Tag Archive for: movement

Why Pilates?

Why Pilates?

If you’ve ever experienced muscle and/or skeletal pain, it was probably the result of one or more mechanical 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 — which is precisely the way it should be.

Pilates isn’t just about strength and balance, it’s about body mechanics.

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.

Many people who come to us with back pain think that their pain would prevent them from participating in an exercise program like Pilates – but the truth is, it’s the opposite! Guided, individualized Pilates combined with a physical therapy regimen is actually one of the best things you could do for your back. We even offer a specific at home program  designed for people with back pain! It’s incredibly beneficial for clients dealing with pain or injury to have the support system of a physical therapist and a Pilates instructor working in tandem to find the right movements to rehabilitate each particular individual.

Our goal is always to get our clients back to their full range of movement and activities.

We NEVER want to avoid any movement permanently in order to avoid pain. But on the road to that full recovery, the structure of Pilates and the opportunity for physical assistance can be an extremely powerful counterpart to physical therapy. Pilates strengthens your entire body, starting from your core, which naturally prevents future back issues stemming from muscular weakness or imbalance. Furthermore, Pilates (combined with PT) teaches correct movement – which is the number one way to relieve any current pain!

Are you experiences nagging back pain and want to incorporate pilates to help? We offer a program just for you! Our At Home Pilates 101 Get [Your] Back to Health program might be perfect for you, to apply and learn more CLICK HERE! We’d love to have you start your Pilates journey with us.

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. This 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.

Looking for ways to safely strengthen your core?

Our At Home Pilates 101 Get [Your] Back to Health program might be perfect for you, to apply and learn more CLICK HERE! We’d love to have you start your Pilates journey with us.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her Guide to Easing Back Pain and Stiffness – click here.

Stretches not Working? Three Reasons Why

Do you suffer from chronic muscle tightness or back stiffness and ever wonder… why aren’t my stretches working?

Perhaps you’ve Googled and YouTubed every stretch under the sun but still – you haven’t gained an ounce of mobility.

There are a few reasons why all your stretching efforts might not be doing anything for you. It could be your technique. It could be that you’re doing the wrong stretch. Or, it could be that you just shouldn’t be stretching at all!

Let’s go over the different reasons why your stretching routine could be failing you – and most importantly – what you can do about it.

You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into any stretch you’re doing. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work. Some people (myself included) respond better to “moving stretches.” This is where instead of holding one static position for a prolonged period, you repeatedly move through one or several end-range stretches. Moving neck rolls are a great example of this. If you’ve been diligently stretching and not seeing the results you want, try adjusting your technique. Moving stretches might be a better strategy than static holding. I know for me it is!

You’re doing the wrong type of stretch.

This one could be a little tougher to figure out on your own. There is a difference between corrective stretching and stretching to feel good. For example, let’s say your back is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stiffens up your back. Generic back stretches, such as bringing your knees to your chest or child’s pose, may be all you need to quickly get rid of the general stiffness you’re experiencing.

But let’s say you have associated back pain, or pain and numbness running down your leg. In these instances, generic back stretches won’t work or could even make you worse. You likely need corrective stretches, like what we prescribe for patients in our office. Corrective stretches are specifically prescribed to address symptoms, and are very different from the generalized stretches that are designed to feel good and relieve tension.

You shouldn’t be stretching at all.

Did you know that chronic muscle tightness can be a sign of a weakness? This is a very common problem with our clients. I’ve seen many folks over the years with chronic tightness and discomfort in their neck, backs, hips, etc. – and no matter how often they stretch or massage, it doesn’t improve.

How does this happen?

Well, groups of muscles are connected by this substance called fascia. If one group of muscles in the “fascial line” are not doing their job, a different group of muscles will have to take up the slack. When muscles are tasked with more work than they are intended for, they can become tight.

For example, if your deep core is not working properly, then the front of your neck will often kick in and try to help. If your neck is always sore or tight after a good ab workout, this is what could be happening. Stretching your neck won’t help one bit in this case – because what you need to be doing instead is strengthening your core. I see this same pattern with tight hips flexors. Once people start strengthening their core properly – the chronic tightness magically melts away.

Remember, when we are attacking the correct problem and doing the right thing – our body will respond. If you’ve been stretching and stretching and not seeing results – something is missing.

The longer your problem goes on, the more time it has to develop into a complicated fix.

If you’re suffering from any kind of pain or tightness that is keeping you from doing the things you love, our specialists are here to help!

Just CLICK HERE to request a Free Discovery Session!

Travel Plans? Avoid Neck and Back Pain on the go

We typically see an uptick in travel plans every August. But this year we’re seeing more than ever given that travel was basically non-existent for the entirety of last year.

Traveling is so good for the mind and soul – but it’s not always fun for your neck and back.

When our clients get back from a long trip, we hear common complaints of stiff necks and backs, aggravated sciatica, and just overall achiness.

The good news is you can prevent or significantly minimize most of these symptoms with just a few easy tips. Whether you’re traveling by train, plane, or automobile – here are some of my top tips for easing neck and back pain when you travel.

1. Remember the 30 min rule

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting – often in cramped spaces. Our bodies are made to move continuously throughout the day. On road trips, or on planes and trains, getting out of your seat is critical for keeping your neck and back healthy and mobile. Motion is lotion. And one of the best things you can do for your neck and back is to interrupt any prolonged posture – especially sitting – once every 30 minutes. If you’re unable to actually stand for a few seconds, then try arching your back or stretching your arms up over your head while sitting. Do a few neck rolls and chin tucks to stretch your spine. The more you move, the better your spine is going to feel.

2. Use a lumbar roll

Our spine is made up of distinct curves for a very good reason. They are designed to balance forces and sustain shock – and it’s best if you can maintain them. When you sit, the curve in your lower back (lumbar spine) decreases, or sometimes disappears all together. While it’s perfectly acceptable to sit like this for small increments of time (remember the 30 min rule), your spine will not like this after several hours. Plus, your neck responds by changing it’s curve as well. Typically, you’ll find your neck in what we call a “forward head” posture if your lower and mid back or curved over.

One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your lumbar spine. Place it right at your lower back any time you’re sitting and you’ll find that your spine has a lot less strain.

Want to purchase a lumbar roll for yourself? We have them right here in our office. Reply back to this email if you want us to put one aside for you 🙂

3. Stay hydrated

We all know that it’s important to stay hydrated, but why is it especially critical for avoiding back and neck pain during travel? Well, water is the vehicle responsible for transporting nutrients to your cells, including the nutrients your muscle cells need to do their job. Dehydration causes muscle cramps because it deprives your body of electrolytes. Proper hydration increases strength, balance, and flexibility. Water also helps to lubricate your joints, which is a bonus for keeping your spine working smoothly and allowing it to support the movements of your entire body. So, if you’re planning to hit the road soon, make sure you bring a reusable water bottle and fill it up regularly. And the extra bathroom breaks will give you an excuse to stay moving!

4. Pack light

No matter where you’re going or how you’re getting there, traveling involves packing, and packing too much stuff can be a quick recipe for back pain. Anyone who has flown knows that lugging multiple bags and/or suitcases around an airport is not only exhausting and stressful but can leave you sore and unbalanced for days. Even if you’re traveling by car, you still have to load and unload your bags, and carry them to wherever you’re staying. Your best bet is to pack light. If you’re bringing a suitcase with wheels, pack heavier items in there so that you don’t put unnecessary strain on your neck and shoulders. Opt for a backpack instead of an over-the-shoulder bag to avoid uneven distribution of pressure, and stock it with your water bottle, small travel essentials, and healthy snacks.

5. Prepare your body

The best way to prevent injury or pain (in general) is to stay as mobile as you can and maintain an active lifestyle. Oftentimes when you travel, you are walking more than usual and doing more activities than you are accustomed to when you’re home. If you’ve got an active trip planned, it’s best to prepare your body beforehand. Something else to consider is your sleeping surface. Different mattresses and sleeping surfaces can really wreak havoc on your neck and back. It’s a good idea to bring your favorite pillow with you, and plan to use extra blankets or clothing items to provide extra cushioning or support where you need it. Whatever you can do to simulate what it’s like to sleep at home is going to help minimize neck and back stiffness.

I hope at least one of these tips helps you to have less back and neck pain on your next travel excursion.

Need more tips?

CLICK HERE – to talk to one of my specialists for free if you’re currently looking for help with neck and back pain right now.

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.

 

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

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 treat back pain on your own and avoid 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.

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.

Here are three reasons why your physical therapy treatment might not have worked:

1. Incomplete Evaluation

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 PTs have too many patients at once, and are forced to take shortcuts. 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.

2. Too Many Passive Modalities

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 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.

3. Too Many Exercises

The last reason I see physical therapy not working is because there are just too many exercises being done. 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, and 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.

Now 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!

If you’re local to Portsmouth, NH – You can do that by Requesting a Free Discovery Session right 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, or get a free copy of her guide to taking care of back pain, email her at [email protected].

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!

tight hips

Should Age be a Reason to Avoid Certain Activities?

We’re continuing with our topic of the month – Getting Fit After 50 – and people have been asking me…

Are there certain types of exercise I should avoid once I hit a certain age?

The short answer is no.

Most of our clients are over the age of 50 and they do everything from surfing, to playing tennis, hockey, running, and even tap dancing!

None of these activities are considered “easy on the joints,” but they do them anyway.

So why is it that some folks see age as just a number – where others use it as a reason to stop doing certain things?

After age 50, the number one reason I see people avoid activities they want to do is because of pain. The second most common reason is because they were told to.

Let’s start with pain.

Having been a physical therapist for twenty years, I know a thing or two about what goes through people’s minds when they are dealing with back or joint pain. In most cases, the pain itself is not the biggest concern. People are willing and able to tolerate a certain amount of pain at the expense of doing what they truly love. We do it all the time in our 20’s or 30’s… and don’t think twice about it.

But as we age – a little bit of fear starts to set in when we’re in pain.

We’ve typically seen or heard horror stories from friends or family who have paid the price for either pushing through – or ignoring pain all together. When we’re younger, we’re more likely to approach pain with a “wait and see” approach. But as we age – pain becomes a bigger concern and we’re more likely to seek professional medical help sooner.

This leads me to the second reason people over 50 will just stop doing certain exercises…

Because they were told to. And often by a well-meaning health care professional.

Let me explain that.

Our medical system is overloaded, and everyone does the best they can to keep up. But if you’re a musculoskeletal health professional who’s NOT up with current medical research – you’re likely to give advice based on “old-school” ways of thinking.

For example, diagnosing all musculoskeletal pain based on X-rays and MRI’s… If your X-ray shows “bone on bone” arthritis – then a joint replacement is assumed to be your only option. If your MRI shows a meniscus tear or bulging disc – then you automatically need arthroscopic surgery.

But the current research disputes this line of thinking…

And says 80% of ALL musculoskeletal problems – even when you’re over 50 – can be solved without surgeries or other procedures.

How your pain behaves is what matters most. Not your age or arthritis. The best way to explain this concept is with a case study!

This client (we’ll call him “Jim”) is 57 years old and was told knee replacement surgery was his only option to resolve the knee pain he was suddenly experiencing.

When he questioned the knee replacement and asked if he could wait, his doctor’s response was that because of his age – and because of the “bone on bone” arthritis that was showing on his X-ray – surgery was his best option. Otherwise, if he wanted to wait, he would need to stop the running and hiking he had been enjoying so much until very recently.

Research studies show that the indication of osteoarthritis on X-ray alone does not mean it’s the cause of your pain.

In other words, it’s entirely possible Jim’s knee pain could be due to something other than his “bone on bone” arthritis.

Did he really need surgery? And did he really need to stop some of his exercises because of arthritis or his age?

Ceasing his activities would have certainly made Jim’s arthritis worse. And if he went through with the knee replacement without being completely sure if arthritis was the main cause of his knee pain – he not only risks unnecessary surgery – but also risks getting set back several months for recovery.

This would delay his ability to get back to running and hiking even further.

Although age is most of the time NOT a factor in your choice of exercise… it is a factor when it comes to how quickly you’re able to recover from surgery.

So here’s what happened.

We prescribed him a corrective movement strategy to see if arthritis was the main factor causing his knee pain. And just like we see over and over again – his knee pain significantly improved after just a few visits!

Research says that if pain responds quickly to a corrective movement done repeatedly – your pain is primarily due to a mechanical origin – and not arthritis. Arthritis doesn’t change that quickly – in fact it doesn’t change at all (unless you get surgery). But mechanical pain does.

Turns out that Jim’s knee pain was due to some mechanical imbalances in his knee joint, and NOT the arthritis. Arthritis was a factor for sure – it made his knee stiff – but it was not the main cause of his knee pain.

If you’re getting older… know that age related changes like arthritis are quite normal and nothing to be afraid of.

And arthritis, along with your age, are certainly not reasons to avoid exercise.

Jim was given medical advice to have a surgery he does NOT need yet based solely on his X-ray and his age. But there are SO many other factors worth considering as well.

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.