Is Your Back Killing You?

Physical Therapy for Back Pain and Injury

ARE YOU LIVING WITH NEW OR CHRONIC BACK PAIN?

Upper and lower back pain and injuries can occur in any number of anatomical structures that make up your back. Muscles, bones, nerves, fascia, ligaments, intervertebral discs and tendons weave together to form the back. Pain or discomfort in this area can arise from an acute injury to muscle or bone, or can develop over time in response to repetitive or faulty movement patterns or to muscle length and strength asymmetries. This article will help you to understand the causes, symptoms and possible treatments that you can expect during a physical therapy treatment.

LET’S GET A BETTER UNDERSTANDING OF THE SPINE AND HOW IT FUNCTIONS:

The spine, made up of 34 bones forms, well, the backbone of the body. It provides stiffness and structure to the torso while still allowing for the flexibility and movement needed to perform our daily tasks. The seven vertebrae that make up the neck, known as the cervical spine, the 12 vertebrae that make up the mid back, or thoracic spine, and the 5 vertebrae that make up the lower back, or lumbar spine, create a long canal that houses the spinal cord. The spinal cord is made up of a bundle of nerves that arise from the brainstem and leave through channels between the bones of the spine to innervate and carry movement and sensation information between the brain and the rest of the body. The broad and flat sacral bones sit beneath the last lumbar vertebrae and act as connectors between the pelvic bones and the spine. Beneath that, lives the coccyx or tailbone.

There are many muscles that compose the back. Some muscles are more superficial--closer to the skin--and often help in moving or positioning the arms. Intermediate layers of muscles act on the ribcage to help with respiratory function and finally there is the deep layer of muscles which lie close to and help move the spine. Any of these anatomical structures may be involved in back pain or injury and your physical therapist will perform a series of tests and measures to help them to localize the cause.

It is important to understand that while in some cases, a specific anatomical structure may be primarily to blame for your back pain or discomfort such as a herniation at an intervertebral disc or a strain of a specific muscle but often times the underlying cause is due to faulty movement patterns and your physical therapist at Evolve will be evaluating how you move as much as he or she is examining the structures of the back.

WHAT MIGHT BE THE CAUSE OF YOUR BACK PAIN?

Back pain is often multifactorial. Your back pain might be due to an injury or irritation to one of the structures we talked about above but could also be related to how strong your hips are, how flexible your shoulders are, how often you perform certain activities and how well you control the movement of your body during everyday tasks. The good news is, your physical therapist is well-trained to spot all of the contributing factors to help create a comprehensive treatment plan. To help you to better understand some of the causes of back pain, here are some examples:

Muscle Strain: A pulled or strained muscle can result from a trauma such as a fall, unexpected twist or pull. It can also result from repetitively overloading muscles through less than ideal biomechanics. These overloaded muscles may eventually be unable to compensate for weakened or fatigued primary muscles leading to a muscle strain. Symptoms of a muscle strain include pain, swelling, bruising, stiffness and limited range of motion. When you come to physical therapy your PT will not only address the symptoms of the muscle strain through modalities such as ice, ultrasound and electrical stimulation but will work to correct any underlying biomechanical inefficiencies and muscle imbalances to prevent future injuries.

Intervertebral Disc Herniation: Between the bones of the spine lie the intervertebral discs which provide height and cushioning. A herniation of the jelly-like center (nucleus) of the disc through the outer, tougher layer (annulus) is called a disc herniation and it can occur from a sudden trauma or due to gradual age-related changes in the disc. It can sometimes place pressure on the nerves where they exit the spinal canal causing pain both locally and at times, into remote areas such as the legs or feet. If severe enough it can cause changes in the sensation of the skin and strength of muscles in the legs and even affect bowel and bladder function. During your treatment your PT will be prescribing you a series of movements and exercises to help relieve the pressure on the nerves and optimize your movement patterns to minimize future discomfort. You can also expect your PT will be educating you on this condition and how you can modify your activity in the meantime.

Sciatica: Sciatica refers to pain, burning, tingling, cramping, numbness and sometimes weakness that often begins in the buttock and travels down the back of the leg. It is caused by compression or irritation of the sciatic nerve that arises in the low back and travels down the posterior leg. With severe or prolonged compression or irritation muscle weakness can also occur. Your physical therapist will be assessing for a number of causes including disc herniations, misalignment of the pelvis, tightness in the hip or buttock muscles, narrowing of the spine or biomechanical problems before they begin treating you. Treatment may include manual therapy techniques to help restore normal movement and soft tissue mobility, self-stretching to improve muscle length, strengthening to address weakness and education on improving movement patterns.

While upper and lower back pain can be disruptive to your daily life, conservative treatments such as physical therapy are often highly effective. Physical therapists can identify the myriad of factors contributing to your specific back pain and provide you with a rehabilitation program to improve your symptoms now and help prevent them in the future. A physical therapist at Evolve can help you get on the road to healing your back pain. Our therapists do not just treat symptoms, but we get to the root of the cause. We strive to enable our patients to live pain free, and prevent the recurrence of related issues.

Are you or someone you know experiencing upper back pain or lower back pain? Call Evolve Physical Therapy in Brooklyn today to make an appointment. Our physical therapists will work with you to reduce the risk of complications, and help you get back to living your life to the fullest. Call- 1-718-258-3300 or visit- https://evolveny.com/physical-therapy/back-physical-therapy-brooklyn 

About EvolveNY-

Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Brooklyn Physical Therapy Clinic Locations!

1-718-258-3300

https://EvolveNY.com

WORKING FROM HOME CAUSING YOU BACK PAIN?

GET BACK ON TRACK! Reduce Back Pain While Working from Home.

4 Tips to Reduce Back Pain

If you’ve been working from home for a while and are noticing lower back pain that lingers, it could be caused by your home office set-up. Working longer hours, not having a supportive chair and poor posture can all lead to back pain. “The urgency in which people were sent home to work during the peak of the pandemic, left little to no time to set up a proper office space,” explains Dr. Nathan Kind, physical therapist at Evolve Sport Rehabilitation - Brooklyn. “Also, without the usual distractions of work, people find themselves sitting for 3-4 hours or more without getting up to run to various meeting room shared office spaces.

Extended sitting leads to poor posture, which can ultimately lead to pain. Nathan further explains that “The stress from juggling life at home can also increase pain from ramped up cortisol, tightness in muscles, shallow breathing and decreased circulation throughout the body,” Dr. Kind explains. “It’s been a perfect recipe of factors that contribute to back and neck pain.” Dr. Kind shares advice on how to get “back on track” reduce back pain while working from home.

Tips on How To Reduce Back Pain And Sciatica While Working From Home-

START YOUR DAY WITH A STRETCH!

Whether you’re suffering from pain in the lower back, mid-back, or upper back and shoulders, here are two stretches that are easy to try:

Knee to chest: Don’t be fooled by this stretch’s simplicity. This is a really effective way to stretch the hamstrings and lower back. Lie on your back with your legs flat on the floor. Gently bend one leg up, placing your hands over your knee to hold it in place. Hold this for 30 seconds on each leg.

Side bends: While standing, slowly slide your right hand down the side of your right leg, going as far as you can until you feel any stretch or discomfort. Hold for 10 seconds and ease yourself back to standing. Repeat on the left side.

VIEW YOUR COMPUTER SCREEN WITH A STRAIGHT NECK!

Put your screen in front of you at a comfortable viewing height. Don’t look down at your screen, like to a laptop on a table or to your phone. And don’t angle your screen so you must twist your neck–some people like to put their keyboard and mouse in front of them with their screen off to the side, but then they end up dealing with neck pain from the swiveling. If you have a separate screen or if you are using a laptop, you might have to put it on a pile of books or on a cardboard box to raise it to a comfortable viewing position straight in front of you.

STAY HYDRATED!

Simple, yet often forgotten when we get busy, remember to keep up your water intake. Drinking plenty of water helps keep your muscles and skin well hydrated. It ensures the body has plenty of opportunities to take away waste products from the muscles that are working hard keeping you in your forced typing/desk position. There are also secondary benefits too. You have to get up out of your seat to get a refill, giving you a natural break and, most likely, you will be going to the loo more often!

SCHEDULE TIME FOR YOUR BODY TO MOVE!

When we asked Dr. Kind, what’s the most important advice you can give someone working from home ? He replied “ Take a shake break, take a break simply just to move and schedule time to take care of your body”.

The Key is not to stay in any one position for longer than about 45 minutes. Get up and move around be intentional about your movement. If you have a smartwatch or Fitbit wear it and follow the prompts to stretch.

If you need help with getting back on track schedule Physical Therapy as part of your weekly fitness/wellness routine. There are a lot of simple exercises we can teach you to do at home or at work to strengthen your core and support your lower back and spine.

Got Sciatica? Do you have an excruciating pain or electrical shock feeling running down your back and legs that just won't quit? Check Out Some of Evolve Physical Therapy’s Lower Back Stretches and Sciatica Specific Stretches…

Got Pain? Schedule a Consultation Today! Walk Ins Welcome.

Got lower back pain and/or Sciatica? Call us today to schedule an appointment! Call- 1-718-258-3300

About Evolve Physical Therapy in Brooklyn-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of bio-mechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Upper Back Strain?

Upper Back Strains

If you are experiencing pain on your upper back, specifically between your shoulder blades, you may have a rhomboid strain or spasm. The rhomboids are muscles that pull your shoulders back and rotate your scapulae down. They also act as a stabilizer, positioning the scapulae onto the thoracic wall. Activation of these muscles help to maintain proper posture while standing, sitting, and walking. When not activated, the shoulders can protrude forward, leading to poor posture and upper back pain. 

 A rhomboid strain or spasm is usually caused from repetitive motions or other overuse of the shoulder. Some of these include overhead activities such as pitching, serving a tennis ball, rowing, carrying a heavy load such as a backpack, and sustained poor posture for long periods of time. A strain may cause pain in between your shoulder blades and can be assessed by your physical therapist.

Your physical therapist will help you strengthen and stretch the muscles in your upper back and shoulders in order to correct any existing muscle imbalances and to improve your posture. They also may incorporate some modalities into your treatment such as ice, ultrasound, and soft tissue work. All of these approaches will work off of one another to manage pain and inflammation.  In order to facilitate the healing process, you will need to modify your activities in order to avoid anything that aggravates your upper back pain. Your PT will most likely prescribe a home exercise program to complete between visits. You and your physical therapist will become partners in your healing; they will give you the tools you need to get yourself better in a timely manner. Following this plan is important to speed up recovery.  A mild strain should heal within 4-6 weeks while more severe strains may take longer.

There are a few actions you can take to prevent rhomboid muscle strains or spasms:

• Be sure to warm up and cool down before and after your workouts

• Perform dynamic stretches before activity and static stretches after activity 

• If you have a desk job, set an alarm on your device to remind you to take breaks and move around every 45 minutes

• Practice proper technique while playing sports

• If you wear a backpack, make sure to carry it on both shoulders

Here are some exercises that can help with upper back pain due to rhomboid sprains and spasms:

• Shoulder Retractions: Sit or stand with your arms at your sides. Draw your shoulder blades together while bringing them down and back. Hold this position for 5 seconds and repeat for 1 minute

• Rhomboid Stretch: Extend your arms out in front of you, stacking your right hand over your left. Hold this position for 30 seconds and then switch sides. Repeat for a total of 3 times on each side. 

• Neck Rotations: Sit upright at the edge of a chair. Inhale while turning your head to the right and hold at the end of your range for 30 seconds while taking deep breaths. Repeat on the left side. Do this for a total of 3 times on each side.

Got upper back pain? Call us today to make an appointment! Call- 1-718-258-3300

About Evolve Physical Therapy in Brooklyn-

Got Pain? Schedule a Consultation Today! Walk Ins Welcome.

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Best Sleeping Positions to Reduce Pain

Finding a Sleep Position to Reduce Your Back Pain

Dealing with back pain? Well, you definitely are not alone. Back pain has been named as the leading cause of disability globally. You might think most back pain results from trauma or serious medical conditions, but actually bad posture, sleeping positions and other everyday habits can contribute to lower back pain. 

How Should We Sleep and Which Sleeping Position Is the Best?

Try these top sleeping positions and find the right fit for you. Depending on your normal sleep positions, one of these variations can help to reduce pressure on your back, maintain alignment and help alleviate pain.

1- Side Sleeping with a Knee Pillow

For some people, lying on their back can create discomfort. Try rolling over onto your side. Allow the entire length of your body on your sleeping side to make contact with the mattress. Place a pillow between your knees, which reduces pressure on your back. Consider adding a small support, if there is a gap between your waist and the mattress. Make sure you alternate sides, as continually sleeping on one side can cause additional problems. 

Why does this help? The pillow between the knees is the key to this sleeping position. It promotes better spine alignment and reduces pressure on the spine that can further irritate back pain. 

2- Fetal Position- Suffering from a herniated disc? Rather than sleeping on your back, try sleeping on your side curled up like a fetus. Start by gently rolling over onto your side. Bring your knees toward your chest by tucking them upward and curling your upper body down toward your knees, as if you are going to hug your knees. Don’t forget to alternate side on occasion. 

Why does this help? Herniated discs occur when those soft cushions between your vertebrae bulge or move out of place. Putting your body into a fetal position lengthens the space in between your vertebrae. 

3- Stomach with Pillow- Sleeping on your stomach can increase back pain; however, we tend to have favorite sleeping positions that we all gravitate toward. There’s no need to force yourself into sleeping in a foreign position. Instead, place a pillow under your abdomen and pelvic area which relieves some of the pressure from your back. It is likely that in this position, you will choose not to use a pillow beneath your head. Why does this help? This position can reduce the pressure and stress on the spaces between your disc. 

4- On Back with Elevated Knees- For many people, sleeping on your back provides the most back pain relief and is the most desirable. If you prefer to sleep on your back, use a pillow places underneath your knees to keep your spine in a neutral position. It is critical to maintain the natural curve of the lower back when in this position. You can also place a rolled towel under the small of your back to add support.

Why does this help? Sleeping on your back evenly spreads weight across the widest areas of your body, resulting in less weight resting on pressure points. This position also allows for better alignment of your spine.

Are You Properly Aligned?

Regardless of the sleep position you choose, what matters most with back pain is that your spine is in proper alignment, whether you are sleeping, exercising or doing your daily routine. In addition to helping you select a sleep position, a physical therapist can use spinal manipulation and other manual therapy techniques to move your spine back into alignment. Physical therapy can also help you train to improve form and alignment during athletic and non-athletic activities to prevent injury from occurring or progressing. 

The longer you wait to correct misalignment in the back, the more the pain can progress. Seeking expert help can improve your sleep, your performance, and your quality of life.

About Evolve Physical Therapy

NYC's Premier Holistic Physical Therapy Clinics

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Got Back Pain? You May Need to See a Physical Therapist in Brooklyn

Got Back Pain? You May Need to See a PT

Back pain is a major health problem worldwide, and it is one of the leading causes of disability among older adults. It can affect a wide range of age groups, and frequently affects daily life, sleep patterns, work performance, and a decrease in overall general well-being.

Common Causes of Back Pain

While back pain is easily felt, unfortunately, the main cause is not easily diagnosed and identified. This is why medications are not enough to drive away back pain, and why physical therapy is important. A physical therapist may help to identify the main cause of the problem. According to research, the single most common cause of back pain is mechanical stress or soft tissue injuries. 

1. Mechanical Issues - this refers to a muscle strain or a ligament sprain. A strain happens when your muscle is stretched and pulled to a capacity it can’t accommodate. This commonly happens due to overuse, fatigue, poor alignment and improper use of a muscle. For example, we can strain our back muscles if we perform a deadlift incorrectly. Another mechanical issue, a sprain occurs when a ligament (the structure that holds our bones together) is stretched and pulled. When this happens, it is then a muscle’s responsibility to hold the joints together, ultimately resulting in fatigue and pain. If this is the cause of your back pain, rest, stretching, and strengthening exercises are usually implemented during therapy. 

2. A herniated disc & degenerative disc disease - a disc is found in between our vertebral spine. It’s a jelly-like structure that functions as a shock absorber. Sometimes, a disc slips and wedges out in between where it’s supposed to be, and compresses the nerve roots found behind the spine. This then causes pain that corresponds to the nerve it is impinging on. With this type of back pain, one can also expect pain to be present in parts of the lower extremities. Intervertebral discs also go through the usual wear and tear we experience as we age, so they lose water and their jelly like consistency lessens which affects their shock absorbing function. Since they cannot resist forces well, the ultimate result is also back pain. 

3. Sacroiliac joint dysfunction - another condition that causes back pain is an issue with the joint that joins your sacrum at the bottom of your spine to your pelvis. Dysfunctions happen when there is too much or too little movement in this area. There is too little movement when we are very tight around the hips and pelvis, and there is too much movement when we are very flexible around the joint. Both of these circumstances lead to instability. A physical therapist can spot a sacroiliac joint dysfunction through special tests. 

4. Facet Joint Dysfunction - Facet joints are like the pillars of your spine. They connect vertebrae to one and another. Facets can be inflamed when there are degenerative changes. This can cause pain when you turn your back a certain way or if you try to bend forward or backward. When facets undergo degenerative changes, they can also affect the discs, thus causing even more pain to an individual.   

5. Trauma - Fractures and dislocation of spinal segments and parts can also occur, especially in contact sports. These can also result from a very bad fall, or a vehicular accident. Trauma to the spine not only causes back pain, but it can also put a person at risk of paralysis. 

There are also more serious underlying causes of back pain like cancer and osteoarthritis. The goal of physical therapy is not just to eliminate the pain, as medications do, but also define and eliminate the source of the pain itself.

You May Need to See a PT

If you’re in a lot of pain, you would most likely choose to lie down and rest, to let it go away by itself. However, studies suggest that resting will only make your back pain worse! This is because your muscles grow weaker with tightness and fatigue when there is pain and bed rest promotes even more weakness. 

So what should you expect from a typical physical therapy appointment? A PT will help you decrease the pain you are feeling by using physical agents like hot and cold compresses, electrical stimulation, and ultrasound therapies. Physical therapists may also try to do manual therapy in which they use soft and deep tissue massage to loosen your muscles, and joint mobilization techniques to loosen up tendons or ligaments. Lastly, they will teach you exercises that will help stretch and strengthen structures around your spine.

Williams and McKenzie Exercises

These two are almost always incorporated during exercise in a physical therapy program. Williams exercises are all about flexion of the spine, while McKenzie exercises are all about extension. They both consist of about five to six exercises or positions that you have to hold and perform, that stretch and strengthen your spine at a certain level. While they both try to address your pain, it is extremely important to know what is causing your back pain before performing any type of exercises. Williams and McKenzies are only meant for certain types of diagnosis. For example, if you have spinal stenosis, structures in your spine are crammed together when you extend your back. In this scenario, your PT will teach you William’s Flexion Exercises. In cases where a disc is bulging, your PT will likely teach you McKenzie’s Extension to help decrease the backward displacement of your disc. 

Think of your spine as the mast of a ship. It’s a tall pole that’s placed in the center of a ship, with lots of attachments but only a few supports. Your spine is surrounded by internal organs, ligaments and muscles. Your muscles are one of the main supports of your spine, so it’s important to keep them strong and healthy. If they tighten up or weaken, they cause back pain. Don’t forget to ask your PT for a home exercise program, and make sure to follow it!

Preventing Lower Back Pain From Returning

There is always a risk for back pain to return. So here are tips to prevent it from recurring:

1- Remain active. Live a healthier lifestyle!

This includes having a balanced diet. You should try to avoid being overweight since it increases the load on your spine. There is still much work to be done after Physical Therapy for back pain, so it is best if you can find a fitness regimen that will fit your schedule and lifestyle to prevent your muscles from being atrophied and stiff. It can be as simple as a low-aerobic activity like brisk walking in the morning, a 10 to 15 minute full body stretch before going to work, or swimming for an hour every weekend. Some patients feel comfortable with enrolling in yoga and pilates classes, since these types of exercise incorporate both stretching and strengthening in their poses. Exercise is very important as a lot of patients return to PT because their muscles went back to their original state, causing a recurrence of back issues.

2- Work on proper posture, and learn proper body mechanics

It’s quite hard even for the most fit individual to maintain proper posture at all times. One way to help yourself to keep a good posture is exercise, and another is learning proper body mechanics. Body mechanics is a term used to describe how to move around efficiently and without hurting yourself. There is a right way to lift that heavy box of paperwork, and there’s a proper way to move furniture. 

3- Reduce stress and quit smoking!

While back pain is as real as can be, one big factor that can affect it is stress. Having back problems while sitting in front of a desk at work? It will probably worsen if you are stressed and anxious about a deadline. Even worse, what started as just lower back pain can extend up until the upper back, or radiate down the legs- i.e.- Sciatica. Don’t forget to get some “me” time, meditate, and relax. Also, stop smoking. It’s not yet entirely clear how smoking specifically affects back pain, but it does narrow your blood vessels, which can result in decreased nutrients delivered to the spine and back area. 

Suffering from back pain? Give Evolve Physical Therapy in Brooklyn a call today! 1-718-258-3300

NYC's Premier Holistic Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

Muscle Knots and Trigger Points

Muscle Knots and Physical Therapy

Did you know that our body can develop little bumps and knots within muscle tissue? You might even have one right now! If you’re experiencing body pain, chances are a muscle knot is causing your pain.

What are Muscle Knots?

Muscle Knots are those small, bump like areas in your muscles that cause pain when pressed or touched. They’re formally called a Trigger Point, and it literally does what it is called. It “triggers” a painful sensation where it is found, and can also affect nearby areas. The medical dictionary defines it as, a hyperirritable spot, a palpable nodule found in the taut bands of skeletal muscle. These annoying little spots can develop anywhere in our body, specifically in areas that are tense and tight. Aside from causing pain, muscle knots also commonly decrease a person’s range of motion.

What Causes Muscle Knots?

Muscle Knots or Trigger points are a result of muscle tension and tightness. Anyone can develop them, even an active athlete can have them. Muscle tightness usually comes from repetitive motion and activities. For example, if you are a weightlifter, you train the same weight lifting muscles everyday (and neglect some other muscles), therefore repeating the same movements every time you exercise. This tends to result in muscle tightness on certain areas. Muscle tension on the other hand can be a result of stress, such as when an office worker is stressed out about work. Muscle tension can also come from direct trauma or pain. 

When muscles are tensed and tight, they cut off the blood supply of the microstructures within the muscle so all the dirty metabolites and waste by-products of these structures do not drain properly.  Furthermore, muscle fails to relax after tensing up. This happens when a muscle is overworked, such as when we perform repetitive motions. The build up of these waste material is thought to be the muscle knot or trigger point. In another example, when the muscle experiences trauma, the muscle tenses, contracts and tightens as a means to protect itself from further injury. This is primarily a protective reaction mechanism of the body that blocks off blood supply, resulting in another accumulation of waste in an affected area. We must also remember that these occurrences are involuntary movement within the muscle. We cannot willfully control the chain of events that happen within these structures.

What are the signs and symptoms of a trigger point?

Symptoms usually start with a localized pain in a muscle when pressed and may cause pain in another area. For example, pressing a trigger point found in the shoulder may cause a headache. This is called “referred pain”. Typically, it starts with muscles that are involved in maintaining posture such as the neck, shoulders and low back, but may still develop in other muscles like the calf, quadriceps or hamstrings. 

In your first session with a Physical Therapist, they normally would conduct an assessment and evaluation to determine what your body’s current status is. Your PT will perform a physical exam where he will try to find and palpate your muscle knots. He will pay close attention if he can elicit a muscle twitch, a transient, small or palpable muscle contraction. Oftentimes, a physical therapist can also elicit a jump sign in which an individual is startled by intense pain - this reflects the extreme tenderness of a trigger point. Aside from this, your PT will also check your range of motion because frequently, there is a limitation or a decrease in range caused by muscle knots. Lastly, your posture will also be examined, since trigger points are most commonly found in muscles involving posture. 

Trigger points are commonly disregarded in a diagnosis. This is because there are no laboratory or imaging techniques that can confirm if you have a trigger point. Diagnosis is based purely on medical history, physical examination, and physical manifestations. 

How Can a Physical Therapist Help?

The goal of physical therapy is to help you manage the pain and prevent it from recurring. After a thorough assessment, treatment usually starts off by breaking down the trigger point and releasing the muscles that are tight. There are a number of treatment modalities that your physical therapist can use to break down the knots. Manual techniques such as massage, stretching, manual therapy, soft-tissue therapy, active release therapy, and ischemic compression techniques are used to release the muscle and further break down the knot. A technique called the Stretch and Spray is also an option to use. With this technique, your PT will stretch the affected muscle and spray a vapocoolant spray - a cold modality - to numb the pain you feel when a knot is pressed or stretched. Your muscles will also need strength and re-conditioning after the muscle knot subsides as they are more than likely in a bad shape after all that tension and then sudden release. Your Physical Therapist will curate an exercise program based on his evaluation. Aerobic exercise should also be part of your rehabilitation program to increase your overall endurance. 

If the trigger point causes too much pain, your PT can use electrical stimulation to lessen the pain. Doctors can also perform a steroid injection to the trigger point to lessen the pain and tenderness and make it easier for you to perform daily tasks.  

What can you do at home?

Success of a physical therapy rehabilitation program also depends on your diligence to perform exercises given by your physical therapist. You should continue stretching and strengthening your muscles at home. You can opt to use hot or cold compresses and applying it to the painful area. If you can’t take the pain, there’s no harm in taking pain medications prescribed by your doctor. You can also try self massaging your painful muscles and joints, heating pads, cold compresses, or use use a tennis ball (any firm ball actually) or a glass bottle to massage your painful areas. 

Trigger points form because of stress and tension, lessen these factors by learning relaxation techniques such as deep breathing exercises and meditation. Muscle tension and tightness results from improper posture and alignment, you should then adjust your ergonomics based on your needs. For example, fix your workstation at the office so you’ll be able to sit and work comfortably without straining your neck, shoulders and back. Live a stress-free life by getting more rest and sleep, eating healthy, engaging in regular physical activity like swimming, running, or cycling. 

In Conclusion…

Muscle knots or Trigger Points, can potentially have a debilitating effect on our everyday function. Do not wait until the pain is unbearable before consulting a doctor or a Physical Therapist. Keep in mind, your physical therapy session is just one half of your road to recovery. Your physical therapist will show you how to eliminate, manage, and prevent trigger points from hopefully ever happening again.

Brooklyn's Premier Physical Therapy Clinics-

There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better!

First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

Got Pain? Schedule a Consultation Today! Walk Ins Welcome.

Multiple Locations!

1-718-258-3300

https://EvolveNY.com

After Pregnancy Physical Therapy

Postpartum Physical Therapy Services

Exercising during and after pregnancy is exceptionally important, and every pregnant woman should invest her time doing so when under the supervision of her physical therapist and personal trainer.  Movement is the very essence of health and is beneficial to everyone. Just as a professional athlete needs to stay on top of his game year-round, future moms have to take extra care of their health status in order to be able to endure one of the most demanding and beautiful periods of their life.

Running through the basics - what can I expect during pregnancy?

Carrying a baby causes loads of changes, and a lot occurs due to physiological hormonal fluctuations in your body. In the beginning, everything is gradual, then it speeds up dramatically. In the final trimester, you can tell every difference from week to week.

All of this means changes in all tissues, but most important for us as physical therapists, connective and muscle tissue becomes more soft and flexible, so it can adapt to extra weight and distension happening in your abdominal area. It all sounds quite normal, and it absolutely is. However, things involving pain in the back and joints tend to happen as well,  and are often also categorized as "physiological" and transitory. Pain is not something you should tolerate, especially during and after pregnancy while stress is out of the question. My team here at Evolve physical therapy in Brooklyn can assure you that there is much that can be done to make your pregnancy as painless as possible.  

Physiotherapy for Back Pain

The lower back and joint system are where the pain is most likely to occur while carrying a baby. This usually happens around the 5th month, followed by an increase in body weight. Some of the other contributing  factors would be:

• Sitting a lot, or sleeping in a non-physiological position

• Laxity of ligaments in pregnancy

• Increased pressure on lower extremity nerves caused by the enlargement of the uterus

• Distension of the deep abdominal wall

Of course, not all of these problems happen to every single pregnant woman. But still, the main rule I always follow in this particular case is that exercise is our best friend in ensuring a more comfortable postpartum period. In that case, I suggest we get down to working out!

Relieving postpartum back pain is one of our main goals here at Evolve. You can expect one of our therapists to lead you through an individual postpartum workout plan consisting of carefully selected exercises to cover every critical region.

Strengthening your core is something your body will be most grateful for because weakness in the abdomen automatically means weakness of the spine stabilizing system. With nothing to hold your vertebrae, lower back pain is imminent. However, that is something we can and will change.

Our next stop will be mending the abdominal separation, also known as diastasis recti abdominis. During pregnancy as your abdomen distends, and connective tissue or linea alba that connects left and right side of the rectus abdominis muscle becomes stretched and become thinner. This allows the abdominal muscles to stretch as well and make room for the baby. Sometimes this separation in your abdomen spontaneously retreats after giving birth, but there are cases that demand physical therapy treatment. This is where we jump in, offering you the opportunity to try out our postpartum rehab program at Evolve!

Manual therapy as a Healing Approach

Manual therapy consists of applying specific techniques and skills such as joint manipulation and mobilization, as well as methods by which a physical therapist evaluates and treats soft tissues and bone structures. The primary goal of manual therapy is to reduce pain, increase mobility and eliminate inflammatory changes. This will, of course, result in better blood circulation in that region as well, ensuring much quicker convalescence in your postpartum period!

Manual therapy techniques can be used as a multi-modal approach, and we should always strive to combine them with other kinesitherapy and proprioceptive techniques. Many elements of this healing method require certain expertise, and that is why you should consider consulting one of our team members here at Evolve physical therapy.

How can strength training help me in the postpartum period?

Just when you think you're out of the woods you realize that there are loads of things waiting for you on the other side, and it's not going to be easy getting them back like they used to be. Like I said in the beginning, exercising at this point may feel over overwhelming after all you've been through, but it is your one-way ticket to feeling and looking healthy and functional once again. It will benefit you greatly, and help you to do the following:

Reestablish normal breathing patterns: In the postpartum period, paradoxical breathing can occur and gentle, steady breathing exercises and kinesitherapy is just what you need to get back on track.

Strengthen your deep pelvic floor: In order to prevent unpleasant incontinence episodes, muscles of the pelvic floor should always remain on top of their function and serve as a steady foundation for your urogenital tract and pelvic organs. To ensure all of this, we offer you to join us at Evolve and follow a workout plan devised by one of our team members that will help you in cases like this.

Improve stability of your lower back: We already talked about the importance of spine stability through pregnancy and it is equally important for it to stay stable and healthy after your postnatal rehabilitation. Again you can consult one of our therapists, and enroll in our postpartum rehab program that can be designed according to your needs!

Work with the Evolve Team for Physical Therapy After Pregnancy

There is absolutely no need for you to feel additionally exhausted and in pain because of a few bumps on the road. With the right amount of attention and work, everything can become the way it used to be. So come and join us so that we make sure you fully enjoy your newest phase of life. Oh and, congratulations!