Tag Archive | back pain management

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.

For more about PhysioWise program in Carlsbad California, please visit our website www.physio-wise.com

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5 Common Misconceptions About Sciatica

5 Common Misconceptions about Sciatica

Sciatica is a medical condition
Sciatica is a symptom of another medical problem, not a medical condition on it’s own. Sciatica is generally caused by compression of lumbar nerves L3-L5 or sacral nerves (S1-S3) or by compression of the sciatic nerve itself. Sciatica usually affects only one side of the lower body, the pain extends from lower back all the way through the back of the thigh and down through the leg.

Sciatica is always caused by herniated disc or Spinal Stenosis
It is true that sciatica is often a symptom of herniated disc or spinal stenosis, but also piriformis syndrome, degenerative disc disease, spondylolisthesis, osteoarthritis, facet joint syndrome and Si-joint dysfunction can cause sciatica.

Best treatment for sciatica is bed rest
Bed rest is not recommended. Inactivity will usually make the pain worse. Without exercise and movement the back muscles and spinal structures become impaired and less able to support your spine and back. Proper exercise and slight activity help exchange nutrients and fluids within discs to keep them healthy and prevent pressure on the sciatic nerve.

Chiropractor is the only who can help me to relieve my sciatic pain
In most cases people recover from sciatica (depends diagnosis) without any specific treatment. In some cases chiropractor’s care can give you a short-term pain relief but in some cases it will even aggravate the pain. Active forms of back rehab are more effective in the long term and almost always necessary to get rid off the pain. When you engage in a proper exercise program you can recover more quickly from flare up of sciatica and are less likely to experience future episodes of pain.

Pilates is a good exercise form for sciatica
Pilates is generally a good exercise form and rehabilitation for sciatica, but only when taught by a highly experienced pilates instructor or physical therapist trained in Pilates. Pilates is a whole body exercise form which strengthens the deep spine stabilizer muscles that support your spine. It also correct your muscle balance posture and muscle recruitment patterns. It is not recommended to do Pilates based on your own by books, DVDs or Youtube even when they are aimed for people with sciatica. Pilates group classes (mat & reformer) are not recommended either. Investing in a proper one-on-one training with an experienced pilates instructor / physical therapist is the best way to relieve pain and get your active life back.

Our PhysioWise studio in Carlsbad, California specializes in Back Rehab program with combination of Spinal Stabilization Training and Rehab Pilates.The both are specifically designed for people with back pain and sciatica caused by spondylolisthesis, spondylolysis, osteoarthritis, herniated disc, bulging disc, SI-joint pain & dysfunction, piriformis syndrome, degenerative disc disease, scoliosis and osteoporosis.  For more detailed information about our programs please visit our website physio-wise.com.

Pilates – The best way rehab orthopedic injuries

  • 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 PhysioWise pilates rehab training for orthopedic and neurological rehabilitation, please 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

Is Pilates Instructor Capable Rehabilitate your Back Pain

 

Pilates is generally a good exercise method for those who suffer from back pain. Pilates focuses on core strength, stability and spine range of motion, all those areas which need the most improvements by back pain sufferers. However, all those improvements are up to the particular Pilates Instructor. When rehabilitating back pain clients the most important thing is to have an experienced and knowledgeable instructor. Pilates instructor needs to know much more than just Pilates specific exercises. And while Physical Therapists and Physicians recommend Pilates for back pain, the problem is that they don’t often know what kind of exercise Pilates really is, what kind of education Pilates instructors go through and how ready and knowledgeable they are teaching Pilates for those who has fragile spine and chronic back pain.

Many, even comprehensive, Pilates programs do not give enough tools and knowledge for the instructor to teach people with back pain. As both a Physical Therapist and certified Pilates instructor myself, I’m puzzled how openly and confidently many Pilates instructors market their services and teach people with back pain without any anatomy or back pain education in addition to their basic Pilates Instructor certification program. Many comprehensive Pilates teaching programs are just “certification businesses”, and there is a lot of competition in the marketplace where those certification programs don’t have any real, verifiable requirements to people who want to start Pilates education, so basically anybody can become a Pilates instructor. Most programs also lack any knowledge about anatomy, musculoskeletal disorders and body’s, especially spine’s, biomechanics. A basic Pilates instructor is not meant to be a therapist, but  it’s definitely not enough to know just how many vertebras there are on the spine or knowing wide Pilates repertoire and how to cue them verbally. In my professional opinion, a skilled Pilates instructor has to understand in details how the spine is moving and how exactly it should move, what muscles the client should contract or not contract, and most importantly know all contraindicated exercises and how to properly modify Pilates movements individually based on the need and condition of back pain of the client.

Every back pain is different, so should the Pilates program be. There are no “one size fits all” Pilates exercises for back pain. Designing the Pilates exercise regimen should always aim at underlying problems. These problems are usually a poor posture, weak deep abdominal and back muscles, tight low back, hamstrings or hip flexor muscles, and limited spine range of motion. Pilates gives a wonderful toolset to improve all of those elements – but only if the Pilates instructor knows how to use those tools safely, correctly and efficiently. It’s important to notice that if Pilates exercises are taught unprofessionally, they may cause more problems or even re-injuries. Pilates instructor should never teach fitness and back pain clients similarly. Instructors have to be very cautious, especially when teaching clients who have osteopenia, osteoporosis, osteoarthritis, spinal stenosis, spondylolisthesis, spondylolysis, herniated disc or bulging disc.

In Pilates market the competition is hard these days and it’s getting even harder. Many studios have financial problems and some studios even have more instructors than clients. Consequently, there are many Pilates instructors who claim to be specialized in post-rehab and rehab without any education (except certified Pilates instructor), so be cautious when choosing a studio or instructor to rehabilitate your back pain – always ask for instructor‘s education, credentials and real experience. Also, never go overcrowded mat class or your fitness centers mat class with back pain. Many mat Pilates instructors get their certifications through a short, one weekend course or, even worse, by internet. Pilates for back pain should always be individual, one-on-one private session. Check always instructor’s background and previous client referrals too. Many instructors might have a story about their own back pain and injury and how the Pilates “saved their lives”. Good for them, but while not only being subjective, own experience does not necessary mean that they are capable of rehabilitating others back pain. In my opinion, much more education is needed in this area anyway.

I’m very positive that Pilates is a wonderful movement therapy and treatment to rehabilitate back pain. However, quality and education are the key to choosing the right Pilates instructor and studio. Try to find a well educated instructor who understands your specific needs and conditions. When you find a good one to work with, you will be surprised about the results – and that will be priceless!

High Heels Cause Back Pain

Wearing high heel shoes can be sexy and feminine but is not the best thing for your body.

The body is a long chain from head to toe, and when the chain is working optimally your body parts such as bones and spine are on a proper alignment and muscles are working without extra fatigue or tightness. Wearing high heels creates faulty biomechanics and body alignment and put unnecessary stress on your ankles, knees, pelvic and throughout your spine.

High heels force your body weight to be thrown forward and make your legs, feet, hip and spine work against the way they were designed to work. The natural balance is thrown off and your muscles have to make constant adjustments to keep your body somehow balanced. Since high heels cause the body to lean forward, it is compensating that by tilting pelvis forward and changing your spine curvature- increasing lordosis on your lower back. This all creates more stress for the nerves of the lumbar spine and tighten your lower back muscles – causing back pain.

Back pain is not the only problem what you can get by wearing those sexy high heels. You can develop trouble walking, and high heels change also the way the muscles of pelvis, legs and ankle contract. Many of your body muscles have to work more than normally. The hip flexor muscles have to work harder and longer by helping move your leg forward because the toes are pointed downwards and can’t do they normal work. Hip flexor muscles become overused and hip flexor shortness might cause more back pain by changing spine curvature in unwanted direction. High heels also add shortness of hamstrings and calf muscles.

The legs and feet are the foundation of your musculoskeletal system and shoes support your entire body as the only contact between you and the ground. A shoe has everything to do with your posture and how your back, and whole body, feels. The shoes should provide comfort, stability and proper posture for you. Wearing high heels can be fashionable and sexy but think about the total price when you are wearing them! Podiatrists , Chiropractics and Physical Therapists get nice business from those who suffer back, hip, knees or foot pain by wearing high heels. Well, there’s nothing wrong about it but the actual problem will not be solved as long as you continue to wear high heels on a daily basis. Think which one is more important your spinal health or your sexy look.