Tag Archive | physical therapy oceanside

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

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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 

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

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 PhysioWise 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

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.

Hypermobile joints may cause risk of injury, joint pain and arthritis

  

Joint hypermobility means that some or all joints have an abnormal range of motion (movement). This causes joints to be more mobile and less stabile. Many people with hypermobile joints do not have problems, but some might have unpleasant symptoms such as joint & back pain (lower back and SI-joint pain). People with joint hypermobility are also more prone to injuries such as joint dislocation, ligament sprains because they have less joint support around surrounding muscles, tendons and ligaments. Abnormal joint wear and tear may cause  joint arthritis (knee, hip & shoulder) and spine osteoarthritis (degenerative joint disease) earlier than normal aging process does.

There is no health benefit in having a hyperflexible body or being able to twist yourself into a pretzel or able to do split. In fact, pushing your body into extreme stretches can cause injuries. This is something that especially Yoga & Pilates people should know. Yoga is not the best choice for people with hypermobility, for some people it is even contraindicated. Hot Yoga can potentially harm you because heat makes your joints more flexible and you may push even more and way over your joints normal range of motion.

Pilates is good for people with hypermobility because it strengthens all stabilizing muscles in your body, not only core muscles. Unfortunately, Pilates is nowadays more about group exercises, mat and reformer classes, where the teachers don’t pay enough attention to each student’s proper form and individual needs. If you have a problem with your joints and got pain, it’s advisable to take private lessons from a certified Pilates instructor, who also has extended knowledge about body biomechanics and anatomy ( regular Pilates education lacks the knowledge of these two important areas). Some Pilates Instructors have no idea what a normal range of motion of joints is and might force their clients to do too wide range of motion without any joint stabilization, correct alignment or muscles support. However, overall Pilates is a great way to prevent injuries for those who are hyper mobile, as well as for those who are hypo mobile – both of them need a proper amount of muscle stability, strength and control as well as NORMAL muscle flexibility and joint mobility.

It’s very important for Pilates and Yoga instructors to know the joints normal range of motion. It’s unnecessary, and many times unhealthy, to go over normal joints range of motion at any circumstances.

These are the degrees of normal joints range of motion:

  • Spine Thoracic & Lumbar: Flexion: 80, Extension: 20-30, Lateral bending: 35, Rotation 45
  • Hip:  Flexion: 120 , Extension: 30 , Abduction: 45-50 , Adduction: 20-30
  • Knee: Flexion: 135, Extension: 0
  • Shoulder: Flexion: 180, Extension 60, Horizontal flexion: 135, Abduction 180, Adduction 75
  • Elbow: Flexion: 150, Extension: 0-5

For more about PilatesWise program in Oceanside, Carlsbad, Encinitas, Solana Beach and Rancho Santa Fe, please click HERE