Tag Archive for: stretching

Sciatica

Battling Sciatica? Here’s what to Avoid and what you should do Instead

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Did you know that nearly four out of five people will suffer from a debilitating back pain episode at some point in their lives and that it can result in sciatica?

“Sciatica” is a term used to describe searing pain, burning, or numbness that runs from your back and down your leg, often below your knee and into your foot. It occurs because something in your lower back is irritating the nerve that sends signals to your leg. It can be caused by anything that puts pressure on and/or irritates your sciatic nerve –  such as herniated or bulging discs. 

What a lot of people don’t know is that you can have sciatic symptoms without actually having any back pain. Sciatic symptoms can occur just in one place in your leg – like your knee and/or foot – or run down the whole leg as described above. Regardless of how your sciatica is behaving – there are some general “best practices” that almost all versions of sciatica will respond to. 

Here’s what you should avoid when you’re battling sciatica – as well as what to do instead:

What to Avoid:

1. Soft beds and couches 

While it may feel better in the moment – lying in soft beds or couches will ultimately aggravate your sciatica. When you lie in soft beds or couches – it forces you into a slouched posture – which puts unwanted pressure on your already irritated nerves. What’s tricky is that you often won’t notice the aggravation while you’re in the slouched position. It won’t be until later, perhaps when you get up to walk or move around, that you’ll feel worse. Because of this, people mistakenly attribute the aggravation of their sciatica to the activity they just did instead of the prolonged, slouched position they were assuming perhaps just minutes or hours before.

2. Child’s pose and stretching forward.

Just because a stretch feels good, doesn’t mean it is good – another big misconception when it comes to sciatica. Since sciatica is often caused by a bulging or herniated disc that is putting pressure on your nerve – you want to avoid anything that is going to increase that pressure. When you stretch forward – like in child’s pose – you’re opening up the space in between your vertebrae (intervertebral space). In between each vertebrae lies your discs. Although it feels good “in the moment” when you’re stretching forward – and may even temporarily relieve your sciatica – this relief won’t last. By opening up your intervertebral space – you’re making it easier for your discs to protrude out and irritate your nerves – unknowingly prolonging or worsening your sciatica.

3. Letting your MRI dictate treatment.

As already mentioned, sciatica often involves bulging discs – and an MRI will typically confirm this. But here’s what you might not know… Research has shown us that lots of folks (more than 60%) have bulging discs showing up on their MRI’s, but they don’t all have back pain or sciatic symptoms. What that means is that while sciatica is often caused by a bulging disc, a bulging disc doesn’t always guarantee you’ll have sciatica. Why is this important? Because when you allow your MRI findings to dictate your treatment plan, you’re more likely to undergo a procedure or surgery that might not be necessary. Removing the bulging disc material or fusing your spine together might take the pressure off the nerve temporarily, but if the underlying issue is a movement or mechanical problem, and it’s not addressed, it’s only a matter of time before your problem comes back and/or shows up in a different area of your spine.

What to Do:

1. Go for Walks. 

Walking is one of the best things you can do for back pain – even though it may seem counterintuitive to do so when you’ve got pain running down your leg. Walking is an upright activity that is generally good for sciatica versus the slouched, curved posture you have when sitting. When you walk, pay close attention to what happens in your leg. Do your symptoms worsen or start to get better? If they worsen, certainly stop and seek professional guidance. But if your leg starts feeling better – then the walking is likely good for your sciatica.

2. Pay attention to your Posture.

This may seem trivial – but maintaining good posture is critical when you’re suffering from sciatica. When your sciatic nerve is irritated, it becomes highly sensitive to postural changes in your lower back (especially slouched postures). Whether you’re sitting or standing – you want to maintain the natural S-curve of your spine as best as you can. I recommend to my clients they use a lumbar roll whenever they are sitting to make maintaining this posture easier. Correcting your posture alone is often not enough to get rid of your sciatica, but it can keep you from getting worse, and prevent it from coming back if you’ve successfully eliminated your sciatic symptoms.

3. Talk to a Mechanical Pain Specialist.

Did you know that 70-80% of all musculoskeletal pain is mechanical in nature? Both back pain and sciatica can fall into this “mechanical pain” category – which is caused by slowly developing movement problems or habits that eventually result in stiffness and mobility restrictions in your spine. These restrictions can lead to irritated structures, such as nerves. So if your sciatica is due to a mechanical problem – it’s not going to permanently improve with pills, procedures or surgery. You’ll need to find a mechanical pain specialist who can help correct and restore your movement patterns for a long-term solution you can maintain on your own.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

tight hips

Tight hips? Try strengthening instead of stretching.

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When you’ve got tight hips, it can interfere with your ability to enjoy walking, running, golfing, and just exercise in general.

Tight hips are not only annoying and achy, but they often contribute to lower back pain as well. But perhaps more frustrating than the tight hips themselves is the fact that no matter how much stretching you do – they never seem to loosen up. Typically when I hear this, it’s a big red flag for me that tight hip muscles aren’t actually your problem.

In other words, just because it feels like you’ve got tight hips – doesn’t mean they actually are tight.

 

Let me explain.

Your hip muscles can literally be shortened and constricted – in which case – they need lots of stretching. But they can also be “tight” due to weakness or being overworked. When muscles are overtaxed or undertaxed during an activity, they aren’t going to function well and they will find a way to compensate. And this compensation strategy can lead to chronically tight hips over time.

But here’s the thing…

When your hips are tight due to weakness and overcompensation, stretching will not help. Stretching might feel good in the moment, or give you temporary relief, but the tightness in your hips will continue to return until you identify and fix the real underlying problem.

Let’s take your psoas (one of your hip flexors and pelvic stabilizers) as an example to illustrate this concept…

Your psoas is one of your deep hip flexors that also has a connection to your lower back. Although it is capable of flexing (bending) your hip in some capacity – it has more of a stability role. When functioning properly it will assist in exercises like the crunch or sit up, and also work alongside your deep abdominals and glute muscles to help you maintain good upright posture when you’re sitting or standing.

Unfortunately the psoas gets blamed for a lot of things – most notably – tilting your pelvis forward because it’s “tight” and causing lower back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis, and your back pain and hip tightness will disappear. But sadly, this is rarely the case. More often than not, your psoas is tight because it’s overworking to compensate for your deep abdominals/core not working properly.

Do your hips ever cramp or feel achy during abdominal work?

Your inclination will be to stretch them but this will simply not work. You have to get your abdominals and deep core to start working properly so that your psoas can actually relax. Once your hip flexors are no longer doing all the work, they won’t feel tight anymore.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas along with your piriformis and TFL (tensor fascia latae) are the most common victims. We’ve already spoken about your psoas, but your piriformis and TFL love to compensate for weak gluteal (butt) muscles.

An overworked piriformis leads to difficulty sitting cross-legged and a tight TFL can be painful and lead to IT band problems. You can stretch all you want, but if you don’t address the underlying cause and give these muscles a chance to relax, your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of this story is that if you’ve got chronically tight hips and stretching all the time isn’t solving your problem, then consider a different approach. Most people don’t consider strengthening an area that feels tight but this could be what you’re missing.

When it comes to hips – the things to look at are your deep abdominals/core and your glutes/butt muscles. Often there’s an underlying weakness in one or more of these areas that you just can’t recognize. Do yourself a favor and talk to an expert who gets this.

Are you local to Portsmouth, NH?

Consider reaching out to one of my specialists by requesting a free discovery visit HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Avoid Pills. Use Movement as Medicine Instead

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Avoid Pills. Use Movement as Medicine Instead

In the 1990’s, it started becoming widely accepted to prescribe opioids for people recovering from surgery or injury. As well as those suffering with moderate-to-severe musculoskeletal pain (such as back pain and osteoarthritis). Although effective for managing pain, we would soon find out how highly addictive these drugs are. Statistics show that one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. And once addicted, it’s very hard to stop. Keep reading to lear why movement as medicine is a better option.

The Centers for Disease Control and Prevention (CDC) found in their 2018 Annual Survey Report of Drug-Related Risks and Outcomes that in 2016, more than 11.5 million Americans reported misusing prescription opioids. And despite efforts to curb these statistics, this number started to creep up again during the pandemic.

In response, the medical community established more strict control around the prescription of opioids. Many are avoiding prescribing them all together. For patients with severe back pain and arthritis, for example, injections and minor procedures have become far more common and recommended.

While this approach prevents you from becoming addicted to opioids, there are still inherent risks any time you have an injection or undergo a procedure.

So what’s the alternative?

Prescriptive movement strategies are the alternative. Specialized, custom-fit “exercises” that are designed to have a very specific (and noticeable) effect on your pain.

But what’s the difference between generalized exercises that make you feel good vs prescriptive movements that also make you feel good?

Well, the distinguishing factor is both in:

1) how your pain responds to the movement while you’re doing it, and more importantly

2) how it behaves afterward. Lots of exercises feel good while doing them, but not all exercises give you the long-lasting effect you’re truly looking for.

For example, let’s say you’ve got back pain. Perhaps stretching your back a certain way makes you feel good and temporarily eases your pain. But an hour or two later, or the moment you perform an activity that typically aggravates your back, your pain comes right back. The stretch makes you feel better, but it doesn’t do a good enough job to make you stay better.

Over time, you might find that your back pain comes and goes often. Although this stretch always helps, nothing really takes away your problem completely. Instead, you get stuck in that vicious cycle of stopping all activities every time you hurt your back. Or worse – start avoiding certain activities altogether for fear of hurting your back. This is no way to live and it’s not an example of a good prescriptive movement strategy.

So what would a prescriptive movement as medicine strategy look like?

Let’s take the same example above. But this time – you find that a particular stretch not only makes your back pain go away in the moment, but it stays gone the more you do it. Whenever your back pain returns, you can reliably use this stretch to take your back pain away every time. This is an example of a prescriptive movement strategy. You know exactly what to do, how often to do it, when to do it. And it works without fail every time. Plus, once you know what your prescriptive movement is, you can use it to prevent pain as well.

The good news is that 70-80% of all musculoskeletal pain responds to a prescriptive movement strategy. It works in all joints and muscles. You just have to work with someone who knows how to help you find it and then use it over the course of time. I can’t tell you how often I meet people who have the right movement, they just weren’t applying it correctly to get the long-term relief they were looking for.

Too good to be true?

It’s not – I promise. The problem is there’s a lot of mis-information out there and not every health care or fitness professional is trained in discovering the prescriptive movement that you need – or teaching you how to use it properly. The second problem – to be frank – is that hospitals make a lot of money from procedures and surgeries. There’s no real incentive for them to support conservative, natural treatments that you can do on your own at home.

With procedures and surgery, the results are faster, which makes for happier patients (in the short term). But studies show that 2-3 years out from surgery your results are no better or worse than if you were properly prescribed movement as your treatment. And after 10 years, those who’ve managed to avoid surgery for the same problem, actually have much better outcomes than those who went under the knife.

The greatest benefit of taking the time to go slow at first, and find a prescriptive movement strategy that works, is that you’ll have this movement “medicine” at your disposal at all times. It’s always in your “medicine cabinet” and you never need a prescription or pharmacy to refill it.

Hopefully I’ve got you thinking. And encouraged you, at the very least, to explore whether or not movement really can be your medicine. If you’re already tried and failed at this, it’s quite possible you just didn’t have the right approach.

Consider talking to someone from my team if you’re serious about getting help.

We’re trained to help you find YOUR prescriptive movement as medicine strategy and are up to date on the latest research.

CLICK HERE to request a Free Discovery Call with my team to see if you’re a good fit for what we do.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

Stretches not Working? Three Reasons Why

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Do you suffer from chronic muscle tightness or back stiffness and ever wonder… why aren’t my stretches working?

Perhaps you’ve Googled and YouTubed every stretch under the sun but still – you haven’t gained an ounce of mobility.

There are a few reasons why all your stretching efforts might not be doing anything for you. It could be your technique. It could be that you’re doing the wrong stretch. Or, it could be that you just shouldn’t be stretching at all!

Let’s go over the different reasons why your stretching routine could be failing you – and most importantly – what you can do about it.

You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into any stretch you’re doing. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work. Some people (myself included) respond better to “moving stretches.” This is where instead of holding one static position for a prolonged period, you repeatedly move through one or several end-range stretches. Moving neck rolls are a great example of this. If you’ve been diligently stretching and not seeing the results you want, try adjusting your technique. Moving stretches might be a better strategy than static holding. I know for me it is!

You’re doing the wrong type of stretch.

This one could be a little tougher to figure out on your own. There is a difference between corrective stretching and stretching to feel good. For example, let’s say your back is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stiffens up your back. Generic back stretches, such as bringing your knees to your chest or child’s pose, may be all you need to quickly get rid of the general stiffness you’re experiencing.

But let’s say you have associated back pain, or pain and numbness running down your leg. In these instances, generic back stretches won’t work or could even make you worse. You likely need corrective stretches, like what we prescribe for patients in our office. Corrective stretches are specifically prescribed to address symptoms, and are very different from the generalized stretches that are designed to feel good and relieve tension.

You shouldn’t be stretching at all.

Did you know that chronic muscle tightness can be a sign of a weakness? This is a very common problem with our clients. I’ve seen many folks over the years with chronic tightness and discomfort in their neck, backs, hips, etc. – and no matter how often they stretch or massage, it doesn’t improve.

How does this happen?

Well, groups of muscles are connected by this substance called fascia. If one group of muscles in the “fascial line” are not doing their job, a different group of muscles will have to take up the slack. When muscles are tasked with more work than they are intended for, they can become tight.

For example, if your deep core is not working properly, then the front of your neck will often kick in and try to help. If your neck is always sore or tight after a good ab workout, this is what could be happening. Stretching your neck won’t help one bit in this case – because what you need to be doing instead is strengthening your core. I see this same pattern with tight hips flexors. Once people start strengthening their core properly – the chronic tightness magically melts away.

Remember, when we are attacking the correct problem and doing the right thing – our body will respond. If you’ve been stretching and stretching and not seeing results – something is missing.

The longer your problem goes on, the more time it has to develop into a complicated fix.

If you’re suffering from any kind of pain or tightness that is keeping you from doing the things you love, our specialists are here to help!

Just CLICK HERE to request a Free Discovery Session!

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Physical therapy WORKS – Take it From the Ones Who’ve Done it!

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Still not sure about PT? Have you heard a lot of conflicting information about what we really do as physical therapists? Do you need relief from an injury or chronic pain but you’ve been told surgery is your only option?

You’re not alone.

So many of our clients have come through our doors for the first time with those same questions. They may have been told over and over again by doctors that their pain or injury isn’t fixable – or if it is, they need extensive surgery and/or drugs. Many have never tried physical therapy before. Some are nervous because they think that it will be painful, and others doubtful that they’re going to learn anything new or helpful. But time and time again, those same individuals end up seeing amazing improvements in strength, mobility, health, and lifestyle. They consistently report how grateful they are to be simply living pain-free or able to participate in their favorite activities again. And we are always so proud of them for putting in the work and being an active participant in their individualized treatment plan!

I could go on and on about the results our awesome clients have seen, but no one says it better than themselves.

When Jeff first came to us he had a shoulder problem that was keeping him from working out at the gym the way he wanted. He’s also a dentist so leaning over his patients all day wasn’t helping. We worked on strategies during the day to help his mobility and then we tackled his stability! He came in and let us know that he was back to his full chest workout and pushups – with zero pain!

David, age 56, suffered from chronic neck and shoulder pain before coming to us for help.

“I couldn’t run more than 2 miles without radiating neck and shoulder pain and I was really uncomfortable at work. Working with CJ Physical Therapy, I learned how to manage my neck without going the surgery route. Now I can run as far as I like without any neck or shoulder pain.”

Another 56 year old, Kathie, took advantage of both our physical therapy and Pilates programs to resolve her shoulder pain.

“Before coming to CJPT & Pilates I was dealing with a shoulder problem that kept me from things like buckling my seat belt, walking the dog, and putting dishes away. I wanted to try something different from the traditional routes I’d tried in the past. Combining physical therapy and Pilates, and working with someone who understood my personal needs, was the difference that gave me my life back.”

Gale, age 65, experienced a positive difference with our practice that she hadn’t received in the physical therapy that was referred to her following a surgery.

“I was dealing with terrible pain and numbness in my arm and wrist after surgery, and there was still no relief after 15 weeks of regular physical therapy. After coming to therapy here, I can now cook, put on make-up, and I’m no longer worried about getting back to hiking or backpacking which I love. Best experience ever!”

Nothing makes us happier than getting to be a part of a positive change in someone’s life. And we love to hear how PT has impacted not just our clients’ health, but their lives overall! Several of our clients have even shared video testimonials of their experience working with us, which can be found here. They are living proof that anyone can benefit from physical therapy. You can be as skeptical as you want – you just have to be willing to give PT an honest shot. And chances are, you’ll be glad you did!

If you’re wondering if physical therapy is right for you – or if a different kind of physical therapy is right for you – please reach out!  We are so happy to help.  If we can’t help you – we’ll find someone that can.

Back_Pain_Specialists_Portsmouth_NH

Where is your pain REALLY coming from?

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Don’t assume that where your pain is… is where the problem is!

This is a very common assumption and one that that we’ve been seeing a lot lately. If you watched our most recent Happy Hour on Facebook Live, then you know the story of the young guy who came to us looking for help with his heel pain. I checked out his heel, foot, and leg, but didn’t find any issues that would be causing the pain that he had been experiencing for four years.

I had planned on addressing the heel specifically before examining his back, but when he mentioned that he also felt a lot of tightness from his back into his leg, I decided to check it out. We did a test on his back and when he stood up, he immediately told me that his heel felt better! I was just as surprised as he was.  He was able to walk with less pain and his movement felt better overall. But when he started stretching his calf to his heel again, the pain came right back.

All that stretching he’d been doing day after day – to the area that he thought was the problem – may have actually been doing him more harm than good!

Now, it’s pretty clear that this young client doesn’t have a foot problem – where is pain actually was.  He has a back problem. And that’s something we can work through and fix! But if he never saw a specialist physical therapist like myself, he probably would’ve continued to believe that there was just something irreversibly wrong with his heel, and maybe even limited certain areas of his life, like football and sports, because of that.

Why should this matter to you?

You might not have heel pain or even noticeable back issues, but maybe you have pesky knee pain, a hip that hitches when you walk, or an achy ankle. Maybe you just feel muscle tension that never seems to go away, or weakness performing certain tasks.  These could all be indicators of a problem in your back!  Or somewhere else that just hasn’t been looked at yet, because it doesn’t match the main area of your pain.

If you’ve tried a lot of things and it’s not going away, it’s an indicator that your haven’t found the real source of your problem yet. Especially if you’ve gone to a doctor for pain in another part of your body and they’ve told you that there’s “nothing wrong.” Or maybe you’ve been stretching, massaging, and foam rolling religiously every day – only for it to keep coming back like a vicious cycle.  You might think that by doing this, you’re helping your problem and keeping it from getting worse – and you might be – but you certainly aren’t doing anything to actually address the problem and you aren’t any closer to a real solution. That’s why physical therapists are so important to have as part of your healthcare team – we’re trained to examine and treat the whole person – not just the foot/knee/hip/heel.

Getting Help

We know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free Discovery Sessions out of our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are a great opportunity to talk with a specialist about creating the best plan to get you healthy and feeling your best – without any obligation or commitment.

Feel free to reach out anytime, and be sure to like our Facebook page to stay up to date on Friday Happy Hour videos in the weeks to come!

Would a Tech-Detox be Good for your Health?

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Technology is a huge part of all of our lives, and there’s nothing wrong with that. We rely on digital technology to do our jobs, communicate with friends and family, find answers to our most pressing questions, and so much more. If you’re reading this right now, it’s because you have access to the internet via your computer, phone, or other device.A 2016 report published by CNN tells us that on average, Americans spend over 50 hours per week online. This “world at your fingertips” has so many great assets, and yet it can be damaging to your health if you never take a break.

Too much screen time can disrupt normal sleep patterns and cause insomnia, lead to increased feelings of isolation, and decrease your attention span over time. And from a physical therapist’s standpoint, walking around looking down at your phone or sitting hunched at your computer for hours on end is terrible for your spine!

There’s no need to give up technology altogether – smartphones and other devices are an important part of the world we live in. However, research shows it can be incredibly beneficial to engage in a sort of “detox” from your gadgets and take a break! This doesn’t have to be as extreme as locking up your phone for a week or quitting social media altogether. You can take small strides towards freeing up those hours that you would otherwise spend online. For example, you can turn your phone off in the evenings, for instance at 5 or 6:00, so that you are not staring at a screen for several hours before bed. This allows your brain to produce its natural levels of melatonin, which your body needs to both fall and stay asleep! Another option would be to delete certain apps off of your phone. Is Facebook a big time suck for you? Try eliminating it from your mobile devices so that you can only access it from a computer. That way, you can prevent distraction when you’re out and about this summer. You can also delete those games that you play out of boredom or habit- which will free up your storage as well as your time! It’s hard to put away the phone altogether, because many of us rely on it for things like its camera function and music. If you’re carrying your phone with you constantly, try putting it on airplane mode. You won’t get texts or social media alerts, but you’ll still have access to your camera, music, calendar, and clock (including timers, alarms, and the stopwatch). You’ll be less distracted, but still get to enjoy the versatile functionality of your smartphone.

If you spend a lot of time during the day on the computer for your job, or have other commitments that require screen time, consider incorporating timed breaks into your day every 25 minutes to stretch and/or walk around. Easy everyday movement and mobility exercises really help to invigorate the body, and taking these breaks will ease tension in your back. You can read more about how prolonged sitting is tough on your back here. If your job requires constant sitting, try to stay up and moving when you get home. It’s easy to flop onto the couch after a long day, but consider stretching or doing a simple in-home workout while watching TV. Or instead of devoting hours strictly to TV watching altogether, you can catch up on your shows while making dinner or folding laundry, for example. Pairing a mobile activity with a passive activity like watching TV will not only make you more productive, but it will also save your back from the pressure and imbalance of prolonged sitting!

Do you have a tech-detox tip to share? Let us know on Facebook! We love to hear your thoughts, and invite you to get in touch if you have any questions about your back pain, mobility, or activity level.