Spinal Stenosis Treatment in Goose Creek, Mount Pleasant, and Charleston

At Joints in Motion, we have treatmed many patients with the condition of lumbar spinal stenosis. In fact, it is one of the most common reasons for back pain in those over 60. Unfortunately, it is also the most common reason patients get low back surgery https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2913862/, but surgery does not always have to be the answer. A 2015 study showed that physical therapy and lumbar surgery produced similar outcomes in pain and function after 2 years! https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252248/ .Weighing treatment options can be tricky when dealing with back pain and sciatica. Those that have stenosis know how debilitating it can be, but there is good evidence and hope that a well designed physical therapy program can prevent low back surgery . 


What is lumbar spinal stenosis?

Lumbar spinal stenosis is a narrowing of the spinal canal which is the space where the lower part of the spinal cord exists. When this space narrows, it will cause crowding around the nerves in your lower spine. Nerves like space, so this crowding can cause sensitivity in the nerves.  This narrowing can occur for various reasons, but the most common is age related changes. When we age, our bony surfaces become rougher and form outcroppings that can encroach on the spaces where our spinal nerves run. Lumbar spinal stenosis is a diagnosis that is made with both clinical and imaging information, meaning the symptoms you have combined with MRI and radiographic findings are needed to make an accurate diagnosis. This is because MRI and x-ray findings of stenosis occur in people who have no back pain or leg pain. In fact, 50% of people over the age of 60 will have these changes in their spine upon imaging, however, only a fraction of them will have pain and other deficits.  

What are the symptoms of stenosis?

People with this condition may or may not have back pain. The thigh and leg pain is what stands out in this condition. Burning, numbness, pain, and tingling are all commonly reported. Sometimes, it is even challenging to describe the feeling in your legs. Symptoms are typically located in the buttocks, thighs, lower legs, feet, or all of the above. One or both legs may be involved. One leg may be worse than the other. Typically symptoms will become more intense the longer the person stands or walks. Relief is felt with sitting, bending forward, or leaning on an object like a desk or shopping cart. 

How can physical therapy help?

“How is a physical therapist going to change what’s going on in my spine?” This is a frequent question I get asked when treating lumbar spinal stenosis. A physical therapist is not going to change the bony anatomy of your spine and they are not going to reverse any age related changes that happen in all human spines, but they are really good at dosing an exercise program that will allow the spine and nervous system to adapt. We already know that there are plenty of asymptomatic people out there with imaging that shows they have stenosis, so the idea is to not change the anatomy but to change the symptoms. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3775665/


The nervous system can adapt over time.  A physical therapist will help you gradually progress towards an activity or goal that you want to achieve. An example of this can be seen in a patient I have worked with recently. She is a person that puts a high priority on exercise, in fact she makes it a point to exercise every morning, and she had been doing so for years. Her favorite forms of exercise are walking and elliptical. Gradually she started to notice left leg burning and pain when on the elliptical. At first, she ignored the burning thinking it would get better. When the pain continued, she stopped going to the gym altogether.. She was scared that exercise was only making her problem worse. When she came to see us, the last thing I wanted for this person was for her to give up her exercise habit. When we evaluated her, we found certain exercises helped alleviate her leg pain in the short term, but we also came up with a plan to build back her tolerance to walking and elliptical training without giving up her daily exercise routine. We substituted elliptical for a NuStep and walking for a rowing machine. She was able to get the same calorie burn with these two substitutes without increasing her symptoms. In PT, we worked on her leg and hip strength as well as her hip and back flexibility. We gradually built back her tolerance to walking, elliptical, and other upright exercise. Slowly we added walking and elliptical back into her exercise routine until she was able to reach her goal of 30 minutes per day! 

Lumbar spinal stenosis is a difficult condition to live with, but it can be treated and managed without surgery in most cases. Physical therapy is a great treatment option and should be strongly considered if you have been diagnosed with this condition. 

Exercise Examples for Lumbar Stenosis

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exercise for stenosis


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exercise for stenosis exercise for stenosis exercise for stenosis




If you are looking for frozen shoulder treatment in Charleston, Goose Creek, or Mount Pleasant, the information below will help you make a better decision, as well as help you avoid unnecessary and expensive healthcare treatment !!!!

“My arm just keeps getting stiffer”.  “I can’t raise my arm over my head”  We hear patients describe these symptoms on a daily basis.  Often they have been diagnosed with a frozen shoulder or in medical jargon, Adhesive Capsulitis

What is Adhesive Capsulitis or Frozen Shoulder?

The shoulder capsule itself surrounds the glenohumeral joint, or shoulder joint, and is comprised of a type of cartilage called articular cartilage.  A frozen shoulder is a condition characterized by inflammation and irritation of the capsule which often results in pain and a loss in active and passive motion at the shoulder.  Typically, adhesive capsulitis will not occur immediately following a traumatic event or injury.  Instead, it often occurs in three separate phases.

The Phases:

The first phase is known as the “freezing phase,” and usually involves significant pain which is often worse at night.  In this phase, the individual may have zero or only minor ROM (range of motion) loss.  Consequently, many people do not seek out treatment or help in this phase.  This is unfortunate circumstance because seeking treatment during the early freezing phase may help to minimize ROM loss down the road and lead to faster recovery.  The “freezing phase” can often last multiple months.

The second phase is known as the “frozen phase.”  At this point, pain may persist, but both active and passive ROM begins to decrease quickly.  This loss of ROM commonly occurs in a what is known as acapsular pattern with certain motions being more restricted than others.  Each joint in the body has a unique capsular pattern.  In the glenohumeral joint (the ball and socket at the shoulder), the capsular pattern is external rotation/reaching back for a seatbelt (typically limited the most), abduction/reaching out to the side, followed by limitation with internal rotation/hand behind back movements.  The frozen phase is commonly when adhesive capsulitis is diagnosed due to the significant loss of ROM during this period.  Pain may still be present, but generally lessens, especially toward the end of this stage.

The final stage is known as the “thawing stage,” and is characterized by decreased pain and improvements in motion.  However, depending on the severity of limitations as well as when treatment was sought out after the initial onset of symptoms, research has found that in some people, deficits from adhesive capsulitis may last from 6+months up to multiple years.  This illustrates the importance of seeking treatment when these symptoms first appear.


Causes of Frozen Shoulder?

The overall prevalence of adhesive capsulitis has been reported to be between 2% and 5% of the population with females, as well as individuals over 40-50 years of age being at the highest risk.  In addition, research has shown that people with diabetes are at increased risk for adhesive capsulitis with the incidence being 20% of the diabetic population. The cause of adhesive capsulitis is often unknown or without a specific cause.  In other cases, the cause can be an injury or trauma that leads to disuse of the arm and decreased range of motion associated with this condition.  This can include trauma following surgery, as well as general shoulder strains/sprains to the muscles of the shoulder.


Treatment for Adhesive Capsulitis:


Treatment for adhesive capsulitis can be surgical or conservative depending on the severity of pain and limitations as well as duration of these limitations.  Surgical treatment may include manipulation under anesthesia in which the M.D. will move the patient’s arm passively into end ranges of motion.  Another surgical option is a capsular release.  Typically these treatments are utilized after conservative treatment has failed.  Conservative management can include corticosteroid injections into the shoulder to help manage and reduce pain/inflammation as well as physical therapy to strengthen and restore mobility to the involved shoulder.  Excellent  outcomes for adhesive capsulitis are often achieved through PHYSICAL THERAPY which is why physical therapy is considered the first and best coarse of treatment.

What To Do First- See One Of Our Adhesive Capsulitis Specialists In Charleston, Goose Creek, and Mount Pleasant

Physical therapy for adhesive capsulitis follows a general progression in which pain and mobility deficits are typically addressed first.  Manual therapy techniques including joint mobilizations, soft tissue mobilization to address tissue restrictions, as well as passive and active stretching are essential during this time in order to help return normal functional motion in the shoulder.  Joint mobilizations work to stretch the shoulder capsule as well as to help mobilize soft tissue restrictions around the shoulder.  While restoring motion in the shoulder, it is also particularly important to address any weakness in the shoulder girdle.  Adequate shoulder strength can help improve shoulder stability, maintain newly gained ranges of motion and help prevent future injury.

How Will Your Frozen Shoulder Specialist in Charleston, Goose Creek, and Mount Pleasant Treat This Condition?

In general, therapy for adhesive capsulitis lasts anywhere from six weeks to six months depending on the severity of the patient’s limitation.  Treatment will always vary as per the individual but will often include:

  • A Thorough Initial Evaluation
  • Patient Education
  • Stretching
  • Hands On Soft Tissue and Joint Mobilizations
  • Patient Specific Exercises


If you have any questions or feel like you may be experiencing shoulder pain or mobility loss, please feel free to contact us at Joints In Motion Physical Therapy and Wellness.  Our phone number is 843-793-4466.  Thank you for your time.

Chronic Pain Specialists In Charleston

Do You Struggle with Chronic Pain or Been Diagnosed with Fibromyalgia, and live in the Charleston, Goose Creek or Mt. Pleasant Area?  This Information May Benefit You: 

Do you feel like pain is something you struggle with on a daily basis? Have you dealt with pain for a long time and no matter how hard you try it does not get better and it hurts to move?  Are you afraid of being active because you may make your pain worse?  If you have dealt with pain for longer than 3 months your pain is considered chronic.  Other words your doctor may use are Fibromyalgia or Central Sensitization.  When pain becomes chronic our brain and our body can actually start to respond to pain differently which causes heightened pain sensitivity also called “Central Sensitization”.  Our body can actually become used to pain whether the initial stimulus for the pain is there or not and this can lead to issues often associated with Fibromyalgia.  

What Is Pain and Why Do We Have It?

Let’s talk about what pain is.  Pain is our body’s defense mechanism to prevent harm to our body.  If we touch a hot stove, our brain sends a pain signal to our hand in order for us to pull our hand away so we don’t get severely burned.  Pain is what prevents us from doing damaging things to our body.  However, if we are in pain for a long time our brain can remember this and start to send a pain signal to that part of our body without needing a harmful stimulus.  Because of this our threshold for pain is lowered and little to no movement is required to cause pain.  As a result, we start to move less, and then even less movement is required to cause pain, and a vicious cycle starts.  

Something Can Be Done to Help Improve Your Pain:  

However, there is good news!  Evidence shows that moving can actually start to reverse this cycle.  Ten minutes of aerobic activity a day has been shown to increase endorphins which act to combat pain symptoms and calm pain down.  Getting moving can also improve mood and overall health which can contribute to decreasing pain.  

A lot of what we know about getting moving has a lot to do with the nervous system which includes the brain, spinal cord and all the nerves that feed out of the spine to our extremities.  Nerves require a lot of blood and oxygen compared to how much of your body it takes up.  We can feed this need through aerobic exercise which increases blood and oxygen flow.  Studies show that when people run for 6 miles the body releases the happy hormones equal to 10 mg of morphine (Janal MN, Colt EW, Clark WC, Glusman M. Pain sensitivity, mood and plasma endocrine levels in man following long-distance running: effects of naloxone. Pain. May 1984;19(1):13-25. https://pubmed.ncbi.nlm.nih.gov/6330643/ ) which is 5 times the normal dose you would receive at the hospital to mitigate pain.  Aerobic exercise is also known to improve sleep, decrease pain, improve oxygenation in our brain and decrease anxiety and depression.  We start to see positive effects of exercise with as little as 10 minutes of getting our heart rate up. 

Not only does moving more help to calm down our nervous system and reduce pain, it also teaches our body that it is not dangerous for us to move.  As we move more we can start to increase our threshold for pain again and decrease pain sensitivity.  

We Are Specialists In Treating Chronic Pain and Fibromyalgia In Charleston, Goose Creek, and Mount Pleasant

Physical can successfully help treat individuals with chronic pain and fibromyalgia .  If you are in pain and feel like you need help to start moving again, we can help.  With a physical therapy evaluation we can look at movement patterns and contributing factors to pain.  We can specifically address your contributing factors to pain with hands-on treatment and guided exercises.  Pain is not something to ignore but it is something that you can work through with guidance to get you back to a place where you can move more with less pain.  

Give us a call at (843) 793-4466 or Click Here to contact us

Introducing RunHab Charleston

Important Announcement Time!

If You Are A Runner In Charleston, Goose Creek, or Mount Pleasant We Are The Running Experts You Need To SeeAq

We have a new program at Joints in Motion that is geared specifically towards runners.  We call it Runhab Charleston!  As part of the Joints in Motion Physical Therapy and Wellness, Runhab Charleston serves active people who run for a sport, career or leisure. Our team of sports rehabilitation specialists can help you prevent injury, return to sport or improve run performance.

Runhab Charleston was created for runners by runners.  We are physical therapists who take a performance based approach to help you achieve your running goals.  Our mission is to use evidence based treatment methods to help new runners get started on the right foot (pun intended) and help experienced runner’s reach peak performance.  We look at your strength, mobility, and running form in order to guide treatment and help you reach maximum potential.

Who Are Your Running Specialists in Charleston, Goose Creek, and Mount Pleasant?:

We are runners like you!  Our team consists of highly experienced, residency trained and board certified physical therapists that specialize in running injuries.  Our running specialists participate in extensive continued training and utilize the best available evidence to optimize your running.

What to expect when coming to Runhab Charleston:

  • We start with a thorough interview to determine your running experience, injury history, and future training and racing goals.
  • We then perform a mobility and stability screen in order to determine limitations that may affect running performance and cause injury.
  • We do a video gait analysis where we analyze running form and data points that may be indicative of increased injury risk or decreased efficiency.
  • Finally, we develop a comprehensive plan to address issues identified in our exam in order to keep you on the road and performing at your best.

How We Serve The Runners of Charleston, Mount Pleasant, and Goose Creek:

  • Comprehensive running analysis including history, movement screen, gait analysis, home exercise program.
  • Running gait retraining
  • Individualized running performance plans
  • Return to running program
  • Training plan review
  • Coaching

How to make an appointment: 

To make an appointment at Runhab Charleston, please call 843-793-4466 or Click Here To Find us

We look forward to working with you and continuing to serve the Charleston community.  Every runner is unique and we believe we have the skillset to help you achieve your goals and keep you on the road running.  Come see us today!

Plantar Fasciitis Treatment in Charleston, Goose Creek, and Mount Pleasant


If you are looking for plantar fasciitis treatment in Charleston, Goose Creek, or Mount Pleasant, the information below will help you make a better decision, as well as help you avoid unnecessary and expensive healthcare treatment !!!!

“I feel a knife in the heel of my foot when I first wake up”.  This dreaded sentence is heard by physical therapists all over the world and is even more commonly heard at the beginning of the year or when the weather starts to get warmer.  I speak of course about plantar fasciitis (PLAN-tur fas-e-I-tis).  A diagnosis that is not often pronounced correctly but is very often seen in our physical therapy clinic.  We see it at the beginning of the year and when it gets warm because that is when people start to increase walking and/or running for exercise.

What is Plantar Fasciitis and What Causes It

The plantar fascia is a thick band of tissue that runs along the bottom of your foot.  It starts at your heel and will branch off to each toe.  Plantar fasciitis is an inflammation and irritation usually caused by excessive stretching or small tears in that thick tissue.  This happens when the tissue is tight or restricted but is then forced to expand or splay out with weight bearing.  Picture the plantar fascia like a parachute when the foot is pointed down and then fully stretched out and straight when the foot is pointed up.  If your foot is constantly pointing down (e.g., tight calves, wearing high heels, or sitting with your feet dangling in a chair) then the plantar fascia is always shortened in that parachute state.  Then a person stands up with shortened fascia and the tissue is forced to stretch quickly.  This is why the most common symptom people will experience is the previously mentioned stabbing pain when people get up from sitting or lying down for prolonged periods.

Causes of plantar fasciitis include:

  • A rapid increase in physical activity
  • Repetitive motions like distance running
  • Limited flexibility of the gastrocnemius and soleus muscles (your calf muscles),
  • Poor arch support and/or excessive foot pronation
  • Overweight patients are also more likely to develop plantar fasciitis
  • Occupations that require prolonged standing

Usually when we see a patient with these symptoms, they have been present for a year or more and it is now a chronic problem.  It is unclear why people with foot pain feel it is alright to deal with this for so long, but please understand when a condition becomes chronic it takes much longer to treat.  Clinically, the most common signs we see are tenderness to touch at the bottom of your heel, limited range of motion at your ankle and big toe, and often poor shoes.  Luckily, when you know what to look for to recognize plantar fasciitis you then have a path to treating it.


Physical Therapy First is Proven to Help

There are a numerous options for the treatment of plantar fasciitis.  We are strong believers of natural, conservative, hands-on treatment and clinical research support our view: 

The guidelines present evidence that strongly suggests a combination of manual therapy and rehabilitative exercises to help patients with this foot condition. In a study published in the February 2017 issue of JOSPT, researchers reviewed the records of people with plantar fasciitis who were sent to physical therapy. The results of this study support prior studies that show faster recovery time for those who receive evidence-based physical therapy for their foot pain.

Reference: https://www.jospt.org/doi/full/10.2519/jospt.2017.0501

Treating plantar fasciitis is not often completed in a straight line. There are hills and valleys to recovery which can be frustrating.  Despite this, research has shown that there are proven strategies that will help to take away your pain.  At the top of this list- STRETCH YOUR CALVES.  Improving calf muscle tightness will improve your ability to point your foot up and will consequently decrease the time your plantar fascia is shortened.  If you do nothing else…STRETCH YOUR CALVES.  After that there are many other things that can be done. For many a night sock or night splint can be helpful.  These splints help to keep your foot in neutral or pointed up while you are sleeping.  This helps to avoid the prolonged shortening of the plantar fascia and will thereby decrease the symptoms experienced when your plantar fascia is stretched upon getting up out of bed.

What to Do First – See One of Our Plantar Fasciitis Experts in the Charleston, Goose Creek, and Mount Pleasant areas

In addition, from activities you can do at home there IS value in seeking consultation from a physical therapist.  As movement specialists we can identify the source of your issues.  Our treatment plan will often include hands on care to improve mobility at the foot and big toe, taping to unload the plantar fascia, ensuring that you are in the proper shoes, and prescribing exercises specific to your issues.


  • No waiting – In most cases, you can see us right away.
  • No side effects – In most cases, the treatment we provide has little to no side effects and can make you feel much better
  • It’s more affordable – an average course of treatment
  • Seeing one of our physical therapists within 14 days means you’re not likely to need additional care, special tests, injections or surgery
  • Seeing one of our physical therapists first means you are less likely to need addictive opioid drugs

How Will Your Plantar Fasciitis Specialist in Charleston, Goose Creek, and Mount Pleasant Treat This Condition?

Your treatment plan depends on what we learn during your initial evaluation but often includes the following:

  • Slight changes to your daily activities
  • Stretching
  • Education to avoid aggravating activities
  • Hands-on soft tissue and mobilization techniques, and
  • A home exercise program

Plantar fasciitis can be a real pain in the neck, or at least the foot, but it is not something you have to deal with forever.  If you are experiencing that stabbing heel pain when you get up in the morning, please call us at (843) 793-4466 or find us at https://www.jimptw.com/contactus/.  We look forward to helping in any way we can



Adam Smith, PT, OCS

Joints In Motion Physical Therapy and Wellness