Tag Archive for: mobility

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!

tight hips

The Big Reason why Back Pain Keeps Coming Back

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If you’re reading this and you’re over the age of 40, odds are pretty good that you’ve experienced back pain at some point in your life. The odds are also pretty good that you’ve experienced back pain more than once.

Every few months or maybe once per year – your back “acts up”. You get rid of it – but it ALWAYS comes back.

Sound familiar?

Well… you’re not alone. Four out of five people are impacted by back pain, and for many, it’s a constant back-and-forth year after year.

But why? Why does back pain always seem to come back?

There are essentially two main reasons:

  1. Back pain is primarily addressed with “quick-fixes” and passive modalities
  2. You (or your doctor) let MRIs make the decisions about your treatment

Quick fixes and passive modalities…

This is the most common way people tend to address their back pain. And it’s the number one reason why it always comes back.

What is a passive modality? It’s something that is done TO you. It’s where you walk in somewhere, lay on a table, and you receive some kind of treatment. This could be chiropractic care, massage, craniosacral therapy, acupuncture, even injections and surgery. You have no active role in the process — it’s completely passive.

Now, I’m not saying there is anything wrong with these treatments. They are GREAT for getting rid or your back pain — and quite often quickly. And they are also great for helping you with other problems, such a stress relief. (I LOVE getting my massage once per month!)

But when your back pain keeps coming back, it’s a big sign something is missing. These treatments are only addressing your symptoms – for example – tight muscles, tension in your nerves, stiff or out of place joints. These things are all the result of your back problem – not the cause.

And it’s the number one reason why your back problem keeps coming back – because the root cause – the thing that is causing you to have tight muscles or stiff joints – is never addressed.

When MRI’s make the decision…

Traditionally, the medical community diagnoses your back pain with images. They use X-rays and MRI’s to see what’s going on inside your spine, and from there, they make a determination of what your treatment should be.

This is a big problem, because what shows up in your MRI isn’t always the reason for your pain. For example, your MRI might show a herniated or bulging disc in your spine. Your doctor will immediately blame that for your pain. And depending on how “bad” it looks, they may suggest injections or surgery. But the truth is, another person could have the exact same visual results as you on their MRI and have no back pain at all.

So why is it that one person can have a bulging disc with no back pain, and another person can have a bulging disc with excruciating back pain?

It’s because the root cause of back pain is more complicated than your anatomy. Research has shown time and time again that 80% of all back pain is primarily influenced by your habits and the way you move, not by what’s going on structurally in your spine.

So you can go in and cut out the disc, but if you don’t identify and correct your poor movement habits that led to that bulging disc in the first place — it’s either going to come back or bulge somewhere else. It’s why surgery only has a 50% success rate for helping people keep back pain away for the long-term.

If you’re confused right now – I don’t blame you.

It’s why so many people suffer from back pain!

It’s also why we offer the opportunity for you to come talk to us for FREE if you’re tired of suffering from back pain with no real answers.

Click here to request a FREE Discovery Session with on of my specialists.

You can also download this FREE GUIDE on how taking care of back pain on your own. It was written especially with the recent quarantine in mind – where so many people have been stuck at home and off their routines.

Either way, you should know that if you want your back pain to stop coming back — it IS possible. You just might have the wrong approach and could benefit from some specialist care to finally get you going in the right direction.

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.

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 🙂

How you actually CAN recover from chronic back pain

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There’s nothing more discouraging than being in pain and feeling that there’s no way out of it. Back pain is such a common issue, and unfortunately, many people hold onto the mistaken belief that if you have a “bad back” you’re stuck with it for life. Not true!!

It is totally possible to recover from chronic back pain and return to the activities you used to love.

Great news, right? Let’s talk HOW. 

First of all, keep moving.

There are people in healthcare who will tell you to just avoid anything that irritates your back and accept that you can’t be as active as you once were. But what if basically everything triggers back pain? What if your job requires you to be on your feet or you simply want to tie your own shoes or pick up your grandkids? You don’t have to resign yourself to sedentary days spent popping ibuprofen every four hours and missing out on life. Don’t listen to the people who tell you to avoid movement — because in fact, the solution is the exact opposite. Consistent, correct movement heals your body and keeps it from shutting down. If you’re suffering from back pain, it may be a sign that your movement habits are off. You could benefit from working with a specialist physical therapist to retrain your body in how to move properly throughout your day, thus eliminating unnecessary stress on your spine.  

Along the same lines, make sure you educate yourself.

We offer a FREE workshop at our Portsmouth office every month to answer questions from our community, and our next topic is back pain and sciatica! You may feel like surgery and medication are the only options out there for recovery, but in reality they are just two of the less effective strategies for treating back pain. One of our clients, Sean, was dealing with multiple herniated discs and spoke with us on this exact topic. 

“I was considering back surgery until I found CJ Physical Therapy. I walked out of 

therapy with such relief that the thought of surgery was no longer an option. Therapy 

worked so much better than the steroid injection just a few months earlier, that it gave 

me hope of actually being able to feel like I did before the injury a year earlier.”

Nobody wants to get surgery, but if you haven’t been told about any noninvasive therapeutic routes to remedy your pain, surgery may seem like the only option. But time and time again, we have clients come to us with severe back pain and injuries that are often prescribed surgery — and time and time again, they have FULLY recovered through an individually customized program of physical therapy. 

If you’re dealing with chronic back pain, don’t be afraid to reach out.

We understand if you’re not yet ready to commit to PT — that’s why we offer FREE Discovery Sessions for potential clients. This 30 minute session is a chance for you to speak with one of our specialists and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health — whether that’s working with us or not! 

Physical Therapy and Pilates: The Perfect Pair

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We all know the joke:

Patient: “When I go like this, my arm hurts.”

To which the doctor responds: “Well, don’t do that!”

With physical therapy, just “not moving” is never an option. Instead of telling the individual in this scenario to avoid the movement altogether, I would say, “let’s do it differently.”

People typically have muscle and skeletal pain because of one or more 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. And that’s precisely the way it should be.

Pilates teaches correct movement throughout the whole body. 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.

Did you know that 90% of ALL musculoskeletal problems (aches, pains, and strains) can be resolved WITHOUT pain pills, procedures, or surgery?

So chances are, whether you’re suffering from sciatica, neck pain, an achy knee, herniated discs, or any number of physical issues, your pain can be resolved through physical therapy. And if you want to return to your daily activities even stronger than before — you can supplement your physical therapy sessions with Pilates.

Pilates-based physical therapy is excellent for people of any age who want to start an exercise program but might be afraid of injury or pain. Our practice actually specializes in treating clients aged 40+, and many of our clients in their 60s and 70s practice Pilates regularly! We offer a range of classes right out of our physical therapy practice in Portsmouth, which gives you the opportunity to combine your rehabilitation sessions with some therapeutic, strength building exercise for the whole body. Our group classes are geared towards beginners — no experience necessary! And if you’re interested, but don’t want to make a commitment, no worries. You can schedule a FREE Pilates Taster with us to see how Pilates can help you.

Want to find out if Pilates is something you should be incorporating into your physical therapy? Talk to one of our specialists for free! 

Questions About Your Shoulder Pain? Here are Some Real Answers.

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Often when clients come to us with shoulder pain, they’ve already tried several approaches without success. But the real issue is that everyone they’ve seen up to that point has failed to give them an accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause of shoulder pain is missed by many and can actually be difficult to diagnose. Sometimes it really is your shoulder, but in other cases the pain is actually caused by a problem in your neck. If there is irritation or inflammation in your neck, but someone is aggressively treating your shoulder, guess what? You aren’t going to see results and your pain may even worsen.

Here are a few questions to ask if you’re wondering if really have a shoulder problem… or if you should be getting help for your neck instead.

Where is your pain?

 When you have an actual shoulder problem, the pain is always going to be just in your shoulder. The most common areas to experience pain are directly in front of your shoulder, directly on top of your shoulder, or in a more involved shoulder problem – like a rotator cuff injury – you might feel achiness on the side of your shoulder and down into the side of your arm a little. If the pain goes past your elbow, is above your shoulder and into your neck (the upper trap area), deep inside of your shoulder, or in the back into the shoulder blade, it’s entirely possible (and maybe even likely) that your neck is involved or totally responsible for your “shoulder pain.”

Do you have numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening in your neck – say due to a bulging disc or restricted/faulty movement patterns that irritate your nerve roots – you can feel it into your shoulder, shoulder blade, or even down into your arm.

What’s particularly misleading is that all of this nerve difficulty in the neck will only be felt in your shoulder or arm.

When do you feel stiff?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well, is pain free, and your shoulder is stiff, odds are that the problem is in your shoulder. Now, let’s say you’ve got stiffness in your neck as well as your shoulder. It’s possible the neck stiffness is a result of your shoulder not moving properly. However, you’ll never know for sure without a proper assessment. If there is even a hint of a neck issue being fully or partially responsible for your shoulder problem, it must be addressed or you will never achieve full recovery.

I do everything I’m told, why won’t my shoulder get better?

This is probably the number one sign that your shoulder problem is not really a shoulder problem at all. If you’ve had pain for months, or if you fix your pain but it keeps coming back, then there is a very good chance someone has missed something. Quite possibly, it’s a hidden neck problem. I can’t tell you how many times I’ve seen this happen. I’ve seen people try three different therapists who’ve prescribed the best rotator cuff exercises on the planet. I’ve seen people get multiple cortisone injections in their shoulder. And worse, I’ve seen people get surgery – only for their shoulder to problem return months or years later. If this sounds like you, then someone has missed the boat and your shoulder problem may not be a shoulder problem at all. You need to find a physical therapist who is a specialist and can properly assess you. They’ll know the right questions to ask, take their time doing a thorough and proper assessment, and get you on the right track to getting better. 

Is Running Bad for Your Knees when you’re Over 50?

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Is Running Bad for Your Knees when you’re Over 50?

This is a question we get asked a lot — especially by patients at our specialized physical therapy practice in Portsmouth, New Hampshire — who are getting older and worried that they won’t be able to keep running into their 50s and 60’s.

The short answer? No!

If you experience knee pain when you run, it’s not that you’ve “aged out” of the sport! It’s probably just a biomechanical issue that can be fixed with proper education and strengthening (best offered by a specialist physical therapist).

In fact, research supports that running may actually be GOOD for your knees!

Here are some factors that could be responsible for knee pain when you run:

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can in turn impact your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.”
A physical therapist can help you improve ankle mobility in order to prevent long term damage to the joints, tendons, and ligaments of your knees. This might be especially important for you if you’ve ever sprained or twisted an ankle in the past!

2) Weakness

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing strong lower limb muscles is critical. The hamstring and quadriceps groups play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

3) Unstable core

It may seem like running is all in the legs, but in reality, every physical action begins at the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — especially your knees. A stable core is key for maintaining balance and rhythm. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees.
Our favorite way to improve core strength is Pilates! If you are a runner but think you could benefit from a stronger core (let’s be honest, we all could), consider giving it a try — for FREE.

4) Running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — running form is important. It determines where and how the impact of every step is distributed throughout your body. If your body mechanics are compromised — for instance, you’re dragging your feet or running with your shoulders tense and shrugged — you’re more likely to suffer from chronic knee pain, or even experience a serious injury. Work with a movement specialist – like the PT’s in our office – to analyze your form and help you be more efficient when you run.

Running is good for you at any age, if you do it right!

Research shows running can actually slow knee arthritis. According to an article published by Outside Online, “animal models show that exercise promotes cartilage thickening and protects its stretchy properties… instead of wearing down your bearings, running may grease them. That’s key, because cartilage thinning and the loss of elasticity are both prominent causes of osteoarthritis.”

Want to make sure you’re running right? Get in touch!

If you are local to the Seacoast region and considering physical therapy in Portsmouth, NH – you can schedule a FREE Discovery Session if you have chronic knee pain (or any type of pain) to talk about what you’re dealing with and figure out the course of action that works best for you.

You’ll get the opportunity to tell one of my specialists everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

Looking for more information on Knee Pain? – Download our free guide “7 Ways to Stop Knee Pain” HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group.  To get in touch, email her at [email protected].