Tag Archive for: back pain

How Ignoring Back pain could ruin your New Year’s Goals

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Now is the time when people shift their focus to the New Year and start thinking about new and exciting goals for themselves.

According to statista.com – the three most popular New Year’s goals are 1) doing more exercise and improving their fitness, 2) losing weight, and 3) saving money.

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

Let me explain.

Let’s start with doing more exercise and improving fitness. Most people think that if they start exercising more – especially their core – it will solve their back problem. Not necessarily. While the research studies show (overwhelmingly) that exercise is one of the best treatments for back pain – what they don’t reveal is that there are typically some key things that must be in place in order for exercise to be effective. For example, you must have good mobility before you start focusing on stability (or strengthening). If you’ve got a stiff back, general exercise could be all you need, and you’ll notice improvement. But you won’t know until you get going and by then it could be too late.

What if your back is stiff because it’s compensating for something – say a bulging disc or muscle weakness?

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

Say you want to lose weight. This is a fabulous goal. And if you’ve got back pain, losing weight will surely help. But once again, it’s critical to understand why you’ve got back pain in the first place. For example, being overweight is rarely the cause of back pain. A few extra pounds can certainly exacerbate your back problem, but it doesn’t usually cause back pain all on its own. The most common causes of back pain are mechanical (movement) problems.

In other words – bad movement habits such as sitting all the time, bending and rotating too much, or having terrible posture can all lead to back pain slowly over time.

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

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

When you ignore a back problem it’s only a matter of time before it becomes unbearable.

And when we’re desperate, we make poor decisions, which often leads to more money spent than necessary. All that money (and more) that you set out to save as part of your New Year’s goals eventually goes to waste. Instead, get in front of your back pain. For 80% of back pain cases, there is a natural, movement-based solution. Natural solutions are far less expensive – and much safer long term compared to something like surgery. While the impact of ignoring back pain may seem indirect when it comes to a New Year’s resolution of saving money – it will impact you in some way – at some point – in a monetary way if you don’t address it now.

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

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. If local to Portsmouth, NH and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

5 Tips for Wrapping Gifts Without Aggravating Neck or Back Pain

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If you’re anything like me – you’ve left your Holiday wrapping to the absolute last minute. And if that’s the case – there’s a very good chance you’re going to overdo it – and aggravate any existing neck or back pain you might have.

The good news?

There are things you can do to significantly mitigate the chances of your neck and back pain flaring up – and perhaps avoid it altogether.

Here are five great tips – and even a bonus recovery tip – to help you get through your last minute gift wrapping without aggravating your neck or back:

1. Create an Ergonomic Wrapping Station

The way you set up your wrapping station matters. Sitting on the floor or crouching over a low coffee table forces your spine into unnatural positions, creating stress on both your neck and back. Instead, wrap your gifts on a surface that allows you to sit or stand comfortably at waist height.

If you’re sitting, use a supportive chair along with a lumbar roll to keep your back and neck in their most natural position. For those who prefer standing, consider using an anti-fatigue mat to reduce strain on your back. Elevating your workspace ensures you’re not constantly hunching over, which is a common culprit for neck and back pain.

2. Don’t Sit or Stand Too Long – Move!

Sitting or standing in one position for extended periods can lead to stiffness and pain in your neck, shoulders, and back. Set a timer to remind yourself to take movement breaks every 20-30 minutes.

During these breaks, perform a few gentle stretches for your neck and back. Try rolling your shoulders backward, gently tilting your head side to side, or doing a seated spinal twist. Movement encourages blood flow, which helps reduce stiffness and tension. Plus, breaking up the task gives you a mental refresh so you can focus on getting your wrapping done instead of neck or back pain.

3. Use the Right Tools

The tools you use can make a big difference in minimizing strain. Opt for ergonomic scissors with padded handles to reduce stress on your hands and wrists. Tape dispensers are also a must-have to prevent repetitive wrist motions that can lead to discomfort.

If you’re wrapping on the floor, use a cushion to support your hips and lower back. For added neck relief, consider placing a rolled-up towel under your neck during floor session breaks to give it some relief and maintain its natural curve. These simple adjustments can help you avoid unnecessary strain while you focus on creating perfectly wrapped packages.

4. Check Your Posture

Poor posture is one of the biggest contributors to both neck and back pain. While wrapping, make a conscious effort to:

  • Relax Your Shoulders: Keep them down and away from your ears to avoid tension in your neck and upper back.
  • Maintain a Neutral Spine: Whether sitting or standing, ensure your lower back keeps its natural curve.
  • Align Your Head: Avoid craning your neck forward. Bring the gift closer to you instead of leaning toward it.

These small posture corrections can go a long way in keeping discomfort at bay and ensuring your body feels great long after the wrapping is done.

5. Spread Out Your Wrapping Tasks

Rather than saving all your wrapping for Christmas Eve, try wrapping a few gifts at a time over several days. This approach prevents prolonged periods of repetitive motion and reduces the overall strain on your neck and back.

Now – if you HAVE waited till Christmas Eve to wrap your gifts – then ignore this tip and move on to your bonus recovery tip 🙂 

Bonus Recovery Tip: Treat Yourself to a Little TLC

Even with the best precautions, some muscle soreness and tension might still sneak in. Combat this by treating yourself to recovery techniques like foam rolling, deep breathing, a good stretching session, or one of our Regenerative Therapy Sessions! 

And if your pain persists or worsens – don’t ignore it. Seeking advice from one of our mechanical pain specialists can help you address the root cause or your neck and back pain and prevent it from becoming a much bigger issue that impacts more than just wrapping gifts.

Live near Portsmouth, NH? Connect with one of our mechanical pain specialists by clicking HERE!

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. If local to Portsmouth, NH and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

low back pain

3 Reasons Your Lower Back Stretches Aren’t Working

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If you suffer from chronic lower back stiffness or pain – and you’ve been diligent with your stretching routine – it might be time to re-evaluate your approach.

Whether it’s your stretching technique, the type of stretch, or even the idea that you might not need to stretch at all, it’s important to understand why your current regimen might not be helping.

Here are three common reasons why your lower back stretches might not be working and how to address them:

1. You’re using the wrong stretching technique.

Research varies on how long to hold a stretch, but many people find that holding a stretch for 30-60 seconds is effective. However, technique is everything. One common mistake is not fully relaxing into the stretch. It won’t be effective if you’re holding tension in your body or gripping your muscles as you stretch. Make sure you’re breathing deeply and easing into each movement. Forcing the stretch or pushing through pain can trigger muscle tension and defeat the purpose.

If you’ve relaxed fully and your stretches still don’t seem to work, consider trying “dynamic” or “moving” stretches. Rather than holding one static position, move gently through a series of stretches, like pelvic tilts or cat-cow stretches. These can help your muscles stay loose without becoming rigid. Adjusting your stretching approach can make a noticeable difference and reveal that your technique might have been the issue.

2. You’re doing the wrong type of stretch.

Determining the right type of stretch can be tricky without expert guidance. There’s a distinction between general stretches meant for relaxation and specific corrective stretches for targeted issues.

For example, let’s say your lower back tightens up after a long day or due to stress, general stretches like a child’s pose or a seated forward fold may relieve tension. I often use these stretches to keep my own back healthy when I’m on my feet all day helping patients.

However, if you’re dealing with lower back pain or symptoms like sciatica (pain or tingling running down your leg), generic stretches like these might not help and could even worsen your condition. In these cases, corrective stretches tailored to your specific problem are necessary. These stretches are usually prescribed by a specialist who considers your body mechanics and underlying issues, recommending the best type and frequency for you.

3. You shouldn’t be stretching your lower back at all.

One surprising reason your lower back stretches might not be helping is that you may not need to stretch it in the first place. Chronic lower back tightness can sometimes indicate a weak core or hip instability.

This is more common than you might think, and if this is your situation, stretching your back repeatedly can lead to more frustration and even worsen the problem. The deep stabilizing muscles in your lower back are closely connected to your core muscles. If your core isn’t functioning properly, your lower back muscles might compensate, leading to persistent tightness and discomfort.

Ever notice your lower back feels sore after a day of ab exercises or after certain workouts? This could be a sign that your lower back is overcompensating. Instead of stretching more, it’s time to focus on core strengthening and proper movement techniques. Seek guidance from a specialist to assess and correct your form and make sure your core is doing its job.

Lower back pain is common – but having to constantly suffer from it isn’t. If your lower back pain or tightness isn’t improving despite regular stretching – it’s possible that your technique needs adjusting, you’re using the wrong type of stretches, or stretching isn’t what your body needs at all. Finding the root cause of your lower back issues is key.

Consulting with a physical therapy specialist who is an expert in mechanical pain can help you identify the root cause of your back pain and the best course of action – so you can stop wasting time on ineffective stretches and get back to your favorite activities without pain. Need help finding one? Reach out – I’m happy to help.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of our specialists HERE. Our team will listen to your story and help you make the best decision moving forward – whether that means working with us or finding the right plan for you 🙂

What Your Doctor May be Missing About Your Pain’s True Source

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Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body. 

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem). 

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan. 

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all.  I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?  

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit. 

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.  

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

avoid back pain when raking leaves

6 Tips to Protect your Back when Raking Leaves

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Leaves are everywhere right now in New England, which means for many, the tedious task of raking leaves is right around the corner.

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 is there are many things you can do to protect your back when raking leaves. 

Here are 6 of my most popular tips to protect your back when raking leaves:

1. Warm up before you start.

Just as athletes warm up before a game, so should you before raking. Beginning any physical activity without preparing your body can lead to unwanted strains and injuries. For raking, focus on warm up activities that target your back, shoulders, and legs. Something like a quick walk around the block before you start is an excellent way to warm up. It gets blood flowing to your legs and arms, and the gentle rotational aspect of walking is great for your spine and torso. You could also include some basic stretches into your warmup such as torso twists, shoulder shrugs, and arm circles. This gets some lubrication into your joints and spine to help protect your back once you start raking.

2. Choose the Right Rake.

With any repetitive activity such as raking – good ergonomics is essential. Ergonomics refers to how safe and efficient you are in your working environment. Bad ergonomics will typically cost you unnecessary energy and labor – and can often result in an injury. When it comes to raking, choose a rake with a handle that is long enough so that you can maintain upright posture while using it, and go for one that is light in weight yet still durable. A good, ergonomic rake might require a bit more investment than you were intending, but it will be worth it in the long run because ultimately, a back injury will cost you much more. And knowing how to protect your back from injury is priceless.

3. Bend with your legs and hips  

When performing repetitive activities or lifting something heavy, one of the most vulnerable postures for your back to be in is the combined position of flexed (bent forward) and rotated. To protect your back and avoid injury, you want to use your legs and hips to bend and lift. If you’ve got the right rake, it will be easy to maintain an upright posture while raking. And then when it’s time to scoop up the leaves and deposit them, you’ll want to squat using your hips and knees, and pivot with your trunk and pelvis. Avoid lifting with a curved back and twisting from your waist or spine. Maintaining these habits on a regular basis (not just when raking) will help you protect your back from strain or injury that could otherwise be very easily avoided.

4. Take regular breaks

Continuous and repetitive raking can tire out your muscles and make them more susceptible to injury. Plus, when you get into the monotony of raking, the mindlessness of the activity makes it easy to not pay attention to things like maintaining good posture and using good body mechanics. An easy way to combat this is by taking regular breaks. I recommend at least once every 30 min. Set an alarm on your phone or watch to remind you – and when it goes off – stop what you’re doing, put the rake down, and give yourself a quick upright back stretch. This very simple and easy strategy will go a long way in protecting your back when raking leaves.

5. Engage your Core

You don’t need six-pack abs to protect your back while raking leaves, but simply being mindful of your core can be super helpful and certainly won’t hurt you. Most back injuries occur when you least expect it – and when you aren’t paying attention. When you’re raking leaves, or any other mindless, repetitive activity for that matter, make an effort to think about gently drawing in your lower abdominals while you perform the activity. It’s a subtle move, and you should be able to easily breathe and talk while doing it. If you struggle to breathe and talk normally – you’re overdoing it.  This simple act of engaging your core will help keep your spine more supported and stable while raking and it will help protect your back.

6. Keep Moving Afterwards

What you do after raking is equally as important as what you do during to help protect your back from pain and injury. 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 right after strenuous activity. And when you put your spine in a relaxed, flexed position while it’s vulnerable – you’re just asking for an injury. You won’t notice it while you’re resting – but you might feel a tweak or strain when you go to stand up – or even up to several hours later.

Do yourself a favor and perform some gentle stretching after raking, or go for another walk to help relax your back. And be mindful of your resting postures for a few hours after raking.

This is an easy way to protect your back during raking season.

Hopefully these tips give you a few things to think about before you go raking all those leaves in your yard – but most importantly – help you protect your back and avoid unwanted back pain this fall season.

Are you a local in Portsmouth, NH?

CLICK HERE to connect with one of our specialists who can help you manage back pain from raking leaves so you can enjoy the fall season to the fullest!

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or get her free guide for preventing back pain, CLICK HERE or call 603-380-7902.

Sciatica

Why Cortisone Shots Don’t Work for Sciatica

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

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

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

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

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

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

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

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

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

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

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

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

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

So here’s the good news…

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

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

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

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

Avoiding Movement

How Fear Can Worsen Your Injury: The Hidden Dangers of Avoiding Movement

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Fear is a natural, protective response to injury.

But sometimes it can do more harm than good if you’re not careful. Reason being… When we experience pain or injury of any kind – while the pain can range from mild to excruciating – the real “pain” comes from not knowing what you just did. 

Was it anything serious? Will it go away on its own? What should I do?

All these questions compound the unknown which tends to manifest itself as some version of fear and trepidation. And the degree at which this occurs is highly variable among individuals. On one end of the spectrum – the fear of making an injury worse can lead to behaviors that hinder recovery. But on the opposite end – the fear of not doing enough and being cavalier about “no pain no gain” could also impede your recovery.

The good news is that with the right knowledge, tools, and team of experts – you can “train your nervous system” to interpret pain appropriately and avoid the hidden dangers of not moving enough. If fear is caused by the unknown of what’s happening when you feel pain or have been injured – then a better understanding of pain (what it is, what it’s telling you, and how it behaves) and how your body naturally heals from injury is going to help lessen that. I always say: “Movement is medicine – but knowledge is power”

So… as I’ve alluded to… one of the most common misconceptions about injury recovery is the need for prolonged rest.

When we get injured, our instinct is to “protect” the affected area, which typically translates to avoiding movement altogether. While this may seem a prudent strategy, it can actually delay your body’s natural healing process. 

Let me explain…

Yes, an initial resting period makes sense in some cases, especially after an acute injury where you’ve experienced some form of trauma to your tissues. But as soon as that initial inflammatory period ends – you’ve got to start moving. This is crucial for the proper healing of tissues that have been damaged from an injury. Plus – a lot of injuries don’t occur traumatically. They happen slowly over time. This type of pain requires a totally different approach to healing.

In either case – resting for too long and not moving enough can lead to all sorts of problems such as muscle atrophy, joint stiffness, and reduced overall function. Plus – you’re teaching your nervous system that it’s “safer” to not move – which can cause problematic adaptations over time if you’re not careful. In other words, you need movement, and even a little bit of pain to occur for proper recovery from an injury. But you’ve got to balance this. Too much too soon could re-injury you – while not doing enough will put your body and nervous system into “protective mode” – making it harder to incorporate necessary and healthy movement later on.

So how do you balance this process? How do you know if the pain you’re feeling during movement is good or bad?

Understanding how pain behaves is key. Generally speaking, pain during movement that doesn’t last is considered “safe”. We call this hurting versus harming. It’s generally ok to hurt, but never ok to harm. As your mind and body experience this phenomena together – you’re effectively coaching your nervous system to not react to the sensation of “hurting” in such a sensitive way. The more you move, and the more your nervous system realizes the painful feeling is not resulting in harm or more injury, the more that hurt sensation fades. Your nervous system no longer interprets it as pain. This is a normal and healthy response to pain when dealing with any injury – but especially those that are chronic and didn’t come on so suddenly.

The danger you run into when you never allow hurt to happen and avoid any amount of pain altogether – is that you encourage fear to run the show. Your nervous system never “learns” what good pain is vs bad pain – and it starts to get confused. Before you know it, any kind of sensation is perceived as pain (danger) by your nervous system – which only serves to fuel the fear of movement even more. It becomes a vicious cycle that is hard to break.

If you’re confused right now I don’t blame you.

This can be a nuanced and complicated concept to understand – and it’s why I don’t recommend going at it alone. Working with a movement expert who truly understands the process of healing and how your nervous system plays into all this will help take the guesswork out of all this and build confidence in this process.

Movement really is medicine and it’s a powerful one – when you’ve got the knowledge to use it properly.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To book a free discovery visit with one of our specialists CLICK HERE.

Why Strengthening your Core Won’t Cure your Back Pain

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As a back pain expert, I talk to folks numerous times per day about the best things they can do to get rid of their back pain. The most common topic that comes up? Core Strengthening. Everyone wants to learn how to strengthen their core properly and more effectively – in hopes that it will put an end to their back pain.

Unfortunately, getting rid of back pain is not as simple as strengthening your core.

I wish it was. Don’t get me wrong – strengthening your core does have its role in both helping and preventing back pain – but core strengthening alone is rarely enough. In fact, sometimes, it can even make your back pain worse, especially if introduced too soon

So why isn’t core strengthening enough? Even when your Medical Doctor, Google, and YouTube all seem to allude that it should be?

Because 80% of the time, your back pain is due to something we call “mechanical” – meaning the source is way underneath all of those core muscles. While strengthening your core muscles will often make you feel better, and may even temporarily relieve your back pain, strengthening your core muscles will never address the mechanical problem underneath. And it will continue to rear its ugly head until it’s finally resolved.

So how do you solve mechanical low back pain so that core strengthening can actually do its job?

First… Let’s talk about what mechanical low back pain is… and isn’t.

Mechanical low back pain is caused by poor postural habits and repetitive movements and stress that occur slowly over time – and eventually lead to movement dysfunction within the spine. It arises from things like having a job where you sit for 8 hours a day, 5 days per week. Perhaps you’re a new mom and are constantly bending over to care for your new baby. You love to garden, or you’re an avid golfer, and have been doing these things for years. All of these “lifestyle” habits and requirements can be responsible for mechanical low back pain.

But what back pain is often blamed on are structures. Things like herniated or bulging discs, arthritis, stenosis, and pinched nerves. What you have to understand is that most of these ailments occur normally as you age. The majority of the population over the age of 50 will have one or more of these “abnormalities” show up on an MRI – even when they don’t have any back pain. But when you’ve got a mechanical back pain problem – one where your spine isn’t moving as well or as normally as it should – these structures become susceptible for irritation. So yes, the structures cause the pain, but the underlying mechanical problem is what’s responsible for irritating the structures.

If you’re confused – I don’t blame you. All you need to understand is that strengthening muscles of any kind – including your core muscles – will not resolve a mechanical back pain problem. You have to address the mechanical “fault” with very specialized and corrective movements that are prescribed to you. They aren’t cookie-cutter and you can’t find them on YouTube.

So when should you focus on strengthening your core?

After the mechanical back problem is identified and resolved. You’ll need to work with a mechanical back pain specialist to do this. But once you do – core strengthening plays a critical role in keeping you strong, healthy, and balanced. A good core strengthening regimen helps you prevent the mechanical back problem from coming back.

Moral of this story – if you’ve been at core strengthening for awhile now and disappointed that it hasn’t yet “cured” your back pain – then you must consider that you’re in the 80% and have a mechanical back pain problem. Fix what’s underneath first – and then strengthen away.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Back Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or reserve a seat in her upcoming Masterclass for Back Pain & Sciatica Sufferers – click here.

Woman sleeping facedown on a bed.

Tips and Solutions for Morning Back Pain

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Tips and Solutions for Morning Back Pain: Causes and How to Fix it

One of the most common complaints from people suffering from chronic back pain is how stiff and sore their back feels first thing in the morning. For some, it seems random – almost like they’ve “thrown their back out” overnight. For others, it’s a daily struggle, waking up achy no matter how good they felt before bed.

But why does morning back pain happen? Isn’t sleep supposed to be restorative to help your body heal?

The truth is, back pain shows up differently for everyone. And while it’s easy to blame your mattress, the real causes of morning back pain could be due to other factors – like your sleeping position, lack of regular exercise, and bulging dics. 

Let’s dive into each of these potential triggers and look at ways you can address them naturally:

 

Poor Sleeping Position

Your sleep posture can make or break how your back feels when you wake up. But what’s interesting is that the “wrong” sleeping position really depends on the root cause of your back pain. There is no one-size-fits-all. For example, some people find that lying on their back with legs elevated feels wonderful, yet for others, this position leaves them feeling stiff and sore come morning. Others experience tremendous relief sleeping on their stomach, while for some this position places a lot of strain on their spine and they wake up very stiff and achy.

Generally, the most back-friendly sleeping position is on your side. Side-sleeping makes it easier to keep your spine in a neutral, supported position, which reduces stress and tension while you sleep. It’s more challenging to find a neutral spine position when on your back or stomach. If lying on your side bothers your hips or shoulders, you can try placing a pillow under your waist and head, along with one between your thighs, to provide extra support and maintain better alignment. A pillow topper over a firm mattress makes side-sleeping a lot more comfortable as well. Small adjustments like these can significantly improve how your back feels in the morning and allow you to wake up feeling more refreshed.

Lack of Regular Exercise

A lack of regular exercise is one of the most overlooked reasons for waking up with a stiff, sore back. When you’re not moving enough during the day, your muscles (especially those supporting your spine) become weak and tight. Inactivity also reduces circulation, which means less blood flow delivering oxygen and nutrients to your muscles, joints, and discs. Without this nourishment, your tissues stiffen, and when you’re sleeping overnight, that stiffness builds. But regular movement doesn’t just strengthen muscles and nourish tissues – it keeps essential body systems like circulation, digestion, and even your nervous system running smoothly – setting the stage for more restful, regenerative sleep.

Incorporating consistent activity into your daily routine helps break this cycle. Simple exercises like walking, yoga, strength-training, and stretching encourage better blood flow throughout your body. The result? You’re less likely to experience that locked-up, achy feeling when you wake up – and you’ll likely notice deeper, better quality of sleep, too. Movement during the day primes your body to recover more efficiently overnight, reducing the likelihood of morning back pain.

Bulging Discs

This is one of the most common causes of morning back pain that I see. Your vertebral discs play a crucial role in your spine’s health by absorbing shock, holding your vertebrae together, and allowing for movement. What many people don’t realize is that your discs are made up mostly of water. Over the course of a typical day, your discs compress and lose some of that water content. But at night, while you’re lying down, they re-hydrate and can regain up to 17-25 millimeters in height.

While that might sound beneficial, it can actually be problematic if you’re dealing with an irritating, bulging disc. A bulging disc already has the potential to limit movement in your spine. But when it fills up with fluid overnight, it becomes even stiffer, leading to increased restriction and pain when you wake up.

If you’re consistently waking up feeling locked up, in significant pain, or hesitant to move – there’s a strong chance a bulging disc is contributing to your discomfort. Seeking guidance from a mechanical back pain specialist can help you get a proper diagnosis and develop a plan to manage and treat your bulging discs effectively and naturally – so you can avoid resorting to injections or procedures right away.

Don’t Always Blame your Mattress

If you’re dealing with morning back pain, hopefully this article has helped shed some light on why it’s happening. Before you go out and spend a fortune on a new mattress – consider addressing these common causes first. Take a look at your sleeping posture, evaluate whether you’re moving enough throughout the day, and rule out whether bulging discs might be part of the problem.

The good news is that 80 percent of all back pain cases can be treated naturally – and without the need for injections, procedures, or surgery. More often than not, the solution to a pain free back lies in simple, movement-based approaches that strengthen, support, and restore your body’s natural function.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get a free copy of her guide to back pain – click here.

Pain when gardening

Pain-Free Gardening: How to Protect Your Back and Love Your Garden

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Gardening season is finally here – and with all of gardening’s positive benefits – it’s no surprise that gardening is such a huge passion for so many. 

Tending to plants and watching them flourish offers a profound sense of accomplishment. The connection to nature is therapy for your soul. And the meditative practice of gardening reduces stress, gives you a break from the hustle, bustle and stress of daily life, and enhances your mental well being. Plus – let’s not forget all the physical benefits of gardening. Anything that gets you moving, active and mobile I’m a fan of.

But how do you continue to pursue your gardening passion when your back hurts? It’s been a very common concern as of late. The good news is that it’s entirely possible to spend more time loving your garden than tending to your back.

Here are 5 of my top tips to protect your back when gardening:

1. Avoid bending from the waist

A common gardening posture I see is folks standing with straight or slightly bent knees and bending over from their waist – creating an “L-shape” with their body. While this posture is acceptable to do from time to time – it’s not a good idea to do this over and over again while gardening. This particular posture puts a lot of strain on your lower back as well as the backs of your knees. Over time, your lower back muscles will become very sore and tight, which can make them susceptible to injury when you least expect it. What to do instead? Get in the habit of squatting and bending from your knees. If you must do a particular gardening activity for a sustained period – try being on all-fours – and switch your hands periodically. These positions are much better for your back and you’ll be able to sustain the activity for much longer.

2. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back still needs a break. Our spines do not enjoy being bent forward for prolonged periods and when you do this for too long without taking a break – it puts a lot of stress on the vertebral discs in your spine and makes them more likely to bulge. I recommend setting a timer and giving yourself a break every 30 min. Simply stand up and get out of the bent over posture. Your back will thank you and you’ll be able to garden for much longer without risk of injuring your spine.

3. Pivot instead of twist

One of the most vulnerable positions for your back is the combination of bending and rotating. And when done repetitively, you’re almost guaranteed an injury to your spine. When you’re doing things like digging or planting – activities that have you bending and twisting – you want to pivot instead. Keep your body in line with the activity you’re doing. Don’t rotate or twist from your waist. How do you do this? Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and always move them as a unit. While it’s ok to bend and twist from your waist on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you have a history of back pain episodes happening to you in the past.

4. Use gardening tools wisely

Gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench. This will make it easier to sustain activities that require prolonged bending or kneeling. Lastly, use tools with longer handles to help avoid crouched over postures. If you can maintain a more upright posture while gardening, you’ll be able to tolerate it longer and with less back pain. 

5. Raise your gardens

Let’s face it, gardening involves bending over and lots of it. Activities like this are just not good for your back when done over and over. Consider modifying your garden to include more raised boxes and beds. This is going to make it so much easier to tend to your plants without having to bend over so much. And when you need to create a work surface – make sure that is raised too. Bending forward isn’t “bad” for your spine – but when you bend all the time without giving your back a break – you’re asking for trouble. Modifying your garden to make it more ergonomic can make a huge difference in the health of your spine.

Gardening has so many positive benefits and it’s a true passion for so many folks I speak with. The last thing I want is for back pain to be the thing that stops you from doing something you love. Hopefully these tips give you some important things to consider – and more importantly – help you protect your back so you can focus on loving your garden.

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Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or get a free copy of her guide to back pain – click here or call 603-380-7902