Tag Archive for: physical therapist

Avoid Pills. Use Movement as Medicine Instead

Avoid Pills. Use Movement as Medicine Instead

In the 1990’s, it started becoming widely accepted to prescribe opioids for people recovering from surgery or injury, as well as those suffering with moderate-to-severe musculoskeletal pain (such as back pain and osteoarthritis).

Although effective for managing pain, we would soon find out how highly addictive these drugs are. Statistics show that one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. And once addicted, it’s very hard to stop.

The Centers for Disease Control and Prevention (CDC) found in their 2018 Annual Survey Report of Drug-Related Risks and Outcomes that in 2016, more than 11.5 million Americans reported misusing prescription opioids. And despite efforts to curb these statistics, this number started to creep up again during the pandemic.

In response, the medical community established more strict control around the prescription of opioids, and many are avoiding prescribing them all together. For patients with severe back pain and arthritis, for example, injections and minor procedures have become far more common and recommended.

While this approach prevents you from becoming addicted to opioids, there are still inherent risks any time you have an injection or undergo a procedure.

So what’s the alternative?

Prescriptive movement strategies are the alternative. Specialized, custom-fit “exercises” that are designed to have a very specific (and noticeable) effect on your pain.

But what’s the difference between generalized exercises that make you feel good vs prescriptive movements that also make you feel good?

Well, the distinguishing factor is both in:

1) how your pain responds to the movement while you’re doing it, and more importantly

2) how it behaves afterward. Lots of exercises feel good while doing them, but not all exercises give you the long-lasting effect you’re truly looking for.

For example, let’s say you’ve got back pain. Perhaps stretching your back a certain way makes you feel good and temporarily eases your pain, but an hour or two later, or the moment you perform an activity that typically aggravates your back, your pain comes right back. The stretch makes you feel better, but it doesn’t do a good enough job to make you stay better.

Over time, you might find that your back pain comes and goes often, and although this stretch always helps, nothing really takes away your problem completely. Instead, you get stuck in that vicious cycle of stopping all activities every time you hurt your back – or worse – start avoiding certain activities altogether for fear of hurting your back. This is no way to live and it’s not an example of a good prescriptive movement strategy.

So what would a prescriptive movement strategy look like?

Let’s take the same example above – but this time – you find that a particular stretch not only makes your back pain go away in the moment, but it stays gone the more you do it. Plus, fast forward in time, whenever your back pain returns, you can reliably use this stretch to take your back pain away every time. This is an example of a prescriptive movement strategy. You know exactly what to do, how often to do it, when to do it, and it works without fail every time. Plus, once you know what your prescriptive movement is, you can use it to prevent pain as well.

The good news is that 70-80% of all musculoskeletal pain responds to a prescriptive movement strategy. It works in all joints and muscles. You just have to work with someone who knows how to help you find it and then use it over the course of time. I can’t tell you how often I meet people who have the right movement, they just weren’t applying it correctly to get the long-term relief they were looking for.

Too good to be true?

It’s not – I promise. The problem is there’s a lot of mis-information out there and not every health care or fitness professional is trained in discovering the prescriptive movement that you need – or teaching you how to use it properly. The second problem – to be frank – is that hospitals make a lot of money from procedures and surgeries. There’s no real incentive for them to support conservative, natural treatments that you can do on your own at home.

With procedures and surgery, the results are faster, which makes for happier patients (in the short term). But studies show that 2-3 years out from surgery your results are no better or worse than if you were properly prescribed movement as your treatment. And after 10 years, those who’ve managed to avoid surgery for the same problem, actually have much better outcomes than those who went under the knife.

The greatest benefit of taking the time to go slow at first, and find a prescriptive movement strategy that works, is that you’ll have this movement “medicine” at your disposal at all times. It’s always in your “medicine cabinet” and you never need a prescription or pharmacy to refill it.

Hopefully I’ve got you thinking. And encouraged you, at the very least, to explore whether or not movement really can be your medicine. If you’re already tried and failed at this, it’s quite possible you just didn’t have the right approach.

Consider talking to someone from my team if you’re serious about getting help.

We’re trained to help you find YOUR prescriptive movement strategy and are up to date on the latest research.

CLICK HERE to request a Free Discovery Call with my team to see if you’re a good fit for what we do.

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 guide to back pain CLICK HERE or to get in touch, email her at info@cjphysicaltherapy.com.

When You Can’t Feel Your Abs

I’ve been a physical therapist for 20 years, a Pilates instructor for 11, and have been specializing in back pain for the past 10 years of my career.

When it comes to strengthening your core and preventing back pain, I am an expert in my field. Yet for some reason this morning, during my Pilates workout, I just couldn’t feel my abs. I teach people how to do this every single day yet this morning, I couldn’t seem to access my own.

What was happening?

And more importantly – if it can happen to someone like me – it can certainly happen to someone with less training than I have. I started to think about all the reasons this could be happening to me. Had I gotten enough sleep? What had I eaten the day before? Could it be stress?

And then it hit me.

I had just come back from a 2-day course where I’d been sitting far more than usual. I sat for 8 hours straight, two days in a row, not to mention all the very cramped sitting I did on the plane to and from this course. When one of my clients is about to have a few days like this, I recommend they get up from their chair and stretch backwards as frequently as possible every few hours.

But guess what – I didn’t follow any of my own advice. The result? A stiff back and sleepy abs upon my return.

Our bodies are highly intelligent and have every capacity to heal themselves when given the right environment. Conversely, when in the wrong environment, our bodies will also do what it takes to naturally protect from harm and injury. In my case, I came home from this course with a stiff lower back.

Back stiffness is the first sign that your back is not happy, which means your chances of tweaking it or exacerbating an old back injury are higher. When any joint is stiff and not moving well, including the joints/vertebrae in your lower back, the muscles surrounding that joint will become naturally inhibited or weakened. This occurs on purpose as a protection mechanism. Your body doesn’t want a fully contracted muscle compressing an unhappy joint. In the case of your lower back, the muscles that can get inhibited when your back is not happy include your abdominals as well as back muscles.

So what can you do?

The good news is I’ve already helped you with step one: awareness. Inhibited muscles are not the same as weak muscles. In my case, I do have strong abdominals. My weekly routine consists of a regular Pilates practice, lifting weights, and I perform activities like hiking and running that engage my core. Yet despite all this, my abs were simply not having it this particular morning. They were not set up for a successful workout.

The combination of my stiff back and having sat for several days just meant that I needed to do something different to prepare my lower back and abdominals for this workout – so that I wouldn’t injure myself. My sleepy abs and stiff back were, in effect, trying to tell me just that. All I needed to do was have the awareness this was happening so I could take appropriate action.

It’s no different than when you go on vacation and you get off your routine by eating more than usual. You might return a bit bloated and not feeling your best self. This kind of feeling we are accustomed to. And might respond by getting a bit strict with our diets until feeling back on track. Our joints can react similarly to a change in routine – we’re just not as accustomed to the signs and symptoms that let us know. But once you are – you can easily manage this and avoid injury. Had I pushed through my Pilates routine as normal this morning despite sensing that my back and abdominal function was off – there’s a good chance I’d be sitting here writing to you with full on back pain instead of just some lingering stiffness.

If you’re reading this, and you’re over the age of 40, odds are pretty good that you’ve experienced back pain at some point in your life. The odds are also pretty good that you’ve experienced back pain more than once. If this is a recurring pattern for you, your abdominals and deep core may not be functioning at their best and you could be caught in a vicious cycle of trying to improve your core strength only to keep hurting your back.

The missing solution for you might be that nobody has fully examined your back in a way to ensure that it’s moving fully and freely like it should. Once your back moves well, you can usually start to strengthen your abdominals without a problem.

If you’re confused right now – I don’t blame you.

The take home point here is that if you keep experiencing weakness in a particular area despite trying to strengthen it consistently, it’s possible you could have a problem in your joints that is keeping your muscles from fully activating like they should.

Talk to one of my specialists about it.

Someone from my client success team will call you right away and see if you are a good fit for what we do. At the end of the day – we’re here to help.

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 guide to back pain CLICK HERE or to get in touch, email her at info@cjphysicaltherapy.com.

syringe

Shoulder Still Hurting After Your Covid-19 Booster?

Shoulder pain is quite normal after any vaccine.

But prolonged shoulder pain isn’t.

Shoulder injuries related to vaccine administration (otherwise known as “SIRVA”) is a rare, but possible occurrence when you get a vaccine or booster shot. Shoulder injections should enter the deltoid muscle. But SIRVA occurs when a healthcare professional administers the vaccine too high, or too deep into your shoulder.

When not properly administered, your next booster shot could graze your bone or nerve, or even puncture your bursa (a fluid-filled sac that protects your shoulder tendons).

Pain from SIRVA can be really difficult to distinguish from the normal pain that occurs after a shot in your arm. But it’s critical you know what to look for. Because if left untreated, SIRVA can cause prolonged problems in your shoulder over time.

I’ve seen folks end up with entirely preventable rotator cuff tears, bursitis, and tendonitis – all because someone didn’t take their complaints of shoulder pain after getting a Covid shot in their arm seriously enough.

Normal shoulder pain after a Covid vaccine or booster shot:

Mild skin sensitivity and localized shoulder pain is quite normal after a Covid vaccine or booster shot. Some people experience what is now known as “Covid arm” – a mild rash and skin sensitivity that can occur anywhere from a few days to even a week after receiving your shot. You’ll experience skin sensitivity and/or swelling that might look similar to cellulitis.

While annoying, Covid arm is not considered dangerous or threatening.

The symptoms will typically go away after a week or two and in the meantime, talk to your doctor or pharmacist about over the counter or prescription remedies that can address the symptoms of itchiness or swelling.

Localized shoulder pain at the site of your vaccine or booster shot is also normal. The pain you feel is from the mild trauma caused by the needle being inserted into the soft tissue (muscle) of your arm. It often feels like a bruise, and you may experience a little bit of swelling. It will typically go away after 2-3 days. Even though your arm can be quite sore, the important distinction here is that you’ll still have full, normal function of your arm. In other words, despite the soreness, you can still move your arm freely up and down if you had to without restriction.

Your arm soreness will go away with time, but gently massaging the area of pain, and even some easy movement or exercise can help the soreness go away faster.

Abnormal shoulder pain after a Covid vaccine or booster shot:

The symptoms of SIRVA are different, and typically more severe than what I’ve just described above. If not addressed, some of these symptoms could lead to long lasting shoulder problems or compensatory problems elsewhere.

As I’ve already alluded to, one of the main distinctions between “normal” shoulder pain after a vaccination shot and SIRVA is how well your arm functions. If the needle was accidentally inserted into your joint capsule, for example, you will notice limited mobility and possibly limited strength. If unaddressed, symptoms like this can manifest into more serious shoulder problems down the line such as adhesive capsulitis or frozen shoulder.

If the needle was inserted too high or too deeply, and beyond your muscular layer, it could have injured your bursa. This could cause it to become inflamed, turning into shoulder bursitis. Your mobility may or may not be impacted when this happens, but you’ll notice prolonged shoulder pain that doesn’t subside after 2-3 days like it should. Bursitis is actually a really simple injury to treat. But with SIRVA, it’s often dismissed as normal pain after the shot.

When ignored – shoulder bursitis can lead to compensatory movements due to pain – and cause problems later on in places like your neck, shoulder blade or even elbow.

One last common problem we see as a result of SIRVA is rotator cuff tendonitis. Much like bursitis, you may have normal motion in your shoulder, but what you’ll notice with this is again, the pain will persist longer than it should. But unlike bursitis, you’ll also have pain and weakness when you exert force through that tendon – particularly with overhead movements or lifting something with an outstretched arm.

This is also not a complicated injury to rehabilitate, but if not addressed, could turn into a more serious problem such as a rotator cuff tear or chronic tendonosis – conditions that are more difficult to treat.

To recap – your shoulder will hurt after getting a vaccine.

It’s normal. And you may even experience Covid arm. But these symptoms should go away and not remain.

And you should still have normal function of your shoulder, despite the pain.

If you have shoulder pain that persists, and especially if you’re noticing limited mobility, it’s something worth getting checked out. The last thing you want is for these symptoms to go on longer than needed, or turn into compensatory, more complicated problems.

The good news is that even with SIRVA, your shoulder pain can be successfully treated naturally, and without medications or procedures. Don’t let a healthcare professional brush off your concerns and blame your prolonged shoulder pain on your booster shot.

Talk to a musculoskeletal expert who understands this sort of thing and get some help!

CLICK HERE to request a Free Discovery Call with our Client Success Team.

They’ll let you know if we can help – and if you’re a good fit for our services – get you scheduled as soon as possible.

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 info@cjphysicaltherapy.com.

How to Prevent Knee Pain When Hiking

Hiking is a popular way to stay active during the summer months – but it can also wreak havoc on your knees.

Personally, I love to hike. My pup (Bodie) and I are currently in the process of conquering the 48 4K footers of the White Mountains – and the very last thing I want is for knee pain to get in the way of that journey.

The good news is that there is quite a bit you can do to prevent knee pain when hiking. So when one of my readers asked this week – “How do I prevent knee pain when hiking?” – I couldn’t wait to answer it.

Here are 4 of my top tips to help you prevent knee pain when hiking.

 

1. Strengthen your hips and core

Your hips and core provide much needed support for your knee joint to function properly. The large bone in your thigh, called your femur, makes up your knee joint on the bottom, and your hip joint on the top. Your hip joint is connected to your pelvis, which houses major core muscles groups like your glutes.

Let’s say your glutes (part of your core) and hip muscles aren’t as strong as they could be. When you’re trying to climb up a large rock or steep trail, for example, your glutes and hip muscles are supposed to stabilize your pelvis so that your femur can easily extend your hip. When not strong enough, your pelvis will tilt to compensate – which impacts the alignment of your femur – and ultimately the alignment of your knee.

When I hike a 4k footer – I get in approximately 27,000 steps. If your knee is compensating for every one of those steps – it’s eventually going to hurt. If hiking is something you love to do, it’s critical that you strengthen your hips and core.

2. Keep your knees mobile

One of the biggest mistakes I see when it comes to knee problems is a lack of full mobility. Your knee shouldn’t just straighten, it should be able to hyperextend a little bit. When you bend your knee, you should be able to tolerate a full deep squat without any pain. These full end range movements are pretty essential to have when it comes to hiking. Your knee needs to be able to squat, pivot, and tolerate stress on those uneven trails. When you lack full mobility, it impacts your knee’s ability to tolerate these micro-stresses and over time – your knees will ache.

If you’ve got pain or stiffness in your knee in either direction of movement – it’s important to try and push that movement and work through it rather than avoid it – even if your knee seems painful at first. More often than not, the more you move your knee joint, the better it will feel. If that doesn’t happen – then you know it’s time to talk to an expert about it and have them take a closer look at your knee.

3. Work on your balance

Hiking can involve everything from uneven terrain, water crossings, and rock hopping. Good balance is essential for these activities and without it – your knees will suffer.

So how do you work on your balance?

Aside from the obvious (practicing balance exercises), it’s also important to look at a few other things – namely – the mobility of your toes, foot and ankle joints as well as the strength of your arch (plantar fascia). These structures all play a role in how well you’re going to be able to balance. You can do all the balancing exercises in the world, but if you’ve got faulty mobility in your ankle, for example, or a flat, weakened arch – balance is always going to be really difficult for you.

Perform regular stretching of your ankle and calf muscles, Be sure to move those toes – can you lift your big toe up by itself when you’re standing? And use a small ball to regularly massage the arch of your foot to keep it flexible. These small activities can play a huge role in helping you to be able to balance with more ease – especially on the trials.

4. Use Trekking Poles

Even if you implement every single tip I mentioned above, depending on your overall level of fitness, and the condition of your knees prior to when you decided to get into hiking, you could still have some knee pain despite doing “everything right”.

Trekking poles can be a real life saver – or should I say knee-saver.

They help take away some of the stress from your knees and lower legs – especially on really long hikes and technically challenging trails. Plus, if you’re carrying a backpack, trekking poles help to disperse that extra weight away from your knees and into your arms. And added bonus – hiking with poles gives your arms a little extra workout at the same time and keeps your hands and fingers from getting puffy on those extra hot and humid days.

If you love hiking as much as Bodie and I do – then I know the last thing you want is for knee pain to keep you from hiking. I hope these tips help you to ease any knee pain you might currently have as well as prevent future knee pain on the trails.

Do you love to hike but knee pain is currently getting in the way? CLICK HERE to talk to one of our specialists. 

They’ll let you know if we can help – and if you’re a good fit for what we do – they’ll get you on our schedule right away.

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 Free Report CLICK HERE  or to get in touch, email her at info@cjphysicaltherapy.com.

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Nagging pain in your shoulder can be extremely annoying. But when it starts to interfere with things you love to do – you can’t help but wonder – is it time to get a cortisone shot? 

When you’ve got dull, nagging shoulder pain that just won’t go away, cortisone shots suddenly seem very attractive. They’re quick, easy, and seemingly harmless – right? Not so fast. Just because cortisone shots are extremely routine and popular – it doesn’t mean they are the best or right thing to do.

Cortisone shots are typically administered to reduce localized inflammation inside a joint or tendon. In shoulders, it’s very common to use this procedure to reduce pain from arthritis, bursitis, rotator cuff tendonitis, and even frozen shoulders.

When inflammation is confirmed to be the root source of your shoulder problem, and it’s not going away with medication, on its own, or with physical therapy – a cortisone shot may be the right course of action.

But what if inflammation is not the root source of your problem? What if inflammation is actually a secondary symptom?

This is where most of the confusion lies in the medical community. While it might not seem like a big deal (pain is pain, right?) – it’s a problem if you keep getting cortisone shots when you don’t actually need them.

Why?

Well overuse of cortisone shots can cause degeneration of your tendons and joint structures. So you only want to get one when you know: 1) it’s going to help and 2) if it’s necessary.

But how do you know? The key is in understanding the source of your pain. With chemical sources of pain, the source is inflammation and a cortisone shot is a good idea. But when it comes to mechanical pain, inflammation may exist but it’s not the source of your shoulder problem. In these cases, cortisone is either not helpful – or worse – it “works” but then masks your problem, sometimes for years.  

Let’s talk about the two sources of pain to help you understand.

“Chemical Pain”

Chemical pain is the result of your body’s natural inflammatory response to injury. It’s a complex chemical reaction that occurs after tissue damage that involves the releasing of chemicals from your blood and other cells to “flush out” the area and start the healing process.

A good example of this is when you fall and sprain something. The sprain causes temporary tissue damage so your body creates inflammation to heal it. Normally this process only lasts a few days, your pain subsides, and you’re back to normal in no time. But sometimes this inflammatory process lingers longer than it should.

For various reasons the accumulation of toxic chemicals sticks around and the result is constant irritation to the nerves and surrounding tissues. Constant, dull pain, even at rest, that tends to be very sensitive to any and all movement is often a tell-tale sign that you’re dealing with pain that is chemical in nature. In this case, a cortisone injection could be a good course of action for you.

“Mechanical Pain”

Mechanical pain does not need a cortisone shot and it won’t respond well to it. The hallmark sign of mechanical pain is that your pain will come and go based on certain activities, movements, or positions. It’s not constant and throbbing like with chemical pain. Eighty percent of all musculoskeletal problems – including shoulder pain – are mechanical in nature.

Now, the real problem is that whether or not your pain is mechanical, a cortisone shot often does take away your pain. Not only is this confusing – but many people question why they should even be concerned about this. Well – when the pain and inflammation you’re experiencing is secondary – which is often the case with mechanical pain – you never actually treat the true source of your pain when you “cover it up” with a cortisone shot.

For example, you might have an irritated rotator cuff tendon or arthritis that is exacerbated because of poor posture or immobility in your shoulder joint. If you inject cortisone into your tendon or joint, the pain will likely be relieved, but it will be temporary. It’s only a matter of time before your poor posture and movement habits cause irritation and pain again. This is the vicious cycle I see a lot of folks get themselves into. You risk never fixing the real problem, and irreversible damage to your tendon that might eventually need to be fixed surgically. 

Moral of this story… don’t rush to get a cortisone shot just because you’ve been told you have inflammation.

You must figure out the source of your inflammation first. Cortisone shots are not necessary if your pain is mechanical in nature, and might actually prolong your problem. If your pain comes and goes, or you have good days and bad days, this is a classic sign that your pain is likely coming from a mechanical source.

Your best course of action is to work with someone who understands and specializes in this. I’ve seen many cases where getting a cortisone shot provides a false sense of hope, and as a consequence, delays quality treatment that you should be getting instead. 

Are you local to Portsmouth, NH?

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. To get in touch email her at info@cjphysicaltherapy.com or call 603-605-0402

Neck Pain

Tech neck: What it is and How to Cure it

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 back pain – click here.

Traveling

4 Tips to Avoid Neck and Back Pain When Traveling

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

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.

Common Golf Injuries and How to Avoid Them

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.

Avoiding Radiofrequency Ablation in Your Back – Success Story

Have you heard of Radiofrequency ablation (RFA)?

If you suffer from chronic back pain – there’s a good chance you have. Perhaps it’s even been recommended to you?

It’s a common procedure used to disable nerve fibers that are carrying the pain signal to your brain.

Your brain is what decides whether or not you’re going to experience pain. So the goal behind this procedure is to kill (or in this case burn) the “middle man” – the nerve that is responsible for signaling the pain trigger. An electrical impulse is transmitted through a needle that is designed to burn the nerve endings responsible for your pain.

If it works – the results last anywhere from 6 months to a year – but they typically aren’t permanent.

Most of the people I talk to who rely on this for pain relief have to go back at least once per year or more.

But in some cases… the procedure eventually stops working all together…

And then what?

Well… you’ve usually got just two choices…

  1. Live with it
  2. Get surgery

The good news?

You don’t have to accept either of these options and you don’t even have to rely on this procedure at all if you don’t want to.

How do I know?

Because 80% of all spinal pain is mechanical in nature – which means it’s due to poor or insufficient movement habits. These habits – over time – result in compensatory strategies in your body. These compensatory strategies eventually lead to “pissed-off” muscles, ligaments, or nerves – which result in pain.

So you see…

Getting a procedure like RFA is really only a bandaid.

Why not find out what compensatory strategy might be happening in your body – and from there – what caused it to begin with?

That’s what we prefer to do and I’m excited to tell you about a recent success story where this actually happened…

I was re-evaluating one of our patients (“L”) this week and even though she is still working through some back pain – it’s nothing like when we first began working together.

When we first met – she couldn’t walk very far without back pain and she didn’t even think about getting on a bike. (Biking, hiking, and staying active are things she LOVES to do for herself and with her husband)

When we spoke this week – she was not only walking – but starting to do some trail walking – and she was using her bike trainer at home regularly – all with minimal or no back pain. The next step for her is to get on the road with her bike – we have a goal of her riding 30-50 miles!

I am confident we’ll get there 🙂

But the most important part of this ongoing success story that I want to share is this…

“L” told me that the most valuable accomplishment from working with us so far is that she hasn’t had to return for any RFA!

I almost cried when I heard this… not even remotely exaggerating…

Because not everyone has the courage to see a program through and trust in the process.

But “L” did – and I’m so proud of her for it.

She said one of her goals was to not need this procedure anymore…

I’m excited to say that as of today – she’s officially far past the point when she would normally have returned for her RFA procedure.

And it’s because of our program!

The biggest motivator behind everything I do – every email or article I write – is to empower you.

My mission behind CJPT & Pilates is empowerment by education.

We aim to give you all the information you need so you can make the best decisions for your health – and hopefully those decisions involve less pills, less procedures, and certainly not surgery 🙂

I wanted to share this story with you because it is a perfect example of just that.

Yes – “L” still has back pain – but it’s progressing and we’re working through it – but on her terms and not on the procedure/RFA’s terms.

If you want more details on how we helped “L” work through her chronic back pain and avoid procedures like RFA…

CLICK HERE to talk to someone on my Client Success Team to see if we are a good fit to help you avoid RFA.

Ready to get rid of your back pain? Lucky for you we have a totally FREE guide written by leading back pain specialist, physical therapist, and movement expert, Dr. Carrie Jose! CLICK HERE  to read her BEST tips and advice on how to start easing back pain and stiffness right away!