Tag Archive for: wellness

Three Reasons Your Physical Therapy Didn’t Work

Have you been to physical therapy once, twice, maybe even three times for the same thing… and now you’re left wondering why it didn’t work?

Or perhaps you went to physical therapy and it “worked,” but you have to do about 10 exercises per day that if you miss… even once… the pain comes right back. (hint – that means it didn’t actually work.)

This is sadly an all too common occurrence in this profession. However, if you’ve already had the chance to work with us, then you know we are a specialty practice.

But here are three reasons why your treatment in a regular physical therapy clinic might not have worked for you…

For physical therapy to be successful – it MUST start with a full and thorough musculoskeletal examination. But for varying reasons, this isn’t always possible.

The problem in most traditional physical therapy settings is that physical therapists are sometimes restricted with what they can and can’t do. Sometimes the restriction comes from an insurance company, and sometimes they are simply overworked.

If a doctor sends you for knee pain, your PT may only be able to look at and treat your knee. They are “administratively” prevented from giving you the full and thorough examination that you need.

I can’t tell you how many times I’ve seen knee pain being caused by someone’s spine. If I wasn’t able to look at and treat that area, I’d have missed it!

Other times PT’s have too many patients at once, and are forced to take short cuts. This could cause them to miss important details. I’ve been at this for 20 years, and in my opinion, the perfect physical therapy evaluation should consist of three major components: the interview, the examination, and the plan.

Your therapist should be asking you a lot of questions to find out how your pain is impacting you. They should do a lot of movement testing (not just poke you) to confirm why you’re having pain. And lastly, they should clearly explain to you why your pain is behaving the way it is and have a solid plan to solve it – one that is NOT dictated by your insurance company.

If your PT evaluation didn’t look like this, or your therapist was rushed, chances are something got missed.

The second reason I see physical therapy not working for people is because your PT used too many passive modalities.

This includes everything from electrical stimulation, ultrasound, dry needling, Graston technique, traction, laser therapy, and even manual therapy. We call these treatments “passive” because they are done to you.

There is a time and place for these things. But generally speaking, they should only be used to address very specific pain and impairments that are preventing you from moving in a way that is going to produce the real healing.

For example… let’s say you’ve got a tight knot in your upper trap that is giving you neck pain. There are some fabulous modalities like dry needling and massage that will quickly get rid of your pain, but a few days later, the pain will come back…

That’s because the tight knot is the symptom.

The underlying cause of this recurring tight knot is what’s essential to figure out and address.

If all your therapist does is treat the symptom with passive modalities that feel good, your therapy isn’t going to work and you’ll continue to suffer.

The last reason I see physical therapy not working is because there are just too many different exercises being assigned.

Physical therapists LOVE to give homework, but sometimes that homework can turn into two or three pages of exercises.

This is rarely necessary. And the chances of anyone doing all of these exercises every day is highly unlikely.

My firm belief is that your physical therapist should be working on highly specific problems with highly specific exercises. I refer to these as corrective exercises. You typically should only have 3-5 to do at any given time. These corrective exercises should compliment what you are doing in your session, and be designed to specifically address pain, and/or a very specific impairment or weakness.

They should NOT be generalized or cookie cutter – and you should absolutely have a very good understanding of why you are doing them and what they are designed to accomplish.

Ok… so now that you know what quality physical therapy should look like…

If you’re NOT getting it… it might explain why it “didn’t work”.

Sadly, insurance puts a lot of limitations on what physical therapists can and can’t do, which is why a lot of people are starting to move away from using their insurance all together. They know they can get better quality care, and have their problem resolved completely, by paying out of pocket to an office that isn’t tied behind red tape.

Plus, while it might seem cost prohibitive at first, it’s A LOT better than the costly alternative of unnecessary surgery or injections.

Remember that physical therapists are movement experts.

If you’re only doing cookie cutter exercises, riding the bike for 10 min, or just lying on the table every session – you’re not spending adequate time restoring full mobility and quality of movement.

Your physical therapy probably won’t work, and it certainly won’t give you the lasting results you’re looking for.

If this experience is sounding all too familiar – consider working with a practice like ours. We’re not restricted by the red tape and we care about doing things the right way, even if that means more work on our end.

Curious? Talk to one of our specialists for free!

You can do that by Requesting a Free Discovery Session right HERE!

Getting and Staying Fit when you’re Over 50

The importance of being healthy and fit has taken center stage these last 18 months, but especially for the over 50 crowd. Most people aged 50+ who want to get and stay fit struggle, because what might work for someone in their 20’s or 30’s just doesn’t make sense for them in their 50’s. As you age, both your needs AND your priorities change. 

By the time you hit age 50, you may start to suffer from things like arthritis, degenerative and aging joints, and more back and knee pain. And if you aren’t suffering from them yet, you’re worried about when you will. First, let me just tell you that it is 100% possible to get and stay fit after 50. I have the joy of working with folks aged 50+ every day who are the healthiest they’ve ever been in their lives. So what’s their secret?

Here are 5 habits my healthiest clients aged 50+ stick to so they can get and stay fit:

1. Get enough sleep

The myth that you don’t need as much sleep as you get older is false. Most research indicates that even when you’re over 50, you should still be aiming for 7-9 hours of sleep per night. When you don’t get enough sleep, it catches up to you. You lack energy, making you less motivated to exercise and more likely to eat sugary, unhealthy foods. Lack of sleep lowers your immune system, affects your memory and ability to focus, impacts your balance, and increases your chances of developing high blood pressure. In general, lack of sleep is going to significantly impact your ability to eat well and exercise, two essential ingredients for getting and staying fit after age 50. 

2. Keep Nutrition Simple

If you’re over age 50, you’ve likely seen every cleanse, crash diet, health shake, weight loss pill, or gimmick known to man.  There literally isn’t a trick left in the book you haven’t seen.  At age 50+ you also typically aren’t in the mood to be a nutritional extremist either. It’s a good idea to just keep things simple. Focus on eating nutritious whole foods (things that are unprocessed) and drink plenty of water. Start your day with an 8oz glass of water and then aim to drink at least 3 more bottles after that. When you’re planning meals, make your plate up with half vegetables, one quarter protein, and one quarter whole grains. Adding a little bit of healthy fat consisting of plant oils is a good idea too. Good nutritional habits give you the energy and stamina you need to get and stay fit!

3. Lift Weights

I can’t tell you how often I get asked “is it safe to be lifting heavy weights at my age?” People worry that lifting heavy weights could be “bad” for their spine or knees once they’re aged 50+. Lifting weights is not only good for you, but perfectly safe when done correctly. But it’s important that your workout is customized and takes into account any injuries or ailments you may have. Arthritis in your joints, bulging discs, and even meniscus tears are all normal things that occur as you age. They don’t mean you can’t exercise — but you do want to make sure your strength training routine reflects this.

As a physical therapist, the two biggest things I look at when I’m examining someone’s strength routine are form and loading strategies. Good and proper form is critical to protect your joints and back. “Loading” refers to how much weight you lift and how often (reps). This changes as you age because the integrity of your soft tissue (muscles and ligaments) is different. Loading strategies also need to be adapted if you’re injured or in pain. A good strength coach and physical therapist, especially when working together, can make sure that you have a strength training routine that is not only safe but perfect for your age and ability.

4. Strengthen your Core

After age 50 things like balance and reaction times start to become more compromised, and the likelihood of back pain increases. Maintaining good core strength helps with all of this and becomes more important than ever at age 50+. The biggest problem I see with people trying to strengthen their core is that they just don’t know how to do it properly. They may be doing all the right things, but with all the wrong muscles. If you’re new to core strengthening, or perhaps you’ve been doing it awhile but your core strength still isn’t where you want it to be, consider trying Pilates. It’s long been known as the staple of core strengthening because it requires you to perform very controlled and precise movements while focusing on your breath. Having proper control over your breath, body, and movement are the cardinal signs of a truly functioning and strong core. 

5. Address Pain

This may seem obvious, but I can’t tell you how many people either ignore or just work around their pain. When you ignore your pain, you risk developing other problems due to your body compensating. These compensation strategies may last you for a short time, but eventually they will catch up to you. When you’re over 50, recovering from injury is harder and takes longer. So although preventing injury is your best strategy, don’t just ignore pain if you’re experiencing it. When you work around pain, it’s impossible to get the most you can out of your workouts and this delays your ability to get and stay fit. If you’re always having to modify exercise or compensate for pain, not only is this frustrating, but you delay getting to the root cause of your problem. Simply put, if you’re experiencing musculoskeletal pain — get it addressed.

We are a team of specialists who are specifically trained to help you address these issues. If you’re interested in an assessment, consultation, or simply want a couple questions answered — sign up for one of our FREE Discovery Sessions! This 30 minute session allows you to talk one-on-one with a movement expert to figure out what you want, need, and how you’re going to get there.

Should Age be a Reason to Avoid Certain Activities?

We’re continuing with our topic of the month – Getting Fit After 50 – and people have been asking me…

Are there certain types of exercise I should avoid once I hit a certain age?

The short answer is no.

Most of our clients are over the age of 50 and they do everything from surfing, to playing tennis, hockey, running, and even tap dancing!

None of these activities are considered “easy on the joints,” but they do them anyway.

So why is it that some folks see age as just a number – where others use it as a reason to stop doing certain things?

After age 50, the number one reason I see people avoid activities they want to do is because of pain. The second most common reason is because they were told to.

Let’s start with pain.

Having been a physical therapist for twenty years, I know a thing or two about what goes through people’s minds when they are dealing with back or joint pain. In most cases, the pain itself is not the biggest concern. People are willing and able to tolerate a certain amount of pain at the expense of doing what they truly love. We do it all the time in our 20’s or 30’s… and don’t think twice about it.

But as we age – a little bit of fear starts to set in when we’re in pain.

We’ve typically seen or heard horror stories from friends or family who have paid the price for either pushing through – or ignoring pain all together. When we’re younger, we’re more likely to approach pain with a “wait and see” approach. But as we age – pain becomes a bigger concern and we’re more likely to seek professional medical help sooner.

This leads me to the second reason people over 50 will just stop doing certain exercises…

Because they were told to. And often by a well-meaning health care professional.

Let me explain that.

Our medical system is overloaded, and everyone does the best they can to keep up. But if you’re a musculoskeletal health professional who’s NOT up with current medical research – you’re likely to give advice based on “old-school” ways of thinking.

For example, diagnosing all musculoskeletal pain based on X-rays and MRI’s… If your X-ray shows “bone on bone” arthritis – then a joint replacement is assumed to be your only option. If your MRI shows a meniscus tear or bulging disc – then you automatically need arthroscopic surgery.

But the current research disputes this line of thinking…

And says 80% of ALL musculoskeletal problems – even when you’re over 50 – can be solved without surgeries or other procedures.

How your pain behaves is what matters most. Not your age or arthritis. The best way to explain this concept is with a case study!

This client (we’ll call him “Jim”) is 57 years old and was told knee replacement surgery was his only option to resolve the knee pain he was suddenly experiencing.

When he questioned the knee replacement and asked if he could wait, his doctor’s response was that because of his age – and because of the “bone on bone” arthritis that was showing on his X-ray – surgery was his best option. Otherwise, if he wanted to wait, he would need to stop the running and hiking he had been enjoying so much until very recently.

Research studies show that the indication of osteoarthritis on X-ray alone does not mean it’s the cause of your pain.

In other words, it’s entirely possible Jim’s knee pain could be due to something other than his “bone on bone” arthritis.

Did he really need surgery? And did he really need to stop some of his exercises because of arthritis or his age?

Ceasing his activities would have certainly made Jim’s arthritis worse. And if he went through with the knee replacement without being completely sure if arthritis was the main cause of his knee pain – he not only risks unnecessary surgery – but also risks getting set back several months for recovery.

This would delay his ability to get back to running and hiking even further.

Although age is most of the time NOT a factor in your choice of exercise… it is a factor when it comes to how quickly you’re able to recover from surgery.

So here’s what happened.

We prescribed him a corrective movement strategy to see if arthritis was the main factor causing his knee pain. And just like we see over and over again – his knee pain significantly improved after just a few visits!

Research says that if pain responds quickly to a corrective movement done repeatedly – your pain is primarily due to a mechanical origin – and not arthritis. Arthritis doesn’t change that quickly – in fact it doesn’t change at all (unless you get surgery). But mechanical pain does.

Turns out that Jim’s knee pain was due to some mechanical imbalances in his knee joint, and NOT the arthritis. Arthritis was a factor for sure – it made his knee stiff – but it was not the main cause of his knee pain.

If you’re getting older… know that age related changes like arthritis are quite normal and nothing to be afraid of.

And arthritis, along with your age, are certainly not reasons to avoid exercise.

Jim was given medical advice to have a surgery he does NOT need yet based solely on his X-ray and his age. But there are SO many other factors worth considering as well.

Why Proper Breathing is Essential for Good Core Strength

When I’m working with clients, one of the most common things I see when someone is having trouble engaging their core is that they tend to hold their breath.

Why is this important?

Because breathing properly allows you to activate your deep core – and good activation of your deep core is essential if you want the rest of your core muscles to work properly and help you prevent things like back pain.

Let me explain…

Your “deep core” is made up of your diaphragm, pelvic floor, transversus abdominus (deepest layer of abdominals) and your multifidi (deepest layer of back muscles). These four muscle groups work together to make up your deep, inner core. If your deep core doesn’t function properly – your outer core muscles (abdominals, glutes, hip and back muscles) won’t have the support they need to work well. This can all lead to inefficient and compensatory movement patterns over time, and contribute to something like back or neck pain.

Your diaphragm controls how well and how deeply you breathe. When working properly, your deep core acts like a piston system, driven by your diaphragm. Upon inhalation, your diaphragm expands, causing your pelvic floor to lengthen and drop. When you exhale, your diaphragm contracts and your pelvic floor lifts like an elevator – all acting like a piston system moving down and up.

Additionally, the pressure created by this system also acts a bit like a balloon. Breathing in expands your pelvic floor and abdominal muscles out, stretching like a balloon would. Exhaling releases the air and allows your abdominals and pelvic floor muscles to contract, like the natural recoil that would occur if you let the air out of a balloon.

So, if this is a natural process, why do so many of us have problems activating our core properly?

It’s because as we age, and allow poor movement and posture habits to form, we “forget” how to breathe normally and most of the time aren’t even aware this is happening.

Here are some of the most common things I see with clients suffering from neck and back pain, and who aren’t activating their deep core properly:

1. Chest breathing

I see a lot of people breathing deeply but the only thing moving is their chest. Instead of their ribs expanding out and back, all you see is their upper chest moving out and up. This is very common, and it happens because your diaphragm isn’t expanding fully and thus, not pushing air down into your belly. Chest breathing often contributes to tight and elevated shoulders, back pain, and even tight hip flexors – because the deep abdominals can’t kick in properly, causing the rest of your body to compensate. Next time you want to take a deep breath, place one hand on your belly and make sure that it’s moving out and in along with your chest. That’s a first step to learning how to breathe properly so that your deep core can activate!

2. Your neck feels tight

Although back pain is often what’s associated with a “weak core”, people can also suffer from neck pain when they lack proper core activation. When people first start working with us for Pilates, a big complaint is they feel tightness in their necks when they are first learning how to activate their core and do a proper chest lift. The fascia (web like substance that holds and surrounds your muscles) of your deep core is connected to the deep fascia of your neck. If you’re not breathing properly and your deep core can’t activate, your neck may try and help out because it’s partly “connected”. We even see neck tightness like this in our experienced Pilates goers – and it’s a clear sign they’ve lost connection to their deep core or perhaps simply lost connection to their breath. Next time you’re doing abdominal work, check in with your neck and see if it feels tense. If so, it could be a sign you’re not fully activating your deep core. Improving how you breathe during abdominal work could help.

3. You hold your breath when you exercise

Did you know your diaphragm is a muscle? When you hold your breath, you’re contracting that muscle. For a muscle to work properly it needs to contract AND relax. If you hold your breath during exercise, it’s impossible for your diaphragm to expand (relax) and push air into your abdominals and activate that piston system we talked about earlier. In other words, your pelvic floor and deep abdominal stabilizers don’t have an opportunity to activate properly when you hold your breath. Without activation of your deep core, the rest of your body is going to have to compensate somehow. And this can set you up for unnecessary aches and pains, or worse, injury. I always say to my clients, “when in doubt, just keep breathing”. Because if you’re actively breathing, you at least have a shot at activating your deep core properly, even if you’re not 100% sure how to do it.

If you have trouble “feeling your abs” when you exercise, your neck and shoulders tense up when you work out, or your back and neck always hurt every time you work your core – it’s a sign you might not be activating your deep core very well.

Remember that good core strength starts with your breath!

Next time you work out, especially core-focused work, pay attention to the way you’re breathing. If you still have trouble, or you’re noticing back or neck pain, then reach out for a FREE Discovery Session or check out our Pilates offerings.

Could your Knee Pain be Caused by your Lower Back?

Is your knee pain actually due to a problem in your knee – or could it be caused by your lower back?

One of the most important things to get right when it comes to successfully resolving knee pain is to correctly identify the source. And often times that source can be your lower back.

One of the biggest clues that you’ve missed the root source of your knee pain is that it doesn’t go away after trying everything that “should” help it. Perhaps you’ve tried ice, heat, pain medication, foam rolling, strengthening, and stretching… but no matter what, your knee pain just won’t seem to go away.  This is often when knee doctors start to get involved, which is great if you actually have a knee problem. Knee pain that doesn’t respond to conservative treatment should be looked at further. It’s possible that you might need some kind of procedure or surgical intervention.

But what if your knee pain is a symptom of something else?

 

If so, and you don’t get it properly checked, then you risk having unnecessary knee surgery. 

I just spoke to someone who this happened to. She had knee surgery to “clean out” some wear and tear from arthritis after trying several months of physical therapy. She was told it would be a “quick recovery” and that her pain would be significantly reduced. 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 surgery! She came to us for a second opinion, and the very first thing we did was screen her lower back to see if it might be the cause of her knee pain. Turns out it was! This woman’s knee pain was never actually coming from her knee, and she ended up having unnecessary surgery because the root cause – her lower back – was missed. 

How does a misdiagnosis like this even happen?

One of the biggest culprits is imaging. If you’re over age 40, 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. Studies have shown that arthritic changes and meniscus tears are a normal part of aging, so they will show up on your images even if you don’t have any knee pain. This is why you should never dictate your treatment plan, and certainly not surgery, based on an MRI or X-ray alone.

Here are a few clues to help you figure out if your knee pain could be coming from your back.

 

First, pay attention to how and when your knee pain started. If you’ve had a fall or some kind of trauma to your knee, and you experience knee pain or swelling shortly after, then odds are very good you have an isolated knee problem. With isolated knee injuries, you often know exactly when and how you hurt your knee. It may have been associated with a pop or specific strain of some kind. But if your knee pain comes on slowly or out of nowhere, then you must consider that the source of the problem could be elsewhere. 

Another clue is how your pain behaves. When your lower back is the source, often you’ll have difficulty pinpointing exactly where your knee pain is. It may feel dull or even numb. It might move around, or perhaps travel up or down your leg. One day your knee will feel great, and other days it could feel excruciating. When someone comes into our office with pain like this, we ALWAYS check their lower back first. Knee pain that moves around a lot, or that comes and goes frequently, can quite often be due to a back problem.

If you’ve been suffering from knee pain for awhile, it’s worth considering that the root source of your problem could be your lower back.

Before you think about getting images of your knee, or undergoing some kind of surgery or procedure, you’ll want to make certain that your knee problem is indeed a knee problem.

 

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH. To get a free copy of her free guide: 7 Ways to Stop Knee Pain – click here.

3 Tips to Protect Your Knees as you Age

Arthroscopic Knee Surgery – Does it Even Work?

While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still one of the most common surgeries performed, despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to avoid surgery and heal your knee pain naturally and on your own – DOWNLOAD our Free Guide: 7 Ways to Get rid of Knee Pain Naturally.

Could your Hamstring Strain Actually be a Back Problem?

Have you ever strained your hamstring but the pain just doesn’t go away?

It’s been months since you first started hurting, you can’t actually remember how you injured it (it just started aching one day), you’ve been stretching and massaging it diligently, yet your hamstring still hurts.

This happened to a recent client of ours (“Sandy”).

Sandy was a runner and regular gym goer, who one day noticed an ache in her hamstring. She assumed she had just overdone it working out. She rested it a few days and the pain went away, but when she tried to get back to running she couldn’t. Her hamstring pain came right back. Thinking she hadn’t let it heal enough, she went back to resting it, but this time, decided to add some massage and stretching to her routine. 

A few weeks later… you guessed it… Sandy still couldn’t run.

She also noticed the pain in her hamstring started to feel “different.” It was becoming more deep and achy and started to hurt all the time instead of only when she tried to exert it. It even hurt when she sat for too long. She still couldn’t run and was starting to get worried. Her doctor told her it was just a “strain” and that she had to let it heal. The problem was that it wasn’t healing. Several months had now gone by and she was running out of exercises and stretches to try that would “let it heal.”

Luckily, Sandy attended our recent back pain and sciatica class and realized that the pain in her hamstring might not be a strain at all. 

And her instincts were right! Let me explain.

When you truly strain a muscle, it means you have done damage to your muscle tissue. Although it’s possible to have chronic problems from a strain that isn’t rehabilitated properly, strains typically do in fact heal. Once the inflammation from the tissue damage goes away, and you start doing the proper stretching and strengthening, your muscle eventually gets back to normal. Until a muscle strain is fully healed, it will typically be aggravated if you accidentally over-stretch it or exert it. But you usually don’t feel anything when you’re resting the muscle. In Sandy’s case, her hamstring was starting to feel worse when she was resting — the longer she sat, the worse she felt. Your hamstring is completely relaxed when you are sitting, so something wasn’t adding up.

This was the first sign we were likely dealing with something other than a “hamstring strain.” The second sign was that we could take her pain away by moving her back! Yes, you heard that right.

By moving and stretching her back in a specific way, we were able to significantly relieve the pain in her hamstring.

The reason her hamstring was actually hurting was because a nerve had been aggravated in her back. The nerve was causing pain to radiate into her thigh. That’s why it hurt when she sat for too long and it’s why she couldn’t tolerate any running. Sitting puts more stretch and pressure on the nerves in your back, and running puts a lot of compression through your back. Generally speaking, nerves don’t like to be stretched, especially aggravated nerves, and they don’t like to be compressed if they are aggravated either. By stretching her back in a very specific way, we were able to relieve the pressure from the nerve that was giving Sandy her “hamstring strain.” This confirmed that she was indeed having a back problem.

Has anything like this ever happened to you?

If you’ve got pain anywhere in your buttocks, hip, thigh, or leg that isn’t going away — especially if you’ve done your due diligence and tried all the “right things” — it’s possible you could have a back problem causing this pain instead. These types of back problems are easily missed if you don’t know how to accurately assess them and it won’t be picked up by an MRI or X-ray. The best way to figure this out is through specialized movement testing, like we did with Sandy. 

We talked all about this in our recent back pain and sciatica class. If you want access to the recording, just call our office: 603-380-7902. If you want to take the next step and meet us in person — you can schedule a FREE Discovery Session with one of our specialists right here

MRI

How MRI’s Lead Back Pain Sufferers Toward Unnecessary Procedures

One of the most popular questions and concerns I get from clients is whether or not they need an MRI when they are experiencing back pain or sciatica. It’s pretty standard protocol, but is it necessary? In most cases, no.

About 70 to 80% of back problems, even sciatica, are considered mechanical in nature and quite normal.

That means there isn’t anything “serious” causing your pain. Serious causes of back pain include things like a tumor, infection, fracture, or severely compromised nerve. Your symptoms will be pretty specific and obvious to a back pain specialist and will typically require advanced medical intervention.

An MRI can be useful in these cases to get more clarity before medical intervention begins.

But when your back pain is mechanical in nature, an MRI is more often than not misleading and may lead to unnecessary procedures or surgery.

If you’ve had back pain for years, it comes and goes, or you’ve had relief in the past from things like physical therapy or chiropractic treatment, you most likely have mechanical back pain. The root cause of mechanical back pain cannot be diagnosed by an MRI.

And if your back pain falls into the mechanical category, and you get an MRI anyway, you can end up with treatments you don’t need. Over the years, I’ve seen so many people with mechanical back pain get major medical procedures that were irreversible and made them worse.

Here’s the problem.

MRI’s are an amazing technological advancement that will literally show you everything that is going on in your spine. Everything from bulging discs, arthritis, stenosis, and degenerative discs, which are all considered normal as we age, but are usually not the root cause of your back pain. What typically happens is the MRI finds them, and your back pain gets blamed on them. But what we know from research is that all those common MRI findings I just mentioned rarely correlate with what’s actually causing your back pain.

Research has shown consistently that you can have two people with identical MRI’s showing something like bulging discs and arthritis, but only one of them will be suffering in pain. That’s how we know the root cause of your back pain is coming from something else.

One notable study was the Lancet series – three published papers that investigated how MRI findings related to the treatment of back pain.

Martin Underwood, MD, co-author of the Lancet series, and professor at Warwick Medical School, is quoted in The Guardian saying: “If you get into the business of treating disc degeneration because it has shown up on an MRI, the likelihood is that, in most of those people, it is not contributing to their back pain.”

If you notice that certain positions or movements relieve your back pain, or you feel better after walking and exercise, your back pain is likely mechanical in nature, and you don’t need an MRI to diagnose you. Mechanical back pain responds to specialized movement therapy and a selectively progressed exercise protocol. Mechanical back pain does not respond well in the long run to injections, procedures, or surgery, which is what you can end up with if you get an MRI and don’t really need one.

I can’t tell you how many people I’ve seen over the years get surgery for a bulging or herniated disc only to find that it didn’t help their problem, or it came back again with a vengeance.

And once you have surgery, mechanical back pain can actually become more difficult to fix because your tissues and ligaments are now compromised from surgical scarring, no matter how minimally invasive they say your surgery will be.

You can sign up for a FREE 30 minute Discovery Session with one of our specialists right here.

Neck Pain

Why Your Neck Stretches Aren’t Working

Do you suffer from chronic neck pain and ever wonder…

Why don’t my neck stretches work?

Even though you’ve Googled and YouTubed them about a hundred times…

There are a few reasons why stretching your neck might not be doing anything to help get rid of your neck pain.

  1. Your technique could be off
  2. You could be doing the wrong stretch
  3. It could be that you just shouldn’t be stretching your neck at all!

Let’s go over the different reasons why your neck stretches might not be working… and most importantly… what you can do about it.

1. You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into the stretch. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work.

Some people (myself included) respond better to “moving stretches”. This is where instead of holding one static position for a prolonged period – you repeatedly move through one or several end-range stretches. Neck rolls are a great example of this.

If your neck stretches haven’t been working, try adjusting the way you’ve been stretching… if it works… then you were likely just using the wrong technique.

2. You’re doing the wrong type of stretch.

This one could be a little tougher to figure out on your own. There is a difference between corrective neck stretching and stretching to feel good.

For example, let’s say your neck is tightening up because you’ve been under a lot of stress or you just did a lot of activity that impacts your neck. Generic neck stretches such as bringing your chin to your chest, or pulling your chin to the opposite shoulder (known as an “upper trap stretch”) may be all you need.

In fact, I do stretches like this regularly because I’m constantly leaning over to help patients. I stretch my neck to PREVENT it from having problems and because it feels good.

But let’s say you already have a neck problem, or you have pain or numbness running down your arm.

In these instances, generic neck stretching could make you worse.

You likely need corrective stretches, like what we prescribe for patients in our office.

Corrective stretches are specifically prescribed to address your particular problem in your neck – and are very different from the generalized stretches that are designed to feel good and relieve tension.

If you think you might need corrective stretches for your neck – DO NOT google them – you must see a specialist and have them prescribed to you.

3. You shouldn’t be stretching your neck at all!

This is a very common problem we see… folks come in with complaints of chronic tightness and discomfort in their neck and no matter how often they stretch or massage, it doesn’t go away.

Did you know that chronic neck tightness can be a sign of a weak core?

It’s quite common – and if that is the case for you – no amount of stretching will help – and could even aggravate your problem!

The deep, stabilizing muscles of your neck are connected by fascia to the deep muscles of your core. If your deep core is not working properly, then your neck will often kick in and try to help.

Ever notice that your neck is always sore or tight after a good ab workout?

This could be a sign that your neck is compensating for your core.

Stop stretching your neck, learn how to strengthen your core the right way, and see a specialist who can help you.

In our office, our team of specialists work alongside our Pilates instructors to help folks improve their core strength from the inside out – so that their necks and backs stop getting involved.

If you’re dealing with chronic neck problems that aren’t’ responding to stretching…

There’s a good chance you could be not stretching correctly, the stretches aren’t right for you, or you’ve completely missed the root cause of your neck pain and you shouldn’t be stretching at all!

Want to work with our team of specialists and finally get some help for your neck problem?

CLICK HERE to request a free Discovery Session with one of our specialists.

They’ll set up a time to talk to you about what’s going on with your neck. If you’re a good fit for what we do, then they will help you get started!

This is only for people serious about getting help…

And for those that are finally ready for a long-term solution to their pain – one that will put an end to constantly relying on pain pills – and help you avoid expensive procedures and risky surgery.

Request a Discovery Session here.

Stressed out? Tips to Keep the Holiday Season Happy and Healthy

It’s the middle of December, which means we’re in full holiday swing. Although this is meant to be a time of celebration and joy, many people I speak with just can’t seem to avoid the stress. And it’s not just because we also happen to be dealing with a pandemic… although that’s definitely not helping! Unfortunately, stress levels tend to increase around this time every year. In our office, the phone is ringing off the hook right now from people tweaking their necks and backs. Why? Well, stress! Stress makes us move faster than we are inclined to — or slower than we’re inclined to — and it puts our nervous systems on high alert (otherwise known as “fight or flight”).  It’s a recipe for both mental AND musculoskeletal aches and pains. But the good news is that it’s not as difficult as you think to combat stress and give yourself the happy and healthy holiday season you deserve.

Here are my favorite ways to combat stress any time of year, not just during the holidays or a pandemic:

1. Breathe

I know this might sound cliche, but breathing is one of your best friends when it comes to quickly reducing and interrupting stress. As little as 30 seconds can make a dramatic difference! When you breathe deeply it sends a message to your brain to calm down and relax. The best part is you can do this anywhere — in the car, at the office, while shopping, even in the bathroom. Although breathing may not eliminate stress permanently, it does interrupt it. And interruption is key when it comes to managing stress — both emotional and musculoskeletal.  When you interrupt the ability for the cumulative forces of stress to accumulate, you decrease the toll it can have on your body and brain.

 

2. Practice Gratitude.

Did you know that gratitude helps lower cortisol levels in our bodies by about 23 percent? Prolonged stress causes elevated cortisol levels, which causes lots of different health problems such as heart disease and high blood pressure. Research shows that when we think about something we appreciate (i.e. practice gratitude), the parasympathetic nervous system (the calming one) is triggered. Our parasympathetic nervous system is responsible for returning the body to its automatic and natural rhythm. So when the parasympathetic nervous system is activated, your heart rate and cortisol levels lower — which is the opposite of what happens when you’re stressed out. Your sympathetic (fight or flight) and parasympathetic nervous systems work together in opposition, and can’t both be in charge at the same time. So when you consciously practice gratitude, you actively lower your stress!

 

3. Move!

Any kind of movement is going to help you control stress for a few reasons… First, it gets your blood flowing which contains endorphins — natural chemicals of the body designed to decrease pain AND stress. Second, movement helps to end the “flight or fight” response of the body. In ancient times, our fight or flight response protected us from danger (like a lion chasing us), by triggering us to run away. Running away (movement) would signal the end of the stress cycle caused by fight or flight by letting the brain know we were safe and out of danger. In our modern worlds, triggers of stress are not as obvious as a lion trying to eat us and tend to be more unassuming and cumulative. The end of the stress cycle is not always clear and can just keep going. Therefore, purposeful movement can help to decrease stress by physiologically ending your natural fight or flight response! Something as simple as walking can do this for you. But even jumping jacks or dancing in your living room can feel good and get your heart rate up enough to do the trick.  

I hope these tips help you feel confident that it is indeed possible to combat any kind of stress you might be feeling right now. Stress is normal, but dealing with it longer than you should doesn’t have to be. And if you’re experiencing any kind of back, knee, hip, or neck pain that is adding to your stress – check out our FREE, expert-authored guides to dealing with all types of pain. Each guide is sent directly to your email inbox so you can reference them at any time!