Tag Archive for: spinal pain

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? I can tell you that chiseled abs, a thin waist, or the ability to do a hundred sit-ups are NOT reliable signs of a strong core.

Instead, here are five signs to know if 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, and yet most people still don’t consider core strengthening as a way to address those problems. 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 are inevitable. The pain will most likely occur in your lower back, but can even occur in your neck, making simple tasks like bending, lifting, and walking totally miserable for you.

2. You Have Poor Balance

This may not be an obvious one – but one of the main culprits of poor balance is a weak core!  Your core muscles help to stabilize your pelvis, and a stable pelvis allows you to have better balance.  If the muscles around your pelvis (particularly your hips and glutes) are weak, then your balance will undoubtedly be affected. This may not be an issue that you notice right away.  But next time you’re walking across an icy driveway or unstable surface, you’re going to wish that your balance was at 100%. We incorporate Pilates into our physical therapy practice because it is such an effective whole-body strengthening system that can really make a huge difference in core strength and balance. A strong, coordinated, and engaged core helps you to react to balance challenges more efficiently, and may prevent that next fall!

3. You slouch all the time

Most people struggle to maintain good posture when they have a weak core. It becomes so easy to slouch, and you may not even realize you’re doing it.  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!  A lot of people will argue that core strength has nothing to do with your posture. But here’s the thing, a strong core makes it easier and more natural to have good posture, and when better posture becomes effortless, it starts to become your norm. Your whole body – especially your spine – will thank you.

4. Your feet and wrists hurt

Many of our clients come to see us with an initial complaint of foot pain (also known as plantar fasciitis) or wrist pain. It keeps coming back no matter how many times they get rid of it or go to physical therapy. Sound familiar? 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.

So, 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 (or elbows) 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 may be a sign of a weak core!

5. You’re always holding your breath 

If you’re always being reminded to breathe when you move or exercise, this is another sign that your core is weak and not working properly. You’ve heard me talk about this before, but your deep core is made up, in part, of 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 to give you the stability it needs, your diaphragm will contract to compensate.

One of the most tell-tale signs that this is happening is that you always hold your breathe during exercise. This is probably one of the most overlooked signs of a weak core, and one of the most difficult to correct! It’s why we’ve dedicated an entire module to this topic in our Pilates 101: Get [Your] Back to Health program, and it’s one of the most important things we work on with every single client as we prepare them to confidently return to exercise.

What can you do?

I always say – when in doubt – just breath. 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. 

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. Give these tips some consideration and see what happens.

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

But don’t just start doing sit-ups or planks haphazardly and expect good core strength to follow. Being able to do sit-ups and planks are the RESULT of good core strength.

You must first learn how to strengthen your core properly.

The good news is we’ve got an At Home Pilates 101  Get [Your] Back to Health Program designed to help people do exactly this… and it’s done entirely online and is self-paced. You can do at home and on your own time.

Learn more HERE!

 

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.

Do You Really Need an MRI?

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Do you really need an MRI for that?

This is probably the number one question we get from clients  – especially those who suffer from back or neck pain.  Believe me, I get it! When you have pain that won’t go away, and it’s shooting down your arm or leg, often causing numbness and tingling – it’s scary! Why wouldn’t you want an MRI?  An MRI tells you everything and then you know exactly what to do to fix the problem, right?

Not necessarily….

Don’t get me wrong – MRI’s are an amazing advancement in medical technology.

MRIs can easily detect abnormalities in your brain and spinal cord. They can find tumors, cysts and other abnormal growths in various parts of your body. They can even detect certain heart problems and liver disease.  When you don’t know exactly what’s wrong, but you are showing signs that something is not right, an MRI is an amazing tool to help doctors detect the source of the problem.

The problem isn’t with MRI’s – they do their job magnificently.  The problem is with the way they are being used and prescribed.

Let me explain.

When it comes to neck and back problems, for example, what most people don’t realize is that 70-80% of all spine and musculoskeletal problems are what we call “mechanical” in nature.  That means that your problem has to do with the way you move, bad postural habits learned over the years, or muscular and joint imbalances like weakness and poor flexibility. Many of these mechanical “wear and tear” problems don’t show up until your 40’s, 50’s or 60’s – because it takes a while for bad movement patterns or bad postural habits to take their toll.  The best way to figure out a movement problem is with… well… movement!

But how do you know that it’s a mechanical problem and not something more serious?

The easiest way to find out is to ask a physical therapist (we’ll get to that later). But the most common sign is that the problem comes and goes.  Some days you feel great, and then other days you’ll be experiencing severe pain that interferes with your routine and activities.  When the pain comes and goes like that, it is usually NOT due to something serious.  A tumor, or a growth, or a broken bone doesn’t go away. If you feel the pain or discomfort constantly and nothing – not even medication – changes your symptoms very much, that’s an indicator that you should see a doctor and may need an MRI.  But remember what I said – 70-80% of all musculoskeletal problems are mechanical in nature and NOT the result of a significant injury or dangerous growth. To sum it all up – MRIs are not needed as often as they are prescribed.

So what’s the big deal about getting an MRI?  Isn’t it good just to be extra-cautious?

In theory – yes.  But here’s what actually happens.  MRI’s are super powerful and amazing tools.  Because of this, they see everything – including normal age-related changes, such as arthritis, stenosis, degeneration of joints, and even bulging discs. These typical and often unrelated imperfections show up in the MRI and are frequently blamed for the movement problem.

So back to our original question:  Do I really need an MRI?

If you’ve had a bad accident, fall, or trauma – then you’ll want to seek immediate medical attention and an MRI is probably a good idea. But if you are dealing with chronic, long-standing aches and pains that have come and gone over the years and have recently gotten worse – there is a 70-80% chance that it is a movement problem that has finally caught up to you.  It’s best to see a movement expert for this.  A professional and specially trained movement expert (like a specialist physical therapist) knows how to tell if the issue is NOT a movement problem and can send you to a doctor if necessary.  But when you automatically assume that you need an MRI first, you end up spending a lot of money (the average cost of an MRI is $150,000 and you have to pay a portion of this), and often get prescribed unnecessary surgery or procedures for those normal effects of aging that show up in the MRI and get blamed for your problem.

If this story sounds all too familiar, or you’ve been told that you have to get an MRI, get in touch!  We are a specialized physical therapy practice that is well-known for helping people with this exact dilemma and we know how to tell if you need an MRI or not.

Or – download our FREE guide to back pain, written by Dr. Carrie Jose, Portsmouth’s leading back pain specialist and physical therapist. This guide contains her BEST tips – the ones she gives to clients – that will help you get rid of back pain WITHOUT things like pain pills, procedures, and of course MRI’s.

The Snow is Coming… 5 Tips to Avoid Hurting your Back

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When you live in New England, there is no doubt that at some point you will HAVE to shovel snow.

There are some pros — like it being a good workout and getting out into the fresh air. But for the most part, this activity is known for its cons — that it’s cold, wet, and quite literally, “back-breaking.”

While I can’t help you with the cold and wet part, I CAN help you learn how to protect your back. Here are some tips that I give to my own patients with regard to shoveling.

  1. Shovel early, and frequently. It might feel nice to sit by your fireplace with a hot cup of cocoa, watching the snowflakes fall, but you’ll regret it later. As you wait, that snow is likely to turn into a heavy, wet mess. It’s best to get out there early, while the snow is still lighter and fluffy, and just shovel in smaller, more frequent chunks. Doing any activity more frequently but for a smaller amount of time — say 20 min — will lessen the amount of stress put on your spine.

 

  1. Use your legs. The last thing we think about when it comes to shoveling is proper form. However, form is critical if you want to protect your back! Our spines were designed to have enough endurance to hold us upright and maintain good posture — NOT to lift heavy things. That’s what our glutes and legs are for! Save your spine by using the power of your legs to lift the snow. Bend your knees, stick your bottom out, and lift that snow with your whole body instead of curving over from your spine. Your legs might be sore from all that squatting, but your spine will thank you.

 

  1. Don’t twist, pivot. Once you lift the snow, you’ve got to throw it away. You want to use your whole body to pivot, not twist. When discarding the snow, many just twist their upper body and rotate from their spine, letting their arms and trunk do all the work. Instead, you want to pivot with your whole body by keeping your pelvis (the front of your hips) facing and in line with the shovel throughout the whole movement. If your shovel and arms have gone one way, and your hips are still pointing forward, you’re twisting instead of pivoting (and that is asking for trouble)!

 

  1. Breathe and use your core. No matter what, make sure you’re breathing! When you hold your breath, your deep abdominals can’t function fully.  Additionally, the extra pressure that builds from holding air inside your abdomen has to go somewhere — like into your spine. Prolonged, extra pressure can push out on your discs and make them more vulnerable, especially in a forward-bent position like shoveling. In a proper breath, your diaphragm pushes the air down, your abdominals stretch out a little, and then naturally recoil back. This automatic recoil allows your abdominals to contract and support your spine. Rule of thumb —make sure you’re always breathing, and exhale for better abdominal support when lifting the snow.

 

  1. Make it easy on yourself. If you absolutely must shovel snow and can’t get someone else to do it for you (my favorite tip!), make it as easy on yourself as possible. You can decrease the repetitive strain on your body by using an ergonomic shovel or snow blower. But remember, even with a snow blower, you still need to use your legs, breathe, and engage your core while maneuvering the machine. Just because you aren’t doing all of the heavy lifting doesn’t mean your back won’t still end up in a vulnerable position.

If you’ve ever hurt your back shoveling snow, and want more information and tips like these, click here for a free copy of the back health guide we give to our very own patients! 

Three Reasons to Stay Active and Outdoors this November

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November is a tricky month when it comes to staying active and healthy. Between the sudden cold and the onset of the holiday season, it can be hard to stay motivated- especially when it comes to going outside. But don’t let that first cold snap keep you homebound! It’s just as important to spend time outside now, in late autumn, as it was in June. And in fact, there are some definite perks to taking that walk through your neighborhood, hike in the woods, or family bike ride in November.

Perk 1: No Bugs!

Sure, sunny and 75 sounds pretty tempting right about now, but have you forgotten the horrors of being swarmed by mosquitoes every time you stepped outside after 5 pm? Or how about those nasty deerflies that made exploring the woods more painful than pleasant? Not to mention the huge tick problem that we have in New Hampshire! The good thing about cold weather is that you can trade the bug spray for a jacket and be totally comfortable, without the fear of getting bitten and even sick as a result.

Perk 2: Work Off That Thanksgiving Dinner!

First of all, taking a walk after the Thanksgiving meal should be added to everyone’s list of holiday traditions. Walking aids digestion and will help with that sluggish feeling you get after eating half a turkey by yourself. And it’s an easy group activity for everyone in the family! Let’s not restrict our walks just to Thanksgiving day though- getting outside consistently and moving can make a huge difference in your health. As it gets colder, it can be tempting to trade outdoor activity for a walk on the treadmill or stationary bike inside or at a gym. There’s nothing wrong with indoor exercise, but a walk outside is better for you than a walk on the treadmill any day. The changing scenery keeps your mind stimulated and gives you a necessary break from electronics – something you won’t get on a treadmill pointed right at a TV.

Perk 3: Healthy Spine, Healthy Life!

Let’s face it – sometimes November weather seems like it’s begging us to forgo exercise regimens forever and curl up on the couch and watch movies instead. Down time is a crucial part of self-care, but we can’t let it take over! The simple movement of consistent walking -and limited time spent seated with bad posture- is what will keep your spine healthy for years to come. And if your spine suffers, even that easy post-dinner walk on Thanksgiving might become too painful for you. Back pain can severely limit mobility and leave you in that vicious cycle of needing to move to get better, but avoiding movement because it hurts. So why not do your best to eliminate that risk altogether, and stay active while enjoying this November outside? If you want to feel the burn before Thanksgiving, check out our two Wednesday Turkey Burn classes right here in Portsmouth!

If you are already struggling with back pain, and don’t know how to move forward, check out our free guide to fixing your own back. And if you have any questions, feel free to visit our website, Facebook page, or send an email. We’d love to hear from you!