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Hamstrings Always Tight? This Could be Why

If you’ve ever felt tightness in your hamstrings, the typical advice you get from friends, family, and even well-meaning healthcare professionals is to stretch them.

But if even your stretches just aren’t working – what then?

You hear me say this a lot… but if you’re constantly stretching… or even foam rolling a tight or tense muscle… and nothing seems to change… then it’s time to start considering that it might be something else.

I see this scenario ALL the time in our office…

Just recently, a gentleman (we’ll call him “Steve”) came to us with what he thought was a “chronic hamstring strain…”

He had been stretching his hamstrings consistently – but they just weren’t loosening up.

He wanted to know if there were better stretches he could be doing to loosen up the tight, uncomfortable feeling he was experiencing in the back of his thigh every day.

First – it was critical to make certain that Steve’s problem was… in fact… a tight hamstring.

If the chronic tightness in the back of Steve’s thigh was due to a hamstring problem, his stretches really should’ve been having some sort of impact.

Instead, the stretches either did nothing… or made his thigh ache.

Sometimes after stretching a lot – he would “feel” his hamstring for the rest of the day – even when he was just sitting. We checked that he was using proper stretching technique – and he was – so something wasn’t right.

When you’re having a problem with your muscle – and only your muscle – you’ll experience discomfort, tightness, or pain when you’re either using that muscle or stretching that muscle.

Otherwise – you should generally feel perfectly fine.

Muscles are made up of what we call contractile tissue. When you truly strain a muscle, this contractile tissue gets disrupted. You heal it by moving and stretching it – and eventually it goes back to normal. On occasion, people don’t move enough after a muscle strain and the tissue can become chronically tight. But still, you would only experience that tightness when trying to use or stretch the muscle.

This wasn’t the case for Steve.

His pain would, on occasion, linger throughout the day when he was resting or sitting. Sometimes he’d notice hamstring discomfort at night when he was trying to sleep.

Steve was feeling symptoms in his hamstring whether he was using that muscle or not – and his stretches weren’t helping.

This immediately tells me that there was another problem causing his symptoms and it was more than just a tight hamstring. – and when hamstring or thigh tightness doesn’t respond to stretching or exercise – we must always consider the lower back.

Since Steve wasn’t feeling any pain in his lower back – he never considered this himself.

But the key was in how Steve’s pain was behaving…

Your pain behaves in different ways depending on where it’s coming from..

As I mentioned previously, when your muscle is the source, your pain behaves in a very specific and repeatable manner.

But if pain is coming from your spine, it can quite literally be all over the place.

You can feel symptoms in your back, your butt, and your limbs. You’ll have good days and bad days. You’ll feel symptoms at rest, and you can certainly feel tightness in your hamstring – just like Steve.

The other interesting thing about problems that originate from the spine is that you’ll often be able to trigger your symptoms by moving your spine.

When we investigated Steve’s spine… we found that when he moved a certain way over and over… it would produce his hamstring tightness.

Bingo!

This explains why Steve’s hamstring stretches were doing absolutely nothing… He was stretching his thigh when he really needed to stretch his back.

Does Steve’s story resonate with you?

If you’re feeling chronic tightness or pain in your hamstring that just isn’t going away – chances are good that you’re missing something.

Do yourself a favor… DON’T check YouTube or “Dr. Google” for advice…

Talk to one of our experts instead.

Best way to do that is request a FREE Discovery Session.

We’ll talk to you about the symptoms in your hamstring and let you know if stretching is enough… or if you need something more!

CLICK HERE to request a Free Discovery Session with one of our specialists.

 

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5 Tips to Treat Back Pain on your Own and Avoid Surgery

Back pain impacts approximately 31 Million Americans at any given time, and our health care system spends $50 Billion per year on low back pain treatment. It’s the single leading cause of disability keeping people out of work, and it’s the second most common reason for doctor’s visits. Back pain is a big problem in this country. But the even bigger problem, in my opinion, is how the traditional medical system treats and manages those suffering from back pain.

Despite what you may have been told, getting rid of back pain on your own is entirely possible and preventing it can be even easier.

But it starts with understanding what the true cause of back pain is for most people. Eighty percent of back pain is “mechanical” in origin, which means it’s not due to any serious pathology like cancer, infection, or fracture. Mechanical back pain is the result of abnormal or unusual forces occurring in the structures of your spine – like your ligaments, muscles, discs, and vertebrae. These abnormal forces can accumulate slowly over your lifetime or happen quickly in a single event – such as picking something up the wrong way.

The good news is that if abnormal forces can cause your back pain, then reversing those forces can get rid of your back pain. Surgery and other medical procedures won’t do that. They only impact the structure or irritant that is aggravated, like when you remove a piece of your bulging disc. The goal for true back pain recovery is to eliminate what is causing those structures to be aggravated in the first place – and the best way to do that is with healthy movement you can do on your own!

Here are 5 tips to help you minimize abnormal forces on your spine so you can avoid procedures and surgery!

1. Stop sitting so much

Compressive forces on your spine increase by 40% when you sit – and it goes up even more if you’re slouched! Over time, these compressive forces will start to aggravate the ligaments and discs in your spine. Because it happens slowly, you may not notice right away, so one of the best things you can do is interrupt your sitting at least every 30 min. This minimizes the accumulation of abnormal forces on your spine throughout the day.

2. Walk more 


Our spines were designed to be upright and moving. Walking is one of the best and easiest ways to promote this. When you walk regularly, it helps to promote good mobility and blood flow, which can act like lubricant for the structures in your spine. Walking also helps to keep your hips from getting tight. Tight hips can cause abnormal forces to occur at your pelvis, which in turn, will create abnormal forces on your spine.

3. Vary your posture

You might be wondering why I didn’t say “maintain good posture.” To be honest, perfect posture all the time is kind of a myth when it comes to back pain. The truth is your spine is quite resilient and should be able to tolerate lots of different postures – even bad posture for a short period of time – without pain. The problem is when we assume the same posture all the time.

Imagine if you never straightened your knee, eventually it would get stiff and be difficult to move in that direction. The same thing happens in our spines. One of the best things you can do is choose activities (like Yoga or Pilates) that work your spine through lots of different postures and range of motion. This helps keep your spine happy and healthy and it minimizes abnormal forces from the same repeated postures or activities day after day.

4. Strengthen your core

The stronger you are, the more resilient your body is going to be – period. When it comes to back health, having a good strong core is going to minimize stress on ligaments and even discs. When the muscles around your spine are strong, it’s going to be easier for you to lift and carry things, which is one of the most common ways people injure their backs. If your abdominals, glutes, and hips aren’t doing their job, your spine ends up taking more of the stress – and this can lead to both pain and injury. Pilates is my favorite way to strengthen your core because the exercises are designed to target your abdominals.

5. Educate yourself 

There is a lot of misinformation out there when it comes to both diagnosing and treating back pain. You should never let an MRI or X-ray alone dictate what your treatment should be. Remember, the structures in your back don’t get spontaneously irritated. Irritation typically occurs due to abnormal forces on your spine. If you only address the irritated structure – like with an injection, procedure, or surgery – you’re not actually fixing the problem. The best way to address abnormal forces in your spine is with movement – movement that is designed to even out the forces in your spine and relieve pressure from those structures that have become aggravated.

If you don’t currently have back pain – then these tips are going to help you prevent back pain from ever occurring. If you’re currently having some mild back pain or discomfort, then see if any of these tips help you to relieve it on your own! But as always, if you’ve been suffering for a while, then it’s best to seek professional advice from an expert.

Speak with one of our experts for FREE by signing up for a 30 minute Discovery Session here!

You can also access our expertly written guide to managing back pain for free right here.

 

 

 

 

Three Reasons Your Physical Therapy Didn’t Work

Have you been to physical therapy once, twice, maybe even three times for the same thing… and now you’re left wondering why it didn’t work?

Or perhaps you went to physical therapy and it “worked,” but you have to do about 10 exercises per day that if you miss… even once… the pain comes right back. (hint – that means it didn’t actually work.)

This is sadly an all too common occurrence in this profession. However, if you’ve already had the chance to work with us, then you know we are a specialty practice.

But here are three reasons why your treatment in a regular physical therapy clinic might not have worked for you…

For physical therapy to be successful – it MUST start with a full and thorough musculoskeletal examination. But for varying reasons, this isn’t always possible.

The problem in most traditional physical therapy settings is that physical therapists are sometimes restricted with what they can and can’t do. Sometimes the restriction comes from an insurance company, and sometimes they are simply overworked.

If a doctor sends you for knee pain, your PT may only be able to look at and treat your knee. They are “administratively” prevented from giving you the full and thorough examination that you need.

I can’t tell you how many times I’ve seen knee pain being caused by someone’s spine. If I wasn’t able to look at and treat that area, I’d have missed it!

Other times PT’s have too many patients at once, and are forced to take short cuts. This could cause them to miss important details. I’ve been at this for 20 years, and in my opinion, the perfect physical therapy evaluation should consist of three major components: the interview, the examination, and the plan.

Your therapist should be asking you a lot of questions to find out how your pain is impacting you. They should do a lot of movement testing (not just poke you) to confirm why you’re having pain. And lastly, they should clearly explain to you why your pain is behaving the way it is and have a solid plan to solve it – one that is NOT dictated by your insurance company.

If your PT evaluation didn’t look like this, or your therapist was rushed, chances are something got missed.

The second reason I see physical therapy not working for people is because your PT used too many passive modalities.

This includes everything from electrical stimulation, ultrasound, dry needling, Graston technique, traction, laser therapy, and even manual therapy. We call these treatments “passive” because they are done to you.

There is a time and place for these things. But generally speaking, they should only be used to address very specific pain and impairments that are preventing you from moving in a way that is going to produce the real healing.

For example… let’s say you’ve got a tight knot in your upper trap that is giving you neck pain. There are some fabulous modalities like dry needling and massage that will quickly get rid of your pain, but a few days later, the pain will come back…

That’s because the tight knot is the symptom.

The underlying cause of this recurring tight knot is what’s essential to figure out and address.

If all your therapist does is treat the symptom with passive modalities that feel good, your therapy isn’t going to work and you’ll continue to suffer.

The last reason I see physical therapy not working is because there are just too many different exercises being assigned.

Physical therapists LOVE to give homework, but sometimes that homework can turn into two or three pages of exercises.

This is rarely necessary. And the chances of anyone doing all of these exercises every day is highly unlikely.

My firm belief is that your physical therapist should be working on highly specific problems with highly specific exercises. I refer to these as corrective exercises. You typically should only have 3-5 to do at any given time. These corrective exercises should compliment what you are doing in your session, and be designed to specifically address pain, and/or a very specific impairment or weakness.

They should NOT be generalized or cookie cutter – and you should absolutely have a very good understanding of why you are doing them and what they are designed to accomplish.

Ok… so now that you know what quality physical therapy should look like…

If you’re NOT getting it… it might explain why it “didn’t work”.

Sadly, insurance puts a lot of limitations on what physical therapists can and can’t do, which is why a lot of people are starting to move away from using their insurance all together. They know they can get better quality care, and have their problem resolved completely, by paying out of pocket to an office that isn’t tied behind red tape.

Plus, while it might seem cost prohibitive at first, it’s A LOT better than the costly alternative of unnecessary surgery or injections.

Remember that physical therapists are movement experts.

If you’re only doing cookie cutter exercises, riding the bike for 10 min, or just lying on the table every session – you’re not spending adequate time restoring full mobility and quality of movement.

Your physical therapy probably won’t work, and it certainly won’t give you the lasting results you’re looking for.

If this experience is sounding all too familiar – consider working with a practice like ours. We’re not restricted by the red tape and we care about doing things the right way, even if that means more work on our end.

Curious? Talk to one of our specialists for free!

You can do that by Requesting a Free Discovery Session right HERE!

Why your Cortisone Injection Failed You

When you have joint pain that won’t go away, especially after trying lots of physical therapy, your doctor might recommend you get a cortisone shot.

Cortisone shots are often prescribed for things like back pain, bursitis, bulging discs, cartilage tears, osteoarthritis, tendonitis, and many other conditions that are perceived to be inflammatory in nature. While every single one of these conditions can cause things to be inflamed, it doesn’t mean that inflammation is your underlying problem. If something else is causing any of these structures to get irritated and inflamed, then your cortisone injection won’t work. At the very best it will provide you temporary relief, but the problem will ultimately come back in about 6-12 months time.

Cortisone shots also come with many potential problems and side effects. So you really want to be sure that it’s necessary before you get one.

The list includes problems such as: cartilage damage, death of nearby bone, joint infection, nerve damage, temporary facial flushing, temporary flare of pain and inflammation in the joint, temporary increase in blood sugar, tendon weakening or rupture, thinning of nearby bone (osteoporosis), thinning of skin and soft tissue around the injection site, and whitening or lightening of the skin around the injection site. And none of these side effects account for human error with the procedure. If your doctor is “off” with his/her injection – you could end up with unnecessary tissue trauma and pain because your shot wasn’t injected correctly.

So when it comes to cortisone shots, you really want to make sure that 1) the root source of your problem is inflammation and 2) you actually need one.

The reason why so many cortisone injections “fail” is because quite often – they weren’t needed in the first place. Even though the actual pain you are experiencing might be due to inflammation, the underlying cause leading to the inflammation could be something else entirely. Cortisone shots are used to address inflammation. But 80% of the time the musculoskeletal pain you’re experiencing is due to a mechanical or movement problem. So while the symptoms you’re experiencing could be due to inflammation, the root cause of your issue could be due to something else. In this case, the cortisone shot will not help – or worse – provide you with temporary relief that leads you to think it did.

Let me explain with a bit of scientific research.

Studies show that 70-80% of people over the age of 50 have a bulging disc on their MRI. 60% have a meniscus tear in their knee. These findings are considered normal as you age. The research also says that not all of these people experience pain. So you can have two people with the exact same MRI findings and one person will be perfectly fine while the other can barely walk. This is how we know that “the finding” (a bulging disc or meniscus tear for example) isn’t necessarily the problem.

The source of the problem is what is causing that bulge or tear to get annoyed.

About 80% of the time it’s going to be something like a faulty movement pattern or “mechanical issue,” such as poor mobility or stability, leading to some compensatory movement strategies in your body. When you don’t move well, structures like normally occurring disc bulges and meniscus tears can get irritated.

For example, let’s say you have a bulging disc in your back. If you sit for most of the day, travel a lot for work, or have a job that involves a lot of repetitive lifting, these types of activities are known to really aggravate a bulging disc. If all you do is inject cortisone to calm down the irritation, you won’t be fixing the real problem… which in this case is your daily movement habits. After about 6 months of returning to all these activities again, the pain WILL come back.

The good news is that there are ways to solve this type of problem (and others) naturally, and without a cortisone injection. But the important thing for you to realize here is that if you did get a cortisone shot recently and it appears to have “failed,” the last thing you want to do is get another one or resort to an even more invasive procedure. It’s possible you didn’t need it in the first place, so you want to make sure that is uncovered first.

So, if you’ve recently had a cortisone shot and it didn’t work, it could very well be that you never actually needed it… or that the wrong problem (inflammation) was being addressed instead of the underlying cause.

If you are considering something like a cortisone shot, it’s always a good idea to get a second opinion to make certain you really need it and that it’s the best course of action for your problem. And if you’ve already had one and it didn’t work, don’t worry, odds are good that there is still a solution out there for you… and it doesn’t have to involve more procedures. It could be as simple as learning how to move better! Sign up for a FREE Discovery Session today with one of our specialists to see if we can help you avoid quick fixes like cortisone shots and get long term, lasting results. 

Are you overdoing it on “Vitamin I”?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This is never a good idea.

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

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

In this case it increased!

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

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

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

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

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

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

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

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

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

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

Movement is my favorite form of medicine.

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

Request a FREE Discovery Session with one of my specialists.

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

Should you Rest when your Back Hurts?

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

The short answer is “no.” 

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

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

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

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

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

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

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

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

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

If you’re looking for a new, safe way to get moving, check out our Pilates offerings. New clients can even try UNLIMITED Pilates offerings for 5 weeks with our New Client Pass!

Arthroscopic Knee Surgery – Does it Even Work?

While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still one of the most common surgeries performed, despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

We’ll be talking about this whole topic and more during our next Online Zoom workshop for Knee Pain sufferers, happening Tuesday, April 27th from 6-7 pm.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to not only avoid surgery – but help get rid of knee pain naturally and on your own – be sure to attend our workshop! It’s free to attend. CLICK HERE to reserve your seat.

 

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!

Got a Pain in Your Butt? Here’s what to do first.

Nobody likes a “pain in the butt.” But what do you do when you’re dealing with literal pain in your butt versus the figurative kind?

It starts with figuring out where it’s coming from. Understanding the origin of your pain is necessary if you really want to solve it! One of our Pilates regulars (“Stacy”) has a story that illustrates this concept perfectly.

Stacy had been doing all the right things. She keeps active, does Pilates with us, and walks regularly. But still, she ended up with that dreaded pain in her butt that so many of us deal with on a regular basis. She tried to work through it herself by foam rolling and stretching – but none of that worked to completely eliminate her pain. Plus, her symptoms were starting to limit her Pilates and walking. This made her nervous because staying active and mobile is one of the most important things to Stacy, and the idea of being stuck at home and in pain this winter season made her want to take action now. She did the right thing by going to see our PT team.

Their first course of action was to accurately determine the root cause of Stacy’s butt pain. It could be a few different things.

Most often, symptoms like Stacy’s will get “labeled” generically as any one of the following:

1. Bursitis

They’ll call it this if you’re feeling the pain more in the side of your hip versus center of your butt.

2. Piriformis syndrome

This refers to a pain in the center of your butt. You might feel some tightness as well.

3. Back problem/Sciatica

They’ll call it this if your pain is more diffuse and achy, and perhaps even running into your thigh. This last diagnosis will be more common if you’ve got back pain along with the hip or butt pain.

As I mentioned, any one of these things could be the source of Stacy’s symptoms, and getting it right is critical. The correct diagnosis is the determining factor of whether Stacy’s problem gets resolved for good, or becomes something she deals with for the rest of her life. The problem with diagnosing your butt pain (or any problem for that matter) based on the location of your symptoms alone is that it’s not a reliable diagnosis.

The location of your pain alone does not tell you where your problem is really coming from.

For example, I’ve seen people with pain in their hip and butt that is actually coming from their back – even when they’ve never had a back problem. If your butt pain is coming from your back, and you think it’s “piriformis syndrome,” you’re going to be really disappointed in a few weeks when your pain is still there (or perhaps even worse) because you’ve been going about treating it the wrong way. In order to accurately determine what was really going on with Stacy’s butt pain, we needed to do some specialized movement screens and tests.

Research has shown that your pain’s response to movement, and how it behaves, is a much more reliable way to figure out the source of your problem versus relying on the symptom location alone.

In Stacy’s case, some quick movement tests revealed that her butt pain was indeed coming from her back – even though she did not have any back pain. How did we know? Pretty simple actually. When we asked Stacy to move and bend her back in specific directions, it triggered her butt pain! Her piriformis muscle was also tight – and may still need to be stretched – but it’s very possible that the tightness she is experiencing is also being caused by whatever is going on in her back. It’s possible for nerves to refer both pain and a feeling of “tightness.” We’ll know for sure in a few weeks, because we prescribed Stacy a corrective exercise designed to target the problem in her back and take pressure off the nerve that was triggering her butt pain. In fact, if she had not come to see us and kept stretching what she thought was a tight piriformis, she likely would have aggravated her nerve and made her condition worse. Nerves don’t like to be stretched. This is a great example of why it’s critical to know the true source of your problem before you start treating it.

Hopefully Stacy’s story helped you understand that the first step in getting rid of a pain in your butt, is to accurately determine where it’s coming from! If you’re experiencing unexplained pain in your butt that isn’t going away with stretching or general exercise, perhaps you’re going after the wrong problem. Try paying closer attention to how your symptoms behave. Do you notice they get worse after you’ve been sitting for a while, raking leaves, or driving? Do they move around on you – and go from your butt, to your hip, to the back of your thigh?

Signs like this could mean you’re dealing with a back problem, not a butt problem. Click here for access to our FREE back pain guide! This guide contains our best tips and advice on how to start easing back pain and stiffness right away — and get on the road to pain-free movement just like Stacy did.

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!