Help My Back “Went Out”. Now What?!

Help My Back “Went Out”. Now What?!

Help! My Back “Went Out” Now What?!


            80% of Americans will experience back pain at some point in their lives. For some this pain can be so debilitating and excruciating to the point that they will have a hard time getting up from laying down or sitting. This pain is all too real and I’ve had many patients say things like:

“My back went out and I could barely move without excruciating pain”……

 “All I did was plug my charger in and the next thing I knew I was on the floor because my back pain was so bad”…….

 “I sneezed and next thing I knew I could no longer move without severe back pain”.

 We’ve all heard of a close friend or family member’s “back going out” but until we experience it then it’s hard to really tell how terrible it feels. Just imagine not being able to get out of bed, get up from a chair, or even do simple things like dress yourself without severe back pain. 

 If you ever find yourself in this unfortunate predicament there are a few vital steps you should and shouldn’t take. Depending on what you do may prolong the amount of time you’re in pain or may actually accelerate the healing process.


Don’t panic!

            The worst fears always pop up in our heads when we have low back pain.  “Will I need surgery?” “How will I be able to live like this?” “What if something is seriously wrong with my low back”? It is a concerning time but you should know that MOST cases of low back pain do resolve with the proper guidance and care. Research has shown that <3% of low back pain cases are caused by something serious (i.e cancer).  When you are in high amounts of pain it is VERY hard to be calm but I always recommend some deep breathing to those who are dealing with a sudden lower back pain episode. It can be hard to see even a week in advance or let alone even a few days but just know that this back problem will resolve if taken the right approach.


Avoid movements that cause the pain

    This might seem obvious but you would be surprised how many patients I’ve seen that were “stretching into the pain” or “working painful muscles” only to aggravate them more. Many times simple movements like getting up and down from the chair or getting in and out of bed can be really painful. To make getting out of a chair easier scoot to the edge and really focus on using your legs more to stand yourself up. It helps to “hinge” at the hips so that your lower back doesn’t bend. The same goes for sitting down in the chair. Focus on using your hips and legs to control lowering yourself down. Avoid excessive twisting when getting in and out of the car.


Forget everything you’ve been told about posture

      I see so many people come into my office who focus on the “perfect posture”. I’m sorry to say that perfect posture is a MYTH. The best posture is one that is variable and changing. For instance instead of worrying about sitting upright like a perfect soldier try and just sit relaxed for a little (dare I say even a little slouched). Everybody responds differently to different adjustments in posture. Don’t be afraid to try sitting slumped or slouched to see if that helps. In some cases that can be helpful and in other cases you may need to sit upright for the most relief. The point is don’t get married to a particular posture just because that was the one posture you “were told to sit in”.


You will get better!

       Just know that your back pain WILL subside. Yes it may be very painful right now but it will get better if you take a sound approach. Back pain attacks can be likened to the common cold. When you get a cold it can last 2-3 days or maybe even a week but it does get better. The same can be true for back pain IF the correct steps are taken to take care of it. It’s really hard to see 2-3 weeks in the future but know that most cases of acute flare ups in the low back resolve within a 6-10 week period. You should see gradual improvements each way if you are taking the right precautions and seeking competent help.

     An acute back pain attack can be scary but it doesn’t need to ruin our lives. While it can be a major inconvenience it’s the steps you take after you experience the flare up that will help determine your success in recovery. Seek help from a competent medical provider that is familiar with acute lower back pain flare ups. A physical therapist can help you determine what caused the problem, help you alleviate the pain, and show you ways to prevent it from coming back. If you want to learn more than you can up a call with a back pain specialist physical therapist to help you determine what you should do next.


3 Reasons Your Elbow Pain Won’t Go Away

3 Reasons Your Elbow Pain Won’t Go Away

            Tennis elbow and golfer’s elbow are no fun to deal with.  While both types of injuries are located in different areas of elbow they are very similar in nature. They tend to be painful and nagging injuries that seem to never go away. The typical cycle may look something like this. You start to feel a pain in your elbow (inside area if it’s golfer’s elbow and outside area if it’s tennis elbow). Once you feel pain you figure some rest might help, so you rest and then decide to “test” it out again. But the pain returns again!

          So you rest it, ice it, slap a brace/band on it, and maybe take some pain killers and the pain subsides. Feeling good you decide to get back out there and UGH the pain returns!  It can certainly be a frustrating experience especially when you are beginning to miss out on some of your favorite activities including tennis, golf, or lifting weights. What’s going on? Why isn’t the elbow pain getting any better?

1. Ice, Pain Killers, and Armbands/Braces Are Only “Band Aids”

       Pain killers, braces, arm bands, are usually the first “go to” quick fixes for people dealing with elbow pain. When I see someone dealing with this problematic issue these are the FIRST things they say they have tried. There’s nothing inherently bad or wrong with using these things to help decrease pain but the problem is that they only address the “symptoms” of the problem and not the true “root cause” of why the pain is occurring.  This is why the elbow pain calms down for the short term but then ramps up again once you try to get back to your favorite activity. The truth is that there are no “quick fixes” to golfer’s elbow or tennis elbow.  

2. Rest Is Needed But It HAS To Be The Right Amount

     We all know rest is needed in order for an injury to heal. Rest is important yes but understanding the appropriate amount of rest is vital. If you just rest and NOTHING else then you will be doing nothing to address the underling issue of the elbow being overworked. Here are a few big take aways regarding rest.

 Don’t rest for extended period of time (without taking any other action) hoping the pain will just go away. Usually pain occurs because there is some sort of strength, flexibility, or movement fault. Rest will not fix these issues

Don’t completely avoid activity. Sometimes it’s OK to feel a little sore in the elbow after playing tennis, golf, or working out. It’s when this soreness turns into pain and lingers for 2+ days that it becomes an issue. Cut back on the amount of the activity you do instead of avoiding it all together.

Don’t rush back into things give your body some time to heal. Yes you want to rest the area but while you are resting you need to work on the issues that are causing the pain to occur. Typically some of the causative factors include a lack of strength and flexibility in not only the elbow but the wrist and shoulder as well.

3. The Wrong Area Is Being Treated

          This one can be tricky for some. The pain is felt in the elbow and the first line of defense is to focus only on treating the area of the pain. This will bring some symptom relief but leave you disappointed when the issue doesn’t go away completely. What most people miss out on is treating the areas above and below the elbow including the neck, shoulder, and wrist.  These areas MUST be looked out in order to understand what the root cause of the elbow pain. Chances are if an epsiode of elbow pain is lasting longer than you can stand and you’ve tried treatments directly at the site of the elbow then you may need to look above and below the elbow.

         If you find yourself in the endless cycle of elbow pain flare ups, calming down, and flaring up again then the reasons above may be why you haven’t enjoyed the lasting recovery you are seeking. The key is to understand that there is ALWAYS an answer as to why the elbow pain occurs. If you’ve tried all of the above mentioned tactics then it may be time to seek a second opinion to figure out the true root cause of your elbow pain.

Insult to Injury: Why You Haven’t Made A Full Recovery

Insult to Injury: Why You Haven’t Made A Full Recovery

Insult to Injury: Why You Haven’t Made A Full Recovery


        If you are a runner, fitness enthusiast, weekend warrior, or weightlifter then chances are that you have dealt with an injury at some point. You may very well be dealing with an injury right now and are unsure of how to overcome it. Unfortunately the sequence of events below is all too common and leaves you frustrated and concerned on whether or not you’ll be able to get back to your favorite routine. The typical sequence of events from injury to recovery looks like this:

  1. Injury Occurs
  2. Injury is rested for some time
  3. Athlete, runner, fitness enthusiast tries to return back but the pain is still there.
  4. Multiple doctor visits with frustration and no answers (or no plan on how to recover properly)
  5. Maybe even some Google or YouTube advice
  6. Frustration sets in even more with concern on how you will get back to your favorite activity whether it be running, exercising, weight lifting, or your favorite fitness class.

     Sound familiar at all? Whether you are on step 1 from above or step 3 the important thing to consider is WHY you haven’t made the full recovery yet. There are some very common reasons as to why the body has not fulled healed and the pain from injury remains which I will discuss below.

 1.Wrong Diagnosis

Photo by from Pexels

              I’ve heard it a lot in my clinic. “I went to see a PT already but didn’t get better”, “I saw an orthopedist but I am still in pain”, “I already have been to see a Chiropractor but I only got minimal relief”. One common theme with these statements is that the person sought out help but was left disappointed when the treatment they received did not FIX their issue.  One question I always ask is ” What did they THINK the problem was” and unfortunately the answer I often get is “Well they weren’t really sure what the issue was” or “I was never given a clear diagnosis”.  That is MAJOR problem. Before fixing any injury (which essentially is providing the right healing environment for the body) you must figure out what is actually causing the issue to begin with (“the root cause”). Most injuries occur because of some sort of deficit or imbalance in the body. It is vital to go through a proper assessment to determine what the “cause” of the injury actually is. Once the true root cause of the condition is found proper treatment can be given. If treatment is given without this assessment and without identifying risk factors then you will not get the results that you desire.

2.Wrong Treatment

          Far too often I hear patients tell me stories about how they were given generic exercises (aka “cookie cutter approach”)  that did not work for them. They invested a good amount of time and money but weren’t given the tailored approach that their body needed for them to heal. Each person who deals with an injury should be treated according to their SPECIFIC needs. For instance not all knee pain should be treated with the same exercises and stretches. Treatment depends on #1 the diagnosis (see above). Even then after the correct diagnosis is given the treatment can vary depending on what stage of injury the person is currently at ( i.e very beginning, middle, end stage, chronic). Think about it this way. If you have a small leak in the roof then you get the roofing company to come out and diagnose the issue quickly right? They provide the immediate easy solution and the leak is fixed. However what if you let that leak linger and it becomes bigger? Does the issue become more complex? Maybe it starts to involve other parts of your home? The point is that the simple leak that is found quickly is treated much more differently than the  leak that has “been there for a while and is starting to cause more issues”. The same concept can be applied to an injury. Some key things to consider when resolving an injury is:

  1. What stage (early, middle, late) of healing are you currently at (your healthcare provider should be able to tell you this)
  2. What can you do to provide an optimal healing environment (i.e specific exercises, activity modification)

3.Wrong Healing Environment

          An optimal healing environment is CRUCIAL to overcoming injury. It is often one of the most overlooked factors that can help get you back to running, surfing, exercising, or playing your favorite sport.  Below are some of the factors that are involved in having the optimal healing environment for your injury:


        Sleep is very important to allow for healing. During sleep our body takes the time to repair and remodel any damage that has occurred. In order for an injury to heal properly the appropriate amount of rest must take place. If you are waking up tired and find yourself needing that caffeine pick up in the early afternoon you likely are not getting the appropriate amount of sleep for optimal recovery.


        Its likely that your injury has kept you from being able to exercise to the full extent. Yes, you may not be able to do a lot of your favorite exercises but it would be beneficial for you to find other avenues. For example if you love running but your knee hurts then try biking. If you have a hip injury that only hurts during squats and box jumps then skip those during your next workout (just do everything else that doesn’t cause your hip to hurt). Point being that its important to stay as ACTIVE as possible when dealing with any injury. It will help your mood and keep your moving towards your goal.


       This is another factor that is also overlooked. What kind of food have you been eating? The body relies on good nutrients to perform optimally. Take a good look at what you eat and drink then ask yourself if you think its beneficial or detrimental for you. Get your diet right so your body can make the best use of those nutrients it needs to heal.


       Keeping a positive mindset is crucial to recovery. There are so many psychological aspects that are overlooked when recovering from injury. People often fear the worst “What if this doesn’t work?”, “I guess I’ll have to live with this for the rest of my life”, “Nothing seems to work for me”. All of these negative thoughts WILL affect recovery. If you don’t think something will work or you are constantly worried you are wasting your time then it’s likely that you won’t put the effort in to reach your goals.  The stress of life can also affect our ability to stay focused and that is why being in a supportive environment is very important.

       If you are dealing with an injury and have not recovered the way you expected then consider what has been mentioned above. The most common reasons runners, fitness, enthusiasts, and weekend warriors are kept from doing what they love is because of the issues discussed in this article. There’s so much confusion out there about what to do or who to see and that can make the whole situation even more frustrating!  Click Here For a Free Injury Phone Consult if you are struggling and are not sure what to do. We’ll have an open and honest conversation about what you are struggling with and what the best step for you to take is. Here’s to happy and healthy healing!




3 Myths About Knee Pain (Have You Been Told These?)

3 Myths About Knee Pain (Have You Been Told These?)

3 Myths About Knee Pain (Have You Been Told These?)

Don’t Get Stuck On The Sidelines Because Of These Myths!

Knee pain is becoming a very common issue, especially with active adults who love to run, workout, or participate in their favorite boot camp classes.

Approximately 1 in 4 adults will experience knee pain that affects their ability to remain active, healthy, and fit. This can be a frustrating experience especially since many of the clients I work with tell me that they “just aren’t the same” if they miss out on their daily run or exercise routine.

Wouldn’t it be nice to go for that 5 mile run, participate in your favorite HIIT workout, or play your favorite sport without having to worry about your knee getting worse?

Having treated many fitness enthusiasts and runners I found that there were several myths that were floating around that actually were hindering their recovery. This often lead them to a delayed recovery and more time spent on the sideline.

By simply understanding these myths you can save time, money, and the FRUSTRATION of missing out on another 5k or enjoying a workout with your friends.

Myth # 1 Rest Is All You Need To Get Better (Hoping it Will JUST GO AWAY!)

Photo by Alexander Possingham on Unsplash

I know what your thinking…….don’t I need to rest to heal? Well the answer is YES! However it all depends on how you go about “resting”. While rest is needed for the body to heal naturally and correctly it is often done in an incorrect manner. Here’s  3 DO’s and Don’t about resting your injury.

  • Do’s

    • Rest in intervals. What does this mean? You may still be able to run 2x a week or workout 2x week but you will need to spend those other days in rest. Don’t keep aggravating the pain.
    • Shorten your exercise/run time. Run for shorter distances (before any pain is felt). Perform shorter workouts so you do not push into pain
    • Warm Up Before Don’t go into a workout or run COLD. Do some active warm ups. Maybe some high knees, butt kicks, Karaoke drill
  • Dont’s

    • Don’t rest for extended period of time (without taking any other action) hoping the pain will just go away. Usually pain occurs because there is some sort of strength, flexibility, or movement fault. Rest will not fix these issues
    • Don’t completely avoid activity. Sometimes it’s OK to feel a little sore in the knee after a run or workout out. It’s when this soreness turns into pain and lingers for 2+ days that it becomes an issue. Run 1 mile instead of 3. Squat 150Lb instead of 300Lb
    • Don’t take painkillers hoping it will go away. Painkillers only provide temporary relief and do not address the root cause of WHY you are experiencing your knee pain

Myth #2 Your MRI And Xray Tells You The Whole Story

Do you need an MRI for your low back pain or sciatica?

One of the most frustrating things for the clients I have worked with is that they have been led to believe (at no fault of their own) that whatever shows up on their MRI or Xray is the reason for their pain. Many times they are just given a diagnosis and no method of fixing their pain.

Here are some common statements I hear from people I have worked with:

  • “Nothing showed up on my MRI/XRAY but the pain is still there”
  • ” I was told I have chondromalacia and patella femoral pain syndrome”
  • “They just said I have a bone bruise and that it will go away”

The problem here is that these people were given a “diagnosis” just based off a picture. That fancy scan is just a picture that is STILL in time. It does not take into consideration different movements and activities that hurt your knee. So while the scan showed (or in some cases didn’t show) something it did not provide to reason as to WHY the pain is occurring.

This can lead to BIG problems when getting treatment because many clinicians will just treat based off what the MRI or XRAY shows and not take into effect the different deficits in muscle strength, flexibility, and faulty movement patterns.

In most cases of knee pain although the pain OCCURS in the knee it is not actually CAUSED by something in the knee. This is another reason why scans can be misleading because the cause of the pain often comes from the hip, pelvic ,and back region. The body needs to be “in balance” and when there is an area of the body that is “out of balance” it can then transfer excessive forces to the knee, thus causing pain.

Keep in mind that when I am speaking about knee pain and imaging I am referring to the type of knee pain that gradually occurs over the course of time (not the type of knee injury where something traumatic happens). The proper imaging is required if:

  • You hurt you knee during a sport or activity
  • You heard a pop or click in your knee when you injured it
  • There was swelling present in your knee after you injured it

Myth #3 Changing Your Shoes, Wearing A Brace , Getting Orthotics Will Fix the Problem

Photo by SJ Baren on Unsplash

One of the first “quick fixes” that people try is to change their shoes, wear a support, or get some orthotics/insert. This is often the quickest and cheapest way to go about trying to fix knee pain but often leads the user disappointed in the result.

This is not to say that shoes and orthotics/inserts AREN’T needed. It just means that there is more to the problem than just changing or adding to EXTERNAL factors. Now what do I mean by that? When dealing with knee pain there are usually internal factors that need to be addressed along with external factors.

Some examples of internal factors that needs to be addressed include:

  • Muscle Weakness
  • Lack of Flexibility/Mobility
  • Decreased stability

Some examples of external factors include:

  • Shoe wear
  • Shoe Inserts
  • Taping/brace

It’s important to know that external factors usually can bring about a temporary relief with knee pain as they do not address the underlying root cause. Permanent relief is achieved when the internal factors are addressed.

Treating and fixing knee pain usually involves addressing multiple components and multiple moving parts so be wary of any one product or device that promises to “fix” the issue permanently.

Right……So What Can You Do About Your Knee Pain?

The keys to treating and ending knee pain for GOOD involves these 3 steps:

  1. Proper assessment of how your body moves (i.e during walking, squat, jumping, running)
  2. Identify deficits in strength and flexibility in the body
  3. Modify your activity level so that the injured area is given proper rest (not JUST extended periods of rest though).

Worried and concerned about your knee pain? Are you unsure about how you will overcome this knee pain and return to your active lifestyle?

Ask about our FREE phone consultation. We’ll have simple discuss about your health and listen to how your knee problem is affecting your life. Then we’ll be able to help you come away with the best solution for you!


Fix Tight Hip Flexors (Without Stretching!)

Fix Tight Hip Flexors (Without Stretching!)

How To Fix Tight Hip Flexors (Without Stretching!)

Are you tired of stretching or rolling out tight hip flexors with no improvements? If you are a runner, weight lifter, or team sport athlete, chances are you have heard a teammate or friend complain about having “tight hip flexors”. Either that or you yourself have had to deal with the problem. The problem with these tight hip flexors is that people will stretch, stretch, and ……..stretch some more (until the cows come home) and get NO RELIEF. This keeps people in a perpetual cycle of ALWAYS stretching their tight hip flexor with no real permanent relief.  The cycle looks something like this:

  1. Roll/Mash a ball or foam roller into your hip flexor muscle until it “releases”
  2. Perform a hip flexor stretch that you found on YouTube or one that someone had shown you
  3. Repeated Step 1 and 2 with NO real results!

This leaves you frustrated and yes……….with consistently tight hip flexors.  A crucial step is often missed with trying to stretch away tightness or pain. Before anymore blame is placed on the hip flexor muscle, it needs to be properly assessed. Then after an assessment is performed you can determine what the right hip flexor exercise for you to do is.

Hip flexor anatomy

Let’s brush up on some hip flexor anatomy so that you can understand what exactly a hip flexor is and what it’s function is in the body. The Hip Flexors are actually a group of the following muscles: Hip tightness

  1. Iliopsoas (combination of psoas muscle and iliacus muscles)
  2. Rectus Femoris (part of your quadricep muscles)
  3. Tensor Fasciae Latae (sounds like a fancy drink)
  4. Note – There are other muscles that aid in hip flexion but for this article let’s focus on the main ones.

These muscles are all involved in the action of flexing the hip which is required during squatting, running, and playing sports. Something important to take note of here is that the psoas muscle (part of the iliopsoas) actually starts at the spine and runs down to the hip. It is considered to play a role in spinal stabilization. Common complaints include a pinch/sharp/tight sensation when getting down into a squat, pain in the front of the hip/thigh during running, or sensation of tightness when sitting for long periods of time.

How to test hip flexor flexibility

A simple and common test that can be used to determine whether or not you need to stretch your hip flexor is the Thomas Test. Follow the steps below:

  1. Lay at the edge of a table, mat or equivalent surface with your tailbone resting at the edge.
  2. Pull one knee to your chest and let the opposite leg hang down.
  3. See pictures below.

hip flexor

2. Leg parallel. No lack of flexibility. 

hip flexors

1. Leg in the air. There is lack of flexibility!

  Take note to see if the thigh rests down parallel to the ground (Picture 2) or if it stays up in the air (Picture 1) (You will need someone to be nearby to see what your leg does). Perform on both sides and compare. If the thigh does not stay raised up in the air then there is no true hip flexor tightness and stretching does not need to be performed. If one of the thigh/legs stays up noticeably higher than the other, then stretching will need to be performed. If your leg is able to hang down comfortably parallel to the ground or lower then you passed the test!

So what can cause hip flexor tightness if there’s no lack of flexibility?

As stated before, one of the primary hip flexor muscles is the psoas major. This muscle plays a role in core stabilization (something that is needed during running, squatting, and sitting) due to its attachment site at the spine. If there is a lack of core stability or poor movement patterns during these tasks then the hip flexor can become overworked/tired/fatigued (think what happens when your co workers or teammates don’t do their job, you have to pick up the slack and work harder, bringing you more stress and fatigue). It is when the hip flexor becomes fatigued that the sensation of tightness sets in. This is because the hip flexor has to “work harder” to compensate for other muscles not doing their job.

What can be done to alleviate this hip flexor tightness?

The first step that needs to be taken is to determine if the tightness is due to a true lack of flexibility (perform the Thomas test above) or if it is because of weakness in the muscle itself. Once that is determined you need to focus on reducing the tension felt in the hip flexor and improving core control/stability so that the issue does not return. As with any condition, the root cause must be found (the root cause is not often at the site of pain) in order to get long lasting relief. This is why so many people unfortunately have to deal with this issue for several months or even years…..because the root cause was never found and they were just given generic information to “open up the hips” or “just stretch more”. Below are some common exercises I like to give to patient’s to start out with to help alleviate this condition. (Please keep in mind that every individual patient has different needs but these exercises tend to work in MOST cases.) The first hip flexor exercise involves actually strengthening the hip flexor while focusing on a neutral spine for core stability.

  1. Wrap a band around your feet and lay on your back.
  2. Bring both knees in the air so hips are at 90 degrees.
  3. Maintain a neutral spine by keeping your back flat against the mat. DO NOT let your back arch up in the air.
  4. Now slowly straighten out your leg, return, and repeat to other side.
  5. Perform to fatigue of 20-30 reps for 2-3 sets 3x a week. (You can also perform for 1-2 minutes 2-3 sets if you don’t like counting.)
  6.  You will likely feel fatigue in your lower abdominals and the front of your hips.

Working on gluteal muscle strength (buttock muscles) can be beneficial to reduce hip flexor tightness. Working the glute muscles pulls the hip into extension (the opposite of flexion which is what the hip flexor does) and improves muscle balance at the hip. Increasing the strength of your gluteal muscles can help calm the hip flexor down and reduce the feeling of “tightness”.

  1. Lay on your back.
  2. Press affected leg heel into the ground and slowly lift hips into the air.
  3. As you lift your hips into the air, kick the opposite leg out and hold.
  4. Hold each lift 5-10 seconds for 10 reps on each side to start at 2 sets each. Perform 3-4x a week.

If you’ve been dealing with tightness in the hip flexors or hip flexor pain for quite some time now and haven’t found the solution, then give these exercises a try. You may be pleasantly surprised with the results! Want more information on Hip Pain? Download our Free Report on Hip Pain “5 Secrets About Hip Pain That Will Surprise You….And Help Get Your Back To Exercising/Running Pain Free” Click Here to Download This Free Hip Pain Report