Tag Archive for: neck pain

5 Tips for Wrapping Gifts Without Aggravating Neck or Back Pain

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If you’re anything like me – you’ve left your Holiday wrapping to the absolute last minute. And if that’s the case – there’s a very good chance you’re going to overdo it – and aggravate any existing neck or back pain you might have.

The good news?

There are things you can do to significantly mitigate the chances of your neck and back pain flaring up – and perhaps avoid it altogether.

Here are five great tips – and even a bonus recovery tip – to help you get through your last minute gift wrapping without aggravating your neck or back:

1. Create an Ergonomic Wrapping Station

The way you set up your wrapping station matters. Sitting on the floor or crouching over a low coffee table forces your spine into unnatural positions, creating stress on both your neck and back. Instead, wrap your gifts on a surface that allows you to sit or stand comfortably at waist height.

If you’re sitting, use a supportive chair along with a lumbar roll to keep your back and neck in their most natural position. For those who prefer standing, consider using an anti-fatigue mat to reduce strain on your back. Elevating your workspace ensures you’re not constantly hunching over, which is a common culprit for neck and back pain.

2. Don’t Sit or Stand Too Long – Move!

Sitting or standing in one position for extended periods can lead to stiffness and pain in your neck, shoulders, and back. Set a timer to remind yourself to take movement breaks every 20-30 minutes.

During these breaks, perform a few gentle stretches for your neck and back. Try rolling your shoulders backward, gently tilting your head side to side, or doing a seated spinal twist. Movement encourages blood flow, which helps reduce stiffness and tension. Plus, breaking up the task gives you a mental refresh so you can focus on getting your wrapping done instead of neck or back pain.

3. Use the Right Tools

The tools you use can make a big difference in minimizing strain. Opt for ergonomic scissors with padded handles to reduce stress on your hands and wrists. Tape dispensers are also a must-have to prevent repetitive wrist motions that can lead to discomfort.

If you’re wrapping on the floor, use a cushion to support your hips and lower back. For added neck relief, consider placing a rolled-up towel under your neck during floor session breaks to give it some relief and maintain its natural curve. These simple adjustments can help you avoid unnecessary strain while you focus on creating perfectly wrapped packages.

4. Check Your Posture

Poor posture is one of the biggest contributors to both neck and back pain. While wrapping, make a conscious effort to:

  • Relax Your Shoulders: Keep them down and away from your ears to avoid tension in your neck and upper back.
  • Maintain a Neutral Spine: Whether sitting or standing, ensure your lower back keeps its natural curve.
  • Align Your Head: Avoid craning your neck forward. Bring the gift closer to you instead of leaning toward it.

These small posture corrections can go a long way in keeping discomfort at bay and ensuring your body feels great long after the wrapping is done.

5. Spread Out Your Wrapping Tasks

Rather than saving all your wrapping for Christmas Eve, try wrapping a few gifts at a time over several days. This approach prevents prolonged periods of repetitive motion and reduces the overall strain on your neck and back.

Now – if you HAVE waited till Christmas Eve to wrap your gifts – then ignore this tip and move on to your bonus recovery tip 🙂 

Bonus Recovery Tip: Treat Yourself to a Little TLC

Even with the best precautions, some muscle soreness and tension might still sneak in. Combat this by treating yourself to recovery techniques like foam rolling, deep breathing, a good stretching session, or one of our Regenerative Therapy Sessions! 

And if your pain persists or worsens – don’t ignore it. Seeking advice from one of our mechanical pain specialists can help you address the root cause or your neck and back pain and prevent it from becoming a much bigger issue that impacts more than just wrapping gifts.

Live near Portsmouth, NH? Connect with one of our mechanical pain specialists by clicking HERE!

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. If local to Portsmouth, NH and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Headache sufferer

5 Signs your Headaches are coming from your Neck

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Headaches impact approximately 47% of the population and are one of the most common disorders of the nervous system. If you suffer from headaches regularly, then you already know how disruptive they can be on your work life, social life, daily activities, and just overall energy and well-being. 

But what makes headache management particularly challenging is how often they are misdiagnosed. The most common types of headache disorders are what’s known as primary headache disorders – and those include migraines, cluster headaches, and tension-type headaches. But you could also be suffering from a secondary headache disorder – which is caused by some other illness or physical issue. One of the most common forms of secondary headache is something called a “cervicogenic headache” – meaning it comes from your neck. They can be quite debilitating and are commonly confused with migraines – but there are some key signs to look for that make them different. 

Let’s look at 4 signs that might indicate your headache is coming from your neck:

1. Headaches worsen with certain neck movements

If you find that certain movements or positions of your neck exacerbate your headaches – it could be a sign that your headaches are coming from your neck. Sometimes it’s very specific movements that trigger a headache – such as tilting your head forward or backward – or turning it from side to side. But other times it’s less obvious and related to more prolonged postures. For example, I’ve had patients experience headaches from sitting at a bar for several hours and turning their head to a certain side to talk to their friend. Pay attention to whether certain neck movements or positions create discomfort in your neck that either precedes or worsens your headache. It could mean that your headache is coming from a source in your neck.

2. Your Neck is Stiff

Another telltale sign of neck-related headaches is limited mobility or range of motion of your cervical spine (neck). If you find yourself struggling to turn your head fully, or you experience pain and stiffness when attempting to do so, it could indicate an underlying issue in your neck that is causing your headache. A common saying in my office is “mobility before stability”. If the joints in your neck don’t move fully and freely, the structures around those joints (muscles and nerves) can become angry and irritated – and this could be the source of your headaches.

3. Tenderness in your neck muscles

If you routinely have sensitivity and tenderness in the muscles of your neck – it could indicate an underlying neck problem. If you notice that your headaches seem to get triggered whenever the tension or tenderness in your neck muscles worsens – then there’s a good chance your headaches are coming from your neck. The muscles of your neck can get tense and irritated for a number of reasons – most commonly because of poor posture or because they are being overused in some capacity. Since your neck muscles have direct and intricate attachments to the base of your skull – they can be a common cause of your headaches.

4. Location of your Pain

A headache that stems from the base of your skull and stays on one side of your head – often radiating into your temple or behind your eye – is a common sign that your headache is coming from your neck. If you tend to get associated shoulder or arm pain at the same time as your headache – it’s another indicator your headache could be cervicogenic. That’s because the nerves in your neck extend into these areas and are capable of radiating pain into these locations. If you suffer from chronic headaches, pay attention to where the pain is coming from or where it’s radiation. If it’s extending beyond your head – there’s a good chance your headaches are coming from your neck.

5. Massage and Chiropractic Manipulations Help.

If you find temporary relief from your headaches any time you get a massage or see a chiropractor, it’s almost certain your headaches are cervicogenic. While it’s great you’ve found pain relief – the problem with relying on these modalities is that they are completely “passive” – meaning – you don’t have an active role in the process of relieving your headaches. Passive modalities work great when paired with specialized, corrective exercises you can do on your own that are designed to prolong the effects of these treatments. But when passive treatments are used in isolation – the headache relief tends to be short-lived. The take home point here is that if you find treatments like massage and chiropractic treatment help – your headaches are almost certainly coming from your neck.

If you suffer from debilitating headaches and haven’t yet gotten your neck thoroughly checked out as a source – you should. Because when your headaches originate from a source in your neck, it’s entirely possible to learn how to treat it and manage it naturally and on your own. But you’ll need to work with a specialist who understands cervicogenic headaches as well as the associated mechanical joint components influencing them.

Are you local to Portsmouth, NH? CLICK HERE to speak with one of my specialists for free.

pain

Your Pains Location May Not be it’s Source

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Pain is both a confusing and scary topic.

There’s lots of advice out there on what to do when you experience pain and it’s hard to know who to listen to. Should you rest – exercise – apply heat – apply ice – see a doctor – get an MRI – or just wait it out to see if it goes away on its own? Any or all of this advice could be right – but it’s irrelevant until you accurately determine where your pain is coming from.

For example, if you have pain in your knee, and it’s coming from your back, the best knee treatment in the world isn’t going to fix it. Inaccurate diagnosis of pain is one of the most common reasons why so many people suffer longer than they need to, and it’s one of the biggest contributors to unnecessary procedures and surgery. You must accurately determine the source of your pain for treatment to be effective. And the location of your pain, alone, is not a reliable way to figure that out.

Let me explain.

I’ve met people who’ve suffered from unrelenting tennis elbow for years – despite treatment protocol after treatment protocol – only to find out it was coming from their neck. I’ve met people who’ve undergone major knee surgery and it failed – only to find out later they never actually had a knee problem. Isolated extremity pain (knees, elbows, shoulders) is one of the most mis-diagnosed problems in the musculoskeletal world. In a study published in the Journal of Manipulative Therapy, they found that over 40% of people suffering from isolated extremity pain had a spinal source responsible for their symptoms, even when there wasn’t any spine pain. In other words, the pain they were feeling in their knee, elbow, or shoulder was actually coming from their back or neck (respectively).

Confused? I don’t blame you.

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

As already mentioned, the most common place for this to happen is with extremities. If you’ve got shoulder, elbow, or knee pain, and you don’t recall having a specific injury to it, you must consider that it could be coming from your spine. There’s a 40% chance that it is. Where this gets really confusing is that typically, when you’ve got isolated knee or shoulder pain that won’t go away, your doctor will order an MRI. And if you’re over 40 years old, the MRI will almost always show “something”. It could be a torn rotator cuff, torn meniscus, arthritis, or wear and tear. But what most people don’t realize is that these findings are quite normal and happen naturally as you age.

Just because they show up in your MRI – doesn’t mean they are responsible for your pain. Despite the science proving this over and over – doctors continue to order these tests and rely on them to make important decisions about treatment. It’s how people end up undergoing unnecessary procedures or surgery – they let images and an inaccurate diagnosis lead the way.

Whenever I meet someone with isolated extremity pain, especially if it came on suddenly and out of nowhere, I always consider that it could be coming from their spine.

How can you figure this out?

Well, it’s challenging to figure it out on your own. But if you work with a movement specialist who understands this concept – you’ll be able to figure this out accurately. The basic premise is that if you can move your spine in specific directions – repeatedly – and influence the symptoms you feel in your extremity – then there is a very good chance your problem is coming from your spine. Or at the very least, your spine is involved. And whenever your spine is responsible solely or partially for pain elsewhere – and it’s ignored – your problem will persist and likely get worse over time if it’s not addressed.

Moral of this story… If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source, and that where your pain is may not be where your problem is. And if you’re considering some kind of surgery or procedure, you definitely want to rule out that the problem could be elsewhere.

Specialized movement exams are one of the most reliable ways to figure this out – studies have proven it. If you’ve had unexplained pain in your elbow, knee or shoulder that isn’t going away, look for someone who understands this and can give you a proper movement exam to accurately identify the source of your pain.

Looking for help and local to Portsmouth, NH? Click here to speak with a specialist.

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 one of her free guides to knee and back pain, visit www.cjphysicaltherapy.com or email [email protected].

morning neck pain

Three Causes of Morning Neck Pain and What to Do

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Waking up with morning neck pain puts a huge damper on your day right from the start. While neck pain may not be at the top of the list when it comes to debilitating musculoskeletal problems (aka people tend to just “live” with it) – it still impacts between 10-20% of the population at any given time – so it’s worth discussing. 

One of the most common problems I see with those suffering from neck issues is that seemingly out of nowhere they can go to bed feeling great – but wake up with a stiff and painful neck that can last up to a day or two. When this pattern starts to repeat itself and goes on for too long – you can end up with a chronic neck problem that doesn’t just show up in the morning – but will start to impact your day-to-day life and get in the way of things you love to do.

Here are Three Common Causes of Morning Neck Pain and What you can Do:

1. Sleeping position

Any joint – including those that make up your neck – will feel strained after being in a prolonged position for too long. In a healthy, uncompromised neck – this is fine if it happens on occasion. But if it’s happening once per month or more – it’s time to address your sleeping position.

Those that like to sleep on their stomachs, or with multiple pillows under their head, are going to have the biggest problems. When you sleep, you want to get your neck as close to what I call a “neutral spine” as possible. That means your neck feels relaxed, maintains its natural curves, and your ears, neck, and shoulder will be aligned on top of one another.  I find the best way to achieve this is by sleeping on your side – or on your back with just one pillow. If you’re a multi-pillow type of person – make sure you’re using the second pillow to hug and support your arm – or in between your legs – not underneath your head.

2. Clenching Your Teeth

While many people tend to associate clenching your teeth with TMJ – or jaw dysfunction, it can cause neck problems as well. When you clench your teeth, you’re also tensing the muscles around your neck. If you do this every night, and for prolonged periods, your neck is going to become very unhappy and start to have problems of its own.

Many folks are unaware they are clenching their teeth at night. But some signs this could be happening to you  include tense or fatigued jaw muscles in the morning, walking up with headaches, or a stiff and painful neck and shoulder when you first wake up. Clenching teeth is often a reaction to stress – so having a good end of day routine could really help with this problem. Be sure to shut off TV and electronics at least one hour before bedtime. Practicing some meditation and/or relaxation breathing just before bed could help too. If all else feels, a night guard could help as well. It won’t stop you from clenching completely, but it will protect your teeth and could minimize your neck pain.

3. A Bulging Disc

This isn’t spoken about too often, but if you’ve got a bulging or problematic disc in your neck – this could be the reason you’re waking up with a stiff and painful neck in the morning. When you lie down and “unload” your spine for a period of time – such as at night while sleeping – our intervertebral discs hydrate and actually get larger. If you wake up with a sudden movement – this could be all it takes to “pinch” that disc and cause your neck to feel “locked up” and with sudden pain.

Now, don’t feel like you need to go running to the doctor for an MRI to figure this out. It’s not necessary. Most people have bulging dics occurring normally as they age throughout their entire spine. They only become a problem when you don’t take care of your spine. When it comes to your neck, the biggest risk factors for turning a normal bulging disc into a painful and problematic one include behaviors such as looking down at your phone, tablet, or computer for too long and not being respectful of the fact that a healthy neck needs to move in all directions – not just forward and down. Doing some simple chin tucks frequently throughout the day and making sure your upper back stays flexible can go a long way in preventing (normal) bulging discs from becoming a problem.

I hope these tips help shed some light on why you might be waking up with morning neck pain and most importantly – what you can do about it. If you try some of these remedies and still find yourself unsuccessful – then it’s time to talk to a mechanical pain expert. There’s no need to rely on pain pills or expensive tests and procedures to resolve morning neck pain. Most of the time, problems like I’ve just described can 100% be resolved naturally and with the right “movement therapy”.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists. Tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you.

It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

Click here to book a free Discovery Visit.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of one of her guide to neck and shoulder pain CLICK HERE or to get in touch, email her at [email protected].

Neck stretches

3 Reasons Your Neck Stretches aren’t Working

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If you suffer from chronic neck stiffness or even pain – and you’ve done your due diligence when it comes to neck stretches – it’s time to consider you might be missing something.

It could be your stretching technique, you could be doing the wrong stretch altogether, or it could be that you shouldn’t be stretching your neck at all…

Let’s go over three reasons why your neck stretches might not be working and help you pinpoint where it’s going wrong…

 

1. You’re using the wrong stretching technique.

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 the stretch. 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. Neck rolls are a great example of this. If your neck stretches haven’t been working, try adjusting the way you’ve been stretching. If you notice a difference right away then you have your answer – you were likely using the wrong stretching technique.

2. 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 neck stretching and stretching to feel good.

For example, let’s say your neck is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stressed your neck out. Generic neck stretches such as bringing your chin to your chest, or pulling your chin to the opposite shoulder (known as an upper trap stretch) may be all you need.

In fact, I do stretches like this regularly because I’m constantly leaning over to help patients. I stretch my neck to PREVENT it from having problems and because it feels good. But let’s say you already have a neck problem, or you have pain or numbness running down your arm. In these instances, generic neck stretching could make you worse. You likely need corrective stretches for your neck. Corrective stretches are specifically prescribed to address a particular problem, and prescribed at a specific frequency. They are different from the generalized stretches that are designed to feel good and relieve tension.

3. You shouldn’t be stretching your neck at all.

This is a very common problem we see here in our office. Folks come in with complaints of chronic tightness and discomfort in their neck and no matter how often they stretch or massage, it doesn’t go away.

Did you know that chronic neck tightness can be a sign of a weak core?

It’s quite common, and if that is the case for you, no amount of stretching will help (and can even aggravate your problem!) The deep, stabilizing muscles of your neck are connected by fascia to the deep muscles of your core. If your deep core is not working properly, then your neck will often kick in and try to help.

Ever notice that your neck is always sore or tight after a good ab workout?

This could be a sign that your neck is compensating for your core. Stop stretching your neck, learn how to strengthen your core the right way, and see a specialist who can help you.

If you’re dealing with chronic neck problems that aren’t responding to stretching, there’s a good chance you could be not stretching correctly, the stretches aren’t right for you, or you’ve completely missed the root cause of your neck pain and you shouldn’t be stretching at all.

Consider talking to a movement specialist who understands how to figure this out so you can get rid of your neck pain and back to all the activities you love!

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists HERE.

They will ask you all about what’s been going on – and help you make the best decision moving forward – whether that’s working with us not!

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

Neck Pain

Tech neck: What it is and How to Cure it

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Tech neck – also known as text neck – is a commonly used term to describe neck pain that results from overuse of various electronic devices. If you’re looking down at your cell phone or iPad too much, or sitting in front of your computer too long – and you feel pain in your neck – you are likely suffering from tech neck.

So what’s the big deal? Is this even a real syndrome?

I’ll be honest. I had my doubts at first. I’ve been a physical therapist for 20 years and when I first heard this term I thought it was a joke. But over the last 12-15 years I’ve seen more and more cases pop up and I can tell you with certainty that tech neck is, indeed, a real problem for people.

Tech neck – when allowed to go unaddressed – can result in headaches, tension into your upper shoulders, or even pain and tingling into your arms and hands.

The good news – it’s not only entirely possible to get rid of it – but you can learn how to prevent it all together.

So what can you do about tech neck? Here are three simple tips:

1. Be mindful of your posture

When you’re constantly looking down or hunching forward – it eventually wreaks havoc on your neck. Being mindful of your posture is not only the number one way to cure tech neck – but it’s the best way to prevent it.

The biggest problem with poor posture is that you don’t know it’s a problem until it’s too late. Postural problems take a lot of time to reveal themselves. The changes in your soft tissue and the wear and tear on your spinal joints that occur from being positioned poorly and repeatedly don’t happen overnight – and you rarely notice them when they are first happening.

Truth be told, “bad posture” on occasion is not bad for you and should not cause you any major problems. Poor posture all the time is where you get in trouble. That’s why simply being mindful of how you’re positioned when using your favorite electronic devices can go a long way.

2. Use headphones

Our spines crave movement but also alignment. But we don’t want alignment at the expense of other joints – namely – our shoulders. It’s not always comfortable to hold your phone or iPad in front of your face – which is what you need to do if you want to maintain optimal neck alignment when using your device. While great for your neck – this position can cause strain and tension in your upper shoulders.

For this reason I highly recommend using headphones. Especially wireless headphones. This allows you to keep your phone or iPad on your desk while freely sitting upright and talking. Headphones also allow you to use the speak to text feature quite easily so you don’t have to strain your thumbs or shoulders when talking to your friends, kids, or grandkids.

3. Interrupt your sitting and standing

Prolonged posture in any form is not great for you. Our bodies – especially our spines – crave movement. We hear a lot about the detrimental effects of sitting all the time – but standing all the time isn’t great either. When it comes to sitting, your lower back tends to hunch over time which forces your neck into that “forward head” posture when you’ve been sitting for more than 20 min or so. When you add an electronic device to the mix the effects are even worse.

Because of this – standing desks have become much more common over the past few years. But I see folks having problems from standing too long also. If you don’t have great core engagement, for example, which is important when you’re standing for prolonged periods, you might hold tension in your jaw or neck to compensate. This can create unwanted tension and stiffness in your neck muscles.

How do you combat all this?

Simply interrupt your position. Try not to stay sitting – or standing – longer than 30 min at one time. Your body – and especially your neck – will thank you.

Recognizing tech neck early is crucial and if you catch it in time – it’s very easy to cure on your own.

The problem is that it’s something that tends to creep up over time and not addressed until it’s too late. If you’re suffering from chronic headaches, or symptoms down your arms or into your hands – the tips I’ve given you here may not be enough to address the problem.

Don’t worry – you can still get help with these symptoms naturally and without pills and procedures – you will likely need some expert help.

Talk to someone who understands posture and the importance of healthy movement in your spine – they are the best people to help you cure and prevent tech neck.

Local to Portsmouth, NH?

Consider talking to one of our specialists free. They’ll let you know if you’re a good fit for what we do and get you on our schedule as quickly as possible! CLICK HERE to request a free Discovery Call with someone from my client success team.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of neck and shoulder pain – CLICK HERE

Traveling

4 Tips to Avoid Neck and Back Pain When Traveling

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4 Tips to Avoid Neck and Back Pain When Traveling

Memorial Day weekend is the “unofficial” start of summer – and AAA estimates that 39.2 million people will travel this weekend. That’s 8.3% more than last year, and it’s going to mean the exacerbation of neck and back pain for a lot of folks out there – especially the over 40 crowd.

So why does traveling wreak such havoc on our spines? 

Road trips, planes and trains typically involve lots of sitting and driving, which necks and backs just don’t like when done frequently and for prolonged periods. You’re typically off your routine when you travel, and sleep on surfaces you’re not accustomed to.  Any one of these things – but especially when combined together – can flare up old patterns of neck and back pain.

The good news is there are lots of things you can do when traveling to ease neck and back pain. Here are 4 of my top tips:

 

1. Use 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. Whenever possible, getting out of your seat often 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 min. 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, when not supported. While it’s perfectly acceptable to sit like this for small increments of time, it will start to cause problems after several hours. Prolonged curvature of your low back puts unwanted stress on the discs, ligaments, and muscles in your spine.

Your neck also responds to this posture by assuming a position we call “forward head”. This can give you headaches, neck pain, and cause extra tension to occur in your mid back and upper shoulders. One of the best things you can do is use a cylindrical lumbar roll to help maintain the natural curve in your low back. If you’re driving, the lumbar support in your seat usually isn’t enough. Take a small towel roll, sweatshirt, or pillow and place it at the small of your back any time you’re sitting. You’ll find it’s easier to maintain the natural curves in your spine – and you’ll have a lot less strain on your neck and back.

3. Bring your own pillow

Sleeping on surfaces we’re not accustomed to can not only ruin a vacation but set us up for unwanted neck and back pain. If possible – bring your favorite pillow from home – or ask for extra pillows wherever you’re staying. If a mattress is too firm for you – you can use pillows to cushion areas of your body like hips and shoulders so that you don’t wake up sore. Conversely, if a mattress is too soft, you can use extra pillows to build up the surface under your waist if you’re a side sleeper, under the small of your back if you’re a back sleeper, and under your belly if you’re a stomach sleeper.

Lastly, if a pillow is too fluffy or too flat – your neck will end up paying for it. When you’re sleeping – the goal is to position yourself in a way that allows your spine to stay in neutral alignment. You don’t want your head tilted down or up – it’s the fastest way to stir up an old neck injury or wake up with a tension headache.

4. Extend instead of bend

Did you know that the average person bends or flexes forward between three and five thousand times per day? When you’re traveling – you’re going to be on the upper end of that metric. Our spines crave balance. And because of the disproportionate amount of time we spend bent over – we need to make a concerted effort to move our spines in the opposite direction. When you’re traveling – look for opportunities to be upright and mobile.

Walking is an excellent, therapeutic activity for your spine – plus – it’s a great way to see the sights wherever you’re going. When you’re practicing the 30 min rule, give your back and neck a nice stretch backwards each time you stand to interrupt your sitting. But probably more important than what you do during travel is what you do when you’re back home. Be cautious when jumping back into your typical gym or exercise routine. All the sitting and bending that comes with travel makes your spine vulnerable for injury. It’s very common to get injured a week or two after you’re home – seemingly “out of nowhere”.

 

Looking for more help with your neck and back pain?

Sign up for a FREE Discovery Session today to speak with my client success team to see if we can help you get rid of your neck and back pain for good.

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

Why your Cortisone Injection Failed You

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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 to speak with my client success team to see if we can help you avoid quick fixes like cortisone shots and get long lasting results. 

Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH.  To get a free copy of her guide to taking care of back pain – click here.

golf injuries

Common Golf Injuries and How to Avoid Them

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Most golfers I know won’t let anything stop them from being out on the course – especially here in New England where the golf season is not very long.

But let’s face it, when something hurts, playing 9-holes is just not as fun.

Jack Nicklaus had it right when he said, “Professional golfers condition to play golf; amateur golfers play golf to condition.” That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they’re out of shape, have poor swing mechanics, or don’t adequately warm up.

Here are three common golf injuries and things you can do to avoid them.

Elbow Tendonitis

Tendonitis is characterized as the painful inflammation of a tendon. It’s caused by repetitive movements that overload the tendon, eventually causing it to feel strained and overworked. When it occurs on the inside of your elbow, which is something that happens a lot with golfers, it’s called “golfer’s elbow.” The treatment is ice and rest initially (which means you don’t get to play golf for a while) followed by progressive and proper loading of the tendon to get it back to a healthy state. This whole process, if done properly, takes time… and it can certainly ruin your golf season if it’s not caught early.

What causes elbow tendonitis? We know that technically, it’s inflammation of tendons in your elbow. But what leads to that in the first place? Often weakness in your mid-back and shoulders along with mobility restrictions in your wrists. Your elbow is significantly influenced by what happens above and below it. If your mid-back and shoulder area are weak, the rest of your arm won’t feel supported and your elbow can get overworked. If your wrist is tight and immobile, your elbow will be forced to move more than it should, especially through a golf swing. This will cause extra stress on your tendons and eventually result in tendonitis. The best way to prevent this from happening is to make sure you’ve got adequate mobility in your wrists, and good strength in your mid back and shoulders.

Back Pain

One of the most common ways to hurt your back is with repetitive flexion (bending) and rotation (twisting). Well, what does a round of golf consist of over and over? Repetitive bending and twisting! Every time you swing that golf club, you’re putting your spine through one of its most stressful positions. And if it’s not prepared — it’s going to get injured.

One of the best ways to prepare your spine for a long and healthy golf season is to avoid a lot of sitting and keep it mobile. Sitting for prolonged periods makes your back more susceptible to injury in general, but especially if you’re going to be doing a lot of bending and twisting. Interrupting your sitting frequently during the day is a very easy way to minimize its harmful effects. 

If you lack adequate mobility in your spine, it will feel strained every time you try and swing your club. When you overstress a joint that is stiff, the muscles around it tend to tighten up and spasm in response. It’s important that you take time to optimize and maintain your best spinal mobility for golf season. This will significantly help to decrease the stress that occurs in your spine when you swing in one direction repetitively, and ultimately help you prevent a back injury.

Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints. If you lack adequate mobility or stability in and around your knees, you’re going to have problems. Much like the elbow, the most common source of knee pain I see in my golfers comes from the joints above and below, and not from the knee itself. To keep your knees mobile and healthy and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as stability in your feel and ankles. 

The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees will want to try and help, and they are not designed for this. Your knees need to be loose and free during a golf swing. If not, the muscles and ligaments around your knee joint will take on unwanted stress. 

Another cause of unwanted stress to your knee joint is lack of support from your feet and ankles.

Your knees need a stable foundation if they want to bend and twist without stress. If stability below is lacking, your knees will tighten up in an effort to compensate. Moral of the story: make sure you’ve got mobile knees, a strong core and hips, plus stable feet and ankles, so that knee pain doesn’t derail your golf season.

Hopefully these tips help you understand why golf injuries happen and most importantly, how to prevent them. If you’re feeling stuck and looking for individualized expert help – request a FREE Discovery Session. We look forward to speaking with you!

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 taking care of back pain – click here.

Shoulder Pain

Neck Pain Not Going Away? 3 Reasons Why

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Over 30% of people report they have neck pain, and of those, 50% will continue to have problems without any real answers or solutions. And during the pandemic, we saw more people becoming generally less active, falling off their routines, and working from home in less than optimal “work stations”. It’s no surprise that people are suffering from more neck pain than usual.

Having been a mechanical spine pain specialist for the last 10 years – and a physical therapist for just over 20 – I can tell you that resolving neck pain is trickier than resolving back pain.

And there are some good reasons for that. Your neck is the most mobile area of your spine – which makes it more complicated to manage – and the muscles in your neck are a bit more fragile than some of the bigger muscles in your lower back. The way you strengthen muscles in your neck can’t be approached in the same manner you might tackle your lower back – for example.

If you suffer from persistent neck pain – there could be several explanations as to why it’s not going away. But the biggest culprit I have found is an inaccurate diagnosis. Without the correct diagnosis – your neck pain treatment fails – and it’s more likely you’ll be prescribed injections or pills to relieve your neck pain and get stuck with this treatment regimen for the long-term.

Here are three reasons why the root cause of your neck pain might be getting missed – and why your neck pain just isn’t going away:

 

1. Your neck problem is disguised as shoulder pain:

Shoulder problems are confused with neck problems more often than you would think. If this happens – you risk spending weeks (or months) trying to resolve shoulder pain that is actually a neck problem. Not only will your shoulder pain not fully resolve – your neck pain won’t either – and could actually become worse. Because your neck is so mobile, it’s easy for nerves in your neck to get irritated and refer pain into the middle of your shoulder blade, top of your shoulder, or down the side of your arm. When you consider this, it makes sense why neck problems are so easily mis-diagnosed as shoulder problems. It’s a very common scenario that not only results in neck pain not going away – but persistent shoulder problems too. My general rule of thumb – if you’ve been working on a particular problem persistently and consistently for 2-3 weeks or more without significant improvement – something is missing. You’re either treating the wrong thing or have the wrong treatment approach. It happens a lot with neck pain so be sure to pay attention to this common error – especially if you’ve got coinciding shoulder pain.

2. Your core is weak:

Lack of core strength is commonly associated with back problems – but believe it or not – it can have a lot to do with neck pain too. Most people are familiar with how muscles and joints are connected – but did you know your muscles and organs are connected as well? They’re connected by a web of tissue called fascia – and this connection is often referred to as myofascial. “Myofascially speaking” – your deep neck muscles are connected to your core. If your core isn’t functioning properly – your neck will try to compensate and it will result in neck pain. Do you consistently feel neck pain or tightness every time you do a core workout? This could be a sign that your neck is compensating for your core – and there’s a good chance proper core strengthening is what’s missing. It could explain why your neck pain isn’t going away no matter how aggressively you treat it.

3. The Wrong Neck Exercises:

The anatomy of your neck, more so than the rest of your spine, is fairly intricate and quite mobile. Not only does this require special care and accuracy when it comes to examining your neck, it makes it easy for someone who is not expertly trained to miss things. For example, one of the most common things I see is someone thinking that full range of motion has been restored in your neck when it hasn’t. If you start strengthening your neck when it doesn’t have full mobility, you can run into problems later on that result in persistent pain. Additionally, strengthening the muscles in your neck, especially in a neck that hurts, needs to be done carefully. The muscles in your neck were designed for stability – which is very different from say – the muscles in your legs – which are designed for power. You can’t approach strengthening them in the same way. All too often I see neck strengthening exercises that are too aggressive for the small muscles in your neck. This results in unnecessary neck tension – and delayed resolution of neck pain.

Generally speaking – if you’ve been suffering from neck pain for a while now – and you’ve tried lots of different treatments without any success – there’s a really good chance you’ve been misdiagnosed and have the wrong treatment plan. Don’t settle for relying on pills or injections for the rest of your life. And don’t undergo any kind of surgery or procedure until you’ve truly exhausted all possible causes of your neck pain. Ideally, find a mechanical pain expert who understands the intricacies of neck problems and work with them. If diagnosed properly, it’s not only possible to get rid of your neck pain naturally, but you can learn to keep it gone all on your own.

 

Ready to get rid of your neck pain?

Download 7 Easy Ways to Get rid of Neck & Shoulder Pain written by Dr. Carrie Jose – leading physical therapy specialist and mechanical pain expert in Portsmouth, NH