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The Do’s and Don’ts of Dry Needling

Trigger Point Dry Needling is one of several strategies we use at CJ Physical Therapy and Wellness 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 are some basic do’s and don’ts when it comes to pursuing dry needling treatment.

Do work with a physical therapist to use dry needling in conjunction with movement based rehabilitation. Dry needling can work wonders to relax your muscles, but 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.

Do not think of dry needling as a quick fix. Dry needling is just the first step for some individuals who aren’t able to begin a physical therapy treatment regimen without first breaking up the pain cycles in the muscles that are prohibiting healthy movement. Once those muscles are more relaxed, the dry needling can be integrated with regular physical therapy and strengthening activities such as Pilates.

Do educate yourself. You can request a free Discovery Visit at our conveniently located Portsmouth practice and we can work together to decide if dry needling is right for you!

Do not 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. 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

Feel free to reach out if you have any questions about dry needling. You can also follow us on Facebook and Instagram to learn more about our practice and the importance of healthy, pain-free movement!

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

A strong, healthy core isn’t marked by chiseled abs or a thin waist- in fact, the abdominal muscles are just a small part of a much larger system. The muscles in your back, your glutes, trunk, and stomach all work together to keep your spine safe and your movements effective. If any of the following phenomena ring true for you, it’s likely that your core is weak and it’s time to get serious about strengthening those muscles – properly.

(If you are looking for a program right here in Portsmouth, NH that teaches you how to strengthen your core the right way- then be sure to check out our Pilates 101 programs by clicking here.)

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 damage, and muscular strain and tension is inevitable. The pain will most likely occur in your lower back, but can even occur in your neck, and can make 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 to 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 glutes, are weak then your balance will undoubtedly be affected. This may not be an issue that you notice.  In fact, you may be so used to living with a weak core that you’re just accustomed to imbalance, and can compensate for it with other muscle and strategies.  But next time you’re walking across an icy driveway, you’re going to wish that your balance was at 100%.  Having a strong, coordinated, and engaged core helps your body to be able to quickly react to balance challenges, and keeps you from falling or hurting yourself!  If you continue to rely on compensation strategies for good balance, eventually they fail – so taking some time to properly strengthen your core is key.

3. You Always Slouch

Most people struggle to maintain good posture when they have a weak core. It’s so easy to slouch, you may not even realize you’re doing it until you start being mindful of your body.  Observe your posture right now. Are your shoulders rolled forward? Is your back missing its natural inward curve through the spine? When you adjust your posture, does it feel difficult or tiresome to maintain? If so, your core needs strengthening!  A lot of people will argue that core strength has nothing to do with your posture.  But here’s the thing, a strong core won’t preventyou from having poor posture, but poor posture will actually start to feel uncomfortable for you and less “natural” when your core is strong, conditioned, and naturally engaged.

4. You’re always “tweaking” or “straining” something

Because of the popularity and marketability of workouts that claim to give you six pack abs or amazing glutes, we sometimes forget that without a true, strong core – these workouts won’t be possible!  Eventually, your body will break down because it doesn’t have a strong foundation (your core!). Every activity, from throwing a ball for your dog to climbing stairs, is affected by the strength or weakness of your core. If you have a weak core, you’re more likely to strain muscles in your arms and legs.  I’ve actually seen a lot of knee and elbow problems that relate back to weakness in the core. If you feel like you exercise all the time but don’t seem to actually be getting stronger (aka – you keep tweaking or injuring yourself), then there is a very good chance that your core is weak!

5. You Dread Planks or Push ups

Both planks and push-ups are a great test of your core strength. A lot of people think of these more as arm exercises – but here’s a little hint – if you feel like all you are doing is strengthening your arms with these moves – then you definitely aren’t engaging your core!  If you’re still unsure as to how much work you need to put into building core strength, try holding a plank while taking 10 full deep breaths.  You should be able to maintain your plank for all the breaths without letting your back arch and certainly without feeling any back pain or tension.  If you can’t, don’t feel bad- it just means you have the opportunity to get stronger!

Even if you can hold the plank, you’re in great shape, and you never have back pain, core strengthening is still important. But odds are you’re like the rest of us, and do experience at least one of these signs of a weak core. Don’t worry! There are tons of ways to engage those muscles consistently and build strength. Our personal favorite is Pilates! Pilates is a movement system designed specifically to strengthen the whole body, starting with the core. It promotes spine health and has helped relieve a lot of back pain for many of our clients! In fact, we’re reopening our signature Pilates 101 program in January 2018. If you’re anywhere near Portsmouth, New Hampshire, and want to learn more about the program, click here. Spaces are limited in order to provide each participant the personalized attention and instruction they deserve, so don’t miss your chance to sign up! We’d love to see 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!

Do I Really Need an MRI?

Do I really need an MRI for that?

This is probably the number one question and concern I get from clients that I work with – 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.  They 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, and they can even detect certain heart problems and liver disease.  When you don’t know what’s wrong, and 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 or non-mechanical.  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 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 it’s 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 movementexpert for this.  A professional and specially trained movement expert (like a specialist physical therapist) knows how to tell if the issue is not just 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, give us a call!  We are a specialized physical therapy practice that is well-known for helping people with this exact dilemma.

You can find us at 53 Green Street in Portsmouth, NH.  Call us at 603-380-7902 or request to speak to one of our specialists for FREE if you’re looking for some help.  Or – download our free guide to back pain!  You can get that by clicking right HERE.

Dr. Carrie Jose, MSPT, DPT, cert. MDT helps people on the NH Seacoast stay active, healthy and mobile – so you can spend time doing the activities you love instead of sitting at the doctor’s office. Her practice, CJ Physical Therapy and Wellness, specializes in using physical therapy and Pilates to help people move and feel better without the use of prescription pain-killers or procedures like injections or surgery.