Tag Archive | pilates carlsbad

Knee osteoarthritis Management

Runners-knee_SAGOsteoarthritis, often referred to as degenerative joint disease (DJD), is the most common disease affecting weight-bearing joints like knee joints. Osteoarthritis causes pain, muscle weakness, and limits the joints range of motion which can lead to disability. Factors such as excess weight, joint trauma, misalignment (pinch knee, bow knee), weakness of quadriceps muscle and abnormal tibial rotation are identified as risk factors for developing OA.

OsteoarthritisPost traumatic arthritis in the knee occurs in response to ANY injury that affects the joint structures, but particularly following acute ligament and meniscal tears. Trauma, also including repetitive microtrauma, is a common cause of degenerative changes in the knee joint. The symptoms of OA include pain, limited motion, and muscle guarding.

Joint pain and stiffness also inhibit quadriceps muscle function which leads to a lack of joint control as well as problems with gait and balance. The limitation of a knee joint’s range of motion is also typical and usually occurs more often during knee flexion than extension.

Muscle support and strength

Muscle weakness is an important additional risk factor for knee OA development and progression. Muscular weakness and imbalance can have a significant impact on the ability to develop and withstand forces with compensatory movement patterns that increase force applied to the static joint structures.

The loss of quadriceps (knee extensors) strength and a loss of muscle mass (atrophy) have  commonly shown impairments associated with knee OA. Much emphasis has been placed on the quadriceps; however, impairment of other muscles have also been documented. For example: hip rotators, hip abductors & adductors, hip extensors and knee flexors.

The main muscular contributors to knee joint anteroposterior stabilization are quadriceps, hamstrings, gastrocnemius, and popliteus muscles. New studies have also shown that glutealis muscles, especially, gluteus medius have an important role in stabilizing knee joint.

Joint stabilizing muscles and muscle strength around the osteoarthritic knee joint offer the support and shock absorption that takes away excess pressure from the painful joint. Also, all the joints in our body require synovial fluid and lubrication to stay mobile. So, muscle condition and exercise are essential treatment for knee OA.

Move it or Lose it

Exercise is a well documented management for those suffering from knee OA. It is common sense that you want to do something low-impact instead of overload your joint (i.e. running or playing tennis). Too much of a wrong kind of exercise can load up the affected joints by causing more pain and stiffness. However, too much rest is not good either because it makes joints stiffen up and weakens the muscles around the joints.

The suitable low-impact exercises for OA are swimming, water-aerobic, biking (flat surface), pilates and yoga. Physical therapy may help those with Osteoarthritis because physical therapists usually give you home exercises which emphasis the strengthening of your weak muscles (quadriceps, gluteus muscles) and the stretching of any tight ones (hamstrings, hip rotators, it-band and calves muscles).

As a Physiotherapist and certified Pilates Instructor, I work weekly with people with knee injuries and Osteoarthritis. My program combines together therapeutic exercises, balance training and pilates. Pilates exercises with a reformer and trapeze table are very suitable and recommended for people with OA. These exercises are low-impact and gentle for your joints, they reduce pain and stiffness by strengthening and stretching the muscles around knee joint. Also, Pilates one-on-one training improves your overall posture and body awareness which helps correct your muscle imbalances and faulty movement patterns (compensatory movement because of pain). For more about PhysioWise in Carlsbad, California please visiti http://www.physio-wise.com

  

 

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Pelvic and Hip muscles imbalance and misalignment cause pain

Pelvicore-muscles-300x228s is your body’s center. Pelvic area problems are caused and contributed by pelvis and SI joint misalignment, improper loading and muscle imbalances. Usually a muscle imbalance shows the weakness of glutealis, deep back stabilizing muscles (transverse abdominus and multifidus), tightness of hip flexors, and hip internal and external rotators.

The neutral position of the pelvis is in the middle position – not twisted or tilted forward or backward. In the neutral pelvis alignment your spine gets its natural curves. When the pelvis alignment and center of gravity change, it can cause uneven loading and pain. When one part of your body doesn’t work correctly, other parts have to compensate for the weak point. Weakness of supporting muscles causes superficial muscles to be overworked, which may result in pain, excess muscle tension, and spasms.

Because your body works as a kinetic chain from head to toe, the upper body’s and foot’s function and alignments affect also your pelvis function. In walking and running, your rib cage and thoracic spine should be moving (rotating) naturally. If that movement is restricted then your lumbar spine will compensate with overloading and pain. If your foot elasticity and strength are missing, the kinetic chain from foot to pelvis can’t activate your muscles correctly during gait, which causes muscle imbalances and a risk of injury. As you see every body part is connected.

Incorrect pelvic alignment should be corrected as soon as possible because over time it may cause degenerative changes on your spinal structures, or even herniated disc and sciatica. Besides spinal structures, the SI-joint can be affected from pelvic misalignment. SI-joints are small joints between your Ilium and Sacrum which have very small but important motion. However, too much or too little motion can change your pelvis and SI-joint alignment and affects your gait. Si-joint pain is very local on one or both sides of the buttocks. SI-joint problems can be caused by weakness of supporting muscles ( muscles surrounding spine, pelvis and hip), which allow your pelvis girdle to tilt forward and causes excess pelvic motion while walking or running.

By correcting your muscle imbalances and misalignment are better treatment for your pain and dysfunction than passive manual therapy alone. Physiotherapist are educated to understanding your body’s bio mechanics, and help get you back in “balance”. Unfortunately here in the US, physical therapists rarely look and treat your body as a whole because usually they treat just a specific injury and pain. The reason for this is clear, physical therapist’s time is expensive and insurance companies are paying only for treatment towards injury and pain, not for prevention. However, the truth is that the source of pain and injury can be somewhere else than where the patient gets treatment, so it is important to take care of the body as a whole.

exercise-therapyPilates one-on-one training with a skilled physiotherapist or a very experienced Pilates Instructor helps tremendously for those who is suffering pelvic girdle dysfunction, low back, hip or SI-joint pain. Modified Pilates and Exercise therapy’s training goal is correcting your muscle imbalances and improving your muscles recruitment patterns. The Pilates approach is to work on your body as a whole and with “no pain is all gain regimen!” Be sure that your Pilates Instructor has the knowledge and education to help you. Even if they have 500 hours of training, it usually doesn’t include much training and modification for people with pain. Also the training usually has very little education on anatomy and physiology. But if you find a good one that is going to be PRICELESS!

For more about PhysioWise program in Carlsbad, California HERE

Sciatica Pain Caused by Piriformis syndrome and Treatment

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.

For More about PhysioWise program in Carlsbad, CA, please visit http://www.physio-wise.com

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

Benefits of Pilates for before and after knee and hip replacement surgery

 

Knee and hip joints replacements are becoming more and more common. These procedures improve the quality of life for those people who suffered from constant joint pain and loss of function. Pilates is a great training method before and after knee and hip replacement surgery. By getting into better shape before surgery with Pilates, it also helps you to recover faster. By adding Pilates to your post rehabilitation stages, it helps correct your faulty movement patterns and muscles imbalances.

One of the best part of Pilates in one-on-one training is that it addresses the body as a whole. It doesn’t only strengthen the particular muscles or muscle groups or increase range of motion just in the one joint, it also trains the whole body as it was designed. Due to the low impact form of Pilates and assistance of Pilates equipment, joint can exercise very gently and pain free while strengthening surrounding muscles.

Pilates is ideal before knee & hip replacement surgery

Pilates before surgery is a safe and effective way to prepare your body for operation. Pilates exercises maintain the joint range of motion and strengthen the surrounding muscles of affected joints, even when range of motion is limited and lack of cartilage of the knee or hip makes your movement more difficult. Pilates exercises address your deep spinal stabilizer muscles – your core – which is very helpful for your overall balance and body control. Better balance makes you more confident on moving and less afraid of falling. Strong core muscles as well as shoulder girdle strength and stability are also a big help after surgery to get around and being independent while you are using walker, crutches or a cane. The stronger and more well-balanced the muscles before surgery, the faster the recovery period. In some cases the Pilates training can even postpone your need for joint replacement surgery.

 

Pilates is even more ideal after knee & hip replacement surgery

There is more rehabilitation after joint replacement than a short initial physical therapy which concentrates to regain the function of your brand new hip or knee joint. The previous years of pain have created faulty compensation patterns in your body, and unfortunately, that won’t get fixed only by replacing your joint. Even when your pain is gone or mostly gone, the body is still used to moving as if you are protecting your painful joint. This moving pattern puts a lot of pressure on other joints and tissues by creating muscle imbalances and poor habits to walk and move. With Pilates, and with a skilled Pilates Instructor or Pilates trained Physical Therapist, you can identify and properly treat your faulty movement patterns and muscle imbalances. Pilates program also focuses on lumbar-pelvic stability and strengthening of hip abductors to improve the symmetrical gait and standing balance. In Pilates, the quality of movement is more important than quantity as well as integrating the whole body to working and functioning symmetrically as it is designed. This is the best and most effective way to rehabilitate your body.

Pilates is a viable alternative method of rehabilitation and very good continuation after physical therapy when your goal is achieving optimal recovery and overall well-being.

As a Physical Therapist I warmly recommend to start Pilates if you have hip or knee osteoarthritis or you are heading to knee or hip replacement. Before you begin Pilates you will want to make sure that the Pilates instructor has proper experience and knows your limitation and can modify the movements for you. After knee or hip replacement surgery, Pilates can be extremely beneficial but only if taught by a Physical Therapist or truly experienced Pilates instructor.

Spinal muscles are an essential part of back pain relief and prevetion

Importance of spinal muscles rehab to relieve and prevent back pain

pilates_back rehab_carlsbadDid you know that muscles have a critical role of supporting your spine, preventing and reducing back pain? Very often medical professionals underestimate the importance of the deep stabilizer muscles helping your recovery process from the back injury.

Studies show that after first episode of back pain, the deep back and abs stabilizer muscles become impaired and stop working properly. Those muscles are not recovering themselves, even when your back pain is gone. After that initial recovery your back and spine are still unstable and vulnerable to re-injury. So the fact is that very often poor spinal stability and support are directly linked with acute as well as chronic back pain.

The deep stabilizer muscles have a big role in taking off the total load from your back and let your spine and back heal better itself. So, in order to getting a long term solution to relieve back pain and prevent future injuries, a proper exercise program is essential.

Achieving and maintaining spinal stability

ImageThe human spine is unstable without its musculature and muscle control. The deep muscles, which are close to the lumbar spine, function is protecting spine from injury and their dysfunction shows as low back pain. Researchers have found out that people with lower back pain lose their ability to properly contract deep stabilizer muscles (probably) through pain inhibition. Deep back muscles – Multifidus and deep abdominal muscles Trasverse abdominus – are vital in controlling the lumbar spine. If those stabilizer muscles fail to function, stability may temporarily be provided by mobilizer (external obliques, rectus abdominal) muscles instead. The precision of movement is lost, leading to an observable movement dysfunction. So, finding the right muscles to train is a crucial part of an effective back rehabilitation. Unfortunately, many “traditional” back exercises only engage superficial muscles and actually may even increase uncontrolled mobility (instability) and decrease stability in the lumbar spine thus increasing risk of re-injury.

Spinal Stabilization training with Physical Therapist, or Pilates with very experienced Pilates instructor or Physical Therapist, will help you find and train your deep stabilizer muscles. These both methods focus on improving mechanical support of the spinal joints through specific deep muscle contraction exercises and clients learn to dissociate the use of deeper muscles from the use of the more superficial muscles.

Pilates for back rehabilitation and prevention
Pilates develops spinal (core, back) stability. The exercises focus on developing the strength and flexibility through appropriate use of the spinal muscles, which act as stabilizers and create vital support for the spine. Training with an experienced Pilates instructor improves your body awareness and teaches you how the proper muscle functions support and protect the spine. The Pilates method is designed to condition the whole body and will also help your overall muscle control, coordination and proper movement patterns.

Spinal stabilization training for back rehabilitation
Spinal stabilization training (used often by Physical Therapists) refers to back rehabilitation exercises specifically designed to isolate stabilizing and strengthening weak muscles of the spine as well as pelvic hip region. The SST is gradually progressive and specifically designed based on your specific needs and conditions. Spinal Stabilization training helps ensure movement in a controlled pain free range with proper muscle activation.

Pilates as well as Spinal Stabilization training focus also on improving overall muscle balances and posture which often heavily contribute back pain or are even the cause of the back pain in the first place. Both training methods are safe and effective way to rehabilitate back pain as well as prevent back injuries. Investing in your back and spinal health is important and with pilates or spinal stabilization training you will get a long-term solution to get rid of your back pain, or least learn to manage it. You will get sooner back to your active lifestyle and sport what you love!

Our PhysioWise Back Rehab program, in Carlsbad California, is specifically designed for people with back pain caused by herniated disc, sciatica, bulging disc, SI-joint dysfunction, scoliosis, osteoporosis, osteoarthritis,spondylolisthesis, spondylolysis, spinal stenosis, degenerative disc disease etc. The program is combination of Pilates exercises and Spinal Stabilization training and taught by Physical Therapist & certified Pilates Instructor.

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.