Tag Archive for: back problems

man getting back pain treatment

5 Reasons Exercise is Hurting your Back

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5 Reasons Exercise is Hurting Your Back

The research continues to show that the best “treatment” for back pain is exercise. But what do you do when exercising hurts your back instead of helps? 

This is one of the most common frustrations I hear from my clients. The doctor looks at their back and takes an X-ray. He or she only sees something like arthritis or degenerative disc disease. Surgery doesn’t make sense – so the advice is to go exercise – and specifically to strengthen their core. But when it doesn’t work they are at a loss.

Why would exercise hurt your back when the research overwhelmingly shows that it’s supposed to help? 

Here are 5 reasons why…

1. It’s the wrong type of exercise

While the research isn’t wrong about exercising and back pain – it doesn’t always reveal the specifics on the type of exercise that’s being done. For example, walking is considered one of the best activities for back pain sufferers, and for the majority it will help significantly. But I also have clients who get worse just walking to their mailbox at the end of the driveway. What the research is really saying is that movement – not necessarily “exercise” – is what’s really good for back pain – even acute back pain. But you need to make sure it’s the right type of movement for YOUR specific type of back pain. If you get the type of exercise or movement wrong you’ll feel worse. This is one reason why exercise will sometimes hurt your back instead of help.

2. Stability training is introduced too soon

 

Stability training is an important part of back pain recovery – but I often see it introduced too soon. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. You want to make sure you explore that fully and get the spine moving the way it should be before you begin stabilizing or strengthening it. Every now and then I stabilize first, but it’s rare. More often than not I see that people with long standing back pain are suffering from a mobility problem that was missed. When your spine doesn’t move well, you risk developing compensatory movement pattern. These can cause structures in and around your spine to get irritated. You want to figure that out first before jumping ahead to stability training of your core and spine.

3. You aren’t activating your core

 

Knowing how to properly activate your core is different from having good core strength. You can have the strongest abs in the world – but if you don’t use them when they count – your 6-pack abs are useless.  Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or performing complicated movements that require good coordination, you’re setting yourself up for injury.

The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. Pilates (when done properly and with a well-trained instructor) can accomplish this quite well. If you’re constantly having back pain every time you exercise or try to strengthen your core, it could be that you lack the ability to activate it when it counts.

4. You aren’t breathing properly

 

Not breathing properly – or not breathing at all – can significantly impact the effectiveness of your exercise routine and impede your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise, and in order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abdominals, your deep back muscles, your pelvic floor, and your diaphragm.

Your diaphragm is what controls your breathing. Let’s say you hold your breath when you exercise. When this happens it means your diaphragm isn’t expanding or contracting in the way it needs to for your deep core to be fully functional. Additionally, when your diaphragm doesn’t work like it should, it adds unnecessary strain and work to your back muscles. This is one reason why you might not be able to activate your core properly – and why exercise might be hurting your back.

5. You’re using improper form

 

The last and most common reason why exercising might be hurting your back is because you aren’t doing it right. There’s a lot of people out there who think posture and form don’t really matter. But they do. If you’re lifting weights – especially when frequently and repetitively – you want your spine to be in good alignment. It might not hurt the first time you lift with improper form, but it will hurt when you get to your 100th rep. Same goes for body weight exercises. Just because you aren’t adding load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. That’s really where people get in trouble. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture or it’s going to catch up to you and cause you unnecessary back pain.

If exercising is currently hurting your back – it could be one of these 5 things. Get expert help to figure out which one it might be – because at the end of the day – exercise IS good for your back. You just might need some help to get there first.

 

Want to safely strengthen your back? Check out our Pilates 101 Get [Your] Back to Health Program. This is our one-of-a-kind 8-session program that delivers safe, yet highly effective Pilates-based core strengthening exercises that are easy on the joints, and help improve your flexibility and posture. Apply here!

 

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. 

Why Strengthening Your Core Could Be Hurting Your Back

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As you probably already know, we specialize in back pain and core strengthening via Pilates…

So why on earth then – would we be writing about how strengthening your core could actually be hurting your back instead of helping?

One of the number one reasons people come to see us is because they want to strengthen their core – in hopes that it will put an end to their back pain.

But here’s the thing about core strengthening and back pain…

In most cases, it will make you feel better and possibly even take away your pain. But there are many times when going to core strengthening first is not right for your back, and can actually make it worse.

The biggest misconception I see when it comes to getting rid of back pain is that if the pain is gone – the problem is gone.

NOT TRUE!

And this is where people can get in trouble. If they try to strengthen their core too soon, back pain will come back with a vengeance.

Here are a few ways to tell if strengthening your core could be hurting your back instead of helping…

 

1. You feel stiffer after workouts.

As I mentioned previously, the absence of back pain does not mean you have addressed the root cause of your back problem. This is especially true if you’re prone to “throwing your back out” year after year.

One of the precursors to a full-blown back pain episode is stiffness.

If you find that your spine feels more stiff after your core strengthening routine, it could be a sign that you are aggravating your back instead of helping it. It’s only a matter of time before you wake up one morning stuck in pain and unable to move.

In our office, whenever we transition our clients from back pain treatment to our Pilates program, we teach them how to self-assess and check their spines.

This allows them to know if the core strengthening being done in Pilates is starting to aggravate them for some reason. If their self-assessment reveals a stiffening back, they know how to correct this before it turns into pain, allowing them to quickly get back to strengthening without skipping a beat.

2. Your neck hurts

I’ve spoken about this before, but increased neck pain or tension during or after core workouts is typically a sign that you’re not activating your core properly.

If you’re trying to work your core to recover from back pain, this could be a big problem for you. It’s only a matter of time before your back pain returns.

When you don’t know how to activate your core properly, you aren’t able to properly control pressure and tension in your abdomen. And you likely have difficulty controlling and coordinating your breath. When this happens, you can end up with unwanted pressure in your lower back every time you work those abdominals. This will eventually result in back pain.

This is one of those cases where core strengthening could be the right thing for your back, but you just aren’t doing it at a level that is appropriate for you.

Learning how to activate and build your core strength the right way is important all of the time – but it’s critical when you’re recovering from back pain.

3. Your hamstrings are sore and achy

A good core strengthening program targets more than just your abs. You should be strengthening your hips, glutes, and hamstrings as well.

While it’s normal to have some soreness after a good workout, when it comes to back pain, it’s important that you know the difference between muscle soreness and pain caused by nerve irritation.

Where you feel your pain and how it behaves is one of your best clues.

Let’s say that after a good Pilates session you notice soreness in both of your thighs and hamstrings the next day. This is typically considered “good” soreness. It’s symmetrical, feels better when you stretch, and likely subsides in 2-3 days. The more you work out, the less this soreness seems to occur.

But let’s say you feel an ache or a pull-down only one of your hamstrings after a Pilates class. You stretch and it doesn’t help. It possibly even aggravates your leg. You rest, the pain goes away, but then comes right back after your next workout.

This could be a sign that your core strengthening routine is causing irritation to a nerve in your spine.

If you don’t address the irritation, your leg won’t feel any better and your back will start to hurt as well.

Plus, if you feel pain or soreness anywhere in your body after a workout, it’s important that you learn to recognize the difference between good and bad pain so that you can correct problems before they happen.

Looking for ways to safely strengthen your core?

Our At Home Pilates 101 Get [Your] Back to Health program might be perfect for you, to apply and learn more CLICK HERE! We’d love to have you start your Pilates journey with us.

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.

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

Back Pain MRI

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.

 

 

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].

Are you overdoing it on “Vitamin I”?

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A few weeks ago, I asked a new client what he had already tried for his back pain. He surprised me by replying with “Vitamin I.”

He could see I was puzzled, so he quickly clarified — Ibuprofen.

It’s the first I’d heard of this term, but is it NOT the first time I’ve heard of people taking Ibuprofen routinely or for prolonged periods. For some it’s because they are in pain already… but for others it’s to prevent pain when they are about to do something they know will hurt.

Ibuprofen is a type of NSAID (non-steroidal anti-inflammatory drug) that is commonly used to reduce inflammation and pain.

Some reasons you might take it are because you’ve had an acute injury such as a sprain or strain, to deal with headaches, because your arthritis flared up, or because you need to bring a fever down.

When you absolutely can’t get control over pain or inflammation naturally (such as with ice, rest, or therapeutic movement) taking Ibuprofen can be helpful.

But when you’re taking it on a regular basis to control and manage pain, or if you find you’re always taking it before certain types of exercise or activity just so you can prevent pain… it’s something to be concerned about.

Long-term use of Ibuprofen has its consequences. Plus, being in pain all the time, or experiencing pain every time you exercise or do a certain activity, is not normal and you should get it checked out.

So what are the consequences of too much “Vitamin I?”

The consequences are minimal if you’re just grabbing Advil every now and then to ease a headache or take the edge off of a particularly painful back pain episode. You’ll always want to check with your doctor or pharmacist first before taking any type of medication — even one like Ibuprofen that is easily accessible over the counter — but assuming you’ve been cleared, it’s rare that you’ll experience any harmful effects from the occasional dose of “Vitamin I.”

The problem is when you’re always reaching for that Advil.

At some point you want to consider what might be causing your pain to keep coming back.

Every time you resort to something like Ibuprofen as a way to control recurring pain, you’re only putting a bandaid on the problem. When it comes to musculoskeletal pain, such as back, knee, hip, shoulder pain or headaches…

Remember that 80% of the time it can be resolved with movement instead of medication.

So consider talking to one of our movement experts who can help you naturally resolve your pain and get you off that “Vitamin I” regimen.

Another common reason people resort to regular use of Ibuprofen is to prevent inflammation or muscle soreness before exercise or vigorous activity. This has become especially common with athletes and weekend warriors.

This is never a good idea.

Research has shown that taking “Vitamin I” ahead of exercise can actually hurt your performance and hinder your recovery. Not to mention the long-term health implications of using Ibuprofen in this manner!

In a study published my Medicine and Science in Sports and Exercise, researchers discovered that when distance runners took 600mg of Ibuprofen before an event, they ended up with more tissue-damaging oxidative stress afterwards compared to those who took nothing, thus debunking the theory that “Vitamin I” can help you avoid inflammation.

In this case it increased!

Another study done on cyclists found that Ibuprofen can damage your gut during exercise and lead to a leaky small intestine.

And finally, scientists have conducted animal research that shows taking “Vitamin I” as a prophylactic for muscle soreness actually hinders your recovery.

If you’re finding yourself constantly in pain or very sore after or during certain types of exercises and activities, you may want to look at how you’re warming up or preparing for these things.

If you have consistent problem areas such as back or knee pain, there are corrective exercises you can learn that will better prepare your joints for repetitive and strenuous activities.

In many cases, corrective movements can help you avoid pain entirely.

But at the very least, they’ll help to reduce any pain you do experience much faster, and you’ll recover more quickly.

And for tissue inflammation, there are great natural alternatives that are safe to consume before a particularly strenuous workout. Tea, tart cherry juice, and turmeric are all considered natural anti-inflammatories that are safe, and don’t come with the harmful side-effects of “Vitamin I.”

While I’m a huge advocate of avoiding pain medication whenever possible, there are times when taking Ibuprofen makes sense. But it should be occasional and minimal and you should always be checking in with your doctor to make sure it’s safe.

But even when your doctor says it’s ok to use right now, know that long-term use of Ibuprofen can damage your digestive system, interfere with your hormones, and increase your risk of heart attacks and stroke.

It’s always best to look for natural ways to ease pain first.

Movement is my favorite form of medicine.

If you want to find the movement that is YOUR medicine, so you can stop using “Vitamin I” as a bandaid…

Request a FREE Discovery Session with one of my specialists.

They’ll talk to you first to make sure you’re even a good fit for what we do… and if so… let you know how we can help!