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Knee pain? Top three causes and what to do about it.

Knee pain is one of the most common complaints that brings people into our office.

Since most of our clients are in their 40’s, 50’s and 60’s, they start to really worry that knee pain could bring an end to their active lifestyle. But that doesn’t have to be the case! The good news is that unless you’ve had some serious trauma (like a major accident or fall), 80% of all knee problems can be resolved without any kind of procedure or surgery – and most importantly – you can learn how to continue managing them on your own so that they never get in the way of your favorite activities again.

Sound too good to be true?

It’s not – I promise – but the first step is figuring out where your knee pain is coming from. Once you know that, you can get on the right path to resolve it.

Here are three of the most common causes I see that make people suffer from knee pain and what you can do about them:

1. Iliotibial band syndrome

This is a very common problem that typically affects runners, avid walkers, and hikers. It is often misdiagnosed and confused with patellofemoral syndrome (see below). Your iliotibial band (IT band) is a very large thick band on the side of your knee that will often get overworked due to a muscular imbalance elsewhere in your body (usually your hips and core). When this happens, you’ll feel pain that is on the side of your knee that is usually very sore and tender to touch, and typically sharp and stabbing versus achy. It will impact you most when you’re going downhill or down the stairs.

It’s important to note that even though a tight, and painful IT band is the structure causing you to have pain – it is typically a symptom of an underlying problem. Like I said before, IT band problems are usually the result of your core and hips not stabilizing your pelvis properly – which ultimately results in your knee not receiving the support it needs when you’re running, walking, or hiking.

Getting rid of the actual pain is the easy part… in our office we use things like dry needling, soft tissue work, and sometimes even some taping. But if you want to keep the pain gone – you MUST address the underlying causes as well. This is what a lot of people miss. We love using Pilates-based exercises in our office because they not only target your core, but also get your muscles working in a coordinated, symmetrical fashion, helping to keep things balanced as you get back to your favorite activities.

2. Patellofemoral Knee syndrome

This problem is very similar to IT band syndrome, with just a few key differences. This first is that it can impact almost anyone – not just runners, hikers, and walkers. You’ll also experience the pain in the front of your knee – typically under your kneecap – and it will tend to be more achy than sharp. This problem will often come on very slowly and can be more chronic than its IT band cousin. You’ll feel this more when you’re going up stairs, up hills, and with squatting. You’ll also notice stiffness and pain in the front of your knee after sitting awhile – that usually will go away once you start moving.

Much like IT band syndrome – these are all symptoms of an underlying cause. A weak core and hips can cause this problem too, but I usually see more weaknesses in glutes and hamstrings with this one. When the backs of your hips and legs aren’t kicking in like they should, it can result in tight hip flexors or quads. This is a super common culprit for patellofemoral syndrome. So once again, you can get rid of the pain quite easily in most cases, but you must make sure to determine – and address – the root cause so that you can keep this pain gone for good.

3. Osteoarthritis

Many people hear that they have osteoarthritis in their knee and think there isn’t anything they can do about it. Not true!! Arthritis is often blamed for knee problems but it isn’t always the cause of what you’re feeling… Let me explain….

When arthritis is the true cause and culprit for your knee problem, it will be painful and stiff all the time. You’ll lack significant mobility and it will be almost impossible to walk and bear weight without support or a cane. When this is truly your problem – you are a great candidate for total knee replacement surgery. Now here’s the catch… sometimes your X-ray or MRI will show that you have terrible arthritis or that you have “bone-on-bone”… but that doesn’t mean you need to rush to surgery! Your symptoms should really decide that.

If your pain comes and goes (meaning you have good days and bad days), if you can walk around most days and go up and down the stairs and your knee just “catches”, or maybe you feel stiff a lot but this eases up with movement – you might have arthritis in your knee but it is not the root cause of your knee problem. Because here’s a hint – arthritis does NOT come and go – but other common musculoskeletal problems can. When your pain comes and goes, you know it can’t be entirely from arthritis.

So what should you do?

With arthritis, whether it’s partially to blame, or whether it’s just something that shows up on the X-ray and gets blamed… we still need to look at the surrounding structures and root cause of the problem.

If your quads are really tight, and the muscles around your knee are imbalanced, this can create compressive forces in your knee joint which will exacerbate what might normally just be “mild” arthritis (compression will aggravate arthritis). You could also have weakness or problems in your ankles, feet, or core that are causing your knee to work harder than it needs to. This can cause pain all on its own, OR aggravate your arthritis. The point is, get checked by a musculoskeletal expert – people trained like us – so that instead of just fishing for the problem or only treating symptoms, you are getting to the root cause of your problem and setting yourself up for success!

If any of this sounds familiar to you, you may benefit from working with a specialist physical therapist who can help you get back to the activities you love – without pain pills or unnecessary procedures. You can click right here to request a FREE Discovery session with one of our specialists. We’d love to help you figure out the root cause of your knee problem so that you can get back to doing everything you love – instead of spending time in the doctor’s office 🙂

Not quite ready for a solution yet but looking for more information? Request a seat at our next Health and Posture class! It’s totally free and the next topic just happens to be all about hip and knee problems! Figure out if your problem is arthritis, IT band syndrome, patellofemoral syndrome, or something else entirely… with other folks just like you.

5 Signs Your Core is Weak – And What You Should Do About It!

A strong, healthy core is important for our health and posture. When your core is strong and working properly, you will have less back pain, better posture, and will move with more ease and endurance.  But how do you know if your core strength is where it needs to be? I can tell you that chiseled abs, a thin waist, or the ability to do a hundred sit-ups are NOT reliable signs of a strong core. Instead, here are five signs to know if your core is weak and what you can do about it:

1. Your Back Hurts

The most common side effect of a weak core is back pain, and yet most people still don’t consider core strengthening as a way to address those problems. Your core’s job is to support your spine and act as the center from which all movement stems. If those muscles are not properly conditioned – meaning, if they aren’t conditioned to engage when they are supposed to – your spine is at risk for being overworked, and muscular strain and tension are inevitable. The pain will most likely occur in your lower back, but can even occur in your neck, making simple tasks like bending, lifting, and walking totally miserable for you.

2. You Have Poor Balance

This may not be an obvious one – but one of the main culprits of poor balance is a weak core!  Your core muscles help to stabilize your pelvis, and a stable pelvis allows you to have better balance.  If the muscles around your pelvis (particularly your hips and glutes) are weak, then your balance will undoubtedly be affected. This may not be an issue that you notice right away.  But next time you’re walking across an icy driveway, you’re going to wish that your balance was at 100%. We incorporate Pilates into our physical therapy practice because it is such an effective whole-body strengthening system that can really make a huge difference in core strength and balance. A strong, coordinated, and engaged core helps you to react to balance challenges more efficiently, and may prevent that next fall!

3. You slouch all the time

Most people struggle to maintain good posture when they have a weak core. It becomes so easy to slouch, and you may not even realize you’re doing it.  Observe your posture right now… Are your shoulders rolled forward? Is your low back missing its natural curve? Is your head poked forward? When you go to correct your posture, does it feel difficult or tiresome to maintain? If so, your core might need some endurance-training!  A lot of people will argue that core strength has nothing to do with your posture. But here’s the thing, a strong core makes it easier and more natural to have good posture, and when better posture becomes effortless, it starts to become your norm. Your whole body – especially your spine – will thank you.

4. Your feet and wrists hurt

Many of our clients come to see us with an initial complaint of foot pain (also known as plantar fasciitis) or wrist pain. It keeps coming back no matter how many times they get rid of it or go to physical therapy. Sound familiar? When you have a weak core, and lack the proper central support and stability you need, your outer muscles and joints will eventually suffer. We already talked about balance. If your core isn’t working to help you stay more stable, your feet will have to work harder, resulting in overtaxing of the tissue on the bottom of your foot. If your middle back can’t support you when you’re pushing or pulling, your wrists will take the brunt and this can result in stiffness or pain over time. If you’ve got any chronic problem that isn’t getting resolved over time, something is missing. In the case of your wrists and feet – it may be a sign of a weak core!

5. You’re always holding your breath 

If you’re always being reminded to breathe when you move or exercise, this is another sign that your core is weak and not working properly. You’ve heard me talk about this before, but your deep core is made up, in part, of your diaphragm, which is your main breathing muscle.  When your core lacks stability, or in most cases, doesn’t know how to engage in the right way to give you the stability it needs, your diaphragm will contract to compensate. One of the most tell-tale signs that this is happening is that you always hold your breathe during exercise. This is probably one of the most overlooked signs of a weak core, and one of the most difficult to correct! It’s why we’ve dedicated an entire module to this topic in our Pilates 101: Get [Your] Back to Health program, and it’s one of the most important things we work on with every single client as we prepare them to confidently return to exercise.

If any of these signs seem familiar to you, then you might want to start paying more attention to strengthening your core! But don’t just start doing sit-ups or planks haphazardly and expect good core strength to follow. Being able to do sit-ups and planks are the RESULT of good core strength. You must first learn how to strengthen your core properly. We’ve got an entire 8-week Pilates program designed to help people do exactly this and it starts in a few weeks! Enrollment is open NOW and spots go fast, so don’t wait — click here to apply. 

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.

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 life-long 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?

If you’re a local, click here to learn more about our Pilates program and see if it might be a good fit for you! If you’re brand new to Pilates – click here to learn about our signature Pilates 101 program – designed specifically for folks dealing with back problems.

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!

5 Tips to Save your Neck and Back During Summer Travel

Summer is FINALLY here, which means many of us are getting ready to do some traveling! Whether you’re headed up to the mountains for a weekend or planning a flight across the Atlantic, it’s so important that you make sure you’re taking care of your body. Back and neck pain are the most common travel-related complaints we get from clients, and we want to make sure everyone has these five tips in their back pocket to prevent pain and injury!

1. Interrupt your sitting

The biggest strain on your body while traveling — whether you’re on a plane, bus, train, or in a car — is undoubtedly the prolonged periods of sitting in cramped spaces. Our bodies are made to move continuously throughout the day. On road trips, getting out of the car is critical for keeping your neck and back healthy. If you pull over at rest stops for a bathroom break, try adding a five or ten minute walk each time. Take advantage of scenic vistas to walk around, and ask your physical therapist for tips on healthy stretches that work for you to lengthen your spine and work through any pain or stiffness.

Flying is notorious for triggering back pain and spasms, especially in older adults. If you fall asleep on planes, you’re also more likely to end up sleeping in an uncomfortable position (often putting a lot of strain on your neck) and wake up feeling stiff and sore. If you can, we recommend choosing an aisle seat on planes so that you can get up and move more frequently without bothering your neighbors. Try getting up every 30 minutes to an hour on longer flights to walk to the back of the plane, stretch, and spend five minutes standing (if it is safe to do so, of course!). And if you plan on sleeping for part of the flight, try using a supportive neck pillow to reduce the strain on your vertebrae.

2. Use lumbar support

In addition to neck pillows on flights, you might want to invest in some reliable lumbar support for all modes of travel. We use lumbar pillows specially designed to take the pressure off of your spine that accumulates while sitting for prolonged periods. They help maintain the natural arc of your spine and promote healthy posture. You can even use a lumbar support pillow when sitting at your desk at work or home!

3. Stay hydrated

We all know that it’s important to stay hydrated, but why is it especially critical for avoiding back and neck pain during travel?

Well, water is the vehicle responsible for transporting nutrients to your cells, including the nutrients your muscle cells need to do their job. Dehydration causes muscle cramps because it deprives your body of electrolytes. Proper hydration increases strength, balance, and flexibility. Water also helps to lubricate your joints, which is a bonus for keeping your spine working smoothly and allowing it to support the movements of your entire body. So if you’re planning to hit the road soon, make sure you bring a reusable water bottle and fill it up regularly. And the extra bathroom breaks will give you an excuse to stay moving!

4. Pack light

No matter where you’re going or how you’re getting there, traveling involves packing, and packing too much stuff can be a quick recipe for back pain. Anyone who has flown knows that lugging multiple bags and/or suitcases around an airport is not only exhausting and stressful, but can leave you sore and unbalanced for days. Plus, you may have to lift a heavy bag in and out of the overhead compartment or carry a backpack with you as you’re exploring your destination.

Even if you’re traveling by car, you still have to load and unload your bags, carry them to wherever you’re staying, and still make sure there’s enough space in the vehicle for everyone to have decent legroom! Your best bet is to pack light, no matter what kind of trip you’re taking. If you’re bringing a suitcase with wheels, pack heavier items in there so that you don’t put unnecessary strain on your neck and shoulders. Opt for a backpack instead of an over-the-shoulder bag to avoid uneven distribution of pressure, and stock it with your water bottle, small travel essentials, and healthy snacks.

5. Prepare your body

The best way to prevent injury or pain in general is to maintain an active lifestyle that incorporates healthy, biomechanically correct movement on a daily basis. If you have a trip coming up, it may be worth investing in your health beforehand and meeting with a physical therapist to take an inventory of your body’s specific needs as well as potential problems. A physical therapist can help you learn how to strengthen your whole body in a way that both improves flexibility and gets rid of tension and pain. They can also teach you specific, individually customizable exercises to do during travel that will help your body take care of itself and prevent injury.

Are you taking a trip soon? Try these suggestions and let us know if they worked for you! You can also reach out to schedule a FREE Discovery Session with us! This 30-min session is a chance for you to speak with one of our specialists, tell us everything that’s been going on with you, and determine for yourself if we can help prepare you for your travels or improve your strength and mobility in general.

Happy summer, and safe travels!

Is Running Bad for Your Knees when you’re Over 50?

This is a question we get asked a lot — especially by clients who are getting older and worried that they won’t be able to keep running into their 50s and 60’s.

The short answer? No!

If you experience knee pain when you run, it’s not that you’ve “aged out” of the sport! It’s probably just a biomechanical issue that can be fixed with proper education and strengthening (best offered by a specialist physical therapist).

In fact, research supports that running may actually be GOOD for your knees!

Here are some factors that could be responsible for knee pain when you run:

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can in turn impact your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.”
A physical therapist can help you improve ankle mobility in order to prevent long term damage to the joints, tendons, and ligaments of your knees. This might be especially important for you if you’ve ever sprained or twisted an ankle in the past!

2) Weakness

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 strong lower limb muscles is critical. The hamstring and quadriceps groups play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

3) Unstable core

It may seem like running is all in the legs, but in reality, every physical action begins at the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — especially your knees. A stable core is key for maintaining balance and rhythm. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees.
Our favorite way to improve core strength is Pilates! If you are a runner but think you could benefit from a stronger core (let’s be honest, we all could), consider giving it a try — for FREE.

4) Running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — running form is important. It determines where and how the impact of every step is distributed throughout your body. If your body mechanics are compromised — for instance, you’re dragging your feet or running with your shoulders tense and shrugged — you’re more likely to suffer from chronic knee pain, or even experience a serious injury. Work with a movement specialist – like the PT’s in our office – to analyze your form and help you be more efficient when you run.

Running is good for you at any age, if you do it right!

Research shows running can actually slow knee arthritis. According to an article published by Outside Online, “animal models show that exercise promotes cartilage thickening and protects its stretchy properties… instead of wearing down your bearings, running may grease them. That’s key, because cartilage thinning and the loss of elasticity are both prominent causes of osteoarthritis.”

Want to make sure you’re running right? Get in touch!

You can even schedule a FREE Discovery Session if you have chronic knee pain (or any type of pain) to talk about what you’re dealing with and figure out the course of action that works best for you.

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.