Hey everyone, welcome to the Stay Healthy El Paso Podcast. I'm your host Dr. David Middaugh, specialist physical therapist over at El Paso Manual Physical Therapy, and today we're covering the top seven tips for lower back arthritis.

Now we see people here with lower back arthritis in the clinic all the time. It's one of the most common things that we help out. And typically, people have a combination of arthritis and stenosis and sciatica. When they're looking for help initially, they don't really know what they have going on. But maybe they've got an X ray and MRI, frequently people bring those in with them. And they'll point out on the MRI or on the X ray where it says Look, look at L-5 or L-4. I have arthritis, osteoarthritis!

When they've got that, then they are concerned because it's like I'm getting older and I've got arthritis, that stuff doesn't go away. It just stays with you for life. And they are always worried about how to begin to get help, and they're not sure who to see, or if they're going to need surgery someday. That's always a huge concern for people, especially once their back starts hurting, then they think, I don't know what to do about this and how am I going to protect this from getting worse, and I've seen my parents, they had arthritis too, and their backs are all messed up and they're on a walker on a cane or they're taking medications all the time getting injections.

If you have any of that stuff going on, you are going to want to hear these seven tips on how to get started on fixing your lower back arthritis problem. Now, just the way this works, it's not really fixing it. I'll tell you more about that here in a second. But arthritis is generally something that comes on as we age, and it can be painless. In some instances, it can be painful in other instances, it just depends if it flares up, but think of it more so as like getting gray hair or wrinkles.

As we age, we get gray hair and wrinkles and they don't really hurt. They don't hurt physically but it might hurt emotionally for some people. But if we look on the inside of our bodies with an X ray or an MRI, then you'll see that as we age and people that are older, they just tend to have more arthritis. And it's okay, it's normal. It's not it's not a bad thing necessarily.

What we're concerned about is when it becomes too severe, when it becomes out of control, that's typically a sign that there's a bad forces going through those joints, there's bad stuff happening. It's usually the way that the muscles are pulling on the joints. That's why there's bad forces on there. That's what makes the Arthritis situation progress faster and become more severe.

But anyways, I'm going to cover those top seven tips for you right now. And that way you can learn about what you can start doing right away at home. Right now, as you're listening to this podcast, you can try out some of this stuff for beak or your plan to stop doing that some of these things, because I'll tell you what to avoid as well. I think this will be helpful for you. So let's get to it.

Let's talk about the top seven tips to help out lower back arthritis.

Tip Number One Core Strengthening Exercises.

A lot of people say just go get exercise, but to be specific, we have to strengthen the core and it's typically the abs muscles, but I would also throw in the glutes, just about every single time. It's pretty rare, I'd say 9 out of 10 times, it's just an ab problem. It's an abs and a glute weakness problem that contributes to a lower back arthritis situation.

So, if you haven't really worked on your abs, and that's something you want to get going on. If you are confused about how to do it, or maybe you have already been trying it out, and it's been hurting your back more than helping your back. Then I encourage you to go over to our playlist on lower back videos in our channel for El Paso Manual Physical Therapy. There are tons of videos in there that talk about specific exercises for lower back problems and start with those. Those tend to be pretty safe and easy to do.

And if you are still having trouble, you need to get some professional help to make sure that you are doing your core exercises correctly. Because it is proven, I see it in the clinic all the time. That's how we help people is by strengthening certain muscles, in addition to all the hands on work that we do, but core strengthening is going to be your number one place to start fixing a lower back arthritis problem at home.

Number two simple stretches.

When I talk about stretches, you want to just stay in this forward and back motion. Like going towards your toes and going backwards can be beneficial. I would, there are certain stretches that I would want to avoid. That's actually tip number three. I'll cover that in a second. But its stretches where you feel like you are bending your back all the way forward or all the way backwards are generally okay to start with.

Now, what I want to point out with stretches is, they can be overdone and can actually become harmful after a while. So use them sparingly, but it's a good way to relieve the backache to relieve some tension off your back and possibly avoid taking pain medication in the short term. Just to kind of get you by for a period of time. But I wouldn't look to do stretches to cure a back problem. It's just going to get you started and allow you to avoid taking the harmful medications.

Number three, avoid twisting motions.

Typically, and this is related to those stretches, avoid twisting motions. Some people like to twist all the way around one way, and the other way, and maybe you enforce a joint to pop or click. And that can be relieving sometimes, but I would avoid it if you have a low back arthritis problem, because chances are, there's a bunch of stiff joints in the lower back because of the arthritis. And there's usually one or two joints that are compensating for all the stiff joints. And you might be over twisting that one joint that's moving way too much in creating a disc problem or a pinched nerve problem later on.

I would avoid the twisting motions. Our spines are just not designed to take a lot of twisting and repetitive twisting. So, make sure you avoid daily twisting motions, as well like twisting while doing little things, at home activities, like chores in the yard at home. If you have to stand with your feet pointed in one direction you twist over one way, or if you are sitting at a desk or cooking in a kitchen and you find that your feet aren't really going with the upper body, make sure to just reposition your feet so that they are in line with the rest of your body so that you avoid twisting through your spine. So, keep away from those twisting motions.

Tip number four drink lots of water stay very hydrated.

Our joints are reliant on our hydration so if you feel like you have not been drinking enough water over the past few months, and you are back arthritis problem is just getting a bit worse, it could very well be affected by your hydration levels. Cartilage is over 60% water up to 70% water and you have tons of cartilage. Discs in your spine are also highly dependent on hydration. And then there's fluid inside the little spine joints. The rosette joints is what they are called in the lower back. And that fluid needs to be there in order to properly lubricate the joint surfaces. So drink plenty of water.

I know the side effect is that you have to get up and go to the bathroom frequently. But I would weigh that if you are having a problem with having to go frequently versus potentially having some surgery some day because this arthritis problem was managed properly. You got to weigh those risks. So just think about that I would I'm always going to lean on the side of drink plenty of water and it's okay if you had to get up every now and then go to the potty. Just make that trip counted as exercise.

Tip number five, avoid shoes with heels.

Now this goes for both men and women. Of course, women are probably the ones that are typically going to wear heels more so than men. But men do wear heeled shoes here and there. You know smaller heals typically with like in boots or dress shoes, but that little elevation even if it's a small amount, it changes the way that your ankles are positioned when you walk, which influences the knees and hips and can translate all the way into the lower back. And generally, the bigger the heal, the more forces are going to be disrupted and affecting your back & neck.

Really, so it just doesn't allow the muscles that control the spine, the lower back to properly operate and give you the stability that is needed for everyday motions. If you have a chronic back problem, if you have arthritis in your back, I would definitely stay away from the heels until that problem gets resolved.

Now, let me put a disclaimer in here. I'm not against heels forever. I think if you are healthy, and if your back is fine, you don't have any other issues that are affected by the heels. Wear heels all you want, and it should be just fine for you. But if you are trying to avoid medications, injections and having a surgery, get off those heels in the short term and let's fix the back problems so that you can get back to her in the heels as you might like want as you want to later on in life.

Tip number six, avoid walking for exercise.

I put this tip in here because a lot of people that I meet here in the clinic and out in public, they say hey, I want to start exercising and stretches, start with walking, right? That's kind of the easiest thing to do. You just get out and put on your walking shoes and go for it. And yeah, it's an easy thing to do and it was pushed a lot back in, in the 90s and even early 2000s as a great way to start exercising. I think it's still generally accepted as a great way to start exercising.

If you don't have any sort of back problem, I'm okay with it. But if you are dealing with back arthritis, lumbar arthritis, it is not a good thing to go walking for 20 minutes, 30 minutes or more to cover many, many miles because there is a decent amount of twisting that happens through the spine when walking. And if your joints aren't moving properly, because you have arthritis in there that's preventing the motion, then you are technically doing a repeated twisting motion over and over again, and it can aggravate the back problem.

We have seen people come in here in the clinic that say, I started walking and it kind of felt better because it's stiff. I understand and my back eased up some. But then it started to bother me as time went on and I just didn't enjoy going for walks. So, if that's you stop the walking right now. There are other exercises that you should be doing. And then walking can begin to happen for regular exercising if you choose to. If you like to go hiking or you are just an outdoors person like to get out every now and then it's not a forever thing kind of like with the heels.

You want to just put a pause on the walking beyond what you'd have to normally do for everyday living, walking within your house and for work. But walking for exercise like where you go on a dedicated walk, I would avoid if you are trying to correct a low back problem, an arthritis problem in the low back.

Tip number seven, get expert help.

This is by far the quickest way to make sure that the lower back arthritis problem gets under control and managed properly. Now the reality of what we've discovered in the healthcare field over the past 20 years is that arthritis in the past, is actually Okay, as we age, it's expected as we age.

Think of it as like rust on a on a car, if you look under an old car like from the 60s or 70s, or even before that time, if there's bits of rust here and there, it's not going to impede the function of the car, your car's still going to run and you can go enjoy a cruise. But if there's a massive hole that is rusted out on the frame or on some important part of the of the undercarriage of the car, then you should get some concern and you should think Am I going to be able to enjoy my rider? Is something going to break or is this crazy? We're going to start then you got a problem. It's the same thing.

If you are looking at the arthritis in your spine, it's all over. It's just there's tons of it. Just like there's a lot of rust on the bottom of a car. You are going to have some likely long-term back issues and you can still get under control and manage it so it's not worse and avoid a surgery or having to rely on medications. But the fact of the matter is, it's just affected more joints, more cartilage in the spine. But if it's just a little bit of arthritis, in other words, if they told you that you have mild arthritis, even moderate arthritis, then I wouldn't get too concerned that's like looking at a 56-year-old car.

And if it just has mild amounts of rust or even moderate amounts of rusting but everything still works, then you have an excellent shot at getting back exactly to what you were doing before, without having to worry about having surgery one day or having to rely on injections or medications.

But getting expert help really just speeds up that process to make sure that you are doing the right exercises that you are not doing the wrong stuff. And that you are thinking about this properly so that you can learn how to take care of your back arthritis for the rest of your life. So I strongly encourage you to reach out to an expert like a manual physical therapists to make sure that your lower back arthritis problem gets under control and handled properly.

Hey guys, thanks for listening, I really appreciate it. If you thought that this podcast was helpful for you, I encourage you to leave us a five star review, that would be super awesome. If you tried some of this stuff and you had a good outcome then please leave us a bit about your story in a review, we'd love to hear that. That's always encouraging that we're helping people that are listening in El Paso, or in the area or even around the world, around the country.

We always love hearing people sharing their stories about how we might have helped them. If you are thinking that we might be able to help you out if you're in the El Paso area, call our clinic if you think that you want to get help by us, our numbers 915-503-1314 and if you just want to learn more, find out about us you can Visit our website at www.EPmanualPT.com and there's tons of free resources on there. Our blog is full of helpful information for back problems and other issues as well. You can go check it out and find more details. But anyways, I hope that you have a wonderful day and we'll talk soon.

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Hey everyone, welcome to the Stay Healthy El Paso Podcast. I'm your host Dr. David Middaugh, specialist physical therapist from El Paso Manual Physical Therapy. Today we are going to talk about the top four reasons for knee pain from walking and running.

The reason why we made this set of tips and advice for knee pain from walking and running is because, since all the shutdowns everyone stayed at home and had to miss going out to the gym, had to miss accessing their treadmills, and all the normal workout equipment they might have at the gym if they were going to the gym.

There has been an obvious increase in people out in the streets, out in the sidewalks, running and walking for exercise. And as a result of that, we've seen more patients in the clinic here with knee problems, hip problems and foot problems but the big one has definitely been knee pain. So, I'm going to cover with you today the top four reasons for knee pain from walking and running.

Reason number one, bad form

A lot of people don't realize how terrible their running form, or even their walking form is. And every time we get somebody with a knee problem here in the clinic, that's one of the first things we cover. You probably have been walking for years and years of your life if you have been lucky enough to have functioning legs. You have been walking and probably even running, and you wouldn't think twice about how you did it, the way that you stepped, which muscles you used, how much you raise your knees, how hard you step.

There are all these different factors that we go into depth, when it comes to walking form and running form. And then it changes at different speeds. There is likely a huge chance that the way that you are running, the way that you are walking even, is affecting your knee problem. If you take thousands of steps, even just hundreds of steps, it can put some bad forces through tissues that aren't designed to take those forces.

Because you have a running form issue, or a walking form issue, it just overloads that tissue. It might be a ligament, a meniscus, it could be a muscle or tendon as well. If that tissue gets overloaded, then it's easy to just irritate the tissue, eventually possibly tear the tissue. Definitely get some swelling in the area. But at the lowest level, your body lets you know, by just reporting pain, you just feel some pain in the area, sometimes the joint, the knee will get hot as well. And sometimes it just gets achy.

There are times when the knee won't hurt during running or walking, it actually might feel better. But then later in the day, the knee starts to ache, maybe even at night. That is a sign that there's some knee problem going on when you are running. It typically is a sign that it's a cartilage problem or a ligament problem as well. Versus if you get pain during running, it's more likely going to be a tendon or muscle problem.

That's not a hard and fast rule. Those are just likely reasons for the problem that you are facing. But if you are having any sort of pain around the time that you are running, whether it's during running, right after, or later on in the day, then there's likely going to be some running form problem or walking form problem. The best thing to do to fix your running form, or your walking form is definitely to talk to an expert, especially an expert Physical Therapist, we deal with movement.

With running and walking, there are lots of moving parts that we can address for you. And it's not a big fix, most of the time, it's just tiny tweaks that you can make instantly and begin to reduce that pain problem that you are facing in your knee.

Reason number two, too much too soon or overloading

Let's assume that you have great running form and great walking form. If all that's fine, it may be that you are doing too much too soon. In other words, you weren't walking as much as you started to walk recently. And you feel good, you felt fantastic. You enjoy the fresh air, you enjoyed the sun and everything around you. If you are on a hike, you are enjoying your hike, and you just overdid it, that can definitely cause pain in your knee.

What you have to look at is giving yourself smaller amounts of walking or running. And then gradually building it up over time to the distance, or the time that you desire to do so its going to sustain for the long term. If you are going to begin a running program or a walking program for exercise, and you want to work up to three miles for instance, you won't be able to cover three miles. I wouldn't go into doing three miles the first time you go run or walk. That's going to likely overload your tissues, and you are going to do too much too soon, and you are going to have some knee problem very likely.

You got to start out with maybe a half mile to a mile at the beginning. Do that for a week or two. It just depends on how out of shape you are. Then work your way up to a mile and a half to two miles, and then work your way up to two and a half to three miles over time. This might take you a month or two months or three months. It just depends on your specific situation.

But you need to consult an expert on this. If you are confused about how to do it. There is a lot of information online that is very helpful. You might start there too. And if you have a running friend that's gone through marathon training successfully, or half marathon training, or even ten-k training, they might be able to help you quite a bit, based on how much to walk or run at the beginning, and then how to work into as you get better and stronger.

Reason number three for any pain from running and walking is your footwear

Your shoes, especially for walkers, because people that walk may not always wear the right shoes. You definitely want to have some sort of athletic shoes or running shoes is ideal. But if you are wearing your casual shoes that don't have a whole lot of support, you might switch those out for some more athletic shoes that offer you plenty of support.

Here's why it's important. You are running, you are on your feet, you are walking, you are on your feet, there are muscles in your feet and there are muscles up into the leg that just get tired as you do more. And what those athletic shoes do for you is, they help support the position of your foot, which affects the position that your knee and hip and all the way to your low back. And if your muscles get way too tired because you are pushing yourself, then they won't support you the way that they are supposed to, because they are just not strong enough yet. But that shoe can give you that that little boost that you can last as long as you need to.

Another common mistake, related to shoes is, people just wear their shoes out. If your shoes are pretty old, or you just put a lot of mileage on them, you have walked around on them quite a bit, then it's time to get new shoes. And, there is all kinds of debates about every six months or every 12 months, or even if you didn't use them for six months, the I've heard that the materials kind of wear out. There is all kinds of debate. What I would go by, for you specifically is what feels best for you.

I can tell you from experience, I've been an avid runner myself, and I tried switching it out every six months and I tried other times as well. I couldn't find something specific. I just went by the feel I had. Some shoes I used for over a year. Currently I have some shoes that are probably two or three years old, that I still use to exercise in, and they still give me good support. They give me what I need, and they are in decent shape. I don't find a reason to get new shoes at this point me personally. But as soon as I feel like those shoes aren't supporting me, you bet I'm going to go get some brand-new shoes. And I'll be just assessing as I go on.

That's what I encourage you to do. If you are walking out there, and you are thinking to yourself, oh, gosh, these shoes that I'm about to put on are five years old. But then you might rationalize yourself and say, Well, I haven't been on a running program or walking program in five years, so maybe they are going to be okay. I'd say give it a shot.

But if you got knee pain, and you can't quite solve it, definitely go get some new shoes, it's not going to hurt, it's only going to help and that might be the fix that allows you to continue your walking routine and your running routine without having to go visit a doctor get medications or injections or anything like that. Running shoes is always a good, easy fix for you.

Reason number four old unaddressed injuries

Many people had knee problems back when they were in high school, when they played sports, and they played volleyball or football, or they were running before. They may have suffered injuries back in the day, but they never really fully got them addressed. They just laid off of them. And then now they are picking up a walking routine or running routine. They are kind of coming back but were never fully addressed.

Typically, what we find in physical therapy is that there's some muscle imbalance or some improper joint movement that is hard to feel or find out. Or it doesn't really come on unless you stress the joint like when you go on a walking program or running. But in normal everyday activities, it just wasn't enough to bother you. Those old unaddressed injuries now get magnified for you, especially if you are going to be more intense with your walking or running routine.

What I would strongly urge you to do is talk to an expert about this. Because if you can address subtle injury at the beginning of your new walking or running routine, it's going to go a lot smoother for you than if you keep running through it or walking through it, and it festers into an arthritis problem or some tear in some tissue that isn't ready to take what you are going to put it through. I strongly encourage you to talk to some experts like myself about this knee problem, so that it's not going to stop you from reaching your goals from being able to run as much as you want or walk as much as you want.

If you are unable to get to an expert, there's nobody in your area, or you just want to stay at home, make sure that you are safe at home, then I strongly urge you to consider checking out our 28-day Knee Health And Wellness Boost Program. This 28-day structured program will show you how to get stronger in your knees, strong in your hips, even your feet. It's a structured program to make sure to boost the health of your knees and make sure that you know how to address your knees strength moving forward, and how to maintain it so that you are not having recurring knee problems. Check out more about that program by visiting the link in the description here.

Thanks so much for listening to our podcast. I hope that you learned a lot about all these reasons for knee pain from walking and running. If you have more questions or you just have some specific questions about your specific problem, if you are dealing with a knee pain problem, you can reach out to us. Our phone number is 915-503-1314.

Of course, if you are in the El Paso area, we can help you directly. Now if you are looking to find us online, you can find us at www.EPmanualPT.com and you could see our website there, find all our free resources right on the homepage. You can go into our blog and find more tips and helpful advice for knee problems. I hope that this podcast was helpful for you, and we'll talk again soon. Bye

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