Tag Archive for: pilates

pain

Shoulder Impingement Syndrome – Treating the cause over symptoms

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If you’ve ever had pain in your shoulders when you try to raise your arms overhead, pull off a sweatshirt, grab a gallon of milk from the fridge, or place grocery bags on the counter – you were likely dealing with shoulder impingement syndrome – also known as rotator cuff impingement.

They call it impingement syndrome because your rotator cuff tendons literally get “impinged” between the round head of your shoulder joint and a hook-shaped bone in the front of your shoulder joint (called the acromion) that is part of your shoulder blade. This can occur for a number of reasons… You could have a deformity that causes this, an injury could lead to this, arthritis could contribute to this, or poor posture can cause it.

Any of these scenarios can cause crowding in the space where your rotator cuff tendon passes in front of your shoulder – and if this happens often enough – it’s going to get irritated every time you raise your arm past 90 degrees.

When this first begins to happen, it will typically cause acute inflammation, and you may be diagnosed with rotator cuff tendonitis. But eventually, the more constant pain and irritation of tendonitis subsides and you only feel pain when you go to raise your arm or reach in certain directions. This is more commonly known as shoulder impingement.
With the exception of a deformity, almost all cases of shoulder impingement can (and should) be resolved naturally. The tempting and easy fix is to get a cortisone shot to calm the inflammation. But what you need to understand is that impingement syndrome – in most cases – is actually the symptom of a more overarching problem. And injecting the tendon with cortisone will often cause more harm than good. While the cortisone will temporarily mask your problem, it will eventually cause damage to your tendon if you keep getting injections.

Remember, impingement is caused by crowding of the space where your tendon passes through. You can temporarily take the inflammation away and it will feel better – but unless you address the reason for the crowded space – your problem will keep coming back.

So how do you naturally get rid of shoulder impingement for the long term?

First, you must address the reason for the crowded space in your shoulder joint where your tendon passes through. Most often – it’s due to poor postural habits and immobility around your shoulder joint – specifically your neck and upper back. For example, if your upper back is stiff, curved, and lacks adequate mobility – it’s going to impact how your shoulder blades move and are positioned. With a stiff and curved upper back, your shoulder blades will respond by moving out and up. This scenario makes that hook-like bone (the acromion) sit more forward and down than it should. When this happens, there isn’t enough room for your tendon when you lift your arm above shoulder height. The bony surfaces above and below your tendon create friction and this eventually turns into pain and inflammation. This can happen slowly over time – or more quickly if you’ve got something like arthritis where that space might have naturally already narrowed. Another common scenario is after a shoulder injury. Your neck and upper back may have learned to compensate for a time while you were healing from your injury – and the result is some unwanted postural deformities that can lead to impingement of your rotator cuff tendon.

When it comes to shoulder pain, always make sure to examine your neck and upper back first.

If there are poor postural habits there, your shoulder will undoubtedly be impacted. If you really want to get rid of your shoulder impingement – and back to lifting, reaching, and carrying things without any worry – it’s essential that you identify and address the root cause, not just the symptoms (inflammation of the tendon). Next time you go to the doctor complaining of shoulder pain – and you hear the words “impingement syndrome” or “rotator cuff tendonitis” – don’t assume you need rest, ice, a cortisone shot, or surgery to resolve it. None of these solutions will give you the long-term solution you’re looking for. The very last thing you want to do is choose passive treatment interventions that either mask the pain or prolong the problem because they only address symptoms. You want to do everything possible to preserve the integrity of your tendon – and the best way to do that is by optimizing the mobility and strength around your shoulder joint first – before resorting to more aggressive measures like cortisone or surgery.

Ready to get help with your pain or injury?

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

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

Senior Man Suffering From Back Pain Whilst Gardening

5 Tips to Avoid Back Pain While Gardening

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Gardening has so many health benefits and it’s an activity many people fall in love with. It gets you outdoors in the fresh air, exposes you to vitamin D, it’s meditative, helps to improve hand-eye coordination, and it’s great exercise. But one thing it’s not always great for is your back. If you love gardening – but cringing about what it might do to your back this Spring – keep reading.

Here are 5 tips to avoid back pain while gardening:

 

1. Avoid bending from the waist

A common gardening posture I see is folks standing with straight or slightly bent knees and bending over from their waist – creating an “L-shape” with their body. While this posture is acceptable to do from time to time – it’s not a good idea to do this over and over again while gardening. This particular posture puts a lot of strain on your lower back as well as the backs of your knees. Over time, your lower back muscles will become very sore and tight, which can make them susceptible to injury when you least expect it. What to do instead? Get in the habit of squatting and bending from your knees. If you must do a particular gardening activity for a sustained period – try being on all-fours – and switch your hands periodically. These positions are much better for your back and you’ll be able to sustain the activity for much longer.

2. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back still needs a break. Our spines do not enjoy being bent forward for prolonged periods and when you do this for too long without taking a break – it puts a lot of stress on the vertebral discs in your spine and makes them more likely to bulge. I recommend setting a timer and giving yourself a break every 30 min. Simply stand up and get out of the bent over posture. Your back will thank you and you’ll be able to garden for much longer without risk of injuring your spine.

3. Pivot instead of twist

One of the most vulnerable positions for your back is the combination of bending and rotating. And when done repetitively, you’re almost guaranteed an injury to your spine. When you’re doing things like digging or planting – activities that have you bending and twisting – you want to pivot instead. Keep your body in line with the activity you’re doing. Don’t rotate or twist from your waist. How do you do this? Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and always move them as a unit. While it’s ok to bend and twist from your waist on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you have a history of back pain episodes happening to you in the past.

4. Use gardening tools wisely

Gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench. This will make it easier to sustain activities that require prolonged bending or kneeling. Lastly, use tools with longer handles to help avoid crouched over postures. If you can maintain a more upright posture while gardening, you’ll be able to tolerate it longer and with less back pain. 

5. Raise your gardens

Let’s face it, gardening involves bending over and lots of it. Activities like this are just not good for your back when done over and over. Consider modifying your garden to include more raised boxes and beds. This is going to make it so much easier to tend to your plants without having to bend over so much. And when you need to create a work surface – make sure that is raised too. Bending forward isn’t “bad” for your spine – but when you bend all the time without giving your back a break – you’re asking for trouble. Modifying your garden to make it more ergonomic can make a huge difference in the health of your spine.

Gardening has so many positive benefits – and the last thing I want is for back pain to be the thing that stops you from doing something you love. Hopefully these tips give you some important things to consider – and more importantly – help you look at gardening as something enjoyable again versus something you dread because of your back.

Do you have nagging back pain that gets in the way of your everyday activities? Request to talk 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. 

morning neck pain

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

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

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

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

     1. You’re not using your abs. 

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

Here’s what happens. 

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

    2. Your neck is in the wrong position. 

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

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

     3. You have an underlying neck problem. 

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

Let me explain.

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

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

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

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

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

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

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

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

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

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

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

5 Signs Your Core is Weak – And What You Should Do About It!

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A strong, healthy core is important for our health and posture. When your core is strong and working properly, you will have less back pain, better posture, and will move with more ease and endurance.  But how do you know if your core strength is where it needs to be? 

Here are five signs that might indicate your core is weak and what you can do about it:

1. Your Back Hurts

The most common side effect of a weak core is back pain. Your core’s job is to support your spine and act as the center from which all movement stems. If those muscles are not properly conditioned – meaning, if they aren’t conditioned to engage when they are supposed to – your spine is at risk for being overworked and muscular strain and tension is inevitable. 

What can you do? When it comes to back pain, it’s really important that you talk to an expert about how to properly strengthen your core. Don’t go at it haphazardly. A lot of people jump to core strengthening to fix their back pain when there are other things that need to be addressed first. Without proper guidance, you could make your back worse doing the very thing that is meant to help you.

2. You Have Poor Balance

Believe it or not, it’s not just your feet and ankles that help you balance. Your core strength plays a huge role in this as well. Your core muscles surround your pelvis and help to stabilize it – if those muscles are weak – particularly your hips and glutes – your balance will undoubtedly be affected. 

What can you do? Work your core in a functional manner. If you’re already practicing balance exercises, don’t just hope for sheer luck. Actively focus on the connection between your foot and your deep core. You’ll be surprised at what this visualization will do for both your balance and core activation. If you struggle with this – then it’s a good idea to work with an expert who can help you.

3. You slouch all the time

If you’re struggling to maintain good posture – you might have a weak core. Observe your posture right now. Are your shoulders rolled forward? Is your low back missing its natural curve? Is your head poked forward? When you go to correct your posture – does it feel difficult or tiresome to maintain? If so, your core might need some endurance-training.  

What can you do? This is a situation where consistent core training will carry over into your sitting posture. Your postural stabilizers are what allow you to sustain prolonged sitting and standing postures. The more accustomed they are to being activated and working – the more likely they will naturally kick in when you’re standing and sitting. Over time, it will become easier to maintain good posture and with a lot less effort.

4. Your feet and wrists hurt

When you have a weak core – and lack the proper central support and stability you need – your outer muscles and joints will eventually suffer. We already talked about balance. If your core isn’t working to help you stay more stable, your feet will have to work harder, resulting in overtaxing of the tissue on the bottom of your foot. If your middle back can’t support you when you’re pushing or pulling, your wrists will take the brunt and this can result in stiffness or pain over time. If you’ve got any chronic problem that isn’t getting resolved over time, something is missing. In the case of your wrists and feet – it could be a weak or underfunctioning core.

What can you do? If you’ve been trying to resolve your foot or wrist pain for a while and aren’t getting the results you hoped for – consider shifting your focus to deep core training. I’m not talking sit-ups and crunches, I’m talking about deep stability training that is going to result in a better balanced body – where your wrists, core, and feet are all connected and working together. Something like Pilates can help you achieve this – provided you’re working with a highly skilled instructor. Pilates is specifically designed to strengthen your core in a way that emphasizes full body strength.

5. You’re always holding your breath 

If you’re always being reminded to breathe when you move or exercise, it’s a sign your core might not be working properly. Your deep core is made up in part by your diaphragm, which is your main breathing muscle.  When your core lacks stability, or in most cases, doesn’t know how to engage in the right way, your diaphragm will contract to compensate.  One of the most tell-tale signs that this is happening is that you always hold your breath during exercise. 

What can you do? I always say – when in doubt – just breathe. If you’re breathing through every movement then your diaphragm can’t stay contracted. Start here. If you notice that other things start to get tight and uncomfortable as a result – namely your hips and your neck – then it means you’re now using those muscles instead of your diaphragm to compensate for your weak core. In that case – consider getting expert help because these movement patterns are hard to break on your own. 

If any of these signs sound familiar to you, then you might want to start paying more attention to your core strength!

There’s so much more to a strong core than 6-pack abs and the ability to hold a plank for days. Pay attention to the more subtle signs I’ve just outlined for you. If you’re noticing one or more – it could be a sign that your core needs some extra love and attention – and the you need to learn how to strengthen it properly. 

Are you local to Portsmouth, NH? 

Check out our Pilates offerings and other services here. We have specialists who may be able to help you strengthen your core properly – from the inside out.

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

Why Pilates?

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Why Pilates?

If you’ve ever experienced muscle and/or skeletal pain, it was probably the result of one or more mechanical stressors occurring in joints or muscles. When I treat a patient, I am often working to help them change the mechanics of their movement and therefore decrease or eliminate those stressors. It’s one of the main reasons why I incorporate Pilates into my treatments. It’s also why most of my patients will tell you that it is often difficult to tell where physical therapy leaves off and fitness exercises begin — which is precisely the way it should be.

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

Each exercise is carefully designed to direct and reinforce the way in which a healthy musculoskeletal system should function. By practicing Pilates, you are strengthening your muscles correctly in a way that is conducive to all forms of exercise, as well as improving posture and balance. It’s a really great supplement to physical therapy because as you’re retraining or rehabilitating a specific part of your body, you have the opportunity to match that progress holistically.

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

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

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

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

man getting back pain treatment

5 Reasons Exercise is Hurting your Back

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5 Reasons Exercise is Hurting Your Back

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.

Why would exercise hurt your back when the research overwhelmingly shows that it’s supposed to help? 

Here are 5 reasons why…

1. It’s the wrong type of exercise

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.

2. Stability training is introduced too soon

 

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.

3. You aren’t activating your core

 

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.

4. You aren’t breathing properly

 

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.

5. You’re using improper form

 

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. 

5 benefits of adding pilates to your fitness routine

5 Benefits of Adding Pilates to Your Fitness Routine

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5 Benefits of Adding Pilates to Your Fitness Routine 

Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method.

If you didn’t already know – it was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates or enjoy the benefits. It has become increasingly popular for the over 50 crowd – and for good reason…

Unlike what’s often touted in the media, the benefits of a regular Pilates practice go way beyond a lean beach body and 6-pack abs.

For Mr. Pilates, his method was created out of a quest to improve his overall health in a holistic way that went beyond what could be achieved with traditional strength-training methods. He suffered from various health ailments – and thanks to his incessant curiosity and fascination of the human body and what it was capable of – he eventually came up with his transformational method of total body conditioning.

Personally, I’ve been incorporating Pilates into my own work as a physical therapist for over 10 years, and I practice Pilates myself weekly. I love and believe in it so much that I’ve designed my entire business model around it!

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength.

The better you can understand and connect to your body, the easier it is to prevent injury and push your body to limits you otherwise may not have thought possible.

Here are 5 Benefits of Adding Pilates to Your Fitness Routine – and why you should consider adding a regular Pilates practice to YOUR fitness routine as well…

 

1. Pilates helps with back pain.

Once you hit 40, your risk of back injury starts to climb, and a regular practice of Pilates is a safe and sustainable way to help keep your back pain-free and strong. Pilates focuses on core strength but is also a well-balanced exercise system. Full body strength and balance is a critical component for life-long back health – something that isn’t always addressed in traditional back pain rehabilitation programs or strength-training regimens. We even have specific Pilates classes geared towards people with back pain!

2. Pilates strengthens your whole body – not just your core.

Pilates is known as the staple of core training – but it doesn’t just stop there. Pilates strengthens your arms, glutes, hips, and legs in a way that helps them to not only be strong – but work together in a balanced and coordinated fashion. I call this “balanced strength” – and it’s one of the keys to truly enhancing your fitness and performance levels.

3. Pilates improves your flexibility and mobility.

People use these terms synonymously but they are actually quite different. Flexibility refers to muscle length and pliability. Mobility refers to joint range of motion. Flexibility without mobility is useless – and you need a balance of strength and flexibility to optimize mobility. In other words – a balanced joint – one that is strong and flexible – allows the joint to move fully and freely – which optimizes its mobility. Pilates emphasizes continuous, slow, and precise movements through a large range of mobility. This allows you to work on both strength and flexibility simultaneously – and thus – your mobility as well.

4. Pilates puts minimal stress on your joints.

Aging is a real thing and along with it comes arthritis. The key to combating arthritis is optimizing the area around the affected joint or joints. When you have good mobility, and balanced strength, you have less compressive forces on your joints. Arthritis doesn’t like compressed, crowded joints. So when you strengthen and stretch your whole body in a good, balanced way – arthritis becomes less painful and stiff. Pilates helps with all this while not causing any added stress on your joints in the meantime.

5. Pilates trains your nervous system.

Your nervous system is responsible for conducting messages from your brain to your muscles. If that’s not in-tune – you could develop compensations and inefficient movement patterns that eventually lead to pain and injury. Pilates emphasizes precise and coordinated movements, which enhances and reinforces this brain to muscle connection. You can’t just go through the motions when you do Pilates. You have to use your brain and really concentrate on what you’re doing. This helps to train your nervous system – resulting in smoother, more coordinated movements – and better balance as well.

Are you interested in learning more about pilates and seeing if it’s a good fit for you?

CLICK HERE to check out our in studio pilates offerings!

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

Man getting knee pain treatment

Is Your Knee Problem Really a Problem? How to tell.

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Is Your Knee Problem Really a Problem? How to tell.

Knee pain is the second most common musculoskeletal complaint after back pain. Studies say that 1 in 4 adults now suffer from chronic knee pain, and the number of swollen and stiff knees has risen 65 percent in the past four decades. But just because you have knee pain – doesn’t mean you have a knee “problem”. Knee pain can be tricky to figure out – especially if it’s chronic. Over the course of my career, I’ve seen so many cases of chronic knee pain that weren’t getting resolved because the real problem was coming from someone’s back or ankle. One of the most important factors in successfully resolving knee pain for good is correctly identifying its source.

So how do you know if your knee problem is really a knee problem?

First – pay attention to how and when your knee pain started. If you’ve had a fall or some kind of trauma directly to your knee, and you experience knee pain or swelling shortly after, odds are pretty good you have an isolated knee problem. People who perform regular, intense activities like soccer, hiking, skiing, football, and basketball are much more at risk for an isolated knee injury. Typically, you’ll know exactly when and how you hurt your knee. You may even recall a specific pop or strain of some kind.

Osteoarthritis (OA) of the knee is another example of a knee problem that could really be a knee problem. However, this one is tricky because if you’re over the age of 50, you most likely have OA in your knee, and it will show up on your X-ray whether you have knee pain or not. So what commonly happens is that if you’ve had knee pain for a while, and you get an X-ray that shows you have OA, the OA will get blamed for your knee pain. So yes – knee OA can be an isolated knee problem – but knee OA tends to be an over-diagnosed source of knee problems.

So what are the clues that tell you your knee problem might not be a knee problem?

One of the biggest clues that you’ve missed the correct source of your knee pain is that it doesn’t go away no matter what you’ve tried, or it keeps coming back.

This is the biggest complication I see with folks suffering from long-lasting knee pain.  They’ve iced it, taken pain medication, foam rolled, stretched, and strengthened – but their knee pain doesn’t get resolved.  And once your problem becomes chronic, knee doctors start to get involved.  This is great if you’ve actually got a knee problem. But if your knee pain is a symptom of something else, then you risk getting recommended unnecessary knee surgeries or procedures.

I spoke to a woman the other day who had surgery on her knee to clean out some cartilage and wear and tear from arthritis. It was supposed to be a “quick recovery” and take her pain away. Well, three months later, her knee is feeling worse than pre-surgery. And to fix the new pain she has, they tell her she will need even more procedures. Her initial problem wasn’t coming from knee OA – it was coming from something else. And now she’s going to have even more problems because she had surgery she never needed.

How does something like this happen?

The biggest reason is because of the over-reliance on imaging to form a diagnosis and treatment plan. If you’re over 50, and you get an X-ray or MRI taken of your knees, there is a 60-80% chance they’ll find arthritis or meniscus (cartilage) tears, whether you have knee pain or not. That’s because these are normal changes that occur as you age.

So if you’ve got knee pain, and your doctor wants to do some imaging, there is a very good chance they’ll find one or more of these changes in your knee – and then blame your knee pain on it. But here’s the thing – and research backs this up – there is no way to tell for certain from a picture of your knee where the true cause of your pain is coming from. The only way to tell if what you see in the imaging is actually the cause of your pain is with proper movement testing. If you don’t do that, you risk getting an unnecessary procedure when the real problem might be coming from somewhere else.

In conclusion…

If your knee pain seems to come on slowly or out of nowhere, if you have trouble pinpointing exactly where the pain is, if it moves around and changes from day to day, or if it runs up or down your leg – there is a good chance your knee pain is a symptom of a mechanical problem elsewhere – typically your back or your ankle.

Before you think about getting images of your knee, or undergoing some kind of surgery or procedure, you’ll want to make sure you get a thorough screen by a mechanical pain expert. Never rely on imaging to tell you the full story.

Remember that knee problems can be resolved 80% of the time without procedures or surgery. You just have to have some patience and make sure you’re working with someone who understands mechanical pain and the importance of looking at the whole body – beyond just where the pain is.

Are you looking for help with knee pain now?

Sign up for a discovery visit with one of my specialists to see if we would be a good fit to help you! 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. 

Holding Knee with Arthritis

3 Tips to Protect Your Knees as you Age

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3 Tips to Protect Your Knees as you Age

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

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

 

  1. Strengthen your Hips and Core

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

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

  1. Mobility before Stability

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

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

  1. Work on your balance

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

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

So – let’s summarize…

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

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

Ready to get help with your pain?

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

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

 

 

plantar fasciitis

Your Pain’s Location May Not Be Its Source

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Your Pain’s Location May Not Be Its Source

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. 

For example,

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?

As already mentioned, the most common place for this to happen is with extremities.

If you’ve got shoulder, elbow, or knee pain, and you don’t recall having a specific injury to it, you must consider that it could be coming from your spine. There’s a 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. 

If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source.

That source could be your spine. And if you’re considering some kind of surgery or procedure, you definitely want to rule 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.

Ready to get help with your pain?

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

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