Tag Archive for: back injury

golf injuries

Common Golf Injuries and How to Avoid Them

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Most golfers I know won’t let anything stop them from being out on the course – especially here in New England where the golf season is not very long.

But let’s face it, when something hurts, playing 9-holes is just not as fun.

Jack Nicklaus had it right when he said, “Professional golfers condition to play golf; amateur golfers play golf to condition.” That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they’re out of shape, have poor swing mechanics, or don’t adequately warm up.

Here are three common golf injuries and things you can do to avoid them.

Elbow Tendonitis

Tendonitis is characterized as the painful inflammation of a tendon. It’s caused by repetitive movements that overload the tendon, eventually causing it to feel strained and overworked. When it occurs on the inside of your elbow, which is something that happens a lot with golfers, it’s called “golfer’s elbow.” The treatment is ice and rest initially (which means you don’t get to play golf for a while) followed by progressive and proper loading of the tendon to get it back to a healthy state. This whole process, if done properly, takes time… and it can certainly ruin your golf season if it’s not caught early.

What causes elbow tendonitis? We know that technically, it’s inflammation of tendons in your elbow. But what leads to that in the first place? Often weakness in your mid-back and shoulders along with mobility restrictions in your wrists. Your elbow is significantly influenced by what happens above and below it. If your mid-back and shoulder area are weak, the rest of your arm won’t feel supported and your elbow can get overworked. If your wrist is tight and immobile, your elbow will be forced to move more than it should, especially through a golf swing. This will cause extra stress on your tendons and eventually result in tendonitis. The best way to prevent this from happening is to make sure you’ve got adequate mobility in your wrists, and good strength in your mid back and shoulders.

Back Pain

One of the most common ways to hurt your back is with repetitive flexion (bending) and rotation (twisting). Well, what does a round of golf consist of over and over? Repetitive bending and twisting! Every time you swing that golf club, you’re putting your spine through one of its most stressful positions. And if it’s not prepared — it’s going to get injured.

One of the best ways to prepare your spine for a long and healthy golf season is to avoid a lot of sitting and keep it mobile. Sitting for prolonged periods makes your back more susceptible to injury in general, but especially if you’re going to be doing a lot of bending and twisting. Interrupting your sitting frequently during the day is a very easy way to minimize its harmful effects. 

If you lack adequate mobility in your spine, it will feel strained every time you try and swing your club. When you overstress a joint that is stiff, the muscles around it tend to tighten up and spasm in response. It’s important that you take time to optimize and maintain your best spinal mobility for golf season. This will significantly help to decrease the stress that occurs in your spine when you swing in one direction repetitively, and ultimately help you prevent a back injury.

Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints. If you lack adequate mobility or stability in and around your knees, you’re going to have problems. Much like the elbow, the most common source of knee pain I see in my golfers comes from the joints above and below, and not from the knee itself. To keep your knees mobile and healthy and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as stability in your feel and ankles. 

The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees will want to try and help, and they are not designed for this. Your knees need to be loose and free during a golf swing. If not, the muscles and ligaments around your knee joint will take on unwanted stress. 

Another cause of unwanted stress to your knee joint is lack of support from your feet and ankles.

Your knees need a stable foundation if they want to bend and twist without stress. If stability below is lacking, your knees will tighten up in an effort to compensate. Moral of the story: make sure you’ve got mobile knees, a strong core and hips, plus stable feet and ankles, so that knee pain doesn’t derail your golf season.

Hopefully these tips help you understand why golf injuries happen and most importantly, how to prevent them. If you’re feeling stuck and looking for individualized expert help – request a FREE Discovery Session. We look forward to speaking with you!

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

Why Pilates?

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Why Pilates?

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

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

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

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

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

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

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

How you actually CAN recover from chronic back pain

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There’s nothing more discouraging than being in pain and feeling that there’s no way out of it. Back pain is such a common issue, and unfortunately, many people hold onto the mistaken belief that if you have a “bad back” you’re stuck with it for life. Not true!!

It is totally possible to recover from chronic back pain and return to the activities you used to love.

Great news, right? Let’s talk HOW. 

First of all, keep moving.

There are people in healthcare who will tell you to just avoid anything that irritates your back and accept that you can’t be as active as you once were. But what if basically everything triggers back pain? What if your job requires you to be on your feet or you simply want to tie your own shoes or pick up your grandkids? You don’t have to resign yourself to sedentary days spent popping ibuprofen every four hours and missing out on life. Don’t listen to the people who tell you to avoid movement — because in fact, the solution is the exact opposite. Consistent, correct movement heals your body and keeps it from shutting down. If you’re suffering from back pain, it may be a sign that your movement habits are off. You could benefit from working with a specialist physical therapist to retrain your body in how to move properly throughout your day, thus eliminating unnecessary stress on your spine.  

Along the same lines, make sure you educate yourself.

We offer a FREE workshop at our Portsmouth office every month to answer questions from our community, and our next topic is back pain and sciatica! You may feel like surgery and medication are the only options out there for recovery, but in reality they are just two of the less effective strategies for treating back pain. One of our clients, Sean, was dealing with multiple herniated discs and spoke with us on this exact topic. 

“I was considering back surgery until I found CJ Physical Therapy. I walked out of 

therapy with such relief that the thought of surgery was no longer an option. Therapy 

worked so much better than the steroid injection just a few months earlier, that it gave 

me hope of actually being able to feel like I did before the injury a year earlier.”

Nobody wants to get surgery, but if you haven’t been told about any noninvasive therapeutic routes to remedy your pain, surgery may seem like the only option. But time and time again, we have clients come to us with severe back pain and injuries that are often prescribed surgery — and time and time again, they have FULLY recovered through an individually customized program of physical therapy. 

If you’re dealing with chronic back pain, don’t be afraid to reach out.

We understand if you’re not yet ready to commit to PT — that’s why we offer FREE Discovery Sessions for potential clients. This 30 minute session is a chance for you to speak with one of our specialists 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! 

Do You Really Need an MRI?

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Do you really need an MRI for that?

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

Not necessarily….

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

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

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

Let me explain.

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

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

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

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

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

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

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

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

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

New Year — New You — New Pain?

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New year, new you, right?

We’re officially in 2019 and it’s a brand new start… You’re excited, you’re motivated, and you’re on your way to achieving your goals for the year. But what happens when back pain hits you? Or your knee starts to hurt? Or your hip starts bothering you? The last thing you want is for your new routine to be disrupted and your progress halted…

So how do you know if the pain you’re experiencing is something to really worry about, or if it’s just a result of your body adjusting to a more active routine? (related: Where is your pain really coming from?)

These FOUR questions will help you clarify the type of pain you’re dealing with, help you figure out what to do about it, and most importantly – prevent “new pains” from getting in the way of your goals in the new year!

1. Does your pain come and go?

If the pain comes and goes, and starts to decrease the more you improve your fitness level, it’s probably just a sign that your body is getting used to your new activities. For example, if you’ve started doing squats for the first time and notice some knee pain when you first begin, you shouldn’t worry unless the pain gets progressively worse as you exercise.

Best practice: Keep an eye on this kind of pain – or download one of our FREE GUIDES – but there’s no urgent need to run to the doctor.

2. Does the pain last after the activity but go away the next day?

If your pain follows a pattern — e.g., your knee pain stays with you for the rest of the day after doing your squat sets but is gone when you wake up the next morning — means your body is trying to tell you something. This type of recurrent pattern is a warning sign that your body isn’t responding correctly to the exercise and could start to incur damage. If you’re experiencing a similar phenomenon, now is the time to make an appointment with a specialist physical therapist. Going to the doctor or orthopedic surgeon would be a less productive path to take, as they will likely send you down a rabbit hole of unnecessary tests and procedures (Do you really need an MRI?). But meeting with a physical therapist before the problem becomes too serious can help you adjust your movement and strengthen the right muscles so that you’re able to continue exercising as planned.

Best practice: Talk to a physical therapy specialist who can analyze your movement and the source of your pain.

3. Is the pain causing you to move differently?

People who ignore pain without seeing a physical therapist often end up here, which leads to a more difficult recovery. They often end up limping, walking “crooked,” modifying movements such as bending over, and moving stiffly. This is a result of your body compensating for the pain initially triggered by the exercise. Such compensations start to cause wear and tear on other areas, which only create more problems down the road.  If you’ve hit this phase – it’s still not too late to get some help.  Working directly with a physical therapy specialist will help you to quickly get rid of your pain and correct the compensations you’ve started to develop – so they don’t get worse.

Best practice: Make an appointment with a physical therapy specialist (at our office your first one is FREE)

4. Is your pain causing you to avoid or stop doing something?

When your pain is stopping you from doing something — whether that be doing squats, running, or picking things up off the floor— it’s a sign that your body is in distress and needs help from a physical therapy specialist, orthopedic specialist, or your doctor. However, I encourage people to seek out a physical therapist first. Traditional doctors typically don’t perform movement tests, relying solely on imaging and procedures to make diagnoses. They’re also more likely to prescribe rest, surgery, or painkillers  — despite the fact that 80-90% of ALL aches and pains can be resolved through corrective exercise and movement strategies administered by a movement expert (such as a specialist physical therapist). If the problem does require further intervention, then a physical therapist can refer you to the appropriate medical specialist.  Most states (including NH) don’t require a prescription to see a physical therapist. You can give us a call and come straight in!

Best practice: See if physical therapy can help FIRST by talking to a specialist and getting an evaluation

The moral of the story is, don’t wait to ask for help! You’re better off being extra-careful and addressing your pain early than waiting for it to become a full blown injury. If you are experiencing pain and/or need any help staying on track with your new movement program, don’t hesitate to reach out! You can also find us on Facebook and Instagram and learn more about our services here.

Happy New Year!

Movement is Medicine – When Prescribed Properly!

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We hear all the time that “movement is medicine,” but it’s important to add the qualifier – when prescribed properly. If you were sick, you wouldn’t just walk into a pharmacy and blindly pick a medicine without thorough knowledge of what your condition is and a recommendation (or better yet a prescription) from your doctor. When you’re in serious physical pain that keeps you from living the lifestyle you want to live, movement can absolutely be your medicine. You just need to make sure you’re using the right kind…

Every person’s body is different, so every individual dealing with pain has a slightly different experience. That’s why working with a physical therapist – who is trained to customize a treatment plan for your specific issue – is so beneficial. We can identify specific movements that actually are worsening your symptoms, while conversely being able to pick out movements that not only relieve pain in the short term but allow your body to recover fully and become stronger. A lifetime of poor movement patterns can lead to pain and injuries down the road, even in the most athletic and active among us! Physical therapy is all about redesigning those movement patterns and reinforcing correct movement so that people can remain active and pain-free.

Many of our more active clients find that exercising independently will relieve their symptoms for a little bit, but when they wake up the next morning the pain is back in full force. Part of a physical therapist’s job is to help you find the specific exercises that create lasting relief and enable you to go back to your normal activities without having to start over from square one every day. There is no “one size fits all” treatment when it comes to pain, which is why we personalize every client’s treatment to their individual needs and circumstances. We “prescribe” the movements that are right for the individual, not just those that are generally helpful for people with back pain or people with knee problems.

In addition to prescribing specific physical therapy movements, we love to add the movement system of Pilates to our clients’ treatment in order to improve strength, balance, and coordination. It’s incredibly beneficial for clients to have the support system of a physical therapist and a pilates instructor working in tandem to find the right movements to rehabilitate each particular individual. Our goal is always to get our clients back to their full range of movement and activities – we NEVER want to avoid any movement permanently in order to avoid pain – but on the road to that full recovery, the structure of Pilates and the opportunity for physical assistance can be an extremely powerful counterpart to physical therapy.

How Olympian Karen Chen Uses Pilates to Overcome Back Pain

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18 year old Karen Chen is already a figure skating sensation – she is one of only three female figure skaters representing the United States at the 2018 Olympic Games in South Korea and recently released a book about her journey to becoming the US National Figure Skating Champion in 2017. However, Karen has had to deal with several injuries and ongoing back problems in her road to international athletic success.

Karen Chen skates in the Championship Ladies Short Program for the 2018 US Figure Skating Championships at the SAP Center in San Jose, Calif., on Wednesday, January 3, 2018. (Nhat V. Meyer/Bay Area News Group)

In her book, Finding the Edge, Karen explains that she started experiencing debilitating back pain as a teenager. She was competing at a very high level in figure skating and was worried that her back issues would prevent her from following her dreams of becoming an Olympian someday. She says “I was so worried about my spine and so nervous about the pain that I was tense all the time. And that tension made everything worse. I was tight and my muscles were constantly seizing, which only intensified the sharp pain radiating from my back down through to my legs” (Parade). Karen saw multiple doctors and received varying opinions and advice. Some even thought she might not be able to continue skating. But as Karen says in her book, “champions figure out a way to persist. And in order to help my back, I added more Pilates and core stability work to my off-ice training. All those core muscles help hold my vertebrae in position. If my core was strong, the vertebrae weren’t as likely to slip around and cause further problems.”

We say this all the time to our clients. Pilates strengthens your whole body, starting with your core, and actually prevents back pain! Karen Chen told Us Weekly that she practices Pilates every day. And now she’s competing on the biggest stage in sports, living her dream, because she refused to let her back pain limit her. Instead, she found a way to resolve it that did not involve surgery, pain pills, or other invasive procedures. Now Karen Chen is stronger than ever, and ready to compete in Seoul this week.

Curious about how Pilates can help you? Get in touch! You don’t have to be an Olympian to benefit from Pilates – all you need is the desire to lead a strong, pain-free life. Friend us on Facebook to stay up to date on all the latest news on our Pilates programs right here in Portsmouth, NH.