165 Lilly Rd NE, Suite B, Olympia • 360.455-8014

back pain

Physical therapy- will it hurt?

People often wonder, if I go to physical therapy will it hurt?  Sometimes I’ve heard people say “PT” stands for “pain and torture.”

So, does physical therapy hurt?  This is the good news:  most of the time the answer is NO!

When will physical therapy hurt?   Once in a while the answer is yes, BUT that is because of the surgery you have had and the steps that you need to go through to get past the normal side effects of having a surgery.  What surgeries will be more painful to rehabilitate from?  In my experience as a physical therapist, new knee replacements seem to be the most painful.  Second to that is shoulder surgery.   The worse pain is usually there for a while only then gets better as you recover and move more, usually within a few weeks to a month.

When should physical therapy be comfortable?  Most of the time physical therapy should be comfortable and make you feel better as each treatment progresses.  The old adage of “no pain no gain” does NOT apply.  When you have an injury, working weak muscles until they are tired will be a good limit of exercise;  if you push past the muscle you are working feeling tired (heavy and achey)  you might cause more pain because your body is working in its weak zone and that is when more pain happens.

Will there be soreness after my physical therapy session?  It is pretty common for patients to feel sore after their PT appointment, especially your first visit because we have to have you move a lot to fully evaluate your problem.  Sometimes after introducing a new exercise, or increasing resistance you will be sore too.  You should not be in pain, however and if your soreness is there for more than 1-2 days, speak up on your next PT session because that is too long.

Most of the time physical therapy should be comfortable and leave you feeling good!

 

 

 

 

 

Exercise and Muscle of the Week: Serratus Anterior

The serratus anterior muscle is THE core muscle of the shoulder and arm. It lifts and supports the shoulder blade and arm from below and underneath. This muscle is key to good posture.

During the day at work, school, and chores and sports, to remind the serratus anterior to contract and help you have good posture and reduce pain, here is a video:

 

If you are interested in research on the serratus anterior and shoulder pain, here is a link to an article: http://www.aott.org.tr/index.php/aott/article/view/4897/2610

Back Pain When Shoveling Snow? Try a few of these exercises {Olympia, Wa}

Did you get an achey back after shoveling snow?  You may wonder why that happens.  It happens because the deeper supportive muscles get tired and the larger lumbar paraspinals take over but they become achey.  Here is a picture of the lumbar paraspinals:

What exercises can you do?  First get onto your bed or floor, and stretch your hips back towards your knees.

Then, to relax the larger muscles and strengthen your core, contract your pelvic floor (Do a Kegel’s) and while holding the Kegel’s, pull your tummy in towards your spine.  Hold for 5 seconds, and do 10 repetitions.  Here is a picture of the deeper core muscles:

Have fun in the snow!

Why does an ankle sprain cause back pain?

Have you ever sprained your ankle, and noticed that your back began to hurt? Why does one lead to the other?

Sprains can take 6 weeks to 3 months to heal.  If you want to run before that time, you should wear a brace and be checked out by a physician or health care provider first.  

In addition to the actual sprain having to heal, injuries to the ankle also cause secondary problems as a result of being off your feet for so long and having pain.  You may have noticed that you begin to limp.   When you limp, your hip muscles get very weak, and so do your knee muscles and your calf muscles. You can also develop back pain.  

In addition, you balance will suffer and you will be more likely to re-sprain your ankle again when running.

What can you do to decrease your back pain from walking with a limp?

First, make sure you don't have a fracture, and get checked out by your physician or primary care provider.

Secondly, use the RICE (rest, ice elevation) formula in the short term immediately after you sprain your ankle.

Thirdly, Begin to do gentle range of motion exercises, for example drawing the alphabet with your foot. Add gentle strengthening of the knee, hip and core to reduce back pain when walking with a limp.

Fourth, when your physician clears you to use a brace and not be in a cast boot or on crutches make sure to gentle strengthening exercises of the foot. You can use surgical tubing or theraband for foot exercises. Biking for cardio conditioning is a good idea.

Fifth, once your strength and movement is a little better you can begin strengthening in weight on your bad foot. Add some balance exercises.

Of course you may want some guidance to help you recover sucessfully and get back to full time running.

Working your core and still have back pain? Here’s why

Out of sync muscles cause pain cycle

Have you had a back injury, worked your core muscles and still hurt?  Have you wondered why you still have pain?  Even if you work your abs, you may not be working the true "inner core."  The secret to getting better with back pain is working the true inner core; retraining it to contract at the right time to protect your back, and getting your Muscles In-SyncTM.  

It turns out the the "inner core" is programmed like a computer to contract first before you reach your arm or kick your leg out.  It does this to support and protect your back.  When your back gets hurt, it starts contracting after  you move your arm or leg.  At first, after an injury, this actually helps to protect your back;  the bigger muscle spasm to lock up your back so you don't move farther and hurt your back more.  

The problem is the spasms stick around and don't unlock, and the "inner core" keeps contracting after the big muscles.  When the big muscles fire first it causes low back pain.  

A vicious cycle gets set up that keeps the pain going.  

How do you break the pain cycle? You get your  true "inner core"  Muscles In-SyncTM .   Begin by contracting your true "inner core". What exactly is the true "inner core". It is the transverse abdominus, pelvic floor and multifidus.  It get the best result, come to Comstock Physical Therapy where we can use our Ultrasound Imaging machine to take a look at your true "inner core."  Here are images of the transverse abdominus (TrA):

transverse abdominal muscle contracting on cue