people actually need back surgery. And for many folks — the pain just ends up coming back.

So why are we spending so much money on back surgery when the majority of people don’t actually need it?

First of all, back pain is not fun. It can be excruciating, debilitating, and can have a significant impact on your life and happiness. If you’re told surgery will fix your problem (and it often does take your pain away in the short-term), why wouldn’t you choose this option? 

Well, if you knew the facts, you might be willing to hold off on a surgical “quick fix” and investigate options that are less risky. The research shows over and over that 80% of the population suffers from “non-specific low back pain,” meaning, it’s not from something structural like a tumor, broken bone, or deformity. The research also shows that non-specific low back pain does NOT benefit from surgery! The better solution for the majority of back pain sufferers is correctly prescribed movement followed by regular exercise to maintain your strength (especially your core) and postural endurance.

So again, why are we spending so much money on back surgery when the research and data clearly show it’s not the best course of action for the majority of back pain sufferers? 

There are a few reasons. First, most of the time we just don’t know any better.

Back pain is typically diagnosed with imaging (X Rays and MRI’s). Although these highly specific tests are critically beneficial after a major trauma or accident, or when you suspect something more serious is going on (like a tumor or broken bone), they are not the best way to diagnose non-specific low back pain. That’s because these tests are designed to show you everything – including all the normal, age-related changes that occur in your spine such as arthritis, degenerative discs, stenosis, and even bulging discs.

The truth is that 60-80% of people walk around with these findings in their spine all the time and have absolutely zero pain.

That means that your back pain is likely coming from something else, typically, a bad movement pattern or habit. Poor posture and movement habits can exacerbate a bulging disc or stenosis, and this is where the confusion comes in. Surgically “fixing” your bulging disc or stenosis will not correct your poor habits. That’s why so many people suffering from back pain get surgery only to find their pain comes back several months or years later. What you need to do is find the true cause of your low back pain and attempt to address that first before ever considering something like surgery.

The second reason back surgery is so common and over-prescribed is because it does a great job at taking pain away quickly where conservative therapy often fails. Conservative therapy really can help you get rid of back pain and keep it gone – but it has to be done correctly. And sadly, there are many well-meaning therapists, trainers, and movement professionals out there that lack the expert knowledge to get it right. If you don’t get the correct conservative treatment for your back pain, you’ll assume it didn’t work, and will be more apt to get surgery.

So how do you know you’re getting correct and effective conservative treatment? Quite simply, it will work, and fairly quickly! 

Remember, 80% of all low back pain responds to the right conservative treatment. You’ll notice obvious improvement in your back pain within 2 weeks. If you fall into the 20% where conservative treatment doesn’t work as well, it will be pretty obvious to a back pain expert almost immediately. In our office, for example, we have special movement screens and tests that we perform on everyone to determine if you’re in the 80% or the 20%. If you fall into the 20%, we know right away and can send you to your doctor, or a surgeon, for one of those highly specific tests to see what’s really going on.

The take home point is this: If you currently suffer from on and off back pain, have tried every treatment you can think of, and are just tired of it because it really hurts – I completely understand why back surgery would be an attractive option for you right now.

But please consider the facts and research first before you make the decision to go under the knife. Back surgery has its risks, and there is no going back from the unimaginable happening. If you have back pain that you’re ready to solve for good — sign up for a FREE 30 minute Discovery Session with one of our specialists today! 

 

Five Easy Ways to Keep Active and Moving this Thanksgiving

Thanksgiving might look a lot different this year, but that doesn’t mean you can’t find ways to stay active during the holiday. And if you suffer from back or knee pain, it’s especially important to find ways to keep active and moving. Our spine and joints don’t like to be sedentary for prolonged periods. That’s especially true if you have arthritis. You may not notice any pain while you’re sitting or relaxing, but you WILL pay for it the next day. 

Here are five very easy ways to keep active and moving this Thanksgiving:

1. Interrupt your sitting.

This is quite possibly the easiest and most effective strategy to minimize pain and stiffness in your back and knees. I give this tip out all the time, not just for Thanksgiving. Our bodies were not designed to sit for prolonged periods, so getting up frequently (I recommend once every 30 min) keeps your knees, hips, and spine from getting painful and stiff. 

2. Do a Turkey Trot!

Thanksgiving Turkey Trots are a tradition for many. But just because races aren’t happening live and in person this year, doesn’t mean you still can’t get out there! Plus, many of these popular events have switched to virtual and have arranged ways for people to still participate but on their own time, and socially distanced. Turkey Trots are typically 5K’s – or 3.2 miles – so grab your dog, headphones, or favorite podcast or audiobook and start your morning off right. Whether you walk or jog, it will feel great to get your Thanksgiving Day started with lubricated joints and blood flowing. 

3. Stretch during Commercials.

Yes – the Macy’s Day parade is still happening (on TV only) and there will of course be football. A very easy way to keep yourself from sitting or slouching too much because you’re watching TV is to get up during commercials! I literally teach my clients to do “TV exercises”. Choose some very easy stretches or mobility exercises to do during the commercial breaks. It’s the perfect opportunity to do a quick 2 min exercise or stretch.  It doesn’t have to be complicated. Choose from a quick set of squats, some heel raises, a set of planks, or back stretches on the floor or in standing. You can alternate through these during each commercial break.

4. Walk for Dessert.

Just because you did that Turkey Trot in the morning doesn’t mean you have to be done for the day! Skip the dessert (maybe) and go for a nice easy walking stroll after dinner. Walking is one of the best exercises you can do. And it gives you many of the same benefits of running (only slower). Walking is very functional, and it’s good for your hips, back and knees. Since we tend to sit and bend so much during the day, walking is a very natural and active way to get some much needed lengthening and stretching into our bodies. Plus, it can’t hurt to work off some of those Thanksgiving calories!

5. Help with set up and clean up.

You may not like this tip, and your kids and grandkids might fight you on it, but it’s another easy way to keep moving on Thanksgiving Day. If you’re suffering from back problems, be careful bending and repetitively leaning over when you’re collecting or setting dishes down. And watch your posture when you’re cleaning dishes or loading the dishwasher. An easy fix for this, and a great way to protect your spine from the harmful effects of too much bending, is to remember to stand up straight and stretch backwards often and frequently whenever you’re doing an activity that requires a lot of bending forward. And remember to bend from your hips and knees instead of curving over from your spine.  And of course, if your back is so bad that it prevents you from being able to help clean up, or do any of the other activities I mentioned in this article, please reach out! 

I hope you enjoy your Thanksgiving, and that these tips help to give you some easy, practical ideas to stay active and moving!

Got a Pain in Your Butt? Here’s what to do first.

Nobody likes a “pain in the butt.” But what do you do when you’re dealing with literal pain in your butt versus the figurative kind?

It starts with figuring out where it’s coming from. Understanding the origin of your pain is necessary if you really want to solve it! One of our Pilates regulars (“Stacy”) has a story that illustrates this concept perfectly.

Stacy had been doing all the right things. She keeps active, does Pilates with us, and walks regularly. But still, she ended up with that dreaded pain in her butt that so many of us deal with on a regular basis. She tried to work through it herself by foam rolling and stretching – but none of that worked to completely eliminate her pain. Plus, her symptoms were starting to limit her Pilates and walking. This made her nervous because staying active and mobile is one of the most important things to Stacy, and the idea of being stuck at home and in pain this winter season made her want to take action now. She did the right thing by going to see our PT team.

Their first course of action was to accurately determine the root cause of Stacy’s butt pain. It could be a few different things.

Most often, symptoms like Stacy’s will get “labeled” generically as any one of the following:

1. Bursitis

They’ll call it this if you’re feeling the pain more in the side of your hip versus center of your butt.

2. Piriformis syndrome

This refers to a pain in the center of your butt. You might feel some tightness as well.

3. Back problem/Sciatica

They’ll call it this if your pain is more diffuse and achy, and perhaps even running into your thigh. This last diagnosis will be more common if you’ve got back pain along with the hip or butt pain.

As I mentioned, any one of these things could be the source of Stacy’s symptoms, and getting it right is critical. The correct diagnosis is the determining factor of whether Stacy’s problem gets resolved for good, or becomes something she deals with for the rest of her life. The problem with diagnosing your butt pain (or any problem for that matter) based on the location of your symptoms alone is that it’s not a reliable diagnosis.

The location of your pain alone does not tell you where your problem is really coming from.

For example, I’ve seen people with pain in their hip and butt that is actually coming from their back – even when they’ve never had a back problem. If your butt pain is coming from your back, and you think it’s “piriformis syndrome,” you’re going to be really disappointed in a few weeks when your pain is still there (or perhaps even worse) because you’ve been going about treating it the wrong way. In order to accurately determine what was really going on with Stacy’s butt pain, we needed to do some specialized movement screens and tests.

Research has shown that your pain’s response to movement, and how it behaves, is a much more reliable way to figure out the source of your problem versus relying on the symptom location alone.

In Stacy’s case, some quick movement tests revealed that her butt pain was indeed coming from her back – even though she did not have any back pain. How did we know? Pretty simple actually. When we asked Stacy to move and bend her back in specific directions, it triggered her butt pain! Her piriformis muscle was also tight – and may still need to be stretched – but it’s very possible that the tightness she is experiencing is also being caused by whatever is going on in her back. It’s possible for nerves to refer both pain and a feeling of “tightness.” We’ll know for sure in a few weeks, because we prescribed Stacy a corrective exercise designed to target the problem in her back and take pressure off the nerve that was triggering her butt pain. In fact, if she had not come to see us and kept stretching what she thought was a tight piriformis, she likely would have aggravated her nerve and made her condition worse. Nerves don’t like to be stretched. This is a great example of why it’s critical to know the true source of your problem before you start treating it.

Hopefully Stacy’s story helped you understand that the first step in getting rid of a pain in your butt, is to accurately determine where it’s coming from! If you’re experiencing unexplained pain in your butt that isn’t going away with stretching or general exercise, perhaps you’re going after the wrong problem. Try paying closer attention to how your symptoms behave. Do you notice they get worse after you’ve been sitting for a while, raking leaves, or driving? Do they move around on you – and go from your butt, to your hip, to the back of your thigh?

Signs like this could mean you’re dealing with a back problem, not a butt problem. Click here for access to our FREE back pain guide! This guide contains our best tips and advice on how to start easing back pain and stiffness right away — and get on the road to pain-free movement just like Stacy did.

Is Shoulder Pain “Impinging” on Your Lifestyle?

If you’ve ever had pain in your shoulders when you try to raise your arms overhead, pull off a sweatshirt, grab a gallon of milk from the fridge, or place grocery bags on the counter, you were likely dealing with shoulder “impingement syndrome…” otherwise known as “rotator cuff impingement” or “rotator cuff tendonitis.”

They call it “impingement” because your rotator cuff tendons get pinched between the round head of your shoulder bone and a hook-shaped bone in your shoulder blade called the acromion.

The pinching tends to happens every time you raise your arm above ninety degrees. After a while, the pinching eventually irritates your tendon, resulting in pain and inflammation. These symptoms are exacerbated and pronounced with any arm movements above shoulder height. Most of the time, the root cause of this problem has been there for a long time, but it’s only just now manifesting itself as pain — and this so-called “impingement syndrome.”

So what causes your rotator cuff tendon to get pinched or impinged in the first place?

Most of the time, the answer is POSTURE.

If your upper back is stiff, curved, and lacks adequate mobility, it’s going to impact how your shoulder blades move and position themselves. With a stiff and curved upper back, your shoulder blades will respond by moving out and up. This scenario makes that hook-like bone (the acromion) sit more forward and more down than it should. When this happens, there isn’t enough room for your tendon when you lift your arms above shoulder height. The bony surfaces above and below your tendon create friction, and this eventually turns into pain and inflammation.

The tempting and easy “fix” is to get a cortisone shot or attack the inflammation more conservatively with ice and topical anti-inflammatory agents.

But what you need to understand is that in most cases, “impingement syndrome” is actually the SYMPTOM. The root cause is usually coming from immobility and poor movement patterns in the upper back or neck. If you really want to get rid of your shoulder pain, get back to lifting and carrying things without any worry, and have full and free mobility of your arms, it’s essential that you identify and address the root cause and not just the symptoms. Since there is an 80% chance your shoulder pain is a mechanical or movement problem — the best people to examine and address this FIRST are movement experts like us.

So moral of the story… next time you go to the doctor complaining of shoulder pain and you hear the words “impingement syndrome” or “rotator cuff tendonitis” — don’t assume you need a cortisone shot or surgery to fix it.

Neither of these solutions will likely give you the long-term solution you’re looking for. The very last thing you want to do is get some kind of procedure or surgery that either masks the pain or corrects the wrong problem. You want to do everything possible to preserve the integrity of your tendon, and the best way to do that is by optimizing mobility and using natural movement and strength training prescribed by movement experts.

Interested in seeing if physical therapy could resolve your shoulder pain? Try a FREE Discovery Session on us. This is a chance for you to speak with one of our specialists, tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

Tight Hamstrings: a Case Study

If you’ve ever felt tightness in your hamstrings, the typical advice you get from friends, family, and even well-meaning health and wellness professionals is to stretch them.

Well… if it’s just your hamstring that’s actually tight then this might be good advice to follow.

But what if it’s something else?

If you accidentally stretch a hamstring that feels “tight” due to a back problem – there is a very good chance you’ll make your condition worse.

This exact scenario happened to a recent client of ours (we’ll call him “Jack”) who came to us with what he thought was a “hamstring strain.”

Jack had been stretching and stretching his hamstrings – which he had been told to do by his chiropractor – but he wasn’t feeling any looser. In fact, his hamstring even started to hurt the more he stretched, so he thought maybe he caused himself a strain.

Was he doing too many stretches? Or perhaps doing them incorrectly?

He made the smart decision to call us for help and came in for an examination.

And the first thing we asked him was…

“Where is your pain?”

Jack pointed to the back of his leg, but when he started describing his symptoms… it turned out they actually started in his butt, traveled down the back of his thigh, and stopped at his knee. But on occasion he’d also feel the tightness in his calf. And since doing all that hamstring stretching, he was even starting to feel pain!

Lesson number 1:

Your hamstring starts at your ischial tuberosity – otherwise known as your “sit bone” – and extends down to just below your knee. Since muscles and joints can’t actually refer symptoms (only nerves and sometimes fascia can do that), feeling pain or tightness anywhere other than your actual hamstring is the very first clue you could be dealing with something other than a hamstring problem.

Since Jack was feeling symptoms in his butt and also down into his calf, we knew immediately that “hamstring strain” was NOT Jack’s problem.

The next step was to figure out where his tightness was coming from.

Lesson number 2:

Since he’d been stretching for several weeks already and was starting to feel more problems in his leg – the likely explanation was that it was coming from his back.

While yesm over-stretching can make you sore, and yes, stretching incorrectly can cause you discomfort… that wasn’t the case with Jack. He was still feeling tight, and now on top of that he was dealing with pain.

All signs were pointing to a problem in his back.

Well now that we had our theory – it was time to test it!

After performing several movement tests with Jack’s back, we were able to produce the exact same tightness AND pain he had been feeling in his leg. And with some different movement tests we were actually able to ELIMINATE his symptoms temporarily.

Since moving his spine in certain directions was responsible for both turning “on” AND turning “off” his leg symptoms, we were able to confirm that he had a back problem – not a hamstring problem.

Pretty cool – right?

Jack thought so… but more importantly… he was glad to finally have some answers! Finally, he had a plan to move forward.

  1. He stopped stretching his hamstring.
  2. He started doing a different – and properly prescribed movement instead – that was designed to eliminate the symptoms in his leg.

We’ll of course need to continue working with Jack to make sure that his leg symptoms not only go away – but that they stay gone. Part of the process will be teaching Jack how to do this on his own in case the problem ever comes back again.

Sadly, I can’t tell you how many times I’ve seen a case like Jack’s in my office.

Lucky for Jack, he came to us early on – when his symptoms were mild. Basically, the nerves in Jack’s spine were starting to get irritated, and the result was a “tight” feeling in his hamstring. Nerves don’t like to be stretched, so Jack was actually making his problem worse by stretching and he didn’t even know it. Had he not gotten this addressed – the tightness in his leg could have progressed into full blown sciatica!

If you have any kind of ache or pain that isn’t going away on it’s own with natural movement or stretching – don’t try to figure it out on your own.

And as you learned from Jack’s case – not all movements are created equal. It’s possible you could look up a stretch on Google or YouTube and actually make yourself worse!

Don’t guess… TEST 🙂

And when it comes to pain during movement or certain activities – let the movement experts be the ones to test you and figure it out. All you have to do is click here to schedule a FREE, no-obligation consultation with one of our specialists! These Discovery Sessions are your chance to determine where your pain, tightness, or stiffness may be coming from and if we’re the right people to help fix it.

When Traditional Physical Therapy Fails…

I’ve been a physical therapist for a very long time — 20 years to be exact — and I’ve seen a lot of changes in healthcare over the course of my career. One of the biggest (and saddest) changes I’ve seen in my field is the overcrowding of clinics. As reimbursements from insurance companies go down, traditional physical therapy clinics have been forced to increase their patient volume. That means you rarely get to spend time with your therapist, and your treatment sessions consist of repetitive exercise sets that you typically can do at the gym or on your own.

If you do manage to get some one-on-one time with your therapist, whether it be for hands-on-care or actual consultation about what’s going on with you, it’s often just a quick 20 minutes. The rest of the time, your poor therapist is usually held hostage by a computer because of all the documentation requirements placed on them, and you’re left on your own doing all those exercises.

Has this happened to you?

With this model of care, it’s impossible for the quality of your treatment NOT to suffer. Many folks I speak with say that traditional physical therapy is a “waste of time.” 

Why bother going when they can do everything on their own at home?

Worse, when traditional physical therapy does fail, most people go back to their doctors hoping for a different solution. Many times, the next step for these folks involves unwanted procedures, pain pills, or surgery.

So what do you do if you don’t want to go down the medical route of procedures or surgery, but the “physical therapy” didn’t work?

Well first, you need to understand what physical therapy actually is, seek that out, and don’t settle for anything less.

Physical therapy is NOT just a bunch of general exercises or ultrasound — at least it’s not supposed to be. After your pain is gone and your problem has been resolved, the role of general exercise is to keep your pain gone, and to continue optimizing your strength, performance, and mobility. That’s what we use our Pilates program for.

When you receive proper physical therapy in the way it was intended, it looks something like this…

Your therapist will first give you a proper examination and an actual diagnosis. Your physical therapy diagnosis might be different than your medical diagnosis. In fact, it should be. For example, you may come to us with a diagnosis of “bulging disc,” but our job is to figure out WHY your disc is bulging. Our diagnosis is going to be related to the specific movements, habits, and musculoskeletal deficiencies that led you to having that problem in the first place (discs don’t just bulge spontaneously). Once we know that, we can come up with a plan for you.

Here’s an example…

Let’s say your bulging disc is due to poor sitting posture, a weak core, and poor mobility in your spine. When your spine doesn’t move well and you sit too much, compensations like bulging discs can occur. Your plan might then consist of strategies for better, less painful sitting postures, as well as some help getting your spine back to full mobility again — so that your bulging disc no longer irritates you.

At this stage in your treatment, any “exercises” given to you should be corrective, very specific to your problem, and should be prescribed specifically to you.

There should be nothing cookie-cutter or general about them — and they should be working!

When you have the right “movement prescription” and when your exercises are corrective versus general — your pain goes away, your problem gets resolved, and most importantly, you’ll know exactly why and can even replicate this on your own in the future.

Once this has all been achieved, THEN we can get you back to the fun stuff like exercises at the gym, Pilates, or yoga — the stuff that is designed to keep you feeling healthy, active, and mobile.

Getting rid of something like back, knee, or neck pain doesn’t have to be complicated. It doesn’t have to involve pills, procedures, or surgery. But it may require you to be a bit open-minded about HOW you receive physical therapy.

If you’ve had a frustrating experience with physical therapy in the past, don’t just give up!

Consider working with a specialist practice like ours that operates differently from traditional clinics.

Click here to request a Discovery Visit.

It’s completely FREE! A discovery session serves as an opportunity for you to “discover” what’s going on with your body and what we do in our practice. You’ll speak with one of my specialists, find out if we’re a good fit for you, and then get started on a path to natural recovery!