Tag Archive for: movement as medicine

Holding Knee with Arthritis

When Traditional Physical Therapy Fails…

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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!

Sciatica

Why Back Pain Keeps People from Exercising

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Did you know that eighty percent of the population suffers from what we call “non-specific low back pain” (NSLBP)?

You might have NSLBP if your back pain:

  • is often chronic
  • comes out of nowhere
  • comes and goes (you have good days and bad days)
  • is not due to a recent or major accident or fall

If you’re reading this right now, odds are very good that YOU are one of the 80% suffering from NSLBP.

Did you also know that research says exercise is the BEST treatment for this type of back pain?

But what do you do if back pain keeps you from doing the one thing that is best for you??

We have an 8-week program designed to tackle this very important problem… but before I get into that, let’s go over some reasons why back pain keeps so many people like you from exercising.

1. FEAR

Back pain is scary! This is the number one reason back pain sufferers don’t exercise. Is the pain you’re feeling good or bad? Should you be feeling any pain at all? Pain is confusing. And when you experience pain during exercise, it can be difficult to know if it’s normal or a warning sign. For many, the safest thing to do is avoid any exercise or movement that causes pain. But doing this can lead to a host of other issues, namely, loss of mobility and in-activity. When you become less mobile and active, your back pain gets worse, and now you’re in a vicious cycle.

2. BULGING DISCS

Most people who suffer from long-standing NSLBP pain eventually find themselves getting an MRI. And 60-70% of the time, it will show one or more bulging discs. If you’ve been following me for a while, you already know that most people over the age of 40 walk around with bulging discs – and that 65% of them feel no pain at all! In other words, if you’ve got a bulging disc, you can’t be certain it’s the cause of your back pain. Research proves this. And being told you’ve got a bulging disc is NOT a reason to avoid exercise. Movement is actually one of the best things you can do for a bulging disc. It may require some customization of your current exercise routine, but a movement specialist can help you with this. Don’t just stop or avoid exercise altogether without talking to one first.

3. YOU WERE TOLD TO REST

Well-meaning doctors and family members who aren’t up to date on the latest back pain research will advise you to rest every time you experience back pain. This might be reasonable advice when you’re dealing with an acute episode of back pain, but it’s terrible advice for chronic back pain sufferers. Rest is one of the worst things someone with chronic back pain can do. Since most people don’t have a thorough understanding of this concept, they find themselves in a yo-yo effect. They rest to “heal” their back pain. When it’s gone they return to exercise. When they hurt their back again they stop and return to rest… I’ve seen so many people fall victim to this perpetuating cycle and it’s a big reason why so many back pain sufferers find themselves with the NEXT problem on this list…

4. YOU’VE GOT A “BAD BACK”

I can’t tell you how many times I’ve heard this one and it makes me want to scream! First off, there is no such thing as a “bad back”. There are backs with problems, and there are backs more sensitive to pain than others, but there is no reason to believe your back is inherently “bad” or that you should stop exercising. Not exercising causes almost all back problems to become worse, but it can also turn a “bad back” into a strong and healthy one! For most people, once you get the right guidance, you can quickly find yourself safely and confidently exercising again.

5. INEFFECTIVE CORE STRENGTHENING

Interestingly enough the research on this topic is quite scattered. Much of the research says that targeted core work doesn’t have any added benefit compared to general exercise when it comes to reducing back pain. What the research doesn’t tell you is that your core strength can make or break how well you exercise. If you don’t exercise with good proper form, you’ll end up with back pain. Learning how to properly strengthen your core has a HUGE impact on your ability to exercise in a way that will not cause your back to hurt. I meet a lot of folks who start doing “core exercises” to get their abs stronger and reduce back pain, but they end up hurting their backs instead. That’s because there is a right and a wrong way to properly strengthen your core, especially if you’re prone to back problems.

On Sunday, September 6th, we’re opening enrollment to our Pilates 101: Get [Your] Back to Health™ program.

You MUST apply to join this program.

Click here to learn more.

Since this program fills up every time we offer it, we typically give the folks on our VIP waiting list an opportunity to sign up first.

Plus… when you sign up early, you can save up to $200 off the program!

If you’re suffering from NSLBP and you’ve stopped exercising, know that you’re not alone.

This is such a confusing topic and there are so many mixed messages out there about what the “right” and “wrong” thing to do is.

Don’t try to go at it alone!

Exercise is GOOD for your back, but you may just need a little help and guidance — and perhaps proper core strengthening — to get you there.

Should You Heat or Ice an Injury?

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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!

Is Rest or Movement best for Back Pain

Movement is medicine (when prescribed properly)

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I have a confession to make. A few months ago I hurt my own back.

Yes, you read that correctly, the back pain expert injured her own back! I preach this ALL the time to my clients, but one of the reasons I’m so passionate about helping people with back problems is because the treatment is not cookie-cutter. But once we find what works for you, physical therapy is so effective and rewarding.

In my case, I was able to use very specific movements to get rid of my back pain, and then start focusing on strengthening exercises to keep it gone. Don’t get me wrong, there were moments when I wanted to call my doctor and ask him for pain pills, and even the idea of an injection crossed my mind once or twice. But because I keep up with the research, I know that pills and injections really don’t work well for long-term results. Aside from the many potential complications and side effects, quick-fix treatments tend to mask your pain and keep you from doing the real work that is necessary to keep the problem from recurring in the future.

At CJPT & Pilates, long-term solutions are the only thing we are interested in. We believe that movement is medicine.

For all musculoskeletal injuries, including back pain, the research shows that movement and exercise really is the best course of treatment in about 80% of all cases. OK, I know what you’re thinking. If it were that easy, why can’t you just go to the gym, to yoga, or follow an exercise video at home to get rid of your own back or knee pain?

It’s because although movement IS medicine, it only works when prescribed for you properly.

Let me explain.

I’m working with a gentleman right now who’s had back pain for over a year. It started after a car accident. He’s tried regular physical therapy, chiropractic, steroid injections and radiofrequency ablation. None of it worked. He feels good when he exercises and moves around, but the pain always comes back.

When he came to see us, the really interesting thing I noticed about his back was when he put himself in certain positions, he would stand up and literally be crooked. His spine would shift to one side, and become very painful and stiff. In the PT-world we call this a lateral shift, and it’s a sign that indicates he likely has a bulging disc. The great thing about a bulging disc is that they tend to respond very well to corrective movements. Once we know what movement “fixes” you, we can prescribe it to you. This gentleman can now make himself straight and get rid of his back pain in under a minute. Of course the goal is to get him to the point where he no longer needs this corrective movement, but for now, it quite literally is his medicine.

I think the reason more people don’t use this approach is because it requires a little bit of work, and you don’t often see the results immediately. When you get an injection, or even take a pill, the pain is gone in a few hours and it will often stay gone for a period of time without you really needing to do much. With movement, you have to stick with it and do it correctly for it to work. And although you can get an immediate reduction in pain from the correctly prescribed movement, it takes several weeks for it to start to stick and produce long-term relief.

But here’s the best part about using movement as medicine — it’s natural, there are no harmful side-effects, and you can do it completely on your own.

If you’ve been suffering in pain for awhile and tired of using pills or quick fixes to manage your pain, sign up for a FREE Discovery Session with us to find out if movement can be your medicine instead! You can also check out our free back pain guide right here.

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.

Back Surgery

Can you get rid of Back Pain with Exercise?

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With small group fitness, Pilates studios such as our own, and many gyms reopening again on June 1st, people are itching to get back into their exercise routines. In our last post, we talked about tips and considerations on things you can do to ensure your body is ready to go back, especially after weeks of quarantine.

But many folks I speak with have had back pain for years, long before quarantine. So many people have tried weekly massage, daily stretching and foam rolling, and every exercise under the sun — only to find that their back pain ALWAYS comes back.

Research has confirmed many times over that exercise is the best “treatment” for back pain.

While prescription medication, steroid injections, and even surgery may be more successful at getting your back pain gone quickly — a proper exercise routine beats these things out every time. Outcomes are either the same, or better, when you choose exercise over those procedures. It’s why in our business, we focus on empowering you through movement — instead of pills or procedures! If a long-term solution is what you’re looking for, and you want to end the merry-go-round of your back pain always returning, then proper exercise is the best route hands down.

Sounds simple, right? Why then, do four out of five people continue to suffer from debilitating back pain?

It’s because not all back pain is created equal, and neither is exercise. The tricky part is that for most back pain, any kind of movement is going to make you feel better. Our bodies are designed to move and not sit still. It’s why you wake up feeling stiff and painful, and better after you’ve moved around for about an hour. Movement brings blood flow to our muscles and joints, and exercise spreads pain-reducing endorphins throughout our body. But more often than not, the pain comes back the next day, or in come cases, feels worse two or three days later. And the frustrating part is that you never know exactly what you did — so you just rinse and repeat — hoping the next day it finally “works”.

Exercise DOES work to help your back pain, just like the research says, but it needs to be specific.

Skill and coordination also matter. One exercise can act like a miracle for one person’s back pain, while it aggravates another’s. I see this all the time in my office. The nuances come down to cues, tiny little tweaks, or sometimes you need a different exercise all together for your particular body.

Back pain is not cookie-cutter, and your exercise prescription shouldn’t be either. You don’t want to go on for years just managing your back pain when you could actually get rid of it entirely with the right movement strategy.

As you enter back into the world of fitness, take note of how your body and especially your back is feeling. The correct exercise routine is going to make you feel better, and STAY better. You’ll notice continued progress, and you won’t have to foam roll and stretch every single day to manage your back pain. The wrong exercise routine will make you feel worse, often several days or months later, and the worst part is you won’t be sure where it came from.

If this sounds familiar, or you find this back pain cycle starts happening to you when you return to the gym, feel free to give us a call. You can talk to a specialist for free and find out if your exercise routine is sufficient for your type of back pain.

Woman sleeping facedown on a bed.

Tired all the Time? Get Moving!

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All of us have experienced tiredness, exhaustion, and fatigue. Sometimes it hits after a late night spent working or socializing. Other times, our exhaustion seems to come out of nowhere. With our fast-paced modern lifestyles, it’s not surprising that statistics from the Center for Disease Control and Prevention (CDC) report around 15.3 percent of women and 10.1 percent of men regularly feeling very tired or exhausted in the United States.

A lack of sufficient sleep isn’t the only factor that could be contributing to your fatigue – poor dietary habits, excessive napping, unhealthy amounts of stress in your daily life, and living a more sedentary lifestyle are all possibilities according to a recent article published by Medical News Today. It might seem counter-intuitive that more exercise could help you feel less tired, but it’s the truth! Sitting on the couch is one of the worst things you can do for chronic fatigue or tiredness (not to mention the impact it has on your back). Moderate amounts of exercise are proven to boost your energy, not drain it – and getting a good workout in during the day will help you sleep better at night.

If you rarely exercise with intention, or spend most of your day at a desk, it can be challenging to transition into a more active lifestyle. Many people in such circumstances benefit from joining a group fitness class or finding an “exercise buddy” to hold them accountable. Our Pilates classes right here in Portsmouth are a great option because they’re geared towards beginners, and Pilates gives you that full body workout that will leave you feeling invigorated and energized afterwards – but ready to fall right asleep at bedtime! The mindfulness aspect of Pilates as well as the exercise make it helpful for reducing stress, which in turn reduces fatigue.

We say all the time that movement is medicine, and it’s true in more ways than one. Movement is medicine for the aches and pains of your joints and muscles, but it’s also medicine for your stress and exhaustion. Exercise stimulates endorphin release, triggering positive feelings of elation or mild euphoria. Shifting into a more positive mental state during a day when you’re feeling completely drained will help you cope better with whatever you’re dealing with, in addition to giving you more energy to get through it. You don’t need to spend hours at the gym every day – just 30 minutes of movement each day, whether it be walking, running, biking, Pilates, yoga, golf, etc. will make a difference.