Pain Free Performance — Posture Alignment Therapy

Live Pain Free!

Joint Pain

Knee Pain: How to treat, prevent, and live Pain Free with Egoscue Method

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Knee pain is a frequent issue that brings individuals into Pain Free Performance. Pain in the knees can often be diagnosed as arthritis, instability, weakness, or tearing of the supporting structures. In order to identify the root of the pain and not just treat the symptom, the first assessment needs to focus on the joint position of the knee that created the diagnosis.

During an initial assessment, it is important to palpate the joint position and identify muscular and structural imbalances. Clients with knee pain often present with knees that are rotated externally or internally from the hip. A kneecap (patella) or femur position (the position of the thigh bone from the hip) that is not straight creates an uneven distribution of load on the knee, ankle, and foot. The knee was designed to be a hinge joint and function by bending and straightening. If many of us are walking, running, and jumping with knees that are rotated, it is no wonder acute and chronic knee pain are frequently diagnosed and treated!

Our bodies are brilliant at compensating for muscular imbalances and changes in function. Clients with acute or chronic knee pain often stand with their knees bent in flexion to take pressure off the knee. This creates a cascade of compensations throughout the body. The hip begins to tilt, the spine is altered through rotation and flexion, and the ankle and foot begin to turn outward. Compensation for joint position and pain can lead to more issues down the road. When the joint position of the knee is rotated and out of alignment, individuals with knee pain who undergo imaging, such as an MRI or CT scan, may show a meniscus tear or cartilage degeneration. In our practice over the past decade and a half, many of these clients had been advised to have arthroscopic surgery that did not resolve their knee pain but instead made it worse. Recently, medical literature has supported this observation, stating that “for most patients with osteoarthritis of the knee, arthroscopic surgery offers little benefit” (Mounsey A, Ewigman B. Arthroscopic surgery for knee osteoarthritis? Just say no. J Fam Pract. 2009 Mar;58(3):143-145. PMID: 19284940; PMCID: PMC3183924).

So how do we treat knee pain? At our practice, we use postural alignment therapy, the Egoscue Method, to identify the root cause and imbalances creating pain and work toward lasting change in a functional body. This is accomplished through a whole-body assessment designed to reduce knee pain while enhancing overall mobility and function. The Egoscue Method does not just address the pain—it addresses the root cause of the pain.

Alignment: Treating the Body as a Whole to alleviate Pain

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Healthcare today is focused on the parts. Our healthcare practitioners are specialized and focus on specific sites and no longer view the body as a whole. As a result, we are missing how each site impacts another directly.

With the Egoscue method, alignment matters. When the position of the head, shoulders, vertebrae, hips, knees, and ankles are in line the forces through the joints are distributed to allow movement with minimal effort. This is the ability to move freely and without pain.

When our body is not in alignment, our joints wear down and uneven load is placed on parts of our body that are not meant to bear the added weight. This dysfunction is often the root of pain.

Many clients find Egoscue after trying other modalities that are not addressing the compensation created by their tissues, muscles, and joints. When we see clients for the first time, their gait and the movement of their body tells the story of a system trying to fix its parts. In order to determine what is causing their neck pain, knee pain, or hip pain we must determine what body part positions are misaligned.

Our job is to release the muscular compensation and strengthen the correct muscles to bring the body into alignment. We do this through specific exercises targeted towards what is off in a client’s specific body. After each exercise, we use gait analysis and functional testing (like an arm circle or reaching to touch the toes) as tests to see how the body is changing. As things become in a better joint position, the body is noticeably moving more fluidly, straighter, and more balanced.

This is why we must consider the body holistically when pain is present. Often the site or location of pain is not the cause. Our goal is to identify the dysfunction and create an integrated muscular skeletal system where movement is freer and function is unlimited.

A Simple Trick to Test Your Alignment

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Many clients seek out our practice to reduce pain and regain their quality of life. 

Often, they are not aware that their body is out of alignment. 

When one aspect of the body is altered, it changes the function of the muscles and joints that surround that site. 

For most of us, our work week involves sitting at a desk in front of a computer. 

This position drives the shoulder forward, forcing the upper back to round, and bringing the head and neck into a flexed position.

In order to not develop chronic neck, shoulder, and back pain here is a simple trick to see if you body is aligned:

Stand vertically at the wall with the back of your head, shoulders, hips, and feet touching the wall.

In this position, is your head able to touch the wall? Or is there tension in your neck from bringing the head back?

For every inch forward that your head is from the wall, it increases the weight of your head on your neck by 10 lbs!

With the Egoscue method, we can reduce the forward head positioning and neck strain by getting to the root of the problem in the body.

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 look into Knee Pain

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As postural alignment specialists and graduates of Egoscue University, our focus is on the position of the client’s load bearing joints. Our shoulders, hips, knees, and ankles bear the weight of our body when standing and moving upright. When we look at our client’s joint position, many of our client’s are surprised by their knee position. 

The load bearing joints of the shoulders, hips, knees, and ankles should align.

Try this:
Stand in front of the mirror
Look at the middle of your thigh bone that is named the femur. Then look at the middle of your knee cap.
Draw an imaginary line from the center of the thigh bone to the middle of the knee cap.
Does the knee turn to the outside of the body or does the knee roll toward the middle of the body?

If the center of your thigh and center of your knee cap are not in line, the rest of your load bearing joints are picking up the work for the uneven load. This uneven load leads to knee pain, arthritis in the knee joint, bursitis, and torn ligaments!

When knees turn out or roll toward the middle of the body, there is significant wear and tear on the knee joint. Imagine going up and down the stairs with the knee cap pointing outward. The friction and demand on the uneven knee joint will lead to knee pain. Over time to avoid the knee pain we begin to sell our house to live on one level or we take the escalator to avoid the movement that leads to pain. This avoidance of triggers will decrease the feeling of the knee pain, but does not address the cause of the knee pain.

Oftentimes the exercise we do to be healthy and support our heart, aggravates our knees and we begin to wonder why. If your knees turn outwards and you cycle or run for 30 minutes, that is 30 minutes that your knee joint is impacted and inflamed. Frequent wear and tear from a misaligned knee exercising on the elliptical, bike, or treadmill will lead to arthritis of the knee and the need for a knee replacement. The exercise is not the enemy, but the position of the knee cap in relation to the thigh bone and pelvis. 

How do we avoid knee replacements, ligament tears, and arthritis? We must consider the muscles that support the thigh bone (femur) and knee cap (patella). Through a postural alignment assessment, we will identify what is off in your body and which muscles need to be activated to bring your body into alignment. By correcting and supporting the position of the lower legs, you will continue to be able to tackle stairs and maintain your heart healthy cardio!

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.

Set In Our Ways

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The modern era has provided us with many benefits. Enhanced technology has changed our health care, our connections with one another, and increased our access to opportunities we would not have had without it. We see the changes with our children and their relationships with their peers. As technology changes our lives, we adapt socially and our bodies physically adapt.

Most of us have had periods in our life that require us to commute long distances or work in front of a screen. In order to live our lives, we frequently sit. Sitting or holding any position for an extended period of time changes our muscles, our joints and our cardiovascular system. These changes can decrease blood flow throughout our body and make our muscles atrophy. When we sit or hold any position for too long, some muscles shorten and other muscles stretch. Our body begins to adapt to the improper muscle length change which pulls our joints out of alignment. That’s when the pain begins.

At Pain Free, we use the Egoscue method that considers the whole body and the relationship of all muscles and joints to each other. We understand that a patient’s health history and movement history has created adaptations and changes in their musculoskeletal system. These changes have affected their body’s mobility, blood flow, and led to pain. This could be back pain, knee pain, hip pain, foot pain, or any part of the body that has had to adapt to hours of holding a position. With time, we are able to realign the body and nourish muscles that support the body. When muscles work the way they were designed to, we are pain free!

Back Pain

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Last week a wonderful woman came to see me who has been struggling with extreme lower back pain for years. She has stenosis in her spine and has endured several injuries throughout her life. The pain in her back had gotten so bad that she couldn’t even walk without the back pain intensifying.

After evaluating her back pain, in order to see the response of the prescribed Egoscue program in her body, I asked her to walk after completing each stretch or position (E-cises). Watching her gait allowed me to see exactly how her body was responding and as importantly allowed her to feel the changes in her body.  Within ten minutes she had completed four Egoscue E-cises that encouraged the spine, shoulders, and pelvis to be in a better position. As she began to walk, she was overwhelmed with emotion. She couldn’t believe that her lower back didn’t hurt anymore!  This was the first time in years she did not have back pain.

Analyzing her gait, I could see that her shoulders were not as forward, she had increased range of motion in her hips, and she appeared lighter on her feet. As an Egoscue therapist, it is so exciting to see instant changes! While it doesn’t always happen this dramatically, when the E-cises are introduced the body changes.  Back pain is relieved.

In order to keep progressing toward a pain free body, these E-cises must become a way of life. You have to challenge the body as it evolves with new stimuli. You have to be dedicated. Doing the E-cises daily, even for as little as ten minutes, will benefit your body! Your back pain can be relieved.

For some people, the relief of back pain, shoulder pain, hip pain or knee pain might not happen in the first ten minutes, but over time the changes do add up and the pain retreats. The time and energy you’ve invested while doing your Egoscue program will decrease your pain and allow your body to function in the way that you desire! Walking, running, hiking, standing and sleeping without pain are within your reach! This result is emotional for our clients and for us.  Finally being pain free is life changing.  It’s what we do at Pain Free – we are here to help you realize the possibility of life without pain once and for all.