Pelvic and Hip muscles imbalance and misalignment cause pain

Pelvicore-muscles-300x228s is your body’s center. Pelvic area problems are caused and contributed by pelvis and SI joint misalignment, improper loading and muscle imbalances. Usually a muscle imbalance shows the weakness of glutealis, deep back stabilizing muscles (transverse abdominus and multifidus), tightness of hip flexors, and hip internal and external rotators.

The neutral position of the pelvis is in the middle position – not twisted or tilted forward or backward. In the neutral pelvis alignment your spine gets its natural curves. When the pelvis alignment and center of gravity change, it can cause uneven loading and pain. When one part of your body doesn’t work correctly, other parts have to compensate for the weak point. Weakness of supporting muscles causes superficial muscles to be overworked, which may result in pain, excess muscle tension, and spasms.

Because your body works as a kinetic chain from head to toe, the upper body’s and foot’s function and alignments affect also your pelvis function. In walking and running, your rib cage and thoracic spine should be moving (rotating) naturally. If that movement is restricted then your lumbar spine will compensate with overloading and pain. If your foot elasticity and strength are missing, the kinetic chain from foot to pelvis can’t activate your muscles correctly during gait, which causes muscle imbalances and a risk of injury. As you see every body part is connected.

Incorrect pelvic alignment should be corrected as soon as possible because over time it may cause degenerative changes on your spinal structures, or even herniated disc and sciatica. Besides spinal structures, the SI-joint can be affected from pelvic misalignment. SI-joints are small joints between your Ilium and Sacrum which have very small but important motion. However, too much or too little motion can change your pelvis and SI-joint alignment and affects your gait. Si-joint pain is very local on one or both sides of the buttocks. SI-joint problems can be caused by weakness of supporting muscles ( muscles surrounding spine, pelvis and hip), which allow your pelvis girdle to tilt forward and causes excess pelvic motion while walking or running.

By correcting your muscle imbalances and misalignment are better treatment for your pain and dysfunction than passive manual therapy alone. Physiotherapist are educated to understanding your body’s bio mechanics, and help get you back in “balance”. Unfortunately here in the US, physical therapists rarely look and treat your body as a whole because usually they treat just a specific injury and pain. The reason for this is clear, physical therapist’s time is expensive and insurance companies are paying only for treatment towards injury and pain, not for prevention. However, the truth is that the source of pain and injury can be somewhere else than where the patient gets treatment, so it is important to take care of the body as a whole.

exercise-therapyPilates one-on-one training with a skilled physiotherapist or a very experienced Pilates Instructor helps tremendously for those who is suffering pelvic girdle dysfunction, low back, hip or SI-joint pain. Modified Pilates and Exercise therapy’s training goal is correcting your muscle imbalances and improving your muscles recruitment patterns. The Pilates approach is to work on your body as a whole and with “no pain is all gain regimen!” Be sure that your Pilates Instructor has the knowledge and education to help you. Even if they have 500 hours of training, it usually doesn’t include much training and modification for people with pain. Also the training usually has very little education on anatomy and physiology. But if you find a good one that is going to be PRICELESS!

For more about PilatesWise program in Carlsbad HERE

Multiple Sclerosis (MS) Common Problems, Exercise Therapy and Rehab Pilates

 acordax616Healthline website wrote a very good description about Multiple Sclerosis: “Multiple sclerosis (MS) is a progressive autoimmune disease. Autoimmune diseases mistake normal, healthy parts of the body as foreign and attack them. In the case of MS, the body attacks and destroys the protective sheath that surrounds your nerves. This sheath is called myelin. The damage to and destruction of the myelin eventually affects the nerves. Nerve damage delays and disrupts communication between your brain and parts of the body”.

Common physical problems with Multiple Sclerosis clients:

1. Foot drop

Foot drop is usually caused by a combination of weakness of the muscles of ankle dorsi flexion and tightness in the muscles of ankle plantar flexion. The weakness can be secondary to a loss of central nervous system activation, to disuse, or to some combination of the two. The tightness can be a result of plantar flexor spasticity, prolonged positioning in plantar flexion leading to decreased range of motion, or both.
Regardless of the cause, foot drop leads to higher risk of falling. An exercise program should focus on active and passive plantar flexor stretching, dorsi flexion strengthening, and exercises that retrain the ankle to function more properly during gait and balance activities.

2. Gait and balance dysfunction
For Multiple Sclerosis the gait difficulties are common and complicated. Gait may be limited by foot drop, and/or by hip and knee weakness and stiffness, lower extremity sensory loss, visual and vestibular damage, and cognitive loss. Balance loss in MS is similarly complex and is usually caused by a combination of factors that include weakness, stiffness, sensory loss, visual and vestibular loss, motor control impairments, and cognitive issues.
To prevent potential complications from gait dysfunction and balance loss is recommended to start physical therapy or Rehab Pilates (w/physical therapist) very early on.

3. Weakness and stiffness
MS clients overall weakness and stiffness are caused by CNS dysfunction but also may be a result of disuse. Stiffness can cause weakness and vice-versa.
Although stretching and strengthening exercises are clearly indicated, they must be tailored to each client’s individual needs and state of disease. Stretching and strengthening exercises should be gentle, and that is why Pilates with apparatus is a good fit for people with MS.

4. Fatigue
One of the most common findings in MS is fatigue, a lack of physical and/or mental energy. It can be primary due to CNS dysfunction, or caused by disuse atrophy from an overly sedentary lifestyle that the MS patient has adopted. Movement becomes increasingly difficult and exhausting, leading to a cycle of further immobility and worsening fatigue.
Exercise has to be gentle and with rest breaks—proper exercise program makes possible greater fitness gains without excess fatigue. Many MS clients find that Pilates exercises works well, because of breathing, engaging your deep core muscles and slow pace movements. After a class with a good teacher you feel more relaxed and less tired even though you have been working hard.

5. Mobility
MS is a disease of mobility. The big factors like loss of strength, range of motion, endurance, and balance cause many problems for MS clients daily activities and quality of life. So, that’s why exercise is the number one treatment for people with multiple sclerosis. USE IT OR LOSE IT!

9090TowerBar

Why Pilates for Multiple Sclerosis Rehab / Fitness?

Studies show that Pilates training develops balance, mobility and muscle strength of MS clients. For this reason, Pilates exercises, which are appropriate for the disability level of the clients, may be very beneficial and suggested. Pilates focuses on core muscles. Those are the muscles located around your center and spine. They are very important for your overall stability and balance. Pilates does not only build your core muscles, but also enhances your overall strength, body awareness, posture, flexibility and mobility. Muscle flexibility and Joint mobility are important to reduce stiffness and pain. Pilates training emphasizes proper breathing and smooth, flowing movements which are both natural stress relievers and causes less fatigue after session than normal exercise class. Pilates (with a good Pilates Instructor) facilitates proper movement patterns, so the muscles can learn to work more efficiently. Pilates exercises also re-educate the multiple sclerosis clients neuromuscular system. Pilates taught by Physical Therapist or very experienced Pilates Instructor is a safe workout and a good rehabilitation form for MS of any age and any other conditions because sessions can be modified for your needs and conditions.

Any Challenges?

Finding a good Pilates instructor experienced in working with people that have neurological issues and Multiple Sclerosis may be a big challenge. Our program NEUROPILATES is available for people who live around the San Diego, North County, CA.

Sciatica Pain Caused by Piriformis syndrome and Treatment (Carlsbad, Oceanside, Encinitas Pilates)

Piriformis syndrome, Sciatic Pain and treatment

download (1)

The piriformis muscle is a small muscle located deep in the buttock under the gluteus maximus. The muscle runs very close to sciatic nerve and some people the nerve even can run through the muscle. Piriformis muscle function is assisting to rotate the hip, turn the leg and foot outward (hip external rotation).

344900-28012-42

Piriformis syndrome may caused by muscle spasm or excess tightness in the piriformis muscle, either because of irritation in the piriformis muscle itself, or irritation of a nearby structure such as sacroiliac joint ( SI joint) or hip. Most commonly, clients describe acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Pain Increases after prolonged sitting, walking or running and it also may limit range of motion of the hip joint, especially hip internal rotation. Piriformius syndrome is very common in long-distant runners and those who’s sport requires repetitive external rotation of hip (ice hockey).

Many of my client who got a Piriformis syndrome, have also problem with their SI (sacroiliac) joint and visa versa. By saying that, SI-joint dysfunction may be sometimes root of pain, not piriformis muscles itself. Piriformis syndrome, SI-joint dysfunction and hip pain have very similar symptoms and they are hard to diagnose. Sciatica pain may also be caused by piriformis syndrome as well as SI joint dysfunction.

Almost every treatment approach for piriformis syndrome will include a focus on carefully and progressively stretching the piriformis muscle.
However, stretching only piriformis muscles may not be enough to treat piriformis syndrome. Piriformis syndrome may cause or caused by muscle imbalances in lumbo-pelvic-hip region. Stabilization of the pelvic may be affected by tight and short muscles hip flexors, hamstrings, piriformis and SI- joint dysfunction, resulting in overuse and spasm of the piriformis. So, muscle balance around your hip, pelvic and SI-joint are also important to treat. Faulty movement patterns are common for people who is suffering from piriformis syndrome. Piriformis spasms limit pelvic movement and in turn leads to gait deviations and compensations. If the muscle imbalances and faulty movement patterns left untreated, piriformis syndrome may return.

If you go to Physical therapy and did not get help, try Pilates with experienced Teacher. Pilates one-on-one training treats your whole body, not just a pain. So, you get help also your overall possible muscle imbalances and compensations – That is priceless.

Best Treatment for Degenerative Disc Disease – Proper Exercise Program

Importance of exercise for degenerative disc disease

Degenerative%20Disc%20Disease_WebDegenerative disc disease is one of the most common causes for low back pain. The diagnosis of “degenerative disc disease” is not really a disease but a term used to describe the normal changes in our spinal discs as we age. All people experience the changes in their discs that are consistent with greater or lesser degree of degeneration, but not all people will develop symptoms like pain, sciatica or spinal stiffness.

Degenerative disc disease involves the intervertebral discs. Those are the pillow-like cushions between your vertebrae in your spine. They help your back carry weight and allow complex motions of the spine while maintaining stability. As you age, the discs can lose flexibility, elasticity, and shock absorbing characteristics. They also become thinner as they dehydrate. When all that happens, the discs change from the support that allows fluid movement to a more stiff and rigid state that restricts your movement and causes pain.

A regular routine of back exercises can prevent low back pain and/or reduce the severity and duration of any “flare-ups.” Controlled, gradual, progressive back pain exercises can help the back retain its strength and flexibility. Also, back movement promotes the delivery of nutrients to spine, keeping discs, muscles, ligaments, and joints healthier. Prior to starting a new exercise program, it is always advisable for patients to first see a spine specialist who is trained in developing individualized back exercise programs and in instructing patients in using a correct form and technique for each exercise. Low back pain exercise regimens varies widely depending on the patient’s diagnosis and level of pain.
The best treatment regimen is a proper Spinal Stabilization exercise program

exercise-therapyProper Spinal stabilization exercises with knowledgeable teacher or physical therapist is recommended for treating disc degeneration and the sciatica pain. Alleviating sciatic pain caused by degenerative disc disease includes finding the most comfortable position for the lumbar spine and pelvis (neutral pelvic) and training the body to maintain this position during activities. In doing this correctly, one can improve the proprioception (sense of movement) of the lumbar spine and reduce the excess motion at the spinal segments. This will in turn reduce the amount of irritation at these segments, relieving pain and protecting the area from further damage.

These dynamic lumbar stabilization exercises often require specific hands-on instructions because they offer much less benefits if done incorrectly, and they tend to be much more difficult than they appear. This type of exercise program is progressive, starting with the easier exercises and advancing to the more difficult exercises once the lower level program is mastered. The most important aspect of using these sciatica exercises is sensing and controlling motion in the spine. Once learned, the body can eventually take over and do this without the level of concentration it takes early on.

Pilates is a good way to back rehab

Pilates training in one-on-one settings is also a good way to rehab and prevent back problems. Pilates is a low-impact whole body exercise regimen. Pilates foundation stabilizes your core by contracting deep abdominal, back and pelvic floor muscles with proper breathing. If you are looking for Pilates to help your back pain caused by degenerative disc disease, as a physiotherapist I recommend you to work with a very experienced Pilates instructor. Doing Pilates by DVD’s, books or in group settings (mat and reformer classes) are not good ways to learn proper Pilates and may even cause more harm. You may need a instructor or physical therapist who has good hands-on skills and can correct you as needed. Once you find a good instructor you’ll be in your way to get rid of your pain – and that is PRICELESS!

For more about PilatesWise SpinePilates program for people with Degenerative Disc Disease, Sciatica and Lower Back pain in Carlsbad, California, Please visit our website and click HERE

Kinesiophobia – The hidden reason why the back pain becomes chronic

Kinesiophobia – The hidden reason why the back pain becomes chronic

tumblr_l55qdyr1fd1qbqjovo1_500

Kinesiophobia is a disorder where a person believes that movement can cause more injury and pain. A constant cycle of pain, fear, disuse and depression can be a result of kinesiophobia and it definitely slows down a normal recovering process from injury. This can also lead to a long-term problems and chronic pain.

Persons with kinesiophobia tend to believe that the pain what they are experiencing may worsen if they do exercises and certain movements. They start to decrease their physical activity which unfortunately causes even more problems like joint stiffness, unnecessary muscle tension, supporting muscles weakness, etc. People with kinesiophobia are in a pain cycle (picture below), and getting out of this circle is very hard to do on their own.

pain cycle

As a Physiotherapist and Pilates Instructor I have treated many chronic back pain clients who are terrified exercising but want to get better. Some of them have already had bad experiences on Physical Therapy and doctors care. Painkillers do definitely not help if the source of pain mostly comes from patient’s fear, compensations and guarding. In Physical Therapy the trend is to work on many clients at same time, so they probably don’t have any extra time to concentrate or realize your fear and compensations. It is not either a good idea to give home exercises to people who has a kinesiophopia because they find it hard to do them correctly. Fear of pain also effects negatively to neuro-muscle connection and muscle recruitment, so exercises may do more harm than good. However, the truth is that movement heals and it has a crucial role of chronic back pain treatment, but it really does matter what kind of exercises and instruction you get to actually help you.

exercise-therapyOne-on-one Pilates with skilled Physical Therapist or very experienced Pilates instructor can help those who have kinesiophobia and chronic back pain. Well designed, slow, graded and progressive Pilates program which aims on practicing control of movement, breathing and proper muscle work will definitely help reduce fear of movement and also gradually overcome kinesiophobia. In Pilates every movement has to be PAIN FREE! Pilates with a good teacher helps you get your confidence in your ability to move. Returning to normal movement is an important step in breaking the kinesiophobia pain cycle. Pilates exercises help you rebuild normal movement and function which in turn relieve pain and improve your overall quality of life. Staying active is a critical component of chronic pain and back pain treatment. Don’t let your fear ruin your full potential recovery and stop you to do the activities that you love.

More about PilatesWise program in Carlsbad California, please visit our website www.pilateswise.com, our SpinePilates program is now also available via SKYPE for people around US and world!!! MORE ABOUT SKYPE TRAINING, PLEASE CLICK HERE.

Benefits of Pilates for before and after knee and hip replacement surgery

 

Knee and hip joints replacements are becoming more and more common. These procedures improve the quality of life for those people who suffered from constant joint pain and loss of function. Pilates is a great training method before and after knee and hip replacement surgery. By getting into better shape before surgery with Pilates, it also helps you to recover faster. By adding Pilates to your post rehabilitation stages, it helps correct your faulty movement patterns and muscles imbalances.

One of the best part of Pilates in one-on-one training is that it addresses the body as a whole. It doesn’t only strengthen the particular muscles or muscle groups or increase range of motion just in the one joint, it also trains the whole body as it was designed. Due to the low impact form of Pilates and assistance of Pilates equipment, joint can exercise very gently and pain free while strengthening surrounding muscles.

Pilates is ideal before knee & hip replacement surgery

Pilates before surgery is a safe and effective way to prepare your body for operation. Pilates exercises maintain the joint range of motion and strengthen the surrounding muscles of affected joints, even when range of motion is limited and lack of cartilage of the knee or hip makes your movement more difficult. Pilates exercises address your deep spinal stabilizer muscles – your core – which is very helpful for your overall balance and body control. Better balance makes you more confident on moving and less afraid of falling. Strong core muscles as well as shoulder girdle strength and stability are also a big help after surgery to get around and being independent while you are using walker, crutches or a cane. The stronger and more well-balanced the muscles before surgery, the faster the recovery period. In some cases the Pilates training can even postpone your need for joint replacement surgery.

 

Pilates is even more ideal after knee & hip replacement surgery

There is more rehabilitation after joint replacement than a short initial physical therapy which concentrates to regain the function of your brand new hip or knee joint. The previous years of pain have created faulty compensation patterns in your body, and unfortunately, that won’t get fixed only by replacing your joint. Even when your pain is gone or mostly gone, the body is still used to moving as if you are protecting your painful joint. This moving pattern puts a lot of pressure on other joints and tissues by creating muscle imbalances and poor habits to walk and move. With Pilates, and with a skilled Pilates Instructor or Pilates trained Physical Therapist, you can identify and properly treat your faulty movement patterns and muscle imbalances. Pilates program also focuses on lumbar-pelvic stability and strengthening of hip abductors to improve the symmetrical gait and standing balance. In Pilates, the quality of movement is more important than quantity as well as integrating the whole body to working and functioning symmetrically as it is designed. This is the best and most effective way to rehabilitate your body.

Pilates is a viable alternative method of rehabilitation and very good continuation after physical therapy when your goal is achieving optimal recovery and overall well-being.

As a Physical Therapist I warmly recommend to start Pilates if you have hip or knee osteoarthritis or you are heading to knee or hip replacement. Before you begin Pilates you will want to make sure that the Pilates instructor has proper experience and knows your limitation and can modify the movements for you. After knee or hip replacement surgery, Pilates can be extremely beneficial but only if taught by a Physical Therapist or truly experienced Pilates instructor.

Spinal muscles are an essential part of back pain relief and prevetion

Importance of spinal muscles rehab to relieve and prevent back pain

pilates_back rehab_carlsbadDid you know that muscles have a critical role of supporting your spine, preventing and reducing back pain? Very often medical professionals underestimate the importance of the deep stabilizer muscles helping your recovery process from the back injury.

Studies show that after first episode of back pain, the deep back and abs stabilizer muscles become impaired and stop working properly. Those muscles are not recovering themselves, even when your back pain is gone. After that initial recovery your back and spine are still unstable and vulnerable to re-injury. So the fact is that very often poor spinal stability and support are directly linked with acute as well as chronic back pain.

The deep stabilizer muscles have a big role in taking off the total load from your back and let your spine and back heal better itself. So, in order to getting a long term solution to relieve back pain and prevent future injuries, a proper exercise program is essential.

Achieving and maintaining spinal stability

ImageThe human spine is unstable without its musculature and muscle control. The deep muscles, which are close to the lumbar spine, function is protecting spine from injury and their dysfunction shows as low back pain. Researchers have found out that people with lower back pain lose their ability to properly contract deep stabilizer muscles (probably) through pain inhibition. Deep back muscles – Multifidus and deep abdominal muscles Trasverse abdominus – are vital in controlling the lumbar spine. If those stabilizer muscles fail to function, stability may temporarily be provided by mobilizer (external obliques, rectus abdominal) muscles instead. The precision of movement is lost, leading to an observable movement dysfunction. So, finding the right muscles to train is a crucial part of an effective back rehabilitation. Unfortunately, many “traditional” back exercises only engage superficial muscles and actually may even increase uncontrolled mobility (instability) and decrease stability in the lumbar spine thus increasing risk of re-injury.

Spinal Stabilization training with Physical Therapist, or Pilates with very experienced Pilates instructor or Physical Therapist, will help you find and train your deep stabilizer muscles. These both methods focus on improving mechanical support of the spinal joints through specific deep muscle contraction exercises and clients learn to dissociate the use of deeper muscles from the use of the more superficial muscles.

Pilates for back rehabilitation and prevention
Pilates develops spinal (core, back) stability. The exercises focus on developing the strength and flexibility through appropriate use of the spinal muscles, which act as stabilizers and create vital support for the spine. Training with an experienced Pilates instructor improves your body awareness and teaches you how the proper muscle functions support and protect the spine. The Pilates method is designed to condition the whole body and will also help your overall muscle control, coordination and proper movement patterns.

Spinal stabilization training for back rehabilitation
Spinal stabilization training (used often by Physical Therapists) refers to back rehabilitation exercises specifically designed to isolate stabilizing and strengthening weak muscles of the spine as well as pelvic hip region. The SST is gradually progressive and specifically designed based on your specific needs and conditions. Spinal Stabilization training helps ensure movement in a controlled pain free range with proper muscle activation.

Pilates as well as Spinal Stabilization training focus also on improving overall muscle balances and posture which often heavily contribute back pain or are even the cause of the back pain in the first place. Both training methods are safe and effective way to rehabilitate back pain as well as prevent back injuries. Investing in your back and spinal health is important and with pilates or spinal stabilization training you will get a long-term solution to get rid of your back pain, or least learn to manage it. You will get sooner back to your active lifestyle and sport what you love!

Our SpinePilates program, in Carlsbad California, is specifically designed for people with back pain caused by herniated disc, sciatica, bulging disc, SI-joint dysfunction, scoliosis, osteoporosis, osteoarthritis,spondylolisthesis, spondylolysis, spinal stenosis, degenerative disc disease etc. The program is combination of Pilates exercises and Spinal Stabilization training and taught by Physical Therapist & certified Pilates Instructor.