Tag Archive for: health

Opioid Addiction in Adults over 40: a Public Health Emergency

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The COVID-19 pandemic has been top of mind for months. We’ve all experienced some major curveballs this year, and most people have learned a lot about public health and epidemiology along the way. But why now? Why are we finally learning how viruses attack the respiratory system, what it means to be immunocompromised, and the best practices for disinfecting? Maybe it’s because of the unpredictability and common threat associated with this virus. Although some demographics have an increased risk of serious outcomes, anyone can get this novel coronavirus and anyone can become ill. 

Unfortunately, Covid isn’t the only public health crisis facing Americans in 2020.

The opioid epidemic has been in the news for years, but many of us don’t bother to take precautions or educate ourselves because we don’t think opioid addiction can happen to us.   

That couldn’t be further from the truth!

Anyone can become addicted to opioids. Many of the Americans battling addiction right now don’t have a history of drug abuse. Instead, what they have in common is something relatively routine. They deal with chronic pain or they had a surgery, and a physician prescribed them opioids.

According to the US Department of Health and Human Services, “opioid overdoses accounted for more than 42,000 deaths in 2016” and “an estimated 40% of opioid overdose deaths involved a prescription opioid.” Between 2010 and 2016, opiate prescriptions from surgeons rose by over 18 percent (UCI Health). And according to the National Institute on Drug Abuse, approximately 21 to 29 percent of patients who are prescribed opioids by physicians end up misusing them. Eight to 12 percent become addicted (NIDA). And the reality of opioid addiction is sobering. In 2017 alone, over 47,000 people in the United States overdosed on opioids and died. 

In 2017, the opioid epidemic was declared a public health emergency.

A public health emergency is just that — public! The emergent status of this crisis is not limited to one demographic or “type” of person. Although media attention through TV and movies tends to focus on heroin and young people getting high, data from the Substance Abuse and Mental Health Services Administration tells us that 63.4% of the adults who misused prescription opioids in 2015 did so to relieve legitimate physical pain. Chances are, we’ve all felt pain at one time or another that ibuprofen or tylenol alone couldn’t get rid of. Everyone is at risk for opioid addiction because anyone could get in a car accident, or require surgery, or develop arthritis. 

Pain-relieving drugs like Oxycodone, Oxycontin, Vicodin, Percocet, and others can be extremely helpful in some circumstances. But unfortunately, they are often overprescribed thanks to aggressive incentivising and pressure from drug manufacturers. The fact that opioids are so often prescribed after surgery and for patients with chronic pain means that middle aged and older adults are at a higher risk for drug addiction than ever before. In 2016, 14.4 million adults on Medicare (age  65+) had at least one opioid prescription (Consumer Voice). Older adults are also more sensitive to the physical effects of opioids. Side effects such as respiratory depression and cognitive impairment increase in severity as the patient’s age increases, often leading to hospitalizations and even deaths. 

So many clients in our practice fall into this at-risk demographic.

We have countless clients coming to us with severe chronic pain. Some have already had surgeries or been told that surgery is their only route to a pain-free life. Many have considered opioids to treat their back pain. And we are so grateful that we’ve been able to help hundreds of individuals recover from their injuries AND chronic pain without resorting to drugs, surgery, or both!

We promote both physical therapy and Pilates as alternatives to surgery and for preventing painful musculoskeletal problems because they truly work.

We recognize that most knee, back, and other injuries occur because the surrounding muscles are too weak to support those joints and systems properly — and we have the expertise to retrain your body in correct movement. You may think that your regular exercise and stretching is enough, but oftentimes working specific muscle groups leaves others underdeveloped and your body unbalanced as a whole. Our team of specialists is trained to create individualized solutions for your particular needs, because we believe that movement is medicine — when it’s prescribed properly! The idea of a quick fix is tempting — but a quick fix can easily turn into long term opioid addiction, illness, and even death. Taking the time to teach your body how to heal itself is so much more rewarding in the long run.

Want to learn more about how we can work with you to determine the safest, strongest, most effective route to recovery? Just click here to sign up for a FREE Discovery Session with one of our specialists.

 

This article was authored by Katya Engalichev. Katya is a pharmacy technician, EMT, and graduate student who writes for CJ Physical Therapy & Pilates. 

Carrie working on a client's shoulder

Shoulder Pain not Going Away? This could be why…

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Whether it’s shoulder pain, neck pain, back pain, or knee pain that you’re dealing with — if you have a nagging pain or injury that just won’t go away no matter what you try, it’s a clue that you’re missing something.

We see this ALL the time in our office with shoulders.

Folks just like you come to us wondering why their shoulder still hurts after trying ice, heat, rest, physical therapy, massage, and every possible shoulder exercise you could imagine.

The pain either goes away temporarily, or sometimes it gets WORSE!

When it comes to shoulder pain, it’s critical that you know for certain if the pain is actually coming from your shoulder, or somewhere else. If not, you risk trying to fix the wrong problem… and that explains EXACTLY why your shoulder pain isn’t going away.

So… if your shoulder pain isn’t caused by your shoulder — where is it coming from?

The most common culprit is actually your NECK. Below are a few key signs to help you figure out if that’s the case…

(PS – we’re doing an online workshop on this topic in just a few weeks.)

Where is your pain?

When your pain is coming from your shoulder, the pain will always be localized to your shoulder alone. True shoulder pain is felt directly in front of your shoulder, directly on top, or in a more involved shoulder problem (like a rotator cuff injury) you might feel some achiness down the side of your arm… but it will never go below your elbow.

If the pain goes past your elbow and into your forearm or hand, or radiates above your shoulder into your neck (the upper trap area), or if you feel it deep inside of your shoulder blade in your mid-back, odds are pretty good that you’re dealing with a neck problem and not just a shoulder problem. This could be the reason why your shoulder pain isn’t going away.

Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening, it’s likely coming from your neck – and could be due to a bulging disc or a restricted/faulty movement pattern that is irritating nerve roots in your neck. An isolated shoulder problem typically does NOT involve nerve root compression or irritation. This is much more common in a problem related to your neck, and if that’s what’s happening, you will feel symptoms into your shoulder, shoulder blade, or even down into your arm. What’s particularly misleading is that it’s entirely possible to feel all these nerve symptoms and not actually feel anything localized to your neck. This is a big reason why shoulder pain caused by a neck issue gets missed by so many health practitioners.

Have you lost mobility or range of motion?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well and is pain free, but your shoulder is stiff and immobile, odds are good that the problem is actually in your shoulder and you just haven’t found the right treatment approach yet. BUT… if you have a stiff and painful neck, and you lack mobility in your shoulder, then it’s absolutely imperative that you investigate your neck. If your care provider only focuses on stretching and improving your shoulder mobility, and never bothers to look at your neck, it’s possible you could be missing a key component to full recovery… and that’s why your shoulder pain keeps coming back.

 

4 Tips to Save your Neck and Back During Summer Road Trips

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Now that summer is in full swing, but a lot of people don’t feel comfortable flying, many of us are planning road trips for those special summer getaways! It’s always fun to hit the road and explore a new place — but first, let me help you out with some tips to save your neck and back…

(For more tips – check out our Free Guides section on our website and also join us for our next virtual workshop all about neck and shoulder pain!)

Tip #1: Interrupt your sitting

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting. Our bodies are made to move continuously throughout the day. Too much sitting puts extra load and compression on your spine, and can trigger an underlying problem you weren’t even aware of.

On road trips, getting out of your seat is critical for keeping your neck and back healthy. Try to plan extra time in your trip to pull over at rest stops and walk around. We recommend interrupting your sitting every 30 minutes for good neck and back health. I understand keeping up with that frequency on a long road trip is difficult, but something is better than nothing! You’ll want to capitalize on your rest stops by moving around instead of sitting.

Tip #2: Use a lumbar pillow

A proper lumbar pillow is not only essential for good lower back alignment while sitting, but also for proper neck alignment. We have natural curves in our spine that are designed to absorb shock and disperse load. When those curves aren’t maintained, especially for prolonged periods, you get abnormal and unwanted forces throughout your spine – resulting in pain and stiffness.

Ever heard of the dreaded “forward head?”

That’s the posture your neck assumes when it needs to compensate for lower back slouching. We sell lumbar pillows in our office, but you can also try making your own by rolling up a towel or sweatshirt. Just make sure the roll is thick enough to maintain the natural curve in your lower back without much effort while you sit. The built-in lumbar supports that come with your car are typically NOT adequate enough.

Tip #3: Adjust your car seat

This is an often overlooked, but important component to achieve healthy posture while driving. Too often, I see folks driving around with seats that are either too far away or too close to their steering wheel. If you’re too close, it will cause you to sit overly straight or upright, resulting in unnecessary strain in your neck and low back. If your seat is too far back, then it will be virtually impossible to maintain the natural curve in your lower spine, even with one of our lumbar pillows. Your arms will need to overreach for the steering wheel, causing strain in your shoulders. And your neck will assume that forward head posture just to remain upright, causing strain to your neck.

You want to make sure your seat is positioned in a way that allows your neck to be easily balanced on top of your spine and pelvis – without much effort. Your elbows should be at an approximate 90 degree angle when your hands are on the steering wheel, and there should be a relaxed 45 degree bend at your knee so that your foot can easily switch from gas to break without you having to constantly flex your thigh. Having your car seat positioned correctly before you take a long drive will significantly decrease the strain on your neck and back.

Tip #4: Use a neck pillow when you sleep

On road trips – we often sleep on mattresses that are less than optimal and certainly not as comfy as our own. Using a neck pillow while you sleep can significantly decrease morning pain and stiffness caused by poor sleeping postures.

Getting a good night’s sleep and not waking up in pain has a lot to do with the position you sleep in.

Just like with sitting, you want your sleeping position to be as balanced as possible. When you sleep on your stomach, your neck has no choice but to stay turned and extended to one side all night. Prolonged poor postures are not great for any joint in your body, but especially those in your neck. Your neck is the most mobile section of your spine which makes it much easier to “kink” if in a poor position. Sleeping on your back is not terrible, and it’s what many people prefer.., but depending on how firm or soft the mattress you’re sleeping on is… it could be difficult to maintain the natural curves in your neck and back while you sleep. If you sleep in a slouched position all night long, you’ll wake up with pain and stiffness.

If you can tolerate it, my favorite position for sleeping is on your side and with a neck pillow. This allows both your neck and low back to stay relaxed and with their natural curves.

To make a neck pillow, use a small towel roll about 3 inches in diameter and stuff it the long way inside the bottom of your pillow case. When you rest your head on the pillow, it acts like a comfy support to maintain good neck alignment while sleeping on your side. We can also order one for you!

How Stress Leads to Pain

Three Ways Stress Can Cause Back Pain

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In our fast-paced world, stress has become an almost unavoidable part of daily life.

From work pressures to personal challenges, it can be quite overwhelming at times. But while stress is often thought of as a mental or emotional issue, its impact on the body can be profound. One of the most common physical complaints associated with stress is back pain. Whether it’s a dull ache or sharp discomfort, the connection between stress and back pain is real – and understanding why this happens is the first step toward finding relief.

Here are three ways that stress can lead to back pain:

1. Social conditioning: 

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

2. Trauma Response: 

Trauma is often associated with a singular, catastrophic event like a car accident or a severe fall – but trauma can also occur in the form of cumulative “micro-traumas.” These micro-traumas are more subtle, often emotional or psychological in nature, and can go unnoticed for years. Research shows that the body can actually store memories of trauma – whether it was large or small – as part of the brain-body connection. And your body can remember this physical response for a very long time – even years after the event has passed. Our nervous systems (particularly the autonomic portion) can be triggered by emotional stress, and may reactivate old trauma responses that your body has stored.

This explains why for some people – physical symptoms of back pain can resurface any time their body perceives stress – especially if that’s where their trauma response occurred initially.

3. Environmental Stressors and Habits:

Your physical and postural habits have a huge impact not only in how your body feels from day to day, but in how well it recovers from pain or injury. For example, sitting too much is a number one cause of persistent and chronic back pain. And stress can play a role in this. When you’re stressed, it’s often accompanied by less motivation, and you may opt for unhealthy coping mechanisms, such as more TV and couch time. If being a homebody is how you react to stress – versus getting out for a walk or exercise – you’re  more likely to experience back pain when you’re stressed out.

Movement can Help:

Regardless of how or why stress impacts your body – there is one thing I know for certain – and it’s that movement helps. Physical activity helps to release tension stored in muscles, improves circulation, and promotes the release of endorphins which are your body’s natural pain killers and mood elevators. But movement also helps to break up the fight or flight response that can often occur in your nervous system when it’s under stress.

If you’ve got back pain and are wondering if stress could be part of it – consider talking to a mental health professional who can help uncover the source of your stress. 

And incorporate more movement and exercise in your left – which will help address both the mental and physical aspects of back pain. Now, if your back pain is so severe that movement or exercise is not an option – then seek the help of a mechanical pain/movement specialist who understands back pain. They will prescribe you healthy, corrective movement strategies designed to relieve your back pain – and likely some of your stress – since the two can be so linked.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a copy of her free guide for back pain – CLICK HERE.

work from home, coronavirus, back pain, quarantine

Back Pain Doesn’t Go Away for the Coronavirus!

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The coronavirus (COVID-19) is forcing everyone to adapt to new routines — but many of us are still experiencing the same old chronic pain. In fact, your back pain may start acting up again now due to stress, decreased exercise, and more time spent at home on your computer. The important thing is that you don’t ignore it! Listen to your body and KEEP MOVING!  

Prior to seeing us, many of our clients who suffer from back pain were told that the best way to recover was to ice and lie down. They were advised to rest, relax, and limit their movement until the pain goes away. The problem with this model for treatment is that it goes against everything we know about the basic principles of joint and tissue healing.

Our modern health research suggests that early movement is actually the BEST way to head off chronic back pain!

Of course, if you’ve suffered a trauma like a car accident or a major fall, you should absolutely go get checked out by a medical professional and follow their advice based on your injuries. But if you are dealing with a chronically aching back or general soreness, stiffness, and pain, it turns out that movement is actually the best course of action!

But not ALL types of movement and exercise are safe or beneficial when you’ve hurt your back…

That’s where physical therapy comes in! A physical therapist is able to identify specific movements that actually work through and relieve that pain, based on your individual condition. We call these initial exercises “first aid movements” – and they are especially helpful because you can use them any time you might tweak your back in the future! If you’re experiencing acute back pain, of course it doesn’t make sense to continue with all of your activities as usual if they are just exacerbating your symptoms. But there is a middle ground between overdoing it and completely stopping the movement that your body craves. 

But how are we supposed to see a physical therapist, you ask, when everything is shutting down to contain this coronavirus? 

Is Pilates the missing link in your fitness?

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Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method.

It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates — or enjoy the benefits.

I’ve been incorporating Pilates into my physical therapy practice for the last 10 years and it’s been transformational for both my clients AND my practice. Every March, we join participants from all across the globe to share the love for the original work of Joseph Pilates. Over the years, much of Pilates has turned contemporary, but for one month – the Pilates community pays respect to his traditional, classical Mat exercises. This movement is known as March MATness, and anyone can join!

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength — and it helps my clients connect to their bodies in a way that they haven’t been able to achieve with traditional strengthening methods.

Most of my clients are well into their 50’s and 60’s, and they love Pilates because it helps them have more energy, better balance, and improved strength and mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases the likelihood that their injury will come back.

Here are five reasons why Pilates was a missing link in my physical therapy practice, and why it might be the missing link to YOUR life-long fitness as well.

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We see a lot of folks with recurring back pain in our office. They’ve seen traditional physical therapists or chiropractors who get rid of their pain in the short term, but they aren’t able to keep it gone. Regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but also is a well-balanced exercise system — so it keeps your back feeling mobile in all directions — a missing link in most “back strengthening programs.”

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

One of the keys to lifelong fitness is what I call “balanced strength.” That’s when each part of your body works together to produce the right amount of force, at the right time, to do your favorite activity in the most efficient way possible. Efficiency means you’ll be able to do it for a lot longer. I see lots of strong people in my office, but often certain muscles are working harder than others. And this can cause problems down the line. Pilates emphasizes full body strength that is coordinated — and this leads to a balanced body.

3. Pilates helps you get flexibility the right way.

Do you stretch your hamstrings every single day and find they just never get more flexible? It’s probably because you’re not stretching the right way — or maybe you don’t even need to be stretching them at all! What I love about Pilates is that it stretches your body in a dynamic way — with movement — so that muscles lengthen the right way and where they are supposed to. “Mobility before stability” is a phrase you will hear me say often, and it’s one of the keys to lifelong fitness.

4. Pilates puts very little stress on your joints.

Aging is a real thing and along with it comes arthritis. But it’s not a death sentence like most people are led to believe! The key to combating arthritis is maintaining a mobile and well balanced joint. When you optimize everything that surrounds your arthritic joints, your symptoms decrease. Pilates helps with all this and doesn’t cause any added stress. When your joints are happier, it becomes much easier to do your favorite activities – hopefully for life!

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is — and it’s almost ALWAYS a missing link that I see for people who’ve been at a certain activity for a really long time and then suddenly things start breaking down. They start experiencing pain when they never have before. If you don’t train your nervous system, it gets lazy, and that is how compensations develop in your body. Pilates helps with this because it is a mind-body exercise that emphasizes balanced strength and coordination. Your nervous system can’t get lazy when you do Pilates!

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

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!

5 benefits of adding pilates to your fitness routine

Setting Goals for the New Year? We can help!

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A new decade is on the horizon, and so are new health and wellness goals for many of us!

Are you already discussing resolutions or considering ways to make 2020 your best yet? The new year is a great opportunity to form new habits that will help us become our healthiest, happiest selves. Setting detailed goals is a constructive way to approach the 2020’s that can help you feel more motivated and hopeful about the future.

The idea of New Year’s resolutions is great, but most people only stick to them for a couple weeks.

Resolutions are so often left unfulfilled in part because they’re usually pretty general statements that are made without much forethought, intention, or planning. At some point we’ve probably all resolved to “get healthy” or “eat more vegetables” or “spend less money.” All worthy ideas, but can you see why people don’t follow through?! There’s WAY too much wiggle room, and nowhere near enough specificity. That’s why oftentimes, setting goals with distinct processes will help you accomplish much more than a run-of-the-mill resolution.

There are two essential factors in goal setting. First, the goal must be attainable. Secondly, you must define concrete steps that you intend to take towards reaching that goal.

Most of us want to be healthier, but what does that actually look like? One person’s journey to becoming healthy could be totally different from another’s. These goals can be made in conjunction with a health professional such as a physical therapist, especially if they relate to mobility, strength, and physical activity. Many of us have intended to “exercise more,” but those two words rarely yield results. A more effective goal might be to enroll in a Pilates class, take a half hour walk outside five days a week, drink the recommended 64 ounces of water each day, or to do ten minutes of stretching every morning after getting out of bed.

A group program such as Pilates can be especially helpful because it gives you a sense of accountability and camaraderie. In fact, our signature Pilates 101 program is relaunching in January, and we are so excited about it! Pilates 101: Get [Your] Back to Health is a one-of-a-kind 8-week program that delivers safe, yet highly effective Pilates-based core strengthening exercises that are easy on the joints, designed to lessen back pain, and help improve your flexibility and posture.

If you can track, schedule, or measure the steps of your goal, you’ll know when you’re making progress. If those steps happen alongside people who share similar goals and under the direction of a movement expert who can support you for two whole months — even better!

So, let’s finish off this decade strong — and don’t miss out on Pilates 101! These spots go fast, so apply now to make sure you don’t miss your chance.

5 Reasons People over 40 should do Pilates

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Pilates is good for anyone and everyone… but especially for middle aged and older adults. Here are just some of the reasons to take Pilates classes if you’re in your 40s, 50s, 60s and beyond!

1. Relieve -and prevent- back pain

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. 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!

2. Increase balance

Since Pilates is all about core strength, it makes sense that continued practice can improve your balance by leaps and bounds! This is an especially important benefit for the older adults who do Pilates with us. As we age, our balance unfortunately deteriorates. However, those changes are not irreversible! Pilates retrains the balance and strength that makes falls less likely.

3. Improve flexibility

You don’t have to be flexible to start Pilates, but you will see your range of motion improve drastically after consistent practice! Improving flexibility is especially important as we age. The founder of the Pilates system himself, Joseph Pilates, once said,

 “if your spine is inflexibly stiff at 30, you are old; if it is completely flexible at 60, you are young.”

The years you’ve spent on earth is just a number… but it’s the condition of your body that dictates your age – not the other way around! And flexibility is the cornerstone to musculoskeletal health and resilience.

4. Reduce stress

We know that exercise in general is a great stress reliever, but Pilates is especially beneficial because it focuses on literally releasing that stress from your body through guided, intentional movement. Plus, having a regular Pilates class to attend can be a consistent fixture in your life that can serve as an outlet for all your day to day stresses!

5. Improve physique

“In 10 sessions you’ll feel the difference, in 20 sessions you’ll see a difference, and in 30 sessions you’ll have a whole new body.”

That’s another great quote from Joseph Pilates! Pilates is one of the best full body workouts out there, and it’s super effective for improving muscle tone overall and shedding excess body fat. If you practice Pilates regularly, you’ll continue to gain strength overall, which will improve your ability and performance in any other physical activity you enjoy!

knees

Happy Halloween! Spooky Noises coming from your Knees?

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“What are those cracks and noises coming from my knees? Is there something wrong??”

Our clients come in with this question all the time. They usually feel nervous and fearful that the noises they hear may indicate something more serious is going on within the joint. Is there damage occurring whenever they hear this sound? Do they need to avoid activities that provoke these symptoms? Will they need to rely on pain pills and surgeries in order to maintain their mobility if their joints deteriorate? 

Crepitus refers to these clicking, popping, and creaking sounds that a large portion of the population experience on a regular basis.  This phenomenon can occur at any joint, but is most commonly reported in the knees, shoulders, ankles, hips, and spine. 

Although these noises often don’t produce any pain, they can cause anxiety. Individuals start to develop their own beliefs about what is going on, and ultimately alter their behavior to avoid these cracking or popping sensations.

What causes these noises?

Many structural factors can contribute to joint noises.  Some of the most common are:

  • Tendons rubbing along bony prominences (bumps on bones)
  • Nitrogen bubbles popping due to pressure changes within the joint
  • Small labral or meniscus tears that get caught or pinched as we move

However, we don’t have the luxury of utilizing x-ray goggles during our examinations.  This means that we often cannot be certain of exactly which structures are creating these sounds.  What we do know is they aren’t a reason to be highly concerned as long as they aren’t associated with pain or swelling in the affected joint.  

How can I prevent it from getting worse?

The best way  to prevent these symptoms is to keep moving!! Motion is lotion. Regular movement throughout the day allows our joints to lubricate themselves, kind of like applying WD-40 to a creaky door hinge.  Additionally, it’s important to keep the muscles surrounding your knees strong and balanced. This helps to offload the forces through the joint, which limits “typical” wear and tear on cartilage and bony structures.

What if I’m noticing pain or inflammation in the joint that’s making these noises?

If you have a specifically noisy joint that’s also painful or swollen, it’s best to come in for a formal examination with a physical therapist – ideally someone who specializes in movement mechanics.  We train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.

If finding the solution to your problem is something you’re interested in, you can come in for a free Discovery Session at our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are great for people who want to talk with a specialist about what might be causing their problem, and we’ll help you figure out what the next best steps are.  Our goal is to give you all the information you need so that you can make the best decision for your health – without any obligation or commitment.

We also know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free health and posture classes!  These events are for people in our community who want really valuable, expert information about movement, pain, and overall wellness. We know it’s confusing out there with all of the information floating around on Google and Facebook, and this is a valuable first step towards getting some answers for your problem.

Hopefully you found this information helpful, and the only thing scaring you this Halloween will be haunted houses instead of the noises coming from your joints!

PS – If you found this information helpful, please share this with a friend or on your Facebook feed.

Knee pain? Top three causes and what to do about it.

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Knee pain is one of the most common complaints that brings people into our office.

Since most of our clients are in their 40’s, 50’s and 60’s, they start to really worry that knee pain could bring an end to their active lifestyle. But that doesn’t have to be the case! The good news is that unless you’ve had some serious trauma (like a major accident or fall), 80% of all knee problems can be resolved without any kind of procedure or surgery – and most importantly – you can learn how to continue managing them on your own so that they never get in the way of your favorite activities again.

Sound too good to be true?

It’s not – I promise – but the first step is figuring out where your knee pain is coming from. Once you know that, you can get on the right path to resolve it.

Here are three of the most common causes I see that make people suffer from knee pain and what you can do about them:

1. Iliotibial band syndrome

This is a very common problem that typically affects runners, avid walkers, and hikers. It is often misdiagnosed and confused with patellofemoral syndrome (see below). Your iliotibial band (IT band) is a very large thick band on the side of your knee that will often get overworked due to a muscular imbalance elsewhere in your body (usually your hips and core). When this happens, you’ll feel pain that is on the side of your knee that is usually very sore and tender to touch, and typically sharp and stabbing versus achy. It will impact you most when you’re going downhill or down the stairs.

It’s important to note that even though a tight, and painful IT band is the structure causing you to have pain – it is typically a symptom of an underlying problem. Like I said before, IT band problems are usually the result of your core and hips not stabilizing your pelvis properly – which ultimately results in your knee not receiving the support it needs when you’re running, walking, or hiking.

Getting rid of the actual pain is the easy part… in our office we use things like dry needling, soft tissue work, and sometimes even some taping. But if you want to keep the pain gone – you MUST address the underlying causes as well. This is what a lot of people miss. We love using Pilates-based exercises in our office because they not only target your core, but also get your muscles working in a coordinated, symmetrical fashion, helping to keep things balanced as you get back to your favorite activities.

2. Patellofemoral Knee syndrome

This problem is very similar to IT band syndrome, with just a few key differences. This first is that it can impact almost anyone – not just runners, hikers, and walkers. You’ll also experience the pain in the front of your knee – typically under your kneecap – and it will tend to be more achy than sharp. This problem will often come on very slowly and can be more chronic than its IT band cousin. You’ll feel this more when you’re going up stairs, up hills, and with squatting. You’ll also notice stiffness and pain in the front of your knee after sitting awhile – that usually will go away once you start moving.

Much like IT band syndrome – these are all symptoms of an underlying cause. A weak core and hips can cause this problem too, but I usually see more weaknesses in glutes and hamstrings with this one. When the backs of your hips and legs aren’t kicking in like they should, it can result in tight hip flexors or quads. This is a super common culprit for patellofemoral syndrome. So once again, you can get rid of the pain quite easily in most cases, but you must make sure to determine – and address – the root cause so that you can keep this pain gone for good.

3. Osteoarthritis

Many people hear that they have osteoarthritis in their knee and think there isn’t anything they can do about it. Not true!! Arthritis is often blamed for knee problems but it isn’t always the cause of what you’re feeling… Let me explain….

When arthritis is the true cause and culprit for your knee problem, it will be painful and stiff all the time. You’ll lack significant mobility and it will be almost impossible to walk and bear weight without support or a cane. When this is truly your problem – you are a great candidate for total knee replacement surgery. Now here’s the catch… sometimes your X-ray or MRI will show that you have terrible arthritis or that you have “bone-on-bone”… but that doesn’t mean you need to rush to surgery! Your symptoms should really decide that.

If your pain comes and goes (meaning you have good days and bad days), if you can walk around most days and go up and down the stairs and your knee just “catches”, or maybe you feel stiff a lot but this eases up with movement – you might have arthritis in your knee but it is not the root cause of your knee problem. Because here’s a hint – arthritis does NOT come and go – but other common musculoskeletal problems can. When your pain comes and goes, you know it can’t be entirely from arthritis.

So what should you do?

With arthritis, whether it’s partially to blame, or whether it’s just something that shows up on the X-ray and gets blamed… we still need to look at the surrounding structures and root cause of the problem.

If your quads are really tight, and the muscles around your knee are imbalanced, this can create compressive forces in your knee joint which will exacerbate what might normally just be “mild” arthritis (compression will aggravate arthritis). You could also have weakness or problems in your ankles, feet, or core that are causing your knee to work harder than it needs to. This can cause pain all on its own, OR aggravate your arthritis. The point is, get checked by a musculoskeletal expert – people trained like us – so that instead of just fishing for the problem or only treating symptoms, you are getting to the root cause of your problem and setting yourself up for success!

If any of this sounds familiar to you, you may benefit from working with a specialist physical therapist who can help you get back to the activities you love – without pain pills or unnecessary procedures. You can click right here to request a FREE Discovery session with one of our specialists. We’d love to help you figure out the root cause of your knee problem so that you can get back to doing everything you love – instead of spending time in the doctor’s office 🙂