Tag Archive | alternative treatment carlsbad

Kinesiophobia – The hidden reason why the back pain becomes chronic

Kinesiophobia – The hidden reason why the back pain becomes chronic


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.


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

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 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

Restorative Pilates Class For Fibromyalgia, Arthritis, Chronic Back Pain in Carlsbad, CA

Restorative Pilates For Chronic Pain And Overall Wellbeing


This class is for everyone, but it’s specifically designed for chronic pain such as fibromyalgia, lupus, myofascial pain syndrome, chronic back pain and osteoarthritis. The class is an unique blend of pilates, therapeutic strengthening and stretching exercises, breathing and relaxation techniques, myofascial release techniques and MELT method.


Proper exercise program is the best treatment for chronic pain. Movement heals physically and physiologically. Our classes focus on

  • Strengthen supporting muscles surround your joints and spine
  • Mobilizing joints and spine and emphasizing full range of motion
  • Stretching tight muscles
  • Releasing unnecessary muscle tension
  • Releasing myofascia and hydrating connective tissues
  • Relaxing body and mind

This all support your wellbeing physically and physiologically – and the most importantly – relieve overall pain.

 Are you in this pain cycle? We can help you out of it with our Restorative         Pilates class, taught by Physical Therapist & certified Pilates Instructor.

Classes are held on

  • Wednesdays at 11 am and
  • Saturdays at 9.30 am.

All classes are by appointment only and space is limited for max 5 people.

Please call or text 760.481.4943 to reserve your spot.
Your first class is FREE!

Rates: Single class $18, 10 class package $150 ($15/class)

For more about our Pilates fitness and Rehabilitation 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.

Knee Injury – Torn Meniscus and Rehabilitation


The knee is the largest joint in the body. The knee joint has two crescent-shaped cartilage menisci, one inside (medial) and another on the outside (lateral) of the knee. The menisci stabilize the joint, absorbs shock, and disperse lubrication known as a synovial fluid. They are essential for an efficient functioning of the knee. A meniscus injury can lead to critical impairment and overall biomechanics of the knee joint.

Meniscus tear is the most common knee joint injury. The motions that require pivoting, twisting, over-flexing the knee and sports with sudden stops (tennis, basketball) may cause meniscus damage. The most commonly injured meniscus is the one on the inner side of the knee, the medial meniscus.

Meniscus tear onset of symptoms are gradual. The pain is in the inner side of knee and you may hear or feel a pop sound when the injury happened. The knee joint may also click and lock and feel that it is giving away. It may also be swollen and is hard to straighten up.

A blood supply on the meniscus in very poor, and that’s why the meniscus injury heals slowly. If you are an athlete and want to continue your sport, you may need an arthroscopic surgery. If you are middle aged and not that active anymore, the rehabilitation with physical therapy or even pilates with a physical therapist are good ways to rehabilitate your knee injury.

Knee rehabilitation with or without arthroscopic surgery should focus on re-gaining knee’s normal range of motion, enhancing strength of quadriceps (especially vastus lateralis and medialis) and hamstrings muscles and decreasing unnecessary muscle tightness of IT-band and hamstrings muscles. Close attention should also be paid to the overall muscle control, coordination, balance and proprioception.

Pilates for knee rehabilitation with a skilled Pilates Instructor and Physical Therapist is good, safe and efficient way to rehabilitate your
meniscus tear and knee injury. While traditional physical therapy helps you with your knee injury and pain, with Pilates you are going to rehabilitate and strengthen your whole body and prevent efficiently re-injuries by correcting your faulty movement and compensation patterns and improving your overall alignment and posture. We in Pilates rehabilitate the root of pain and injury, not only injury itself and that is what makes the difference resulting a pain and injury free body. Therapeutic / Clinical Pilates rehabilitate and prevent at same time. Pilates is something you should seriously consider when you need a rehabilitation or post-op rehabilitation on your knee injury.

More about PilatesWise knee injury rehabilitation and prevention program, please visit our website and click HERE