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

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.

Quality Over Quantity

This next question is a continuation from the last post. I feel like I actually don’t hear this question asked enough, “What if I can’t do the exercise because it is too hard?” Often I feel like patients are not going to ask this question. Many times, they want to work hard and think they can just push through it. Other times, I think they don’t want to be seen as weak. And then there are times where they just might not care. However, I feel like this is a very important question, and you should never feel like you can’t ask this question. If your therapist gives you an exercise to do, and then walks off to do something else, if you feel like you can’t do it correctly, stop and wait until they get back.

If you feel like you are sacrificing your technique or compensating to do the exercise, stop immediately! That is how people end up hurting themselves. You can always modify an exercise, and this is why it is important to tell your therapist if you are having difficulty with an exercise. Any exercise can be modified by reducing the resistance or decreasing the motion. Once you have perfected it at that level, you can then build yourself back up to the full range or resistance.

Please do not try to continue to do an exercise if you truly feel like it is too hard. Compensating will not make it better, and you might end up hurting yourself even more than you started, or even hurt something else. Remember quality over quantity!

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