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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!

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! 

 

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.

syringe

Steroid injections may do more harm than good, research shows

Have you been told you need to get a cortisone injection? Have you already tried them more than once? 

Research is now showing that cortisone injections may hurt more than help in the long run! 

The results of a recent study from Radiology has raised concerns in the medical community about potentially adverse effects on joints following corticosteroid injections. These injections are commonly used to treat arthritis, especially osteoarthritis of the hip and knee. The researchers in this study observed patients who had previously received steroid injections and found that some of the patients exhibited further joint damage on medical imaging tests. According to the original article, these patients presented with “accelerated OA [osteoarthritis] progression, subchondral insufficiency fracture, complications of osteonecrosis, and rapid joint destruction, including bone loss.” 

The joint issues that can be triggered by cortisone injections don’t just show up right after the procedure — which makes it easy to see the steroid shot as a quick fix with no drawbacks.

And it’s true that there are usually no short-term side effects. However, when it comes to your joints, it’s all about the long game. And it’s worth noting that an analysis from the Cochrane Review in 2015 found that the benefits of steroid injections usually wear off after about six months…  meaning it’s a temporary “band-aid” solution to a bigger problem — a band-aid with the potential to result in permanent degradation of your joints!  

Arthritis is an issue we see all the time in our physical therapy practice, and that’s why patient and physician concerns with steroid injections are so relevant to us. Many of our clients have had injections suggested to them or have gone through with the procedure but not experienced any long-term healing. In many cases, this can be an overly simplified answer to the very complicated question of individual pain. Physical therapy, on the other hand, isn’t a one-size-fits-all solution. Our treatment model is entirely based around addressing the root cause of your pain instead of just providing temporary relief. Plus, we’re all about keeping your treatment non-invasive, movement-based, and entirely customized to YOU. 

If you’ve been told that you need a cortisone injection in your back, knee, or shoulder, think twice and get informed about other options!

If you’d like a NATURAL route to pain relief — and one that will make you more mobile and active at the same time — come talk with us! You can even schedule a FREE 30 minute Discovery Session with our specialists right now — no strings attached. 

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! 

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!