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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

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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.

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