Tag Archive for: back pain

Movement Strategies to Combat the Stress of Pandemics and Politics

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I think we can all agree that 2020 has been far from a typical year. We continue to find ourselves in a state of uncertainty — and it’s causing people to live in a constant state of stress.  

Eight months ago, when this pandemic began, we saw a huge surge in back and neck pain coming into the office. At first, I knew it was due to people being stuck at home and off their routines. But now, and especially with the current political climate, I’m seeing a different and more prevalent kind of stress-induced pain in my office. It’s caused by the body’s natural “fight or flight” response and it’s taking a real physical toll. People feel it in their necks, backs, hips, and shoulders and are looking for help to get rid of it.

Why does this happen?

Fight or Flight is a natural (and important) stress response to anything your brain perceives as stressful or frightening. Back in the caveman days, this was essential to our survival. If you saw a lion, for example, and he looked hungry, you needed to be able to quickly get yourself out of danger. Fight or flight is your body’s way of doing just that. Your heart and respiratory rate increase, so that more blood and oxygen can be pumped toward your brain and muscles – where you need it most – so that you can quickly run and flee away from danger. Another consequence of fight or flight is tense, tight muscles. Your body does this to protect you from the threat. Our ancestors would only find themselves in this situation once in a while. The rest of the time, their bodies functioned normally and without this stressful response. 

Fast forward to our modern day lifestyles… our brains perceive threats and stressors differently.

Everything from a big presentation due at work to a difficult conversation with your boss, spouse, or kid’s teacher, to bad news flooding our newsfeeds and email every second of the day can activate this response. Add a pandemic and election cycle on top of all that, and we find ourselves living in a chronic state of fight or flight. And we are evolutionarily conditioned to look for ways to escape these situations to get “out of danger.” 

Even though fight or flight is natural and embedded deeply into our brains, it was meant to be life-saving and reserved for very specific situations – not all day every day. If your body never comes out of this, your muscles become chronically tight, resulting in constant pain and tension. Stretching and massage might help to temporarily relieve these symptoms, but they will come right back if you don’t learn to manage your fight or flight response for what it is. 

How do you manage and interrupt your fight or flight response?

One easy way is to breathe. This is one of the most practical ways to calm your nervous system by lowering your heart and respiratory rate. You can literally do this in 30 seconds starting the moment you feel any kind of tension or tightness in your body. The better you become at recognizing tension in your body ahead of time, the easier it will be to interrupt and stop your fight or flight response. Simple, deep breathing is a signal to your nervous system that you are safe – and that you don’t need to prepare to run or flee by tightening up all of your muscles.

Daily exercise is another easy way to combat stress.

When you’re in fight or flight, your body is preparing to either engage the threat or run from it. If you don’t do either of these things, your nervous system doesn’t know that you’re out of “danger.” Intentional movement and exercise solves this problem and helps to close the loop of your flight or flight response. With regular movement and exercise, you can help better regulate this response since it is so constant in our lives right now. Our exercise of choice is Pilates. It’s a particularly effective exercise system to combat fight or flight because it involves focused and controlled breathing and it works your whole entire body. And since we work with so many folks suffering from neck and back pain, we also love it because Pilates targets your core. Good core strength is one of the BEST ways to keep neck and back pain away.  

Is Shoulder Pain “Impinging” on Your Lifestyle?

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

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

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

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

Most of the time, the answer is POSTURE.

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

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

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

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

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

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

Tight Hamstrings: a Case Study

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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 health and wellness professionals is to stretch them.

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

But what if it’s something else?

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

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

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

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

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

And the first thing we asked him was…

“Where is your pain?”

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

Lesson number 1:

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

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

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

Lesson number 2:

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

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

All signs were pointing to a problem in his back.

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

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

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

Pretty cool – right?

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

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

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

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

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

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

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

Don’t guess… TEST 🙂

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

Neck stretches

Neck Pain During Crunches? Here’s Why & How to Avoid it

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Abdominal crunches are one of the most popular “ab exercises” around. It’s a movement that emphasizes upper abdominal strength. You start by lying on your back, typically with your hands behind your head and knees bent. You then lift your head and chest off the floor, “crunching” your upper body into a C-shaped curve.

Over the years, many “experts” have dismissed this exercise, claiming it’s ineffective for core strengthening. While I agree that it shouldn’t be the ONLY core exercise you do — the crunch does have its place. I work on this a lot with my private clients, because it’s a functional move that when done correctly, will help you sit up from the floor with more ease and with less risk of injury. And of course you see variations on this movement all the time in Pilates, which is a key part of our practice and our efforts to help people recover from back pain.

I often hear that people don’t like crunches because they’re uncomfortable or hurt your neck. But when you’re doing a crunch, you want to make sure you’re feeling it in your abs… NOT in your our neck. Here are the biggest problems I see with crunches and how to tell if it’s a technique problem or a neck problem:

You’re not actually using your abs

This sounds pretty obvious, right? But a lot of people have trouble figuring this out. During our Pilates 101 class this week, one woman experiencing neck pain appeared to be doing the move correctly — but she couldn’t feel it in her abs, only in her neck.

It’s because she was using her neck and chest muscles to curl her upper body into the crunch instead of initiating the move from her belly (abs). My tips to correct this were to pull her lower belly in toward her spine and the front of her ribs down toward her belly button. Then, keeping this shape locked in, use her breath (exhale) to help her initiate and start the curl from her abs.

Sometimes people don’t have the abdominal strength yet to perform a crunch from lying flat. If that’s the case, you won’t be able to do this correctly no matter how well you follow my cues. If you think that’s your problem, place a small pillow under the back of your head. This gives you a head start into the curl. Once your abdominals get stronger, you can try doing the crunch with your head starting from the floor again.

Your neck is in the wrong position

When you’re doing a crunch, you want your neck to be slightly curled (chin toward chest). Most people either curl their neck too much, or not enough. If your chin is touching your chest, you’re curled too much. And if you feel your chin and neck jutting forward toward the ceiling, you’re not curled enough. Either of these positions could lead to neck problems down the line if not corrected.

The ideal position for your neck is to begin with a slight nod of the chin (like you’re nodding “yes”) and then keep it there. The rest of the curling motion will come from contracting your trunk and abs. As you curl up, I recommend keeping your eyes focused on your belly and keeping a tennis ball’s distance between your chin and your chest.

Sometimes your hand and arm position can be what causes your neck to be in the wrong place. If your hands are behind your head, be sure you’re not using them to pull your neck forward. Your head should be gently pressing into your hands and your elbows should be at a 45 degree angle from your body. Your abs do the rest.

You have an underlying neck problem

In our practice, we specialize in neck and back pain. When you’ve got an underlying neck problem, doing crunches isn’t a good idea until the underlying problem is resolved.

Let’s say you have a small bulging disc in your neck that you weren’t aware of or that you thought was fixed. The curled position of your neck during a crunch can exacerbate this problem, even if you are using your abs correctly and following every tip I just mentioned above.

Some clues that you might have an underlying neck problem could be pain that shoots into your shoulder blade or numbness and tingling down your arm. You might experience these symptoms during the movement, or even up to several hours after.

Either way, symptoms like this could be a sign that there is more to your neck pain than simply incorrect crunch-technique or weakness in your abs.

If this is happening, it’s a good idea to get it checked out by a movement/mechanical specialist like the physical therapists in our practice. The good news is that we can help your neck feel better even if you do have a problem like bulging discs — and you can get back to doing crunches again without any neck pain.

You can also check out our FREE guide to neck and shoulder pain right here!

It comes right to your email inbox and explores seven easy ways (plus a bonus section!) that are PROVEN to help you ease neck and shoulder pain quickly – without pain medication, procedures, or surgery.

If you have any additional questions or want a more personalized assessment, sign up for a FREE Discovery Session with us! It’s a quick, no-obligations opportunity for you to see if working with us could be the best decision for your health.

Man getting knee pain treatment

Tight Hip Flexors? When Stretching isn’t Enough…

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When it comes to feeling stiff and immobile, tight hip flexors are the second most common complaint I hear – right after tight hamstrings.

Tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are tight, it can be painful or uncomfortable to walk, run, play golf, exercise, and even stand up straight!

Typically, the recommended treatments for this problem include lots of stretching, foam rolling, massage, and myofascial release.

But what if the stretching and all that other stuff doesn’t work?

What if no matter how often you stretch, the tightness just keeps coming back?

Sometimes – actually often – the tightness you feel in your hip flexors (or any other muscle group for that matter) can be due to weakness or overworking of the muscle.

If this is your problem, then no amount of stretching or foam rolling is going to help you.

Stretching and foam rolling will help to temporarily ease the stiffness from an overworking muscle, but it will only be a bandaid until you tackle the root cause.

You need to first identify WHY these muscles are weak or overworking, and THEN figure out the proper exercise and load that will help turn your hip flexors from feeling tight and overworked – to flexible and mobile.

Your hip flexors consist of the muscle group located in the front of your hip in the area of your groin. They are responsible for flexing or bending your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back… and this is where we see a lot of problems and confusion.

The rectus femoris, part of your quadriceps muscle group, and your psoas, part of your deep abdominal muscle group, are the two major hip flexors. Your rectus muscle is the one primarily responsible for lifting your thigh. When you are walking or running, and repetitively flexing your leg, this is the muscle you are using.

Your psoas, on the other hand, is much shorter and actually attaches to your lumbar spine. Because of this, it has more of a stability role. When functioning properly, it will assist in exercises like the crunch or sit up, and it helps to stabilize your pelvis during any of these movements as well as when you are standing upright. Your psoas, abdominals, and glute muscles all have to work together in harmony for you to have good posture.

Let’s talk about the psoas for a moment… because this is where many folks I speak with are misinformed.

The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle – then you will balance out your pelvis and your back pain will disappear.

Sadly – this is rarely the case. Read more

Holding Knee with Arthritis

When Traditional Physical Therapy Fails…

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

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

Has this happened to you?

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

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

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

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

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

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

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

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

Here’s an example…

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

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

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

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

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

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

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

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

Click here to request a Discovery Visit.

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

Five Ways Adding Pilates to your Life will Enhance your Fitness.

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Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method. It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates — or enjoy the benefits. 

We’ve been incorporating Pilates into our physical therapy practice for the last 10 years and it’s been transformational for both our clients AND our practice.

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength. It helps our clients connect to their bodies in a way that they haven’t been able to achieve with traditional strengthening methods. Most of my clients are well into their 50’s, 60’s, and 70’s, and they love Pilates because it helps them have more energy, better balance, improved strength, and more mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases their risk for injury.

Here are five reasons why I personally love adding Pilates to any fitness routine, and why you should consider adding it to yours too!

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We specialize in back pain, so see a lot of folks with this problem in our office. They’ve often worked with traditional physical therapists or chiropractors in the past to successfully get rid of back pain in the short term, but it keeps coming back. And our clients want it gone for the long-term. A regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but is also a well-balanced exercise system. Full body strength and balance is a critical component for life-long back health, and it is not always addressed in traditional back rehabilitation programs or treatments.

2. Pilates strengthens your whole body, not just your core.

One of the keys to truly enhancing your fitness is what I call “balanced strength.” That’s when each part of your body works together to produce the right amount of force, at the right time, to do your favorite activity in the most efficient way possible. Efficiency means you’ll be able to do it for longer and with more ease. We see lots of strong people in our office, and they can’t understand why they’re in pain. It’s entirely possible to be “strong,” but still have certain muscles working harder than others. This creates an imbalance, which eventually leads to problems. Pilates emphasizes full body strength that is coordinated, which helps promote balanced strength throughout your body and leads to fewer injuries over time.

3. Pilates helps you get more flexible and mobile.

Do you stretch your hamstrings every single day and get frustrated because they’re still tight? It’s probably because you’re not stretching the right way. What I love about Pilates is that it stretches your body in a dynamic way – with movement – so that muscles lengthen the right way. The days of statically holding a stretch for 30 seconds are long gone. Plus, mobility is extremely important for strength. Muscles work better when your joints move fully and freely. “Mobility before stability” is a phrase you hear daily in our office. And Pilates is a great way to get your joints and muscles mobile while ALSO promoting stability.

4. Pilates puts minimal stress on your joints.

Aging is a real thing, and along with it comes arthritis. The key to combating arthritis is optimizing the area around the affected joint or joints. When you have good mobility, and balanced strength, you have less compressive forces around your joints.  Arthritis doesn’t like compressed, crowded joints. So when you strengthen and stretch your whole body in a good, balanced way – arthritis becomes less painful and stiff. Pilates helps with all this and doesn’t cause any added stress on your joints. There’s a good reason you see lots of folks in their 60’s and 70’s enjoying our classes.

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is – and it’s almost ALWAYS the missing link for people who feel stuck, or can’t seem to get beyond a certain point in their fitness. It can also be the reason why an activity you’ve been doing “for years” suddenly becomes problematic or painful. If you don’t train your nervous system, it gets lazy, and compensations will develop in your body. Compensations lead to problems when unchecked. Since Pilates is a mind-body exercise, it helps to keep the communication between your brain and your muscles fresh. Pilates emphasizes precise and coordinated movements, which enhance and reinforces this connection.  In other words, your nervous system can’t get lazy when you do Pilates!

If you’re not yet incorporating Pilates into your fitness or rehab routine — what are you waiting for?

As a specialist physical therapist it’s my go-to exercise system for folks over 40 and my favorite way to help people keep their back pain gone.  We’re actually re-launching our signature 8 week program, Pilates 101 ! Pilates 101 is completely dedicated to folks who are new to Pilates, or who have back pain and want to learn how to develop a safe core-strengthening routine. If you want more information, just click here!

 

 

Sciatica

Why Back Pain Keeps People from Exercising

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Did you know that eighty percent of the population suffers from what we call “non-specific low back pain” (NSLBP)?

You might have NSLBP if your back pain:

  • is often chronic
  • comes out of nowhere
  • comes and goes (you have good days and bad days)
  • is not due to a recent or major accident or fall

If you’re reading this right now, odds are very good that YOU are one of the 80% suffering from NSLBP.

Did you also know that research says exercise is the BEST treatment for this type of back pain?

But what do you do if back pain keeps you from doing the one thing that is best for you??

We have an 8-week program designed to tackle this very important problem… but before I get into that, let’s go over some reasons why back pain keeps so many people like you from exercising.

1. FEAR

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. And 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 is avoid any exercise or movement that causes pain. But doing this can lead to a host of other issues, namely, loss of mobility and in-activity. When you become less mobile and active, your back pain gets worse, and now you’re in a vicious cycle.

2. BULGING DISCS

Most people who suffer from long-standing NSLBP 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 already 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 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 without talking to one first.

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 episode of back pain, but it’s terrible advice for chronic 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. When they hurt their back again they stop and return to rest… I’ve seen so many people fall victim to this perpetuating cycle and it’s a big reason why so many back pain sufferers find themselves with the NEXT problem on this list…

4. YOU’VE GOT A “BAD BACK”

I can’t tell you how many times I’ve heard this one and it makes me want to scream! First off, there is no such thing as a “bad back”. There are backs with problems, and there are backs more sensitive to pain than others, but there is no reason to believe your back is inherently “bad” or that you should stop exercising. Not exercising causes almost all back problems to become worse, but it can also turn a “bad back” into a strong and healthy one! For most people, once you get the right guidance, you can quickly find yourself safely and confidently exercising again.

5. INEFFECTIVE CORE STRENGTHENING

Interestingly enough the research on this topic is quite scattered. Much of the research says that targeted core work doesn’t have any added benefit compared to general exercise when it comes to reducing back pain. What the research doesn’t tell you is that your core strength can make or break how well you exercise. If you don’t exercise with good proper form, you’ll end up with back pain. Learning how to properly strengthen your core has a HUGE impact on your ability to exercise in a way that will not cause your back to hurt. I meet a lot of folks who start doing “core exercises” to get their abs stronger and reduce back pain, but they end up hurting their backs instead. That’s because there is a right and a wrong way to properly strengthen your core, especially if you’re prone to back problems.

On Sunday, September 6th, we’re opening enrollment to our Pilates 101: Get [Your] Back to Health™ program.

You MUST apply to join this program.

Click here to learn more.

Since this program fills up every time we offer it, we typically give the folks on our VIP waiting list an opportunity to sign up first.

Plus… when you sign up early, you can save up to $200 off the program!

If you’re suffering from NSLBP 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 — and perhaps proper core strengthening — to get you there.

Should You Heat or Ice an Injury?

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Earlier this week, we put on a free Zoom workshop all about preventing and overcoming knee pain – and one of the questions that came up was if you should apply heat or ice when something is hurting. This is a VERY common question in our office, so we wanted to share the same advice we give to clients right here!

When to apply ice:

Generally speaking, the best time to apply ice is within 24 to 48 hours immediately following an injury. Application of ice during this stage has been shown to reduce the formation of edema and “secondary injury.” After that, it really becomes a personal choice. If you’re in pain, and ice makes you feel better, go for it! Some research has claimed that icing an injury after 48 hours is “bad” for you. But if you really dig into the research, it’s inconclusive on this topic. What I tell my clients is that if something feels irritated or inflamed – go for ice. It’s a much better and more natural alternative to pain pills!

When to apply heat:

Once you’re into the chronic stages of injury or pain, I’m generally a fan of heat. But the term “heat” is relative – and doesn’t necessarily refer to the application of a heating pad only. In fact, research has shown that heating pads are not able to penetrate deeply enough to actually have an effect on the injured muscle or soft tissue. But it does feel good… which can be beneficial in and of itself because when you “feel” better – your nervous system relaxes. If the superficial heat can relax the nervous system enough so that you can actually tolerate the movements or exercises that WILL actually heal you – then I can see a benefit.

The BEST way to provide “heat” as a way to promote healing to an injury is through movement – but you need the right prescription. The mistakes I often see, especially around 2-4 weeks post injury, is that people aren’t moving enough (if at all), or they are overloading the tissue and moving too much.

Movement truly is medicine, and it’s one of the best and most natural ways to properly heal from an injury – but you MUST get the prescription right.

So there you have it. You can’t really go wrong with either modality. The general rule is that if it’s an acute injury – ice up to 48 hours. For anything else, we typically recommend heat.

If you’re presently healing from an injury and not satisfied with your progress – perhaps you’re just missing the correct prescription. If you’re wondering what that magical movement is, or you’re wondering if the current movement you’re doing is safe, get in touch!

Speaking of movement as a way to heal…

Our Pilates 101: Get Your Back to Health is back!

This is our signature program and it’s designed to help those dealing with lingering back problems learn to move and heal the RIGHT way – from the inside out with proper core strengthening. It’s also ideal for those that had recent back surgery and you’ve already been through your initial stages of general physical therapy.

Interested in learning more or getting on the VIP waitlist for the program? Click here!

Knee Pain while Running? Don’t Blame Arthritis

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Knee Pain while Running? Don’t Blame Arthritis

Is running bad for your knees? Does it cause arthritis?

We get asked these questions a lot, especially by clients who are in their 50s and 60’s and wondering if it’s safe to keep running.

The short answer is no — running is NOT bad for your knees! If you experience knee pain while running, it’s not that you’ve “aged out” of the sport or that it’s causing arthritis in your knees. This is a very common misconception. In fact, research supports that running may actually be GOOD for your knees!

Staying strong, active, and mobile is your best defense against osteoarthritis.

Therefore runners, because they are typically active and healthy individuals, often have healthier knees compared to non-runners.

Ok then — so if not arthritis — what really causes knee pain in runners?

In most cases, it’s simply a biomechanical issue that goes unaddressed over time. But the GOOD news is that once identified, these issues can actually be fixed with proper education and strengthening (best offered by movement specialists like us!).

Here are three of the most common factors we see that cause knee pain while running:

 

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can impact your knee. If your ankle doesn’t move fully, freely, and adequately, excess forces will be shifted up to your knee. The knee may be forced to flex, rotate, and/or tilt more than it needs to. This, in turn, may result in unwanted loads that the tissues of the knee can’t handle. An expert in biomechanics and movement can not only help you identify if this is the true root of your “knee problem,” but can also help you improve your ankle mobility. This will help prevent long term damage to the joints, tendons, and ligaments in your knees. We actually see this as a very common problem. Specifically, in those that have sprained or twisted their ankles in the past. If that’s you, this could be a reason why you’re suffering from knee pain while you run.

2) Weakness in your hips and thighs

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing good, balanced strength in your hips and thighs is critical. The hamstring and quadriceps muscles play a crucial role in stabilizing the patella, otherwise known as your kneecap. Since running is extremely repetitive on your joints, especially your knees, it requires they have good durability and endurance — something that is lost quickly when you neglect proper strength training. Often “wear and tear” in your knees (otherwise known as arthritis) will get blamed for your knee pain when in actuality, the loss of strength around your knees is what’s causing that wear and tear to feel worse than it needs to.

3) Unstable core

It may seem like running is all in the legs, but the stability of your pelvis and trunk have a huge influence on how your legs perform. You derive the majority of your power, speed, and stamina from your core muscles and glutes. Much like with ankle mobility, if your core is not performing adequately or efficiently – your legs will have to work harder. A stable core is key for developing and maintaining good balance and rhythm with any activity – but especially running.

With a repetitive activity like running, efficiency and form is everything. Without a strong core, it’s impossible for your leg muscles and knee joints to work as efficiently as they were designed to. It will be really difficult for you to maintain good and proper running form. When your core strength is weak, and doesn’t have enough endurance to sustain the amount of miles you want to run, your knees will suffer.

What’s important for you to remember is that arthritis is NORMAL — everyone gets it as they age. 

What doesn’t have to be “normal” is for arthritis to stop you from running, or doing any other activity that you love. You can get surgery to fix the “wear and tear” in your knees, or injections to decrease the inflammation, but if you don’t check and address any underlying biomechanical issues, these fixes will be temporary and your knee pain will keep coming back. And worse… they could force you to stop running all together!

If you’re local to Portsmouth, NH and suffering from knee pain that’s starting to impact your ability to run or do any other activity that you love, you might want to consider speaking to one of my specialists.

In this FREE Discovery Session you can tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

CLICK HERE to request a free discovery session.

Dr. Carrie Jose – back pain specialist and Pilates expert – owns CJ Physical Therapy & Pilates in Portsmouth, NH.