Tag Archive for: back pain

Shoulder Pain

Traveling for the Holidays? Tips to Ease Back and Neck Pain

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Are you traveling for the Holidays? Unlike last year, there’s a lot more people getting out of town to see friends and family they didn’t get to see last year. Personally, I love to travel. But what I don’t love is the back and neck pain that often comes with it. The good news is you can prevent – or significantly minimize it – with tips to ease and back and neck pain during holiday travel. Whether you’re traveling by train, plane, or automobile… 

Here are 5 tips to ease back and neck pain during Holiday travel:

 

1. Walk at Rest stops and Airports

Walking is not only great exercise but it’s well known for helping ease back and neck stiffness. Our bodies like to be upright and generally don’t like to be still and sitting for very long. If you’re flying somewhere this Holiday season, walk around the terminal while waiting for your flight instead of sitting. Don’t take the people mover – get those extra steps in and walk instead. If you’re driving somewhere long distance, make a point to stop along the way and be sure to get out and walk a little. Bonus – walking is great for hip and knee stiffness too.

2. Stay Hydrated

When it comes to back and neck pain – people don’t really think of hydration as something that makes a difference. The discs between our vertebrae need fluid to do their job – which is to provide cushion and shock absorption. They can get dry and brittle when not properly hydrated which can exacerbate back and neck pain. When you add travel to the mix, which involves a lot more sitting than you might do on a normal day, you put even more stress on your discs. So remembering to drink enough water when you travel is very important. Opting for foods like watermelon, lettuce, spinach and soups can help you stay hydrated as well as avoiding beverages that contain caffeine and alcohol. 

3. Interrupt your Sitting

If you make a point to walk when you can, and drink plenty of water, interrupting your sitting is going to naturally happen and not be that difficult. As I mentioned already, our bodies were not meant to be sitting for prolonged periods and it’s one of the top reasons so many people suffer from unnecessary back and neck pain. When you sit, there is more pressure on your vertebral discs. But more than that, they start to weaken in certain areas from too much sitting – making you more susceptible for a disc bulge or herniation. Prolonged sitting also puts extra stretch on your muscles. Over time this contributes to them losing their elasticity – making them weaker and more painful – and easier to strain. My general rule is to always interrupt your sitting at least once every 30 min. This interruption acts as a reset button for your spine and helps to minimize the cumulative forces responsible for all of the problems I just mentioned.

4. Stretch in your Seat

If you absolutely can’t stand up and interrupt your sitting – the next best thing is to move and stretch in your seat. While it’s not as ideal as standing up – it’s certainly better than just sitting there. My two favorite stretches to do while sitting are: 1) the chin tuck and 2) thoracic extension. 

To perform the chin tuck…

To stretch your thoracic spine…

5. Use a lumbar Roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together. While it’s perfectly acceptable to sit like this for small increments of time (remember the 30 min rule), your spine will not like this after several hours. Plus, your neck responds by changing it’s curve to a “forward head” position as well. One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your lumbar spine. Place it right at your lower back any time you’re sitting and you’ll find that your back and neck have a lot less strain. 

Give one more more of these tips to ease back and neck pain during holiday travel a try – you’ll see that easing your back or neck pain by even 30% could have a big impact on your travels.

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

Three Easy Tips to Keep your Back from “Going Out”

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Three Easy Tips to Keep your Back from “Going Out”

Most people – four out of five to be exact! – will experience a debilitating back pain episode at one point during their lives, and 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!

1. Stand Up & Take a Load Off

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 with a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. In other words, if you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. Aside from participating in regular strengthening exercise, like Pilates, this is the easiest way for the average person to prevent back injury (and heal your back faster if you already have an injury).

2. Watch for Curves

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.  When we sit, the protective curves in our spine are harder to maintain and often disappear.  And while a healthy core and strong back muscles are important to back health, they won’t protect your back if you sit for long periods, or when the curve in your lumbar area disappears while you’re sitting.

Fortunately, the solution is as simple as rolling up a towel and placing it between your chair or car seat and the small of your back (just above the belt line). Using a purpose-designed lumbar roll is my favorite choice, and what I use for low-back support. You can use a lumbar roll in your office chair, car, and on the plane if you’re flying! If you want to learn where you can get on of your own contact us about them here. Or  see in more detail how to use them in our free e-book!

3. Extend instead of Bend

The human spine (and entire body) craves balance, which means both extension and flexion.  But we spend the majority of our time in flexion, bending over to put shoes and socks on, brushing our teeth, driving, sitting at work and then driving home. At home we bend forward to cook, sit some more as we eat and then curl up on our couch or an easy chair. As long as we’re not gymnasts or circus performers, it’s safe to say we could all use a little more extension in our day.

A really good exercise is to stand and 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.  This is also a great activity to do when you are interrupting your sitting during the day.  If you’ve never arched you 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, stop and consult with a qualified physical therapist who specializes in back pain.

If you like these tips and want to learn even more ways to prevent debilitating back pain episodes, check out our FREE back pain report right here!

It reveals five easy ways (plus two bonus tips!) that are PROVEN to help you ease back pain quickly – without pain medication, frequent doctor’s visits, or surgery. And don’t forget to check out our Pilates programs if you’re looking for a way to exercise that will target – and resolve – back pain!

Failed Back Surgery Syndrome. What you need to know.

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Failed Back Surgery Syndrome. What you need to know.

I was recently doing some research on how often back surgery fails – and I came across more than one research paper talking about “Failed Back Surgery Syndrome”.

Say what?

I knew that approximately 50% of back surgeries were unsuccessful, but I didn’t know it was common enough that they had actually coined the term!

Failed Back Surgery Syndrome refers to patients with chronic, long standing back pain, with or without referred leg pain, who have had one or more surgical interventions that have failed to treat the pain.

It’s also known as “post-surgical spine syndrome” – and it’s estimated to occur in 20 – 40% of all surgical cases.

A systematic review of the literature of patients under the age of 70 suffering from disc herniations, and who underwent discectomies, found that between 5 and 36% of these folks suffered from recurring back or leg pain after 2 years. Another study by Skolaksy et al investigating 260 patients with degenerative changes in their spine who underwent surgery for spinal stenosis – found that almost 30% of these patients had either no change – or increased pain – 12 months after surgical laminectomy with or without lumbar fusion.

Despite these statistics, approximately 500,000 Americans are still undergoing back surgery every year to relieve their pain.

The Agency for Healthcare Research and Quality estimates back surgery to cost us $11 billion annually. That’s a lot of money to spend on something that isn’t even guaranteed to work.

So why ARE we spending so much money on back surgery when for almost half of these people, it’s not successful?

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

Second, there is a major problem with the way back pain is diagnosed.

Most of the time, back pain is diagnosed via imaging (X-rays or MRI’s) and a treatment plan is based off of the results of those images. If you’ve got a bulging disc with severe leg pain or numbness, they recommend you cut it out. If you’ve got severe degenerative changes causing stenosis, they recommend fusion.

Back pain should always be diagnosed first with specialized movement testing.

Why?

Because we now know from research that 70-80% of all back pain is considered “mechanical”- meaning the root cause or your pain is due to poor mobility or movement habits, and not actually caused by the findings in your images.

Findings such as bulging discs, disc degeneration, and stenosis are all a normal part of aging and there are plenty of people out there who have these exact same findings and no pain at all. What typically happens is that your inefficient movement patterns, or immobility problems, will exacerbate these structures and findings – and that is when you start to experience pain.

This explains why so many back surgeries are unsuccessful and why more people than necessary end up with Failed Back Surgery Syndrome. When underlying movement or mobility problems go undiagnosed, and are not addressed first, your symptoms come back. It may not be right away, and could be up to a few years, but they do return. And sadly, they become even more difficult to address after one or more surgery has occurred.

So if you’ve got back pain and are considering surgery, definitely think twice and be sure you’ve been fully examined by a mechanical back pain expert FIRST.

And if you’ve already had back surgery and it didn’t work to fully resolve your symptoms and get you back to doing everything you love to do – there’s still hope for you – a good place to start is with a proper mechanical back pain exam to see what was missed prior to your surgery.

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 to catch a replay of her online Back Pain & Sciatica Masterclass – visit cjphysicaltherapy.com

Are your Back MRI results reliable? Research says otherwise.

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Are your Back MRI results reliable? Research says otherwise.

Whenever pain flares up – one of the most popular questions and concerns I get from clients is whether or not they need an MRI. When you have persistent pain that won’t go away, or shooting pain or numbness down your arm or leg, it’s scary. It makes sense to get a look inside with an MRI, right?

Not necessarily.

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. But what we now know from research is that all those findings on an MRI don’t always correlate with what’s actually causing your pain.

One notable study was the Lancet series – three published papers that investigated how MRI findings related to the treatment of back pain. Martin Underwood, MD, co-author of the Lancet series, and professor at Warwick Medical School, is quoted in The Guardian saying: “If you get into the business of treating disc degeneration because it has shown up on an MRI, the likelihood is that, in most of those people, it is not contributing to their back pain.”

Let me explain.

When it comes to back problems – or joint problems in general – what most people don’t realize is that 70-80% of all spine and musculoskeletal problems are what we call “mechanical” in nature.

That means your pain has to do with the way you move, bad postural habits learned over the years, or muscular and joint imbalances like weakness and poor flexibility. Many of these mechanical “wear and tear” problems don’t show up until your 40’s, 50’s or 60’s – which coincidentally is also the time that things like disc degeneration and other age-related changes show up on an MRI.

What it’s important to understand is that disc degeneration, arthritis, and bulging discs are ALL a normal part of aging, but they often get blamed for problems they don’t actually cause. In other words, the source of your pain is often a movement dysfunction learned and repeated over time that is irritating you – not the age-related changes themselves. The best way to figure out if your problem is movement-related vs structure-related is… well… with a movement assessment… NOT an MRI.

So how does movement testing work and why is it more reliable than an MRI? 

This is a great question and not one that is easily explained… but I’m going to try!

When your back, neck or joint pain is mechanical in nature – one of the most important things to look at and pay attention to is how your pain behaves. Not necessarily where it’s located. With pain – the most important thing to determine is how it reacts against certain triggers and with different activities.

Does your pain come and go? Do you have good days and bad days? Can you change positions and influence your pain?

When your pain is variable, it’s the most reliable sign that your pain is “mechanical” in nature. It also means you don’t need surgery or any kind of procedure to fix it. In fact, a procedure or surgery could leave you feeling worse off than before. Let’s say you “cut out” the structure – or inject it to make it numb – your movement problem hasn’t gone away and it’s only a matter of time before it starts aggravating something else.

Take home point… MRI’s are a super powerful and amazing diagnostic tool – but their results when it comes to diagnosing neck, back, or joint pain MUST be taken with a grain of salt – and should absolutely be coupled with an expert mechanical joint evaluation before you decide on a treatment plan.

Because if you are dealing with chronic, long-standing aches and pains that have come and gone over the years – or have recently gotten worse – there is a 70-80% chance that it is a mechanical problem finally catching up to you and not a structural problem.

Figure out the root source of your neck, back, or joint pain by seeing a movement expert who specializes in mechanical pain FIRST. Because when you automatically assume that you need an MRI first, and you base your whole treatment plan off of those results – you can end up down a rabbit hole of unnecessary medical procedures or surgery that ultimately won’t give you the long-term relief you’re looking for.

 

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.

 

 

plantar fasciitis

Tendonitis versus Tendinosis: The Big Difference and Why it Matters

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Tendonitis is a term you’re likely familiar with. You’ve probably even suffered from it at some point in your life. It’s an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon. Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon. It involves deterioration of collagen, a structural protein in your tendon.  While the two conditions sound very similar, and are often used interchangeably, they couldn’t be more different. And the treatment for each condition should be different too.

Tendons are tight but flexible bands of fibrous tissue that connect your muscle to bone.

 

Without tendons, your muscles would be useless. Tendons are extremely organized, and the fibers are designed in a way to withstand and transmit high forces of tension so your muscle can function properly. 

With tendonitis, your tendon becomes inflamed and irritated, typically due to repetitive overuse.

 

Tendonitis causes pain when you try to move. The most common areas for tendonitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle). Tendonitis is an acute condition, and the best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. From there, you want to figure out what caused the tendonitis to occur in the first place and address that. Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendonitis!

When you don’t manage tendonitis properly, and it goes on longer than a few months, it can result in tendinosis.

 

Tendinosis is a very different condition where the fibers in your tendon actually start to break down. An important thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you. I can’t tell you how many times I’ve spoken to people still doing this 6-8 months after an unresolved tendonitis issue. Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers in order to resolve tendinosis and get your tendon functioning properly again. 

Passive treatments like ice, rest, and medicine will not help tendinosis.

 

They might help to relieve any pain you’re having from overdoing it or undertreating it — but the tendinosis will continue to progress. Unresolved tendinosis leads to progressive weakening of your tendon over time, making it easily susceptible to full blown tears. This is how so many folks tear their Achilles tendon or rotator cuff, for example, “out of nowhere.” Once I speak with them, they often report that over the years they had recurring bouts of tendonitis in that area. In other words, their tendonitis wasn’t managed properly and it led to chronic tendinosis, making them an easy target for a torn tendon.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

 

You have to re-organize those fibers so your tendon can work properly again! Sounds easy, right? Well technically it is, but the biggest problem is that this process takes time, up to 9 months in many cases. And most patients I come across simply don’t have the patience for this… or they simply aren’t told. The other issue is that if you’re expecting an insurance company to cover your treatment, they typically don’t want you in physical therapy for more than 6-12 weeks at a time. This is not long enough to properly treat tendinosis.

The only way to re-organize those tendons is to put stress on them.

 

You have to put just the right amount of stress to cause a little bit of pain, but not so much that your tendon gets inflamed again.  This is literally the one time where “no pain no gain” is actually true. A properly trained physical therapist who is well-versed in tendinosis will know how to do this. You basically have to retrain the fibers to withstand force again – and this process takes time.  The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love as if nothing ever happened!

If you’re confused after reading this, don’t worry – so is half the medical community. The take home points to remember are that tendonitis involves pain and inflammation, there is no damage to your tendon, and it only lasts about 4-6 weeks. Treatment for this should involve passive modalities like ice and rest, and the focus should be on what caused your tendon to get irritated in the first place. 

But if problems in your tendon have gone on longer than 3 months, you must suspect tendinosis, which no longer involves inflammation but instead, a breakdown of your tendon. Passive treatments will NOT work and could actually prolong your problem – so stop icing and resting. Getting rid of tendinosis requires carefully prescribed loading strategies (aka strengthening) that will properly re-organize your tendon so that it can be strong again! This is extremely challenging to do on your own, so it’s a good idea to talk to an expert about this. You can even schedule a FREE Discovery Session with one of our experts today!

 

Stretches not Working? Three Reasons Why

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Do you suffer from chronic muscle tightness or back stiffness and ever wonder… why aren’t my stretches working?

Perhaps you’ve Googled and YouTubed every stretch under the sun but still – you haven’t gained an ounce of mobility.

There are a few reasons why all your stretching efforts might not be doing anything for you. It could be your technique. It could be that you’re doing the wrong stretch. Or, it could be that you just shouldn’t be stretching at all!

Let’s go over the different reasons why your stretching routine could be failing you – and most importantly – what you can do about it.

You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into any stretch you’re doing. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work. Some people (myself included) respond better to “moving stretches.” This is where instead of holding one static position for a prolonged period, you repeatedly move through one or several end-range stretches. Moving neck rolls are a great example of this. If you’ve been diligently stretching and not seeing the results you want, try adjusting your technique. Moving stretches might be a better strategy than static holding. I know for me it is!

You’re doing the wrong type of stretch.

This one could be a little tougher to figure out on your own. There is a difference between corrective stretching and stretching to feel good. For example, let’s say your back is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stiffens up your back. Generic back stretches, such as bringing your knees to your chest or child’s pose, may be all you need to quickly get rid of the general stiffness you’re experiencing.

But let’s say you have associated back pain, or pain and numbness running down your leg. In these instances, generic back stretches won’t work or could even make you worse. You likely need corrective stretches, like what we prescribe for patients in our office. Corrective stretches are specifically prescribed to address symptoms, and are very different from the generalized stretches that are designed to feel good and relieve tension.

You shouldn’t be stretching at all.

Did you know that chronic muscle tightness can be a sign of a weakness? This is a very common problem with our clients. I’ve seen many folks over the years with chronic tightness and discomfort in their neck, backs, hips, etc. – and no matter how often they stretch or massage, it doesn’t improve.

How does this happen?

Well, groups of muscles are connected by this substance called fascia. If one group of muscles in the “fascial line” are not doing their job, a different group of muscles will have to take up the slack. When muscles are tasked with more work than they are intended for, they can become tight.

For example, if your deep core is not working properly, then the front of your neck will often kick in and try to help. If your neck is always sore or tight after a good ab workout, this is what could be happening. Stretching your neck won’t help one bit in this case – because what you need to be doing instead is strengthening your core. I see this same pattern with tight hips flexors. Once people start strengthening their core properly – the chronic tightness magically melts away.

Remember, when we are attacking the correct problem and doing the right thing – our body will respond. If you’ve been stretching and stretching and not seeing results – something is missing.

The longer your problem goes on, the more time it has to develop into a complicated fix.

If you’re suffering from any kind of pain or tightness that is keeping you from doing the things you love, our specialists are here to help!

Just CLICK HERE to request a Free Discovery Session!

Travel Plans? Avoid Neck and Back Pain on the go

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We typically see an uptick in travel plans every August. But this year we’re seeing more than ever given that travel was basically non-existent for the entirety of last year.

Traveling is so good for the mind and soul – but it’s not always fun for your neck and back.

When our clients get back from a long trip, we hear common complaints of stiff necks and backs, aggravated sciatica, and just overall achiness.

The good news is you can prevent or significantly minimize most of these symptoms with just a few easy tips. Whether you’re traveling by train, plane, or automobile – here are some of my top tips for easing neck and back pain when you travel.

1. Remember the 30 min rule

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

2. Use a lumbar roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together. While it’s perfectly acceptable to sit like this for small increments of time (remember the 30 min rule), your spine will not like this after several hours. Plus, your neck responds by changing it’s curve as well. Typically, you’ll find your neck in what we call a “forward head” posture if your lower and mid back or curved over.

One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your lumbar spine. Place it right at your lower back any time you’re sitting and you’ll find that your spine has a lot less strain.

Want to purchase a lumbar roll for yourself? We have them right here in our office. Reply back to this email if you want us to put one aside for you 🙂

3. Stay hydrated

We all know that it’s important to stay hydrated, but why is it especially critical for avoiding back and neck pain during travel? Well, water is the vehicle responsible for transporting nutrients to your cells, including the nutrients your muscle cells need to do their job. Dehydration causes muscle cramps because it deprives your body of electrolytes. Proper hydration increases strength, balance, and flexibility. Water also helps to lubricate your joints, which is a bonus for keeping your spine working smoothly and allowing it to support the movements of your entire body. So, if you’re planning to hit the road soon, make sure you bring a reusable water bottle and fill it up regularly. And the extra bathroom breaks will give you an excuse to stay moving!

4. Pack light

No matter where you’re going or how you’re getting there, traveling involves packing, and packing too much stuff can be a quick recipe for back pain. Anyone who has flown knows that lugging multiple bags and/or suitcases around an airport is not only exhausting and stressful but can leave you sore and unbalanced for days. Even if you’re traveling by car, you still have to load and unload your bags, and carry them to wherever you’re staying. Your best bet is to pack light. If you’re bringing a suitcase with wheels, pack heavier items in there so that you don’t put unnecessary strain on your neck and shoulders. Opt for a backpack instead of an over-the-shoulder bag to avoid uneven distribution of pressure, and stock it with your water bottle, small travel essentials, and healthy snacks.

5. Prepare your body

The best way to prevent injury or pain (in general) is to stay as mobile as you can and maintain an active lifestyle. Oftentimes when you travel, you are walking more than usual and doing more activities than you are accustomed to when you’re home. If you’ve got an active trip planned, it’s best to prepare your body beforehand. Something else to consider is your sleeping surface. Different mattresses and sleeping surfaces can really wreak havoc on your neck and back. It’s a good idea to bring your favorite pillow with you, and plan to use extra blankets or clothing items to provide extra cushioning or support where you need it. Whatever you can do to simulate what it’s like to sleep at home is going to help minimize neck and back stiffness.

I hope at least one of these tips helps you to have less back and neck pain on your next travel excursion.

Need more tips?

CLICK HERE – to talk to one of my specialists for free if you’re currently looking for help with neck and back pain right now.

Hamstrings Always Tight? This Could be Why

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

But if even your stretches just aren’t working – what then?

You hear me say this a lot… but if you’re constantly stretching… or even foam rolling a tight or tense muscle… and nothing seems to change… then it’s time to start considering that it might be something else.

I see this scenario ALL the time in our office…

Just recently, a gentleman (we’ll call him “Steve”) came to us with what he thought was a “chronic hamstring strain…”

He had been stretching his hamstrings consistently – but they just weren’t loosening up.

He wanted to know if there were better stretches he could be doing to loosen up the tight, uncomfortable feeling he was experiencing in the back of his thigh every day.

First – it was critical to make certain that Steve’s problem was… in fact… a tight hamstring.

If the chronic tightness in the back of Steve’s thigh was due to a hamstring problem, his stretches really should’ve been having some sort of impact.

Instead, the stretches either did nothing… or made his thigh ache.

Sometimes after stretching a lot – he would “feel” his hamstring for the rest of the day – even when he was just sitting. We checked that he was using proper stretching technique – and he was – so something wasn’t right.

When you’re having a problem with your muscle – and only your muscle – you’ll experience discomfort, tightness, or pain when you’re either using that muscle or stretching that muscle.

Otherwise – you should generally feel perfectly fine.

Muscles are made up of what we call contractile tissue. When you truly strain a muscle, this contractile tissue gets disrupted. You heal it by moving and stretching it – and eventually it goes back to normal. On occasion, people don’t move enough after a muscle strain and the tissue can become chronically tight. But still, you would only experience that tightness when trying to use or stretch the muscle.

This wasn’t the case for Steve.

His pain would, on occasion, linger throughout the day when he was resting or sitting. Sometimes he’d notice hamstring discomfort at night when he was trying to sleep.

Steve was feeling symptoms in his hamstring whether he was using that muscle or not – and his stretches weren’t helping.

This immediately tells me that there was another problem causing his symptoms and it was more than just a tight hamstring. – and when hamstring or thigh tightness doesn’t respond to stretching or exercise – we must always consider the lower back.

Since Steve wasn’t feeling any pain in his lower back – he never considered this himself.

But the key was in how Steve’s pain was behaving…

Your pain behaves in different ways depending on where it’s coming from..

As I mentioned previously, when your muscle is the source, your pain behaves in a very specific and repeatable manner.

But if pain is coming from your spine, it can quite literally be all over the place.

You can feel symptoms in your back, your butt, and your limbs. You’ll have good days and bad days. You’ll feel symptoms at rest, and you can certainly feel tightness in your hamstring – just like Steve.

The other interesting thing about problems that originate from the spine is that you’ll often be able to trigger your symptoms by moving your spine.

When we investigated Steve’s spine… we found that when he moved a certain way over and over… it would produce his hamstring tightness.

Bingo!

This explains why Steve’s hamstring stretches were doing absolutely nothing… He was stretching his thigh when he really needed to stretch his back.

Does Steve’s story resonate with you?

If you’re feeling chronic tightness or pain in your hamstring that just isn’t going away – chances are good that you’re missing something.

Do yourself a favor… DON’T check YouTube or “Dr. Google” for advice…

Talk to one of our experts instead.

Best way to do that is request a FREE Discovery Session.

We’ll talk to you about the symptoms in your hamstring and let you know if stretching is enough… or if you need something more!

CLICK HERE to request a Free Discovery Session with one of our specialists.

 

5 Tips to Treat Back Pain on your Own and Avoid Surgery

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5 Tips to Treat Back Pain on your Own and Avoid Surgery

Back pain impacts approximately 31 Million Americans at any given time, and our health care system spends $50 Billion per year on low back pain treatment. It’s the single leading cause of disability keeping people out of work, and it’s the second most common reason for doctor’s visits. Back pain is a big problem in this country. But the even bigger problem, in my opinion, is how the traditional medical system treats and manages those suffering from back pain.

Despite what you may have been told, getting rid of back pain on your own is entirely possible and preventing it can be even easier.

But it starts with understanding what the true cause of back pain is for most people.

Eighty percent of back pain is “mechanical” in origin, which means it’s not due to any serious pathology like cancer, infection, or fracture. Mechanical back pain is the result of abnormal or unusual forces occurring in the structures of your spine – like your ligaments, muscles, discs, and vertebrae. These abnormal forces can accumulate slowly over your lifetime or happen quickly in a single event – such as picking something up the wrong way.

The good news is that if abnormal forces can cause your back pain, then reversing those forces can get rid of your back pain. Surgery and other medical procedures won’t do that. They only impact the structure or irritant that is aggravated, like when you remove a piece of your bulging disc. The goal for true back pain recovery is to eliminate what is causing those structures to be aggravated in the first place – and the best way to do that is with healthy movement you can do on your own!

Here are 5 tips to help you treat back pain on your own and avoid surgery:

1. Stop sitting so much

Compressive forces on your spine increase by 40% when you sit – and it goes up even more if you’re slouched! Over time, these compressive forces will start to aggravate the ligaments and discs in your spine. Because it happens slowly, you may not notice right away, so one of the best things you can do is interrupt your sitting at least every 30 min. This minimizes the accumulation of abnormal forces on your spine throughout the day.

2. Walk more 


Our spines were designed to be upright and moving. Walking is one of the best and easiest ways to promote this. When you walk regularly, it helps to promote good mobility and blood flow, which can act like lubricant for the structures in your spine. Walking also helps to keep your hips from getting tight. Tight hips can cause abnormal forces to occur at your pelvis, which in turn, will create abnormal forces on your spine.

3. Vary your posture

You might be wondering why I didn’t say “maintain good posture.” To be honest, perfect posture all the time is kind of a myth when it comes to back pain. The truth is your spine is quite resilient and should be able to tolerate lots of different postures – even bad posture for a short period of time – without pain. The problem is when we assume the same posture all the time.

Imagine if you never straightened your knee, eventually it would get stiff and be difficult to move in that direction. The same thing happens in our spines. One of the best things you can do is choose activities (like Yoga or Pilates) that work your spine through lots of different postures and range of motion. This helps keep your spine happy and healthy and it minimizes abnormal forces from the same repeated postures or activities day after day.

4. Strengthen your core

The stronger you are, the more resilient your body is going to be – period. When it comes to back health, having a good strong core is going to minimize stress on ligaments and even discs. When the muscles around your spine are strong, it’s going to be easier for you to lift and carry things, which is one of the most common ways people injure their backs. If your abdominals, glutes, and hips aren’t doing their job, your spine ends up taking more of the stress – and this can lead to both pain and injury. Pilates is my favorite way to strengthen your core because the exercises are designed to target your abdominals.

5. Educate yourself 

There is a lot of misinformation out there when it comes to both diagnosing and treating back pain. You should never let an MRI or X-ray alone dictate what your treatment should be. Remember, the structures in your back don’t get spontaneously irritated. Irritation typically occurs due to abnormal forces on your spine. If you only address the irritated structure – like with an injection, procedure, or surgery – you’re not actually fixing the problem. The best way to address abnormal forces in your spine is with movement – movement that is designed to even out the forces in your spine and relieve pressure from those structures that have become aggravated.

If you don’t currently have back pain – then these tips are going to help you prevent back pain from ever occurring. If you’re currently having some mild back pain or discomfort, then see if any of these tips help you to relieve it on your own! But as always, if you’ve been suffering for a while, then it’s best to seek professional advice from an expert.

Three Reasons Your Physical Therapy Didn’t Work

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Have you been to physical therapy once, twice, maybe even three times for the same thing… and now you’re left wondering why it didn’t work?

Or perhaps you went to physical therapy and it “worked,” but you have to do about 10 exercises per day that if you miss… even once… the pain comes right back. (hint – that means it didn’t actually work.)

This is sadly an all too common occurrence in this profession.

Here are three reasons why your physical therapy treatment might not have worked:

1. Incomplete Evaluation

For physical therapy to be successful – it MUST start with a full and thorough musculoskeletal examination. But for varying reasons, this isn’t always possible. The problem in most traditional physical therapy settings is that physical therapists are sometimes restricted with what they can and can’t do.  Sometimes the restriction comes from an insurance company, and sometimes they are simply overworked. If a doctor sends you for knee pain, your PT may only be able to look at and treat your knee. They are administratively prevented from giving you the full and thorough examination that you need. I can’t tell you how many times I’ve seen knee pain being caused by someone’s spine. If I wasn’t able to look at and treat that area, I’d have missed it.

Other times PTs have too many patients at once, and are forced to take shortcuts. This could cause them to miss important details. I’ve been at this for 20 years, and in my opinion, the perfect physical therapy evaluation should consist of three major components: the interview, the examination, and the plan. Your therapist should be asking you a lot of questions to find out how your pain is impacting you. They should do a lot of movement testing (not just poke you) to confirm why you’re having pain. And lastly, they should clearly explain to you why your pain is behaving the way it is and have a solid plan to solve it, one that is not dictated by your insurance company. If your PT evaluation didn’t look like this, or your therapist was rushed, chances are something got missed.

2. Too Many Passive Modalities

The second reason I see physical therapy not working for people is because your PT used too many passive modalities. This includes everything from electrical stimulation, ultrasound, dry needling, Graston technique, traction, laser therapy, and even manual therapy. We call these treatments “passive” because they are done to you. There is a time and place for these things, but generally speaking, they should only be used to address very specific pain and impairments that are preventing you from moving in a way that is going to produce real healing .

For example, let’s say you’ve got a tight knot in your upper trap that is giving you neck pain. There are some fabulous modalities like dry needling and massage that will quickly get rid of your pain. But a few days later, the pain will come back. That’s because the tight knot is the symptom, the underlying cause of this recurring tight knot is what’s essential to figure out and address. If all your therapist does is treat the symptom with passive modalities that feel good, your therapy isn’t going to work and you’ll continue to suffer.

3. Too Many Exercises

The last reason I see physical therapy not working is because there are just too many exercises being done. Physical therapists LOVE to give homework, but sometimes that homework can turn into two or three pages of exercises. This is rarely necessary. And the chances of anyone doing all of these exercises every day is highly unlikely. My firm belief is that your physical therapist should be working on highly specific problems with highly specific exercises.

I refer to these as corrective exercises, and you typically should only have 3-5 to do at any given time. These corrective exercises should compliment what you are doing in your session, and be designed to specifically address pain, and/or a very specific impairment or weakness. They should not be generalized or cookie cutter, and you should absolutely have a very good understanding of why you are doing them and what they are designed to accomplish.

Now you know what quality physical therapy should look like. If you’re not getting it, it might explain why it “didn’t work.” Sadly, insurance puts a lot of limitations on what physical therapists can and can’t do. Which is why a lot of people are starting to move away from using their insurance all together. They know they can get better quality care, and have their problem resolved completely, by paying out of pocket to an office that isn’t tied behind red tape. Plus, while it might seem cost prohibitive at first, it’s a lot better than the costly alternative of unnecessary surgery or injections.

Remember that physical therapists are movement experts.

If you’re only doing cookie cutter exercises, riding the bike for 10 min, or just lying on the table every session – you’re not spending adequate time restoring full mobility and quality of movement.

Your physical therapy probably won’t work, and it certainly won’t give you the lasting results you’re looking for.

If this experience is sounding all too familiar – consider working with a practice like ours. We’re not restricted by the red tape and we care about doing things the right way, even if that means more work on our end.

Curious? Talk to one of our specialists for free!

If you’re local to Portsmouth, NH – You can do that by Requesting a Free Discovery Session right HERE!

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 get a free copy of her guide to taking care of back pain, email her at [email protected].