Back Pain Treatment in Encinitas

Here are Six Reasons Why You Should See a Physical Therapist First if You Have Lower Back Pain

Has this happened to you or someone you know?  You bend over, maybe twist a little and bang, your experience serious lower back pain.  It’s a common problem.  In fact, 8 out of 10 adults will experience significant lower back pain sometime during their life.  The good news is that in over 95% of the cases, it’s going to get better.  Your response – “That’s nice to know but my back is killing me right now!”  We understand.  Back pain can be severe.  So, if you are looking for back pain treatment in Encinitas, read on – we hope you find this information helpful.

Bad Pain Does NOT Mean You Have a Bad Problem

It’s important to understand that the pain intensity is not directly related to the severity if the injury.  In fact, minor problems in the lower back can cause excruciating pain.  Moreover, for most people that experience lower back pain, there’s no way to tell specifically what is causing it.  Case and point.  About two-thirds of people with NO lower back pain at all will have a positive MRI.  The major risk with having an MRI right away is that chances are very good that you will be labeled with a condition that isn’t causing your pain.

What You Should Do If You Experience Lower Back Pain

  1. Know that in almost all cases, your lower back pain is going to get better.
  2. Put some ice on it initially. Lying on an ice pack can numb the area and relieve pain.
  3. Keep moving. Prolonged bedrest does not help.
  4. See a physical therapist first!

Why You Should See a Physical Therapist First

Our physical therapists are experts in the evaluation and treatment of lower back pain.  Better yet, scientists have researched what happens when patients with acute back pain see a physical therapist within two weeks of when the pain starts:*

  1. You’re 53% less likely to need invasive and risky spinal surgery.
  2. You’re 52% less likely to need steroid injections in your spine.
  3. You’re 46% less likely to need an expensive and often confusing MRI or CT scan.
  4. You’re 35% less likely to need additional visits to specialist doctors.
  5. You’re 11% less likely to use pain medications over an extended period of time.
  6. Accessing a physical therapist within 2 weeks of the start of the pain typically reduces your cost of care by as much as $2700.00.† 

Don’t Wait, Give Us a Call Now – We Have a Location Near You

In summary, most will experience lower back pain sometime in their life.  While the pain can be severe, it’s not usually an indicator of serious injury.  Therefore, it’s important not to receive an inaccurate diagnosis from diagnostic tests.  What’s more useful, and can save you a lot of money, is seeing a physical therapist first.

Do you, or someone you know, have lower back pain?  Click here to find a location near you and then give us a call.


*As reported in the Apr., 2012 issue of Spine.

†As reported in the Dec., 2012 issue of Spine.



5 Safety Tips To Avoid Injury At The Gym

Does your New Year’s Resolution consist of going back to the gym to get fit for 2017? Your fitness level depends on getting regular exercise, but how you approach a workout program will determine whether it enhances your physique or actually lead you to possible injury.

No one plans on getting injured when they go to work out. Still, most people tend to do just that at least once in their journey to a better physique.

Check out these 5 steps for a safer workout and more fun in the gym.


For strength training, good form is essential. Using good form not only helps you to maximize your strength gains, but it helps prevent some serious injuries. Initially, use very light weights when learning a new exercise. Never sacrifice good form by struggling to lift heavier weights. More importantly, never sacrifice good form by hurrying to finish reps or sets leading to modified range of motion.

Take the time to learn control and feel the work in your muscles. This includes avoiding any type of bouncing, jerking or partial moves forced by necessity. In other words, if you stop halfway down when performing a biceps curl because you would not be able to curl up may indicate fatigue from using too much weight.

Perform each exercise in full available range of motion at a reasonable pace to decrease stress and possible injury to your joints and soft tissue structures.


  • Do not hold onto the top of the treadmill when walking at an incline:

    The concept of walking at an incline is to increase your cardiovascular endurance in a given amount of time the activity is being performed. The mechanics places your body at an acute angle with the treadmill increasing your energy expenditure. However, when holding onto the top and thus leaning backwards, you place your body closed to a 90 deg. Angle with the treadmill – in turn, the same angle as if you were walking on a flat ground.

  • Do not lean heavily on the “Stair Master” rails:

    Leaning heavily on the rails will put a lot of unnecessary weight on your wrists, shoulders and back leading to possible injury. The need to lean is a sign of fatigue and your body’s way to use accessory breathing muscles of the neck and rib cage for further rib expansion. The overuse of these muscles can lead to neck stiffness from muscle tightness and pain.


Simply drink plenty of water! Make sure you are replacing the fluids that you are losing through sweat during your workout. Drinking water will help reduce your chances of becoming dehydrated, which can lead to poor performance. A good rule of thumb includes the following:

  • Drink 2 cups (16 ounces) of water about 15 minutes prior to activity
  • A quick sip every 10 to 20 minutes during activity
  • Another 16 ounces post activity during your cool down


Failure to stretch will make your muscles tight and eventually shorten over time, making you less flexible. While it may seem like a minor detail, your muscles and joints become a lot more vulnerable to injury by interfering with the normal mechanics of the exercise. Not a big deal at first, but over time if you train “wrong,” you will be placing a lot of extra stress on joints, ligaments and unintended secondary muscle groups due to compensations.

In a nutshell, do not be so eager to hit the weights and skip out on or ignore stretching altogether.

This is a HUGE MISTAKE!!!

Proper stretching can be included during your warm-up or cool down. Your warm-up shoulder focus on raising your core temperature, getting your metabolism into gear and “pre-lubricating” the joints in preparation for the actual workout. Furthermore, stretching can be helpful during the cool down phase to flush out lactic acid and byproducts while bringing in fresh nutrients helping your muscles recover faster.

So do yourself a favor and take 5 to 10 minutes to warm-up and cool down properly. A proper warm-up and cool-down should include:

  • 5-10 mins of moderate cardio on a treadmill or stationary bike
  • 5 minutes of light stretching


“Too much of a good thing” should not be the motto of your workout. Overuse injuries are very common when you perform the same type of exercise over and over again. For example, swimmers place a lot of repetitive stress on their shoulders, while runners pound away at this knees, ankles and feet.

Not only will you make yourself prone to injury with a repetitive routine, but your body will begin to adapt when you do only one type of exercise. This type of body adaption decreases the benefit from the workout, thus not giving you the results that you are looking for.

The best exercise programs involve a mixture of aerobic (cardio) activity and strength training, along with stretching. Always vary your aerobic activity to keep it interesting and to decrease overuse injuries. Such activities can included, swimming, riding a bike, brisk walking, playing basketball, dance classes, etc.

Additionally, always take off at least one day between strength training sessions to allow your muscles to recover. A few routine examples are as follows:

Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Example 1 Rest 30 mins on the bike Arm strengthening 30 mins walking/running Rest Leg strengthening Outdoor activity
Example 2 Rest 30 mins walking/running 30 mins rowing
Arm strengthening
Rest 60 mins workout class Rest Leg strengthening

How Can Your Pillow Help Reduce Spine Pain?

Basic Use of Pillows to Reduce Spine Pain

Sleep is one of the most elemental needs of the human body.

Good sleep refreshes and rejuvenates the body and mind, while bad sleep can make for a miserable morning, especially when waking up with neck and back pain.

The most common cause of morning neck and back pain is your pillow.

A good pillow should conform to the shape of your body, giving support without applying pressure, while ensuring that weight is spread evenly along the vertebrae of the spine. The following information will discuss what to look for in pillows and the correct way to sleep on your pillow to reduce possible onset of morning neck and back pain.

Before we get started, think about your sleeping position – whether you sleep on your back, the right/left side, or stomach. Proper pillow placement varies for different sleeping positions.


When properly aligned, the spine possesses a natural “S” curve when viewed from the side, which pillows should support during sleep.

If your spine is not supported, the misalignment will cause muscles and connective tissue to cramp and become sore leading to waking up with aches and pain during the night or the following morning.

The goal of using a pillow is to help keep your head and spine in neutral alignment – meaning that your head is sitting in “mid-line” position between your shoulders, where both the head and neck are straight.

If You Sleep On Your Back…

Your pillow should support the neck, head, and shoulders, keeping the curvature of the spine in a natural position.

If the pillow is too thin, your head will tilt backwards increasing the spinal curve, which can lead to pain and discomfort. On the other hand, if the pillow is too thick or multiple pillows are stacked the head will be in a forward flexed position, tilting the chin and putting stain on the neck.

Any existing neck problems may be amplified if the neck is not supported when laying on your back. Sometimes using a medium pillow with a rolled towel under the neck will provide the needed support – or finding a pillow with an extra loft in the bottom third of the pillow to cradle the neck.

Additionally, placing a pillow under the knees can also lessen the strain on the spine when sleeping on your back.

If You Sleep On Your Side…

A pillow (1 or 2 depending on the thickness) should support the head and neck so that the spine remains straight in a horizontal position.

The pillow should fill the space between the outside of the shoulder and the ear to prevent the neck from bending at an awkward angle.

Side sleepers may also benefit from sleeping with a pillow between the knees to help improve spinal alignment.

If You Sleep On Your Stomach…

You are more prone to neck and back pain due to the difficulty in maintain the proper spinal position leading to an increase in aches and pain. If possible, avoid sleeping on your stomach.

However, if you wish to sleep on your stomach, avoid using a pillow for head support. Instead, place a pillow under the hips to take stress off of the lower back. You can also use a pillow under the ankles for additional cushioning.

Final Thought:

Your body is probably used to sleeping one way, but you may want to try all the positions, as pillow placement can make quite a change in your sleep.

Certain positions may feel unnatural at first, however the more that you practice the quicker your body will adjust leading you to a good night of pain-free sleep.

Stick Your Landing: The 101 on Ankle Instability in Gymnastics

One of the most common issues in gymnastics is joint laxity (instability) of the ankle joints leading to chronic ankle sprains.

For a variety of reasons, gymnasts develop very hypermobile ankle joints, along with large muscle imbalances, and associated laxity of the surrounding ankle joint structures. This can lead to a variety of repeated injuries with one of them being reoccurring ankle sprains.

Although inversion sprains (e.g. falling to the outside of the foot, rolling the foot inward) are the most common, many other injuries can possibly develop from hypermobility and a lack of ankle stability such as stress fractures, bone bruising, anterior ankle impingement pain, and various arch related problems.

The most familiar scenario many gymnasts can relate to is when he/she is supposed to have amazing balance while landing an incredible dismount, then roll their ankle walking off the mat leading to an ankle injury. Also, many athletes can be seen rolling out their ankles when walking around the gym or during a warm up, which may be doing more harm than good.

Poor Ankle Stability

Some research states the relationship between neuromuscular control and why ankle instability may occur. Neuromuscular control is a term used to describe the interactions of nerves and muscles, and how they communicate with each other to control structures of the body during movement.

Additional terms that can be used to describe this relationship are as follows:

Sensory Input and Sensory Receptors:

Refers to the information that muscles and joints send back to the brain through multiple nerve pathways, gathering information about the body to understand what the body is doing in space. Different types of receptors send different information – such as muscle length, pain, temperature and pressure.

Motor Output and Muscular Activation:

Refers to the information that the brain sends back to the muscles of the body to initiate and continue movement. The brain is constantly sending signals to muscles and joints of the body about how to move and keep the body safe within the surrounding environment, based upon the incoming signals from the body.

Functional Joint Stabilization:

Refers to the equal balance of strength and flexibility of muscles around a joint and proper neuromuscular control, working together to help keep the joint stable. The body relies on the constant flow of sensory information in and muscle activation out to functional properly during movement.


The most important concept to understand – refers to the brain’s ability to know where different body parts are in space. The more an athlete trains on higher level of balance and proprioception based exercises, the nervous system comes more efficient at sending nerve signals, receiving nerve signals and handling complex movements, especially the ones that occur in the sport of gymnastics.

In summary, based on the incoming sensory input, the brain interprets what each part of the body is doing during a specific movement, then sends outgoing information through nerves to muscles to make sure that the body’s joints are balanced and stable during activities.

Contributing Factors:

Gymnastics requires an incredible amount of balance and functional joint stability to deal with high forces and quick movements.

This involves the athlete having really good proprioceptive sense to meet the demands of the sport. If one of the areas noted above are lacking, the gymnast will have an increase risk of ankle injury during performance.

Additional contributing factors to injury are:

  • Creating high forces at high velocities during tumbling skills
  • Toe point (plantarflexion) leading to excessive joint mobility
  • Psychological and neuromuscular fatigue during prolong practice(s)
  • Repetitive performance on pain causing joint damage
  • History of ankle injuries

When an ankle joint loses stability and its capability to tolerate high forces, problems may arise.

Athletes participating in high level sports, like gymnastics, may be at great risk of ankle sprains when they do not practice ankle balance/stability exercises regularly.

Scoliosis 101: How to Practice Perfect Posture

Scoliosis is a term used to describe any abnormal, sideways curvature of the spine. It is a common deformity of the spine that affects 1 in 40 people, within all age groups. However, screening for the condition begins in grade schools throughout California due to its onset occurring between the ages of 10 and 15 years, when the body is still growing. According to research, it is estimated that 30,000 children are fitted for a brace annually and more than 100,000 children and adults undergo surgery for scoliosis in the United States.

Viewed from the back, a typical spine is straight. With scoliosis, the spine can curve in one of three ways:

  1. The spine can curve to the left, shaped like the letter “C”
  2. The spine can curve to the right, shaped like a backwards letter “C”
  3. The spine has two curves, shaped like the letter “S”

The spine can be considered as building blocks, similar to the figure above.

The long side of the block represents lengthening (stretching) of your muscles. The short end of the block illustrates shortening (contracting) of your muscles.

Both extremes affect your ability to use your back muscles appropriately for posture and functional activities. Therefore, it is important to attain and maintain a straight spine in order for your muscles to be used at their full functional level.

To do so, you must become more aware of your body, especially your spine, in order to use self-correction to change your spine’s position during daily activities.

Your spine is strong and stable when you practice healthy posture. But when you stoop or slouch, your muscles and ligaments struggle to keep your body upright and balanced. Poor posture can stress or pull muscles, which may lead to pain. It is important that you practice and maintain good posture throughout the day. Although good posture should be natural, you might feel stiff and awkward at first. The key is to practice good posture all the time!

Good Standing Posture

Bad Standing Posture

Lumbar Lordosis

Thoracic Kyphosis

Forward Head

Good Sitting Posture

Ear Over Shoulder and Back Straight

Bad Sitting Posture

Slouching and Rounded Hips

Arching Back and Sticking Out Chest

Early Indications

A spinal curve develops over time, therefore the gradual changes may be difficult to identify. However, possible indications of scoliosis can be but are not limited to the following:

  • Uneven shoulders
  • Asymmetrical ribcage
  • Prominent shoulder blade or hip
  • Leaning to one side

Wrist Pain in Gymnastics: How to Prevent Injury

In gymnastics, wrist pain is a common injury due to the high repetition and forces placed through the hands during skills. There can be a gradual onset of pain that worsens when weight bearing through the arms, which can often lead to possible ligamentous and bone damage. Main contributors to wrist pain in the sport of gymnastics are less than optimal flexibility and stability at the wrist, shoulder and upper back. In the majority of cases, there are two limiting factors that affect the ability to move into excessive wrist extension:

Overuse stress forces

As gymnasts, many athletes simply know how to “push through the pain” not fully understanding the consequences that may develop further down the road. If the issue is left unaddressed, the overuse stress forces may progress into a variety of problems like tendonitis, bone bruising, ligament damage, growth plate irritation, scar tissue build up, and possible stress fractures.

Overall, the structures of the wrist and hand are not designed for heavy weight-bearing, like the ankle joint is, which in turn compromises the internal joint stability during excessively high forces. Further understanding the concepts as to why a gymnast may develop wrist pain, in addition to several techniques to help an athlete possibly manage their problems, are described below:

  • Tight forearm flexors due to overdeveloped grip force required to swing on bars and balance body weight and control during a handstand position. The muscles are also needed for a proper “block” during vault and tumbling, generating power through a propulsion force of the athlete from the surface. Overtime the flexor muscles become very tight from the high repetition of these skills.
  • Many gymnast possess true shoulder restrictions from tightness in latissimus dorsi muscles, limiting the athlete’s ability to fully raise their arms overhead. This limitation can also have an impact on the wrist joint by causing the wrist to hyperextend when compensating for the lack of range up the chain.

So what can be done to improve the flexibility and decrease the stress at the wrist joint?

The listed exercises can be performed to assist a gymnast in pain management and/or limit the possible onset of wrist pain:

Wrist Mobility

Many times gymnast will stretch their wrists during warm-up, but do not mobilize the joint with the stretch.

Shoulder Flexibility

Foam Roller Against a Wall

Foam Roller Against a Wall

Latissimus Dorsi Stretch: Bilateral

Latissimus Dorsi Stretch: Bilateral

Shoulder Stability

Many times the shoulder blades and joint are not doing their job properly, decreasing the activation of the small stabilizing muscles when reaching overhead. “Wall Angels” are a simple exercise to help cue the athlete to engage their scapular muscles when reaching overhead. The main focus should be on standing flat against the wall, squeezing the shoulder blades together and keeping the hands against the wall as they slowly straighten overhead.

Wall Angels