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Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

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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 – Will a Cortisone Shot Help Your Nagging Shoulder Pain?

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 Shoulder 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 shoulder 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 this will only 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 it 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.

If you can’t wait for the call  – get our free guide to neck and shoulder pain now. 

This totally free guide – written by leading back pain specialist, physical therapist, and movement expert, Dr. Carrie Jose – reveals seven easy ways (plus a bonus section!) that are PROVEN to help you ease neck and shoulder pain quickly – without pain medication, procedures, or surgery.

Click here to download the guide!

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] or call 603-605-0402

Shoulder Pain

Neck Pain Not Going Away? 3 Reasons Why

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Over 30% of people report they have neck pain, and of those, 50% will continue to have problems without any real answers or solutions. The last 2 years of the pandemic saw people becoming generally less active, falling off their routines, and working from home in less than optimal “work stations”. It’s no surprise that people are suffering from more neck pain than usual.

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

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

While there are several reasons for your neck pain not going away – the biggest culprit I have found is inaccurate diagnosis. Without an accurate diagnosis – your neck pain treatment fails – and it’s more likely you’ll be prescribed injections or pills to relieve your neck pain and get stuck with this treatment regimen for the long-term.

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

 

1. Your neck problem is disguised as shoulder pain:

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

2. Your core is weak:

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

3. Not working with an expert:

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

Generally speaking – if you’ve been suffering from neck pain for a while now – and despite trying lots of different treatments you’re still having problems – there’s a really good chance you’ve got the wrong treatment approach because you’ve been misdiagnosed. Don’t settle for relying on pills or injections for the rest of your life. And don’t undergo any kind of surgery or procedure until you’ve truly exhausted all possible causes of your neck pain. Ideally, find a neck pain expert and work with them, particularly one who prioritizes natural, movement-based solutions over pills and procedures. If diagnosed properly, it’s not only possible to get rid of your neck pain naturally, but learn to keep it gone all on your own.

 

Ready to get rid of your neck pain?

Check out this totally free guide on 7 Easy Ways to Get rid of Neck & Shoulder Pain to learn easy tips that are PROVEN to help your neck and shoulder pain – without pills, procedure, or surgery. CLICK HERE to get the free guide.

 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.

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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.

Common Pickleball Injuries and what to do

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

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

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

 

1. Rotator cuff strains

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

2. “Pickleball” elbow

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

3. Ankle sprains

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

4. Achilles tendonitis

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

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

Ready to get help with your pain or injury?

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

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

 

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Shoulder Injuries after Vaccination? What to look for

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Shoulder injuries related to vaccine administration (otherwise known as “SIRVA”) is a rare, but possible occurrence when you get any vaccine.

SIRVA happens when a vaccine is injected into the capsule of your shoulder joint instead of your deltoid muscle. It can also occur if the needle being used is not the correct length for you, or if it’s administered too high or too deeply into your muscle. SIRVA is essentially a shoulder injury that occurs due to an improperly administered vaccine – not from the vaccine itself.

Now, it should be noted that this condition is very rare. However, due to the sheer volume of vaccines being administered right now – we have seen a slight uptick in unresolved shoulder problems here in our office. Anywhere from weeks to months after vaccination. For most, the shoulder pain is very mild and it goes away on its own. But for a select few, their shoulder pain has persisted and manifested into a more severe problem. This could be a sign you have SIRVA.

Since the signs and symptoms don’t show up right away, I thought it would be helpful to go over with you what is considered “normal” versus not normal shoulder pain after you get a vaccine.

You’ve likely heard of the “Moderna arm” by now. This is a mild skin irritation specifically related to the Moderna vaccine for COVID-19 that typically involves a mild rash and skin sensitivity after your second shot. It usually lasts about 3-5 days and can be easily treated with topical anti-inflammatories. Moderna arm is not considered to be anything serious, and although it’s not normal to experience this after most traditional vaccines, it is considered a common reaction to the Moderna vaccine. If you’ve recently had your second Moderna shot and are experiencing what you think could be Moderna arm, speak with your doctor or dermatologist if symptoms continue to persist past 5 days, just to make sure there isn’t something else going on.

Localized shoulder pain at the site of your vaccine injection is also normal.

We see this with any type of injection or vaccine into your arm, not just with Covid vaccines. 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 a little faster. 

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. As I alluded to above, one of the main distinctions between “normal” shoulder pain after vaccination 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. When left 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, you can end up with shoulder bursitis, which means the needle was inserted beyond your muscular layer and directly into the bursa (a cushiony fluid-filled sack), causing it to become inflamed. Your mobility may or may not be impacted when this happens, but what you’ll notice is that your shoulder pain will take a lot longer than 2-3 days to subside. Bursitis is actually a really simple injury to treat, but where I see most things go wrong is that you can end up with compensatory problems in places like your neck, shoulder blade or elbow the longer it is allowed to persist.

The last thing you might see from an improperly injected needle is rotator cuff tendonitis. What you’ll notice with this is that you’ll likely have full mobility in your shoulder, but it will be very painful and weak to exert force in your arm.  Much like bursitis, this is not a complicated injury to rehabilitate, but if not rehabilitated properly, it leads to other problems that do become more difficult to treat down the line.

So to summarize, your shoulder WILL hurt after getting a vaccine.

And with the Moderna vaccine in particular, you may notice some skin sensitivity, mild swelling, and even a rash.

But these symptoms should go away after a few days.

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, long lasting problems. The good news is that even with SIRVA, these problems and symptoms can be successfully treated naturally, and without medications or procedures. We’ve been successfully helping people right here in our office. If you’re worried about a potential shoulder problem after the vaccine and not sure where to turn – reach out. You can schedule a FREE Discovery Session with one of our specialists right here!

 

Is Shoulder Pain “Impinging” on Your Lifestyle?

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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…” otherwise known as “rotator cuff impingement” or “rotator cuff tendonitis.”

They call it “impingement” because your rotator cuff tendons get pinched between the round head of your shoulder bone and a hook-shaped bone in your shoulder blade called the acromion.

The pinching tends to happens every time you raise your arm above ninety degrees. After a while, the pinching eventually irritates your tendon, resulting in pain and inflammation. These symptoms are exacerbated and pronounced with any arm movements above shoulder height. Most of the time, the root cause of this problem has been there for a long time, but it’s only just now manifesting itself as pain — and this so-called “impingement syndrome.”

So what causes your rotator cuff tendon to get pinched or impinged in the first place?

Most of the time, the answer is POSTURE.

If your upper back is stiff, curved, and lacks adequate mobility, it’s going to impact how your shoulder blades move and position themselves. 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 more down than it should. When this happens, there isn’t enough room for your tendon when you lift your arms above shoulder height. The bony surfaces above and below your tendon create friction, and this eventually turns into pain and inflammation.

The tempting and easy “fix” is to get a cortisone shot or attack the inflammation more conservatively with ice and topical anti-inflammatory agents.

But what you need to understand is that in most cases, “impingement syndrome” is actually the SYMPTOM. The root cause is usually coming from immobility and poor movement patterns in the upper back or neck. If you really want to get rid of your shoulder pain, get back to lifting and carrying things without any worry, and have full and free mobility of your arms, it’s essential that you identify and address the root cause and not just the symptoms. Since there is an 80% chance your shoulder pain is a mechanical or movement problem — the best people to examine and address this FIRST are movement experts like us.

So moral of the story… 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 a cortisone shot or surgery to fix it.

Neither of these solutions will likely give you the long-term solution you’re looking for. The very last thing you want to do is get some kind of procedure or surgery that either masks the pain or corrects the wrong problem. You want to do everything possible to preserve the integrity of your tendon, and the best way to do that is by optimizing mobility and using natural movement and strength training prescribed by movement experts.

Interested in seeing if physical therapy could resolve your shoulder pain? Try a FREE Discovery Session on us. This is a chance for you to speak with one of our specialists, tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

5 Ways to Save your Back While Stuck at Home

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Staying at home during the coronavirus pandemic doesn’t have to mean staying stationary. If you already have occasional or chronic back pain, it’s so important to take extra care of your spine during this time! Even people who rarely experience back pain may see new flare-ups due to increased time spent sitting at home.

For many, work stations at home are not ergonomically ideal or perhaps even nonexistent. On top of that, social-distancing and closed fitness facilities are likely to reduce our overall level of activity and mobility throughout the day. Combined, prolonged, poor posture and reduced mobility are the main ingredients for increasing back and neck pain. But have no fear! There are still many ways to prevent your back pain from kicking up, even while stuck at home!

1. Stand Up & Take a Load Off

When we sit for too long, the burden of our weight is placed abnormally on our spine and can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution? Limit your sitting to half-hour periods with a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. In other words, if you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. Aside from participating in regular strengthening exercise, like Pilates, this is the easiest way for the average person to prevent back injury (and heal your back faster if you already have an injury).

2. Watch for Curves

We have natural curves in our spine that help us handle stress and loads.  Whether sitting or standing, it’s important to maintain these curves.  When standing, our spinal curves occur more naturally and are usually easier to maintain.  When we sit, the protective curves in our spine are harder to maintain and often disappear.  And while a healthy core and strong back muscles are important to back health, they won’t protect your back if you sit for long periods, or when the curve in your lumbar area disappears while you’re sitting.

Fortunately, the solution is as simple as rolling up a towel and placing it between your chair or car seat and the small of your back (just above the belt line). Using a purpose-designed lumbar roll is my favorite choice, and what I use for low-back support. You can use a lumbar roll in your office chair, car, and on the plane if you’re flying! If you want to learn where you can get on of your own contact us about them here. Or see in more detail how to use them in our free e-book!

3. Extend instead of Bend

The human spine (and entire body) craves balance, which means both extension and flexion.  But we spend the majority of our time in flexion, bending over to put shoes and socks on, brushing our teeth, driving, sitting at work and then driving home. At home we bend forward to cook, sit some more as we eat and then curl up on our couch or an easy chair. As long as we’re not gymnasts or circus performers, it’s safe to say we could all use a little more extension in our day.  A really good exercise is to stand and place your hands on your lower back for support and then arch back as far as you can go.  Repeat this 10 times, at least once per day.  This is also a great activity to do when you are interrupting your sitting during the day.  If you’ve never arched you back like this before, it may feel stiff or even hurt a little at first. But, with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.  If it doesn’t, or becomes troublesome for you, stop and consult with a qualified physical therapist who specializes in back pain.

4. Stay Hydrated

We all know that drinking water is important, but don’t forget WHY! Water lubricates the joints, keeps the body’s soft tissues and fascia hydrated, and boosts exercise performance (yes, including at-home Pilates!). Water also improves skin health and elasticity — keeping you looking (and feeling) young! Water is also essential for digestion, flushing the body of waste and reducing unnecessary snacking. Water makes up 90% of our blood – which helps regulate the body temperature, deliver oxygen to all the cells in our body, and improve concentration and reasoning. Now more than ever, to stay healthy and mobile – make sure you are getting at least 7-8 cups of high quality H2O per day!

5. Build Stability

Mobility and then stability! Stability comes from a strong core. It can seem challenging to maintain strength with little equipment at home, but there are, in fact, plenty of ways to activate your muscles without any equipment at all! A basic strengthening flow daily can help keep our muscles active, blood flowing and reduce likelihood of pain. The flow you see below targets some of our most commonly weak muscle groups in a simple-to-do floor routine.

 

If you like these tips and want to learn even more ways to prevent debilitating back episodes, you can sign up for access to our FREE COVID-19 back pain survival guide right here!  And don’t forget to check out our Virtual Pilates programs if you’re looking for a way to exercise in your home that will target — and resolve — back pain. We have virtual small group classes at least once every day, Monday through Friday. We’re here for you through this quarantine and beyond!

Persistent neck pain and tired of not getting answers?

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

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

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

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

Without an accurate diagnosis, treatment fails.

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

Why?

There are a few reasons…

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

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

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

Questions About Your Shoulder Pain? Here are Some Real Answers.

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Often when clients come to us with shoulder pain, they’ve already tried several approaches without success. But the real issue is that everyone they’ve seen up to that point has failed to give them an accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause of shoulder pain is missed by many and can actually be difficult to diagnose. Sometimes it really is your shoulder, but in other cases the pain is actually caused by a problem in your neck. If there is irritation or inflammation in your neck, but someone is aggressively treating your shoulder, guess what? You aren’t going to see results and your pain may even worsen.

Here are a few questions to ask if you’re wondering if really have a shoulder problem… or if you should be getting help for your neck instead.

Where is your pain?

 When you have an actual shoulder problem, the pain is always going to be just in your shoulder. The most common areas to experience pain are directly in front of your shoulder, directly on top of your shoulder, or in a more involved shoulder problem – like a rotator cuff injury – you might feel achiness on the side of your shoulder and down into the side of your arm a little. If the pain goes past your elbow, is above your shoulder and into your neck (the upper trap area), deep inside of your shoulder, or in the back into the shoulder blade, it’s entirely possible (and maybe even likely) that your neck is involved or totally responsible for your “shoulder pain.”

Do you have numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening in your neck – say due to a bulging disc or restricted/faulty movement patterns that irritate your nerve roots – you can feel it into your shoulder, shoulder blade, or even down into your arm.

What’s particularly misleading is that all of this nerve difficulty in the neck will only be felt in your shoulder or arm.

When do you feel stiff?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well, is pain free, and your shoulder is stiff, odds are that the problem is in your shoulder. Now, let’s say you’ve got stiffness in your neck as well as your shoulder. It’s possible the neck stiffness is a result of your shoulder not moving properly. However, you’ll never know for sure without a proper assessment. If there is even a hint of a neck issue being fully or partially responsible for your shoulder problem, it must be addressed or you will never achieve full recovery.

I do everything I’m told, why won’t my shoulder get better?

This is probably the number one sign that your shoulder problem is not really a shoulder problem at all. If you’ve had pain for months, or if you fix your pain but it keeps coming back, then there is a very good chance someone has missed something. Quite possibly, it’s a hidden neck problem. I can’t tell you how many times I’ve seen this happen. I’ve seen people try three different therapists who’ve prescribed the best rotator cuff exercises on the planet. I’ve seen people get multiple cortisone injections in their shoulder. And worse, I’ve seen people get surgery – only for their shoulder to problem return months or years later. If this sounds like you, then someone has missed the boat and your shoulder problem may not be a shoulder problem at all. You need to find a physical therapist who is a specialist and can properly assess you. They’ll know the right questions to ask, take their time doing a thorough and proper assessment, and get you on the right track to getting better.