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

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

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

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

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

 

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

 

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

 

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

 

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

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

New Year — New You — New Pain?

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!

Physical therapy WORKS – Take it From the Ones Who’ve Done it!

Still not sure about PT? Have you heard a lot of conflicting information about what we really do as physical therapists? Do you need relief from an injury or chronic pain but you’ve been told surgery is your only option?

You’re not alone.

So many of our clients have come through our doors for the first time with those same questions. They may have been told over and over again by doctors that their pain or injury isn’t fixable – or if it is, they need extensive surgery and/or drugs. Many have never tried physical therapy before. Some are nervous because they think that it will be painful, and others doubtful that they’re going to learn anything new or helpful. But time and time again, those same individuals end up seeing amazing improvements in strength, mobility, health, and lifestyle. They consistently report how grateful they are to be simply living pain-free or able to participate in their favorite activities again. And we are always so proud of them for putting in the work and being an active participant in their individualized treatment plan!

I could go on and on about the results our awesome clients have seen, but no one says it better than themselves.

When Jeff first came to us he had a shoulder problem that was keeping him from working out at the gym the way he wanted. He’s also a dentist so leaning over his patients all day wasn’t helping. We worked on strategies during the day to help his mobility and then we tackled his stability! He came in and let us know that he was back to his full chest workout and pushups – with zero pain!

David, age 56, suffered from chronic neck and shoulder pain before coming to us for help.

“I couldn’t run more than 2 miles without radiating neck and shoulder pain and I was really uncomfortable at work. Working with CJ Physical Therapy, I learned how to manage my neck without going the surgery route. Now I can run as far as I like without any neck or shoulder pain.”

Another 56 year old, Kathie, took advantage of both our physical therapy and Pilates programs to resolve her shoulder pain.

“Before coming to CJPT & Pilates I was dealing with a shoulder problem that kept me from things like buckling my seat belt, walking the dog, and putting dishes away. I wanted to try something different from the traditional routes I’d tried in the past. Combining physical therapy and Pilates, and working with someone who understood my personal needs, was the difference that gave me my life back.”

Gale, age 65, experienced a positive difference with our practice that she hadn’t received in the physical therapy that was referred to her following a surgery.

“I was dealing with terrible pain and numbness in my arm and wrist after surgery, and there was still no relief after 15 weeks of regular physical therapy. After coming to therapy here, I can now cook, put on make-up, and I’m no longer worried about getting back to hiking or backpacking which I love. Best experience ever!”

Nothing makes us happier than getting to be a part of a positive change in someone’s life. And we love to hear how PT has impacted not just our clients’ health, but their lives overall! Several of our clients have even shared video testimonials of their experience working with us, which can be found here. They are living proof that anyone can benefit from physical therapy. You can be as skeptical as you want – you just have to be willing to give PT an honest shot. And chances are, you’ll be glad you did!

If you’re wondering if physical therapy is right for you – or if a different kind of physical therapy is right for you – please reach out!  We are so happy to help.  If we can’t help you – we’ll find someone that can.

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Where is your pain REALLY coming from?

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Don’t assume that where your pain is… is where the problem is!

This is a very common assumption and one that that we’ve been seeing a lot lately. If you watched our most recent Happy Hour on Facebook Live, then you know the story of the young guy who came to us looking for help with his heel pain. I checked out his heel, foot, and leg, but didn’t find any issues that would be causing the pain that he had been experiencing for four years.

I had planned on addressing the heel specifically before examining his back, but when he mentioned that he also felt a lot of tightness from his back into his leg, I decided to check it out. We did a test on his back and when he stood up, he immediately told me that his heel felt better! I was just as surprised as he was.  He was able to walk with less pain and his movement felt better overall. But when he started stretching his calf to his heel again, the pain came right back.

All that stretching he’d been doing day after day – to the area that he thought was the problem – may have actually been doing him more harm than good!

Now, it’s pretty clear that this young client doesn’t have a foot problem – where is pain actually was.  He has a back problem. And that’s something we can work through and fix! But if he never saw a specialist physical therapist like myself, he probably would’ve continued to believe that there was just something irreversibly wrong with his heel, and maybe even limited certain areas of his life, like football and sports, because of that.

Why should this matter to you?

You might not have heel pain or even noticeable back issues, but maybe you have pesky knee pain, a hip that hitches when you walk, or an achy ankle. Maybe you just feel muscle tension that never seems to go away, or weakness performing certain tasks.  These could all be indicators of a problem in your back!  Or somewhere else that just hasn’t been looked at yet, because it doesn’t match the main area of your pain.

If you’ve tried a lot of things and it’s not going away, it’s an indicator that your haven’t found the real source of your problem yet. Especially if you’ve gone to a doctor for pain in another part of your body and they’ve told you that there’s “nothing wrong.” Or maybe you’ve been stretching, massaging, and foam rolling religiously every day – only for it to keep coming back like a vicious cycle.  You might think that by doing this, you’re helping your problem and keeping it from getting worse – and you might be – but you certainly aren’t doing anything to actually address the problem and you aren’t any closer to a real solution. That’s why physical therapists are so important to have as part of your healthcare team – we’re trained to examine and treat the whole person – not just the foot/knee/hip/heel.

Getting Help

We know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free Discovery Sessions out of 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 a great opportunity to talk with a specialist about creating the best plan to get you healthy and feeling your best – without any obligation or commitment.

Feel free to reach out anytime, and be sure to like our Facebook page to stay up to date on Friday Happy Hour videos in the weeks to come!

Surgeons in surgery

Surgery versus PT: What You Need to Know

“I have to get surgery for my torn meniscus. I’m going to be out of commission for a while.”

“My back problems have gotten so bad that my doctor says I need surgery to repair the herniated disk.”

“The MRI doesn’t look so good. Hopefully surgery will be a quick fix.”

Sound familiar? Most of us know someone who has been told that they needed surgery for a knee or back issue – or have received that disheartening news ourselves. A herniated disk is one of the most prevalent back problems in adults, and is often treated with lumbar discectomy as the first option. The goal of this surgery is to remove the herniated portion of the disc from the patient’s back, releasing pressure on surrounding nerves and muscles. The goal is for the patient to be able to live without pain post-surgery, but this process usually involves lots of medication and prolonged periods of rest. Another common injury that frequently leads to surgery is a meniscus tear. Your meniscus stabilizes and cushions the knee joint. A tear would be viewed easily on an MRI, which can cause many doctors to immediately prescribe surgery. Following that type of surgery, you would probably spend about two weeks with your leg completely immobilized. Then you would be introduced to a rehabilitation plan that included physical therapy – not to recover from the original injury to your knee, but to recover from the surgery that supposedly fixed it.

Surgery, in the right circumstances, can be extremely beneficial. But unfortunately, it is over-prescribed and often unnecessary, especially for individuals with back and knee pain. Seeing a herniated disc or torn meniscus on the MRI screen may trigger an automatic prescription of surgery and medication- but these “quick fixes” may not be your safest or most helpful options. In fact, MRIs can produce false positives and lead to invasive surgeries for specific injuries that didn’t even exist in the first place. MRIs are a useful tool, but their readings should always be taken with a grain of salt. When given the opportunity, your body will do its best to heal itself. Why not try careful, guided exercise and strength-building before you submit to incisions and long, medicated recoveries?

This is where physical therapy comes in. Consider working with a specialist physical therapist to address your specific injury or pain- someone who doesn’t just prescribe exercise and passive modalities, but genuinely wants to help you recover in a natural and low-risk manner. A specialist physical therapist will carefully listen to your history, analyze your symptoms, come up with a customized plan of action, and problem-solve WITH you versus trying to solve the problem FOR you. One of the primary goals of our practice is to use guided, natural movement to help your body recover to full strength and health based on your own individual needs. Pilates-based rehabilitation is also a uniquely tailored approach to recovery that can make a huge difference. Most knee, back, and other injuries occur because the surrounding muscles are too weak to support those joints and systems properly. You may think that your regular exercise and stretching is enough, but working specific muscle groups can leave others underdeveloped and makes your body unbalanced as a whole. Pilates is a full body workout that starts from your core and balances you both mentally and physically! It won’t create further damage to any injuries because it’s so low impact, and working with a professional will allow you to customize your session to your own individual needs.

Do you live in the Seacoast area and want to learn more about why surgery shouldn’t be your first – let alone ONLY – option for recovery? Click here to get in touch, ask questions, and schedule an appointment. If you’re struggling with back pain, you can even download our FREE report on five easy ways to get rid of back pain WITHOUT surgery! And don’t forget to browse our selection of Pilates classes located right here in Portsmouth.

Movement is Medicine – When Prescribed Properly!

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.

Why Rest Might Be the Worst Advice for Your Back Pain

The majority of the people who come through our doors are seeking relief from back pain. Unfortunately, many of them have been told -or have simply assumed- that the best way to recover from their pain is to simply use their back muscles as little as possible. They’ve been advised to rest, relax, and limit their movement until the pain goes away.

The problem with this model for treatment is that it goes against everything we know about the spine and core muscles. Our modern health research suggests that early movement is actually the best way to head off chronic back pain! Of course, if you’ve suffered a trauma like a car accident or a major fall, you should absolutely go get checked out by a medical professional and follow their advice based on your injuries. But if you are dealing with a chronically aching back or general soreness, stiffness, and pain, it turns out that movement is actually the best course of action!

Of course, not all types of movement and exercise are beneficial when you’re in this situation.

That’s where physical therapy comes in! A physical therapist is able to identify specific movements that actually work through and relieve that pain, based on your individual condition. We call these initial exercises “first aid movements” – and they are especially helpful because you can use them any time you might tweak your back in the future! Knowing the specific movements that can help your back muscles relax and work fluidly with the rest of your body again can be a lifesaver if you work a physical job or rely on your ability to be active and mobile every day.

If you’re experiencing acute back pain, of course it doesn’t make sense to continue with all of your activities as usual if they are just exacerbating your symptoms. But there is a middle ground between overdoing it and completely stopping the movement that your body craves. (more about that topic here)

That middle ground, for a lot of people, is found through physical therapy.

If you deal with back pain and want to start learning how you can help yourself through movement, check out our FREE report right here on five easy ways to get rid of back pain! You can also get in touch with us directly through Facebook or right here.