Pain Free Performance — Egoscue Certified

Posture Alignment Therapists, Certified by Egoscue University

pain treatment

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!

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!

Things I Wish I Explained Better….

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I often have a conversation with a client that causes me to think – “Wow, I didn’t do a very good job of covering all the information I wanted to!” There is a lot of information we share with clients and it’s a lot to absorb, especially in the beginning.  We also have such a smart group of people who come to Pain Free Performance, we sometimes assume people know things that they don’t.

Here is a smattering of random questions and topics that come up often and might be helpful as you continue your Egoscue journey toward a pain free body! Clients often ask or say….

Can I resume weightlifting?

At first, NO.  We don’t want to strengthen any misalignments.  When your body is ready, we will give you some pointers on how to start with weights again.  You will be surprised at the “work-out” you will get from your Egoscue!

Can I go to Yoga class? Pilates? Tai Chi? Can I jog?

We are all about getting you back to your fullest most pain free life – whatever you love to do! The easy answer is yes, of course.  Talk with your Egoscue therapist regarding your particular issues and your favorite class or activity to make the most of it!

I twisted my ankle (bruised my elbow, tweaked my back) so I’m just going to cancel my appointment.

No, just the opposite! That’s the perfect time for you to come in – this is what we do – treat people in pain!  So, keep your appointment and have your therapist assess the injury and create a program that will enable you to heal faster and keep your newly aligned body on track!

I may not be doing my E-cises correctly and it made my leg hurt so I just stopped doing the program.

Contact us immediately if you feel that your program is causing any pain. We want to know, ask you a few questions and tweak the program if necessary.

I do my e-cises when I get home in the afternoon ……

Do your program in the morning! I know, I know sometimes it’s just not possible but here’s the thing…if you do your E-cises in the morning, you are setting yourself up to have your most aligned body possible to carry out all of the living you have to do during the day!  This means better function, less pain and less possible injury.  Talk with your therapist about how to adjust your program to fit your schedule.

Don’t cherry-pick from your program – do all of the E-cises in the order only!

The order of your Egoscue program is key. The e-cises are prescribed to either wake up certain muscles that are not doing their job or quiet muscles that are overdoing which creates that pesky misalignment, poor function and pain! Depending on your specific issues, there is an important chain of events that must occur by doing the e-cises in order to get you to the best outcome….which is a pain free body!

Do I have to do everything on both sides?

Occasionally, I have a client who ran out of time, or thought because her pain was on the right side that she’d just do the e-cises on the right side. Not with Egoscue.  We are trying to get the two halves of the body to work together as intended.  What you do to one side, you must do to the other.  It is important for regaining muscle balance, symmetry and healing to do the complete program on both sides.  If you’re often running late, talk to us and we can tweak your program to fit those days that are just too busy!

Do I have to do Egoscue the rest of my life?

Yes, but a very doable, shorter version of your program. It will be as easy as brushing your teeth or bathing…a necessary and desirable habit to maintain your pain free functional body!  When you’re ready, your Egoscue therapist will instruct you on how to continue with abbreviated and rotating programs that will keep you aligned and living life to the fullest!

 Speaking of function….

One of the most important things I want our clients to understand is that our job is to improve the way your body functions. Pain relief is the amazing benefit of having a functional body. Pain is the symptom, not the cause.  When the joints in the body are in the proper position and the muscles are balanced – the pain goes away!

 

Egoscue should be your first stop….

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I was working with a client who happens to be a physician and at the end of his session he said something very powerful about his patients – “This should be their first stop, not their last!”.   So often, people come to us in incredible pain after months or years of trying everything else under the sun, finally experiencing relief with Egoscue.  Why?  Instead of focusing on the symptom, we get to the root of the pain.  We diagnose the underlying cause and provide the specific tools to gently move the body back into the intended alignment, alleviating the pain.  This is not a temporary fix, it’s for life.

It’s what we do.  So, don’t make us the last stop in your search for a pain free life, make Pain Free Performance your first stop.

 

PAIN FREE — IT’S YOUR BIRTHRIGHT!

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Pain Free Performance – It’s the name of our posture clinic in Charlottesville, Virginia and it is also every person’s birthright.  We should be able to do whatever we want free of any kind of chronic musculo-skeletal pain.  For most of us, that is not the case.  We live with pain every day, but the good news is, we don’t have to!

In its truest form, pain is the body’s alarm system.  It is telling us that something is wrong and urging us to do something about it.  When we listen to that alarm, a whole new world awakens!  First, we need to determine what our body is trying to tell us and then take responsibility and be pro-active to regain our health.  That’s where our expertise at Pain Free Performance comes in!

In listening to your pain, is there a position that helps it feel better or decrease?  Is that position associated with an activity?  What happens when you do that activity with perhaps more mindfulness?  Does the pain/symptom increase, decrease or not change? 

The body thrives on movement and it must move to maintain health.  Load bearing joints need to line up in vertical and horizontal lines to allow the body to move without limitation or pain.  So, if you’re in pain, you need some help with alignment to get your body back to its original perfect design.   After all, for thousands of years we have walked, run, danced, crawled, dug, thrown, climbed, swung, jumped and played.  By doing these things, we thrived! There’s no reason we shouldn’t be doing these things all of our lives.  Our technology-oriented society has taken us away from our life of movement and well-being  (hunched over desks in front of computers rather than moving) but we can reclaim our active lifestyles!

So, I ask you, is your back pain, shoulder pain, hip pain, neck pain or knee pain keeping you from doing something that brings you joy or makes you feel good about life?  Are you willing to take some action to change that?  People may be suggesting medication, injections, even surgery but there is another way.  You have to do it, but we’re here to show you how.  It’s your move and your body! 

HOW POSTURE THERAPY WORKS

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HOW POSTURE THERAPY WORKS

I had a client the other day that came in with major pain and I thought I would share his story with you because this visit clearly illustrates how posture therapy works.

“Tom” came to us with left knee pain.  He had tried all kinds of things to help it – yoga, massage, stretching, chiropractic, physical therapy, even medication.  Nothing seemed to help and often his knee hurt as much if not more after these activities.

The focus of our posture work is looking at the body as a unit, as a complete system.  Most people think the problem is where the pain is, but that is hardly ever the case.  Tom’s pain tells us there is an issue with his left knee, but the cause of that knee pain is most likely somewhere else.  How do we find out where the root of the pain is?  Let me take you through our thought process as Posture Alignment Specialists certified by Egoscue University.   

As I said before, we look at the body as a unit, without focusing on the symptom (Tom’s knee pain).   I look at him to see if his ankles, knees, hips and shoulders line up in straight lines and at ninety degree angles.  I’m not thinking about what I can give him to make his knee feel better but I ask myself how is his body working as a unit?

Looking at Tom, the first thing that jumped out at me was that his right hip was an inch higher than the left.  Viewing from the front or back, his right hip was definitely elevated.  Just standing there, I could see that he did not really put equal weight on his right side.  With a hip that is elevated, it is so out of position that it is unable to do its job taking equal weight.

As a little test, I asked him to stand on one leg at a time, bending the other and bringing it up waist high.  Standing on his left side, the painful one, he could balance easily, but he could not balance standing on his right side.  So, I’m thinking that hip elevation is probably the major cause of his left knee pain, but I want to watch him walk first.  When he walks across the room and back I can see that he definitely shifts more onto his left side.  When I ask him if he can feel that he lands harder on his left side, his answer was “yeah, sort of” but when I have him watch himself walk in the mirror, he sees it clearly.

It’s a little strange that he shifts onto his painful side.  Most people shift away from the painful side.  Tom agrees that it doesn’t make any sense to him and has no idea why he would do that.  I explain that with his right hip so out of position, he simply is unable to load his weight equally from left to right.

So, Tom’s thought was “If my left knee hurts because my right hip is elevated, I’ll do some hip exercises to even them out and we’re good, right?”  “Hang on” I explained, “Let’s figure out why that hip is elevated.  Maybe that hip is the problem, but there could be something else going on.”

Often what we see in the clinic is that the client’s upper body position has a huge effect on the ability of the lower body to work properly.  When I look at Tom from his side views, I see his head way forward,  his shoulders hinged forward and his upper body rounded over.  He looks like a big “C”.  Tom’s spine should have three little curves in a gradual “S” shape, not a big “C”.  I put my hands on the top of each side of his pelvis to confirm that his right hip is higher and leaving my hands there I have Tom interlace his fingers together and put his hands behind his head and pull his elbows back as hard as he can.  He grimaces as if this is a bit difficult, then jokes about the only other time he did this, he was talking to a police officer!  But, guess what, with his hands up like that his hips become even.  I have him walk across the room again keeping his hands behind his head and elbows back and as he does that his hips stay level and load equally from left to right.  The hip disparity is gone and he can see it for himself as he walks toward the mirror.  He is amazed.

He laughs, “so all I have to do is walk around like this the rest of my life?”  I said “yeah, and in your neighborhood, they’d think nothing of it!!”  In all seriousness though, we have to get Tom’s upper body in that position without him having to put his hands up to get there.  I could see that Tom got it.

Putting his hands behind his head took his upper back that was stuck in flexion and shoulders that rounded forward and got them into a more extended position, closer to where the body was designed to be.  In this position the rest of his body changed and we could see his hips were level and his walking become equal left to right.

Bottom line:  Tom’s left knee hurts because every step he takes, he makes it work harder than it’s supposed to by putting more weight on it than it should normally get.  Along with that, as he keeps loading that left hip more and more, it gets tighter and tighter and over time stops rotating the way it should, so then the knee has to take up that job.  The knee was never designed to rotate – it’s a hinge.  So he’s not only putting more weight on that side with every step, he’s asking his left knee to do something it was never designed to do — rotate!  That knee is working like crazy taking more weight and twisting with every step – one hard step off a curb and the ACL tears – ouch!!!

Because the right hip is out of position he cannot load evenly left to right.  The right hip is out of position because his upper body is pulling it there.  In order to resolve the knee pain we have to get his upper body and shoulders in a more extended upright position.

All the other people trying to help him were only seeing his knee as the problem and so focused on the knee.  But the cause of his knee pain symptom was not the knee but the position of his upper body.  He could have done and did all kinds of things for his knee (the symptom) nothing changed because the cause of that symptom was not addressed.  We gave him a sequence of exercises to get the upper body more extended and some others to help the hip change position and stabilize so by the end of our session he felt better and walked better than he had in years.

This is not the end of the story.  In fact, it’s just a beginning.  Tom has to do his exercises every day to retrain his body so it will live in the better position.  It’s not a quick fix, but if he does the work, he will begin to stay in that better position and he won’t have knee pain. 

Where you are having pain (symptom) is rarely the actual cause of the problem.  The body works as a unit.  When we observe and treat the whole body as a unit the results can be amazing; some people have said miraculous.  It’s not so much a miracle, it’s just returning to the body’s original design of straight lines and 90 degree angles.  If you would like some help getting your body back to this basic design, give us a call or check out our website.

If you can understand these simple concepts, you don’t have to live with or be afraid of pain.  Pain is just a message that something is wrong and your body is asking for help.  Instead of ignoring it, let’s listen and then respond to it with grace and intelligence.  Believe in your body and honor it by giving it the motion it needs and the results can be truly amazing.

 MACKIE BOBLETTE

Stop Holding Your Stomach In!

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Stop Holding Your Stomach In!

I know most of you women (and a lot of you men) will think this is sacrilege when I say this, but for the good of your health and your posture…..

LET YOUR STOMACH RELAX!!!!

So, STOP HOLDING IT IN – LET IT GO – BREATHE!  Feel your belly expand as you take a breath.  Forget all that stuff you’ve been told (over and over and over) about zipping up the abdominals and strengthening your “core”. Your core is a lot more than your stomach! In fact, there are about 70 different muscles that make up your core and if you hold the stomach in, most of those other muscles cannot do their job of stabilizing your spine and pelvis. You are asking the 4 stomach muscles to do the work of 70 muscles and they cannot do it.

Secondly, if you hold any muscle in a constant contraction, it gets shortened and weak.  Muscles need movement – contraction and release – to gain and maintain strength. Think about what happens to your bicep when you keep your arm bent at 90 degrees (as happens with a broken arm). It gets weak and immobile. The stomach muscles will do the same – become weak and unable to move.

It also prevents your pelvis from moving as you walk.  Each half of your pelvis should go through a few degrees of flexion with each step (heel strike to extension as you push off of your toes). Holding your stomach in keeps that from happening, then you compensate in some way, for example twisting or elevating your hips, which leads to even more trouble!

And last, but not least, holding your stomach in effects your breathing!  As you inhale, the diaphragm should drop down to pull air into the lungs.  As it drops down, the stomach and low back need to expand to accommodate that movement.  If you are holding your stomach in, the diaphragm shuts down and you use only the accessory breathing muscles (the small muscles between the ribs and around your shoulder blades). Your breathing becomes very shallow and your oxygen intake is lessened by one-third!  In a normal day, we breathe up to 25,000 times so that’s a lot of oxygen lost.  Furthermore, the small muscles trying to do all the work without the diaphragm tire fairly quickly. They need help from the shoulders and neck to do the work, creating strain, pain, or tightness.  The muscles are exhausted and we are exhausted!!

So please, please let your stomach relax and take a nice deep belly breath!!! You’ll feel less stressed, you’ll feel less pain, you’ll give every cell in your body what it needs!

What About Pain?

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WHAT ABOUT PAIN?

Most of us have a perverse relationship with pain – any kind of pain – back pain, shoulder pain, knee pain, or neck pain.  If we have it, we don’t want it and we do any number of things to get it to go away – prescription or non-prescription drugs, lifts, braces, wraps, and even surgery – all because we don’t understand pain.

If we can look at pain for what it is – the body’s message system – then we can listen to what message the body is sending us. So what is the quality of the pain you feel?  Is it the sharp, knifelike, electric white-hot kind? Oh yeah, you have to stop whatever your doing and find a new position and placement. That kind of pain is the fire alarm so to speak.  But if it’s not that sharp electric kind of pain, if we can look it in the eye, we can learn a great deal about our bodies.  Is it there all the time or can you adjust your position and see it increase or decrease? Does it come in the morning upon waking or later when you’re tired? Does it occur while moving and doing things or when you’re more static? What brings this pain on and can you get it to decrease?

A common mistake we make around pain is to use it as the only measure that we’re doing better when it is only one way of measuring how we’re doing. Typically, pain is the last thing to change so it’s not the best measure, just the one we want to see the most!  The pain will go away when the body is able to maintain a more equal, bilateral, symmetrical position. That means you have to start developing your “kinesthetic awareness” – sensing, feeling our bodies from the inside out – which is not something we are encouraged to do in our culture!

As a posture exercise therapist, if I can get you to think about something other than your pain, we’ve made a giant step forward toward getting you better.  To practice kinesthetic awareness, ask yourself these questions:  Where do you feel the weight in your feet? Is the weight equal left to right or different?  Is it more in the heels or balls of the feet? Is it more toward the arch or little toes? If you stand with your toes together and heels apart with your legs really straight does that change anything or can you feel what changed? If you do several exercises and walk around again can you feel what has changed? Can you feel the position of your shoulders in relation to the rest of you?  Is your head in line with your shoulders and spine or is it more forward? Can you feel your body with your body (hence, the kinesthetic part) or do you have to look in a mirror to tell (more visual)? The imbalances you discover and feel in your body can be corrected.  The pain you feel from the imbalance can be alleviated. It’s what we do at Pain Free Performance.

So, while pain is an important sensation and a clue to misalignment it should not frighten us, but put us on the path to understanding the message. Acknowledging the pain and correcting the muscle imbalances will stop the pain. Listening to our pain rather than automatically stopping it with medication or procedures will help us make the necessary changes to live pain free.  At Pain Free Performance we will give you the tools to do just that.