Hi, I'm Doctor Jo, a licensed Physical Therapist and Doctor of Physical Therapy. I hope you enjoy my video demos of stretches & exercises for common injuries and syndromes. If you have a question, just ask! Be safe. Have fun. And I hope you feel better soon.

Back Flexion Stretches

This video is for back flexion exercises. If you are having some stiffness in your lower back, or if you have been diagnosed with spinal stenosis or degenerative disc disease (DDD), these stretches will help relieve some pain. These will also help if you are having some numbness or tingling down one of your legs. Sometimes pain in the hips, knees, and even feet can actually be coming from your back. First, lie on your back with your knees bent. Starting with a single knee to chest stretch, bend one knee and bring your leg up to your chest as far as you comfortably can. Hold this for 30 seconds and do it three times on each side. Next, bring both knees to your chest, and hold it for 30 seconds doing it three times. This is called a double knee to chest stretch.

Next, you want to stretch your hamstrings. It is very important to use correct technique when stretching. If you don't you will not be getting the desired stretch, and even worse you could hurt yourself more than help. The first stretch will be on your back again. Grab the back of your thigh, and bring your hip to about 90 degrees. Slowly start to straighten your leg until you feel a good stretch as seen in the video. Not everyone will be able to straighten their knee completely. Do three sets of 30 seconds on each side. If your legs starts to shake and it is too hard to hold up, try using a belt or dog leash to help hold the stretch. This time you want to keep your leg straight the whole time. Try not to bend your knee, and gently pull your leg towards your head until you feel a good stretch.

Now you will see some stretches sitting up. The most important part of this stretch is to keep your back straight. Many people try to curl their backs to be able to touch their toes. Your hamstrings are attached to what is called the ischial tuberosity, or your butt bone. So if you bend at your back, you are not going to get a good hamstring stretch. Try to bend at your hips.

These stretches you will turn over onto all fours, or quadruped. The cat stretch is performed by tucking your chin in and arching your back. You can hold this for 30 seconds and do it three times. Then you will go into the prayer stretch position. Bring your butt back onto your heels, and keep your arms straight out. Relax your head down to the ground. 

The last stretch is called the pelvic tilt. You will roll back onto your back with your knees bent. You want to imagine pushing your belly button into the ground, or push your back flat onto the ground like you are squishing something. You can put your hand under the curve of your back, and try to push your back into your hand. Make sure you are breathing and not holding your breath while doing these exercises!  

 

Take Your Meds as Prescribed

One frustrating comment I hear often is, “The doctor prescribed pain medication, but I don’t want to take it and get addicted.” Or something like, “I just don’t like taking pain medication.” Another one that gets me is, “I have a high tolerance for pain.”

Okay, I am not here to promote taking medication in excess, but pain medication definitely serves a purpose. Contrary to popular belief, it’s not only to stop the pain, but it’s also to help the healing process. In response to the first comment, unless you have a very addictive personality, and you are taking your medication more than prescribed, you will not get addicted to your pain medication. Your doctor should be monitoring how much you are requesting and will perscribe more than necessary.

Unless you have bad reactions or side effects to pain medication, you should take your them as prescribed. I understand that some people simply cannot tolerate the medication, and it might make them nauseous or extremely drowsy. That’s the time to let your doctor know, and something else should be prescribed.

Even if you have a high tolerance for pain, pain medication blocks the receptors going to your brain telling your defense system to kick in. When you are in pain, especially after a surgery, inflammation and swelling will continue, and this slows the healing process. If you are unable to sleep because of the pain, this will also slow down the healing process. When we are sleeping, our bodies are healing. Therefore, poor sleep equals poor healing. Also, when you are hurting, it is very difficult to do stretching and exercises.

So in the end, please take your pain medication as prescribed and probably about 30 minutes to an hour before you start your therapy.

 

Mobilize, Stretch, and then Strengthen

Here's another email question. This one if from Kendra L: “Hey Dr. Jo!  I watched your video for back extension stretches (above). I’ve been doing my stretches and I feel really good, but the pain always comes back. Am I doing something wrong?”

Hey Kendra, thanks for sending in your question! I’m glad you’re feeling better, even if it is only temporarily. You have started out on the right track! Now you need to progress to the next level. The key is to mobilize, stretch, and then strengthen. It’s important to remember that stretching will definitely help with the pain, but if you don’t strengthen the muscles too, you will never fix the problem. Also, you have to be very consistent with your exercises. Doing them just in therapy is not enough. That is the whole reason for a home exercise program. So please check out the swiss ball strengthening exercise video for your back.

If you don’t have a swiss ball, they are not very expensive and you can get them from your local Wal-mart or order one from Amazon.com. Try some of the simple beginner exercises first, and if those don’t increase the pain, you can progress with the exercises to get your core very strong to protect your back. I hope these help your back to continue feeling better. Remember, be safe, have fun, and I hope you feel better soon!

No Pain, No Gain?

I received an email the other day from Jackson M. “I am recovering from a hamstring strain, and my dad keeps saying, ‘No pain, no gain.’ Do you agree?”

Hey Jackson! Thanks for sending in your question. Hopefully the video above will help with the strain, but as for "No Pain, No Gain," I actually hear people say that often, and it usually makes me cringe. I am sure you will hear different answers from different therapist or trainers, but for the most part that is not my philosophy.

Let me explain. There are certain times, like after a surgery – rotator cuff repair, total knee arthroscopy, etc – that you do have to follow that mentality. That’s one of the reasons doctors prescribe such powerful pain medications. When you have a surgery, there is a small window before adhesions (scar tissue) build up. You have to push your way through the movements for your body to be able to heal properly. These are the only times I would tell a patient “no pain, no gain.”

In most other situations, I do not believe this is true. Pain is your body’s way of saying, “don’t do that.” Pain can also lead to increased inflammation and muscle guarding. Both of these can slow the healing process and actually increase pain. Now I am not saying you are not going to be uncomfortable or feel pressure, maybe even some burning sensations, but when your body tells you to stop doing something, you should probably listen.

Again, this is why it is very important to let your therapist know if something is truly painful. Remember, we can always modify a stretch or exercise and progress as the pain decreases. Please go check out the hamstring stretches video to help you along in your recovery. Have fun, be safe, and I hope you feel better soon!

Don't Hold Your Breath

I had a patient come in the other day, and she had been to different PT clinics in the past. She asked me, “Why do people keep telling me ‘don’t hold your breath while exercising?’ It’s just natural for me to do it.”

Don’t hold your breath!! This is called the Valsalva Maneuver. The Valsalva Maneuver is dangerous for two specific reasons. It increases pressure in the thoracic cavity. This reduces the amount of blood flowing into the thoracic cavity, especially in the veins leading to the heart. This can cause a drop in blood pressure. That is why many times you feel light-headed when you hold your breath and push forcefully. The maneuver can also cause blood clots to detach, bleeding, irregular heart rhythms and cardiac arrest. Have I said enough to scare you yet? I hope so. Please don’t hold your breath when you are using the restroom either. Among those scary possibilities above, it can also cause hemorrhoids.

The key is to take a nice deep breath in, and as you are exerting your force, breath out. For example, if you are doing exercises to correct a pelvic rotation, like in the SI joint dysfunction video, you want to take a breath in, and then breath out as you are squeezing into the ball or pillow. If you can’t talk while you are doing your stretches or exercises, then you might be holding your breath.

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