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Carrie working on a knee

Three Causes of Knee Pain and What to Do

Knee pain has been the hot topic around our office this week!

With the nicer weather we’ve been having – more people are outside – and their knees are “talking” to them.

Knee pain is the second most common complaint of musculoskeletal pain (back pain is number one) and it impacts one-third of all Americans at one time or another.

Most of our clients are in their 50’s and 60’s and love to ski, run, hike and bike. They worry that knee pain could bring an end to their active lifestyles.

The good news is that eighty percent of ALL knee problems can be resolved without procedures or surgery – but it starts with accurately identifying the root cause.

Here are three of the most common causes of knee pain and what you can do to resolve it.

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, patellofemoral knee syndrome (PFS) is characterized by pain in the front of your knee – usually just below or behind your knee cap. With PFS, the source of the problem typically has to do with unwanted pressure in the front of your knee… that eventually results in pain.

It’s very tempting to just get a cortisone shot – or take pain pills – to reduce the inflammation caused by this wear and tear. But then you’re only addressing the symptoms…

If you truly want to put an end to PFS, you’ll need to find the cause of this problem.

Typically, it’s poor form and movement habits that are the result of an imbalance somewhere between your hips, quads (front of the thigh), and hamstrings (back of the thigh). When you figure that out, you’ll restore healthy, balanced movement in your knee again – and reduce the aggravation at your knee cap.

2. Iliotibial band syndrome

This is a very common problem that is similar to PFS except that you’ll experience pain on the side of your knee instead of the front. Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called tensor fascia latae (TFL).

When your TFL gets overworked – your ITB suffers – and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage – and while these are great modalities to relieve your symptoms – they do NOT address the root problem.

You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis. Your TFL is neighbor to your glutes so when they decide to be lazy – your TFL loves to help out – and eventually overdoes it.

When you can get these two groups of muscles working properly together – you’ll put an end to ITB syndrome 🙂

3. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get surgery to replace their knees.

Not true!

First of all… arthritis is normal and it happens to everyone as they age. What is NOT normal is for you to think you’re helpless because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process – there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement.

The more mobility you have – and the more stability you have around your knees – the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core strength, and good flexibility in your hips and ankles. If anything is off in these areas – your knees will want to compensate – which could result in aggravation of arthritic symptoms.

“Motion is lotion” is not just a saying – it works! Especially when it comes to arthritis.

If you’re currently suffering from knee pain, remember that there is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills – or think that procedures and surgery are your only options!

If you’re curious about what might be causing your knee pain and you’re looking for expert help so that you can avoid injections and surgery – Request a Discovery Session with one of our specialists!

You can do it over Zoom or in person – and our specialists will let you know if you’re a good fit for what we do and if we can help you with your knee pain. 🙂

CLICK HERE to Request a Free Discovery Session.

Could your Hamstring Strain Actually be a Back Problem?

Have you ever strained your hamstring but the pain just doesn’t go away?

It’s been months since you first started hurting, you can’t actually remember how you injured it (it just started aching one day), you’ve been stretching and massaging it diligently, yet your hamstring still hurts.

This happened to a recent client of ours (“Sandy”).

Sandy was a runner and regular gym goer, who one day noticed an ache in her hamstring. She assumed she had just overdone it working out. She rested it a few days and the pain went away, but when she tried to get back to running she couldn’t. Her hamstring pain came right back. Thinking she hadn’t let it heal enough, she went back to resting it, but this time, decided to add some massage and stretching to her routine. 

A few weeks later… you guessed it… Sandy still couldn’t run.

She also noticed the pain in her hamstring started to feel “different.” It was becoming more deep and achy and started to hurt all the time instead of only when she tried to exert it. It even hurt when she sat for too long. She still couldn’t run and was starting to get worried. Her doctor told her it was just a “strain” and that she had to let it heal. The problem was that it wasn’t healing. Several months had now gone by and she was running out of exercises and stretches to try that would “let it heal.”

Luckily, Sandy attended our recent back pain and sciatica class and realized that the pain in her hamstring might not be a strain at all. 

And her instincts were right! Let me explain.

When you truly strain a muscle, it means you have done damage to your muscle tissue. Although it’s possible to have chronic problems from a strain that isn’t rehabilitated properly, strains typically do in fact heal. Once the inflammation from the tissue damage goes away, and you start doing the proper stretching and strengthening, your muscle eventually gets back to normal. Until a muscle strain is fully healed, it will typically be aggravated if you accidentally over-stretch it or exert it. But you usually don’t feel anything when you’re resting the muscle. In Sandy’s case, her hamstring was starting to feel worse when she was resting — the longer she sat, the worse she felt. Your hamstring is completely relaxed when you are sitting, so something wasn’t adding up.

This was the first sign we were likely dealing with something other than a “hamstring strain.” The second sign was that we could take her pain away by moving her back! Yes, you heard that right.

By moving and stretching her back in a specific way, we were able to significantly relieve the pain in her hamstring.

The reason her hamstring was actually hurting was because a nerve had been aggravated in her back. The nerve was causing pain to radiate into her thigh. That’s why it hurt when she sat for too long and it’s why she couldn’t tolerate any running. Sitting puts more stretch and pressure on the nerves in your back, and running puts a lot of compression through your back. Generally speaking, nerves don’t like to be stretched, especially aggravated nerves, and they don’t like to be compressed if they are aggravated either. By stretching her back in a very specific way, we were able to relieve the pressure from the nerve that was giving Sandy her “hamstring strain.” This confirmed that she was indeed having a back problem.

Has anything like this ever happened to you?

If you’ve got pain anywhere in your buttocks, hip, thigh, or leg that isn’t going away — especially if you’ve done your due diligence and tried all the “right things” — it’s possible you could have a back problem causing this pain instead. These types of back problems are easily missed if you don’t know how to accurately assess them and it won’t be picked up by an MRI or X-ray. The best way to figure this out is through specialized movement testing, like we did with Sandy. 

We talked all about this in our recent back pain and sciatica class. If you want access to the recording, just call our office: 603-380-7902. If you want to take the next step and meet us in person — you can schedule a FREE Discovery Session with one of our specialists right here

MRI

How MRI’s Lead Back Pain Sufferers Toward Unnecessary Procedures

One of the most popular questions and concerns I get from clients is whether or not they need an MRI when they are experiencing back pain or sciatica. It’s pretty standard protocol, but is it necessary? In most cases, no.

About 70 to 80% of back problems, even sciatica, are considered mechanical in nature and quite normal.

That means there isn’t anything “serious” causing your pain. Serious causes of back pain include things like a tumor, infection, fracture, or severely compromised nerve. Your symptoms will be pretty specific and obvious to a back pain specialist and will typically require advanced medical intervention.

An MRI can be useful in these cases to get more clarity before medical intervention begins.

But when your back pain is mechanical in nature, an MRI is more often than not misleading and may lead to unnecessary procedures or surgery.

If you’ve had back pain for years, it comes and goes, or you’ve had relief in the past from things like physical therapy or chiropractic treatment, you most likely have mechanical back pain. The root cause of mechanical back pain cannot be diagnosed by an MRI.

And if your back pain falls into the mechanical category, and you get an MRI anyway, you can end up with treatments you don’t need. Over the years, I’ve seen so many people with mechanical back pain get major medical procedures that were irreversible and made them worse.

Here’s the problem.

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. Everything from bulging discs, arthritis, stenosis, and degenerative discs, which are all considered normal as we age, but are usually not the root cause of your back pain. What typically happens is the MRI finds them, and your back pain gets blamed on them. But what we know from research is that all those common MRI findings I just mentioned rarely correlate with what’s actually causing your back pain.

Research has shown consistently that you can have two people with identical MRI’s showing something like bulging discs and arthritis, but only one of them will be suffering in pain. That’s how we know the root cause of your back pain is coming from something else.

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.”

If you notice that certain positions or movements relieve your back pain, or you feel better after walking and exercise, your back pain is likely mechanical in nature, and you don’t need an MRI to diagnose you. Mechanical back pain responds to specialized movement therapy and a selectively progressed exercise protocol. Mechanical back pain does not respond well in the long run to injections, procedures, or surgery, which is what you can end up with if you get an MRI and don’t really need one.

I can’t tell you how many people I’ve seen over the years get surgery for a bulging or herniated disc only to find that it didn’t help their problem, or it came back again with a vengeance.

And once you have surgery, mechanical back pain can actually become more difficult to fix because your tissues and ligaments are now compromised from surgical scarring, no matter how minimally invasive they say your surgery will be.

If you’re confused, I don’t blame you. It’s why we are doing a free online class for back pain and sciatica sufferers Tuesday, March 16th, from 6 to 7 p.m.

We’ll be going over why so many people suffer from back pain, how to tell if your back problem is mechanical or if you’ve got something more serious going on, why MRI’s are so confusing and may lead you to getting unnecessary procedures and surgery, and we’ll be sharing tips on how to get control of your back pain naturally and on your own.

If you miss the class — no worries! You can sign up for a FREE 30 minute Discovery Session with one of our specialists right here.

Why Strengthening Your Core Could Be Hurting Your Back

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, which 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.

If any of this is sounding familiar, and you’re not sure if strengthening your core right now is good for your back…

Join us for our next Back pain and Sciatica Class happening on Tuesday March 16th from 6-7p.

RESERVE YOUR SEAT HERE

It will be live via Zoom so you don’t have to leave your home, and it’s FREE to join.

Can’t make it live? No problem. Reserve your seat anyway and we’ll send you a complimentary replay of the class 🙂

Here are just a few things we’ll be going over…

  • Why so many people suffer from back pain
  • When you should and shouldn’t strengthen your core
  • Why MRI’s and x-rays are unreliable for diagnosing back problems
  • How to get control of your back pain without pills, procedures, injections, or surgery.

Reserve your seat HERE for our Free Online Back Pain & Sciatica Class – Tuesday March 16th from 6-7p – from the comfort of your own home via Zoom.

Hope to see you in the class!

physical_therapy_seacoast_portsmouth_NH

Tight knots in your muscles? Do’s and Don’ts

At one point or another, or perhaps even this very second, you’ve experienced tight muscle knots somewhere in your body.

They are annoying, nagging, uncomfortable, and quite often painful. The most common area to feel these knots is in your upper traps (the triangle shaped area between your shoulder blades and base of your neck). But other areas of your body that love to get knotted up include your mid and lower back, your hips and butt, the front and sides of your thighs, and the back of your lower legs.

The first thing people think to do when experiencing these tight knots or muscle spasms is to get a massage or try rolling them out with a foam roller. Lately, theraguns seem to be the craze. These devices look like power drills and use percussive therapy to reduce pain and relieve tightness in the affected area. In our office, for really stubborn and painful knots, we use something called dry needling, which is where you take a tiny acupuncture needle and insert it into the tight knot to bring blood flow to the area and release tension.

These are all great options, and for the most part, I put them in the category of “Do’s” when it comes to getting rid of tight muscle knots.

Sounds pretty simple, right? Well, not so fast. Not all muscle knots are meant to be released.

“Don’t” aggressively release a tight muscle knot until you know why it’s there. 

Sometimes, muscle knots form as a critical compensatory strategy. If released too quickly, they can set off an array of problems. I was just talking to my massage therapist about this, because she’s seen it happen to her own clients. Occasionally, she’ll work her magic to get rid of tight muscle knots only to find the client feels worse after the session. This can happen when the tight knot was there to compensate for a weak muscle elsewhere. 

Let me explain. 

Muscles are connected via highly innervated tissue called fascia. It looks like a spider web and one of its main functions is to connect organs and muscles together. Fascia is still being studied, but one of the theories is that if one muscle group in that fascial line is not doing its job, a different muscle will work extra hard in its place to take up the slack. Eventually, that muscle will get exhausted and tighten up into a knot, because it’s doing more work than it was designed to.

If you release a knot that is “holding the line” together, you’re asking for trouble.

In this example, what I’ve found is that the passive methods of releasing muscles (those I mentioned earlier) aren’t very effective at helping you get rid of the problem. You might actually end up feeling worse or having pain elsewhere. If your tight muscle knot is there to act as a survival mechanism, it’s going to take a more comprehensive and total body approach to resolve it. You’ll need to figure out which muscle or muscles the tight knot is compensating for and address them at the same time you work to release the tight knot. You can keep getting your weekly massage, but you’ve got to pair it up with correctly prescribed exercises.

To summarize, DO figure out why you have a tight muscle knot in the first place.

Is it there because you overworked it in the gym? Maybe you’ve taken on a new project at home that is repetitive in nature? If these are the reasons you’ve got tight knots in your muscles, then DO release them. You’ll likely feel better. And then correct the movement patterns, so the knot doesn’t come back. If you feel worse after releasing the tight knots in your muscles, or the knot keeps coming back, then the problem likely involves more than just that muscle and you need a more comprehensive approach to get rid of it. DON’T continue to release it over and over. If you’re suffering from stubborn knots that won’t go away, get assessed by movement experts like us who can diagnose your problem accurately and help you get rid of your muscle knots for good.

The Location of Your Pain may NOT be its Source…

One of the most confusing topics we deal with in our practice is pain. And there’s lots of advice out there on what to do about it…

Should you rest or move? Apply heat or ice? See a doctor or let it go away on its own?

Before you can even think about a solution to your pain, you must first accurately determine where it’s coming from. If you have pain in your knee, but it’s actually coming from your back, the best knee treatment in the world is not going to fix it.

Inaccurate diagnosis of pain is a BIG reason why so many people suffer longer than they need to, and undergo unnecessary surgeries.

You must accurately determine the source of your pain for treatment to be effective, and the location of your pain alone is not a reliable way to do that.

For example, I’ve seen people in my office with what they think is unrelenting tennis elbow, only to find out it was actually a problem in their neck causing it. I’ve seen people disappointed after a failed knee surgery, because the problem was never in their knee and actually coming from their back.

Isolated extremity pain (knees, elbows, shoulders) is one of the most misdiagnosed problems we see in our office.

A recent study by Richard Rosedale, et al. in the Journal of Manipulative Therapy investigated this – and it was found that over 40% of people suffering from isolated extremity pain actually had a spinal source of symptoms.

In other words, their extremity pain was actually coming from their neck or back.

I can’t tell you how many times we’ve seen folks with unexplained shoulder pain lasting months or years get better as soon as we begin treating their neck, even though they never had neck pain.

Same for knees…

It’s possible to have knee pain that is caused by your back, without ever hurting your back!

Confused? I don’t blame you.

But more importantly, how do you figure out the source of your pain when it’s not always where you’re feeling it?

As already mentioned, the most common place for this to happen is with extremities. If you’ve got shoulder, elbow, knee or foot pain – and you don’t ever recall a specific injury to it – you MUST consider that it could be coming from your spine.

There’s a 44% chance that it is!

Where this gets really confusing is that typically your doctor will order an MRI when you’ve got isolated knee or shoulder pain that won’t go away. And if you’re over 40 years old, the MRI will almost always show “something” – a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

Remember that these are normal signs of aging in everyone, and may not be the cause of your pain.

If you haven’t already had your spine checked properly as a possible source, you can’t rely on these findings (or the location of your pain) as an accurate diagnosis. That is how people end up having surgeries they don’t really need.

Whenever someone comes into our office with isolated extremity pain, we don’t even look at it without an exam of their neck and back first.

By moving your spine repeatedly, and in certain directions, we can often produce – or take away – the pain you’re feeling in your knee or shoulder.

Why?

Because if the pain in your extremity is caused by a pinched or aggravated nerve, moving your spine around is going to influence that, and tell us where the source really is.

An MRI and X-ray won’t be able to determine this for you with certainty – because sometimes your nerve only gets irritated when you move a certain way – or when you’re in a certain position. Since MRI’s and X-rays can’t see what’s going on while you’re moving, you can’t rely on those tests alone to tell you exactly where your pain is coming from.

If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source.

That source could be your spine.

And if you’re considering some kind of surgery or procedure, you definitely want to rule that out first.

Specialized movement exams like we do in our office are one of the most reliable ways to figure this out. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, CLICK HERE to request a Free Discovery Session with one of our specialists.

How to Keep Knee or Back Pain from Derailing your New Year’s Goals

More than ever right now, people are excited to move on from the strange year that was 2020. And for many, one of the ways to get on with 2021 as fast as possible is to focus on some New Year’s goals! The most popular goals for the New Year continue to revolve around weight loss and exercise. But here is one thing that can get in your way when pursuing those goals… unresolved back or knee pain. So many people make the mistake of thinking that exercise or weight loss alone, is going to “cure” their nagging pain. But that’s not always the case. 

Here are some top tips and advice I give all my clients around this time of year to help you get the most out of your health and fitness goals for 2021, and NOT let something like back or knee pain get in your way…

Mobility before Stability

Your muscles can’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a joint that isn’t moving at its best, or you’ll encourage compensation. If your nagging back or knee pain is due to inadequate mobility, you’ll run into problems (and more pain) if you suddenly increase your exercise or activity level. We saw this happen at the beginning of the pandemic. People started walking and exercising more and we saw a huge influx of unexpected back and knee pain as a result. Their joints weren’t accustomed to moving so much and it highlighted the lack of mobility and compensations. Don’t let the same thing happen to you! Make sure all of your joints, including your spine, can move fully and freely without any pain before you begin a new exercise program.

Pace yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember, the tortoise won the race, not the hare. It’s important to not beat yourself up if you’re not seeing immediate results. If you’ve been out of shape for a while and doing something completely new, expect to be sore. But if you’re limping around for days or experiencing sharp pain in your back or knee, there is a chance you overdid it.

My general rule of thumb is to monitor your soreness on a scale of one to ten. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise we haven’t tried in a while. If you find that your pain level goes above a six, or persists at that level (or higher) for more than a day, there’s a chance you’re overdoing it and setting yourself up for an unwanted injury. When in doubt, listen to your body. And if you’re not sure what it’s saying to you, enlist the help of experts like us!

Stay Hydrated

Most people don’t drink enough water during their regular day, never mind when they increase their activity level. Drinking lots of water has two great benefits. It will give you the extra hydration you need if you’re planning to be more active. And it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day is to begin with 10 oz of water first thing upon waking. A good place to start when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

Get assessed by a movement expert

If you’ve already got some nagging back and knee pain, do yourself a favor and get assessed by a movement expert FIRST, before you begin your new exercise routine or New Year’s goal. Your first thought might be to go see your medical doctor, which of course isn’t a bad idea, but it’s important you understand how different medical professionals look at you when you have knee or back pain.

Medical doctors are trained to screen your whole body and spot for serious problems. If you see them for musculoskeletal pain, they will typically take X-rays and MRI’s to make sure there are no broken bones or serious pathologies. They do not have extensive training to assess how your pain behaves during movement or exercise, which is the majority of people’s problems. That’s where we come in.

A specialty practice like ours will be able to assess your movement in detail, through various movement tests, which will tell a much better story about how your pain may or may not impact the new exercise or weight loss program you’re about to start. Plus, once we know how your pain behaves, what the triggering patterns are, we can also teach you how to control it – so that you don’t have to let nagging back or knee pain derail your 2021!

I hope your New Year is off to an amazing start, and if you want to ensure that back or knee pain doesn’t get in the way of that, reach out for a FREE 30 minute Discovery Session. We would love to talk with you about your goals and be part of your support team as we all launch into 2021!

 

 

Tips to Combat Arthritis this Winter

People tell me all the time: “I don’t need to check the weather anymore, my joints tell me what’s coming.” And as winter approaches, I know I’m going to be hearing more and more of this.

So why is it that arthritis sufferers tend to be impacted more during the colder, wetter months?

The actual science on this is inconclusive. Some studies have completely debunked the myth that weather can affect your joint pain, while others have shown that arthritis sufferers do indeed have what we call “weather sensitivity” — and they feel worse in the cold, especially when it’s about to rain or snow. The working theory behind this is related to barometric pressure. As a storm system develops, barometric pressure (atmospheric pressure) begins to drop. Some scientists believe that this results in expansion and contraction of tissue in and around your joints (tendons, muscles, bones, and even scar tissue). If those tissues are already sensitive due to arthritis, this could irritate them further. Additionally, the lower temperatures of winter are thought to increase the thickness of fluid inside your joints, making them stiffer and perhaps more sensitive to pain during movement.

Regardless of whether this phenomenon is myth or fact, it doesn’t make your pain any less real! The good news is there are things you can do to minimize pain related to arthritis as winter gets closer. 

There are two types of arthritis, inflammatory and non-inflammatory. Rheumatoid arthritis is the most common form of inflammatory arthritis, and osteoarthritis is the most common form of non-inflammatory arthritis. Although they have very different causes, weather changes can still have an impact, and there are still things you can do to minimize that impact.

Both forms of arthritis are characterized by one or more of your joints being inflamed.

Inflamed joints do not like to be compressed or irritated. It’s often why people will tend to rest and decrease their activity when they have pain. Add cold winter temps and weather to the mix (along with a pandemic), people just naturally do less this time of year. They think if they take the weight off their joints, or move less, they are protecting their joints. That’s actually not true. What protects your joints is strength and flexibility. The more mobile you are, the less likely your joints will get irritated, even arthritic ones. Have you ever worn a piece of clothing that’s too tight? You get irritated. Same with your joints! If they aren’t free to move, they get angry. The muscles around your joints and how strong they are also play a huge role in minimizing irritation.

In the absence of strength and stability, your body will do what it needs to compensate. The structures around your joint will contract to make your joints stiff and tighter in an attempt to give your joints the stability they are lacking. But arthritic joints don’t want to be stiff and tight, they want to be free and mobile! So if you suffer from arthritis, it’s critical that you have good mobility and good strength — period.

In general, the most important thing you can do for your arthritis any time of year, not just in winter, is to keep moving.

And you will move better when you’re strong and flexible. Movement gets blood flowing, which is our best and most natural form of anti-inflammation. Walking is the easiest and most practical way to get healthy movement daily, but biking and swimming are great choices too. You’ll also want to engage in some form of activity, such as Yoga, Pilates, or Tai Chi, that allows you to move your limbs, body and joints in a full range of movement. Cardiovascular activities like walking and biking won’t do that. Pilates is great because it emphasizes both full body strength (which helps balance out your joints) and it promotes flexibility at the same time. It’s why we like to use it in our office. Although it’s easy to just stretch and get more flexible, it’s important that you incorporate strength training into your routine also. Achieving good mobility AND strength is the secret to combating arthritis. Folks tend to only focus on the flexibility part, which is one of the common mistakes I see. 

I hope this helps you better understand why your arthritis might feel worse in winter, and what you can do about it! If you’re suffering from any kind of back or knee pain that is preventing you from being more active and mobile and therefore worsening your arthritis, check out our FREE Back Pain and Knee Pain guides. Just click to have the guide sent straight to your inbox with no obligations or strings attached!

When Traditional Physical Therapy Fails…

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

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

Has this happened to you?

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

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

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

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

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

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

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

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

Here’s an example…

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

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

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

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

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

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

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

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

Click here to request a Discovery Visit.

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

Should You Heat or Ice an Injury?

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

When to apply ice:

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

When to apply heat:

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

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

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

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

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

Speaking of movement as a way to heal…

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

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

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