Posts Tagged ‘exercise for pain relief’

Is Core Strength a Medical Necessity?

Sunday, October 10th, 2010 by Karena

Core strength has been a buzzword in the fitness world for quite a while but now we

We accept your insurance through our partnership with SCV Therapy Services!

We accept your insurance through our partnership with SCV Therapy Services!

are hearing that same buzz from the medical field.  Clients are being referred to a Pilates program by their medical doctors who know that increased core strength can only mean decreased physical pain. So how do you know if core strengthening is for you?

Will Core Strengthening Help YOU?

  1. Have you experienced muscle spasms?
  2. Have you suffered an injury that has affected your ability to do everyday activities?
  3. Do you find it difficult to maintain excellent posture?
  4. Is it difficult to sit for long periods of time or does doing the same prolonged activity exacerbate your symptoms?

These are just some questions that are strong indicators that core strengthening could help you.  Here’s why:

  1. Muscle spasms happen in the large muscles, turning the small, core muscles off.
  2. Injuries tend to make us rely on our largest muscles because they are the strongest, again, turning the small core muscles off.
  3. If you can maintain excellent posture throughout the day then your core strength is intact.  Excellent posture uses your core muscles all day, every day.
  4. If sitting still hurts, that pain indicates that your spine is collapsing while you sit; pushing bony structure onto nerves or other bony structures instead of being lifted and supported. Pain while pursuing activities indicates that you lack core endurance.

Core strengthening, while beneficial to all, is especially beneficial to anyone who has every suffered an injury. As an interesting side note, core strength is not just about the spine and the stomach muscles.  Every joint has core muscles; all the smallest muscles in charge of the balance and control of the joint are the core muscles. So any injury throughout the body benefits from core strength.  Cool, huh?

At Pilates Teck we are able to accept your health insurance through our partnership with Santa Clarita Valley Therapy Services, a physical therapy clinic that offers the most up-to-date and thorough care in traditional therapy as well as occupational and aquatic therapy. Need to know more? Please call us! 661.260.1609.

Back Hurts When You Sit?

Thursday, September 16th, 2010 by Karena

As far as I can tell that is the best kind of back pain to have.  Lucky you!

In very broad terms, I see two

All our happy hours at our computers can be the worst thing for back pain

Many happy hours sitting at the computer can make for a very sad spine.

types of back pain clients:  The first has increased pain when they are still, especially sitting, and the second group has increased pain when they are moving.  In both scenarios great improvement can be made to pain levels but, generally, the first responds most quickly to therapeutic exercise or pilates exercise.

If you feel pain when you are sitting but feel relief when you get up and walk around the fix is pretty obvious: Move more.   As a rule, even painful joints have pain-free ranges of motion.  Maybe your back hurts when you do ‘X’ but you can still do ‘Y’ and ‘Z’.  That’s very common, so be sure to continue to do ‘Y’ and ‘Z’. The importance of moving, moving, moving is in this short little note. Take a peek if you haven’t seen it already.

I had a frustrated client today. He said: ‘Exercise isn’t going to change the fact that I have a bone spur or how the bone spur pushes on the nerve and hurts like heck.’  I agree on Part I: Your bone spur will not be affected by exercise except that it may not get larger if your alignment is corrected.  I don’t agree with Part II: That exercise won’t change the pain you feel from the bone spur pressing on a nerve.  When did your pain get bad?  Six months or 2 years ago?  And when did you develop that bone spur? Probably long before that.  If we age inactively then the muscles supporting the area around the injury (the bone spur, in this example) become weak and offer less support in a position of great compression (sitting).

Get exercising. Get stronger. Lose the pain. If you can walk without limping, take short walks that don’t flare up your back muscles and then find a few toning exercises to take care of your weak spine muscles and butt muscles.

Use the navigating tabs to the left to go to find free exercises for back pain: Look up Back Pain Series 1-8.  Also, our DVD for exactly the issue of weak spines can be found under the store tab on this site.  Please let me know if you have any questions!

Exercise Tips for Hip (Trochanteric) Bursitis

Sunday, August 29th, 2010 by Karena

As I was lying on the couch, acutely aware of where my trochanter protrudes on my femur. I thought: ‘I should write my little friends (you!) a note about bursitis’.  I have had some flare ups with the ol’ ‘B’ word but I can generally keep the pain pretty short-lived because I know what to stay away from.  And if you have bursitis, I think you should know, too!

Hip burisitis occurs when the cushion between the hip bone and thigh bone gets inflamed

Hip bursitis, and more specifically trochanteric bursitis, occurs when the cushion between the hip bone and muscles of the thigh becomes inflamed,

Acute episodes of bursitis need never become chronic. Just stop pushing on the bursa!  The bursa is a soft little pillow that cushions the connection between a bony point on your thigh bone (the trochanter) and the tissues of the outside of the thigh. And if your thigh bone squishes the bursa, it becomes inflamed; hence the ‘-itis’ that gets suffixed onto the backside of bursa…

How do you squish the bursa? The bursa is easily squished when you externally rotate the thigh or repeatedly rub the trochanter against the bursa once inflamed. External rotation crams the greater trochanter against the bursa squeezing the life out of it. That’s fine when the bursa is happy but when it’s not happy you need to avoid squishing, smushing and otherwise irritating the bursa.

Here are some things you can do to avoid externally rotating the thigh.

  1. Don’t cross your legs with one ankle dropped over the opposite knee.
  2. Do sit with the legs together, knees touching. If you can cross the legs and smush the inner thighs together you will still be avoiding external rotation and you could be internally rotating which will pull the thigh bone away from the bursa–aaahhhh, sweet relief…. (think piriformis stretch for the professionals out there)
  3. Walk with your feet pointed straight ahead: no duck feet. Duck feet externally rotate the hip and smush the bursa
  4. Perform exercises that internally rotate the hip.  Lie on your back, feet hip-width apart and push the knees towards each other.  You can do an isometric push here.
  5. Another exercise: Lie on your side, bottom leg bent, top leg straight. Now lift the top leg to just below hip height.  Then bring the entire inside of the foot back down to touch the floor (heel to big toe knuckle)
  6. Sleep on your back with your ankles crossed and knees rotated inward.  Okay, so you might not last the entire night that way but it is a great way to get off that bursa!
  7. Do not move the leg to the side of your body past the hip bone.  (No hip abduction for the professionals…) You will have to adopt a demur lady-like position in everything you do until the pain subsides.
  8. Do not sit cross-legged.
  9. If you are really flared up you’ll get discomfort with walking for a period of time or otherwise moving the trochanter against the bursa. If you are doing something that hurts, I would recommend not doing that.

Does this make sense? Each and every time you externally rotate the thigh or carry the thigh to the outside of the body you ’smush’ the bursa.  Since the bursa is inflamed that kind of motion is only going to tick it off further.   So…you’ll get relief extremely quickly if you can just remember to STOP SMUSHING THE BURSA.

Good luck and let me know if you have any questions! K

Understanding Pain

Sunday, May 9th, 2010 by Karena
Dysfunction can create increased nociceptors and therefore increased pain

I took a great class from Eric Cobb of Z-Health at the Pilates conference about a month ago about understanding the neuroscience behind pain.  It was a great class and I find myself referring to one point over and over again with my clients and my staff so I thought you might be interested too. So here it is.

When there is an injury, let’s use an injured back as an example, the brain starts to create change to several systems in your body to react to that injury.  Let’s focus on just the nervous system, and then just one small part of the nervous system.

There are many different types of nerve receptors but let’s talk about these two:

  1. Mechanoreceptors: in charge of mechanics. It is because of mechanoreceptors that that we are able to receive movement information.
  2. Nociceptors: in charge of sensing pain. Sensing pain is of utmost importance to survival. Nociceptors can be triggered by any stimulus that your body/brain finds noxious.
  3. In a normal, pain-free muscle there is a balance between mechanoreceptors and nociceptors. When pain exists, an unbalance is created.The unbalance is created because of a tendency to brace or not use an area that is painful.  You tend to stop moving, and in our example the backs become stiff.

The brain senses a threat (because not moving well is a dysfunction) by erring on the side of caution, not on the side of performance, by reducing mechanoreceptors and increasing nociceptors.  With more nociceptors there is more pain. So your clients that are in pain are going to generally be ‘really good’ at being in pain because there are more nociceptors.  The more nociceptors, the less movement (because of increased pain).  The less movement, the more the brain senses a dysfunction and creates more nociceptors.  Classic vicious cycle.

So how do we stop the cycle? We have to move.  If we begin moving, the brain senses the need for mechanoreceptors. If the brain is sensing more movement then that signals an end to dysfunction.  And what happens with an end to dysfunction? Less nociceptors.  No more pain.

Eric Cobb, made an important point about increasing movement.  The activity must be active not passive.  Passive movement is not something that normally happens in a Pilates environment but I thought I should throw that in there.  The number of nociceptors will not change if your client is not moving her body by herself.  Do not, in other words, move your clients body for her.  Yes, I know, not really going to happen in Pilates unless you are working in the physical therapy sector. When your client is moving the joint, find every possible pain-free range of motion. It is not possible, in most cases, to decrease pain by increasing pain; it messes up the nociceptor balance.

Good luck and let me know how it goes!

Does it hurt to bend forward?

Saturday, April 10th, 2010 by Karena

Picture 32If it does, then you might be what we call in the biz, ‘flexion intolerant’. Simply means that it hurts to bend the spine forward. It probably also hurts to bend over the sink to brush your teeth, or do the dishes. Sitting for long periods of time either in the car or in front of the tv is probably not your friend either. So what do you do with this information? The short answer is to not bend forward. The long answer is this:

Train your spine to work in neutral.

A neutral spine means that you are neither bending forward or backward. You are in your perfect alignment. Here’s how to find your perfect neutral alignment:

  1. Lie on your back with your knees up and the soles of feet planted on the floor.
  2. Rock your pelvis back and forth between an arch (pulling away from the floor) and a curve (pressing into the floor).
  3. Gradually make the rocking smaller until you rest somewhere in the middle.
  4. That is your neutral position. It’s a little different for everyone. Some will be able to slide their hand under their low back in this position and some may be able to put a small pea under their low back.
  5. Now use this position when you are standing. You can practice the pelvic rocking using a mirror and find your neutral while upright.

Important: In order to hold the position you will have to brace the muscles around your new posture until your spine and abdominal muscles get used to holding it, otherwise the muscles will pull you back to the alignment that you are used to. To get the muscles to hold your new alignment, imagine that a two-year-old is getting ready to punch you in the back. You brace to keep the blow from hurting. Remember, though, this is a two-year-old punch not a twenty-year-old punch. Don’t overdo it.

Now, when you brush your teeth or do the dishes you are no longer going to bend forward from the waist. You are going to brace your neutral spine and if you have to bend forward it will be from the hip joints so that the spine can maintain neutral.

A Tip from the Golfers…

When you watch golfers pick a golf tee up they don’t bend forward at the waist and they also don’t squat down and use their knees. They cantilever over. They put one hand on their thigh and the other leg swings behind them as they reach down to grab the tee. It’s excellent biomechanics. I recommend that you practice that one for all the lightweight things you need to pick up from the floor.

Pilates for Back Pain – Part 6 of 8

Wednesday, July 22nd, 2009 by Karena

Pilates for Back Pain: Part 6 of 8

Moving onward and upward to something a little more challenging. This Pilates exercise challenges the flexors of the spine. It challenges them to NOT flex. Instead, the challenge is to stabilize. To hold the spine in a cushion of safety by not allowing errant twisting, tweaking and torsion. A weak spine tends to be a wiggly spine. This exercise will create strength to prevent too much wiggling (some wiggling is good after all).

Before we get started, here’s an interesting fact. When tested, those with a history of back pain have more endurance in their ability to hold a flexed position of the spine than those who have never had back pain. (A flexed position of the spine in this case is holding a sit-up position when you are halfway up in the process of performing a sit-up.)

Isn’t that amazing that someone with back pain had a better ability to hold this position than someone without back pain? And all these years we’ve been told if we have back pain we need to strengthen the stomach muscles. Appears to be false. It appears that those with back pain have too much strength/endurance there. And do you know where the back pain patients were weak? In their spines.

::Okay, is it just me or does these seem like common sense?::

A weak spine does need stabilization help from the oblique muscles and the spine flexors. But those muscles need to learn to stabilize. So that the upper and lower bodies can move without increasing the wiggle-factorof the spine.

The exercise above is an alternate to sit-ups. You will strengthen your abs by bracing them, not be flexing the spine. Flexing the spine is not only an area that doesn’t need strengthening if you have back pain but it also an enormous amount of pressure on a sore spine. Good luck and let me know if you have any questions about this series of exercises for pain relief.

Pilates Exercise for Back Pain – Part 5 of 8

Wednesday, July 15th, 2009 by Karena

Gentle stretching. The key word is gentle. Most of us tend to over-stretch and push into the ‘grimace-range’. If you are grimacing you may be over-doing it. Don’t inflict pain on yourself. Seems obvious, doesn’t it?

The point of this stretch is to improve posture and to get the spine moving in a direction that we don’t often move: side-to-side. We spend our days bent over computers, kitchen counters and steering wheels. This exercise gets the spine moving in a way that will help remind your body that there are other options than slumping forward. By the way, little note here…don’t stretch your spine by slumping forward and hugging your knees. More forward slumping is the last thing your spine needs if you are achy.

Also, this exercise addresses the less flexible side of the spine. Most of us are not ambidextrous. What that means to our spines is that we spend most of the day leaning into the strong side: think about carrying heavy groceries and how the weight-bearing shoulder will be higher while you are holding the extra weight. Or even consider your mouse hand. Ever notice how that shoulder tries to hug your ear? This extra work consistently being done on the same side creates a slight scoliosis or curve of the spine. Muscular imbalances result.

I do want to emphasize that these imbalances are normal. Much the same way as when you look in the mirror you see a slight difference between the right and left side of your face. No one is perfectly symmetrical: not from one side of our faces to the other or from one side of our spines to the other. Now, having said that, it is still very worthwhile to work both sides of your body equally when you exercise. Become aware of the imbalances and see if you can’t create more strength on the weak side and more flexibility on the stiff side. Working on these imbalances will help prevent undue imbalance and the possible resultant muscular discomfort.

With the hips stabilized and pushing into the mat the upper back has the opportunity to move. If the hips are not anchored then the upper back stays stuck. Anchor the hips and allow the spine to move as far as it comfortably can.

Try this exercise. If you have back pain, be sure not to stretch first thing in the morning. The discs take on water at night (just like our hands can be swollen and our rings can be tight when we wake up in the morning). This extra water stresses the muscles around the spine and stretching is an additional stress they do not need first thing in the morning. Let me know if you have any questions about these exercises for pain relief.


p.s. Oh My, my hair is stunning this week…