Tag Archive for: back pain

Herniated Disc

3 Reasons You’re at Risk of a Herniated Disc

A herniated disc can occur in any part of our spine. However, we often see it happening in the lower back.

This condition has also been known as a bulging, protruding, or ruptured disc. 80% of people will experience lower back pain at one point in their life – and for some this may be from a herniated disc.

Anyone can develop a herniated disc, but certain factors may increase that risk.

Here are three reasons you might be at a greater risk of developing a herniated disc:

1. You’re sitting For Long Periods

When we sit for too long, the burden of our weight is placed abnormally on our spine. This can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution?

Limit your sitting to half-hour periods. Have a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. If you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. I give this advice to every single client I have who comes to me with back problems. It’s one of the easiest ways for the average person to prevent a debilitating back problem over the long term.

2. You’re bending too much

Did you know that the average person bends or flexes forward between three and five thousand times per day?

That’s a lot of bending over time and eventually something will give – and it tends to be a disc in your lower back. Our spines crave balance, but unfortunately, our modern-day lives are designed to have us bending forward more than we should. Sitting in front of a computer, putting shoes and socks on, driving, house and yard work, even brushing our teeth are all daily activities that involve bending forward in some way.

To combat this, we need to make a concerted effort to extend instead of bend. A really simple exercise you can do every day is to stand and extend your spine. Place your hands on your lower back for support and then arch back as far as you can go. Repeat this 10 times, at least once per day. If you’ve never arched your back like this before, it may feel stiff or even hurt a little at first. But with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.

3. Your Age

Age is one of the most significant risk factors for developing back problems.

As we age, our muscles naturally weaken, including those in our back. This can make it harder for us to support our spine and maintain good posture.

Making sure that you are maintaining a proper nutritional diet is very important. It will aid in avoiding injuries like a herniated disc. When our bodies are supplied with the vitamins and minerals they need – your bones and supportive structures are supported to work at their best.

As we get older, we may become less active, which can lead to unwanted weight gain and weaker muscles. This can cause a strain on our back and increase the chances of having a herniated disc. It is generally recommended to be active for around 150 minutes per week. Staying mobile and strong will delay the wear and tear on our bodies as we age.

The good news is – the majority of herniated discs can be completely resolved without surgery.

Are you local to Portsmouth, NH and looking to get help with your pain NOW? CLICK HERE to request a Free Discovery Session with one of my Specialists. They’ll ask you all about what’s been going on – and figure out if we would be a good fit to help.

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

Sciatica

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

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

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

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

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

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

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

The Dont’s:

1. Avoid resting in bed or on the couch.

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

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

2. Avoid child’s pose and stretching forward.

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

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

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

3. Don’t let your MRI decide treatment.

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

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

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

The Do’s:

1. Keep moving.

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

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

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

2. Watch your Posture.

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

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

3. Talk to a Movement Specialist.

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

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

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

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

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

Back Surgery

Back Surgery: Why it fails and do you need it

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

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

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

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

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

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

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

So when should you get back surgery?

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

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

Your symptoms will be progressive and severe.

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

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

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

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

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

It’s why 50% of back surgeries fail.

Let me explain…

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

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

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

How does that happen?

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

Most back pain comes from poor movement habits and lifestyle.

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

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

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

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

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

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

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

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

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

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

Back Pain

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

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

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

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

1. Fear

Let’s face it – back pain is scary.

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

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

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

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

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

2. Bulging Discs

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

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

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

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

3. You Were Told to Rest

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1. Mobility Before Stability

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

2. Pace Yourself

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

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

3. Stay Hydrated

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

4. Get Assessed by a Mechanical Pain Expert

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

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

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

 

Are you local to Portsmouth, NH? – CLICK HERE to speak with one of my specialists. We will ask you about what’s been going on – and see if we would be a good fit to help!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

How Stress Leads to Pain

How Stress Leads to Pain

How Stress Leads to Pain

People are dealing with more stress than ever right now and it’s impacting people in different ways. Many folks I speak with have been experiencing a rollercoaster of emotions — and their bodies are reflecting that. Keep reading to learn how stress leads to pain.

Stress impacts everything from your gut, to your immune system, to your mental health, to your musculoskeletal system.

When it comes to musculoskeletal pain – common areas in your body that easily get impacted include your shoulders, jaw, head, and lower back.

Stress is your human response to physical, emotional, or mental changes in your body or living environment.

According to internal medicine physician Richard Lang, MD, PhD from the Cleveland Clinic: “Stress doesn’t necessarily cause certain conditions, but it can make the symptoms of those conditions worse.” It’s easy to fall into a vicious cycle. Your physical symptoms worsen. Your stress increases – and so on and so on. 

We know without a doubt that stress impacts our bodies – but exactly how or why this happens is an interesting phenomenon that is still being researched.

But for now – here are some of the working theories on how stress leads to physical pain.

Social conditioning 

Many of us are taught from a young age that expressing emotions, particularly negative emotions, is “bad” or “unacceptable.” The result is that you may have learned to hold stress inside your body when faced with a stressful situation. Researchers who study this believe that the muscle tension we develop is the result of “unspoken social beliefs” that we adopted as children in order to feel accepted or liked. This pattern carries into adulthood and becomes embedded into our subconscious systems, i.e. our nervous system. Later on, when faced with any type of stress, our muscles react based on how we’ve taught them. If you grew up learning to bury emotions and tension somewhere in your body as a response to stress, it’s easy to continue that pattern into adulthood.

Trauma

When we think of trauma – we often associate it with one big event or injury. Like an accident, major fall, or perhaps a violent crime or incident. This type of trauma typically results in obvious physical damage such as broken bones, bruises, or soft tissue and organ injuries. But trauma can also be more emotional in nature and less obvious. Emotional “micro-traumas” typically occur over the course of a lifetime and go unrealized for years. And regardless of the type of trauma or its perceived severity, your body reacts and “remembers” the emotional impact. But these memories are rarely conscious. Similar to what happens with social conditioning, if you’re faced with a stressful situation later in life that reminds your brain of a previous trauma, your body may still react like it did when the actual trauma occurred, except you won’t consciously know it.

For some folks, until they’re able to associate their physical symptoms with the deep, often emotional trauma that happened much earlier in life. They may continue to suffer or worse, resort to lifelong medications to manage their pain. Have you suffered from chronic pain and been told there is no “logical” evidence or reason for it? It’s possible it could be related to undiagnosed trauma. Find a therapist (psychology today is a great resource) who’s been specifically trained in this to help you.

Environmental Stressors and Habits 

Your environment and daily habits can have a huge impact on how your body feels from day to day. They can also influence both physical and emotional stress. For example, if you’ve been reading my articles for awhile, you know that sitting too much is a number one cause of back and neck pain. Sitting too much could be the result of your job – or stress.

When you’re stressed, you tend to be less motivated and you may opt for unhealthy coping mechanisms, such as more TV and more couch time. You’ll be less reluctant to exercise or go for a walk. How you set up your environment can play a big role in combating stress at home. If you’re working from home – choose a set up where you can stand at your computer for part of the day. Reduce the physical stress that sitting has on your body. Get the TV out of your bedroom. You’re more likely to get a good night’s sleep and less likely to turn the news on first thing in the morning.  This can be a source of stress in and of itself. The take home point is that life is hard enough. So set yourself up for success by creating an environment that encourages good daily habits.

Regardless of how or why stress impacts your body, there is one thing I know for certain, movement helps.

Start there and see what happens. Regular, every day movement helps you both physically and mentally and I have yet to see any negative consequences from a daily movement or exercise habit. If musculoskeletal pain is currently keeping you from daily movement – then talk to an expert who can help. 

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

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

avoid back pain when raking leaves

5 Tips to Avoid Back Pain when Raking Leaves

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

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

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

1. Take a walk before you start.

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

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

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

2. Stretch every 30 minutes.

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

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

3. Bend with your legs and hips.

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

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

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

4. Engage your core.

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

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

5. Keep moving afterwards.

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

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

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

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

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

Consider speaking to one of my specialists.

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

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

Herniated Disc

Three Ways to Keep your Back from “Going Out”

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

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

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

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

 

1. Avoid sitting for prolonged periods.

When we sit for too long, the burden of our weight is placed abnormally on our spine and can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution?

Limit your sitting to half-hour periods. Have a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. If you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. I give this advice to every single client I have who comes to me with back problems. It’s one of the easiest ways for the average person to prevent a debilitating back problem over the long term.

2. The curves in your spine matter

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

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

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

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

3. Extend instead of bend.

Did you know that the average person bends or flexes forward between three and five thousand times per day?

That’s a lot of bending over time and eventually something will give – and it tends to be your lower back. Our spines crave balance, but unfortunately, our modern-day lives are designed to have us bending forward more than we should. Sitting in front of a computer, putting shoes and socks on, driving, house and yard work, even brushing our teeth are all daily activities that involve bending forward in some way.

To combat this, we need to make a concerted effort to extend instead of bend. A really simple exercise you can do every day is to stand and extend your spine. Place your hands on your lower back for support and then arch back as far as you can go. Repeat this 10 times, at least once per day. If you’ve never arched your back like this before, it may feel stiff or even hurt a little at first. But with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days. If it doesn’t, or becomes troublesome for you, then it’s important to speak with a specialist.

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

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

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

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

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

When You Can’t Feel Your Abs

I’ve been a physical therapist for 20 years, a Pilates instructor for 11, and have been specializing in back pain for the past 10 years of my career. When it comes to core strength and preventing back pain, I am an expert in my field. Yet for some reason this morning, during my Pilates workout, I just couldn’t feel my abs. I teach people how to do this every single day yet this morning, I couldn’t seem to access my own.

What was happening?

And more importantly – if it can happen to someone like me – it can certainly happen to someone with less training than I have. I started to think about all the reasons this could be happening to me. Had I gotten enough sleep? What had I eaten the day before? Could it be stress?

And then it hit me.

I had just come back from a 2-day course where I’d been sitting far more than usual. I sat for 8 hours straight. Two days in a row. Not to mention all the very cramped sitting I did on the plane to and from this course. When one of my clients is about to have a few days like this, this is what I recommend. Get up from your chair and stretch backwards as frequently as possible every few hours.

But guess what – I didn’t follow any of my own advice. The result? A stiff back and sleepy abs upon my return.

Our bodies are highly intelligent and have every capacity to heal themselves when given the right environment. Conversely, when in the wrong environment, our bodies will also do what it takes to naturally protect from harm and injury. In my case, I came home from this course with a stiff lower back.

Back stiffness is the first sign that your back is not happy. This means your chances of tweaking it or exacerbating an old back injury are higher. When any joint is stiff and not moving well the muscles surrounding that joint will become naturally inhibited or weakened. This occurs on purpose as a protection mechanism. Your body doesn’t want a fully contracted muscle compressing an unhappy joint. In the case of your lower back, the muscles that can get inhibited when your back is not happy include your abdominals as well as back muscles.

So what can you do when you feel less core strength?

The good news is I’ve already helped you with step one: awareness. Inhibited muscles are not the same as weak muscles. In my case, I do have strong abdominals. My weekly routine consists of a regular Pilates practice, lifting weights, and I perform activities like hiking and running that engage my core. Yet despite all this, my abs were simply not having it this particular morning. They were not set up for a successful workout.

The combination of my stiff back and having sat for several days just meant that I needed to do something different to prepare my lower back and abdominals for this workout – so that I wouldn’t injure myself. My sleepy abs and stiff back were, in effect, trying to tell me just that.

All I needed to do was have the awareness this was happening so I could take appropriate action.

It’s no different than when you go on vacation and you get off your routine by eating more than usual. You might return a bit bloated and not feeling your best self. This kind of feeling we are accustomed to. And might respond by getting a bit strict with our diets until feeling back on track. Our joints can react similarly to a change in routine – we’re just not as accustomed to the signs and symptoms that let us know. But once you are – you can easily manage this and avoid injury. Had I pushed through my Pilates routine as normal this morning despite sensing that my back and abdominal function was off – there’s a good chance I’d be sitting here writing to you with full on back pain instead of just some lingering stiffness.

If you’re reading this, and you’re over the age of 40, odds are pretty good that you’ve experienced back pain at some point in your life. The odds are also pretty good that you’ve experienced back pain more than once.

If this is a recurring pattern for you, your abdominals and deep core may not be functioning at their best.

You could be caught in a vicious cycle of trying to improve your core strength only to keep hurting your back.

The missing solution for you might be that nobody has fully examined your back in a way to ensure that it’s moving fully and freely like it should. Once your back moves well, you can usually start to strengthen your abdominals without a problem.

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

The take home point here is that if you keep experiencing weakness in a particular area despite trying to strengthen it consistently, it’s possible you could have a problem in your joints that is keeping your muscles from fully activating like they should.

Talk to one of my specialists about it.

Someone from my client success team will call you right away and see if you are a good fit for what we do. At the end of the day – we’re here to help.

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

Sciatica_Therapy_Portsmouth_NH_2

3 Reasons You Need PT After Minimally Invasive Spine Surgery

Minimally invasive spine surgery (MISS) started to take off in the 1990’s. It has since become far more common for spinal conditions. Some being degenerative disc disease, herniated discs, spinal stenosis, scoliosis, spinal infections, spondylolisthesis, compression fractures, and spinal tumors.

Minimally Invasive Spine Surgery is a far better alternative to open-spine surgery.

You can expect less anesthesia and less blood loss during surgery. Along with a reduced risk of infection, less pain after surgery, less pain medication needed, smaller scars, shorter hospital stays, faster recovery time, and quicker return to daily activities and work.

But don’t confuse the term “minimally invasive” with minimal risk.

With MISS – you’re still at risk for many of the same consequences of open-spine surgery should things go wrong. Therefore, you want to make sure you really need spine surgery before you go “under the knife” – even if it’s a tiny one.

There are some risks of MISS:

  • Bad reactions to anesthesia
  • Pneumonia after surgery
  • Blood clots in your legs that could travel to your lungs
  • Infection (although this is significantly minimized with MISS)
  • Blood loss during surgery requiring a transfusion
  • Injury to the nerves of your spinal cord

While rare, these are very real risks and they do happen. Risks like this don’t occur with conservative treatment – such as specialized physical therapy.

It’s why I’m a huge advocate of folks not undergoing surgery until all conservative approaches have been exhausted. Or if you’ve got what we call a progressive neurological deficit occurring. Such as quick deterioration in your muscle strength, ability to walk, or ability to control your bowel/bladder.

All that being said – assuming you really do need surgery and will benefit from MISS – you still need physical therapy.

I’m amazed at how many surgeons no longer prescribe rehab after a minimally invasive procedure. Just because recovery time is reduced – doesn’t mean you don’t need a specialist to help you recover properly.

Here are 3 reasons you need PT after minimally invasive spine surgery:

1. Proper scar management

Minimally invasive procedures already do a great job of reducing scar formation. The incisions are smaller and less invasive, but there is still an incision. And the incision with MISS is deep because you have to get to the layers of the spinal nerves, vertebrae, and discs. Because the scars are small, people mistakenly assume they will heal without issue. The truth is they might. But the odds of your scar healing properly are much better with professional scar management. Scar mobilization should begin about 2 wks after MISS.

A specially trained physical therapist will not only help you manage your scar healing, but teach you how to do it on your own. You’ll improve blood flow to the area of the incision (which promotes healing), increase soft tissue mobility, and help reduce any swelling that formed in the area.

2. Restore pre-existing impairments

Odds are pretty good you didn’t end up with spontaneous MISS. You likely had a long road leading to your surgery. It’s critical you go back and address all of the problems that occurred prior to your procedure.

This includes everything from muscle weakness, to poor compensatory movement strategies your body adapted to deal with pain, immobility that occurred either because of pain or to protect you from pain, and residual numbness and/or radiating pain that is still in your legs. MISS might do a great job of quickly getting rid of your back pain, but something led to that pain to begin with.

The absence of pain does not equal the absence of a problem. Now is the perfect time to work with a specialist who will help you not only optimize your recovery from MISS – but make sure the problems/impairments that led you to the operating table to begin with don’t come back.

3. Restore deep core strength

Chronic pain tends to inhibit the ability for muscles to work properly. If you’ve been suffering from back pain for awhile – odds are pretty good your deep core strength is not where it needs to be.

Plus, good core strength is critical for the prevention of future back problems (yes – you can still get back pain after back surgery). Ideally, now that your minimally invasive procedure has either eliminated or significantly reduced your back pain, it’s more critical than ever to work with a specialist who can help you restore your deep core strength. They’ll know how to do it safely and effectively – to not only help you recover from your MISS faster – but keep the original problem from coming back – because it can.

If you’re considering any type of surgery – but especially back surgery – I always advocate getting a second opinion first – even if the procedure is minimally invasive. Eighty percent of the time – back problems can be resolved without surgical procedures.

CLICK HERE to get a second opinion from one of my specialists.

If you truly want to avoid surgery – and we think we can help you do that – we’ll let you know and get you scheduled with us as quickly as possible.

However, if you’ve recently undergone MISS, ask your doctor to refer you to physical therapy. Many surgeons won’t. It’s going to help you recover optimally and faster – and will set you up for the best possible future success when it comes to back problems.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of her guide to back pain, email her at [email protected] or call 603-605-0402