Tag Archive | active back rehab carlsbad

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

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.

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.

BACK PAIN RELIEF AND SPINAL HEALTH WORKSHOP IN CARLSBAD

ARE YOU SUFFERING FROM BACK PAIN? OR HAVE YOU HAD BACK PAIN?

THIS  WORKSHOP IS FOR YOU!! LEARN HOW TO RELIEF YOUR PAIN AND KEEP YOUR SPINE HEALTHY!

  • Coming again in fall 2013
  • Cost: $25
  • Location: 800 Grand Ave, Suite B 3, Carlsbad, CA 92008

This 90 min workshop that includes lecture, pilates, spinal stabilization training and stretching, is designed for people who have experienced back pain, or for anybody who is interested in his/her back and spinal health.

You will learn
– spinal anatomy and back biomechanics
– common causes of back pain
– how to strengthen your spinal supporting muscles safely and efficiently
– how to improve your spine mobility and hip & lower back flexibility

This workshop is taught by a certified Pilates Instructor Tuula, who is also trained Physical therapist in Finland and has 10+ years of experience in  Back and Orthopedic Rehabilitation.

 Spaces are limited – Please reserve your spot and call 760-481 4943 

For more about PilatesWise programs, please visit our website and click HERE

Is Spinal Decompression Therapy as Good as Advertised for Relief Back Pain?

 

Spinal Decompression therapy is a non-surgical treatment for people with back pain caused by herniated disc, bulging disc, degenerative disc disease or sciatica. Spinal Depression therapy provides gentle decompression / traction of the disc and let the disc heal itself by helping to get more space between vertebras.

Now, is this magic treatment / therapy as good as advertised for relieve back pain? Well, like every treatments, some people may get help from it but some may feel even more pain after the treatments. Why? Using traction for treatment of bulging and herniated disc may also aggravate the condition. So do your research before starting this treatment.

The advertisement says “Spinal Decompression therapy is the latest non-surgical breakthrough technology”. Really? Believe or not, this “latest” back pain relief therapy / treatment is not new at all! When I was studying Physical Therapy in Finland in mid 80’s, we used to work with very similar spinal decompression table as used today and that treatment was called “spinal traction”. The traction table was exactly like this amazing new technology table. When I graduated at the beginning of 1990, this wonderful spinal decompression therapy method suddenly disappeared. Why? Because the treatment showed to be ineffective and too expensive. One Physical Therapist made some research to see what this “spinal decompression” was all about and found out that since II Word War Physical Therapists have been offering “Spinal Compression” = “Spinal Traction”. Recent studies also found that traction is ineffective for the relief of pain in the lumbar spine – just like Finnish PTs already realized 25 years ago. Seems that old treatment is coming back again but unfortunately this does not make this treatment any better.

Spinal Decompression treatment is also really expensive, about $100-$150 /visit. And if you get some pain relief that might be very short-term because the very underlying problems of your back pain are still there: poor posture, improper body mechanics, weak spinal supporting muscles, and repetitive stress can cause vertebrae to compress the disc or to slip out of their alignment which adds pressure to the discs, thus causing pain. These are really the underlying problems which need to be fixed too. Any spinal decompression therapy or manual therapy is not going to help improve your posture or muscle imbalance.

Almost all of my Pilates clients have back problems and some of them came to me after nothing else was not working. Very often doctors and chiropractors underestimate how important it is that patients take more active role of their own back rehabilitation. Active back rehabilitation with carefully designed exercise program is proven to be much better long-term back pain relief than just handing out home exercises, manual therapy or spinal decompression therapy. Our active back rehabilitation program in PilatesWise is designed and performed by a Physical Therapist. It includes comprehensive assessment, spinal stabilization training, McKenzie method and Pilates training, which does not only help relieve back pain but also keeps your back healthy and strong and prevents from future injuries. You have only one spine and back, so start taking care of it.

For more info, please visit our website http://www.pilateswise.com