Archives

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

Advertisements

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.

Pilates – The best way rehab orthopedic injuries ( Carlsbad, Encinitas, Oceanside)

Pilates – The best way to injury recovery and prevention

Knee-injury If you are injured and have pain, did you know that there is more to recovery than just getting rid of pain? If your rehab only focuses on pain it will always miss the root cause of the real problem. The fact is that pain and injury oftentimes change the way how you use and move your body. The neurological connection between brain and muscles is not working properly and body starts to compensate. The compensation patterns create altered alignment in the joint, leading instability (too much uncontrolled motion) and abnormal wear on the joint surfaces. It also puts excess stress and tension on ligaments, tendons and muscles. When the muscle imbalances and faulty compensatory movement patterns are left untreated, there is a chance that you will suffer from that same injury again or additional injuries somewhere else.

The key to orthopedic rehabilitation is not only to get rid of pain and injury, but also identify and treat muscle imbalances and faulty movement patterns. Unfortunately, that is not often the case in a regular Physical Therapy. Therapists are often too busy and do not have time to look at the whole picture of how you are compensating or how to treat your muscle imbalances. If you really want to get rid of your injury and complete your rehabilitation after Physical Therapy, take private Pilates classes with an experienced hands-on-skilled Pilates instructor, or even better, with Physical Therapist who is trained in Pilates.

exercise-therapyPilates rehabilitation also works as an alternative for Physical Therapy, or together with Physical Therapy. I strongly feel that Pilates really is a missing part these days in orthopedic (musculoskeletal) rehabilitation. In Pilates, clients become more responsible for their own rehabilitation process. It is not just going to a therapist, lying down and receiving passive treatment by a Physical Therapist. Pilates is an active form of rehabilitation which can addresses a specific injury site while rehabilitating entire body. It can vary from specific isolated movements to more dynamic ones as necessary for that stage of rehab. A successful recovery includes regaining deep stabilizer muscles strength, joints’ controlled mobility and achieving muscles flexibility back to the normal level – that’s what Pilates exercises are all about. Pilates focuses also on the total body integration, working the whole body on proper alignments and posture, improving your joint stability and mobility – all those aspects that you need to recover safely and effectively.

However, it’s important to notice that there is big difference between teaching Pilates as a form of fitness and using it as a form of rehabilitation. If you are injured and consider Pilates, it’s important to make sure that your instructor has experience to work with injuries. An experienced Pilates Instructor or Physical Therapist trained in Pilates can provide an individualized rehabilitation program based on your special needs and conditions by identifying and correcting your muscle imbalances and faulty movement patterns. By investing in your sessions, you will get an injury-fee, well-balanced and well-functioning body. Not that bad investment at all, or what do you think?

More about PilatesWise pilates training for orthopedic and neurological rehabilitation, please click HERE

Exercise is part of Arthritis Treatment ( Pilates Wise, Carlsbad, Encinitas )

Exercise is an important part of arthritis treatment

When you have pain, probably last thing what you want to do is exercise. But did you know that disuse and inactivity can lead a muscle loss and joint stiffness by causing even more pain and discomfort? Researches have shown that proper exercise is crucial in managing arthritis and pain. It reduces stiffness and pain, builds strong muscle around joints and increases flexibility, joint stability and control.

Most importantly, proper exercise can help lubricate joint surfaces, build and provide nutrition to cartilage and decreases inflammation. Motion is really a lotion!

One of the most suitable exercise forms for arthritis is Pilates. Pilates exercises strengthen deep stabilizer muscles which support your joints and provide joint protection. Pilates exercises taught by an experienced Pilates instructor can also help reduce your joint stiffness and maintain/improve joints range-of-motion and a proper joint alignment. Posture and proper spine and joints alignment are very important part of treating arthritis as well as preventing further joint degeneration. As you probably know, poor posture put excess pressure on your joints, ligaments, muscles and tendons by causing more pain and joint wear and tear or even arthritis.

Very unique about Pilates are Pilates machines (reformer, trapeze table, wunda chair) which are designed to work your body in a safe and controlled alignment. Those machines are spring loaded which makes them very “joint friendly”. Pilates apparatus together with a knowledgeable instructor help you  work your supporting muscles around your painful and inflamed joints without aggravating them. And the facts that Pilates works your body as a whole and all exercises are low-impact, low resistance and should be performed in pain free range, make it even more suitable for people with arthritis.

If you consider Pilates a part of your arthritis treatment plan, it is important to work with experienced Pilates Instructor or Physical Therapist. An effective Pilates program has to always be customized for your specific needs and conditions.

 More about PilatesWise program in Carlsbad village, California, please click HERE 

Can Yoga Be Bad For You? ( by physiotherapist Carlsbad, CA)

 

Yoga is very well known about it’s healing side, but can yoga also harm you? People have more and more physical problems today and an increasing numbers of population is turning to Yoga for exercise and relaxation. Yoga is well known also about relieving tightness and pain in joints, bones and muscles. Even though Yoga has many health benefits, if practiced incorrectly it may lead to injury and pain. Typical Yoga injuries are muscle strains, torn ligaments, shoulder problems, neck and back aches & pains. One reason of injuries is that people are pushing themselves past their limits and not knowing how far they can go. Another reason is a teacher who is not well-trained and has very limited knowledge about healthy and safe joint alignment and human anatomy.

Did you know that many yoga gurus and yoga enthusiasts have experienced back or neck pain? Many yoga poses force your spine to go too far beyond its normal and healthy alignment. Ideal Yogis are flexible and limber, right? However, too much flexibility is not good for anyone. The joints hypermobility (too much movement) puts excess pressure for your joints, ligaments, tendons and muscles. Loose ligaments and muscles can not support your joint enough, thus increasing risk of injury, pain or even arthritis. Our body is not designed to be like “human pretzel” anyway.

Hot Yoga is worst type of yoga if you have problems with your joint hypermobility, previous orthpedic injuries or fibromyalgia. In the hot room temperature Yoga poses are more intense because warm muscles let you stretch even more and at same time increases risk of injuries tremendously. So, as a Physical Therapist I do not recommend hot yoga as a healing aid for anyone who has problems with inflammation, pain or joint & soft tissue.

In my studio I have two former Yogis with serous back and neck problems. One has fusion in her cervical vertebras as well lumbar vertebras (L4-L5). She has been hypermobile whole her life and her spine was extremely flexible because of spondylolisthesis (slipped vertebras). She used to go to chiropractor three times a week which isn’t definitely helpful for her spinal instability and joint hypermobility. The other Yogis has herniated disc in her cervical spine, I’m wondering what causes that condition for seemingly healthy person…how about head stand or shoulder stand? Normally our weight is shifted by ankle, knee, hip and SI-joint, not by cervical spine. Even though your neck is a correct position while head standing, repetitiions many times a week is not good for your cervical spine and when we are getting older it is not even recommended anyway. It is good to keep in mind that at over 50 years old almost all of us are getting arthritics changes in our spine, which is a normal aging process. My client is over 55 and in a very good shape, but besides herniated disc on her cervical spine, she has also chronic back pain with sciatica, caused by sponlylolisthesis, degenerative disc disease and spinal stenosis. Yep, all of these in one person! She told me that she has been very active for whole her life and also practiced Yoga almost every day in a very advanced level (with head and shoulder stand). If I’m just looking at these two Yogis with all orthopedic problems what they have, my opinion is that Yoga can be sometimes bad for you. Especially if you really are extremely flexible like these two Too much is too much!

So, if you have too much movement (hypermobility) in your joints, you simply need more stability, not joint mobility or muscle flexibility. You need to strengthen supporting muscles around your joints which improve your joint stability and healthy, proper alignments. Pilates is a great form for improving your joints stabilization. Although many teachers typically have dancer background, they may also teach you to go too far. So, take the class from an experienced pilates instructor who has more knowledge about anatomy, proper biomechanics and orthopedic issues that you might have. If you find a good teacher you get definitely a long-term solution for your problems with pain, spine instability and joint hypermobility.

More about PIlatesWise Pilates & Rehabilitation program in Carlsbad California, please click HERE

KNEE PAIN WHILE RUNNING? ( by Pilates Wise in Carlsbad, Encinitas, Oceanside)

Got knee pain while running ? Pilates helps.

Image       hypertonic_muscle_19283_1_1_5835

Knee pain is very common overuse syndrome for runners. Pain is our body’s alarm system telling us that something is wrong. However, many runners ignore this natural alarm system and just keep running. Some runners even look for help from pain medications or knee brace.

But did you know that running with pain changes your strike? You probably start shifting weight more to your non-pain side and maybe start limping a little. This compensatory movement pattern put uneven pressure to your other joints, muscles and ligaments and leads to muscle imbalances, and over the time pain and injury elsewhere.

Two Imagemost common injuries for runners are Patellofemoral Pain Syndrome and Iliotibial (IT) Band Syndrome. Many runners think that just wearing knee brace or band help them to keep running. Unfortunately, these two common knee injuries develop over time from overuse and knee brace or band doesn’t appear to provide additional. Knee brace may even inhibit your normal joint function causing the pain continue or move to the other areas of the body. The best brace is your own muscle brace.

If you are experiencing knee pain from overuse, something is going on and need to be fixed. The essential components of treating your overuse injuries are stretching, strengthening and stability exercises. Muscle imbalance between quadriceps, hamstrings, calves, IT-band and glutealis muscles, are very common for people with knee pain. Tight muscles like hamstrings , quadriceps (Rectus femoris) or IT-band are pulling the knee joint and knee cap out of their proper alignment by causing abnormal stress into the knee joint. Gluteus medius and Quadriceps (Vastus lateralis, Vastus medialis) muscles weakness, which is very common for runners, causes problem with knee joint stabilization. Unstable knee joint is more vulnerable to injury and also put unnecessary stress to ligaments, muscles and tendons around the knee joint.

One-on-One Pilates with experienced Pilates instructor, who has a good knowledge about knee injuries, biomechanics and anatomy, can help with typical runners overuse injuries. Pilates equipment are perfect for knee rehabilitation. They are spring loaded, and very gentle for the joints by putting less pressure for knee joint while strengthen the supporting muscle around joint. In Pilates training improves hip-knee-ankle alignment and muscle balance which often causes your knee problem in the first place. In Pilates we have great attention to whole body alignment from head to toe and we focus on gaining strength, stability and mobility – not only your the injured & weaker side but also the whole body. Besides as knee rehabilitation, Pilates is also very good as overall cross-training form for runners to prevent also from other injuries.

More about PilatesWise program at Carlsbad Village Pilates studio, please click HERE