Tag Archive | pilates oceanside

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 PilatesWise program in Carlsbad HERE

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Best Treatment for Degenerative Disc Disease – Proper Exercise Program

Importance of exercise for degenerative disc disease

Degenerative%20Disc%20Disease_WebDegenerative disc disease is one of the most common causes for low back pain. The diagnosis of “degenerative disc disease” is not really a disease but a term used to describe the normal changes in our spinal discs as we age. All people experience the changes in their discs that are consistent with greater or lesser degree of degeneration, but not all people will develop symptoms like pain, sciatica or spinal stiffness.

Degenerative disc disease involves the intervertebral discs. Those are the pillow-like cushions between your vertebrae in your spine. They help your back carry weight and allow complex motions of the spine while maintaining stability. As you age, the discs can lose flexibility, elasticity, and shock absorbing characteristics. They also become thinner as they dehydrate. When all that happens, the discs change from the support that allows fluid movement to a more stiff and rigid state that restricts your movement and causes pain.

A regular routine of back exercises can prevent low back pain and/or reduce the severity and duration of any “flare-ups.” Controlled, gradual, progressive back pain exercises can help the back retain its strength and flexibility. Also, back movement promotes the delivery of nutrients to spine, keeping discs, muscles, ligaments, and joints healthier. Prior to starting a new exercise program, it is always advisable for patients to first see a spine specialist who is trained in developing individualized back exercise programs and in instructing patients in using a correct form and technique for each exercise. Low back pain exercise regimens varies widely depending on the patient’s diagnosis and level of pain.
The best treatment regimen is a proper Spinal Stabilization exercise program

exercise-therapyProper Spinal stabilization exercises with knowledgeable teacher or physical therapist is recommended for treating disc degeneration and the sciatica pain. Alleviating sciatic pain caused by degenerative disc disease includes finding the most comfortable position for the lumbar spine and pelvis (neutral pelvic) and training the body to maintain this position during activities. In doing this correctly, one can improve the proprioception (sense of movement) of the lumbar spine and reduce the excess motion at the spinal segments. This will in turn reduce the amount of irritation at these segments, relieving pain and protecting the area from further damage.

These dynamic lumbar stabilization exercises often require specific hands-on instructions because they offer much less benefits if done incorrectly, and they tend to be much more difficult than they appear. This type of exercise program is progressive, starting with the easier exercises and advancing to the more difficult exercises once the lower level program is mastered. The most important aspect of using these sciatica exercises is sensing and controlling motion in the spine. Once learned, the body can eventually take over and do this without the level of concentration it takes early on.

Pilates is a good way to back rehab

Pilates training in one-on-one settings is also a good way to rehab and prevent back problems. Pilates is a low-impact whole body exercise regimen. Pilates foundation stabilizes your core by contracting deep abdominal, back and pelvic floor muscles with proper breathing. If you are looking for Pilates to help your back pain caused by degenerative disc disease, as a physiotherapist I recommend you to work with a very experienced Pilates instructor. Doing Pilates by DVD’s, books or in group settings (mat and reformer classes) are not good ways to learn proper Pilates and may even cause more harm. You may need a instructor or physical therapist who has good hands-on skills and can correct you as needed. Once you find a good instructor you’ll be in your way to get rid of your pain – and that is PRICELESS!

For more about PilatesWise SpinePilates program for people with Degenerative Disc Disease, Sciatica and Lower Back pain in Carlsbad, California, Please visit our website and click HERE

5 Common Misconceptions About Sciatica ( By PilatesWise Carlsbad, Encinitas, Oceanside )

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 Pilates studio in Carlsbad, California specializes in Pilates Back Rehab program (SpinePilates) which is 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. Our program is a unique combination of Pilates and Spinal Stabilization training which is scientifically proven to be safe and effective way to rehabilitate & relieve back pain. For more detailed information about our programs please visit our website pilateswise.com.

KNEE PAIN WHILE RUNNING? ( by Pilates Wise in Carlsbad, Encinitas, Oceanside)

Got knee pain while running ? Pilates helps.

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Knee pain is very common overuse syndrome for runners. Pain is our body’s alarm system telling us that something is wrong. However, many runners ignore this natural alarm system and just keep running. Some runners even look for help from pain medications or knee brace.

But did you know that running with pain changes your strike? You probably start shifting weight more to your non-pain side and maybe start limping a little. This compensatory movement pattern put uneven pressure to your other joints, muscles and ligaments and leads to muscle imbalances, and over the time pain and injury elsewhere.

Two Imagemost common injuries for runners are Patellofemoral Pain Syndrome and Iliotibial (IT) Band Syndrome. Many runners think that just wearing knee brace or band help them to keep running. Unfortunately, these two common knee injuries develop over time from overuse and knee brace or band doesn’t appear to provide additional. Knee brace may even inhibit your normal joint function causing the pain continue or move to the other areas of the body. The best brace is your own muscle brace.

If you are experiencing knee pain from overuse, something is going on and need to be fixed. The essential components of treating your overuse injuries are stretching, strengthening and stability exercises. Muscle imbalance between quadriceps, hamstrings, calves, IT-band and glutealis muscles, are very common for people with knee pain. Tight muscles like hamstrings , quadriceps (Rectus femoris) or IT-band are pulling the knee joint and knee cap out of their proper alignment by causing abnormal stress into the knee joint. Gluteus medius and Quadriceps (Vastus lateralis, Vastus medialis) muscles weakness, which is very common for runners, causes problem with knee joint stabilization. Unstable knee joint is more vulnerable to injury and also put unnecessary stress to ligaments, muscles and tendons around the knee joint.

One-on-One Pilates with experienced Pilates instructor, who has a good knowledge about knee injuries, biomechanics and anatomy, can help with typical runners overuse injuries. Pilates equipment are perfect for knee rehabilitation. They are spring loaded, and very gentle for the joints by putting less pressure for knee joint while strengthen the supporting muscle around joint. In Pilates training improves hip-knee-ankle alignment and muscle balance which often causes your knee problem in the first place. In Pilates we have great attention to whole body alignment from head to toe and we focus on gaining strength, stability and mobility – not only your the injured & weaker side but also the whole body. Besides as knee rehabilitation, Pilates is also very good as overall cross-training form for runners to prevent also from other injuries.

More about PilatesWise program at Carlsbad Village Pilates studio, 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

SI-Joint Back Pain and Treatment – Exercise Therapy in Carlsbad, San Diego

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Back pain and SI-joint dysfunction treatment – Exercise therapy

Sacroiliac (SI) joint’s dysfunction is somewhat of a mystery and difficult to identify. However, SI-joint dysfunction is very often source of hip or low back pain but underestimated by doctors and chiropractors. It is much easier to treat hip or low back pain than Sacroiliac Joint dysfunction. People with SI-joint pain do not get relief if the underlying problems and real source of their hip and back pain are left untreated.

SI joint is located between Ilium and Sacrum. It is working as a shock absorption for lumbar spine. So, the sacrum is mechanically associated with the spine, but also affected by alignment and movement of femur.

Any lumbar spine, pelvic and hip region asymmetry, leg-length discrepancy or loss of motion in one joint might alter the forces and can affect abnormal mechanical stress and symptoms in the SI-joint.

ImageI have many clients who got lumbar spine fusion and many years later have painful SI-joint dysfunction. This may happen after L5-S1 fusion, but also people with L4-L5 fusion may have problem on their SI-joint. Naturally, sacroiliac joint is the place that compensate to missing spine motion after the fusion.

There are 35 muscles that attach directly to the sacrum and they produce synchronous motion of the trunk and lower extremities. Decrease in the length and strength of these muscles causes adaptive shortening and muscle imbalances and faulty, compensatory movement patterns of pelvic girdle. SI-joint manipulation by chiropractors or Physical Therapists does not probably work long term, but might get short-term pain relief. The muscles overall have more important role in treating SI-joint dysfunction. Most cases SI-joint problem is really caused by muscle imbalances and compensatory movement patterns than the joint itself. Also, a home-exercise might not work either due to pain and misalignment of pelvic and spine. People with SI-joint dysfunction need to get some “AHA”-moments about their body awareness, posture and alignments.

Our body parts are designed to work together and the best treatment is to treat the body as a whole, and people with SI-joint problems will benefit of that approach, too. Many back pain and SI-joint treatments fail because they only treat symptoms, not looking for how your whole spine-pelvis and hip are functioning together.

Si-joint dysfunction clients need very specific therapeutic exercise program which focuses on neuro-muscle integration by balancing overall pelvic and spine muscles. Pilates is a good exercise form, but not enough if you don’t have a Pilates instructor who has the knowledge about SI-joint dysfunction. Usually instructors do not have that expertise and I’m surprised that even many Physical Therapists have not enough knowledge how to treat people with SI-joint pain. In my experience SI-joint pain decreases tremendously when individual gets more stability and strength in their gluteal, deep core stabilization and pelvic floor muscles as well as flexibility in their hip rotators. Unfortunately, this will not happen overnight…it takes time, approximately 3-6 months. However, the end result is priceless – NO MORE PAIN or at least less pain and stronger muscles around the joints and spine!

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For More about PilatesWise Active back pain and SI-joint dysfunction rehabilitation, please click HERE