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9 Things You Should Know About Pain

9 Things You Should Know About Pain


  1. Pain is output from the brain. While we used to believe that pain originated within the tissues of our body, we now understand that pain does not exist until the brain determines it does. The brain uses a virtual “road map” to direct an output of pain to tissues that it suspects may be in danger. This process acts as a means of communication between the brain and the tissues of the body, to serve as a defense against possible injury or disease.
  2. The degree of injury does not always equal the degree of pain. Research has demonstrated that we all experience pain in individual ways. While some of us experience major injuries with little pain, others experience minor injuries with a lot of pain (think of a paper cut).
  3. Despite what diagnostic imaging (MRIs, x-rays, CT scans) shows us, the finding may not be the cause of your pain.A study performed on individuals 60 years or older who had no symptoms of low back pain found that 36% had a herniated disc, 21% had spinal stenosis, and more than 90% had a degenerated or bulging disc, upon diagnostic imaging.
  4. Psychological factors, such as depression and anxiety, can make your pain worse. Pain can be influenced by many different factors, such as psychological conditions. A recent study in the Journal of Pain showed that psychological variables that existed prior to a total knee replacement were related to a patient’s experience of long-term pain following the operation.
  5. Your social environment may influence your perception of pain. Many patients state their pain increases when they are at work or in a stressful situation. Pain messages can be generated when an individual is in an environment or situation that the brain interprets as unsafe. It is a fundamental form of self-protection.
  6. Understanding pain through education may reduce your need for care. A large study conducted with military personnel demonstrated that those who were given a 45-minute educational session about pain sought care for low back pain less than their counterparts.
  7. Our brains can be tricked into developing pain in prosthetic limbs. Studies have shown that our brains can be tricked into developing a “referred” sensation in a limb that has been amputated, causing a feeling of pain that seems to come from the prosthetic limb – or from the “phantom” limb. The sensation is generated by the association of the brain’s perception of what the body is from birth (whole and complete) and what it currently is (post-amputation).
  8. The ability to determine left from right may be altered when you experience pain. Networks within the brain that assist you in determining left from right can be affected when you experience severe pain. If you have been experiencing pain, and have noticed your sense of direction is a bit off, it may be because a “roadmap” within the brain that details a path to each part of the body may be a bit “smudged.” (This is a term we use to describe a part of the brain’s virtual roadmap that isn’t clear. Imagine spilling ink onto part of a roadmap and then trying to use that map to get to your destination.)
  9. There is no way of knowing whether you have a high tolerance for pain or not. Science has yet to determine whether we all experience pain in the same way. While some people claim to have a “high tolerance” for pain, there is no accurate way to measure or compare pain tolerance among individuals. While some tools exist to measure how much force you can resist before experiencing pain, it can’t be determined what your pain “feels like.”Read more about Painand Chronic Pain Syndromes.

The American Physical Therapy Association launched a national campaign to raise awareness about the risks of opioids and the safe alternative of physical therapy for long-term pain management. Learn more at our #ChoosePT page.

Author: Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC

Physical Therapy
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10 Natural Solutions to Ease your Low Back Pain and Stiffness without Medications, Expensive Tests & Referrals


Are you or someone you are living with suffering from back pain or stiffness? About 80% of Americans will experience back pain at some point in their lives, and it can have an impact on many parts of life. It can affect sleep, mood, work and finances, relationships, ability to do housework or gardening, and enjoyment of cherished activities from playing with the grandchildren to playing a round of golf, a game of tennis or going for a run. Many people think of back pain as an inevitable part of ageing or put it down to stress or lack of exercise. They may have been told by friends or even healthcare providers that nothing can be done other than rest and medication.

In this report I share 10 very powerful strategies that I have found to work for many of my patients over the past 15 years. They are in no particular order, but they all work. Without knowing your specific history and root cause of pain I cannot tell you which strategy will work for you, but in trying out some or all of the strategies described you may go a long way in feeling
better and regaining your active and healthy lifestyle and joie de vivre.

10 Natural Solutions to Ease Your Low Back Pain and Stiffness without Medications, Expensive Tests, and Referrals

1. Avoid Sitting For More Than 20 Minutes At A Time

Your body is not designed to spend much time sitting. When you sit there is about 10 times as much pressure pushing down on your spine than when you stand tall. This happens because we tend to slump or slouch, which does not allow the muscles supporting the spine to work efficiently. Even if you do sit up with good posture initially, the muscles supporting your back will fatigue if you sit uninterrupted for more than 20 minutes. This inevitably causes stiffness, aches and pain. Even just getting up and moving around for a couple of minutes regularly can make a big difference.

2. Avoid Sleeping On Your Stomach

When you sleep on your stomach every part of your spine, from the neck down to the low back, is twisted and in the wrong position. Over time, this can cause a lot of imbalances, damage and pain in your spine.

3. Use Ice

Ice is a great tool to relieve an achy or painful back. It decreases inflammation and has a natural local anesthetic effect. So if you feel achy at the end of a busy day apply an icepack to your back for 10 to 15 minutes. You can do this every couple of hours if needed.

You may wonder when to use heat. Heat can be helpful if your back feels stiff in the morning. Applying a hotpack or hot water bottle for 10 minutes can make it easier for you to loosen up.

4. Avoid Carrying A Bag, Purse Or Backpack On The Same Side Every Day

When you consistently carry a load on one side your spine will have uneven pressure on it. Over time this may adversely affect your posture as your spine may curve sideways and cause decreased mobility and pain.

5. Wear Proper Footwear

Wearing high heels changes your posture and increases the pressure going through your back by about 25 times. Also wearing unsupportive shoes including flip-flops and sandals can put extra pressure on your back, hips and knees. Of course this is a cumulative effect that develops over months and years, and often results in pain and stiffness in the 40’s, 50’s and beyond. Just changing your footwear to something supportive that can absorb a lot of the shock going through your body with each step can dramatically decrease the pressure on your back and decrease or eliminate your back pain.

6. Sleep With A Pillow Between Your Knees

If you sleep on your side, try putting a pillow between your knees. While this may take a few tries to get used to, this technique can really help your back as it helps keep your spine in better alignment and decreases the tension in your low back.

7. Maintain Good Posture

Your regular daily activities, if done with poor posture, cause cumulative strain on your back. Tasks such as leaning over the sink to brush your teeth or leaning over the kitchen counter preparing food can increase pressure in your back about 50 percent. If you are standing at the kitchen counter for a while try to put one foot up on a small foot stool or open the cabinet door and step one foot on the bottom ledge to relieve some pressure in your back.

8. Use Your Endorphins

Your body can naturally produce endorphins, which are hormones that can be as effective as pain medication in blocking pain signals to your brain. You can get your body to produce these pain relieving hormones through aerobic exercise such as walking, or relaxation and meditation techniques. There are free guided meditation podcasts and apps available.

9. Try Pilates Or Yoga

These are well established systems of exercises that can help you become more aware of your posture and areas of tension, improve flexibility and increase muscle tone and control through the core muscles supporting your spine.

10. Give Physical Therapy A Try

This tip will provide you with the fastest relief from back pain and stiffness. With back pain, many people focus just on the symptoms rather than the underlying cause. Physical therapists are movement specialists who can determine the underlying cause and help you restore mobility, reduce pain and improve quality of life. Therapy may include manual therapy help you relax tight muscles or loosen stiff and stuck joints as well as exercises to improve your alignment and strengthen your core muscles.

Most people don’t realize how easy it is to get access to physical therapy. You don’t need a referral from a physician, unless you are on Medicare. You will likely be able to avoid expensive unnecessary tests and medications and quickly get back to doing the things you enjoy. Our clinic can help get you on the right track.

For more information contact me at or: 919-402- 0888

7 Simple Ways to Live with Less Neck and Shoulder Pain without Medication


Birgit Reher PT


If you or someone you live with has problems with neck or shoulder pain or stiffness, you know how much that can interfere with your day-to-day life. It may make it difficult to get restful sleep, work at a desk or computer, to do any kind of overhead activities from painting to playing tennis, cause difficulty with lifting up a grandchild or carrying a bag of groceries. Sometimes, what starts with stiffness or soreness in the neck and shoulder area even progresses to a headache. Whether you are dealing with an occasional flare-up or constant chronic pain or stiffness, there is usually something you can do to help yourself feel better and get back to an active lifestyle.
In my experience over the past 15 years I have found some basic interventions that frequently have resolved neck or shoulder issues. In the report below, I have listed 7 helpful tips for you to try to relieve your symptoms and lead a happier and more comfortable and active life

1. Get Up and Move Frequently Throughout the Day
If you work at a desk job or otherwise spend much or you day sitting, take frequent short breaks. Our bodies are designed for movement. In sitting there is about 10 times as much pressure on your spine as in standing tall. Getting up for micro breaks of one or two minutes to take a few steps every 20 to 30 minutes can really help take stress off your spine and make your neck feel much better. If you have to spend much of your day on the phone try to stand up while talking on the phone. Even while sitting try to change your position frequently. If you need a reminder to get up there are free phone apps available that can do that job for you.

2. Actively Relax Tension
Most of us carry our stress and tension in our neck, unconsciously pulling up our shoulders and tightening the muscles around the neck. This can cause pain and stiffness in our neck and shoulders and even lead to headaches over time. Doing a few simple exercises can relieve neck and shoulder strain and tightness. Some examples include: rolling your shoulders up back and down a few times, squeezing the shoulder blades back and down, gently stretching the neck by tilting your head bringing one ear closer to the shoulder or turning your head looking over one shoulder. These exercises should not cause any pain.

3. Avoid High Heels
Wearing high heels increases the pressure through your back and spine by as much as 25 times. It causes changes in the alignment of your neck and shoulders, hips and knees, changing the way you stand and walk. The effect is cumulative over time, so usually by the 40s can lead to neck and shoulder pain or stiffness and low back issues.

4. Avoid Carrying a Bag on the Same Side Every Day
If you carry a bag on one shoulder every day it adds a lot of pressure on that side and cause your spine to curve sideways. Not only will your head and shoulder to be in an altered position, but also your natural gait will be thrown off. Over time, this can damage muscles and joints and muscles on one side will shorten in response leading to stiffness and pain. There are plenty of things you can do to prevent this. Using a backpack with two wide straps to distribute weight is the best solution. If that is not an option, try to at least lighten your bag as much as possible and alternate sides you carry the bag on.

5. Avoid Sleeping on Your Stomach
Sleeping on your stomach causes severe stress on every part of your spine. It forces your neck to be rotated to one side and the low back to arch leading to additional strain and over time and can cause neck, shoulder and back pain.

6. Find the Pillow that Works for Your Body
Sleeping with a pillow that is wrong for you can interfere with your sleep quality and have you waking up with a stiff or painful neck. The pillow you select should keep your neck in a neutral position. If you sleep on your side the pillow should be just the right thickness to fill out the space between your head and mattress without tilting your neck sideways up or down. Therefore, the pillow thickness you need depends on how wide your shoulders are. If you sleep on your back, your pillow should also keep your neck in a neutral position, which means your chin should be neither tipped up or down.

7. Consult a Hands-On Physical Therapist
If you have tried the tips outlined above and still have neck or shoulder pain that keeps you from doing the things you enjoy, seek help from a hands-on physical therapist before pain gets out of hand. A therapist can assess you, treat the underlying cause of your symptoms, and often very quickly relieve your pain. The therapist may also teach you techniques and exercises to help you eliminate your symptoms and get you back to a full and active lifestyle.

For more information or to schedule a visit with a therapist, contact Birgit Reher PT at or call 919-402-0888.

Health Advice Disclaimer
We make every effort to ensure that we accurately represent the injury advice and prognosis displayed through this Guide.
However, examples of injuries and their prognosis are based on typical representations of those injuries that we commonly see in our physical therapy clinic. The information given is not intended as representations of every individual’s injury. As with any injury, each person’s symptoms can vary widely and each person’s recovery from injury can also vary depending on background, genetics, previous medical history, application of exercises, posture, motivation to follow PT advice and various other physical factors.
It is impossible to give a 100% complete accurate diagnosis and prognosis without a complete physical examination, and likewise the advice given for management of an injury cannot be deemed fully accurate in the absence of this examination from a licensed physical therapist at Synergy Fitness for Her.
We are able to offer you this service at a standard charge. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied in this report.


Copyright Notice
©2016 Synergy Fitness for Her-Fitness Prescription LLC
All rights reserved
Any unauthorized use, sharing, reproduction or distribution of these materials by any means, electronic, mechanical, or otherwise is strictly prohibited. No portion of these materials may be reproduced in any manner whatsoever without express written consent of the publisher. Published under the Copyright Laws of the USA by:
Synergy Fitness for Her- Fitness Prescription LLC, 1125 W. NC Highway 54, Suite 404, Durham, NC 27707

Strawberry Coconut Protein Shake


Quick and easy breakfast idea-Strawberry Coconut Protein Shake

Sweet-Strawberry-Smoothie copy

1 serving vanilla or chocolate protein powder
8 oz unsweetened almond milk
1/2 C. frozen strawberries
1 tsp coconut extract
Optional: 1 Tbsp Barlean’s Omega Swirl (or your version of Flax oil, Flax Seed or Chia Seeds)

Yonanas Banana Chocolate Protein Frozen Yogurt




  • 4 small spotted ripe bananas frozen
  • 1 ½ cup of skim milk
  • 1 scoop of Chocolate Protein Powder



  1. Peel and freeze spotted ripe bananas for 24 hours. Mix protein powder and skim milk thoroughly, pour into ice cube tray and freeze.
  2. 10 minutes prior to processing frozen bananas and protein, pull from freezer and allow to begin to thaw.
  3. After 10 minutes, begin by inserting one banana then add frozen protein powder and milk. Continue to alternate inserting the banana and protein cube into a blender.
  4. Stir mixture to evenly distribute texture and flavor.
  5. Portion mixture into 4 equal servings into separate containers for future snacks.

Each serving is 145 calories 27 g carbs 10 g protein and less than one gram of fat. Not bad for something that tastes so good and with no added sugar!


Seeds Community Garden Supply List

seedsNot interested in yoga but want to help with our community organization this month?

Seeds has submitted an extensive list of needed supplies. Donated supplies will be collected in the studio throughout the month of February!

15- pairs bypass-style corona-brand hand pruners (remind them to use our Amazon Smile)

10- pairs holsters for pruners

10- bahaa-brand folding saws (on sale now)

2- corona 1 1/2″ easy-cut Loppers

5- 3/4″ hose shut-offs

5- hose heads

10- weeders

12- nail brushes

12- Small-sized gloves

7 Ways to Avoid Falling off the Healthy Eating Wagon

1. Don’t Starve Yourself

Eating is a basic human need. Cut your calories in half over night or slash any specific food group out altogether for a prolonged period and you’ll land flat on your face in no time flat. When you’re eating for good health, you still need to eat. You’ll just need to go with healthy options and avoid eating more than your body needs to fuel itself through the day.

2. No Excuses

There are as many excuses to fall off the healthy wagon as there are days in a year. So if you’re going to stay on the wagon, you’re going to have to ignore the excuses and focus in on your goal: eating the right stuff. Which brings us to the next way to avoid falling off the wagon…

3. Stay Focused

Being mindful of your healthy eating ways is easy during the first few days. After all, you’ve spent years eating one way and now you’re changing everything up. In a week or so, however, it can be difficult to remember your desire to eat healthily and even harder to remember why you made that decision. Stay focused on your choices and why you made them to stay strapped tightly on the wagon.

4. Get on the Right Wagon

Every person’s health goals and expectations are different. If you hop on a healthy eating wagon for the first time in your life and expect to shed 30 pounds in a week, you’re going to be disappointed. Setting appropriate goals will help you stay on the wagon and help you make the next goal, as your wagon gets easier and easier to ride to the finish line.

5. Avoid Naysayers

Always struggled with your weight? Tried every diet plan known to man without success? Then you’re going to have a lot of folks who scoff at your desire to eat healthily. Let them scoff on their own and find new friends if you have to. Once your lifestyle changes start to pay off, strut by the folks who said they’ll believe you’re serious about healthy eating when they see results and watch their jaws drop.

6. Stay Away from Triggers

The reason healthy eating is difficult for so many is that unhealthy eating tastes so good! Understanding this and understanding when you most want unhealthy food options will help you stay on the healthy wagon. Have a hard time saying no to sweets at your best friend’s house? Invite him to your place or meet at the park. Eat everything in sight when you’re lonely? Give someone a phone call when no one is around.

7. Know How to Get Back On

You should aim to stay on the healthy eating wagon all day every day. But you should also be ready when you fall off. While you can find any number of ways to get back on the wagon, the best is to just do it! Admit you goofed up, recommit yourself to healthy living, and start living the healthy life you deserve once again. hungry

New Year, New You

Talk about It

After a few years of failed resolutions, you may want to keep your plans a secret. But don’t! If your family and friends don’t know what your goals are, you won’t have their support in your journey. They may scoff or snigger when they find out you have big plans for the coming year, but don’t let them get you down. Most likely, they’re jealous. So whether you want to be more committed to your gym routine, eat better, or be more patient with your kids, don’t keep your resolution for a new you to yourself!

Start with Pre-Tests

Next Monday may be when you’ve decided to really begin committing to your new self, but don’t wait that long. Start today with some pre-tests. Once a day, find a way to implement your new lifestyle into your routine. That may mean skipping dessert one night. Or maybe it’s letting your spouse have the remote control. Then again, it could be chewing on a carrot instead of going for a cigarette break when stressed. Whatever it is, scoring these small victories lets you know that you can indeed become the new person in the New Year that you desire.

Expect Success

There’s a reason New Year’s resolutions are the punch line for countless jokes. There are people, however, who beat the odds and stick with their resolutions. This time around, you’re going to be one of them. Not because you’re better than other people who can’t keep from overeating. And not because you’re smarter than people who don’t read a book every month (like you’re planning to do this year). The reason you’re going to succeed is because you want it, and nothing is going to stop you. When you expect success and realize it is possible—which it is—you’re prepared to do what it takes to find that success. Now go for it!

Go for the Right Goals

Before you set a resolution for a new you in the New Year, take stock of your life to determine what would give you the best bang for your resolution buck. Already spending more time than you’d like away from the family? Maybe you should resolve to work your way into a position at work that requires less travel. Thinking you need to lose more weight when all your friends think you’re exceptionally thin? Maybe you should work on adding muscle to your frame instead. Only when you have the right goals can your new you be the best you.

Have Some Fun

Sometimes, creating a new you can be tiring. After all, you’ve spent a lifetime creating the old you, and your old self will not leave without a fight. When your lifestyle changes feel like too much and you’re drooling for ice cream, jonesing for a smoke, or itching to ignore your family and stare at your phone, turn your focus to something fun. Grab a funny movie, go on a hike, hang out with friends—just do something you enjoy! When you’re done, your head will be cleared and you’ll again be ready to shed the old you in favor of the new you in the New Year!

We have just the exercise plan for you – one that will not only help you recover from your holiday indulgences, but will help keep you motivated and going strong in the future.

If you haven’t joined yet, now is the perfect time to start. Together we will get you focused on your goals with my results-driven method.

7 Excuses That Prevent Weight Loss

7 Excuses That Prevent Weight Loss
Have you ever wondered how some people are able to maintain amazing bodies while you struggle with your weight?

They make it seem so easy to achieve and maintain results. What do they know that you don’t? When you boil it down, the answer is quite simple.

The missing link between you and your ideal body is your go-to list of excuses.

Start with an excuse and expect to be excused from losing weight. Here are seven excuses that have ensured dieters will fail in their weight-loss attempts before they ever get started.

Excuse #1: I’ve Always Been Overweight

Here’s a little secret: feeling sorry for yourself will not help you lose weight. Quite the contrary. Whining and crying that you’ve never been thin can actually work against you, as you start to see yourself as stuck being overweight. Do that long enough and all you can see in your future is an overweight you. If you’re going to really cut your weight, you’ve got to be able to envision a lighter you.

Excuse #2: I Worked Out, So I Can Eat Whatever

Working out often makes you hungry. That’s a good thing. You just burned a bunch of calories and your body is looking to make up for them. However, just because you burned a few hundred calories doesn’t mean you get to indulge in any and every food you see. And you certainly can’t eat as much as you want.

Excuse #3: I Don’t Have Time to Exercise

Spend a few days documenting how you use your time. Write down each and every thing you do and how long you do it for. You’ll soon notice how much time you throw in the trash by mindlessly surfing your favorite social media sites and watching television. Transform those times into workout opportunities and toss the time excuse in the trash.

Excuse #4: Exercise Hurts

Some folks are in pain the day after they work out. If this is you and you find yourself feeling like you just rode a horse for three days straight after a workout, the reason is likely that you only hit the gym once a week or every two or three weeks. To get over that uncomfortable soreness after every workout, you’re going to have to go at it at least three times a week. Yes, you’ll still get sore on occasion, but it’ll be an accomplished sore.

Excuse #5: I Love Junk Food

This may seem a hurdle too large to overcome, but if you’re willing to fight for your weight loss, it can be done. To convince yourself that healthy food doesn’t have to be disgusting, spend more time with health-conscious friends who cook and live healthily. Eat what they eat. You’ll be amazed at the wide range of flavors to savor on a healthy diet.

Excuse #6: It’s No Fun Doing It Alone

Then stop trying to diet alone! Grab your healthiest friends and surround yourself with them. When you’re tempted to go off track with your diet or want to skip a workout, call or text your friends for immediate support. They’ll prop you up, remind you of your goals, and encourage you to stay the course.

Excuse #7: My Body Is Delicate

First off, before you start an exercise routine, it’s a good idea to run the idea by your physician. However, unless you have an incredibly rare condition, exercises done with proper technique and eating healthily will not put you at risk for anything but improved health. As soon as you accept the fact that your body can handle much more than you’ve put it through, the sooner you’ll begin enjoying the gym and make better use of your body.

Exercise is a huge part of the equation when it comes to achieving weight loss.