Tag Archive for: New Hampshire

Back Pain

Is it Safe to Push Through Pain?

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“No pain no gain” is a common phrase we hear but is it accurate? Not always. And it’s important to know when it’s safe – and not safe – to push through your pain. While unpleasant – pain provides us with important information that when understood – can be extremely valuable.

But first, what is pain exactly?

Britannica.com defines pain as “a complex experience consisting of a physiological response to a noxious stimulus”. Say what? In simpler terms – pain is our warning mechanism. It’s designed to alert us of harmful stimuli that are primarily associated with injury or threat of injury. The key word here is threat. Not all stimuli are harmful, even if it elicits pain. And that is where our cognitive brain must kick in to interpret the signal of pain and decide… should or shouldn’t you push through pain?

So how does your brain decide?

Well, your brain learns how to deal with pain from experience. And how those experiences are shaped is important. For example, if your brain is conditioned to think that all pain signals are “bad” or harmful – it’s going to always trigger you to withdraw or freeze. While this might be the safest option from a glance, it’s not always the most effective, and it can cause you more problems down the line. In fact, this is how a lot of chronic pain problems are formed. Your body becomes hypersensitive to pain signals because your brain never learns how to interpret them properly. For some suffering from chronic pain – it’s because your brain has been conditioned to think all pain is dangerous and your body – in turn – will reject any attempt to rectify it.

The best response to pain is to examine how it behaves versus judging it at first glance. There are some instances where pain and damage are synonymous and obvious – such as burns, trauma, broken bones, etc. But for most musculoskeletal aches and pains – it’s not so clear. How your pain behaves in specific situations and over time is what’s most important and it’s how your brain learns what to do.

Does it get worse? Does your pain move around? Does it come and go? Does it get better and stay better the more you move? Or does it worsen the more you move? Understanding how your pain behaves is the first and most important thing to look at when it comes to pushing through your pain or holding back.

For example, let’s look at an acute back pain episode.

It’s typically debilitating, and the last thing you want to do is move. If you rest, your pain will eventually subside, but you’ve taught your brain that doing nothing is the best response, until you hurt your back again. This strategy will only get you so far. Eventually, rest doesn’t work anymore and you’re at a loss. Movement is almost always the best solution for back pain – even when it’s scary. The first time you try to move after a debilitating back pain episode is typically terrible. But the secret to movement is in its repetition.

You want to evaluate how your back pain responds to any given movement over time versus just once. Does it get better and stay better the more you move or stretch a certain way? Or does it only get better temporarily? The response you’re looking for is getting and staying better. This is the kind of experience that reinforces your brain to take an active approach to pain and appropriately push through it. When you have the opposite response, then you know to stop.

I like to think of pain’s behavior like a traffic signal.

When you move in a specific way more often and it feels better – green light – keep going. When you perform a specific movement and it feels worse – stop – that’s a red light. Yellow lights are murky and where you need to decide whether or not it’s wise to push through pain. If pain is not changing and staying the same – or you consistently have good days and bad days – then you might want to “push”. You’ll find yourself at either a green light or red light. This is where you get valuable and reliable information about your pain and know exactly what to do.

Pain is a complicated concept that even those in the medical field have difficulty understanding and managing well. I’m not a fan of managing pain via medication. While it might be a successful strategy for getting rid of pain quickly – it tells you nothing and gives you the best chance of it coming back again or living a life hooked on that medication. Eighty percent of the time the best “medicine” for pain is movement. Use these guidelines to help you figure out if you’re on the right track or not – but the best advice when it comes to getting rid of musculoskeletal pain is to talk to an expert who understands how pain behaves and can help you figure out how to manage it on your own.

Ready to get help with your pain or injury?

Request to speak to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

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.

Common Pickleball Injuries and what to do

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If you haven’t heard of pickleball yet, odds are good you will very soon. Pickleball is quickly becoming one of the most popular recreational sports in the US, especially in the over 50 crowd, and especially in Portsmouth and all around the Seacoast of New Hampshire. It’s essentially a cross between tennis, racket ball, and ping pong. The court is smaller than in tennis and the net is set lower. People love pickleball because it’s a great way to not only get exercise – but to socialize and meet new friends.

But like any other sport, injuries happen. And because injuries become more significant and harder to rehabilitate as you get older – it’s important to have an awareness about the common injuries that tend to occur in pickleball players and what you can do to prevent them.

Here are four of the most common injuries I see in Pickleball and what you can do:

 

1. Rotator cuff strains

Your rotator cuff is a group of muscles in your shoulder that play a critical role in both stability and mobility of your shoulder joint. Because pickleball involves repetitive swinging – your shoulder is at risk for overuse injuries and strains. To help minimize the risk of rotator cuff injury, it’s important to ensure that you have good mobility in your shoulder joint, and good mid-back or scapular strength. Your scapula is also called your shoulder blade – if your scapular muscles are weak – then your rotator cuff might be tasked with extra work or strain. The more mobile your shoulder is, and the more balanced the strength around your shoulder joint is, the more effective your rotator cuff will be when playing a repetitive sport like pickleball.

2. “Pickleball” elbow

This is pretty much identical to tennis elbow – known medically as lateral epicondylitis. It causes pain and tenderness on the side of your elbow or forearm – and happens due to overuse of your forearm muscles – typically due to poor mechanics above, below, or in the elbow itself. To prevent this, you want to make sure the areas above and below your elbow joint are strong and stable. Your shoulder needs to be both strong and mobile for when you swing – otherwise your elbow will compensate and try to help out. Your wrist needs to be stable when holding the racket – or your elbow will need to kick in and try to help. The ligaments and muscles around your elbow aren’t designed to do the job of both your shoulder and your wrist – so if you don’t give these areas some love – you could end up with pickleball elbow.

3. Ankle sprains

Because there is a lot of pivoting and starting/stopping directions during pickleball – it’s easy to sprain your ankle if you’re not careful. Most ankle sprains occur from rolling on the outside of your ankle. This results in bruising, pain and swelling of the ligaments along the side of your ankle. While this injury does heal over time, it can often result in chronic weakening or scarring of those ligaments as well as tightness in your ankle joint – which only makes you susceptible to future ankle sprains. It’s best to make sure you have a good warm-up before you play. One that conditions your ankle and feet for quick stepping and flexibility. You also want to make sure you have strong hip muscles. If your side hip muscles aren’t strong and helping you stay stable in your pelvis – your ankle will take the brunt – and you’ll be more likely to sprain it.

4. Achilles tendonitis

Your Achilles tendon is a very strong, thick tendon that connects your calf muscle to your heel. It’s responsible for generating a lot of power to help you spring off your foot and jump. Its power is generated from its ability to stretch and then contract. Therefore, your ankle needs to have good mobility in order for your Achilles tendon to do its job. If your ankle is stiff and tight, you could be at risk for developing Achilles tendonitis. One other consideration is the strength of your glutes (or butt). Calf muscles love to compensate for weak gluteal muscles. If that happens over and over, they become tight and can put extra strain on your Achilles tendon – since they are connected. So make sure your butt is strong and your ankle is mobile in order to help prevent this common pickleball injury.

If you’re a pickleball lover – or perhaps wanting to get into this popular sport for the first time – I hope these tips help you to become more aware of what you can do to protect yourself from injury.

Ready to get help with your pain or injury?

Request to speak to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. 

 

morning neck pain

Neck Pain During Crunches? 3 Reasons why and what you can do.

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Abdominal crunches are one of the most popular “ab exercises” around. It’s a move that emphasizes your upper abdominal strength more so than your lower. You start by lying on your back – typically hands behind your head and knees bent – then lift your head and chest off the floor – “crunching” your upper body into a C-shaped curve. 

Over the years, many healthcare and fitness professionals have dismissed this exercise entirely claiming its ineffectiveness for working the core. While I agree that it shouldn’t be the only core exercise you do – the abdominal crunch does have its place. When done correctly, mastering this move can help you get up from the floor, and sit up out of bed with more ease and less risk of injury. And of course, you see this move a lot in exercise classes, so it’s important to know how to do this move correctly without hurting your neck. 

If you’re feeling crunches in your neck instead of your abs – here are the biggest problems I see and why they might be hurting you.

     1. You’re not using your abs. 

This sounds pretty obvious, right? Of course you use your abs when you crunch. Anatomically-speaking – it would be impossible for you to perform this move without some form of engagement with your abs. But many people don’t engage their abs enough or in the right way. And this can result in neck pain.

Here’s what happens. 

If you don’t engage your abs enough or in the right way during a crunch – your neck will often kick in to try and help. Eventually your neck gets sore from this because your neck muscles aren’t designed to be the primary mover during a crunch. One easy tip to try next time you do a crunch is to make sure you inhale deeply – and then exhale as you begin to crunch. At the same time, check in with your neck. Make sure you can easily turn and wiggle it side to side. If that is challenging – then you are likely using your neck to help you crunch and your abdominal engagement could use some work.

    2. Your neck is in the wrong position. 

When you’re doing an abdominal crunch your neck position is critical. There is an illusion that your neck moves during the crunch but it should actually stay pretty stationary. The ideal position for your neck is to begin with a slight nod of the chin (like you’re nodding “yes”) and then keep it there. The rest of the curling motion will come from contracting your abdominals to move your trunk. As you curl up, you want to keep a nice C-shaped curve of your upper body – and keep a tennis ball’s distance between your chin and chest. 

Most people either curl their neck too much, or not enough. If your chin is touching your chest you’re curled too much – and you’ll experience strain behind your neck. And if you keep your neck too straight you’ll experience strain in the front of your neck. Another common mistake with neck positioning during a crunch is jutting your head forward. This will put strain in your upper neck right behind your head. While any of these positions will cause temporary discomfort in your neck – they could lead to more long-standing problems down the line if not corrected. 

     3. You have an underlying neck problem. 

Sometimes you will get all of the above right – and still have neck pain when you perform an abdominal crunch. This could be a sign that you have an underlying neck problem – and doing a lot of crunches has just exposed it.

Let me explain.

Let’s say you have a small bulging disc in your neck that you weren’t aware of, or you thought was “fixed”. The curled position of your neck during a crunch can exacerbate this problem, even if you are using your abs correctly and following every tip I just mentioned above. 

Pay attention to what you feel during and after performing an abdominal crunch. If you notice pain that shoots into your shoulder blade, or any numbness or tingling down your arm (especially if past your elbow) – these are clues you could have an underlying neck problem that is being aggravated by crunching. You might experience these symptoms during your crunches, or even up to several hours after. Either way, symptoms like this could be a sign there is more to your neck pain than simply incorrect crunch-technique or weakness in your abs. And it would be important to talk to an expert about this.

If you’re experiencing neck pain during abdominal crunches – hopefully these tips give you a better understanding why – but most importantly – please know this is a very common issue and you’re not alone.

It’s partly why I created Pilates 101: Get [Your] Back to Health™

Although this program is primarily geared toward helping folks who’s back pain is keeping them from strengthening their core and exercising the way they want to…

We actually talk quite about about the relationship between your abdominals and your neck – and teach you how to “crunch” safely and correctly.

I’ve been personally teaching this program for the past 4 years – and previously – you could only do it live with me 1-2x per year…

But NOW – I’m excited to tell you that we’ve opened it up to the entire world!

We’ve had people signing up from all across the country right now – people who’ve been wanting to get help from me but couldn’t because of where they were located.

This program is not for everyone – but if you want to learn more and see if it might be for you – CLICK HERE.

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

Holding Knee with Arthritis

3 Tips to Protect Your Knees as you Age

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3 Tips to Protect Your Knees as you Age

Knee pain is the second most common musculoskeletal complaint behind back pain. It impacts one-third of all Americans at one time or another – and its prevalence has increased substantially over the last 20 years. These statistics indicate that it’s more important than ever to find ways to protect your knees as you age – so you can continue doing things you love – especially if you want to avoid major procedures or surgery.

Here are three tips to help you protect your knees as you age – so that you can stay active and mobile as you age – and hopefully avoid major procedures and surgery:

 

  1. Strengthen your Hips and Core

Your knee joint is situated just below your hips and core. And doctors have found through research that when you have poor control of your upper leg muscles – you get more stress through your knee joint. The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone – or femur – connects your knee and your pelvis – and your core strength controls your pelvis.  If your pelvis isn’t stable – your femur is going to have a difficult time staying in alignment. This will ultimately have a direct stress on your knee joint – causing it to compensate in some way.

Additionally – your outer hip muscles – which include your glute muscles – also play a major role in how well your femur is positioned and stabilized. If you’re wanting to protect your knees and give them the best shot at remaining pain free and mobile as you age – you must strengthen your hips and core.

  1. Mobility before Stability

Mobility before stability is my mantra. And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability – and there are those whose major function is mobility. Your knee needs to be mobile. It’s major purpose is to bend all the way so you can squat and pick things up – and it needs to straighten all the way to give you stability when you need it. When either of these motions are lacking – your ligaments and surrounding muscles will suffer. A lot of folks just “accept” that their knees are stiff – especially if you’ve been told you have arthritis in your knees. 

The limiting belief is that stiffness is par for the course.  But the truth is that if you keep your knees mobile as you age – you can not only maintain the mobility you have but improve what is lacking. If your knees are stiff – start moving them. The thing to understand about arthritis is that it’s a normal part of aging. Debilitating mobility is not. Even a 10% improvement in your knee mobility – which most people don’t realize – can make a huge difference in your function. This can be the difference between a natural solution to knee pain vs undergoing a major surgery like knee replacement.

  1. Work on your balance

The last joint we need to talk about when it comes to protecting your knees is your ankle. Much like your hips and core – if your ankles aren’t stable enough to help you maintain adequate balance – your knees will suffer. But another interesting thing about your ankle joint is that poor mobility can also impact your ability to balance. Let’s say you have stiffness when you squat. Many times this is due to inadequate mobility in your ankles. You’ll know this because you’ll feel a strain in the front of your shins when you try to deeply squat – or you may notice your feet and knees turn in. These are mechanisms your body uses to compensate – which if repeated over and over – will cause problems in your knees.

But how does squatting relate to balance? Well – if your ankle doesn’t flex enough – say in a deep squat – then that means your lower calf and achilles are being overstretched and compromised. Your lower calf muscles are extremely important when it comes to balance – and if they are overstretched or inadequately accessed – because your ankle is too tight – then your balance will be affected. In order to protect your knee joints and balance as you age – be sure you’re being mindful of both ankle mobility and stability.

So – let’s summarize…

If you want to optimize your knee health as you age – which you still can even if you’ve been told you have “advanced arthritis” – prioritize the mobility of your knees and ankles – strengthen your hips and core – and work on your balance.

Focusing on these three things can have a significant impact on the health of your knees as you age and help you to avoid major surgery.

Ready to get help with your pain?

Request to speak to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group.

 

 

knee pain source

Three Causes of Knee Pain and What to Do

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Knee pain has been the hot topic around our office this week!

With the nicer weather we’ve been having – more people are outside – and their knees are “talking” to them.

Knee pain is the second most common complaint of musculoskeletal pain (back pain is number one) and it impacts one-third of all Americans at one time or another.

Most of our clients are in their 50’s and 60’s and love to ski, run, hike and bike. They worry that knee pain could bring an end to their active lifestyles.

The good news is that eighty percent of ALL knee problems can be resolved without procedures or surgery – but it starts with accurately identifying the root cause.

Here are three of the most common causes of knee pain and what you can do to resolve it.

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, patellofemoral knee syndrome (PFS) is characterized by pain in the front of your knee – usually just below or behind your knee cap. With PFS, the source of the problem typically has to do with unwanted pressure in the front of your knee… that eventually results in pain.

It’s very tempting to just get a cortisone shot – or take pain pills – to reduce the inflammation caused by this wear and tear. But then you’re only addressing the symptoms…

If you truly want to put an end to PFS, you’ll need to find the cause of this problem.

Typically, it’s poor form and movement habits that are the result of an imbalance somewhere between your hips, quads (front of the thigh), and hamstrings (back of the thigh). When you figure that out, you’ll restore healthy, balanced movement in your knee again – and reduce the aggravation at your knee cap.

2. Iliotibial band syndrome

This is a very common problem that is similar to PFS except that you’ll experience pain on the side of your knee instead of the front. Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called tensor fascia latae (TFL).

When your TFL gets overworked – your ITB suffers – and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage – and while these are great modalities to relieve your symptoms – they do NOT address the root problem.

You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis. Your TFL is neighbor to your glutes so when they decide to be lazy – your TFL loves to help out – and eventually overdoes it.

When you can get these two groups of muscles working properly together – you’ll put an end to ITB syndrome 🙂

3. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get surgery to replace their knees.

Not true!

First of all… arthritis is normal and it happens to everyone as they age. What is NOT normal is for you to think you’re helpless because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process – there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement.

The more mobility you have – and the more stability you have around your knees – the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core strength, and good flexibility in your hips and ankles. If anything is off in these areas – your knees will want to compensate – which could result in aggravation of arthritic symptoms.

“Motion is lotion” is not just a saying – it works! Especially when it comes to arthritis.

If you’re currently suffering from knee pain, remember that there is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills – or think that procedures and surgery are your only options!

If you’re looking for help here in Portsmouth, New Hampshire CLICK HERE to Request a Free Discovery Session. One of our specialist will reach out to you, ask you about everything that’s been going on, and determine if we’re the best people to help you!

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 her Knee Pain Report CLICK HERE  or to get in touch, email her at [email protected].

Could your Hamstring Strain Actually be a Back Problem?

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Have you ever strained your hamstring but the pain just doesn’t go away?

It’s been months since you first started hurting, you can’t actually remember how you injured it (it just started aching one day), you’ve been stretching and massaging it diligently, yet your hamstring still hurts.

This happened to a recent client of ours (“Sandy”).

Sandy was a runner and regular gym goer, who one day noticed an ache in her hamstring. She assumed she had just overdone it working out. She rested it a few days and the pain went away, but when she tried to get back to running she couldn’t. Her hamstring pain came right back. Thinking she hadn’t let it heal enough, she went back to resting it, but this time, decided to add some massage and stretching to her routine. 

A few weeks later… you guessed it… Sandy still couldn’t run.

She also noticed the pain in her hamstring started to feel “different.” It was becoming more deep and achy and started to hurt all the time instead of only when she tried to exert it. It even hurt when she sat for too long. She still couldn’t run and was starting to get worried. Her doctor told her it was just a “strain” and that she had to let it heal. The problem was that it wasn’t healing. Several months had now gone by and she was running out of exercises and stretches to try that would “let it heal.”

Luckily, Sandy attended our recent back pain and sciatica class and realized that the pain in her hamstring might not be a strain at all. 

And her instincts were right! Let me explain.

When you truly strain a muscle, it means you have done damage to your muscle tissue. Although it’s possible to have chronic problems from a strain that isn’t rehabilitated properly, strains typically do in fact heal. Once the inflammation from the tissue damage goes away, and you start doing the proper stretching and strengthening, your muscle eventually gets back to normal. Until a muscle strain is fully healed, it will typically be aggravated if you accidentally over-stretch it or exert it. But you usually don’t feel anything when you’re resting the muscle. In Sandy’s case, her hamstring was starting to feel worse when she was resting — the longer she sat, the worse she felt. Your hamstring is completely relaxed when you are sitting, so something wasn’t adding up.

This was the first sign we were likely dealing with something other than a “hamstring strain.” The second sign was that we could take her pain away by moving her back! Yes, you heard that right.

By moving and stretching her back in a specific way, we were able to significantly relieve the pain in her hamstring.

The reason her hamstring was actually hurting was because a nerve had been aggravated in her back. The nerve was causing pain to radiate into her thigh. That’s why it hurt when she sat for too long and it’s why she couldn’t tolerate any running. Sitting puts more stretch and pressure on the nerves in your back, and running puts a lot of compression through your back. Generally speaking, nerves don’t like to be stretched, especially aggravated nerves, and they don’t like to be compressed if they are aggravated either. By stretching her back in a very specific way, we were able to relieve the pressure from the nerve that was giving Sandy her “hamstring strain.” This confirmed that she was indeed having a back problem.

Has anything like this ever happened to you?

If you’ve got pain anywhere in your buttocks, hip, thigh, or leg that isn’t going away — especially if you’ve done your due diligence and tried all the “right things” — it’s possible you could have a back problem causing this pain instead. These types of back problems are easily missed if you don’t know how to accurately assess them and it won’t be picked up by an MRI or X-ray. The best way to figure this out is through specialized movement testing, like we did with Sandy. 

We talked all about this in our recent back pain and sciatica class. If you want access to the recording, just call our office: 603-380-7902. If you want to take the next step and meet us in person — you can schedule a FREE Discovery Session with one of our specialists right here! 

The Location of Your Pain may NOT be its Source…

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One of the most confusing topics we deal with in our practice is pain. And there’s lots of advice out there on what to do about it…

Should you rest or move? Apply heat or ice? See a doctor or let it go away on its own?

Before you can even think about a solution to your pain, you must first accurately determine where it’s coming from. If you have pain in your knee, but it’s actually coming from your back, the best knee treatment in the world is not going to fix it.

Inaccurate diagnosis of pain is a BIG reason why so many people suffer longer than they need to, and undergo unnecessary surgeries.

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 do that.

For example, I’ve seen people in my office with what they think is unrelenting tennis elbow, only to find out it was actually a problem in their neck causing it. I’ve seen people disappointed after a failed knee surgery, because the problem was never in their knee and actually coming from their back.

Isolated extremity pain (knees, elbows, shoulders) is one of the most misdiagnosed problems we see in our office.

A recent study by Richard Rosedale, et al. in the Journal of Manipulative Therapy investigated this – and it was found that over 40% of people suffering from isolated extremity pain actually had a spinal source of symptoms.

In other words, their extremity pain was actually coming from their neck or back.

I can’t tell you how many times we’ve seen folks with unexplained shoulder pain lasting months or years get better as soon as we begin treating their neck, even though they never had neck pain.

Same for knees…

It’s possible to have knee pain that is caused by your back, without ever hurting your back!

Confused? I don’t blame you.

But more importantly, how do you 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, knee or foot pain – and you don’t ever recall a specific injury to it – you MUST consider that it could be coming from your spine.

There’s a 44% chance that it is!

Where this gets really confusing is that typically your doctor will order an MRI when you’ve got isolated knee or shoulder pain that won’t go away. And if you’re over 40 years old, the MRI will almost always show “something” – a torn rotator cuff, torn meniscus, arthritis, or wear and tear.

Remember that these are normal signs of aging in everyone, and may not be the cause of your pain.

If you haven’t already had your spine checked properly as a possible source, you can’t rely on these findings (or the location of your pain) as an accurate diagnosis. That is how people end up having surgeries they don’t really need.

Whenever someone comes into our office with isolated extremity pain, we don’t even look at it without an exam of their neck and back first.

By moving your spine repeatedly, and in certain directions, we can often produce – or take away – the pain you’re feeling in your knee or shoulder.

Why?

Because if the pain in your extremity is caused by a pinched or aggravated nerve, moving your spine around is going to influence that, and tell us where the source really is.

An MRI and X-ray won’t be able to determine this for you with certainty – because sometimes your nerve only gets irritated when you move a certain way – or when you’re in a certain position. Since MRI’s and X-rays can’t see what’s going on while you’re moving, you can’t rely on those tests alone to tell you exactly where your pain is coming from.

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.

That source could be your spine.

And if you’re considering some kind of surgery or procedure, you definitely want to rule that out first.

Specialized movement exams like we do in our office are one of the most reliable ways to figure this out. If you’ve had unexplained pain in your knee or shoulder that isn’t going away, CLICK HERE to request a Free Discovery Session with one of our specialists.

Tight Hamstrings: a Case Study

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

Well… if it’s just your hamstring that’s actually tight then this might be good advice to follow.

But what if it’s something else?

If you accidentally stretch a hamstring that feels “tight” due to a back problem – there is a very good chance you’ll make your condition worse.

This exact scenario happened to a recent client of ours (we’ll call him “Jack”) who came to us with what he thought was a “hamstring strain.”

Jack had been stretching and stretching his hamstrings – which he had been told to do by his chiropractor – but he wasn’t feeling any looser. In fact, his hamstring even started to hurt the more he stretched, so he thought maybe he caused himself a strain.

Was he doing too many stretches? Or perhaps doing them incorrectly?

He made the smart decision to call us for help and came in for an examination.

And the first thing we asked him was…

“Where is your pain?”

Jack pointed to the back of his leg, but when he started describing his symptoms… it turned out they actually started in his butt, traveled down the back of his thigh, and stopped at his knee. But on occasion he’d also feel the tightness in his calf. And since doing all that hamstring stretching, he was even starting to feel pain!

Lesson number 1:

Your hamstring starts at your ischial tuberosity – otherwise known as your “sit bone” – and extends down to just below your knee. Since muscles and joints can’t actually refer symptoms (only nerves and sometimes fascia can do that), feeling pain or tightness anywhere other than your actual hamstring is the very first clue you could be dealing with something other than a hamstring problem.

Since Jack was feeling symptoms in his butt and also down into his calf, we knew immediately that “hamstring strain” was NOT Jack’s problem.

The next step was to figure out where his tightness was coming from.

Lesson number 2:

Since he’d been stretching for several weeks already and was starting to feel more problems in his leg – the likely explanation was that it was coming from his back.

While yesm over-stretching can make you sore, and yes, stretching incorrectly can cause you discomfort… that wasn’t the case with Jack. He was still feeling tight, and now on top of that he was dealing with pain.

All signs were pointing to a problem in his back.

Well now that we had our theory – it was time to test it!

After performing several movement tests with Jack’s back, we were able to produce the exact same tightness AND pain he had been feeling in his leg. And with some different movement tests we were actually able to ELIMINATE his symptoms temporarily.

Since moving his spine in certain directions was responsible for both turning “on” AND turning “off” his leg symptoms, we were able to confirm that he had a back problem – not a hamstring problem.

Pretty cool – right?

Jack thought so… but more importantly… he was glad to finally have some answers! Finally, he had a plan to move forward.

  1. He stopped stretching his hamstring.
  2. He started doing a different – and properly prescribed movement instead – that was designed to eliminate the symptoms in his leg.

We’ll of course need to continue working with Jack to make sure that his leg symptoms not only go away – but that they stay gone. Part of the process will be teaching Jack how to do this on his own in case the problem ever comes back again.

Sadly, I can’t tell you how many times I’ve seen a case like Jack’s in my office.

Lucky for Jack, he came to us early on – when his symptoms were mild. Basically, the nerves in Jack’s spine were starting to get irritated, and the result was a “tight” feeling in his hamstring. Nerves don’t like to be stretched, so Jack was actually making his problem worse by stretching and he didn’t even know it. Had he not gotten this addressed – the tightness in his leg could have progressed into full blown sciatica!

If you have any kind of ache or pain that isn’t going away on it’s own with natural movement or stretching – don’t try to figure it out on your own.

And as you learned from Jack’s case – not all movements are created equal. It’s possible you could look up a stretch on Google or YouTube and actually make yourself worse!

Don’t guess… TEST 🙂

And when it comes to pain during movement or certain activities – let the movement experts be the ones to test you and figure it out. All you have to do is click here to schedule a FREE, no-obligation consultation with one of our specialists! These Discovery Sessions are your chance to determine where your pain, tightness, or stiffness may be coming from and if we’re the right people to help fix it.

Back Surgery

Can you get rid of Back Pain with Exercise?

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

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

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

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

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

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

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

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

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

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

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

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Persistent neck pain and tired of not getting answers?

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Have you been dealing with annoying, on and off neck pain for a while now? Have you tried treating shoulder pain with no real results? Are you frustrated with empty answers?

Or maybe you know someone else who is dealing with this?

Over 30% of people report they have neck pain. Of those, 50% will continue to have problems without any real answers or solutions.

When clients come to us with neck pain, often they’ve already tried several approaches without success. But the real issue I see is that everyone they’ve seen up to that point has failed to give them a full and accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause (or causes) of neck pain can be easily missed by many, and is sometimes difficult to diagnose.

Why?

There are a few reasons…

  1. The anatomy of your neck, unlike the rest of your spine, is fairly intricate. 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.
  2. Shoulder pain is very often confused with neck pain. What I mean is, it’s possible to only feel pain in your shoulder, but the real source of the problem is your neck. If you’ve ever been treated for a “shoulder problem” and it hasn’t gotten any better (or maybe it got worse!), there’s a good chance you were misdiagnosed.
  3. Your core strength has a lot to do with how well your neck functions. When it comes to neck pain – or any problem for that matter – a holistic approach is always best and the most thorough. Sometimes your neck pain can be a “symptom” of a root cause somewhere else. Many times I’ve seen people come in having suffered from neck pain for years – and once we properly strengthen their core or other areas of their body – their neck pain starts to finally improve.

These are just a few of the most common reasons I’ve seen, over the years, of why the true source of your neck pain can get missed. And guess what… if the true cause of your pain is missed… then you won’t get consistent relief or a full recovery.

Check out our free neck report here or request a time to speak with one of our specialists here.