Tag Archive for: wellness

Man getting knee pain treatment

Could your Knee Pain be Caused by your Lower Back?

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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.

Holding Knee with Arthritis

Arthroscopic Knee Surgery – Does it Even Work?

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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?

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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! 

Neck stretches

Why Your Neck Stretches Aren’t Working

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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.

Neck stretches

Neck Pain During Crunches? Here’s Why & How to Avoid it

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

Over the years, many “experts” have dismissed this exercise, claiming it’s ineffective for core strengthening. While I agree that it shouldn’t be the ONLY core exercise you do — the crunch does have its place. I work on this a lot with my private clients, because it’s a functional move that when done correctly, will help you sit up from the floor with more ease and with less risk of injury. And of course you see variations on this movement all the time in Pilates, which is a key part of our practice and our efforts to help people recover from back pain.

I often hear that people don’t like crunches because they’re uncomfortable or hurt your neck. But when you’re doing a crunch, you want to make sure you’re feeling it in your abs… NOT in your our neck. Here are the biggest problems I see with crunches and how to tell if it’s a technique problem or a neck problem:

You’re not actually using your abs

This sounds pretty obvious, right? But a lot of people have trouble figuring this out. During our Pilates 101 class this week, one woman experiencing neck pain appeared to be doing the move correctly — but she couldn’t feel it in her abs, only in her neck.

It’s because she was using her neck and chest muscles to curl her upper body into the crunch instead of initiating the move from her belly (abs). My tips to correct this were to pull her lower belly in toward her spine and the front of her ribs down toward her belly button. Then, keeping this shape locked in, use her breath (exhale) to help her initiate and start the curl from her abs.

Sometimes people don’t have the abdominal strength yet to perform a crunch from lying flat. If that’s the case, you won’t be able to do this correctly no matter how well you follow my cues. If you think that’s your problem, place a small pillow under the back of your head. This gives you a head start into the curl. Once your abdominals get stronger, you can try doing the crunch with your head starting from the floor again.

Your neck is in the wrong position

When you’re doing a crunch, you want your neck to be slightly curled (chin toward chest). Most people either curl their neck too much, or not enough. If your chin is touching your chest, you’re curled too much. And if you feel your chin and neck jutting forward toward the ceiling, you’re not curled enough. Either of these positions could lead to neck problems down the line if not corrected.

The ideal position for your neck is to begin with a slight nod of the chin (like you’re nodding “yes”) and then keep it there. The rest of the curling motion will come from contracting your trunk and abs. As you curl up, I recommend keeping your eyes focused on your belly and keeping a tennis ball’s distance between your chin and your chest.

Sometimes your hand and arm position can be what causes your neck to be in the wrong place. If your hands are behind your head, be sure you’re not using them to pull your neck forward. Your head should be gently pressing into your hands and your elbows should be at a 45 degree angle from your body. Your abs do the rest.

You have an underlying neck problem

In our practice, we specialize in neck and back pain. When you’ve got an underlying neck problem, doing crunches isn’t a good idea until the underlying problem is resolved.

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

Some clues that you might have an underlying neck problem could be pain that shoots into your shoulder blade or numbness and tingling down your arm. You might experience these symptoms during the movement, or even up to several hours after.

Either way, symptoms like this could be a sign that there is more to your neck pain than simply incorrect crunch-technique or weakness in your abs.

If this is happening, it’s a good idea to get it checked out by a movement/mechanical specialist like the physical therapists in our practice. The good news is that we can help your neck feel better even if you do have a problem like bulging discs — and you can get back to doing crunches again without any neck pain.

You can also check out our FREE guide to neck and shoulder pain right here!

It comes right to your email inbox and explores 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.

If you have any additional questions or want a more personalized assessment, sign up for a FREE Discovery Session with us! It’s a quick, no-obligations opportunity for you to see if working with us could be the best decision for your health.

Holding Knee with Arthritis

When Traditional Physical Therapy Fails…

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I’ve been a physical therapist for a very long time — 20 years to be exact — and I’ve seen a lot of changes in healthcare over the course of my career. One of the biggest (and saddest) changes I’ve seen in my field is the overcrowding of clinics. As reimbursements from insurance companies go down, traditional physical therapy clinics have been forced to increase their patient volume. That means you rarely get to spend time with your therapist, and your treatment sessions consist of repetitive exercise sets that you typically can do at the gym or on your own.

If you do manage to get some one-on-one time with your therapist, whether it be for hands-on-care or actual consultation about what’s going on with you, it’s often just a quick 20 minutes. The rest of the time, your poor therapist is usually held hostage by a computer because of all the documentation requirements placed on them, and you’re left on your own doing all those exercises.

Has this happened to you?

With this model of care, it’s impossible for the quality of your treatment NOT to suffer. Many folks I speak with say that traditional physical therapy is a “waste of time.” 

Why bother going when they can do everything on their own at home?

Worse, when traditional physical therapy does fail, most people go back to their doctors hoping for a different solution. Many times, the next step for these folks involves unwanted procedures, pain pills, or surgery.

So what do you do if you don’t want to go down the medical route of procedures or surgery, but the “physical therapy” didn’t work?

Well first, you need to understand what physical therapy actually is, seek that out, and don’t settle for anything less.

Physical therapy is NOT just a bunch of general exercises or ultrasound — at least it’s not supposed to be. After your pain is gone and your problem has been resolved, the role of general exercise is to keep your pain gone, and to continue optimizing your strength, performance, and mobility. That’s what we use our Pilates program for.

When you receive proper physical therapy in the way it was intended, it looks something like this…

Your therapist will first give you a proper examination and an actual diagnosis. Your physical therapy diagnosis might be different than your medical diagnosis. In fact, it should be. For example, you may come to us with a diagnosis of “bulging disc,” but our job is to figure out WHY your disc is bulging. Our diagnosis is going to be related to the specific movements, habits, and musculoskeletal deficiencies that led you to having that problem in the first place (discs don’t just bulge spontaneously). Once we know that, we can come up with a plan for you.

Here’s an example…

Let’s say your bulging disc is due to poor sitting posture, a weak core, and poor mobility in your spine. When your spine doesn’t move well and you sit too much, compensations like bulging discs can occur. Your plan might then consist of strategies for better, less painful sitting postures, as well as some help getting your spine back to full mobility again — so that your bulging disc no longer irritates you.

At this stage in your treatment, any “exercises” given to you should be corrective, very specific to your problem, and should be prescribed specifically to you.

There should be nothing cookie-cutter or general about them — and they should be working!

When you have the right “movement prescription” and when your exercises are corrective versus general — your pain goes away, your problem gets resolved, and most importantly, you’ll know exactly why and can even replicate this on your own in the future.

Once this has all been achieved, THEN we can get you back to the fun stuff like exercises at the gym, Pilates, or yoga — the stuff that is designed to keep you feeling healthy, active, and mobile.

Getting rid of something like back, knee, or neck pain doesn’t have to be complicated. It doesn’t have to involve pills, procedures, or surgery. But it may require you to be a bit open-minded about HOW you receive physical therapy.

If you’ve had a frustrating experience with physical therapy in the past, don’t just give up!

Consider working with a specialist practice like ours that operates differently from traditional clinics.

Click here to request a Discovery Visit.

It’s completely FREE! A discovery session serves as an opportunity for you to “discover” what’s going on with your body and what we do in our practice. You’ll speak with one of my specialists, find out if we’re a good fit for you, and then get started on a path to natural recovery!

Five Ways Adding Pilates to your Life will Enhance your Fitness.

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Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method. It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates — or enjoy the benefits. 

We’ve been incorporating Pilates into our physical therapy practice for the last 10 years and it’s been transformational for both our clients AND our practice.

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength. It helps our clients connect to their bodies in a way that they haven’t been able to achieve with traditional strengthening methods. Most of my clients are well into their 50’s, 60’s, and 70’s, and they love Pilates because it helps them have more energy, better balance, improved strength, and more mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases their risk for injury.

Here are five reasons why I personally love adding Pilates to any fitness routine, and why you should consider adding it to yours too!

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We specialize in back pain, so see a lot of folks with this problem in our office. They’ve often worked with traditional physical therapists or chiropractors in the past to successfully get rid of back pain in the short term, but it keeps coming back. And our clients want it gone for the long-term. A regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but is also a well-balanced exercise system. Full body strength and balance is a critical component for life-long back health, and it is not always addressed in traditional back rehabilitation programs or treatments.

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

One of the keys to truly enhancing your fitness is what I call “balanced strength.” That’s when each part of your body works together to produce the right amount of force, at the right time, to do your favorite activity in the most efficient way possible. Efficiency means you’ll be able to do it for longer and with more ease. We see lots of strong people in our office, and they can’t understand why they’re in pain. It’s entirely possible to be “strong,” but still have certain muscles working harder than others. This creates an imbalance, which eventually leads to problems. Pilates emphasizes full body strength that is coordinated, which helps promote balanced strength throughout your body and leads to fewer injuries over time.

3. Pilates helps you get more flexible and mobile.

Do you stretch your hamstrings every single day and get frustrated because they’re still tight? It’s probably because you’re not stretching the right way. What I love about Pilates is that it stretches your body in a dynamic way – with movement – so that muscles lengthen the right way. The days of statically holding a stretch for 30 seconds are long gone. Plus, mobility is extremely important for strength. Muscles work better when your joints move fully and freely. “Mobility before stability” is a phrase you hear daily in our office. And Pilates is a great way to get your joints and muscles mobile while ALSO promoting stability.

4. Pilates puts minimal stress on your joints.

Aging is a real thing, and along with it comes arthritis. The key to combating arthritis is optimizing the area around the affected joint or joints. When you have good mobility, and balanced strength, you have less compressive forces around your joints.  Arthritis doesn’t like compressed, crowded joints. So when you strengthen and stretch your whole body in a good, balanced way – arthritis becomes less painful and stiff. Pilates helps with all this and doesn’t cause any added stress on your joints. There’s a good reason you see lots of folks in their 60’s and 70’s enjoying our classes.

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is – and it’s almost ALWAYS the missing link for people who feel stuck, or can’t seem to get beyond a certain point in their fitness. It can also be the reason why an activity you’ve been doing “for years” suddenly becomes problematic or painful. If you don’t train your nervous system, it gets lazy, and compensations will develop in your body. Compensations lead to problems when unchecked. Since Pilates is a mind-body exercise, it helps to keep the communication between your brain and your muscles fresh. Pilates emphasizes precise and coordinated movements, which enhance and reinforces this connection.  In other words, your nervous system can’t get lazy when you do Pilates!

If you’re not yet incorporating Pilates into your fitness or rehab routine — what are you waiting for?

As a specialist physical therapist it’s my go-to exercise system for folks over 40 and my favorite way to help people keep their back pain gone.  We’re actually re-launching our signature 8 week program, Pilates 101 ! Pilates 101 is completely dedicated to folks who are new to Pilates, or who have back pain and want to learn how to develop a safe core-strengthening routine. If you want more information, just click here!

 

 

Knee Pain while Running? Don’t Blame Arthritis

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Knee Pain while Running? Don’t Blame Arthritis

Is running bad for your knees? Does it cause arthritis?

We get asked these questions a lot, especially by clients who are in their 50s and 60’s and wondering if it’s safe to keep running.

The short answer is no — running is NOT bad for your knees! If you experience knee pain while running, it’s not that you’ve “aged out” of the sport or that it’s causing arthritis in your knees. This is a very common misconception. In fact, research supports that running may actually be GOOD for your knees!

Staying strong, active, and mobile is your best defense against osteoarthritis.

Therefore runners, because they are typically active and healthy individuals, often have healthier knees compared to non-runners.

Ok then — so if not arthritis — what really causes knee pain in runners?

In most cases, it’s simply a biomechanical issue that goes unaddressed over time. But the GOOD news is that once identified, these issues can actually be fixed with proper education and strengthening (best offered by movement specialists like us!).

Here are three of the most common factors we see that cause knee pain while running:

 

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can impact your knee. If your ankle doesn’t move fully, freely, and adequately, excess forces will be shifted up to your knee. The knee may be forced to flex, rotate, and/or tilt more than it needs to. This, in turn, may result in unwanted loads that the tissues of the knee can’t handle. An expert in biomechanics and movement can not only help you identify if this is the true root of your “knee problem,” but can also help you improve your ankle mobility. This will help prevent long term damage to the joints, tendons, and ligaments in your knees. We actually see this as a very common problem. Specifically, in those that have sprained or twisted their ankles in the past. If that’s you, this could be a reason why you’re suffering from knee pain while you run.

2) Weakness in your hips and thighs

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing good, balanced strength in your hips and thighs is critical. The hamstring and quadriceps muscles play a crucial role in stabilizing the patella, otherwise known as your kneecap. Since running is extremely repetitive on your joints, especially your knees, it requires they have good durability and endurance — something that is lost quickly when you neglect proper strength training. Often “wear and tear” in your knees (otherwise known as arthritis) will get blamed for your knee pain when in actuality, the loss of strength around your knees is what’s causing that wear and tear to feel worse than it needs to.

3) Unstable core

It may seem like running is all in the legs, but the stability of your pelvis and trunk have a huge influence on how your legs perform. You derive the majority of your power, speed, and stamina from your core muscles and glutes. Much like with ankle mobility, if your core is not performing adequately or efficiently – your legs will have to work harder. A stable core is key for developing and maintaining good balance and rhythm with any activity – but especially running.

With a repetitive activity like running, efficiency and form is everything. Without a strong core, it’s impossible for your leg muscles and knee joints to work as efficiently as they were designed to. It will be really difficult for you to maintain good and proper running form. When your core strength is weak, and doesn’t have enough endurance to sustain the amount of miles you want to run, your knees will suffer.

What’s important for you to remember is that arthritis is NORMAL — everyone gets it as they age. 

What doesn’t have to be “normal” is for arthritis to stop you from running, or doing any other activity that you love. You can get surgery to fix the “wear and tear” in your knees, or injections to decrease the inflammation, but if you don’t check and address any underlying biomechanical issues, these fixes will be temporary and your knee pain will keep coming back. And worse… they could force you to stop running all together!

If you’re local to Portsmouth, NH and suffering from knee pain that’s starting to impact your ability to run or do any other activity that you love, you might want to consider speaking to one of my specialists.

In this FREE Discovery Session you can 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!

CLICK HERE to request a free discovery session.

Dr. Carrie Jose – back pain specialist and Pilates expert – owns CJ Physical Therapy & Pilates in Portsmouth, NH.

Opioid Addiction in Adults over 40: a Public Health Emergency

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The COVID-19 pandemic has been top of mind for months. We’ve all experienced some major curveballs this year, and most people have learned a lot about public health and epidemiology along the way. But why now? Why are we finally learning how viruses attack the respiratory system, what it means to be immunocompromised, and the best practices for disinfecting? Maybe it’s because of the unpredictability and common threat associated with this virus. Although some demographics have an increased risk of serious outcomes, anyone can get this novel coronavirus and anyone can become ill. 

Unfortunately, Covid isn’t the only public health crisis facing Americans in 2020.

The opioid epidemic has been in the news for years, but many of us don’t bother to take precautions or educate ourselves because we don’t think opioid addiction can happen to us.   

That couldn’t be further from the truth!

Anyone can become addicted to opioids. Many of the Americans battling addiction right now don’t have a history of drug abuse. Instead, what they have in common is something relatively routine. They deal with chronic pain or they had a surgery, and a physician prescribed them opioids.

According to the US Department of Health and Human Services, “opioid overdoses accounted for more than 42,000 deaths in 2016” and “an estimated 40% of opioid overdose deaths involved a prescription opioid.” Between 2010 and 2016, opiate prescriptions from surgeons rose by over 18 percent (UCI Health). And according to the National Institute on Drug Abuse, approximately 21 to 29 percent of patients who are prescribed opioids by physicians end up misusing them. Eight to 12 percent become addicted (NIDA). And the reality of opioid addiction is sobering. In 2017 alone, over 47,000 people in the United States overdosed on opioids and died. 

In 2017, the opioid epidemic was declared a public health emergency.

A public health emergency is just that — public! The emergent status of this crisis is not limited to one demographic or “type” of person. Although media attention through TV and movies tends to focus on heroin and young people getting high, data from the Substance Abuse and Mental Health Services Administration tells us that 63.4% of the adults who misused prescription opioids in 2015 did so to relieve legitimate physical pain. Chances are, we’ve all felt pain at one time or another that ibuprofen or tylenol alone couldn’t get rid of. Everyone is at risk for opioid addiction because anyone could get in a car accident, or require surgery, or develop arthritis. 

Pain-relieving drugs like Oxycodone, Oxycontin, Vicodin, Percocet, and others can be extremely helpful in some circumstances. But unfortunately, they are often overprescribed thanks to aggressive incentivising and pressure from drug manufacturers. The fact that opioids are so often prescribed after surgery and for patients with chronic pain means that middle aged and older adults are at a higher risk for drug addiction than ever before. In 2016, 14.4 million adults on Medicare (age  65+) had at least one opioid prescription (Consumer Voice). Older adults are also more sensitive to the physical effects of opioids. Side effects such as respiratory depression and cognitive impairment increase in severity as the patient’s age increases, often leading to hospitalizations and even deaths. 

So many clients in our practice fall into this at-risk demographic.

We have countless clients coming to us with severe chronic pain. Some have already had surgeries or been told that surgery is their only route to a pain-free life. Many have considered opioids to treat their back pain. And we are so grateful that we’ve been able to help hundreds of individuals recover from their injuries AND chronic pain without resorting to drugs, surgery, or both!

We promote both physical therapy and Pilates as alternatives to surgery and for preventing painful musculoskeletal problems because they truly work.

We recognize that most knee, back, and other injuries occur because the surrounding muscles are too weak to support those joints and systems properly — and we have the expertise to retrain your body in correct movement. You may think that your regular exercise and stretching is enough, but oftentimes working specific muscle groups leaves others underdeveloped and your body unbalanced as a whole. Our team of specialists is trained to create individualized solutions for your particular needs, because we believe that movement is medicine — when it’s prescribed properly! The idea of a quick fix is tempting — but a quick fix can easily turn into long term opioid addiction, illness, and even death. Taking the time to teach your body how to heal itself is so much more rewarding in the long run.

Want to learn more about how we can work with you to determine the safest, strongest, most effective route to recovery? Just click here to sign up for a FREE Discovery Session with one of our specialists.

 

This article was authored by Katya Engalichev. Katya is a pharmacy technician, EMT, and graduate student who writes for CJ Physical Therapy & Pilates. 

Carrie working on a client's shoulder

Shoulder Pain not Going Away? This could be why…

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Whether it’s shoulder pain, neck pain, back pain, or knee pain that you’re dealing with — if you have a nagging pain or injury that just won’t go away no matter what you try, it’s a clue that you’re missing something.

We see this ALL the time in our office with shoulders.

Folks just like you come to us wondering why their shoulder still hurts after trying ice, heat, rest, physical therapy, massage, and every possible shoulder exercise you could imagine.

The pain either goes away temporarily, or sometimes it gets WORSE!

When it comes to shoulder pain, it’s critical that you know for certain if the pain is actually coming from your shoulder, or somewhere else. If not, you risk trying to fix the wrong problem… and that explains EXACTLY why your shoulder pain isn’t going away.

So… if your shoulder pain isn’t caused by your shoulder — where is it coming from?

The most common culprit is actually your NECK. Below are a few key signs to help you figure out if that’s the case…

(PS – we’re doing an online workshop on this topic in just a few weeks.)

Where is your pain?

When your pain is coming from your shoulder, the pain will always be localized to your shoulder alone. True shoulder pain is felt directly in front of your shoulder, directly on top, or in a more involved shoulder problem (like a rotator cuff injury) you might feel some achiness down the side of your arm… but it will never go below your elbow.

If the pain goes past your elbow and into your forearm or hand, or radiates above your shoulder into your neck (the upper trap area), or if you feel it deep inside of your shoulder blade in your mid-back, odds are pretty good that you’re dealing with a neck problem and not just a shoulder problem. This could be the reason why your shoulder pain isn’t going away.

Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening, it’s likely coming from your neck – and could be due to a bulging disc or a restricted/faulty movement pattern that is irritating nerve roots in your neck. An isolated shoulder problem typically does NOT involve nerve root compression or irritation. This is much more common in a problem related to your neck, and if that’s what’s happening, you will feel symptoms into your shoulder, shoulder blade, or even down into your arm. What’s particularly misleading is that it’s entirely possible to feel all these nerve symptoms and not actually feel anything localized to your neck. This is a big reason why shoulder pain caused by a neck issue gets missed by so many health practitioners.

Have you lost mobility or range of motion?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well and is pain free, but your shoulder is stiff and immobile, odds are good that the problem is actually in your shoulder and you just haven’t found the right treatment approach yet. BUT… if you have a stiff and painful neck, and you lack mobility in your shoulder, then it’s absolutely imperative that you investigate your neck. If your care provider only focuses on stretching and improving your shoulder mobility, and never bothers to look at your neck, it’s possible you could be missing a key component to full recovery… and that’s why your shoulder pain keeps coming back.