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
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.
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.
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.
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.
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.
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.
When it comes to chronically stiff muscles – tight hip flexors are the second most common complaint I hear after tight hamstrings. Tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are always tight, it can interfere with your ability to enjoy walking, running, golfing, and just exercise in general.
Typically – the recommended treatment for tight hip flexors is to stretch – right along with advice to foam roll and massage. But what do you do when none of that works? What if no matter how often you stretch, the tightness just keeps coming back?
First, you need to make sure that the tightness you feel in your hips is actually due to tight hip flexors. Just because your muscles feel tight – doesn’t mean they are tight.
Your hip flexors (or any muscle for that matter) can feel tight for different reasons. They can literally be shortened and constricted – in which case – they need stretching – and lots of it. But they can also feel tight due to weakness or being overworked. If your hip flexors are weak, they are going to feel strained when you use them, which can create a sensation of tightness. If your hip flexors are compensating for another underperforming muscle group – say your deep core – then a sensation of tightness may occur because they are simply tired and overworked.
So the first and most important thing you need to figure out is what is causing the sensation of tightness in your hips. Are they actually short and tight? Are they weak? Or do they simply need a break?
Your hip flexors consist of the muscle group located in the front of your hip and groin. They are responsible for bending (flexing) your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back – and this is where I see a lot of problems and confusion. The rectus femoris, part of your quadriceps muscle group, and your psoas, part of your deep abdominal muscle group, are the two major hip flexors. Your rectus muscle is the one primarily responsible for lifting (flexing) your thigh. When you are walking or running, and repetitively flexing your leg, this is the muscle primarily at play. Your psoas, on the other hand, is much shorter and has a connection to your lower back. Because of this, it has more of a stability role. When functioning properly, it will assist in exercises like the crunch or sit up, and also work alongside your deep abdominals and glute muscles to help you have good upright posture when you’re sitting or standing.
Let’s talk about the psoas for a moment, because this is where many folks I speak with are misinformed. The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis and your back pain will disappear. Sadly, this is rarely the case. Most of the time, your psoas feels tight because it’s either too weak and not able to keep up with what it’s being tasked to do, or it’s overworking to compensate for your deep abdominals not working properly. Either way, the result will be an angry psoas that retaliates against you by feeling tight and achy. And stretching it over and over again will simply not work.
Now sometimes your hip flexors – particularly your rectus femoris – can get deconditioned from not being used enough – and this can result in actual constriction of your muscle tissue. This typically happens slowly over time, and is more likely to occur if you sit too much and aren’t very active. In this case, you actually do need stretching to fix the problem – but one of the reasons it doesn’t work – is because you aren’t doing it properly. When your muscle tissue is actually constricted – it requires a very specific stretching protocol to work. The days of holding a stretch for 30 sec and repeating it 3x are long over. If your muscle fibers have actually become constricted – the only way for them to improve their length is to remodel. They need a lot of stress to remodel (aka get longer) and the only way to accomplish this is to stretch repeatedly and often.
At the end of the day, if you’ve got chronically tight hip flexors and you’re stretching all the time, you’re either doing it wrong or shouldn’t be doing it at all. Perhaps you need to strengthen your hip flexors so they don’t feel so tense all the time? Or maybe your core isn’t kicking in and you need to strengthen that instead? Don’t stress yourself trying to figure it out on your own.
Stretching a muscle that feels tight isn’t always your answer, and you’ll know this because stretching over and over just isn’t fixing the problem.
Request to speak to one of my specialists to see if we are the right fit to help get to the root cause of your tight hip flexors. CLICK HERE to request a Free Discovery.
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.
The research continues to show that the best treatment for back pain is exercise. But what do you do when exercising hurts your back instead of helps?
What most people do when exercise flares their back up is they just stop. They simply wait for the pain to go away – and begin the cycle all over again. This is not the best strategy. Instead, why not figure out why exercise might be hurting your back and do something about it?
While the research isn’t wrong about exercising and back pain – the type of exercise you choose is important. For example, walking is generally considered one of the best exercises for back pain sufferers. But there are certain types of back pain where walking flares you up. In these instances, it doesn’t mean that walking is “bad” for you – and it doesn’t mean you have a serious problem. Many times, it simply means you need a different type of exercise first that gets you back to walking normally. Same goes for strength training and core training. Exercise is good for back pain – but if it flares you up – don’t be quick to blame the exercise. You may just be doing things in the wrong order. Working with a back pain expert can help minimize this and make sure you’re doing the right exercises at the right time – and that won’t flare you up.
Stability training is an important part of back pain recovery – but I often see it introduced too soon – and typically before good mobility is fully restored. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. And when your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to get irritated. When it comes to stability training, there is often resistance or load involved. The last thing you want to do is add load to the spine that is already compensating and irritated. This is a sure-fire way to flare up your back and why exercise might be hurting you instead of helping.
Knowing when and how to properly activate your core is different from having a strong core. You can have the strongest abs in the world – but if you can’t use them when they count – it’s useless. Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or performing complicated movements that require good coordination, you’re setting yourself up for injury. The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. If you’re constantly having back pain every time you exercise or try to strengthen your core, it could be that you lack the ability to activate it when it counts.
Not breathing properly can significantly impact the effectiveness of your exercise routine and impede your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise, and in order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abdominals, your deep back muscles, your pelvic floor, and your diaphragm. Your diaphragm is what controls your breathing. Let’s say you hold your breath when you exercise. When this happens it means your diaphragm isn’t expanding or contracting in the way it needs to for your deep core to be fully functional. Additionally, when your diaphragm doesn’t work like it should, it adds unnecessary strain to both your back muscles and your discs. If you’re not in tune with your breathing, and you aren’t timing it properly, it’s another reason why exercise might be hurting your back instead of helping.
The last and most common reason why exercising might be hurting your back is because you aren’t doing it right. There’s a lot of people out there who think posture and form don’t really matter. But they do. If you’re lifting weights – especially when frequently and repetitively – you want your spine to be in good alignment. It might not hurt the first time you lift with improper form, but it will hurt after several weeks or months when you get to your 100th rep. Same goes for body weight exercises. Just because you aren’t adding an external load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. This is where I see most people get in trouble. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture or it’s going to catch up to you and keep causing your back to flare up.
If exercising is currently hurting your back instead of helping – it could be due to one of these 5 reasons. Get expert help to figure out which one it might be. Because at the end of the day – exercise really is good for your back. If done correctly, timely, and in the right order – it will help your back instead of hurt it.
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.
“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.
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?
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.
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.
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.
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.
The research continues to show that the best “treatment” for back pain is exercise. But what do you do when exercising hurts your back instead of helps?
This is one of the most common frustrations I hear from my clients. The doctor looks at their back and takes an X-ray. He or she only sees something like arthritis or degenerative disc disease. Surgery doesn’t make sense – so the advice is to go exercise – and specifically to strengthen their core. But when it doesn’t work they are at a loss.
While the research isn’t wrong about exercising and back pain – it doesn’t always reveal the specifics on the type of exercise that’s being done. For example, walking is considered one of the best activities for back pain sufferers, and for the majority it will help significantly. But I also have clients who get worse just walking to their mailbox at the end of the driveway. What the research is really saying is that movement – not necessarily “exercise” – is what’s really good for back pain – even acute back pain. But you need to make sure it’s the right type of movement for YOUR specific type of back pain. If you get the type of exercise or movement wrong you’ll feel worse. This is one reason why exercise will sometimes hurt your back instead of help.
Stability training is an important part of back pain recovery – but I often see it introduced too soon. Mobility is something you always want to look at first. If you don’t have full mobility in your spine, there is a reason. You want to make sure you explore that fully and get the spine moving the way it should be before you begin stabilizing or strengthening it. Every now and then I stabilize first, but it’s rare. More often than not I see that people with long standing back pain are suffering from a mobility problem that was missed. When your spine doesn’t move well, you risk developing compensatory movement pattern. These can cause structures in and around your spine to get irritated. You want to figure that out first before jumping ahead to stability training of your core and spine.
Knowing how to properly activate your core is different from having good core strength. You can have the strongest abs in the world – but if you don’t use them when they count – your 6-pack abs are useless. Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or performing complicated movements that require good coordination, you’re setting yourself up for injury.
The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. Pilates (when done properly and with a well-trained instructor) can accomplish this quite well. If you’re constantly having back pain every time you exercise or try to strengthen your core, it could be that you lack the ability to activate it when it counts.
Not breathing properly – or not breathing at all – can significantly impact the effectiveness of your exercise routine and impede your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise, and in order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abdominals, your deep back muscles, your pelvic floor, and your diaphragm.
Your diaphragm is what controls your breathing. Let’s say you hold your breath when you exercise. When this happens it means your diaphragm isn’t expanding or contracting in the way it needs to for your deep core to be fully functional. Additionally, when your diaphragm doesn’t work like it should, it adds unnecessary strain and work to your back muscles. This is one reason why you might not be able to activate your core properly – and why exercise might be hurting your back.
The last and most common reason why exercising might be hurting your back is because you aren’t doing it right. There’s a lot of people out there who think posture and form don’t really matter. But they do. If you’re lifting weights – especially when frequently and repetitively – you want your spine to be in good alignment. It might not hurt the first time you lift with improper form, but it will hurt when you get to your 100th rep. Same goes for body weight exercises. Just because you aren’t adding load to your spine doesn’t mean you can’t aggravate it by doing something with poor form over and over. That’s really where people get in trouble. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture or it’s going to catch up to you and cause you unnecessary back pain.
If exercising is currently hurting your back – it could be one of these 5 things. Get expert help to figure out which one it might be – because at the end of the day – exercise IS good for your back. You just might need some help to get there first.
Want to safely strengthen your back? Check out our Pilates 101 Get [Your] Back to Health Program. This is our one-of-a-kind 8-session program that delivers safe, yet highly effective Pilates-based core strengthening exercises that are easy on the joints, and help improve your flexibility and posture. Apply here!
Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group.
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.
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.
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.
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.
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.
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.
Pain is a confusing topic. And there’s lots of advice out there on what to do about it.
Should you rest? Should you exercise? Apply heat or ice? Do you 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, and it’s coming from your back, for example, the best treatment in the world isn’t going to fix it. Inaccurate diagnosis of pain is one of the biggest reasons why so many people suffer longer than they need to, and why they undergo unnecessary surgeries. You must accurately determine the source of your pain for treatment to be effective. And the location of your pain is not a reliable way to figure out where it’s coming from.
I’ve met people who’ve suffered from unrelenting tennis elbow for years, only to find out it was coming from their neck. It’s why all the elbow and arm treatment in the world wasn’t solving their problem. 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. Their pain was coming from their lower back – it just got missed – or was never even considered.
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, Richard Rosedale, et al found that over 40% of people suffering from isolated extremity pain had a spinal source responsible for their symptoms. In other words, the pain they were feeling in their knee 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?
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 44% 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.
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 studies showing this to be true, 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.
Whenever I meet someone with isolated extremity pain, especially if it came 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.
That source could be your spine. And if you’re considering some kind of surgery or procedure, you definitely want to rule this out first. 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 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.
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.
Perhaps you’ve Googled and YouTubed every stretch under the sun but still – you haven’t gained an ounce of mobility.
There are a few reasons why all your stretching efforts might not be doing anything for you. It could be your technique. It could be that you’re doing the wrong stretch. Or, it could be that you just shouldn’t be stretching at all!
Let’s go over the different reasons why your stretching routine could be failing you – and most importantly – what you can do about it.
Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into any stretch you’re doing. If you try to force it or push through pain, you’ll likely tense up.
Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work. Some people (myself included) respond better to “moving stretches.” This is where instead of holding one static position for a prolonged period, you repeatedly move through one or several end-range stretches. Moving neck rolls are a great example of this. If you’ve been diligently stretching and not seeing the results you want, try adjusting your technique. Moving stretches might be a better strategy than static holding. I know for me it is!
This one could be a little tougher to figure out on your own. There is a difference between corrective stretching and stretching to feel good. For example, let’s say your back is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stiffens up your back. Generic back stretches, such as bringing your knees to your chest or child’s pose, may be all you need to quickly get rid of the general stiffness you’re experiencing.
But let’s say you have associated back pain, or pain and numbness running down your leg. In these instances, generic back stretches won’t work or could even make you worse. You likely need corrective stretches, like what we prescribe for patients in our office. Corrective stretches are specifically prescribed to address symptoms, and are very different from the generalized stretches that are designed to feel good and relieve tension.
Did you know that chronic muscle tightness can be a sign of a weakness? This is a very common problem with our clients. I’ve seen many folks over the years with chronic tightness and discomfort in their neck, backs, hips, etc. – and no matter how often they stretch or massage, it doesn’t improve.
How does this happen?
Well, groups of muscles are connected by this substance called fascia. If one group of muscles in the “fascial line” are not doing their job, a different group of muscles will have to take up the slack. When muscles are tasked with more work than they are intended for, they can become tight.
For example, if your deep core is not working properly, then the front of your neck will often kick in and try to help. If your neck is always sore or tight after a good ab workout, this is what could be happening. Stretching your neck won’t help one bit in this case – because what you need to be doing instead is strengthening your core. I see this same pattern with tight hips flexors. Once people start strengthening their core properly – the chronic tightness magically melts away.
Remember, when we are attacking the correct problem and doing the right thing – our body will respond. If you’ve been stretching and stretching and not seeing results – something is missing.
If you’re suffering from any kind of pain or tightness that is keeping you from doing the things you love, our specialists are here to help!
Just CLICK HERE to request a Free Discovery Session!
A few weeks ago, I asked a new client what he had already tried for his back pain. He surprised me by replying with “Vitamin I.”
He could see I was puzzled, so he quickly clarified — Ibuprofen.
It’s the first I’d heard of this term, but is it NOT the first time I’ve heard of people taking Ibuprofen routinely or for prolonged periods. For some it’s because they are in pain already… but for others it’s to prevent pain when they are about to do something they know will hurt.
Ibuprofen is a type of NSAID (non-steroidal anti-inflammatory drug) that is commonly used to reduce inflammation and pain.
Some reasons you might take it are because you’ve had an acute injury such as a sprain or strain, to deal with headaches, because your arthritis flared up, or because you need to bring a fever down.
When you absolutely can’t get control over pain or inflammation naturally (such as with ice, rest, or therapeutic movement) taking Ibuprofen can be helpful.
But when you’re taking it on a regular basis to control and manage pain, or if you find you’re always taking it before certain types of exercise or activity just so you can prevent pain… it’s something to be concerned about.
Long-term use of Ibuprofen has its consequences. Plus, being in pain all the time, or experiencing pain every time you exercise or do a certain activity, is not normal and you should get it checked out.
The consequences are minimal if you’re just grabbing Advil every now and then to ease a headache or take the edge off of a particularly painful back pain episode. You’ll always want to check with your doctor or pharmacist first before taking any type of medication — even one like Ibuprofen that is easily accessible over the counter — but assuming you’ve been cleared, it’s rare that you’ll experience any harmful effects from the occasional dose of “Vitamin I.”
At some point you want to consider what might be causing your pain to keep coming back.
Every time you resort to something like Ibuprofen as a way to control recurring pain, you’re only putting a bandaid on the problem. When it comes to musculoskeletal pain, such as back, knee, hip, shoulder pain or headaches…
Remember that 80% of the time it can be resolved with movement instead of medication.
So consider talking to one of our movement experts who can help you naturally resolve your pain and get you off that “Vitamin I” regimen.
Another common reason people resort to regular use of Ibuprofen is to prevent inflammation or muscle soreness before exercise or vigorous activity. This has become especially common with athletes and weekend warriors.
Research has shown that taking “Vitamin I” ahead of exercise can actually hurt your performance and hinder your recovery. Not to mention the long-term health implications of using Ibuprofen in this manner!
In a study published my Medicine and Science in Sports and Exercise, researchers discovered that when distance runners took 600mg of Ibuprofen before an event, they ended up with more tissue-damaging oxidative stress afterwards compared to those who took nothing, thus debunking the theory that “Vitamin I” can help you avoid inflammation.
In this case it increased!
Another study done on cyclists found that Ibuprofen can damage your gut during exercise and lead to a leaky small intestine.
And finally, scientists have conducted animal research that shows taking “Vitamin I” as a prophylactic for muscle soreness actually hinders your recovery.
If you’re finding yourself constantly in pain or very sore after or during certain types of exercises and activities, you may want to look at how you’re warming up or preparing for these things.
In many cases, corrective movements can help you avoid pain entirely.
But at the very least, they’ll help to reduce any pain you do experience much faster, and you’ll recover more quickly.
And for tissue inflammation, there are great natural alternatives that are safe to consume before a particularly strenuous workout. Tea, tart cherry juice, and turmeric are all considered natural anti-inflammatories that are safe, and don’t come with the harmful side-effects of “Vitamin I.”
While I’m a huge advocate of avoiding pain medication whenever possible, there are times when taking Ibuprofen makes sense. But it should be occasional and minimal and you should always be checking in with your doctor to make sure it’s safe.
But even when your doctor says it’s ok to use right now, know that long-term use of Ibuprofen can damage your digestive system, interfere with your hormones, and increase your risk of heart attacks and stroke.
It’s always best to look for natural ways to ease pain first.
If you want to find the movement that is YOUR medicine, so you can stop using “Vitamin I” as a bandaid…
Request a FREE Discovery Session with one of my specialists.
They’ll talk to you first to make sure you’re even a good fit for what we do… and if so… let you know how we can help!
