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How to Tell Good Pain from Bad Pain

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

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

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

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

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

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

So how do you know?

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

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

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

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

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

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

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

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

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

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

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

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

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

 

5 Ways to Save your Back While Stuck at Home

Staying at home during the coronavirus pandemic doesn’t have to mean staying stationary. If you already have occasional or chronic back pain, it’s so important to take extra care of your spine during this time! Even people who rarely experience back pain may see new flare-ups due to increased time spent sitting at home.

For many, work stations at home are not ergonomically ideal or perhaps even nonexistent. On top of that, social-distancing and closed fitness facilities are likely to reduce our overall level of activity and mobility throughout the day. Combined, prolonged, poor posture and reduced mobility are the main ingredients for increasing back and neck pain. But have no fear! There are still many ways to prevent your back pain from kicking up, even while stuck at home!

1. Stand Up & Take a Load Off

When we sit for too long, the burden of our weight is placed abnormally on our spine and can cause damage over time. Before long, those small loads add up to real pain. It makes sense when you consider that our bodies were designed to stand, sit, crawl, run, kneel, bend and move through the world in many different ways. It was never designed to sit in one position for prolonged periods, day after day. Sit too long, too often, and it can lead to bulging discs and weak, brittle muscles that are prone to tearing and other damage.

The solution? Limit your sitting to half-hour periods with a few minutes of standing in between, and you’ll reduce the uni-directional forces on your spine. In other words, if you sit for a long time at work or at home, stand up and walk around a little bit every thirty minutes. Aside from participating in regular strengthening exercise, like Pilates, this is the easiest way for the average person to prevent back injury (and heal your back faster if you already have an injury).

2. Watch for Curves

We have natural curves in our spine that help us handle stress and loads.  Whether sitting or standing, it’s important to maintain these curves.  When standing, our spinal curves occur more naturally and are usually easier to maintain.  When we sit, the protective curves in our spine are harder to maintain and often disappear.  And while a healthy core and strong back muscles are important to back health, they won’t protect your back if you sit for long periods, or when the curve in your lumbar area disappears while you’re sitting.

Fortunately, the solution is as simple as rolling up a towel and placing it between your chair or car seat and the small of your back (just above the belt line). Using a purpose-designed lumbar roll is my favorite choice, and what I use for low-back support. You can use a lumbar roll in your office chair, car, and on the plane if you’re flying! If you want to learn where you can get on of your own contact us about them here. Or see in more detail how to use them in our free e-book!

3. Extend instead of Bend

The human spine (and entire body) craves balance, which means both extension and flexion.  But we spend the majority of our time in flexion, bending over to put shoes and socks on, brushing our teeth, driving, sitting at work and then driving home. At home we bend forward to cook, sit some more as we eat and then curl up on our couch or an easy chair. As long as we’re not gymnasts or circus performers, it’s safe to say we could all use a little more extension in our day.  A really good exercise is to stand and place your hands on your lower back for support and then arch back as far as you can go.  Repeat this 10 times, at least once per day.  This is also a great activity to do when you are interrupting your sitting during the day.  If you’ve never arched you back like this before, it may feel stiff or even hurt a little at first. But, with a gradual increase in frequency, it will feel less stiff and more natural over the course of a few days.  If it doesn’t, or becomes troublesome for you, stop and consult with a qualified physical therapist who specializes in back pain.

4. Stay Hydrated

We all know that drinking water is important, but don’t forget WHY! Water lubricates the joints, keeps the body’s soft tissues and fascia hydrated, and boosts exercise performance (yes, including at-home Pilates!). Water also improves skin health and elasticity — keeping you looking (and feeling) young! Water is also essential for digestion, flushing the body of waste and reducing unnecessary snacking. Water makes up 90% of our blood – which helps regulate the body temperature, deliver oxygen to all the cells in our body, and improve concentration and reasoning. Now more than ever, to stay healthy and mobile – make sure you are getting at least 7-8 cups of high quality H2O per day!

5. Build Stability

Mobility and then stability! Stability comes from a strong core. It can seem challenging to maintain strength with little equipment at home, but there are, in fact, plenty of ways to activate your muscles without any equipment at all! A basic strengthening flow daily can help keep our muscles active, blood flowing and reduce likelihood of pain. The flow you see below targets some of our most commonly weak muscle groups in a simple-to-do floor routine.

 

If you like these tips and want to learn even more ways to prevent debilitating back episodes, you can sign up for access to our FREE COVID-19 back pain survival guide right here!  And don’t forget to check out our Virtual Pilates programs if you’re looking for a way to exercise in your home that will target — and resolve — back pain. We have virtual small group classes at least once every day, Monday through Friday. We’re here for you through this quarantine and beyond!

Persistent neck pain and tired of not getting answers?

Have you been dealing with annoying, on and off neck pain for a while now? Have you tried treating shoulder pain with no real results? Are you frustrated with empty answers?

Or maybe you know someone else who is dealing with this?

Over 30% of people report they have neck pain. Of those, 50% will continue to have problems without any real answers or solutions.

When clients come to us with neck pain, often they’ve already tried several approaches without success. But the real issue I see is that everyone they’ve seen up to that point has failed to give them a full and accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause (or causes) of neck pain can be easily missed by many, and is sometimes difficult to diagnose.

Why?

There are a few reasons…

  1. The anatomy of your neck, unlike the rest of your spine, is fairly intricate. Not only does this require special care and accuracy when it comes to examining your neck, it makes it easy for someone who is not expertly trained to miss things.
  2. Shoulder pain is very often confused with neck pain. What I mean is, it’s possible to only feel pain in your shoulder, but the real source of the problem is your neck. If you’ve ever been treated for a “shoulder problem” and it hasn’t gotten any better (or maybe it got worse!), there’s a good chance you were misdiagnosed.
  3. Your core strength has a lot to do with how well your neck functions. When it comes to neck pain – or any problem for that matter – a holistic approach is always best and the most thorough. Sometimes your neck pain can be a “symptom” of a root cause somewhere else. Many times I’ve seen people come in having suffered from neck pain for years – and once we properly strengthen their core or other areas of their body – their neck pain starts to finally improve.

These are just a few of the most common reasons I’ve seen, over the years, of why the true source of your neck pain can get missed. And guess what… if the true cause of your pain is missed… then you won’t get consistent relief or a full recovery.

If this is striking a chord for you, or maybe this sounds like the experience of someone you know, I’ve got some good news for you…

We have a FREE dinner and presentation coming up all about neck pain… and you’re invited!

We’ll be teaching you all about the anatomy of the neck, what causes most neck injuries, and what you can do about it! We’ll also be sharing expertise on how your core strength (or lack thereof) could be impacting your neck more than you realize.

This event is happening on Thur Feb 20th – from 6:30 – 9pm – at the Atlantic Grill in Rye.

Tickets are FREE – and dinner is on us!

But space is limited and over half of them have already been filled.

So please reserve your seat NOW by clicking here! 

We can’t wait to see you there!

Can’t make the event? Check out our free neck report here or request a time to speak with one of our specialists here.

Neck Pain? Come to our FREE Dinner with the Docs on Feb 20th

Over 30% of people report neck pain and of those, 50% will continue to have problems.

Tired of taking medication? Tired of going to multiple doctor’s and massage appointments each week? Are you contemplating an injection or procedure?

If so – then this is an event you won’t want to miss.

We’re teaming up with our friends over at Arete Chiropractic to help you understand the anatomy of your neck, how it gets injured, and what to do about it. Our purpose is to help you understand your body and how to both prevent problems, and recover from them.

If you or someone you know has been suffering with neck pain or headaches, and you’re ready to learn about natural solutions that give you long-term results instead of quick fixes…

Join us on Thur Feb 20th – at the Atlantic Grill in Rye – for a complimentary dinner and a fabulous presentation.

SPACE IS LIMITED!!

Tickets are free and you can reserve your seat here.

There will also be exclusive offers available for anyone who attends – but you must be at the event to take advantage.

Call our office if you have any questions and we hope to see you there!  Bring your friends!!

How to NOT let Aches and Pains Ruin your New Year’s Goals

It’s that time of year, when we start looking ahead and setting goals for ourselves. It’s especially exciting now because we aren’t only entering a new year – but a new DECADE!

Exercising more and losing weight are the top New Year’s resolutions on everyone’s lists year after year. But what if you’re suffering from back or knee pain?  One of the worst things you can do is ignore pain and assume that by simply exercising more or losing weight, your ailments will just go away. It’s certainly a reasonable expectation, however, I typically see an influx of people calling my office right around March because these aches and pains have not only worsened — but derailed their New Year’s goals completely.

I don’t want to see that happen for you. So here are my top tips to NOT let aches and pains ruin your New Year’s goals:

1. Get assessed by an expert:

 

Your first thought might be to go see your doctor if you’re suffering from something like back or knee pain. But most medical doctors are trained to screen you for problems like broken bones or serious pathologies – not to actually assess your movement. You need to know how your pain behaves during everyday functional movements to truly fix it – and to avoid unnecessary procedures and surgery.  X-rays, MRI’s, or simply moving your limbs around on a treatment table won’t do that… but that is what a medical doctor is trained to do. A specialty physical therapy practice will be able to assess your movement in detail, through various movement tests, which will tell a much better story about how your pain may or may not impact the new exercise or weight loss program you’re about to start. Plus, we’ll be able to give you customized modifications so that you can embark on your new goal while decreasing your risk of injury.

2. Mobility before Stability:

This is a saying you hear me say all the time in my office. Your muscles won’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a stiff joint, or you’ll encourage compensation. Full and free mobility requires adequate flexibility in your joints as well as your muscles. Most people don’t think – or even know – how to assess their joint mobility. If you’re suffering from chronically stiff joints, you’ll want to get them checked before you start a new exercise program. I recommend seeing a movement expert, like those employed in our office, to make sure you’re ready and able to start on that new exercise program you’re so excited about!

3. Stay Hydrated:

Drinking lots of water has two great benefits. It will give you the extra hydration you need if you’re planning to be more active. And it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day and improve your daily hydration intake is to begin with 10 oz of water first thing upon waking. Add a squeeze of lemon for extra vitamin C and supported weight loss.

4. Pace yourself:

It’s very appealing and motivating to go “all in” on your new exercise or weight loss goal and 10x it… and I applaud you for it. But remember, you have 12 months, and really, the rest of your life to accomplish your goal in any way that you see fit. In other words, take pleasure and pat yourself on the back for simply setting a goal. That’s a first step that many don’t even get to. Be proud of yourself for setting an intention and envisioning a better quality of life. To give yourself the best odds of staying on that path, I encourage you to listen to your body and take your time in acclimating to a new exercise program. Don’t fight your body if it’s talking to you.  Our bodies talk to us for a reason. If you need help figuring out what your body is trying to say to you – click here to schedule a FREE Discovery Session with us in Portsmouth. We’re happy to translate for you!

Happy New Year – and Happy New Decade! 

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.

Five Ways to Keep Your Back from Going Out this Holiday Season

The holiday season is supposed to be a joyful, relaxing time, but the reality is that sometimes it’s much more stressful than we’d like. Between family gatherings, shopping, travel, and the disruption of your normal routine, it can be easy for your back to suffer. Here are our tips for staying pain-free this holiday season!

1. Don’t Sit or Stand Too Long

Experts agree that a sedentary lifestyle is detrimental to overall health and well-being. Staying still for too long will make you stiff and could eventually lead to muscle spasms and cause injury. Take time during those long family meals to get up and walk around.  Too much sitting, in particular, has become widely known to cause problems with your back and eventually lead to debilitating episodes.  Read more about that here.

2. Minimize Stress

A stressed mind inevitably leads to a stressed body. When you’re experiencing stress, your muscles tense, especially in your neck and back. It also leads to more “stress hormones” flowing through your body (known as cortisol) which can result in muscle soreness and pain. There are several easy ways to decrease stress without avoiding those important family activities and shopping trips! You can start with simple gratitude exercises. Making your first words of the day a statement of gratitude can make a huge difference in your perspective and how you approach the day. Writing these “gratitudes” down and collecting them is also an awesome way to stay mindful of what’s important to you, and can help you let go of the things that are bothering you. Positive thinking and deep, measured breaths throughout the day’s activities could be the best gift you give yourself this holiday season!

3. Watch Your Posture

Be mindful of your posture and body mechanics while wrapping presents, lifting them in and out of the car, and decorating the tree. All of this bending and lifting can take a big toll on your back. Many people throw out their backs lifting because they aren’t using a safe technique to do so, or they don’t know how to properly engage their core muscles. It’s important to lift with your legs, not with your back, and to NEVER hold your breath. Otherwise you could do significant damage over time to the muscles and connective tissue in your spine, thus limiting your mobility, causing pain and discomfort, and increasing the chances you will “throw your back out”.

4. Make Time to Move

The holiday season can be incredibly busy, but it’s important to give yourself time to move. Taking a group walk outside is a good way to spend time with family and friends while still staying active and healthy. There are also plenty of simple in home exercises you can spread throughout your day. Five minutes of stretching or light exercise every couple hours will leave you way more relaxed, limber, and prevent back pain. If you’re looking for an exercise program that will keep you in shape and help you with chronic back problems, check out our Pilates 101: Get [Your] Back to Health program starting in January 2018!

5. Travel Right

Many of us travel during the holidays, which can be a major stressor and lead to back pain. Whether you are traveling by car or plane, you will be sitting for long periods of time in a cramped space. It’s important to take frequent breaks in order to stretch your muscles and prevent joint stiffness. Even if you’re flying, you can get up and walk the length of the plane to the bathroom and back- enough to stretch out and get your blood flowing. In your seat, be mindful of your posture and be intentional about stretching your neck, arms, and ankles. Be sure to bring a blanket or dress in layers as well- planes are generally chillier than most people find comfortable, and cold air makes your muscles tense up. Staying warm will keep you relaxed and pain free!  You can also use your extra layers to throw behind your back to use as a make-shift lumbar roll or pillow.  Having something that acts like a lumbar support behind you while sitting minimizes the load on your spine.

We hope you take good care of your back this holiday season, but if you run into any trouble, give us a call at 603-380-7902 or send an email to info@cjphysicaltherapy.edarci.com. You can learn more about all of our specialized Pilates programs that are specifically designed for back-pain sufferers here and stay in touch via Facebook for more helpful information just like this. We’re here to help!