Posts

Carrie working on a client's shoulder

Shoulder Pain not Going Away? This could be why…

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

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

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

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

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

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

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

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

Where is your pain?

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

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

Do your symptoms involve numbness, tingling or burning?

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

Have you lost mobility or range of motion?

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

Confused? I don’t blame you.

If so – then I invite you to join our next online workshop!

It’s completely free — and will be LIVE over Zoom — which means you can join us from the comfort of your own home.

We’ll be talking all about neck and shoulder problems, how to tell the difference, why MRI’s and X-rays are often misleading… and most importantly — what you can do to start actually resolving this pain for yourself WITHOUT pain meds, procedures, or surgery.

Click here to reserve your seat!

 

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!

What is Dry Needling?

At CJ Physical Therapy and Pilates, our goal is to help you live a pain-free life without pain pills or invasive procedures.

Trigger Point Dry Needling is one of several strategies we use to treat muscles that are extremely tense and in spasm. The spasm causes the muscle to be in constant tension which reduces blood flow, decreases oxygen, and can produce fibrotic unhealthy tissue over time (scarring). When a physical therapist inserts the very thin acupuncture needle (dry needle) into a knotted up muscle, it creates a local twitch reflex. Research shows that this not only relaxes the muscle, it breaks up the pain cycle by improving blood flow and oxygen to the muscle. This whole process helps to reduce and normalize inflammation in the area to promote healing. However, dry needling is not necessary for everyone, so it’s important that you know what it is and when it can be used to improve your health! Here’s our advice when it comes to pursuing dry needling treatment.

Work with a physical therapist to use dry needling in conjunction with movement based rehabilitation.

Dry needling can work wonders to relax your muscles. However, they’re just going to get tense and damaged again if you don’t learn how to use them properly and address any movement dysfunction that may be occurring. You don’t want to think of it as a quick fix! Dry needling is just the first step for some individuals who aren’t able to begin a physical therapy or movement regimen without first breaking up the pain cycles in the muscles that are prohibiting healthy movement. Dry needling serves as a “helper” to relax those muscles – and should be integrated with physical therapy treatment and strengthening activities such as Pilates.

Don’t be afraid of trying dry needling!

It can be uncomfortable for some people, but others say they feel no pain at all. It’s not dangerous and has lasting positive effects when used in conjunction with hands-on physical therapy under the direction of a specialist. Furthermore, our clients love it:

“After two back surgeries in my 20s and a new hip at 58, I figured I was lucky just to be walking. Dry needling has transformed the way I move. I’m more flexible. My walking stride has more length and I can stand longer.” – John

Do you have questions about dry needling? Want to see what a specialty physical therapy practice can do for you? We offer FREE Discovery Sessions right here in Portsmouth that give you the opportunity to ask any questions you may have! 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. All you have to do is fill out this quick form, and we’ll be in touch!

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. Check out our free guide for getting rid of back pain and stiffness here.

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.

If you’re local to Portsmouth, NH and want to talk to one of our specialists about better and safer ways to strengthen your core – click right here. It’s free!

 

 

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!

Do You Really Need an MRI?

Do you really need an MRI for that?

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

Not necessarily….

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

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

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

Let me explain.

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

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

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

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

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

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

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

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

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

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.

Three Reasons to Stay Active and Outdoors this November

November is a tricky month when it comes to staying active and healthy. Between the sudden cold and the onset of the holiday season, it can be hard to stay motivated- especially when it comes to going outside. But don’t let that first cold snap keep you homebound! It’s just as important to spend time outside now, in late autumn, as it was in June. And in fact, there are some definite perks to taking that walk through your neighborhood, hike in the woods, or family bike ride in November.

Perk 1: No Bugs!

Sure, sunny and 75 sounds pretty tempting right about now, but have you forgotten the horrors of being swarmed by mosquitoes every time you stepped outside after 5 pm? Or how about those nasty deerflies that made exploring the woods more painful than pleasant? Not to mention the huge tick problem that we have in New Hampshire! The good thing about cold weather is that you can trade the bug spray for a jacket and be totally comfortable, without the fear of getting bitten and even sick as a result.

Perk 2: Work Off That Thanksgiving Dinner!

First of all, taking a walk after the Thanksgiving meal should be added to everyone’s list of holiday traditions. Walking aids digestion and will help with that sluggish feeling you get after eating half a turkey by yourself. And it’s an easy group activity for everyone in the family! Let’s not restrict our walks just to Thanksgiving day though- getting outside consistently and moving can make a huge difference in your health. As it gets colder, it can be tempting to trade outdoor activity for a walk on the treadmill or stationary bike inside or at a gym. There’s nothing wrong with indoor exercise, but a walk outside is better for you than a walk on the treadmill any day. The changing scenery keeps your mind stimulated and gives you a necessary break from electronics – something you won’t get on a treadmill pointed right at a TV.

Perk 3: Healthy Spine, Healthy Life!

Let’s face it – sometimes November weather seems like it’s begging us to forgo exercise regimens forever and curl up on the couch and watch movies instead. Down time is a crucial part of self-care, but we can’t let it take over! The simple movement of consistent walking -and limited time spent seated with bad posture- is what will keep your spine healthy for years to come. And if your spine suffers, even that easy post-dinner walk on Thanksgiving might become too painful for you. Back pain can severely limit mobility and leave you in that vicious cycle of needing to move to get better, but avoiding movement because it hurts. So why not do your best to eliminate that risk altogether, and stay active while enjoying this November outside? If you want to feel the burn before Thanksgiving, check out our two Wednesday Turkey Burn classes right here in Portsmouth!

If you are already struggling with back pain, and don’t know how to move forward, check out our free guide to fixing your own back. And if you have any questions, feel free to visit our website, Facebook page, or send an email. We’d love to hear from you!