Archives

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.

Advertisements

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.

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 

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

Home exercises vs. Pilates training for Orthopedic Rehab (at Carlsbad Pilates studio)

Home Exercises vs Pilates for Orthopedic Rehabilitation

Therapeutic exercises are a part of traditional physical therapy and they are a very important way to get the client more involved in their own rehabilitation process. Unfortunately, the home exercises should be given only if clients can do them with proper form by recruiting correct muscles. Unfortunately, when they are injured or have pain, they may compensate, which makes it harder to learn a proper form. The matter of fact is, if they repeat these home exercises with poor form and control, the exercises may do more harm than good.

Many physical therapy practices seem to use their physical therapy aid to teach home exercises to clients and that is not ideal. Physical therapy aids usually have very little knowledge about body biomechanics and anatomy, even when PT aids are trained and supervised by a Physical Therapist. If those home exercises are not taught well, they are not going to help either. Furthermore, home exercises are usually isolated to strengthening and stretching the muscles around injury, and that may sometimes be too much to tolerate, especially when clients have pain or fear of pain. So, in home environment clients may not repeat their home exercises correctly which may lead them to compensate and add even more muscle imbalances than they have already.

If you were injured and think that you are fully recovered, you may still have 50% chance to get the same injury again or create a new one. Why? Because your brain may develop faulty movement patterns during your injury and pain. You start to compensate and your brain adapts to that faulty way of moving. Sometimes, even though you feel better and don’t have pain anymore, you may still have those compensatory faulty movement patterns. These faulty patterns can lead to new injury by placing abnormal stress and load on joints and soft tissues.

You need to re-program your neuro-muscle system to correct these faulty movement patterns. It may sound easy, but it is not. Unfortunately, your short visits to Physical Therapy and doing home exercises, is probably not helping to correct these faulty movement patterns and muscle imbalances, because they focus more on your injury, not on how you may compensate it. The ideal rehabilitation program should focus on your whole body alignment and how your body parts are working together.  Traditional Physical Therapy may still help at your acute stage but after initial physical therapy it would be very wise to continue your rehabilitation process with Rehab Pilates.

Pilates as a Rehabilitation is a missing link in your recovering process from injury and pain. Pilates Rehab works for many reasons. Great attention to detail and form is a perfect way for clients to gain strength in their weaker and injured muscles and joints as well as the whole body. Pilates develops a smaller muscle group that works to support joints and body structures. It is a great way to complete your Physical Therapy. It works also as an alternative rehabilitation method for people with orthopedic issues and dysfunctions. Pilates one-on-one training with experienced Pilates Instructor or Physical Therapist can help people with their real underlying problems such as correcting those muscle imbalances and faulty movement patterns (which may have caused your injury in the first place). It is pretty much re-educating your body to work more optimally, economically and ergonomically with proper alignment, control and coordination. With Pilates you will get long-term solution about how to take care of your body as a whole – and the best part, being injury FREE! It’s all about PREVENTION!

For more about PilatesWise after Physical therapy program, please click HERE

Is Pilates All That Clients Need to Get Rid Of Back Pain?

   

Is Pilates as good to relieve back pain as many instructors advertise? Back pain is very complicated issue and there is no only one way to get rid of it. Many treatments fail because they only treat symptoms of back pain – not the real underlying problems. For 80% of back pain sufferers the most typical underlying problems are poor posture and muscle imbalance. Pilates is a well-known exercise form which is claimed to improve posture, core stability and strength. It is true that Pilates works better for back pain sufferers than other exercise forms, but results are often as good as the Pilates instructor is.

Muscle Imbalance

Pilates is a wonderful tool to strengthen deep stabilizer muscles (transverse abdominus and multifidus muscles) which support your spine. Studies have found that weak spinal muscles are typically found from people with back pain. Unfortunately, improving back stabilizer muscles is not enough. The pelvic and hip region muscles are also important and when they are unbalanced, they tend to impact back and spine function as well. For example hamstring, piriformis and hip flexor muscles tightness put tremendous pressure to the lower back and changing the pelvic alignment. Many Pilates exercises involve hamstrings, hip flexor and piriformis muscles which may actually further add imbalances and tightness of those muscles. Pilates focuses stretching by lengthening extremities and aiming the joints full range of motion. Unfortunately, just Pilates “lengthening” is probably not enough for a person who has  back pain and extreme tightness of these muscles. So, it’s a good idea to add also some traditional stretching to help better reduce tightness and relieve back pain.

Better Posture

Body alignment is a Pilates foundation which is very important for people with back pain. It’s a big help for back pain sufferers to know what alignment they have to keep and carry themselves, because with the optimal posture the pressure of the lumbar spine is minimal. Neutral pelvic & spine position is important but also the rest of the body’s proper alignment – from head to toe. Pilates instructor who teaches the back pain clients only on the supine position (lying on back) can’t improve much the clients’ posture. It’s important to teach spine and pelvic alignment in both standing and sitting positions where the muscles are working as a daily basis. Pilates improves posture and muscle balance if the Pilates instructors have a good eye and good knowledge of anatomy & biomechanics. Unfortunately, many Pilates instructors lack the knowledge of these areas.

Compensation, Muscle Recruitment

Always when pain is persisting, the muscles work differently. The other muscles “shut down” when the other muscles have to overwork by taking care of the others job. Researches have shown that of the people who has back pain the muscle recruitment changed. Deep spine stabilizer muscles are not working correctly and efficiently and superficial muscles take over, unfortunately with poor outcome. This often makes the back very vulnerable for re-injury. Back pain clients lose the control of deep stabilizer muscles -transverse abdominus and multifidus muscles – and so it’s very important to re-educate these muscles working correctly to help support spine. Pilates is a great tool to re-educate those muscles working correctly because all the movements start by contracting transverse abdominal muscles. Also many back pain clients overuse piriformis, hamstrings & hip flexors muscles and superficial back muscles and under use glutealis muscles. To identify and correct faulty movement patterns as well as faulty muscle recruitment needs again a knowledgeable and experienced instructor who has more in-depth anatomy and body mechanics education than a basic comprehensive Pilates education program can offer.

Fear of Re-Injury

Biggest fear for people with back pain is a chance of re-injury. There are many movements in Pilates which are not suitable for people with back pain and are even contraindicated. Every back pain clients are different, and so are Pilates programs. The biggest mistake is to teach too difficult movements too soon, which can cause even more pain and client is definitely not coming back after that experience. One-on-one Pilates sessions with an experienced instructor are essential! Clients have to have full trust to instructors skills so that they can get over their fear and let the movements heal. As a Physiotherapist I do not recommend group mat Pilates class or reformer class for anyone who have back pain!.

Pilates repertoire has many good exercises for back pain sufferers and it’s a wonderful exercise regimen to improve postural muscles strength and stability by giving more support for spine. Unfortunately, even that Pilates is a good exercise method, it does not mean that it’s completely correct to all problems and issues the back pain sufferers might have and very often good results depend on how good, knowledgeable and skilled the Pilates Instructor actually is. Working with back pain clients needs a more carefully designed program and much more knowledge about suitability of movements, rehabilitation and healing process. And in addition to Pilates it is a good idea to add some classical stretching exercises to loosen tight muscles. The tight muscles (hamstrings, hip flexor, piriformis) might cause the back pain or caused by back pain and they might be the reason why some people’s back pain is continuing or returning later.

Our Active Back Pain Rehabilitation is combination of Pilates and Spinal Stabilization training. Spinal stabilization training and Pilates are both clinically proven to be effective and safe way to rehabilitate back pain and prevent future injuries. Our program is available for clients in San Diego North County. Our studio is located in Carlsbad, just short driving distance from Oceanside, Encinitas, Vista, San Marcos, Leucadia, Solana Beach. Please click HERE and read more about our programs.