Tag Archive for: back

Common Golf Injuries and How to Avoid Them

Most golfers I know won’t let anything stop them from being out on the course – especially here in New England where the golf season is not very long.

But let’s face it, when something hurts, playing 9-holes is just not as fun.

Jack Nicklaus had it right when he said, “Professional golfers condition to play golf; amateur golfers play golf to condition.” That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they’re out of shape, have poor swing mechanics, or don’t adequately warm up.

Here are three common golf injuries and things you can do to avoid them.

Elbow Tendonitis

Tendonitis is characterized as the painful inflammation of a tendon. It’s caused by repetitive movements that overload the tendon, eventually causing it to feel strained and overworked. When it occurs on the inside of your elbow, which is something that happens a lot with golfers, it’s called “golfer’s elbow.” The treatment is ice and rest initially (which means you don’t get to play golf for a while) followed by progressive and proper loading of the tendon to get it back to a healthy state. This whole process, if done properly, takes time… and it can certainly ruin your golf season if it’s not caught early.

What causes elbow tendonitis? We know that technically, it’s inflammation of tendons in your elbow. But what leads to that in the first place? Often weakness in your mid-back and shoulders along with mobility restrictions in your wrists. Your elbow is significantly influenced by what happens above and below it. If your mid-back and shoulder area are weak, the rest of your arm won’t feel supported and your elbow can get overworked. If your wrist is tight and immobile, your elbow will be forced to move more than it should, especially through a golf swing. This will cause extra stress on your tendons and eventually result in tendonitis. The best way to prevent this from happening is to make sure you’ve got adequate mobility in your wrists, and good strength in your mid back and shoulders.

Back Pain

One of the most common ways to hurt your back is with repetitive flexion (bending) and rotation (twisting). Well, what does a round of golf consist of over and over? Repetitive bending and twisting! Every time you swing that golf club, you’re putting your spine through one of its most stressful positions. And if it’s not prepared — it’s going to get injured.

One of the best ways to prepare your spine for a long and healthy golf season is to avoid a lot of sitting and keep it mobile. Sitting for prolonged periods makes your back more susceptible to injury in general, but especially if you’re going to be doing a lot of bending and twisting. Interrupting your sitting frequently during the day is a very easy way to minimize its harmful effects. 

If you lack adequate mobility in your spine, it will feel strained every time you try and swing your club. When you overstress a joint that is stiff, the muscles around it tend to tighten up and spasm in response. It’s important that you take time to optimize and maintain your best spinal mobility for golf season. This will significantly help to decrease the stress that occurs in your spine when you swing in one direction repetitively, and ultimately help you prevent a back injury.

Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints. If you lack adequate mobility or stability in and around your knees, you’re going to have problems. Much like the elbow, the most common source of knee pain I see in my golfers comes from the joints above and below, and not from the knee itself. To keep your knees mobile and healthy and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as stability in your feel and ankles. 

The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees will want to try and help, and they are not designed for this. Your knees need to be loose and free during a golf swing. If not, the muscles and ligaments around your knee joint will take on unwanted stress. 

Another cause of unwanted stress to your knee joint is lack of support from your feet and ankles.

Your knees need a stable foundation if they want to bend and twist without stress. If stability below is lacking, your knees will tighten up in an effort to compensate. Moral of the story: make sure you’ve got mobile knees, a strong core and hips, plus stable feet and ankles, so that knee pain doesn’t derail your golf season.

Hopefully these tips help you understand why golf injuries happen and most importantly, how to prevent them. If you’re feeling stuck and looking for individualized expert help – request a FREE Discovery Session. We look forward to speaking with you!

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 taking care of back pain – click here.

Avoiding Radiofrequency Ablation

Avoiding Radiofrequency Ablation in Your Back – Success Story

Have you heard of Radiofrequency ablation (RFA)?

If you suffer from chronic back pain – there’s a good chance you have. Perhaps it’s even been recommended to you?

It’s a common procedure used to disable nerve fibers that are carrying the pain signal to your brain.

Your brain is what decides whether or not you’re going to experience pain. So the goal behind this procedure is to kill (or in this case burn) the “middle man” – the nerve that is responsible for signaling the pain trigger. An electrical impulse is transmitted through a needle that is designed to burn the nerve endings responsible for your pain.

If it works – the results last anywhere from 6 months to a year – but they typically aren’t permanent.

Most of the people I talk to who rely on this for pain relief have to go back at least once per year or more.

But in some cases… the procedure eventually stops working all together…

And then what?

Well… you’ve usually got just two choices…

  1. Live with it
  2. Get surgery

The good news?

You don’t have to accept either of these options and you don’t even have to rely on this procedure at all if you don’t want to.

How do I know?

Because 80% of all spinal pain is mechanical in nature – which means it’s due to poor or insufficient movement habits. These habits – over time – result in compensatory strategies in your body. These compensatory strategies eventually lead to “pissed-off” muscles, ligaments, or nerves – which result in pain.

So you see…

Getting a procedure like RFA is really only a bandaid.

Why not find out what compensatory strategy might be happening in your body – and from there – what caused it to begin with?

That’s what we prefer to do and I’m excited to tell you about a recent success story where this actually happened…

I was re-evaluating one of our patients (“L”) this week and even though she is still working through some back pain – it’s nothing like when we first began working together.

When we first met – she couldn’t walk very far without back pain and she didn’t even think about getting on a bike. (Biking, hiking, and staying active are things she LOVES to do for herself and with her husband)

When we spoke this week – she was not only walking – but starting to do some trail walking – and she was using her bike trainer at home regularly – all with minimal or no back pain. The next step for her is to get on the road with her bike – we have a goal of her riding 30-50 miles!

I am confident we’ll get there 🙂

But the most important part of this ongoing success story that I want to share is this…

“L” told me that the most valuable accomplishment from working with us so far is that she hasn’t had to return for any RFA!

I almost cried when I heard this… not even remotely exaggerating…

Because not everyone has the courage to see a program through and trust in the process.

But “L” did – and I’m so proud of her for it.

She said one of her goals was to not need this procedure anymore…

I’m excited to say that as of today – she’s officially far past the point when she would normally have returned for her RFA procedure.

And it’s because of our program!

The biggest motivator behind everything I do – every email or article I write – is to empower you.

My mission behind CJPT & Pilates is empowerment by education.

We aim to give you all the information you need so you can make the best decisions for your health – and hopefully those decisions involve less pills, less procedures, and certainly not surgery 🙂

I wanted to share this story with you because it is a perfect example of just that.

Yes – “L” still has back pain – but it’s progressing and we’re working through it – but on her terms and not on the procedure/RFA’s terms.

If you want more details on how we helped “L” work through her chronic back pain and avoid procedures like RFA…

CLICK HERE to talk to someone on my Client Success Team to see if we are a good fit to help you avoid RFA.

Ready to get rid of your back pain? Lucky for you we have a totally FREE guide written by leading back pain specialist, physical therapist, and movement expert, Dr. Carrie Jose! CLICK HERE  to read her BEST tips and advice on how to start easing back pain and stiffness right away!

When exercise hurts your back instead of helps

When Exercise Hurts Your Back Instead of Helps

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? 

What most people do when exercise flares their back up is they just stop. They simply wait for the pain to go away – and begin the cycle all over again. This is not the best strategy. Instead, why not figure out why exercise might be hurting your back and do something about it?

Here are 5 reasons why exercise might be hurting your back instead of helping:

 

1. Its the wrong type of exercise

While the research isn’t wrong about exercising and back pain – the type of exercise you choose is important. For example, walking is generally considered one of the best exercises for back pain sufferers. But there are certain types of back pain where walking flares you up. In these instances, it doesn’t mean that walking is “bad” for you – and it doesn’t mean you have a serious problem. Many times, it simply means you need a different type of exercise first that gets you back to walking normally. Same goes for strength training and core training. Exercise is good for back pain – but if it flares you up – don’t be quick to blame the exercise. You may just be doing things in the wrong order. Working with a back pain expert can help minimize this and make sure you’re doing the right exercises at the right time – and that won’t flare you up.

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 – and typically before good mobility is fully restored. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. And when your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to get irritated. When it comes to stability training, there is often resistance or load involved. The last thing you want to do is add load to the spine that is already compensating and irritated. This is a sure-fire way to flare up your back and why exercise might be hurting you instead of helping.

3. You aren’t activating your core

Knowing when and how to properly activate your core is different from having a strong core. You can have the strongest abs in the world – but if you can’t use them when they count – it’s 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. 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 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 to both your back muscles and your discs. If you’re not in tune with your breathing, and you aren’t timing it properly, it’s another reason why exercise might be hurting your back instead of helping.

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 after several weeks or months when you get to your 100th rep. Same goes for body weight exercises. Just because you aren’t adding an external load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. This is where I see most 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 keep causing your back to flare up.

 

If exercising is currently hurting your back instead of helping  – it could be due to one of these 5 reasons. Get expert help to figure out which one it might be. Because at the end of the day – exercise really is good for your back. If done correctly, timely, and in the right order – it will help your back instead of hurt it.

Ready to get help with your pain or injury?

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

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 taking care of back pain – click here.

Senior Man Suffering From Back Pain Whilst Gardening

5 Tips to Avoid Back Pain While Gardening

Gardening has so many health benefits and it’s an activity many people fall in love with. It gets you outdoors in the fresh air, exposes you to vitamin D, it’s meditative, helps to improve hand-eye coordination, and it’s great exercise. But one thing it’s not always great for is your back. If you love gardening – but cringing about what it might do to your back this Spring – keep reading.

Here are 5 tips to avoid back pain while gardening:

 

1. Avoid bending from the waist

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

2. Take frequent breaks

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

3. Pivot instead of twist

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

4. Use gardening tools wisely

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

5. Raise your gardens

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

Gardening has so many positive benefits – and the last thing I want is for back pain to be the thing that stops you from doing something you love. Hopefully these tips give you some important things to consider – and more importantly – help you look at gardening as something enjoyable again versus something you dread because of your back.

Do you have nagging back pain that gets in the way of your everyday activities? Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

 

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 taking care of back pain – click here. 

5 Signs Your Core is Weak – And What You Should Do About It!

A strong, healthy core is important for our health and posture. When your core is strong and working properly, you will have less back pain, better posture, and will move with more ease and endurance.  But how do you know if your core strength is where it needs to be? I can tell you that chiseled abs, a thin waist, or the ability to do a hundred sit-ups are NOT reliable signs of a strong core.

Instead, here are five signs to know if your core is weak and what you can do about it:

1. Your Back Hurts

The most common side effect of a weak core is back pain, and yet most people still don’t consider core strengthening as a way to address those problems. Your core’s job is to support your spine and act as the center from which all movement stems. If those muscles are not properly conditioned – meaning – if they aren’t conditioned to engage when they are supposed to – your spine is at risk for being overworked, and muscular strain and tension are inevitable. The pain will most likely occur in your lower back, but can even occur in your neck, making simple tasks like bending, lifting, and walking totally miserable for you.

2. You Have Poor Balance

This may not be an obvious one – but one of the main culprits of poor balance is a weak core!  Your core muscles help to stabilize your pelvis, and a stable pelvis allows you to have better balance.  If the muscles around your pelvis (particularly your hips and glutes) are weak, then your balance will undoubtedly be affected. This may not be an issue that you notice right away.  But next time you’re walking across an icy driveway or unstable surface, you’re going to wish that your balance was at 100%. We incorporate Pilates into our physical therapy practice because it is such an effective whole-body strengthening system that can really make a huge difference in core strength and balance. A strong, coordinated, and engaged core helps you to react to balance challenges more efficiently, and may prevent that next fall!

3. You slouch all the time

Most people struggle to maintain good posture when they have a weak core. It becomes so easy to slouch, and you may not even realize you’re doing it.  Observe your posture right now… Are your shoulders rolled forward? Is your low back missing its natural curve? Is your head poked forward? When you go to correct your posture, does it feel difficult or tiresome to maintain? If so, your core might need some endurance-training!  A lot of people will argue that core strength has nothing to do with your posture. But here’s the thing, a strong core makes it easier and more natural to have good posture, and when better posture becomes effortless, it starts to become your norm. Your whole body – especially your spine – will thank you.

4. Your feet and wrists hurt

Many of our clients come to see us with an initial complaint of foot pain (also known as plantar fasciitis) or wrist pain. It keeps coming back no matter how many times they get rid of it or go to physical therapy. Sound familiar? When you have a weak core, and lack the proper central support and stability you need, your outer muscles and joints will eventually suffer. We already talked about balance. If your core isn’t working to help you stay more stable, your feet will have to work harder, resulting in overtaxing of the tissue on the bottom of your foot. If your middle back can’t support you when you’re pushing or pulling, your wrists (or elbows) will take the brunt and this can result in stiffness or pain over time. If you’ve got any chronic problem that isn’t getting resolved over time, something is missing. In the case of your wrists and feet – it may be a sign of a weak core!

5. You’re always holding your breath 

If you’re always being reminded to breathe when you move or exercise, this is another sign that your core is weak and not working properly. You’ve heard me talk about this before, but your deep core is made up, in part, of your diaphragm, which is your main breathing muscle.  When your core lacks stability, or in most cases, doesn’t know how to engage in the right way to give you the stability it needs, your diaphragm will contract to compensate. One of the most tell-tale signs that this is happening is that you always hold your breathe during exercise. This is probably one of the most overlooked signs of a weak core, and one of the most difficult to correct! It’s why we’ve dedicated an entire module to this topic in our Pilates 101: Get [Your] Back to Health program, and it’s one of the most important things we work on with every single client as we prepare them to confidently return to exercise.

What can you do?

I always say – when in doubt – just breath. If you’re breathing through every movement then your diaphragm can’t stay contracted. Start here. If you notice that other things start to get tight and uncomfortable as a result – namely your hips and your neck – then it means you’re now using those muscles instead of your diaphragm to compensate for your weak core. In that case – consider getting expert help because these movement patterns are hard to break on your own. 

There’s so much more to a strong core than 6-pack abs and the ability to hold a plank for days. Pay attention to the more subtle signs I’ve just outlined for you. If you’re noticing one or more – it could be a sign that your core needs some extra love and attention. Give these tips some consideration and see what happens.

If any of these signs sound familiar to you, then you might want to start paying more attention to strengthening your core!

But don’t just start doing sit-ups or planks haphazardly and expect good core strength to follow. Being able to do sit-ups and planks are the RESULT of good core strength.

You must first learn how to strengthen your core properly.

The good news is we’ve got an At Home Pilates 101  Get [Your] Back to Health Program designed to help people do exactly this… and it’s done entirely online and is self-paced. You can do at home and on your own time.

Learn more HERE!

 

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 taking care of back pain – click here.

Why Pilates?

Why Pilates?

If you’ve ever experienced muscle and/or skeletal pain, it was probably the result of one or more mechanical stressors occurring in joints or muscles. When I treat a patient, I am often working to help them change the mechanics of their movement and therefore decrease or eliminate those stressors. It’s one of the main reasons why I incorporate Pilates into my treatments. It’s also why most of my patients will tell you that it is often difficult to tell where physical therapy leaves off and fitness exercises begin — which is precisely the way it should be.

Pilates isn’t just about strength and balance, it’s about body mechanics.

Each exercise is carefully designed to direct and reinforce the way in which a healthy musculoskeletal system should function. By practicing Pilates, you are strengthening your muscles correctly in a way that is conducive to all forms of exercise, as well as improving posture and balance. It’s a really great supplement to physical therapy because as you’re retraining or rehabilitating a specific part of your body, you have the opportunity to match that progress holistically.

Many people who come to us with back pain think that their pain would prevent them from participating in an exercise program like Pilates – but the truth is, it’s the opposite! Guided, individualized Pilates combined with a physical therapy regimen is actually one of the best things you could do for your back. We even offer a specific at home program  designed for people with back pain! It’s incredibly beneficial for clients dealing with pain or injury to have the support system of a physical therapist and a Pilates instructor working in tandem to find the right movements to rehabilitate each particular individual.

Our goal is always to get our clients back to their full range of movement and activities.

We NEVER want to avoid any movement permanently in order to avoid pain. But on the road to that full recovery, the structure of Pilates and the opportunity for physical assistance can be an extremely powerful counterpart to physical therapy. Pilates strengthens your entire body, starting from your core, which naturally prevents future back issues stemming from muscular weakness or imbalance. Furthermore, Pilates (combined with PT) teaches correct movement – which is the number one way to relieve any current pain!

Are you experiences nagging back pain and want to incorporate pilates to help? We offer a program just for you! 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.

Avoiding Radiofrequency Ablation

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

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

Most people – four out of five to be exact! – will experience a debilitating back pain episode at one point during their lives, and typically we put more effort into caring for our backs during those times than when we’re feeling good. But it’s critical that we take good care of our backs all the time, not just when we’re in pain!

1. Stand Up & Take a Load Off

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

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

2. Watch for Curves

We have natural curves in our spine that help us handle stress and loads.  Whether sitting or standing, it’s important to maintain these curves.  When standing, our spinal curves occur more naturally and are usually easier to maintain.  When we sit, the protective curves in our spine are harder to maintain and often disappear.  And while a healthy core and strong back muscles are important to back health, they won’t protect your back if you sit for long periods, or when the curve in your lumbar area disappears while you’re sitting.

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

3. Extend instead of Bend

The human spine (and entire body) craves balance, which means both extension and flexion.  But we spend the majority of our time in flexion, bending over to put shoes and socks on, brushing our teeth, driving, sitting at work and then driving home. At home we bend forward to cook, sit some more as we eat and then curl up on our couch or an easy chair. As long as we’re not gymnasts or circus performers, it’s safe to say we could all use a little more extension in our day.  A really good exercise is to stand and place your hands on your lower back for support and then arch back as far as you can go.  Repeat this 10 times, at least once per day.  This is also a great activity to do when you are interrupting your sitting during the day.  If you’ve never arched you back like this before, it may feel stiff or even hurt a little at first. But, with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.  If it doesn’t, or becomes troublesome for you, stop and consult with a qualified physical therapist who specializes in back pain.

If you like these tips and want to learn even more ways to prevent debilitating back episodes, check out our FREE report right here! It reveals five easy ways (plus two bonus tips!) that are PROVEN to help you ease back pain quickly – without pain medication, frequent doctor’s visits, or surgery. And don’t forget to check out our Pilates programs if you’re looking for a way to exercise that will target – and resolve – back pain!

Are your Back MRI results reliable? Research says otherwise.

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.

 

 

Should Age be a Reason to Avoid Certain Activities?

We’re continuing with our topic of the month – Getting Fit After 50 – and people have been asking me…

Are there certain types of exercise I should avoid once I hit a certain age?

The short answer is no.

Most of our clients are over the age of 50 and they do everything from surfing, to playing tennis, hockey, running, and even tap dancing!

None of these activities are considered “easy on the joints,” but they do them anyway.

So why is it that some folks see age as just a number – where others use it as a reason to stop doing certain things?

After age 50, the number one reason I see people avoid activities they want to do is because of pain. The second most common reason is because they were told to.

Let’s start with pain.

Having been a physical therapist for twenty years, I know a thing or two about what goes through people’s minds when they are dealing with back or joint pain. In most cases, the pain itself is not the biggest concern. People are willing and able to tolerate a certain amount of pain at the expense of doing what they truly love. We do it all the time in our 20’s or 30’s… and don’t think twice about it.

But as we age – a little bit of fear starts to set in when we’re in pain.

We’ve typically seen or heard horror stories from friends or family who have paid the price for either pushing through – or ignoring pain all together. When we’re younger, we’re more likely to approach pain with a “wait and see” approach. But as we age – pain becomes a bigger concern and we’re more likely to seek professional medical help sooner.

This leads me to the second reason people over 50 will just stop doing certain exercises…

Because they were told to. And often by a well-meaning health care professional.

Let me explain that.

Our medical system is overloaded, and everyone does the best they can to keep up. But if you’re a musculoskeletal health professional who’s NOT up with current medical research – you’re likely to give advice based on “old-school” ways of thinking.

For example, diagnosing all musculoskeletal pain based on X-rays and MRI’s… If your X-ray shows “bone on bone” arthritis – then a joint replacement is assumed to be your only option. If your MRI shows a meniscus tear or bulging disc – then you automatically need arthroscopic surgery.

But the current research disputes this line of thinking…

And says 80% of ALL musculoskeletal problems – even when you’re over 50 – can be solved without surgeries or other procedures.

How your pain behaves is what matters most. Not your age or arthritis. The best way to explain this concept is with a case study!

This client (we’ll call him “Jim”) is 57 years old and was told knee replacement surgery was his only option to resolve the knee pain he was suddenly experiencing.

When he questioned the knee replacement and asked if he could wait, his doctor’s response was that because of his age – and because of the “bone on bone” arthritis that was showing on his X-ray – surgery was his best option. Otherwise, if he wanted to wait, he would need to stop the running and hiking he had been enjoying so much until very recently.

Research studies show that the indication of osteoarthritis on X-ray alone does not mean it’s the cause of your pain.

In other words, it’s entirely possible Jim’s knee pain could be due to something other than his “bone on bone” arthritis.

Did he really need surgery? And did he really need to stop some of his exercises because of arthritis or his age?

Ceasing his activities would have certainly made Jim’s arthritis worse. And if he went through with the knee replacement without being completely sure if arthritis was the main cause of his knee pain – he not only risks unnecessary surgery – but also risks getting set back several months for recovery.

This would delay his ability to get back to running and hiking even further.

Although age is most of the time NOT a factor in your choice of exercise… it is a factor when it comes to how quickly you’re able to recover from surgery.

So here’s what happened.

We prescribed him a corrective movement strategy to see if arthritis was the main factor causing his knee pain. And just like we see over and over again – his knee pain significantly improved after just a few visits!

Research says that if pain responds quickly to a corrective movement done repeatedly – your pain is primarily due to a mechanical origin – and not arthritis. Arthritis doesn’t change that quickly – in fact it doesn’t change at all (unless you get surgery). But mechanical pain does.

Turns out that Jim’s knee pain was due to some mechanical imbalances in his knee joint, and NOT the arthritis. Arthritis was a factor for sure – it made his knee stiff – but it was not the main cause of his knee pain.

If you’re getting older… know that age related changes like arthritis are quite normal and nothing to be afraid of.

And arthritis, along with your age, are certainly not reasons to avoid exercise.

Jim was given medical advice to have a surgery he does NOT need yet based solely on his X-ray and his age. But there are SO many other factors worth considering as well.

Avoiding Radiofrequency Ablation

Should you Rest when your Back Hurts?

Back pain is the most common type of problem we see here in our office. And the number one question I get from people who’ve hurt their back is, “should I rest until it feels better?” 

The short answer is “no.” 

But I understand why this is confusing. It’s scary to move, or know which exercise is best when something hurts, especially if it’s your back. We also get conflicting advice from the medical community. Many people suffering with back pain have been told they should rest, ice, lie down, and use their back muscles as little as possible until they recover. They’ve been told they should limit their movement and activity until their pain goes away.

Well what if I told you that for 80% of all back problems – movement is actually the BEST medicine.

Research even supports this. Most back pain falls into the category of what we call “mechanical low back pain” – and this type of back pain responds best to movement over anything else. It’s important to note that although movement is good when your back hurts, you want to pick the right type of movement. Generally speaking, early movement like walking is considered one of the best things you can do for your back, along with very specific mobility exercises in a direction designed to relieve your pain quickly. But you’ll want to avoid things like lifting heavy weights at first, or bending/stretching over excessively. If your back pain involves an irritated nerve, stretching forward, even though it might feel good, can often worsen your problem.

So what’s the big deal? Why is it so bad to rest until your back pain goes away?

Although most back pain will go away on its own with time, the problem with resting instead of moving is that it can prolong the time it takes to truly heal. And in some cases, rest can make your back problem worse. Too much rest leads to deconditioning of your muscles, and can even lead to biomechanical changes to the curves in your spine. Resting may take your back pain away, but it’s going to leave you feeling much stiffer and weaker, putting you at risk to just hurt your back all over again. One of the biggest problems I see with back injuries is a lack of mobility, sometimes due to weakness and sometimes due to not moving around enough. A flexible spine is a healthy spine. That’s why choosing activities like walking and corrective stretching exercises over rest will not only relieve your back pain, but will give you a better chance at keeping the pain gone over time.

Another issue with too much resting, especially lying down, is the impact on your discs.

Back problems frequently involve some variation of a bulging disc, and when you lie down, your disc changes in size. Lying down does relieve pressure from your disc, but also causes it to absorb more fluid, making it bigger. You won’t know this is happening until you go to get up. That enlarged disc will not feel good when it gets pinched. It’s why most people who are dealing with back pain feel worse first thing in the morning, just after getting out of bed. Their pain eases once they stand and start moving around a bit. When you walk around and move, you get natural compression of your disc, keeping the disc bulge smaller and thus, less of an irritant. A bulging disc in your spine is a pretty classic form of mechanical low back pain, and we already know that mechanical back pain responds best to movement.

Remember that the absence of back pain does not mean the absence of a back problem.

Back problems can be complicated and they love to linger under the surface until one day, a certain movement just tweaks you. The best way to figure out a back problem – and heal a back problem quickly – is with movement. As tempting as it is, don’t just rest to get rid of your back pain. Try walking, and even some easy stretching, and take note of what happens. You’ll either start to feel better the more you move or worse. If your pain is easing up with the movement you’ve chosen – you’re on the right track! If your pain is not responding or getting worse, then it’s a clue you need to see a professional. Either way, movement is your friend, because it’s going to tell you something. Rest won’t do that for you and if anything, potentially prolong the issue when you could have been doing something about it.