Your back is one of the hardest working parts of your body. Having a strong back keeps us upright and allows us to balance, walk, and be active. It’s also one of the most frequent sources for aches and pains; in fact, it is the most common condition we treat at Rocklin Physical Therapy! With a majority of us spending more time at home this past year, getting less physical activity can increase the odds of back problems.
 
There are a lot of working parts in the back: 24 vertebrae (in the cervical, thoracic and lumbar sections of the spine) held together by myriad ligaments and stabilized by more than 140 muscles – including abdominal, pelvic, and hip muscles. This is why we frequently suggest working on the core first when discussing minor back pain.
 
People often think of core strength as a six-pack, but abdominal muscles are only part of the picture. The muscles around your ribs, upper back and neck are just as important for stability, as they support the back in rotation. Think about these points when strengthening core muscles:
 

• Start by working in isometric positions to avoid compensating with other muscles. Isometric exercise involves static contractions of muscles without moving your joints.
• Make sure you focus on your form before you worry about strengthening.
• Coordinate muscle contractions with your breath.

 
It is very important to use proper form in static exercises (those with little movement) before you start doing more dynamic exercises (coordinating with other movement patterns). This is particularly important if you’re strengthening the muscles that support the back. If you put too much stress on those muscles, you will be putting your back at risk.
 
If you do experience back pain, one of your first thoughts might be wondering what’s causing it. Outside of minor aches and pains, there are three common conditions that can cause sharp or acute back pain.
 
The first is a herniated disc, which is when the gelatinous material in the center of the vertebral disc pushes through the disc’s exterior structure. The second common condition occurs from side effects of aging, like arthritis (when one or more of the discs between the vertebra wears down) and degenerative disc disease (when the vertebrae themselves have worn down). The third cause is problems in the sacroiliac joints, between the sacrum, the boney structure below the last vertebrae, and the ilium, or pelvis. These are all issues that you should discuss with a physical therapist or doctor to determine the best treatment for your pain.
 
Since back pain is so common, when should you call a PT instead of just strengthening at home? Check the list of symptoms above that commonly require professional help with your back pain. If you would like to talk to one of our physical therapists regarding your back pain, please call us at 916-435-3500.
 
The material and information contained on this blog is for information only and is not intended to serve as medical advice or consultation. Consult your personal physician before beginning any exercise program or self-treatment. 

Determining your career can be an arduous task at best for many of us. For some, a career path can be a smooth road based on early interest and skills. For others, it can be a long, windy road filled with inclement weather and road hazards. There are a few things individuals can do to help smooth the process such as having a good mentor, taking a variety of courses that may interest you, internship programs, etc. We sat down with our PT student, Jacob Reynoso, to discuss his thoughts and educational experience to provide our readers with some insight on the process of becoming a physical therapist.
 
 
What made you decide to become a physical therapist?
 I knew I wanted to go into the medical field in some way. In 2010, during my undergraduate program, I shadowed a physical therapist five days a week for three months to learn more about what they do. I thoroughly enjoyed my experience during this internship as I was able to witness the strong interaction between many patients and their therapists. I enjoyed seeing the change in patients’ demeanor from when they started physical therapy to when they graduated their PT program. It was very motivating to hear their stories of improvement and I knew I wanted to be a part of that change.
 
What advice would you give someone who is deciding on a career?
 I think there are several things an individual should be doing when deciding on a career. First, make sure you have a good, solid reason “why” you want to do a particular career. This answer should continue to motivate you when things get difficult – you fail a test, you aren’t accepted into a specific university, countless hours of studying, or the grueling process of finding a job. Always remember your “why”. Second, buckle down now to learn and retain the information your professors are giving you to get a good foundation. Third, read every day. It will help you when the time comes to take your standardize tests. Lastly, develop healthy, effective ways to deal with stress. Activities such as working out, listening to music, playing sports, etc will serve you well to combat the stressful times.
 
What college did you attend?
I attended a local community college where I earned my Associate Degree in natural sciences and mathematics. I then transferred to California State University Chico where I earned my Bachelor of Science degree in exercise physiology in 2016. During this time, I worked two jobs, one in a restaurant and one as a physical therapist aide, as well as volunteered at local hospitals and clinics to get more experience in the field. This was what my life consisted of for 4 years as a hopeful physical therapy student.
 
I am currently in the doctorate program at the University of St. Augustine for health sciences in San Marcos, California and I will officially graduate in December 2020 after a little less than 3 years. The road to becoming a student of physical therapy is different for everyone. For myself, it was a long road. 
 
Was it difficult to get into PT school?
Every physical therapy school has different prerequisites;  however, in order to be competitive, you must have a strong grade point average, experience in a clinical setting, and a competitive score on the graduate record examination (GRE).  My goal was to attend any PT school in California to be close to my family. This meant I had to take numerous prerequisite courses to fulfill the schools’ requirements I was applying to, as well as finish off by taking the GRE. In the end, I applied to 4 physical therapy schools in 2017. Two of which I had gotten accepted to and by what seemed to be a miracle, one of my best friends had gotten into the exact same program, which is a very rare scenario.  My advice to anyone applying to PT school would be to focus on your GRE score, GPA, and brush up on your interview skills.
 
   
What was your daily life like during PT school?
The Doctorate of Physical Therapy program at University of St. Augustine takes nearly 3 years to complete. It consists of six classes at a time with four days a week on campus and an additional day each week online. We go through the program with the same group of students which is very beneficial to be able to help each other along the way. We currently have 60 students in our program. We had in-class instructions for the first four terms and then started working with patients during the fifth term. I’m currently at the end of my student physical therapist career, which means I’m on clinical internship. There is a total of 3 clinical internships and I’m currently on my second at Rocklin Physical Therapy. My last internship is in Santa Rosa, California which I will be beginning in September up until graduation. The final step as a student physical therapist after graduation is passing the state board exam. Once completed, my dream will finally come true. The road getting here was a long one, but worth every second. 

​Shoulder stability, what is it and why is it important? First, let’s cover stability. Stability is your body’s ability to resist a load and maintain movement through that resistance. A lack of stability (or instability) leads to unwanted movement of a joint that over time leads to breakdown of mechanics and potential injury. Stability requires strength but also a large amount of musculature endurance as well. Your muscles must be able to stabilize over and over in order to maintain proper mechanics.
Shoulder stability is when the smaller muscles of the scapula contract in order to direct your arm in a stable manner. This joint mechanic is very important for activities (especially repetitive ones) from placing items into a cabinet to performing a snatch (movement pictured). Poor shoulder stability often leads to pain in the shoulder or even the elbow, especially when performing activities overhead.
How you can improve stability

The best way to improve stability of a joint is to increase the muscular endurance of the surrounding muscles. Increasing endurance is going to allow the joint to resist unwanted movement repeatedly allowing you lift your arm overhead with good joint mechanics.  Check out our social media pages this week for some exercises designed to help you improve you shoulder stability.

Final Thoughts
This is a good way to fix any improper mechanics you may have and can help prevent injury. However, fixing your shoulder stability is not a cure all and isn’t guaranteed to fix or prevent any shoulder or elbow pain.
Every athlete will have different movement faults that needed to be corrected and may not be included in this blog. If you’re not sure about any movement faults you may have or have questions about wellness, movement, or general strength and conditioning set up a screen with one of our qualified physical therapists.

Troy Stogsdill, DPT
​Physical Therapist

For most people, pain is pretty simple: something hurts. If I were to ask you to think of something that has commonly caused you pain (go ahead and think of something) you may think of stubbing your toe, touching a hot pan, or nicking a finger with a knife. While these are all actions that may certainly cause pain in healthy individuals, pain is much more complex than just “hurt”. 

By definition, pain is an unpleasant sensory and emotional experience which follows actual or potential tissue damage or is described in terms of such damage. Key points to take away from this definition are that 1) Emotions contribute to pain, 2) Pain can be described in terms of damage even if no harm or potential injury has occurred, and 3) Pain is an experience.
 
There are generally three types of pain: nociceptive, peripheral neuropathic, and nociplastic. When describing how pain works, we will be talking about nociceptive pain as it is the most common and easiest to understand. In general, nociceptive pain is when a mechanical stimulus (stubbing your toe) or chemical (acid burning a hand) stimulates neurons (called “nociceptors”) to send signals to the brain.  However, as just noted, pain is more than just hurt. The signals sent to the brain are not, in and of themselves, painful.
 
Pain is a multifactorial experience. The amount and type of pain you feel depends not only on the number and type of nerves triggered and how they send signals to the brain, but also on your culture, spirituality, behavioral habits, current emotional and mental state, and how you grew up. Each part plays a role in your pain experience. One person who stubs a toe may perceive the pain differently than another person with a different background. In fact, the same person who stubs a toe during a fun race around the kitchen may perceive less pain than if they were to stub it when getting home after a stressful day at work.
 
When the brain is imaged during painful experiences, no single brain center lights up. Though much occurs in the sensory cortex, multiple areas all across the brain are active. Each area is a part of the pain experience and responsible for processing and interpreting the signals sent by the nociceptors. How the brain interprets these signals can differ from person to person and from situation to situation.
 
A simple example of this is when a child falls and scrapes a knee. If they are with their friends or alone, often times they act fine, curiously look at their cut, and get up to continue playing. However, when they see their parents, they start crying uncontrollably. The scrape on their knee didn’t magically worsen but the perception of the pain had still changed.

Of course, this example uses children who often act irrationally anyways, but the same factors hold true as adults. If you are stressed or are expecting something to be painful, your pain level will probably be increased. Now, all of this is not to say that you shouldn’t comfort a crying and hurt child so they grow up “tough and strong” with a low perception of pain. You most often should care for your kid, but it does point out how even with the same mechanical stimulus, people may perceive pain differently.
 
However, as we finish up this topic, it is important to know that just because someone perceives more pain with the same stimulus than you or I would, that perception is still real. The pain they feel is real. You cannot simply tell them to feel less pain because others don’t feel as much. Even though with mental, environmental, and behavioral changes it may be possible to perceive less pain over time, in that current situation we must understand that no matter how different their pain experiences may be from ours, it is still real to them.  

Written by:

Jordan Eldridge, DPT student

John Zieour, PT, explains how cupping can be used as an effective treatment for plantar fasciitis.

Think about the time you went to pick up your coffee cup in the morning, only to be awakened by a sharp, stabbing pain along the outside of your elbow!  "Tennis elbow" is a fairly common musculoskeletal problem that affects about 2% of the population in the U.S.  People suffering from this condition generally will report pain or soreness along the outer portion of the forearm or elbow.  They usually describe the symptoms varying from a dull, constant ache...to a sharp, stabbing pain that occurs usually when they are doing activities that either involve gripping, twisting, or lifting motions using the hand, wrist, forearm, and/or elbow.  This condition many times is found in occupations that require repetitive motion.  It is typically referred to as an overuse injury that occurs as a result of repeated strain to the muscles and tendons in the area around the outside part of the forearm/elbow.  It is referred to as "Tennis Elbow" because 40-50% of recreational tennis players will suffer from this problem sometime while participating in this sport.