Moving When It Hurts

Over the past 13 years and 25,000 Physical Therapy sessions, I have treated many patients who are afraid to move through pain. Let's consider the patient with chronic pain who has had pain for more than five years related to a work injury or a car accident. There is no question that they are experiencing pain, and in some cases they have severe pain. But some individuals get into the habit of fearing pain and therefore fearing any movement that causes pain. These people sometimes stop moving altogether. 

Have you met people who are sedentary all day? They can't work because they are disabled or retired or any other reason, and they literally can't, won't or don't do anything. They sit down or lie down all day. They only leave the house for doctor visits. They don't go out for leisure or social time or hobbies or anything at all. 

I encouraged a patient today to just start walking, even if it is for a few minutes at a time. Of course, she voiced concern that it makes her back hurt. So I explained that a walking program is not going to make her back worse overall. She will not gain more damage to her spine by walking, but she will cause more damage by the overall lack of movement of her spine. 

To clarify, this is not referring to patients with a brand new back injury or current flare-up. Most of you know someone who has "thrown his/her back out." In that situation, there may be a few days or weeks in which he/she can barely walk and cannot stand up straight. I would not tell that patient to start a walking program today. 

However, if someone you know has chronic pain but has stopped moving for many months or years, he/she likely needs physical activity. If you are not sure where to start or what movements are safe, come see your local Physical Therapist!

Proactive Companies Increase Employee Engagement

Have you ever felt the difference between customer service at Chick-Fil-A and Burger King? Have you ever felt the difference between grocery shopping at Publix versus Wal-Mart? Have you felt the difference between buying Christmas decorations at Hobby Lobby versus Family Dollar? What about Moe's versus Taco Bell? Or Disneyland versus the Sate Fair? I would propose that the better customer experience is at an organization that is proactive in its approach to managing, hiring, training, and supporting its employees. 

When I want to take my kids out for dinner, the most family-friendly fast food joint is Chick-Fil-A. There is a play house for the kids, the food is fresh and tasty, and they treat you like a million bucks. Whenever I tell people I shop at Publix, they say, "I love shopping at Publix!" Publix is known for its exceptional customer service, AKA "where shopping is a pleasure." The employees at these organizations appear to actually enjoy working there. They may be faking it, but to the customer, it counts and they feel better shopping where they are proactively helped, served, and greeted with a smile and positive attitude. 

Would you choose to work for an employer if you knew its average employee only stayed for three months? Or would you prefer to work for an organization in which employees stay for ten or twenty years? 

It takes more initial effort and cost to run an organization that cares about its employees. But the payoff is higher employee satisfaction, employee retention, and employee engagement. This yields better customer service and greater productivity. Isn't that the reason you have employees--to be productive and to serve customers? The more productive you are and the happier your customers are, the faster your customer base increases.

One way to be proactive from the top of your organization is to invest in injury prevention for your staff. I have never taught a group of employees that did not enjoy being trained on how to prevent work injuries. It is a win-win for the employer, the employee, and the customer. #PainTalks #WorkInjuryPrevention #ThinkLikeaPT

Www.PainTalks.org

Shoulder Pain responds to Neck Exercise

An old friend recently told me about her Physical Therapy for a Rotator Cuff Repair. She stated she had received 35 Physical Therapist visits, and her co-pay for each visit was $40. Her total cost out of pocket was $1,400.  She was compliant with all of her home exercise program, but she never gained back her full range of motion for her operated shoulder. She reported being diagnosed with frozen shoulder several months after surgery, during the process of receiving Physical Therapy since she was still quite stiff in her shoulder. Finally, she was discharged from rehab because her surgeon and Physical Therapist did not seen any further rehab potential.

As a McKenzie MDT practicing Physical Therapist, of course the first thing I did was assess her neck. I established baselines, which showed her right shoulder flexion (forward elevation) was 60%. She was lacking the ability to reach overhead. She reported having neck fusion surgery several years ago for disk problems in her lower neck. I showed her how to do neck retractions as an exercise, and she did 3 sets of 10 neck retractions in sitting. Then she stood up and we re-checked her baseline, which was active flexion of the right shoulder. Her new range of motion for right shoulder flexion was 90%.

To clarify, her ability to raise her arm overhead improved from 60% to 90% within two minutes of doing a neck exercise. Her next words were: "You helped me more in a few minutes than 35 visits of regular Physical Therapy!"

McKenzie MDT (Mechanical Diagnosis & Therapy) is a method of assessing spine and joint disorders in order to determine the source of symptoms and the mechanical (movement) solution. It is not uncommon for shoulder, arm, or hand pain to be originating from pinched nerves in the neck. Similarly, pinched nerves in the low back often cause leg symptoms in the high, thigh, knee, lower leg, foot, or toes.

#PainTalks  #PTfirst

How Pain Talks contributes to a successful business

1. Leadership: Pain Talks helps you to develop a plan for decreasing overhead costs associated with work injuries.

2. Culture: Pain Talks promotes a culture of safety.

3. Processes: Pain Talks helps to develop processes customized to keep work injuries at a minimum, which keeps your worker's comp insurance rates low.

4. Goals: Pain Talks helps with your financial and growth goals by lowering your healthcare and insurance costs.

5. Employee Development: Pain Talks teaches your employees proper ergonomics, postures, and body mechanics so they stay productive.

6. Passion: Pain Talks keeps your staff healthy so they can continue to work with passion for your company.

7. Effective Management: Pain Talks helps your management to be proactive in the costly area of healthcare.

8. Organization Moving in Same Direction: Safety is one of the foundations of a successful business. It is an undercurrent below your day to day activities.

9. Minimal Employee Turnover: Pain Talks improves employee engagement. "Engaged employees are 46% more productive" (Psychology Today).


"Successful businesses and teams include: Leadership. Culture. Processes. Goals. Employee Development. Passion. Effective Management. Organization moving in the same direction. Not having a lot of employee turnover." (Tyler Robertson).

A More Efficient and Cost-Effective Form of Healthcare

Soft tissue injuries and musculoskeletal disorders are most effectively treated by a Physical Therapist. So why does it take so long to get patients to Physical Therapy to receive treatment? Most patients see multiple physicians and receive multiple other treatments before even receiving an order for Physical Therapy, but in the end they eventually are referred to P.T. because the other treatments are not fixing the source of the pain.

There is a better way!--Physical Therapy first (#PTfirst)! The military has seen the value in this concept, so if a current soldier in the US Army starts to have knee pain, he sees the Physical Therapist (P.T.) first. The P.T. does an assessment and decides if he needs Physical Therapy, imaging, medication, or a referral to a specialist. If he needs therapy and gets better with P.T., then no other referrals, treatments or MD visits are required. It was the most efficient and cost-effective form of healthcare because it was assessed first by the most appropriate medical professional.

Some large corporations have learned the value of Physical Therapy first for their employees and dependents. Michelin is a perfect example, and they are setting the standard for optimal healthcare for treatment of soft tissue injuries. Michelin contracts Physical Therapists to be on-site for prevention of work injuries and for rapid assessment and treatment of musculoskeletal disorders. Healthcare costs are sliced by utilizing Physical Therapy first. Reach out to me at www.PainTalks.org to find out more!

Training for a Long Run

Photo: National Library of Ireland. 

My sister recently called me, asking: "Am I just too old to run 12 miles?" She is in her early forties, and she exercises daily for at least an hour. She is in excellent shape, and her heart and lungs can more than handle a 12-mile run. So why did she call me?--because she tried running 12 miles on concrete without having trained, and now her knees and feet hurt. Every summer, she vacations at the same beach, and every year she walks or jogs the same 12-mile stretch from the condo to town and back. Last year, she jogged this path, and she came back with knee and foot pain, so she decided it must be her tennis shoes that need replacing, but she never told me about this problem.

A year later, she ran the same route with her newer sneakers, but again she hurt herself, so that is when she called me. What was my advice? "You are not too old to run that far; you just need to train for it!" It would be like training for a half-marathon, which is 13.1 miles.


How Physically Fit Individuals Should Train for a Long Run:
(For someone who exercises regularly and is in good health)
1. Start a walking program on the type of surface you are training for (sidewalk, trails, road, beach, treadmill, track, etc).
2. Increase your walking program progressively until you can walk briskly for 45-60 plus minutes.
3. Start a walk-jog training program. Walk a few minutes, then jog a few minutes, and continue repeating. At first, walk more than you jog.
4. Progress to more jogging than walking.
5. Progress to all jogging.
6. Increase your jogging distance and/or speed.
7. Steadily increase your distance by a little more each week until you reach the desired distance.

Additional tips while Training for a Long Run:
1. Incorporate some cross-training into your weekly exercise routine, so try cycling or Zumba or swimming or any other exercise you enjoy.
2. Add some strength training, especially for your lower body large muscle groups.
3. Do not push through injuries, but if you start to feel pain, back off a little on your training and do exercises that are pain-free.
4. Warm up for at least five minutes before jogging.
5. Stretch after your warmup and after your jog.
6. Do long runs only once per week and shorter runs during the week.
7. It is not necessary to run every day, but it becomes addicting! So your body will tell you that you have to run that day. If you want to run almost every day, decrease your pace, distance, or run on an easier surface such as grass.
8. Change your shoes every 300 miles or as soon as you feel more support is needed.
9. Interval train. On some days, run sprints or faster paces for brief bouts of time.
10. Add plyometrics training to your exercise routine. Do plyometrics exercises once or twice per week. Do these after your warmup but toward the beginning of your workouts.
11. Do back extension exercises regularly. This will help your spine to stay healthy and aligned and will decrease the risk of pinched nerves in your back.

Postures and Low Back Muscle Strain

Photo by Larkery

One cause of low back muscle strain is having an unhealthy spine through habitual poor posture. If you sit all day in a slumped position, your low back is loaded into a forward or flexed position, and the muscles of your back are continually stretched. As a result, you may be more likely to strain a back muscle from light tasks such as loading/unloading the dishwasher. 

Not only does slouching affect your back muscles, but it causes your disks to bulge backwards. The more pressure from bad posture, the more likely your disks cannot realign properly. This leads to pinched nerves, which shoot pain or other symptoms down your leg(s), such as sciatica. 

On the other hand, those with a healthy spine (through repetitively good posture and exercise) may tolerate light tasks but strain their backs when doing more strenuous work such as moving furniture. It is important that both individuals practice good posture and body mechanics in order to avoid straining the low back during routine daily tasks, and especially during difficult physical activities.

How To Treat Back Pain At Home

Throwing your back out is a painful scenario that is actually quite common. It is typical for someone with an acute episode of back pain to tell me:

"I bent down to..., but I could not stand back up."

"I stood up after bending down, but immediately I knew something was wrong with my back." 

"I twisted my back and quickly felt severe back pain."

"My back has been hurting since I was moving a lot of stuff around recently."

What To Do For Acute Back Pain:

Step 1. Decide if it is serious enough to see a doctor immediately.

Reasons To See a Doctor Immediately For A New Back Injury:

1. You can barely walk.

2. Your pain is so severe that no over-the-counter medicine is helping.

3. You experienced major trauma to your back.

4. The injury caused you to lose sensation in your pelvis or legs.

5. The injury has changed your ability to control your bowel/bladder function.
6. You have noticeable weakness in one or both legs as a result of your injury.

Home Treatments For A New Back Injury:

1. Ice. Ice down your back or the painful area for 10-20 minutes at a time, throughout the day.

2. Over-the-counter Pain Medicine, preferably an anti-inflammatory (Advil, Aleve, Ibuprofen).

3. Rest. Find the most comfortable positions and avoid aggravating movements.

4. Time. If it is not a major injury, it should progressively improve over the next few weeks.

Should You Immediately See a Chiropractor For a New Back Injury?
Seeing a chiropractor may be a good option if you have one that you know and trust. Ideally, go to one that has successfully treated you in the past. They can rule out red flags and tell you if/when to see a physician. If your pain is not improving with chiropractic treatment, do not continue for more than 3-4 weeks.

Should You See a Physical Therapist For a New Back Injury?
Yes! However, most Physical Therapists require a doctor's prescription before beginning treatment, so be sure to ask your doctor for this. In my experience, most patients with a new back injury will significantly improve within 1-2 weeks of PT, and many patients will get immediate pain relief within the first visit. If your pain is not improving within a month of PT, follow up with your doctor for further testing or treatment options.

What To Do for Sciatica in my Leg

Photo: John Ragal

There are multiple causes of sciatica or back pain that radiates down the leg(s). The most serious cause of sciatica is when a nerve root in the spine is being pinched by a bulging disc or by arthritis-type changes in the spine itself. Not only can this cause shooting pain into the leg(s) but also weakness in the leg and changes in the sensation in the leg (for example numbness or tingling in a portion of the leg or foot). If this is the case, it would be diagnosed through MRI and treatment options would be recommended by your doctor. 

Physical Therapists treat many patients with such sciatica. The key to relieving this type of sciatica is to stop the compression of the nerve root in the spine where it is being pinched. This can be done through positioning and exercises. If you are completely compliant with Physical Therapy and get no relief from any sciatica symptoms, then your doctor may try injections (usually with Cortisone) to provide some pain relief. This is a steroid, which provides an anti-inflammatory response. If you do not want injections, you may be prescribed oral medications for pain relief and/or anti-inflammation. 

Other conservative treatments for sciatica are going to a chiropractor, mechanical lumbar traction (requires a MD prescription) or getting acupuncture. Also some people get relief from inversion tables. Aquatic Physical Therapy (doing therapy inside a swimming pool) is another helpful tool for patients with sciatica.

Pregnancy, Exercise, and Eating

Photo: Takis Markopoulos

You may be tempted to decrease or stop exercising while pregnant. Or you may be tempted to eat whatever you crave--no matter how unhealthy. But doctors recommend you continue to exercise throughout any normal pregnancy. And, of course, eating right is more important now than ever, both for your health and your baby's.

Pregnancy and Exercise:
If you normally exercise at very high intensity, you will need to decrease to moderate intensity during pregnancy. Your guideline is to keep your heart rate below 140 beats per minute. So if you usually run at 6.5 or 7.0 miles per hour, you will likely decrease your pace to 4-5 miles per hour now. This is difficult for women like me who like hard and sweat-pouring workouts. But you can still do most of your usual workout activities as long as you slow them down or modify them.

Exercise Appropriate During Pregnancy:
Treadmill or walking/light jogging
Elliptical machine
Stair Climber
Stationary bike
Swimming
Yoga/Pilates
Weight training

Exercise Not Recommended During Pregnancy:
Fast Jogging/Running
High Intensity Cardio
Plyometrics
High Impact Aerobics

Pregnancy and Eating:
In the past 9 years I have been pregnant five times, so I understand cravings of all sorts: potato chips, chicken soup, fudge, popcorn, chocolate frosties, and even cheese grits. Most foods can be eaten in moderation during pregnancy. But here is a brief list of unsafe foods: fish high in mercury (including tuna), cold cuts, caffeine, alcohol, unpasteurized cheese, raw sprouts, raw sushi, smoked fish, raw or rare meat, foods prepared with raw eggs. Some of these are allowed in small amounts, such a serving of tuna per week. The book referenced below is very comprehensive about all types of foods and the recommended amounts during pregnancy. Generally, try to eat a wide variety of nutritious foods. Find foods full of iron and folic acid. Eat a lot of fruits and veggies! Drink a ton of water! All of these are great habits to start now and should continue when you are breastfeeding.

References: Murkoff, Heidi and Mazel, Sharon. Eating Well When You're Expecting. Chapter 7: "Eating Safely When You're Expecting."

Don't Wait Til January To Lose Weight!

Photo: Liz Navarrete

If you plan to start your new diet or weight loss plan in January, why not start today?!! Why not make today Day 1 of your weight loss journey? Today is December 14, so if you get started today, you will jump start your weight loss more than two weeks early, and it will motivate you to continue in the new year! Weight loss is a long and tedious process, so the sooner you start, the better! There are so many people that make a New Year's Resolution to lose weight, but do you want to be one of the many people that start well but then quickly fall off the bandwagon?

Think about if you had a jump start to quit smoking. Imagine you were hospitalized and unable to smoke for three weeks. By the end of the three weeks, your body was already adjusting to being smoke-free! It would be sooo much easier to then continue your life without smoking.

Being overweight started with unhealthy habits, so losing weight will require forming new habits. Anyone can start a new habit by repeating the desired activity every day for several weeks. So if you start a healthy habit on December 14, your new habit will be almost formed by January 1st! And by the end of January, it will be a solid and natural part of your lifestyle!

Any part of your weight loss that is not changing your unhealthy habits for healthier ones will likely not last. You can make drastic changes to lose large amounts of weight quickly, but if you are not forming long-term healthy habits, you will gain back the weight once your lifestyle reverts back to your old ways. So here is my action plan for you...today!

Step 1. Select your weight loss program, and write it down at the top of the first page of a journal, notebook, or note page on your phone. For example: My Weight Loss Plan: Dec 14, 2017: Weight Watchers. I will begin weight watchers today and complete it for two months.
Step 2. Select your exercise plan, and write it down. Example: I will walk in my neighborhood for twenty minutes per day, 5 days per week, for the next two months.
Step 3. Share your plan with someone who will hold you accountable regularly (every week or even every day).
Step 4. Weigh in. Write down your starting weight. You will not weigh in again for at least 1-2 weeks, if you are consistent with your new eating and exercising habits.
Step 5. Write down your plan for tomorrow that includes your new habits. For example, I will exercise for twenty minutes at 4:00 pm.  I will not drink any Coke. I will not buy any fast food.

Here are some other examples of healthy habits you may want to incorporate:
-I will start a "Subway Diet", which includes a 6-inch sub for every lunch this week (instead of fast food).
-I will replace chips with light popcorn.
-I will decrease my soda intake by 50%.
-I will eliminate sweet tea from my diet and replace it with unsweet tea.
-I will decrease fast food meals from three times daily to one time daily.
-I will pack my lunch for work this week, including healthy and fresh items.
-I will drink 5 glasses of water every day instead of sugary drinks.
-I will go to a Zumba class two days per week.
-I will not buy ice cream to keep at my house.
-I will join Planet Fitness and go there every day on my way home from work.
-I will watch one less hour of TV and replace it with cooking/cleaning.
-I will write down everything I eat tomorrow and share it with my accountability partner.
-I will buy a pedometer or Fit Bit, and take at least 10,000 steps every day.

4 Steps To Lose Weight After Failed Dieting

Photo: R.A. Navarrete

You may have been excited and compliant with your weight loss program, exercise routine or diet a few months ago, but recently you got off track. So how do you return to losing weight again?

First, select the best weight loss program for your individual needs. What have you tried in the past and failed? Choose something different. Or what has worked in the past? Do it again! Don't just try the latest craze or a diet that your best friend swears by.

Second, find accountability. You can't do this alone because it is too hard. You need someone to help you, especially during your moments of temptation. It can be someone you look up to, someone you relate to, or just someone who wants to help. It can also be a support group such as in Weight Watchers. Check in for accountability at least once per week, and be honest about your struggles. Without someone to hold you to your commitment, you could easily give in or give up. Call this person when you need motivation to resist overeating.

Third, exercise! Do not neglect this part of your weight loss program. It is just as important as eating right. Make exercise a habit in your daily routine by planning it into your day. It must become a priority, and that should never change (even once you achieve your weight loss). The cheapeast and easiest form of exercise is a walking or jogging program. Other convenient alternatives are workout videos or exercise equipment. But I don't recommend spending money on equipment or a membership unless you are committed to exercising consistently.

Fourth, remember that changing your lifestyle is permanent; it is not a yo-yo diet. The best way to lose weight and keep it off is to do so at a slow and steady pace. The healthy habits you form during this process should last forever. The same components that help you lose weight will also enable you to maintain your new, healthy weight. For example, if eliminating sodas and desserts has helped you to lose 20 pounds, don't add them back into your diet except on rare or special occasions. It initially takes willpower to say no to junk food or to say yes to workouts, but it will become a habit with time. Remember that on January 1, everyone says no to sweets. Be the person who still says no in June, October, or even December!

Low Back Surgery: 6 Steps To Full Recovery

Photo: Ted Hood. State Library of New South Wales.

If you have had a recent low back surgery, there are a few tips that will speed your recovery and help you to have a healthier back for the long term.

1. Practice good POSTURE. This may be difficult if you have a habit of slouching, but it is one of the most important ways to keep your spine healthy. Sit in upright, firm chairs with an extra lumbar support or rolled towel behind your low back. Avoid sitting in reclined positions.

2. AVOID BENDING FORWARD or bending down with your back. Learn how to do all your daily activities without bending your back. Many techniques can be used instead of forward bending, such as squatting, kneeling, sitting, pivoting on your hips, using a golfer's lift, or even crawling. Excessive forward bending is often the cause of back injuries, so eliminating bending decreases your risk of future back pain/injury.

3. AVOID TWISTING your back. This may be easy to do while still wearing your back brace, but once you are out of the brace, it is also important to avoid twisting. Maintaining proper spine alignment during daily activities and especially during strenuous activities will help to prevent back injury.

4. STAY ACTIVE. Find a low-impact exercise that you can start or continue, such as walking, stationary biking, or water aerobics. Depending on your stage of recovery, you may only be able to do 10 minutes at a time, but slowly progress as you are able. Mobility promotes healing, as long as you do not overdo and cause more pain.

5. FOLLOW DOCTOR'S ORDERS, such as lifting restrictions, activity restrictions, using a brace, using a cane, Physical Therapy, etc.

6. REQUEST PHYSICAL THERAPY. For the optimal prognosis after low back surgery, it is important for you to learn some strategies, exercises, postures, and functional activities from a Physical Therapist. It may take just a few visits if you are recovering quickly, or some patients need weeks or months of therapy if they are still having limitations or symptoms.

Does The Weather Really Increase Joint Pain?

Photo: Dale McDonald, State Archives of Florida

Almost all my older patients report they feel more pain when the weather is cold and/or rainy. But is it really true? Here is an example of someone who told me: "I woke up with a lot of leg and back pain, and I think it is just because of the weather." So my goal was to show that her pain could be improved, regardless of the present weather conditions.

On a scale of 0-10, pain was 7/10 at the start of our session. Her first exercise was the same one she had been doing for homework: lie face down on the mat and press up onto her hands. Doing this for a few sets decreased her pain from 7/10 to 5/10 and made her leg feel better. With a few more exercises in the same direction of movement (backwards or back extension), her pain further decreased to 1/10 and was located in the center of her low back and not her leg. Objectively, her baseline movements improved and became less stiff and less painful.

So, how much of her pain was weather-related? Some of it may have been caused or aggravated by the climate change, but most of it was movement-related. So within one hour of treatment with the proper movements, her pain decreased from 7/10 to 1/10, and the weather was still cold and wet when she left.

Hand, Foot, and Mouth Disease

If you have young children, you may fear "Hand, Foot and Mouth Disease," so here are some facts about the virus:

1. A child only gets it once in his/her lifetime.
2. It is more common in the summertime.
3. It can look like chicken pox, with small, red bumps not only on the hands and feet but also on the arms and legs. They can become open sores and secrete clear fluid.
4. It is highly contagious and is most common among young children and babies.
5. It can be present with no bumps or sores on the hands/feet.
6. It causes sores in the mouth that are terribly painful and limit the child's desire to eat/drink. The sores can cause excessive drooling.
7. The first symptom is often a fever of 100 to 103 degrees, which lasts for a few days.
8. The disease usually lasts 7-10 days or less.
9. Prescription medication is typically not needed.
10. Treatment is Tylenol and/or Motrin for pain/fever, drinking fluids for hydration, rest, and frequent hand washing.
11. I would recommend you keep the child in long pants, socks, and long-sleeved shirts. For prevention, do the same for your other children.

Additional info on Hand, Foot, and Mouth Disease:
http://www.cdc.gov/features/handfootmouthdisease/

Turkey Avocado Cobb Salad at Schlotzky's

http://www.schlotzskys.com/menu/salads/turkey-avocado-cobb/

The Turkey Avocado Cobb salad at Schlotzky's is one of the best salads I have tried lately. It has a ton of fresh ingredients, such as avocado, corn, just-cooked bacon, goat cheese, and black beans. As the name states, it is topped with turkey deli meat. And, of course, it has croutons, eggs and tomatoes. The serving size of this salad bowl is larger than expected, and it has fresh garlic bread on the side. My dressing choice was Raspberry Vinaigrette, but the salad was tasty enough that I only used dressing toward the bottom of the bowl. How can you say no to a salad so full of protein and good fats? You will almost forget it's a salad.

Does Pilates Cause Or Treat Back Pain?

Photo: State Archives of Florida

Yes, Pilates can cause back pain. And yes, it can treat back pain.

Pilates and Core Strengthening

Pilates has many great benefits, including core strengthening. Core strengthening is beneficial, as it incorporates deep muscles of the abdominals and back that often are weak, especially among individuals with back pain. Having a strong core is one piece of preventing back pain, but other components include postures, body mechanics and proper treatment of present back pain.

Pilates vs. Physical Therapy

Pilates and core strengthening alone will likely not eliminate present back pain. It may play a role in preventing future episodes of back pain, but alone it is not the solution to low back or mid-back pain. If Pilates could treat back pain, I would not have a job as a Physical Therapist. Clearly, there is more to your back pain than weak core muscles, so proper treatment/prevention is urgent. If your back pain comes and goes, get it treated now, and you can learn why it happens and how to decrease the pain and prevent future episodes.  

Pilates Exercises to Avoid

There are some Pilates exercises that can actually produce or aggravate back problems, and these should generally be avoided. Any Pilates exercise that puts your back into a forward-bent (AKA flexed or rounded) position is not ideal for most individuals and can be harmful if you have back problems. Which forward-bending exercises are safe? Cat/camel (on your hands and knees and you arch your back up and down) and abdominal crunches are fairly safe for most people. 

Preferred Pilates Exercises

The Pilates exercises that bend your spine backwards (AKA extended, as in the photo above) are safe and highly recommended for most healthy people. This includes positions such as lying face-down and pressing up onto your hands or lying on your back and lifting your hips. Likely there are many extension exercises incorporated into your Pilates class, so these are generally beneficial and less likely to be harmful.

If either direction of spine movement aggravates your back pain, stop Pilates workouts, and get medical attention.

Why You Should Get Physical Therapy For Your Back Pain

I recently treated a patient with leg pain that radiates from his back. It goes into his thighs and even down below his knees. This pain began 3-4 months ago, and he is unsure how it started. Before his session, I knew his walking had been problematic because when he stood up in the lobby, he significantly stooped over and could barely get his balance. He was using furniture and walls to hold onto. So my initial goal was to find an exercise that would immediately improve his ability to stand up and walk. 

I treated him for 10 minutes with one or two exercises lying on the mat. Then he stood up tall and walked easily back to his chair. He could not believe he was walking that well because since his symptoms began, he has the most pain and difficulty with initially getting out of a chair to walk.

So if you have back pain, you could possibly be only a few minutes away from pain relief. Schedule your Physical Therapy today!

Changing Crib Sheets Without Pain

There are a few baby-related tasks that can be near-impossible without straining your back, so here is what I do for changing crib sheets.

Photo: National Media Museum

1. Buy at least 3-4 crib sheets and 3-4 waterproof pads. I promise that the price of these is far less than a back injury.

2. Take the mattress out of the crib to change the sheets.

3. Layer your waterproof pads and crib sheets over each other so that when the top layer gets wet, you simply remove it and your clean, dry one is already there.

4. As soon as possible, remove the bumper pads. For safety reasons, they are not even recommended anymore. Changing the crib sheet is much easier when there are no bumper pads in the way.

5. Consider using a sheet saver. It is a sheet that actually attaches to the bars of the crib, so it is fairly easy to snap on or off (each sheet has at least 12-15 snaps). There are some safety concerns with this because it does not fit as tightly as a fitted sheet. To get it on or off, it still takes several minutes, and you have to be able to reach all four sides of the crib.

6. For crib sheet selection, buy the T-shirt material ones that stretch a little.

7. Change the sheets for a toddler bed the same way--by taking the mattress out first.

Chick-fil-A Cobb Salad: A Healthy Review

The Cobb Salad at Chick-Fil-A is a delicious and healthy alternative to your usual fast food meal. I have enjoyed it so much that my husband now eats it as well. The cobb salad is made with Romaine and greens, not iceberg lettuce. It's additional veggies are cherry tomatoes, corn, cabbage, and carrots, which are a nice variety. The extra yummy toppings are cheese, bacon, and fried bell peppers. Another healthy addition is hard boiled eggs. And it comes with crispy chicken unless you prefer grilled. With this alone, I love it even without salad dressing. But if you need dressing, I most recommend the Avocado Lime Ranch. This salad is filling, tangy, textured, and colorful!

Because I enjoy the taste of salads, I usually try them wherever I dine. Some other good, fast salads are at Which Wich, McAlister's Deli, Moe's, and Zaxby's. But the fact that my husband eats this one at Chick-fil-A means that it is likeable even for meat-and-potato fans. Lastly, I like it too much to even try their other salads.

Reference: www.Chick-fil-A.com