Do I have Hip Bursitis or Back Pain?

It’s a common story that I hear in the clinic, and a frustrating one. A patient complains of prolonged lateral hip pain (outside pocket area) that came out of nowhere. They went to see their doctor and the doctor says “Congratulations, it’s a boy!” Just kidding, they take an x-ray which comes back negative (good thing) and then say “You have hip bursitis. Let’s give you some cortisone and send you on your way.” The only problem is that your hip doesn’t improve and you are left frustrated, questioning “Why?” The answer is, you probably don’t have hip bursitis, you probably have a back problem. Allow me to explain further. 

What’s Hip Bursitis?

Hip bursitis is an inflammation of the bursa sac on the outside part of your hip. Its job is to keep your muscles and tendons from rubbing on your greater trochanter and damaging them. Bursitis happens when the bursa sac gets compressed and inflamed which will cause pain in the area.

Most of the time the pain is due to activity and will improve if you rest. The patients that I see are the exact opposite. They hip hurts when they rest and will feel better with certain movements. If that is the case then you probably don’t have true hip bursitis. 

If I Don’t Have Bursitis Then What Do I Have?

Let me introduce you to my friends dermatomes and myotomes. These little characters are areas of the body that are innervated by our back. They tell our brain what we feel (myotome) and how we move that area (dermatome). 

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If you can’t tell from the pictures there are two different areas of the spine that innervate the lateral hip where you might be having pain. Let’s look at the dermatome on the left first. You can see the two blue circles around where the L2 spinal segment innervates the skin. As you can see it starts up high by the hip and travels down the thigh. If your back is causing your “hip pain” you will have irritation all along that pattern. Simply take a fork and lightly press it into your skin and compare your irritated side to your non-irritated side. If your irritated side is way worse, or you don’t feel anything at all, your pain is probably coming from your back. 

Now let’s take a peek at the myotome pattern in the picture on the right. You can see in that blue circle that your L5 controls hip abduction (move your foot out to the side), and external rotation (clam shell exercise). Both those movements might cause pain in a patient with hip bursitis so that doesn’t tell us anything. If you have issues coming from your back we can test other movements though. Hip extension (bridges), knee flexion (hamstring curl), and ankle dorsiflexion (bring your foot up) are all partially controlled by L5 as well. If you test the strength in those movements, and they are weak as well, guess what, its coming from your back not your hip. 

Why Do You Hate My Doctor?

I started this post talking about a problem that I see all the time. It’s true that doctors miss a lot when it comes to orthopedic problems, but it’s not their fault. Most general practitioners are not educated enough in ortho. Most Ortho docs are too busy to try to tease things out. I don’t hate any of them. Heck, some PTs miss this stuff too (I know I did when I was just starting out). I just want to educate you so if you are having a similar issue you can be an advocate for yourself. So if you are someone who has been dealing with hip pain for a while that hasn’t gotten better, it’s time to think outside the box. If you run yourself through these tests and start to get some positive results, stop working on your hip, and start working on your back. 

I hope this helps you if you are having hip pain that hasn’t improved. If you have any questions please contact me here at OrthoCore Physical Therapy. Thanks for reading!




Gardening and Back Pain

The weather is getting nicer and we’re all heading outside and getting active. For some of us that means working in the yard and playing in our gardens. For some of us, that also means a return of back pain. You know what I’m talking about. You are in the yard for hours having a great time and then the next day you feel like you can’t move and your back is in a complete spasm. It sucks! No one ever told you that gardening could be such a hazard to your health. Well my friend, have no fear:  I am here to help with some solutions to make your back feel better, and keep it from happening again.

Why Does Gardening Cause Back Pain?

Before we go over the solutions, let’s chat about why you are getting back pain with gardening in the first place. You didn’t think you were going to get off that easy did you? Don’t you know me by now? Most people get pain in their back with gardening because of weakness and positioning. When we work in the yard, and garden, we are usually in a bent over position. You know the one I’m talking about. For every plumber’s crack, there is a gardening crack too.

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This position puts a ton of stress on the lumbar spine and supporting muscles. Sometimes, we do this because we aren’t strong or flexible enough to do anything different. Other times, we do this because it’s the same way we have done it for years. No matter what the cause may be, the solution is simple. Work on performing the deadlift exercise with a stick on your back (I prefer to use a golf club, but that is not necessary). It will ensure that you are bending from your hips and knees, rather than from your back. The more repetitions the better. The purpose being to re-train your brain to bend over the right way vs. the wrong way.

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What if I have Pain?

If you have been dealing with back pain from working in the yard, I’m sure you want some relief. Most of the time the muscles that support the back go into spasm from being overworked. The joints of your spine will also get irritated which will cause even more irritation of the supporting muscles. The way to provide yourself with some relief is to give those muscles/joints some space. The best way that I know how to do that is with a little ELDOA. If you haven’t heard about ELDOA go back and read my last post . For the lumbar spine the position is a little different but the duration is still the same. You want to hold the stretch for a minute and actively try to improve the stretch as you hold it. This will help to give those joints and muscles some space and should give you some pain relief.

Now What?

Once you get those two things down it should help to give you some relief from your back pain. The biggest thing moving forward is getting away from what I call elephant gardening. You can do all the exercise in the world, but if you continue to get into that rounded forward position, I can guarantee you back pain will return. I hope that helps to make your back feel better. Now get out there and get those weeds before they take over your yard!


Do You Get Numbness in Your Feet When Cycling?

Spring has sprung and cycling weather is finally here in the Northeast!  Many cyclists and triathletes are gearing up for summer races and charity rides.  In the clinic I have been seeing clients for a bike fits almost weekly. The common complaint I’ve been hearing is “My feet and legs go numb while riding, but that’s normal right?”  My answer is “No, that is not normal and we are going to figure what is causing it!”

The first two places I check is the saddle and the cleats.  Just like running shoes your saddle can get worn down. I call it “the squish test”.  Your saddle should not be squishy. If it is, it’s time for a new one! I also measure the distance between my clients “sit bones” and then measure their saddle to make sure they are riding on the correct saddle.  The correct saddle is crucial to your bike position and may be the cause of your numbness in your toes and legs. If the saddle is worn out or too wide it is going to cause excessive movements at the hips and the pelvis to rock which could irritate your sciatic nerve and cause pain down the leg.  This also leads to wasted energy and could cause chaffing in the lady and male parts.  On the other hand if your saddle is too narrow can compress your sciatic nerve as it exits the pelvis through the sciatic foramen.   

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Your cleats may also be a culprit for your pain.

If your cleats are worn down they can cause increased pressure on the foot.  Also if your cleat is in front of your knee at the bottom of your pedal stroke, this can lead to numbness in the toes as well.  A quick adjustment to the cleat can make a big difference! So if you’re getting numbness in your legs or feet it’s time to get a bike fit.  Come see me at OrthoCore!




Neck Pain ELDOA Stretch

We’ve all dealt with neck pain in the past. Some of you might be dealing with it as you read this blog post. There is a reason for the phrase “pain in the neck.” Most people will deal with it by using some heat, maybe some ibuprofen, and then just wait it out. In some cases that might work, which is great! What do you do though for that nagging neck pain that sticks around and seems to bother you every time you turn your head? Allow me to help with some neck stretches that you have probably never heard of before. ELDOA!!!

Why Do I Have Neck Pain?

Before we get to the good stuff lets talk about why you are probably having neck pain. A majority of people have neck pain because the facet joints in their spine have locked up. Facet joints are the small joints in the vertebrae that allow for neck movement.

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When they get locked up it causes a restriction when you try to turn your head to one side. It will also cause a protective spasm of the neck muscles. Your brain thinks that your spine is pretty important so whenever it recognizes there is a problem, it goes into lockdown mode. Better to be safe than sorry. In order to restore your movement and decrease the spasm you need to stretch these little joints out and give them some space. The stretches that work best are called ELDOA stretches.

What is an ELDOA Stretch?

ELDOA (Étirements Longitudinaux avec Decoaptation Ostéo Articulaire), or more easily translated to Longitudinal Osteo-Articular Decoaptation Stretching, is a technique created by Osteopath Dr. Guy Voyer. These stretches are designed to give length to the muscles, joints and myofascial system all in one movement. The most amazing thing is that they really work! I know that sounds stupid but once you see the video for the stretches you will think it looks like witchcraft. Trust me though. If you have, or have had, neck pain you should be doing these stretches regularly. They don’t take much time but you will notice a dramatic improvement in your neck mobility and a decrease in stiffness when you turn your head.

I would do each stretch for a minute at least once per day. As always if you have any questions please don’t hesitate to contact me. Thanks for reading.

Golf Distance and X-factor

When I start working with a golfer the first thing that I ask them is “What are your goals?” I have worked with a lot of golfers, and every single one has said “More distance” as one of their main goals. Increasing distance is as simple as increasing separation between your hips and shoulders, or X-factor. Obviously easier said than done, but achievable for every golfer from scratch to a high handicap. Let me help you get there.

X-factor is a big term in the golf fitness and golf instruction world, and all it means is how much can you separate your hips from your shoulders. If you want to hit the ball a far way though, you better be sure you create this magical x-factor at the right moment in your golf swing.

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Most golfers focus on making a full turn and getting to the top of their backswing. As you can see from the picture from Me and My Golf (great group by the way for instruction) at the top of the backswing you want about 45 degrees of separation between your shoulders and hips. The golfers that I work with can get to that position, but they sacrifice separation. What I mean by that is they get to the 90 degree turn with their shoulders, but have way more than 45 degrees of turn with their hips. So if you want to increase your distance start with creating more twist in your body. My absolute favorite exercise for that is an open book stretch.

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If you really want to improve your distance though, you have to be sure that you increase your x-factor as you start your downswing. The big hitters in golf start at that 45 degrees number for separation at the top of the backswing, but then increase it to 50-55 degrees as they start the downswing. Most golfers that I work with who can create the right amount of x-factor that the top of the backswing then throw it away by starting their downswing with their arms. This is a hard feel for most golfers to get though. Well no worries my friends, I’ve got you covered. Try this exercise. All you need is a piece of tubing, or something elastic (could be a bungee cord).

Honestly, in my personal opinion, it’s much more important to start the downswing the right way than it is to create a bigger x-factor. Look at the long hitters on the PGA (John Rahm and Tony Finau) and the top of their backswing position.

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It looks like they are taking a half swing! What you don’t see is how much separation they create as they start their swing with their hips. That is where the power is created that sends that ball a far way down the fairways.

So if you want to increase your distance you need to increase your stretch, and start your swing with your hips. I hope that helps you to make this golf season your best season.

OrthoCore Physical Therapy is here to help you get in the swing of your season! Contact us or make an appointment right here on our website!






Golfer's Elbow

It’s Masters Week!!! If you are a golfer like me then this is basically the Super Bowl. It is also a very exciting time of year because, in the Northern part of the country, it’s the unofficial start to the golf season. Most golfers are dusting off the clubs and heading out to the course. Taking those first couple of swings feels great! Some of you though, won’t get through the first round without that pesky elbow pain coming back. You’ve gone all winter without any issues and the second you pick up your clubs the pain comes back. Well let’s make this golf season the first one that you get to play pain free.

So before we get into fixing your elbow, let’s talk about why you get elbow pain in the first place. Golfers elbow is pain on the inner portion of your trail arm. For a right handed golfer it would be pain in your right elbow.

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This pain comes from, what is called, casting the club from the top of the backswing. Rather than starting your downswing with your lower body. You are throwing the club at the top of the swing and letting your wrists break down before impact. This will overuse your wrist flexors which attach at that point in your elbow. The overuse, coupled with the impact of the ground, leads to a strain of the tendons and inflammation.

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Now that you know what causes the pai, let’s talk about how to fix it. Like I said earlier, your elbow pain is coming from a swing fault. Think of how many times you swing the club in a round (don’t forget to include your practice swings). That is a lot of repetitions. I always tell my clients to think of it like a bruise in your elbow you can’t see. Every swing you take is like poking the bruise. It will never get better until you stop poking it.

What you need to focus on, is starting your swing with your hips from the top of the backswing. The best way to do this, in my opinion, is to feel like you are pausing at the top of your backswing. Once you pause, feel like you are twisting your hips towards your target and let your arms pause behind you. That delay will ensure you are starting your swing with your hips.

Now we need to talk about what your hands are doing at impact. Make sure your wrists don’t break down at impact. What I tell my clients to do with that is feel like the palm of your trail hand (right hand for right handed golfer) is covering the ball at impact.

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If you can do those two things I can guarantee you won’t have elbow pain this season. I can also guarantee you will start to notice an improvement in your handicap. Everyone wins! If you have any questions please don’t hesitate to contact me.

Happy Masters Week Everyone!!!





How to Build a Powerful Golf Swing

Many of you may not know this but I actually started out as a volleyball player way before I was a golfer. I still play both sports and interestingly enough the more I train for volleyball, the more powerful my golf swing gets. I’m sure to most of you that doesn’t even begin to make sense. Allow me to explain why it works, and why you should start to incorporate some plyometric training into your golf fitness program.

When I talk about volleyball I’m purely talking about hitting. I LOVE hitting and I LOVE hitting it as hard as I possibly can. In order to be a good hitter in volleyball you need some key physical components. Other than being tall (trust me there are some great hitters that are short) you need to be able to jump. If you want to jump high you have to create a lot of what is called ground reaction force (nerdy physics term). What that basically means is the harder you can push down into the earth, the higher you will propel yourself up in the air.

Once you are up in the air you have to twist your shoulders and turn your vertical power into rotational power. To do this you have to have a really strong core. Otherwise all that great jumping power you have created will just be wasted. You might as well hit the ball with a wet spaghetti noodle because it will probably work better. Lastly you turn your twisting power into arm speed and turn your hand into a whip. When all that power meets the volleyball it goes DOWN!

So what does any of that have to do with the golf swing? Let’s start at the top of the backswing. As you start to come down into the ball the first thing you should do is squat. You are creating a ground reaction force by pushing your feet down into the ground. The only difference between golf and volleyball is the jump part. Actually if you look at some of the longest hitters on tour, some are actually off the ground at impact.

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Then...just like with volleyball you turn all the vertical power into twisting power with your shoulders. Lastly, use your hands like a whip and crush that little white ball as far as you possibly can.

Now the most important part. How do you incorporate plyometric training into your workouts to build a powerful golf swing? It’s really simple. Just start jumping. It doesn’t have to be complicated. You can do jumping jacks, jump rope, jump in place, anything that has jump in front of it, you can do (I feel like I just gave you a version of Forrest Gump talking about shrimp). The biggest disclaimer is you have to be sure you don’t have any pain. If you have any pain with jumping, you have to stop. You can safely perform plyometrics once a week and you will definitely start to notice some more pop in your golf swing.

If you have any questions please contact me here at OrthoCore Physical Therapy. I hope you enjoy your new, more powerful, golf swing this season!

How I Used Dry Needling to Fix My Neck Pain

Unfortunately...even I get neck pain. I know what you’re thinking. That would be like Superman getting a head cold. It’s not supposed to happen. Well, I’m sure that even Superman is subject to the occasional sinus infection. But, luckily for me, I have access to excellent treatment and know what to do when my neck goes on the fritz. Let me show you how I use dry needling to fix my neck pain.

I’ve dealt with neck pain off and on for a majority of my life. When I was younger I would get chiropractic adjustments to help. Nothing against what a chiropractor does, but I have not needed a single adjustment since being introduced to dry needling in 2010. I was at a conference and my neck went out one morning. To anyone reading this that has had neck pain in the past you know exactly what I’m talking about. I could not turn my head at all to the right and when I did try the pain would shoot down to my shoulder blade and up into the back of my skull. It was horrible. Oddly enough I had met someone at this conference that was certified in dry needling and also giving a talk on the technique and how it can help with all types of pain and restrictions. When he saw how much pain I was in at breakfast he offered to treat me. Now, truth be told, I am not a fan of needles at all (I know, ironic). I was willing to put my fears aside due to the intense pain in my neck and give dry needling a try. Thank god I did, because within 15 minutes I had almost 100% motion back, and no pain. I was hooked, and within a couple of months I was certified myself to help others quickly recover from pains and strains.

Fast forward to last week. I woke up, stretched my arms up like I do every morning and BANG! Searing neck pain. My first thought was, WTH, am I that old? My second thought was, yes. My third though was, I need to get to work and have someone dry needle this so I can function and help my patients.

When I got to work I had similar symptoms to 2010. No neck rotation to the right, getting pain from my shoulder to my neck, and also getting some symptoms down my arm. Even though she was super busy, Kristen agreed to help me (did she really have a choice?). After a dry needling treatment to my C7 and upper trap I was 90% better. The pain was still there slightly and my motion was improved enough to where I could work without any restriction. I then did some exercises to open up my cervical facet joints to take care of that last 10% of my recovery.

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The moral of the story is, we’re all older than we think we are. Okay not really. The moral is that if you are dealing with pain you don’t have to. Think about giving dry needling a try, even if you are skeptical or afraid of needles. You will be pleasantly surprised by how effective it is and how much better you feel after just one treatment.

Interesting in dry needling? Call and make an appointment here at OrthoCore Physical Therapy to see how it can help YOU!



How to Increase Hip Mobility for Golf

The PGA season has begun and, if you’re anything like me, those golf juices are flowing! It has been at least two months since I have swung a golf club (thanks polar vortex). The off season is great for recovery but it’s also a great excuse to get lazy with your fitness program. It’s very easy to get stiff over the colder months because we don’t move as much. This stiffness can rob your golf swing of consistency and power. The biggest area of your body that is responsible for power in your golf swing is your hips. So let’s get those joints moving and get this season rolling!

When you swing a golf club your hips/pelvis to internally and externally rotate about 60 degrees in each direction. As a golfer, when you go to the top of your backswing you need internal rotation of your trail hip, and external rotation of your lead hip. In your downswing you reverse those movements. A restriction in either hip, in either movement, can lead to swing faults. No matter what the fault may be, it will definitely lead to inconsistencies in your golf swing.

Another problem with poor hip mobility is a guaranteed loss of power and distance. If you want to be able to hit the ball a far way you have to be able to spin fast. When we start our downswing we actually push down into the ground with our feet. The earth is just a little bit larger and stronger than us so it pushes back and creates what is called ground reaction force (hello physics!). Now before I lose you in all my golf swing dork talk let me simplify things. For 99% of the world, our legs are the strongest part of our body (not this guy, do you even leg day bro?).

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When we push into the ground, all that energy that is created gets pushed up the legs towards our abdominals. The pelvis turns that energy into torque. The more torque that is created, the faster we spin, and the harder we hit the ball. If we have a restriction in how much our hips and pelvis can twist we can’t create as much torque and we don’t hit the ball as far as we possibly can. Make sense?

Now that I have completely confused you with talk of physics, torque, power, blah, blah, blah let me just tell you what to do about it. Here is my favorite hip mobility exercise for golf. You can perform this stretch multiple times a day. Just be careful if you have any pain in your hips and/or in your knees. If you are consistent with performing this stretch, your mobility will increase, and you will be hitting that ball farther down the fairways before you know it.

If you have any questions please don’t hesitate to contact us here at OrthoCore. Enjoy the last month of the off season and use it to get your body ready for the upcoming season.



Retiring From Powerlifting By Adam Davis (OR: How I learned to Stop Lifting Heavy and Love the Lunge)

I’ve rewritten this blog multiple times now. Originally I was just going to talk about lunges. A client of mine who’s a former trainer herself sent me an article regarding the common mistakes when both practicing and coaching lunges. This article upset me because it challenged how I’ve been coaching this movement for 6 years professionally. It was written by one of our favorite professionals in the industry to boot (Dr. John Rusin). I was forced to open my mind and accept new information. And for the first time since joining the OrthoCore Physical Therapy team, I told my clients I was teaching something wrong (well more like less efficient, we’ll say).

Now where am I going with all of this? Well first off, as a coach I have a policy that I never teach something that I don’t practice on my own, unless a client really needs something unique in their programming. I begrudgingly started to practice these new lunges. I’ve had a long love hate relationship with lunges since the first day I worked out my legs. I know their importance and the importance of unilateral work in general. But lunges suck. Or rather I sucked at lunges. So I avoided doing them for a long time during my powerlifting career. I wanted to focus on competition lifts like squats and deadlifts. Those were fun, short, and heavy sets that felt impressive. Lunges were long, grueling, and boring exercises that burned and used light weight. Not something a 23 year old powerlifter was excited to do.

Well now I’m 30 and have 3 notable prior sports injuries, arthritis of varying degrees in many joints, and a stability issue in my right hip. That issue is likely from years of ignoring lunges I’d wager. Well upon practicing these new lunges that better utilize the mechanics of the hip, I became more aware of this instability, as well as generally had better feedback from it. I had more control than ever before in this exercise when working on that right leg, and despite the muscles being stronger, it felt harder. My rotator cuff was working in ways it wasn’t before (yes your hips have a rotator cuff too).

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This newfound sensation with an old exercise blew my mind. How had I not come across this information on how to perform lunges in 6 years of training and 5 years of competitive lifting? My lower body program shifted to primarily focus on lunges first, and I began to go from heavy weight to lighter weight/higher reps. Now I perform them with unevenly loaded dumbbells to both challenge stability and engage the glutes even more than the original modification did. Compound movements like squats and deadlifts became ancillary lifts in my routine.

Ok so let’s get to the real point here. Ever since my shoulder injury 4 years ago, I’ve been out of the competitive lifting scene. It’s been somewhat of a rough journey as I was just months away from my first major competition (everything I had done before were unofficial amatuer meets that were a bit more loosely regulated). That really messed with me. I went through ups and downs trying to get back to the numbers I used to put up before that injury, never quite making it in any of the competition lifts. I even went through a period of depression because of it and gained a lot of weight.

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The last 2 or so years I’ve been getting back into consistent training and leaned out to a nice healthy level again. But I’ve still always been training for strength overall. So “going heavy” was my priority in a lot of lifts, even if I was sure to do things like care for my shoulder health and isolate where needed. I even got my bench press up to 235 lbs after rehabbing my left shoulder from an impingement! But even though I’m mechanically stronger than I used to be in my powerlifting days (I move weight more efficiently), the fact that the actual amount of weight I was lifting was so much lower continued to nag at me. That was until the last few months.

I’ve recently come to terms with the fact that I will never compete again, at least not in any ranked league, and even if I compete in an amateur meet again I know I will be far outclassed. I had instead been focusing on my clients’ programs, and exploring new avenues like yoga. I specialize in corrective exercise and movement after all, why not broaden my own training to include more avenues regarding it? And although I was initially hesitant to admit there was information that contradicted what I coached, these lunges were my final step to finding where I really need to be training wise for my body at my age.

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Let’s wrap this up as I tend to ramble when talking about my own experiences. Focusing on these lunges first basically meant a lot of my strength and energy would be sapped for the big lifts. So I did what powerlifters swear never to do. I lifted lighter weight. My squats were endurance and mobility focused sets of 10-15 reps. My deadlifts stayed at low rep sets of 3-5 (I personally believe the conventional deadlift is risky for high reps), but the weight I used was relegated to weight that was normally not a 3-5 rep max. I also started to superset multiple types of deadlifts, so it was more like one set of 6-10 when combined, again helping my muscular endurance more than my usual training used to.

And you know what? I’m seeing tons of progress. My hip feels stronger every week. I’m still adding weight to my lifts even if I use less weight overall compared to even a couple of years ago, nevermind my powerlifting days. My shoulder mobility is more consistent, and my core imbalance is improving faster. To top it off, despite lifting so much lighter, I have more muscle mass on my body now than ever before, which helps keep my metabolism well regulated so I stay leaner easier, and cushions my poor arthritic joints.

So after 4 years of frustratingly chasing the dragon of reaching my former glory days. I’ve finally accepted that I’m not living those days anymore. I’ve retired from heavy weight you could say. I still challenge myself, but in ways that are more appropriate for my body given my history and needs. And you know what? I’m happy with my programming, performance, and body for the first time in nearly 5 years. The new year just started, so I guess this is my “new me”. Perhaps something as simple as reexamining your training programming needs is all you need for a “new you” as well. If you’d like to try and don’t know where to start you can always contact me. Otherwise I wish you all luck in your endeavours in health and wellness in this new year. And remember, it’s ok to be a different kind of athlete than you were last year.

~Adam




Hip PNF Kicks

Outside of your core muscles, the hips are probably the most important muscle group in the golf swing. They help your hips to twist and also transfer all of your leg strength up into the trunk muscles. It’s that energy transfer that helps to send that little white ball farther down the fairway. Most golfers who workout do work on their hip strength. The unfortunate part is that most are going about it all the wrong way.

The hip joint is a very dynamic joint. It is a ball and socket joint just like the shoulder.

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The great thing about the hip joint is that it can move in almost any plane due to its kinematics (scrabble word, 800pts). That allows for all the movements that happen during the golf swing. Most people think there is just a twist at the hip. The truth is there is a natural twist, squat, and lateral shift happening at the same time in the golf swing. If it happens during the golf swing why wouldn’t you train that way?

When most golfers hit the gym they might do squats/deadlifts, and some lateral walk or side lunge. Awesome! I’m not saying those are bad to do. I certainly do them when I go to the gym. What I think is important is to incorporate all the movements of the hip joint into one exercise. That way when you make a golf swing your body has been trained to moving through all those planes of movement and can transfer that energy more efficiently. That will equal more power into the golf ball, and hopefully a lot more distance.

So I’ve teased you enough. You are probably saying at this point “what exercise does all this at once? That sounds like an infomercial.” PNF (Proprioceptive Neuromuscular Facilitation) patterns are the way to go. They are simple patterns that move the hip through all the ranges of movement in one movement. Here is a quick video that will show you how to go through the patterns on your own.


I prefer that clients do it without holding on if they can. That way you are working on balance as well which is also very important in the golf swing. I also will have people start with moving slow so you have to own the movement. Once that gets easy add some speed to it. Just don’t move so fast that you start to lose your balance and fall over. If you can’t do it with the resistance band at first that is okay. Just work on the patterns without resistance until it gets easy.  

You will definitely feel the burn in your hips when you do these exercises (take that Jane Fonda). Work on this over the off season and see how much farther you hit that golf ball once winter is over.

OrthoCore Physical Therapy has convenient locations in Westerly and North Kingstown, RI. For more information on our services please call (401) 667-0131






Facet Joint Back Pain

I treat a lot of people with back pain. The hard part about treating patients with back pain is getting the work we do on the table, to translate to standing and walking. Patients who are older (I’m talking 35+) will usually have pain due to a facet issue, degeneration in the back, or both. Lying down is a great position for those issues because it doesn’t put pressure on the back. Once you stand up, the back compresses, puts pressure on the joints, and the pain returns. If this sounds like you, let me give you a simple solution to provide you with some relief for your back pain with standing.

What’s a Facet Joint?

Unless you went to PT school, or some form of medical school, you have no clue what a facet is or what degeneration looks like in your back. Well...that is what I’m here for. Let me school you on some anatomy. Facet joints are the joints of the spine. Just like any other joint in the body, the spine moves. It requires joints to allow that to happen. In your spine you have facet joints on each side of every vertebrae from your head to your hips.

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Like all your other joints, the facet joint can get inflamed. When you compress an inflamed joint, it hurts. Facet joints get compressed when you are standing and when you extend. Hence the reason why lying down feels better, and standing hurts.

What do I do for Standing?

Since most of us can’t lie around all day, what do we do when we’re standing to help alleviate back pain? The key to having less pain with standing is understanding the position of your pelvis. Most of us have what is called an anterior tilt at our pelvis. That means that the front of our pelvis sits lower than the back part of our pelvis.

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Speaking in generalities, this usually happens because our hip flexors are tight and our abdominals are weak. In the game of tug-of-war, a tight muscle always beats a weak muscle. In therapy we will try to stretch the hip flexors, and strengthen the abdominals to correct the imbalance. That doesn’t always carry over to a standing position though. Sometimes, you have learned to stand like that so you need to retrain the brain to stand in a neutral pelvis. What is the best way to do that? Train your hips in a standing position. Here is a simple exercise that I like to give my patients that have back pain with standing.

Give this a try to help alleviate your back pain with standing. You can perform as many of these as you want. The exercise is meant to help you retrain your brains standing pattern. There is no resistance involved so you don’t have to worry about overdoing it.

I hope this helps correct your back pain you are getting with standing. If you have any questions please contact us. If you want a free session to review how to perform the exercise properly just mention this post and OrthoCore will give you a free 15 min session at any of our clinics. Thank you for reading!







Knee Arthritis vs. Meniscus Tear

I’ve had a lot of patients throughout the years with knee pain (I know, earth shattering beginning to a blog post). The biggest thing that we do as Physical Therapists is figure out what is the cause of your pain. I feel like I’ve had a group of patients recently, that have knee pain and their MRI shows they have a meniscus tear…and arthritis. The problem with having both is it makes it hard to discern where the pain is coming from because they are so closely related. The other problem with having both is that surgeons are usually shy about performing a meniscectomy (remove the torn meniscus) because it may not relieve your pain symptoms. That being said, let’s talk about the differences between the two so you can make an educated decision if this is what you are dealing with.

What is a Meniscus Tear?

The meniscus is the shock absorber of your knee. You have one on the inside (medial) and outside (lateral) of your knee. If you were looking down from the top of your knee they look like two lima beans. If you look at them from a straight on view they look like a race car track meaning the peripheral portions are thicker and it slopes down towards the middle of the knee from there.

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Typically a torn meniscus will hurt right over the joint line and will be sore at end ranges of knee movement. It will also usually hurt with activity, especially loading and twisting. Remember, its your shock absorber, so the more bumps you take the more strain you are putting on it. Think of it like driving a car. If you go over a lot of bumps you will feel it more.

When you have a torn meniscus the surgeon will usually just cut out the torn portion, which is usually on the inner portion. That way they can take the torn tissue, while still leaving a lot of meniscus for you to play with.

Recovery is usually quick (if you have a good PT) and you are usually back to your normal activities in a couple months time.

What is Knee Arthritis?

Arthritis is a loss of cartilage. Cartilage is like the shiny end of a chicken bone. When cartilage slides on cartilage, no problem, when it starts to wear down is when bone gets exposed and can lead to inflammation and pain.

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Arthritis is usually worse in the morning and at night. During the day, if you keep your knee moving without much impact, it usually makes the joint feel better. Activities like biking, swimming, non-impact weight lifting are good.

Arthritic pain is usually more global, meaning it’s hard to pinpoint with your finger. Sometimes it hurts in one area. The next day it could hurt in a completely different area. It depends on how much arthritis you have and what types of activities you are doing.

The surgical solution for arthritis is a knee replacement which isn’t as easy to recover from as a meniscectomy obviously. Recovery from a knee replacement is 3-6 months (back to activity with some pain) with full recovery usually by a year.

How do I know what to do?

So what do you do if you go see a doctor only to find out that you have a meniscus tear AND knee arthritis? The best thing to do is start to write down where you have pain in your knee and when. If you start to see that it is more over the joint line, and more with jumping/twisting activities, it’s probably coming from your meniscus. If you find that it is more painful in the morning, but gets better as the day goes along, and not in a consistent spot, it’s probably arthritis.

I would always recommend trying a course of PT first. In both cases there have been plenty of studies that show that PT can be effective without requiring surgical intervention. If PT doesn’t help and it appears to be more meniscus, if it were my knee, I would have the surgery. If PT doesn’t help and it appears to be more arthritis, it depends on what I would recommend. A knee replacement is a much bigger surgery, but is also really effective for relieving knee pain. It is really age related but I will say this … most patients that I have, that have had knee replacement surgery, say they wish they had done it sooner.

I hope this helps to give you an idea of why your knee hurts and what you can do about it. If you have any questions please comment below. If you would like to schedule an evaluation to see what might be causing your knee pain, please contact us at OrthoCore Physical Therapy  401-667-0131 to make an appointment at our Westerly or North Kingstown locations.




Running with Knee and Back Pain

So, I’ve been running more lately. To anyone reading this that knows me, knows that comes as an enormous surprise. I used to be a huge runner (3-4 times/wk) but, running and I fell out of love when I started to get injured. My knees and my back were always bothering me. I was getting tired of showing up to work and feeling worse off than my patients. Instead of working on the flexibility and strength deficits that I had, I decided to just stop running. Not exactly what I would recommend to any of my patients but, effective at eliminating my pain nonetheless.

Well I’m back on the team! I credit my return to three things. 1. Like most other people who run, it’s easy to just get out of the house and run. It doesn’t require driving anywhere, or signing up with any gyms, etc to participate. 2. I can do it with my kids in a stroller. I get to spend more time with them, and it gives my wife a little break (double bonus). 3. I was intrigued when I saw that “Headspace” had a running packet. To those of you who don’t know, Headspace is a meditation app. I’ve been using it for a while now and the running specific pack piqued my interest. I was pleasantly surprised it actually made it really enjoyable to run. It didn’t feel like the mental struggle that I remember from the past.

Unfortunately, with my renewed love of running, my knee and back pain returned as well. It’s like when you get back together with an old girlfriend and realize part of the reason why you broke up was her annoying best friend. Well this time the friend isn’t going to break us up again. Instead of running from my problems (see what I did there), I’m going to address them and make sure that I can keep my feet on the road.

My main issue (as is the case with many runners) is that I have very tight hip flexors and IT bands. Those muscles run in the front of the hip and can restrict your hip extension and stride length.

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The problem with the hip flexors, and the reason why I get back pain, is that they anchor at the lumbar spine. When they are tight, your spine will flex with every stride and put excess pressure on your spine causing pain. The IT Bands run all the way down to your knee. When they are tight they will pull your knee out of alignment. That misalignment with every step will eventually lead to pain. Hence, the reason why I get knee and back pain when I run.

The good news for me (and anyone reading this with similar problems) is that it’s really easy to fix. All I have to do is stretch those muscles regularly to keep my body aligned and moving properly. Here is my favorite hip flexor and IT band stretch. If you are stretching pre-run then perform 15 repetitions holding the stretch for just a couple of seconds. If you are stretching post-run then hold for 30 seconds to a minute and perform the stretch a couple of times.

I hope this helps you stay flexible and keeps your feet on the pavement. If you have any questions please contact me here at OrthoCore Physical Therapy. Otherwise, HAPPY RUNNING!