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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!

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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.

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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

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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.

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.

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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