Appalachian: How Hips Can Cause Back Pain




INSIDE: • Don’t Let Back Pain Slow You Down! • Exercise Essentials • Patient Success Spotlights • Complimentary Seminars • How Healthy Are Your Hips?




Whether you have back pain or have been suffering for a long time, seeing a physical therapist at Appalachian Physical Therapy, Inc. can help you return to a more active and pain-free life. Give us a call at: • Broadway: 540-901-9501 • Harrisonburg: 540-209-8977 • Pinehurst: 910-215-0541 Whenever you walk, instead of your hips moving naturally, the ligaments yank and pull on the pelvis, which is attached to your spine. This causes inflammation, strain, and pain to the back muscles. Furthermore, the loss of hip motion can even cause your pelvis to tilt, altering the posture of your spine and increasing strain. By improving hip mobility, back pain can typically be relieved quite quickly. When you suffer from back pain, make sure that you have an expert physical therapist look at your movement. Even though your back may ache, it may not be the source of your problem. Call us today to discover how our programs can pinpoint the cause of your pain, relieve it quickly and teach you how to maintain a healthy spine.

Are you like many people, with an aching back at the end of the day? Worried about lifting an object due to your back going out? You are not alone, over 80% of the population will suffer back pain at one time or another in their life according to CDC data. It is the price we pay for walking upright on two legs. However, the majority of back pain is non-specific, meaning that there is not a primary cause, such as a fracture or disc protrusion. As physical therapists, we know that a high percentage of people suffering from back pain have 3 common problems or a combination of them all: • Poor posture • Weak core and gluteus muscles • Poor hip flexibility How tight hip ligaments can cause low back pain Your hip joints have to travel through a very large range of motion. There are thick Y shaped ligaments that surround the hip joints called the iliofemoral ligaments, which provide support. However, with prolonged sitting over weeks, months or years, these ligaments shrink, reducing the natural movement of the hip joints.

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Try these simple tests to see if your hips are causing your back pain. You can easily check your hip motion by doing the following tests. If you discover your hip motion is limited, you feel pain or strong discomfort, it’s time to get your hips checked by our physical therapy professionals. Try these tests and see how mobile your hips are:

Hip Mobility Test • Lie on your back with your legs straight out.

• Cross one ankle above the other knee cross-legged in a figure 4 position. • Keep your ankle pressed on the other leg, but now lower the raised knee to the side. Does it lower close to the ground? • Repeat on the other side and see if there is a difference. • This might indicate a hip motion problem and cause pain in the back or hip discomfort on that side.

Hip Squatting Test • Keep your knees parallel facing forward.

• Squat down as far as you can keeping your feet and heels flat on the floor. • If you feel a lot of pressure in your knees or calf muscles, you could have a hip movement problem. • Try again in front of a mirror. Does your body want to go to one side? This can indicate a hip motion problem on one side.

Discover how our programs transform your pain from a pressing problem to a distant memory, allowing you to live a happy, active and pain-free life.

Call us today to schedule an appointment!


“It is great to have Karen’s help!” “Karen has to be prayers answered. She is one of the few people with the knowledge to help make my life so much better. It is great to have Karen’s help.” - Johnny B, Raeford NC “Hands down the absolute best!” “I’ve had PT for back and knee pain with other clinics, but Appalachian Therapy is ‘hands down’ the absolute best. Ray and his staff are knowledgeable and likable.” - Al M, Pinehurst NC “Worked with me to regain proper balance!” “Great care after each of my three back surgeries. Teri was excellent and worked with me to regain proper balance and gait and knew exactly where to relieve my lingering pain. Pleasant atmosphere and very convenient. Definitely recommend.” - Richard W, Pinehurst NC “Very friendly and courteous environment!” “They listened to my issues and focused on the areas that needed help. Very friendly and courteous environment. I would recommend to anyone that is need of therapy.” - Jerry B, New Market VA

“Not all machine use!” “Appalachian has great caring people that wants to see you improve! Not all machine use!” - Donna G, Harrisonburg VA “Always willing to take the time necessary!” “Attentiveness to injuries and to a comprehensive treatment plan. Always willing to take the time necessary not only for treatment but also for questions and concerns.” - Phoebe R, Rockingham VA “The staff bonds with the patients!” “They care about my issues and work tirelessly to see that they can help resolve what is causing the problem. The facility is always clean. Everyone always talks to me. The staff bonds with the patients to fully understand how to help them.” - Hobert H, Broadway VA “I am no longer considering joint replacement!” “Results! The therapy is giving me enough relief that I am no longer considering joint replacement- and that’s a HUGE deal.” - Lou B, Harrisonburg VA “The office setup is perfect!” “Knowledge and treatment by Adam! He is professional and teaches me about my issues, causes and discusses the plan for my treatment. The office setup is perfect and the entire staff is great.” - Ramona M, Broadway VA

COMPLIMENTARY SEMINARS You are invited to our

Karen Backall, PT will host a Caregiver Training Seminar that will be held Thursday, July 25th at our Senior Enrichment Center. CAREGIVER TRAINING SEMINAR JULY 25TH • 4:00-5:00PM SENIOR ENRICHMENT CENTER • 910-215-0541


Bill Whiteford, DPT & Annie Baker, PT will host a Neuropathy, RLS Seminar that will be held Thursday, August 15th at our Harrisonburg clinic.

If you’re confused about what to do and looking for answers, here’s some of what you’ll learn:

We’ll be reviewing methods and techniques to properly foster those needing reliable care.

We’ll be reviewing many ways to improve pain in extremities and how to combat restless legs syndrome.

Don’t delay! Register by calling or via email at


HARRISONBURG LOCATION: HYPERMOBILITY: September 19th, 7-8:30 pm Presented by Colleen Whiteford, DPT & Lisa Shoaf, DPT. VESTIBULAR: October 15th, 7-8:30 pm Presented by Adam Van Nortwick, DPT & Dan Mills, DPT. BALANCE/FALL PREVENTION: November 14th, 7-8:30 pm Presented by Colleen Whiteford, DPT Register by calling our Harrisonburg office at 540-209-8977 or email at

PINEHURST LOCATION: THE MANY CAUSES OF SCIATICA & WHICH DO I HAVE?: August 14th, 7-8:30 pm Presented by Karen Backall, PT, Ray Metzger, PT & Dr. Teri Walsh, DPT.

WHY DO I LEAK?: September 11th, 7-8:30 pm Presented by Ray Metzger, PT and Dr. Teri Walsh, DPT.

PLANTAR FASCIITIS & FOOT PAIN, & HOW TO NATURALLY SUPPORT YOUR ARCHES: October 9th, 7-8:30 pm Presented by Ray Metzger, PT and Dr. Teri Walsh, DPT.

LOW BACK PAIN – THE MOST COMMON INJURY IN AMERICA: November 13th, 7-8:30 pm Presented by Ray Metzger, PT and Dr. Teri Walsh, DPT. Register by calling our Pinehurst office at 910-215-0541 or email at

SENIOR ENRICHMENT CENTER (PINEHURST) ARTHRITIS: Sept. 26, 4-5 pm Presented by Karen Backall, PT

Register by calling the Senior Enrichment Center, on 15-501, Moore County at 910-215-0900 or email at


ARTWORK AT THE OFFICE The next part of the examinationwas not exactly finalized by the timewewere ready to proceed. In true Italian fashion it came together about 30minutes later, while those of us being testedwatched the examiners scramble to get things in order. It was another case presentation but on paper, and we had to demonstrate the steps for recording and completely treating the patient in the FM ® method. This timemy examiners were four Italian men, and they seemed to argue with each other in Italian as much as they pummeled me with questions in English. It was not a calming environment. I did the best I could and felt okwithmy responses, but they kept pressing formore information which made me wonder if I had missed something. After I gave them one more point Hard to believe a year has passed since I wrote about my first trip to Italy in pursuit of Fascial Manipulation ® (FM ® ) certification. Now I am just back frommy second quest, this time for certification as an instructor. It was another good, busy trip with little time for rest or recreation. Like last year, people came from all over the world with a handful of us from the US. It was great to attend such a gathering and actually know a lot of people! Many were there last year, and it was fun to reunite. We all stayed busy with classes, certification, instructor testing, and the one-day Fascia Congress. The class I participated in this year was on Acupuncture and FM ® , comparing the two approaches. I knew they had a lot in common but wanted to learn more. It was pretty amazing to see the correlation of the fascial tissue lines with the meridians. I came away from it with a much broader appreciation for traditional Chinese medicine, of which acupuncture is a component. There were a lot of Chinese participants in the room, listening via translator. It got a little crazy when there was a demonstration of evaluation and treatment by a Chinese doctor. The doctor spoke Chinese only, so a young Chinesewoman translated her comments to English for all of uswatching. The patient spoke only Italian, so another translator interpreted her remarks in English. Sometimes they got a little tangled up as to whose turn it was to talk or translate, but overall they did an admirable job! The evening of the last day of the course came quickly and it was examination time. There were three of us testing to be FM ® instructors: Ferdinand from Spain, Christina fromAustria, andme. The first part of our examwas treating a patient while two other instructors critiqued us. It was not fabricated or acting - they gave you an actual patient with a problemand you had 45minutes to evaluate and treat them. I hoped and prayed for an easy, English-speaking subject and got neither. Micalawas pure Italianwith lots of problems and injuries. Fortunately I was able to sift through the history, formulate a plan, and treat him all in the allotted time (wish I could be so punctual in the clinic… must have been the adrenalin). Afterwards came themoment of truthwhen one ofmy examiners asked Micala how much better his wrist was with my treatment. I waited nervously until his response of “80%” made me shout a silent hallelujah!

that I would treat on the patient the lead examiner, Stefano, shouted out, “It’s enough! I don’t need tohear anymore!” I wasn’t exactly surewhere that leftme, and as I got up and started to leave I askedwhen I would know the outcome. He looked atme kind of funny and said, “You don’t know? Of course you passed!” It was awet noodlemoment. Later, in true Italian fashion, they toasted us with Prosecco, hugs, and well-wishes in Italian. It’s still kind of surreal that it’s behindme now, but I have the certificate hanging on our fridge to prove it! I don’t really knowwhat to expect with teaching courses at this point. InPoland there is a three year waiting list for an FM ® course– they are that popular and well received. But in the US things are a bit slower to catch on. I’mhopeful that people will come to appreciate the great tool that FM ® is for treating an incredible array of problems, and want to be trained in it. In themeantime I’mgoing to enjoy a temporary reprieve from intensive studyingand testing, andmaybea littlemoreProsecco too! Ciao!

Juanita “Winnie” Higgins Winnie Higgins was born and raised in Southern New Jersey and at the age of 90 came to Virginia to live with her daughter. She paints mostly in acrylic but does work with watercolor and colored pencil from time to time. She has won numerous awards both county-wise and state-wise in New Jersey, has taught classes in acrylic painting and judged several exhibits for the Federation of Womans Clubs USA. Her artwork will be exhibited at our Harrisonburg office July 29 - September 25. Open house at our office with light refreshments will be held July 31 from 6-7:30 pm. Come by meet Winnie and see her work!

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EXERCISE ESSENTIALS Try these exercises to keep you moving...

HIP FLEXION AROM - BENT KNEE Strengthen your hip by first standing with good posture. Lift one leg up. Return to the start position with control.

age 1 of 1

Exercises copyright of

Strengthens Hips

good posture

HIP ADDUCTOR STRETCH (LATERAL LUNGE POSITION) Stand with good posture Lift knee high Improve the strength and coordination of your hip muscles. Begin in the side lunge position as shown. Your leg should be out to the side and slightly behind you, both feet flat on the floor. Keeping your back straight, lunge deeper to the side until you feel a stretch along the inside of your leg. Lift knee high


ind you, both

Stretches Hips

de until you

Lunge to side - You should feel a stretch on the inside of your leg

Always consult your physical therapist or physician before starting exercises you are unsure of doing.

e - You should feel a stretch on the inside of your leg

Why You Need To Come In For Another Check-Up:

� Move without pain � Bend and move freely � Balance confidently & securely

� Sit for long periods comfortably � Walk for long distances � Live an active & healthy lifestyle

Back against wall , feet one stride length from wall

Squat until legs bend 45 degrees


0° wall , feet one th from wall

Squat until legs bend 45 degrees

BROADWAY CLINIC 540-901-9501



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