Pain Free Performance — Posture Alignment Therapy

Live Pain Free!

Egoscue

The Evolution of our Practice

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Our clinic first opened in 2006 when our founder, Cindy, encountered a book that shifted her understanding of how the body experiences and resolves pain. At the time, Cindy was working in physical therapy when a client introduced her to Pain Free by Pete Egoscue. The book’s central idea—that the body functions as an interconnected system—offered a new perspective on therapeutic exercise and muscular compensation.

Trusting her intuition, Cindy began applying these principles with her physical therapy patients. The results were striking. Patients who had been preparing for surgical procedures were improving and, in some cases, no longer needed them. Encouraged by these outcomes, Cindy took a leap of faith and opened the first postural alignment therapy clinic in Central Virginia.

After completing her certification through Egoscue University in 2006, Cindy continued to deepen her belief that the body has an extraordinary capacity to heal when muscular imbalances and postural dysfunction are properly addressed. For more than 20 years, our practice has helped clients experience meaningful improvements in function, longevity, and overall quality of life—often allowing them to move beyond chronic pain.

As our understanding of the body has continued to evolve, so has our approach. While Postural Alignment Therapy remains the foundation of our work, we have thoughtfully incorporated additional modalities when they support the healing process. These include hands-on techniques such as Strain Counterstrain, as well as therapeutic technologies like red-light and infrared laser therapy.

Equally important to us is the process of assessment. Each client is evaluated individually through observation, movement analysis, and hands-on palpation. This allows us to understand the subtle compensations within the body in ways that standardized software or automated assessments often cannot capture.

In 2018, after more than a decade as Egoscue affiliates, we chose to continue our work independently at Pain Free Performance. This transition allowed us to expand the services we offer while maintaining the principles that have guided our practice since the beginning.

How long does it take to create pain relief using posture alignment therapy?

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Most of the clients we see are in pain. These clients come to us for relief with their knee pain, back pain, hip pain, and shoulder pain. Oftentimes, our clients have been to chiropractors, physical therapists, doctors, massage therapists, and acupuncturists that have been unable to create a lasting change with their muscle and joint pain. This can be challenging for our clients because their journey for pain relief has already taken weeks and months before we meet our clients for the first time. 

 

In order to create lasting pain relief, as Postural Alignment Specialists that practice The Egoscue Method, we assess the muscular imbalances in their bodies. This begins through a complete health assessment and history to understand the patterns of movement (or lack of movement) that led to pain. We complete postural photos to see how their joint position aligns against a grid to understand how their joints are loading. This can reveal if an elevated shoulder and hip are leading to the back pain or if a forward head position is causing the shoulder pain. Finally, we complete a series of functional testing and gait analysis to determine what muscles are active or inactive that are resulting in muscular compensation and pain. 

 

When our clients leave their first postural alignment session, they can expect to feel a change in their body. This often results in a decrease in pain. If a client’s body has compensated for years, they might notice feeling “lighter” or “straighter” after doing their Egoscue therapy exercises. This is a sign that their body is becoming more functional and balanced. 

 

The work towards alignment and health takes time and effort. Our muscle memory begins to take effect in 90 days and is often the time our clients begin to notice less pain due to their enhanced alignment. Change is not always linear and might result in peaks and valleys. We encourage clients to remain focused on what is changing. Our cells and tissues are constantly adapting and we will continue to adapt new exercises and stimuli to create a change in the muscle structure. One of the great benefits of our bodies is that they are dynamic and constantly in motion. This is why the method works! Now, let’s get moving!

A Peek inside Postural Alignment Therapy Evaluation

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When clients are new to postural alignment therapy, they become awakened to a new awareness of viewing the body. What do we mean by this?

When someone is in chronic or acute pain, the pain becomes their focus. Pain requires individuals to use great effort in order to function throughout their day. Their attention is centered on how to avoid pain. Our bodies are skilled at compensating. To reduce overall pain, our bodies will change the way in which we move as a form of survival.  

So as Egoscue therapists where do we start?

First: We place the focus on the joint position. We identify the joint position though palpating or touching the joints. But what does the joint position tell us? 

When we look at the body, we are looking for what is different from the natural skeletal position. 

        Do the shoulders, hips, knees, and ankles align? 

        Is a shoulder elevated? 

        Or, do the knees and feet turn out instead of being straight. 

If any of these joints are off, the body is unable to work as a unit and pain results from misalignment. 

Second: We assess the way the body is loading. 

        We do this by having the client do a body analysis. The client closes their eyes and connects to the weight of their body. Oftentimes, clients are heavier on one foot and their 

weight distribution can be uneven in both feet. This allows us to know that their body’s are misaligned and that natural compensation patterns are occurring for the client to move. As therapists we

use this assessment to understand the way the client’s joints load the weight bear of their body. This information helps us establish a baseline of their imbalances. 

Third: Gait analysis

All joints and muscles have a function or movement that they perform. When a person is misaligned and their joints are different than the natural skeletal position, their body will compensate for

this misalignment. We, as therapists, look at the way a client walks and moves. We are looking for what part of the body is not working and what parts of the body are compensating for the work

of the inactive part of the body.  Compensation can be new or have developed over years.

Often times in gait or walking we notice:

       No arm swing or more arm swing on one side

       Rotation and twisting in the upper body

       Elevation of a hip

       Knees and feet being turned outward or inward

       Uneven heel strike and decreased movement in the feet

Any compensation pattern will lead to inflammation, arthritis, pain, and decreased quality of life. 

So what do we do with this information!?!

 

Our goal is to pull the body into alignment. We correct the muscle imbalances and improve the way the body moves. Without proper alignment and motion you will set your body up for pain. Correct the alignment and live pain free.

Painful Hip Flexors

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It’s not uncommon for us to hear our clients mention waking up with tight, sore hip flexors. Hip tightness can occur for many reasons. Excessive sitting can cause the muscles to relax and deactivate becoming progressively weaker and shorter, creating pain.

Poor posture habits can create a structural imbalance which will cause an uneven pulling of muscles.  No matter the reason, tightness in the hip flexors will lead to decreased movement in the hip and change the way we walk, stand and sit. Our pelvic position will be out of line because the hip flexors are pulling the pelvis forward. This changes the load of our body and creates instability in our gait. Over time, the uneven load and misalignment leads to inflammation, arthritis and other degenerative changes causing pain.  What to do?

At Pain Free we will evaluate you individually to see what is going on with your body that’s creating the issue.  Part of the prescribed plan will retrain those hip flexors to let go, get back to their intended length and tension to eventually re-establish the entire body’s alignment restoring proper gait.  All of that equals being pain free!

Try this and see if you are able to notice a release:

Stand with your back against the wall. When your hips are touching the wall, your thighs and kneecaps will begin to release. If your thighs want to engage, stay in this position for 2-5 minutes until your thighs release and the backs of your legs begin to work.

Moving into the New Year!

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A new year brings opportunity for new beginnings. Many of us look at January as a start date for change and for removing bad habits from our lives. What if we viewed this new decade as an opportunity to add something positive to our lives? This could be adding an Egoscue e-cise menu to your life to correct your joint position or choosing to do your Egoscue more regularly. When we add positive health choices to our life, even once a week, our body and our health change immensely.

In our culture, going to the gym the first month of the new year is a tradition for many. Many of us believe “moving more” is “exercising more”. This year, we’d like to encourage you change the way you think about movement. Moving more could be taking breaks every twenty minutes from sitting or standing at work. Take a walk around the office or out to the mailbox.  Moving more could be sitting on the floor to watch tv at night instead of collapsing into our couch or comfy chair. The more resistant surface of the floor encourages increased blood flow – seems crazy, but this is sooo good for your body! And, it’s so simple.

When we move in any which way, our bones our nourished and joints have enhanced flexibility. If your goal is to be pain free or enhance your health this new year, consider adding more movement to your life outside of the gym. Be creative. There are no rules to how you have to move just move as often as possible!

Muscle Memory and Egoscue

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What makes the Egoscue method work so well compared to other treatments? The Egoscue method is different because it utilizes the basic way our body learns and remembers movement. When you do your Egoscue exercises each morning, you activate muscles in the correct way to align your body.
Motor memory, or muscle memory, allows the cells within our bodies to coordinate our movements, muscles, and brain to create the desired activity. Each time you move, your body remembers it. When movements are done repetitively, your body keeps track and creates the “new normal”. Science shows that it takes 90 days of that new repetitive motion to have the memory remain without prompting. With Egoscue we are introducing proper stimulus to create equal and bilateral activity in the muscles. This retraining process is amazing because it means we have the ability to change and heal ourselves!
In comparison, when a person goes to the chiropractor, they align their bodies through an adjustment of the bones. Without the memory in the muscles, the skeletal alignment will not stay because muscles pull bones. This creates a need for frequent follow-up appointments. With the Egoscue method, our clients are able to retrain the musculature to hold their bones in the correct position. This is why the Egoscue method is a therapy that creates lasting change and is not just temporary symptom relief.
Utilizing Egoscue, our clients are able to create new alignment with noticeable improvement in pain reduction, movement, balance, and quality of life!

Joint Replacement and Egoscue

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Are you and your physician choosing joint replacement?  Let us help you maximize your outcome.

When your joint is bone-on-bone, the pain is worsening and keeps you from your daily activities; joint replacement may be the next best step.  I get it, I’d try everything I could to avoid surgery, but sometimes it’s inevitable.  So, once you and your physician make this life changing decision, there are some other things to consider as you look forward to getting back to normal.  Consider your alignment.

For those of you who are already on board with Egoscue, you know that we are all about pain relief through proper alignment.  The key to our work is retraining the muscles to work equally so when the weight of your body goes through your joints it is balanced.   If muscles are out of whack and doing too much or too little, bones are pulled out of place, joints are wearing unevenly and therein lies your pain.  Once your joints bear weight evenly you gain strength, balance and function.   This not only alleviates pain, but protects you in the future.  Although I talk about how cartilage regenerates, some joints are so compromised that replacement is the only option.  Each body is different; everyone’s history and injuries are different.  If you are in pain and cannot function, choosing joint replacement isn’t a failure; it is an amazing tool to get your body and your life back to where it needs to be.

If joint replacement is next, you have prepared for it beautifully!  You’re in your best alignment going into surgery – a step ahead of the curve with strength and balance as you also embark on post-surgery rehab.  One of our clients recently exclaimed that “My doctors, all the nurses and my rehab therapists were amazed at how strong I was and how fast I recovered from my knee replacement!”  “They asked me what I had been doing and I told them it was all my hard work doing Egoscue at Pain Free!”   She continues to do her Egoscue e-cises to maintain her alignment and protect her new joint.

If you are planning on joint replacement, we can help you prepare and improve your outcome.  And, we are waiting for you on the other side to help keep your entire body functioning – head to toe – including your new joint!

Exercise and Egoscue

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We tend to think about our daily exercise as strengthening our muscles or stretching our muscles. We do it every day, we are committed and diligent to maintain our strength and flexibility. If we stopped any part of our routine, we’d lose ground and our body would suffer, right? While there is truth to this, it may not be the appropriate thing to do when you are in pain. As Egoscue therapists we are trained to look at the body using a different approach.

In my physical therapy training, I learned the origin and insertion of all of the muscles and where they connect to the bones. I was taught the particular function and range of motion of each of the individual muscles. In physical therapy, I was trained in specific techniques to treat neck pain, back pain, hip pain, knee pain, shoulder pain – you name it. I also designed personal fitness programs to get people strong. I taught stretch classes to relax tight muscles. I owned a fitness studio in the 1980’s when aerobic classes were the thing to do. I taught classes 7 days a week and had so much fun! I was in great shape but my body was a mess. Why? I never thought about the position of my joints. Even with pain, I would have been hard-pressed to give up my exercise. It was a big part of my life. My new Egoscue clients feel the same way when initially stepping back from their exercise might be necessary. They feel as though they will lose ground with their fitness.

Here is what I now understand from my training and certification utilizing the Egoscue Method for the last 13 years. Our habits and old injuries can change the position of our joints. When joints no longer line up correctly, an uneven force goes through them when they bear the weight of your body. This new uneven pattern wears down the cartilage and changes the balance of the muscles. Some muscles are doing more work than they are designed to do, causing them to get stronger and other muscles are doing less work than designed, causing them to weaken. The overall loading of the joints is now very compromised. Let me give you an example:

John Doe works at his desk all day with his back rounded and shoulders slumped over his computer. Years of this posture becomes habit and his muscles now rest in this position. Some of his muscles have shortened over time making it difficult for him to stand straight and pull his shoulders back. It feels normal to have rounded shoulders. John Doe really does not think about it. He has no pain. John Doe goes to the gym and does weight training. His shoulders and his upper back are rounded as he performs bicep curls. Yes, he is strengthening his bicep muscles but, he is also reinforcing the uneven loading of his spine and shoulders.

Fast forward a couple of years and John Doe now has lower back pain. The rounding in his upper back and shoulders changed his center of gravity. This causes the muscles of his lower back to work harder to compensate for the changed center of gravity. The body’s response is that the lower back muscles are tight, creating pressure on the nerves. Strengthening and stretching the muscles of the low back will NOT change the position of the rounded upper back and shoulders. John Doe’s back pain is caused by the position of this upper back and shoulders.

John Doe looks everywhere for relief – physical therapy, chiropractic, acupuncture. Everyone is trying very hard to help but focusing on his back. He still hurts. He finally ends up at Pain Free. In order to help him using the Egoscue Method, we focus on his body as a unit, his alignment. We might recommend temporarily changing how he works his biceps until his upper back and shoulders are in a better position. Does this mean he can never do bicep curls again with weights? Absolutely not! It just means that he may need to back off his old exercise routine a bit until his body responds to the new exercise designed to correct the upper back and shoulder position.

You can understand now that everything in the body is connected. Working on the body part that hurts will not change the way the body moves. The Egoscue Method has taught me how to look at the body as a whole, no longer thinking about strengthening or stretching muscles but alignment. When John Doe stands in front of me in pain, my focus is determining misalignment, what is necessary to correct it and getting him back to his life pain free. Maybe his focus is to be out of pain so that he can get back to his bicep curls. We both win.