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Opioid Addiction in Adults over 40: a Public Health Emergency

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. 

4 Tips to Save your Neck and Back During Summer Road Trips

Now that summer is in full swing, but a lot of people don’t feel comfortable flying, many of us are planning road trips for those special summer getaways! It’s always fun to hit the road and explore a new place — but first, let me help you out with some tips to save your neck and back…

(For more tips – check out our Free Guides section on our website and also join us for our next virtual workshop all about neck and shoulder pain!)

Tip #1: Interrupt your sitting

The biggest strain on your body while traveling is undoubtedly the prolonged periods of sitting. Our bodies are made to move continuously throughout the day. Too much sitting puts extra load and compression on your spine, and can trigger an underlying problem you weren’t even aware of.

On road trips, getting out of your seat is critical for keeping your neck and back healthy. Try to plan extra time in your trip to pull over at rest stops and walk around. We recommend interrupting your sitting every 30 minutes for good neck and back health. I understand keeping up with that frequency on a long road trip is difficult, but something is better than nothing! You’ll want to capitalize on your rest stops by moving around instead of sitting.

Tip #2: Use a lumbar pillow

A proper lumbar pillow is not only essential for good lower back alignment while sitting, but also for proper neck alignment. We have natural curves in our spine that are designed to absorb shock and disperse load. When those curves aren’t maintained, especially for prolonged periods, you get abnormal and unwanted forces throughout your spine – resulting in pain and stiffness.

Ever heard of the dreaded “forward head?”

That’s the posture your neck assumes when it needs to compensate for lower back slouching. We sell lumbar pillows in our office, but you can also try making your own by rolling up a towel or sweatshirt. Just make sure the roll is thick enough to maintain the natural curve in your lower back without much effort while you sit. The built-in lumbar supports that come with your car are typically NOT adequate enough.

Tip #3: Adjust your car seat

This is an often overlooked, but important component to achieve healthy posture while driving. Too often, I see folks driving around with seats that are either too far away or too close to their steering wheel. If you’re too close, it will cause you to sit overly straight or upright, resulting in unnecessary strain in your neck and low back. If your seat is too far back, then it will be virtually impossible to maintain the natural curve in your lower spine, even with one of our lumbar pillows. Your arms will need to overreach for the steering wheel, causing strain in your shoulders. And your neck will assume that forward head posture just to remain upright, causing strain to your neck.

You want to make sure your seat is positioned in a way that allows your neck to be easily balanced on top of your spine and pelvis – without much effort. Your elbows should be at an approximate 90 degree angle when your hands are on the steering wheel, and there should be a relaxed 45 degree bend at your knee so that your foot can easily switch from gas to break without you having to constantly flex your thigh. Having your car seat positioned correctly before you take a long drive will significantly decrease the strain on your neck and back.

Tip #4: Use a neck pillow when you sleep

On road trips – we often sleep on mattresses that are less than optimal and certainly not as comfy as our own. Using a neck pillow while you sleep can significantly decrease morning pain and stiffness caused by poor sleeping postures.

Getting a good night’s sleep and not waking up in pain has a lot to do with the position you sleep in.

Just like with sitting, you want your sleeping position to be as balanced as possible. When you sleep on your stomach, your neck has no choice but to stay turned and extended to one side all night. Prolonged poor postures are not great for any joint in your body, but especially those in your neck. Your neck is the most mobile section of your spine which makes it much easier to “kink” if in a poor position. Sleeping on your back is not terrible, and it’s what many people prefer.., but depending on how firm or soft the mattress you’re sleeping on is… it could be difficult to maintain the natural curves in your neck and back while you sleep. If you sleep in a slouched position all night long, you’ll wake up with pain and stiffness.

If you can tolerate it, my favorite position for sleeping is on your side and with a neck pillow. This allows both your neck and low back to stay relaxed and with their natural curves.

To make a neck pillow, use a small towel roll about 3 inches in diameter and stuff it the long way inside the bottom of your pillow case. When you rest your head on the pillow, it acts like a comfy support to maintain good neck alignment while sleeping on your side. We can also order one for you!

Speaking of neck pain, our next online workshop is happening on Tuesday, July 21st from 6-7pm and it’s all about neck and shoulder pain! Join from the comfort of your home — because it’s virtual!

Click here to reserve your seat!

How Stress Leads to Back Pain

There is a lot going on in the world right now. And it’s impacting people in different ways. Many folks I speak with have been experiencing a rollercoaster of emotions — and their bodies are reflecting that. It’s resulting in symptoms such as more headaches, tension in their jaw, neck pain, and more back pain. Holding stress in your body is an interesting phenomenon, and there is still a lot of research to be done as to why exactly this happens.

Here are some of the top theories and reasons why stress can increase back pain.

Social conditioning:

Many of us are taught from a young age that expressing emotions, particularly negative emotions, is “bad” or “unacceptable.” The result is that you may have learned to hold stress inside your body when faced with a stressful situation. Researchers who study this believe that the muscle tension we develop is the result of “unspoken social beliefs” that we adopted as children in order to feel accepted or liked. This pattern carries into adulthood and becomes embedded into our subconscious systems, i.e. our nervous system. Later on, when faced with certain types of stress, our muscles react based on how we’ve taught our nervous system to repress (versus express) and immediately tense up. If you grew up learning to bury emotions and tension in your back, you’ll still feel more back pain as an adult whenever you’re stressed.

Trauma:

Trauma is often thought of as one, big physical event that is typically violent. But you can experience less obvious emotional or “micro-traumas” over the years that go unrealized over the course of your life. Then there is accidental trauma, such as a car accident or terrible fall, that was not deliberately afflicted on you. Regardless of the type of trauma or its perceived severity, the point here is that your body reacted in a certain way when you experienced it, and it “remembers.” Sometimes not right away, and sometimes not until years later, but stressful, emotional events such as what is going on in the world right now can trigger your body to react to trauma all over again. This could result in back pain if that is where your body held or experienced the stress at the time of the trauma.

Environmental Stressors and Habits:

This is something we help people with all the time in our office. Your daily physical and postural habits have a huge impact not only in how your body feels from day to day, but in how well it recovers from pain or injury. If you’ve been following us for a while, you know that sitting too much is one of the number one causes of persistent and chronic back pain. And stress plays a role in this. When you’re stressed, you tend to be less motivated and you may opt for unhealthy coping mechanisms, such as more TV and more couch time. You stay home instead of heading out for a walk or to exercise. This type of behavior, often influenced by stress, can exacerbate and even cause back pain.

Regardless of how or why stress impacts your body or your back pain, there is one thing I know for sure: MOVEMENT HELPS.

But what if your back pain has gotten so bad that now you can’t move, even if you want to? Or just the idea of moving and exercising has you fearful that you could worsen your back pain?

The first step is awareness. Is stress truly the main source of your back pain, is it something else, or is it a combination of the two? Knowing why your back actually hurts in the first place is essential for determining the correct intervention. If your back pain is primarily due to stress, and you’re about to undergo back surgery, that surgery won’t help you. Your back pain will just come back the next time you are stressed.

If you’re looking for help with back pain and are wondering whether or not stress could be the reason you’re feeling more of it right now, sign up for a FREE 30 minute Discovery Session with one of our specialists. Many of our clients, after meeting with us for the first time, tell us how relieved they are to find out there is hope for getting rid of their back pain, even if they’ve suffered for years.

people walking with face masks

Beyond the Mask: Five Ways to Build Immunity and Stay Healthy

The COVID-19 pandemic has changed so much of how we live, work, communicate, and think about our health. While precautions like face masks can be helpful, the best way to avoid getting seriously ill is to have a strong, healthy immune system. In our office, we’re helping people’s immune systems by making sure they stay active, healthy, and mobile. We’ve been helping people with back and knee pain recover quickly and manage their conditions from home, so they can get back outside and keep moving and exercising.

Exercising regularly is just one way to keep your immune system strong. Here are five more ways to make sure you’re building immunity during  these strange times!

 

1. Hydrate

 

Staying hydrated is one of the best things you can do for your health in general, but it’s especially important when you’re trying to fight disease. Each individual cell in your body that works for your immune system needs to be fully hydrated to perform its job optimally — and that all depends on how much water you drink!

 

2. Stay Moving

 

In the era of working from home and passing time with friends or family on Zoom, it can be hard to get up from your computer and make sure you’re staying active. But it is so important that we interrupt our sitting and make time to exercise! Keeping your blood flowing allows pathogens to be filtered out more efficiently — plus, sweat can even kill pathogens on the surface of your skin. 

 

3. Get Good Sleep

 

Sleep deprivation has been proven to increase the risk of illness, as well as increasing the risk of more serious long term effects. Sleep is when your body’s cells get to repair themselves — including those immune cells! Plus, getting enough sleep at night can help lower your overall stress. 

 

4. Eat Well

 

Nutrition is key for building and maintaining immunity. You should try to avoid processed foods and integrate more clean alternatives like nuts, berries, eggs, and fish. 

 

5. Get Outside 

 

Scientists are telling us that the novel coronavirus thrives best indoors, and out of UV light. All the more reason to get outside! Soaking up that Vitamin D will boost your immune system and just make you feel better in general. Not to mention that going outside is the one of the best ways to get exercise right now with gyms being closed! 

If you’re currently suffering from back, knee, or any other kind of pain that is preventing you from moving and exercising, give us a call.

We’re currently offering free consultations, both in-person and virtually, to help you figure out what’s going on and give you all the information you need to make the best decision about what to do next.

 

How to Tell Good Pain from Bad Pain

Over the last few weeks, we’ve been inundated with people asking for help.  And we’re so thankful for everyone who is reaching out! 

Since being quarantined at home and off their routines, people are noticing more knee pain and back pain (these are the two biggies) because they are either sitting more — or because they are DOING more.

The folks who have been sitting more have been complaining about more back pain and stiffness, tightness in their hip flexors and knees, and more tension in their necks.

However, the people who have been doing more are noticing increased or NEW aches and pains in their knees, muscles, and joints – and are wondering if this is “normal” or if it’s something to be concerned about.

For some, the aches and pains are quite harmless – and it’s easy enough to stretch out on your own at home. If you’ve been more active lately because you’ve been bored or suddenly have more time, these could be symptoms of “good” pain. It’s not unusual to have more soreness in your muscles and joints with increased activity or exercise.

But for others – these symptoms could be a sign of an underlying problem that was already there – and just now surfacing. And if that’s the case – simple home stretches that you look up online are not going to be enough – and could actually make you worse.

So how do you know?

One way is to look at how your pain behaves. Does it get worse? Or does it get worse, but not until later? Does your pain move around? Or does it come and go? Does it get better and STAY better the more you stretch? Or does the stretch only provide temporary relief — like a bandaid — and your pain just keeps coming back?

Understanding how your pain behaves is how you know whether or not you’re doing the right thing or the wrong thing.

And how your pain behaves is not as simple as “getting better” or “getting worse.” 

There is so much grey area when it comes to pain, and it’s where people get really confused.

For example, pain might seem like it’s going away, but then it comes back again. Does that mean you’re better? Or is the problem still there? Sometimes pain will move, and you think it’s a sign of improvement. We see this all the time with back problems. Pain starts in your back and is really painful, but then it moves to your butt, hip, or thigh and is more achy and not as sharp. You think you’re getting better — but most of the time this means your back problem is actually getting worse!

The truth is, you’ve got a 50% chance of getting it right and a 50% chance of getting it wrong. And if you fall on the side of getting it wrong, it can lead to a lot more problems down the line that you won’t be able to fix on your own from home.

The BEST way to figure out if your pain is normal — or if it’s something more — is to talk to an expert.

That’s what we’ve been doing ALL month here. As specialized physical therapists, we have been getting on the phone — or hopping on Zoom — to help you figure out what’s going on in your back, knees, or somewhere else.

It’s totally free to talk to us! We’ll let you know if what you’re experiencing is normal… and if what you’re doing is safe or not.

If you want to get on our schedule — and talk to one of us for free — just fill out this form.

You can talk to us in-person if you’re comfortable leaving your home, or virtually if you’re nervous about leaving. Both methods are equally as effective!

Whatever you do, don’t try to figure out your pain on your own — and don’t just throw pills, ice, or heat at it. This could lead to more problems down the line. Plus, if you let it get bad enough, you may be forced to go to Urgent Care or the ER — two places you DON’T want to be right now.

Instead, get on top of your pain and learn how to treat it properly so that you can be healthy and pain-free for the rest of quarantine! 

 

Is Pilates the missing link in your fitness?

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.

I’ve been incorporating Pilates into my physical therapy practice for the last 10 years and it’s been transformational for both my clients AND my practice. Every March, we join participants from all across the globe to share the love for the original work of Joseph Pilates. Over the years, much of Pilates has turned contemporary, but for one month – the Pilates community pays respect to his traditional, classical Mat exercises. This movement is known as March MATness, and anyone can join!

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength — and it helps my 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 and 60’s, and they love Pilates because it helps them have more energy, better balance, and improved strength and mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases the likelihood that their injury will come back.

Here are five reasons why Pilates was a missing link in my physical therapy practice, and why it might be the missing link to YOUR life-long fitness as well.

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We see a lot of folks with recurring back pain in our office. They’ve seen traditional physical therapists or chiropractors who get rid of their pain in the short term, but they aren’t able to keep it gone. Regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but also is a well-balanced exercise system — so it keeps your back feeling mobile in all directions — a missing link in most “back strengthening programs.”

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

One of the keys to lifelong 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 a lot longer. I see lots of strong people in my office, but often certain muscles are working harder than others. And this can cause problems down the line. Pilates emphasizes full body strength that is coordinated — and this leads to a balanced body.

3. Pilates helps you get flexibility the right way.

Do you stretch your hamstrings every single day and find they just never get more flexible? It’s probably because you’re not stretching the right way — or maybe you don’t even need to be stretching them at all! What I love about Pilates is that it stretches your body in a dynamic way — with movement — so that muscles lengthen the right way and where they are supposed to. “Mobility before stability” is a phrase you will hear me say often, and it’s one of the keys to lifelong fitness.

4. Pilates puts very little stress on your joints.

Aging is a real thing and along with it comes arthritis. But it’s not a death sentence like most people are led to believe! The key to combating arthritis is maintaining a mobile and well balanced joint. When you optimize everything that surrounds your arthritic joints, your symptoms decrease. Pilates helps with all this and doesn’t cause any added stress. When your joints are happier, it becomes much easier to do your favorite activities – hopefully for life!

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is — and it’s almost ALWAYS a missing link that I see for people who’ve been at a certain activity for a really long time and then suddenly things start breaking down. They start experiencing pain when they never have before. If you don’t train your nervous system, it gets lazy, and that is how compensations develop in your body. Pilates helps with this because it is a mind-body exercise that emphasizes balanced strength and coordination. 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?

March MATness is the perfect time to get started with Pilates. We’re celebrating by sending the Pilates exercise of the day right to your inbox, modeled by our expert Pilates instructors! Just follow this link to sign up for our challenge and gain access to daily videos, exclusive offers, and promos!  The fun starts on March 1st!!

knees

Happy Halloween! Spooky Noises coming from your Knees?

“What are those cracks and noises coming from my knees? Is there something wrong??”

Our clients come in with this question all the time. They usually feel nervous and fearful that the noises they hear may indicate something more serious is going on within the joint. Is there damage occurring whenever they hear this sound? Do they need to avoid activities that provoke these symptoms? Will they need to rely on pain pills and surgeries in order to maintain their mobility if their joints deteriorate? 

Crepitus refers to these clicking, popping, and creaking sounds that a large portion of the population experience on a regular basis.  This phenomenon can occur at any joint, but is most commonly reported in the knees, shoulders, ankles, hips, and spine. 

Although these noises often don’t produce any pain, they can cause anxiety. Individuals start to develop their own beliefs about what is going on, and ultimately alter their behavior to avoid these cracking or popping sensations.

What causes these noises?

Many structural factors can contribute to joint noises.  Some of the most common are:

  • Tendons rubbing along bony prominences (bumps on bones)
  • Nitrogen bubbles popping due to pressure changes within the joint
  • Small labral or meniscus tears that get caught or pinched as we move

However, we don’t have the luxury of utilizing x-ray goggles during our examinations.  This means that we often cannot be certain of exactly which structures are creating these sounds.  What we do know is they aren’t a reason to be highly concerned as long as they aren’t associated with pain or swelling in the affected joint.  

How can I prevent it from getting worse?

The best way  to prevent these symptoms is to keep moving!! Motion is lotion. Regular movement throughout the day allows our joints to lubricate themselves, kind of like applying WD-40 to a creaky door hinge.  Additionally, it’s important to keep the muscles surrounding your knees strong and balanced. This helps to offload the forces through the joint, which limits “typical” wear and tear on cartilage and bony structures.

What if I’m noticing pain or inflammation in the joint that’s making these noises?

If you have a specifically noisy joint that’s also painful or swollen, it’s best to come in for a formal examination with a physical therapist – ideally someone who specializes in movement mechanics.  We train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.

If finding the solution to your problem is something you’re interested in, you can come in for a free Discovery Session at our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are great for people who want to talk with a specialist about what might be causing their problem, and we’ll help you figure out what the next best steps are.  Our goal is to give you all the information you need so that you can make the best decision for your health – without any obligation or commitment.

We also know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free health and posture classes!  These events are for people in our community who want really valuable, expert information about movement, pain, and overall wellness. We know it’s confusing out there with all of the information floating around on Google and Facebook, and this is a valuable first step towards getting some answers for your problem.

Hopefully you found this information helpful, and the only thing scaring you this Halloween will be haunted houses instead of the noises coming from your joints!

PS – If you found this information helpful, please share this with a friend or on your Facebook feed.

How you actually CAN recover from chronic back pain

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! 

Physical Therapy and Pilates: The Perfect Pair

We all know the joke:

Patient: “When I go like this, my arm hurts.”

To which the doctor responds: “Well, don’t do that!”

With physical therapy, just “not moving” is never an option. Instead of telling the individual in this scenario to avoid the movement altogether, I would say, “let’s do it differently.”

People typically have muscle and skeletal pain because of one or more 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. And that’s precisely the way it should be.

Pilates teaches correct movement throughout the whole body. 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.

Did you know that 90% of ALL musculoskeletal problems (aches, pains, and strains) can be resolved WITHOUT pain pills, procedures, or surgery?

So chances are, whether you’re suffering from sciatica, neck pain, an achy knee, herniated discs, or any number of physical issues, your pain can be resolved through physical therapy. And if you want to return to your daily activities even stronger than before — you can supplement your physical therapy sessions with Pilates.

Pilates-based physical therapy is excellent for people of any age who want to start an exercise program but might be afraid of injury or pain. Our practice actually specializes in treating clients aged 40+, and many of our clients in their 60s and 70s practice Pilates regularly! We offer a range of classes right out of our physical therapy practice in Portsmouth, which gives you the opportunity to combine your rehabilitation sessions with some therapeutic, strength building exercise for the whole body. Our group classes are geared towards beginners — no experience necessary! And if you’re interested, but don’t want to make a commitment, no worries. You can schedule a FREE Pilates Taster with us to see how Pilates can help you.

Want to find out if Pilates is something you should be incorporating into your physical therapy? Talk to one of our specialists for free! 

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

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

Without an accurate diagnosis, treatment fails.

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

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

Where is your pain?

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

Do you have numbness, tingling or burning?

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

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

When do you feel stiff?

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

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

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

If this post has struck a chord, and you’re wondering if your shoulder problem is really a shoulder problem, then I want to invite you to our next Health & Posture class on Wednesday, July 17th.

Our free Health & Posture classes are an opportunity to hang out with us, meet our team, and ask our specialists anything you want about aches and pains you’re currently dealing with – but can’t seem to get rid of (or keep gone) completely on your own. Each class has a main topic, and on the 17th we will be focusing on neck and shoulder pain — although you can ask any questions you have! 

SPACE IS LIMITED, so make sure you click here to reserve your spot. See you there!