Pain Free Performance — Egoscue Certified

Posture Alignment Therapists, Certified by Egoscue University

joint pain

A look into Knee Pain

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As Egoscue certified postural alignment specialists, 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!

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.

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!

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.

Arthritis and Aging

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Many of us assume that as we age, there will be a certain amount of pain to endure. We think arthritis is a sure thing.  Or, is it?  And if so, is age really the only culprit?

First of all, what is arthritis?     It means “Inflammation, etiology unknown”.  Where does the inflammation come from?  There is the implied theory that we’ve just worn out our joints because we’ve lived so long!  If that were true, then everyone over a certain age would have arthritis or worn joints.  We know that knee pain, shoulder pain, hip pain, back pain comes from wear and tear.

Well, most often patients present with one side or the other hurting –I hear it all the time “thank goodness my other knee feels great!” This phenomenon alone debunks the theory that time on earth is dictating joint wear and pain.  While joint compression from age can be a factor would we really only have knee pain, shoulder pain, hip pain, and back pain on one side if pain was caused just by longevity?  No, both sides would have arthritis pain.

As Posture Alignment Specialists certified by Egoscue University, we evaluate bodies in pain all day every day– young and old, all sizes, shapes, injuries, surgeries, abilities and disabilities and condition levels. Most people come to us because they want pain relief – with knee pain, shoulder pain, hip pain, back pain, and ankle pain.  The simple and amazing thing is that they all have the same problem – their bodies are not properly aligned.  What your body needs is not youth but alignment… the way it was intended.  The earlier one understands the importance of alignment, the less arthritis has a chance!

joint alignment

Notice the alignment showing the ankles, knees, hips, and shoulders vertically and horizontally aligned, the pelvis is neutral, the spine has an s-curve, and the knees and feet point straight ahead. When this isn’t what is happening in our bodies – for whatever reason (accident, surgery, work posture) – some muscles begin doing too much and some not enough.  That is when bones are pulled out of alignment because of the compensation and then joints begin to wear unevenly.  This is true no matter what your age, however, the more years it goes uncorrected the more work one must do to unravel the compensations.

We need alignment so that our joints are properly “loaded” while we participate in as much weight bearing movement as we can handle, keep our range of motion in all joints full and active!  It’s not age, its alignment.  No matter what your age, we can help you retrain your body to be straighter and more functional without all the pain!

 

You get injured, what do you do about your Egoscue program?

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It’s a beautiful day and you’re enjoying the outdoors. Then, bam! You slip over an acorn on the sidewalk and you’re down. And, you’re hurt. You have a knee injury, bruised elbows, a jammed wrist, you have swelling and ankle pain, not to mention you hit your head and the neck pain is killing you. Even if nothing is broken, there is so much pain!

When something like this happens and you’re injured, the advice used to be to put your feet up and rest. And, the last thing you want to do is “exercise”. But, we know better now. Your body will start compromising the minute you get up off the sidewalk. You’ll be guarding, limping and twisting to try to avoid the pain and that will throw everything off in your body. We don’t want you to get “stuck” there, so don’t stop moving but knowing the type of movement to do based on your injuries is key.

Your alignment will affect the outcome and recovery of the new injury. Even if there is a fracture, we’ll provide a revised program based upon your injury and how it affects your ability to do your Egoscue menu. For example, if you can’t handle full weight because of your foot pain or knee pain, we alter the position to take pressure off your injury. If you have a shoulder injury and you have arm pain, we can work around that. We align the rest of the body focusing on straightening your spine and your shoulder becomes less forward making you more functional. This will keep you on your path toward becoming properly aligned, assist in healing your injury properly and get you back to being pain free.

So if you’re injured, after getting the necessary diagnostics, call us and we’ll provide you with an updated program to get you through this unexpected setback. If you have an upcoming appointment with us, don’t cancel it, call us and come in. Your new menu will address the changes that occurred from the fall, while correcting the previous imbalances without compromising your recovery. This will speed up your body’s innate ability to heal by giving it the proper stimulus! We’ll keep you moving forward toward your pain free alignment goal while you’re healing.

Cartilage Regeneration

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The body has an innate ability to heal. What does that really mean? It means that our body produces over 500 billion new cells a day – without conscious direction from us. Cuts heal, broken bones mend, muscle tissue builds, and brain cells, cardiac muscle and, yes, cartilage regenerate!

The key to a healthy healing body is the environment we provide it. Consider your nutrition, how much you move, if you’re getting enough sleep, how you’re managing stress and how aligned your posture is.

If you consistently work on all of these aspects of good health, your body responds. In order for cell production to be optimum, each of these needs to be happening simultaneously. I want to focus on how all of this enables cartilage regeneration, from an alignment standpoint. Maybe you’ve been told your knee (or hip, ankle, wrist) is “bone on bone” and you think the only answer is a replacement. Not true!

Research shows that under the right conditions cartilage can regenerate like any other tissue in the body. The first question to ask if you are told that you are “bone on bone” is why is that joint wearing away? Where did the cartilage go that is supposed to be there? It’s all about the position of the joint and the uneven force going through it as you move. Once the joint position is corrected, the body will produce more tissue to repair itself. Take a look at these before and after x-rays:
Look at the narrow joint space (bone on bone) on your left
knee pain
One year later after a postural alignment regime. Notice the uniform joint spaces!
repaired knee without surgery
Here at Pain Free Performance we watch the way bodies move and stand. We determine if body weight is equal front to back, side to side. We evaluate the position of all major joints looking for proper loading (head over neck, over shoulder, hip, knee, and ankle.) If there is disparity, the body is not functioning properly. There are muscle imbalances causing an uneven force in the joints which creates friction. The friction wears down the cartilage. The joint becomes a victim of the imbalance and bone surfaces begin to wear away. Bone on bone.

What is the remedy? Posture alignment. And I’m not talking about your mom telling you to “pull those shoulders back”. I’m talking about retraining muscles to do the job they are intended to do. Why?…because muscles pull bones. The bones are out of alignment but they are innocent bystanders because the muscles are either doing too much or too little. At Pain Free we unravel what the muscles are currently doing and give you the tools to get them working together again. When the muscles that propel the joints are working correctly again this provides increased blood flow to the area, and allows more movement. And, yes, this gives the cartilage an opportunity to regenerate. It’s not magic but it’s amazing and possible for you too.