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

Piriformis syndrome, Sciatic Pain and treatment

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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).

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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

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 

IS YOUR BACK PAIN CAUSED BY MYOFASCIA? (by Pilates Wise Carlsbad, San Diego)

Fascia covers whole body and it provides structural support around our organs, muscles, joints, bones and nerve fibers. Fascia helps prevent and minimize localized stress in particular muscle, joint or bone. It is always under tension as long as gravity is present, and it also provides stabilizer components that helps our posture and allows us to perform movement automatically.

Fascia has been viewed clinically as a potential source of dysfunction. The research has found that chronic pain patients have some pathological changes in their thoracolumbar fascia. The thoracolumbar fascia is a tough fibrous sheet covering the back. It is tensioned by the muscles above, side and below. The fascia works as an attachment to several muscles and plays an important role of stabilization of the thoracolumbar and pelvic regions (as well sacroiliac joints). The thoracolumbar fascia attaches to the external obliques, internal obliques, transverse abdominals, latissumus dorsi and gluteus maximus. Because these muscles are connected through the same fascia, myofascia chains may contain restrictions and dysfunction in one area that influence another remote area. The thoracolumbar fascia also contains three nerve endings and may play a neuro-sensory role in lumbar spine pain mechanism.

Thoracolumbar fascia’s role as a cause of back pain is something that it is not shown by x-ray or MRI and is often underestimated by doctors. Chiropractors and spinal specialist treat spinal pain as a pain from vertebras or disc, but that is not always the underlying problem and may be a big reason why the back pain becomes, and continues, chronic. In most cases of back pain, especially in sub-acute or chronic back pain, the cause of the underlying problem may be more in muscle imbalances, poor posture or even myofascial dysfunction than spinal structure itself.

 

There are many specific stretching techniques about how you can release and mobilize the thoracolumbar fascia yourself, for example rolling with the foam roll. Besides releasing fascia, it is still very important to take care of your (deep stabilizer) muscles strength around your spine. Spinal stabilization training is specifically designed for people with back pain. It is scientifically proven to be very helpful exercise method for rehabilitating your back more safely and efficiently. For more information about Active Back Pain Rehabilitation, please click HERE