Cartilage Regeneration

The body has an innate ability to heal. What does that really mean? It means that our body produces over 500 billion new cells a day – without conscious direction from us. Cuts heal, broken bones mend, muscle tissue builds, and brain cells, cardiac muscle and, yes, cartilage regenerate!

The key to a healthy healing body is the environment we provide it. Consider your nutrition, how much you move, if you’re getting enough sleep, how you’re managing stress and how aligned your posture is.
If you consistently work on all of these aspects of good health, your body responds. In order for cell production to be optimum, each of these needs to be happening simultaneously. I want to focus on how all of this enables cartilage regeneration, from an alignment standpoint. Maybe you’ve been told your knee (or hip, ankle, wrist) is “bone on bone” and you think the only answer is a replacement. Not true!

Research shows that under the right conditions cartilage can regenerate like any other tissue in the body. The first question to ask if you are told that you are “bone on bone” is why is that joint wearing away? Where did the cartilage go that is supposed to be there? It’s all about the position of the joint and the uneven force going through it as you move. Once the joint position is corrected, the body will produce more tissue to repair itself. Take a look at these before and after x-rays:
Look at the narrow joint space (bone on bone) on your left

One year later after a postural alignment regime. Notice the uniform joint spaces!

Here at Pain Free Performance we watch the way bodies move and stand. We determine if body weight is equal front to back, side to side. We evaluate the position of all major joints looking for proper loading (head over neck, over shoulder, hip, knee, and ankle.) If there is disparity, the body is not functioning properly. There are muscle imbalances causing an uneven force in the joints which creates friction. The friction wears down the cartilage. The joint becomes a victim of the imbalance and bone surfaces begin to wear away. Bone on bone.

What is the remedy? Posture alignment. And I’m not talking about your mom telling you to “pull those shoulders back”. I’m talking about retraining muscles to do the job they are intended to do. Why?…because muscles pull bones. The bones are out of alignment but they are innocent bystanders because the muscles are either doing too much or too little. At Pain Free we unravel what the muscles are currently doing and give you the tools to get them working together again. When the muscles that propel the joints are working correctly again this provides increased blood flow to the area, and allows more movement. And, yes, this gives the cartilage an opportunity to regenerate. It’s not magic but it’s amazing and possible for you too.

Alignment Matters Because Movement Matters

We’re in pain, so we move less. We move less, so we’re in pain.
Which comes first…the chicken or the egg?

When we are in pain it can hurt to move, so most of us stop doing the movement that hurts. Although we avoid the painful movement, we still have to go about our daily tasks. The body will create a new movement pattern to get the task at hand done. The new movement patters ask some muscles to perform in ways they were not designed to, while others stop doing their job altogether. Eventually, the body will break down from the new uneven alignment. We’re in pain so we move less.

We live in a world where we move less and less. We have been marketed a host of gadgets to make our life easier. But, these gadgets make us move less. Think about it. We use remotes to turn on/off our TV’s and open our cars and garage doors; we use back-up cameras to pull out of our driveways. We drive instead of walk. We sit at computers instead of shopping at stores…the list goes on. All of the sedentary things that we do shorten and weaken our muscles. This lack of movement changes our muscle/skeletal alignment which leads to pain. We move less so we’re in pain.

If you’re having back pain, neck pain, knee pain, hip pain, elbow pain it’s probably the result of what we were just talking about. You’re out of alignment. Let us show you how to retrain your body by correcting the muscle imbalances to correct your alignment so that we can get you moving again – without pain. Movement is vital to health. Alignment matters because movement matters.

Movement Challenge

Our bodies are meant to move! Walk, run, jump, kneel, stretch, reach, twist, squat, hang – the more we do these activities, the more aligned and healthier our bodies. You’ve probably heard the “sitting is the new smoking” catch phrase? I want to challenge you to go a step further than just standing up to understand what exactly our bodies need. When we fill our days with the activities listed above, amazing things happen. The movements keep the muscles in our hips elongated; encourage a mobile straight spine, our shoulders fall more easily back into place supporting a strong neck and balanced head.

We’ve got it easy these days compared to our “hunter-gatherer” ancestors. The luxuries that resulted from the Industrial Revolution have presented us with an unforeseen dilemma. With all the conveniences and less to do to get what we need, how do we continue to stay active? The answer I often hear from clients is “I exercise one or two hours every day!” Great! Maybe you’re like me; I love to work up a sweat. I want to be fit. As a former fitness center owner, I cannot imagine not having exercise in my life. I love to hike and kayak with my family. My husband is an avid biker. We exercise, but we need more movement.

After years working in physical therapy, and going on twelve years as a Posture Alignment Specialist, Certified by Egoscue University, I love helping people restore the alignment of their joints, become more functional and relieve their pain. So, you might wonder why I’m talking so much about movement.

Exercise and movement are very different things. Exercise is one important piece of the puzzle – how you move the rest of the day is just as important. Alignment is key. Exercise often works one area of the body through focused repetitive motion. There are great benefits yet at times we are inadvertently compromising other areas of the body. With repetitive exercise we are asking our bodies to function in ways they were not originally designed to function. The body wants and is able to perform with complete range of motion.

When thinking of movement, think of activities more people did generations ago: squatting while harvesting farmland, walking barefoot on uneven terrain, carrying items up and down hills, sitting on the floor. Movement works all parts of the body in the way it was intended to move. Movement is important because it nourishes the whole body by promoting blood flow, improving overall circulation – keeping us strong.

Alignment is important because when you move, the forces that go through your joints determine if your body is functioning properly. Think of your body like a car. If your car tires have worn unevenly, your car will pull to one side. You go and buy new tires and get the car aligned in order for it to drive smoothly. If the muscles in your body are imbalanced, it will create pulls that change the way you move. Correct the muscle imbalances and you improve the function of your body. Improving function means you’re moving better and probably moving more.


The challenge is how to incorporate more movement into our daily lives. Awareness is the key! Just being aware of the amount of movement in your day will help you come up with ways to move more. Stand at your desk and roll your shoulders or do some toe raises. Squat down several times per day to pick things up. Walk on trails or hills rather than sidewalks and wear less rigid shoes for increased foot movement. Sit on the floor more while watching TV and notice how much more you move your body. Next time you take the kids to the park – YOU hang from the monkey bars too! Have fun with it. Challenge yourself. The more you move, the more you can move. Ask us next time you’re in Pain Free and we’ll give you some more amazing ideas!


When we hear about healthy lifestyles from our healthcare professionals, three things are always stressed: eating healthy foods, getting adequate sleep and exercising regularly. As you know, we’re into healthy lifestyles at Pain Free and we talk a lot about total body alignment and movement.

Culturally, we are pretty sedentary with only bursts of movement or exercise adding up to maybe 1 or 2 hours a day. Research is now showing that doesn’t meet our body’s daily movement requirements. THERE IS A BIG DIFFERENCE BETWEEN MOVEMENT AND EXERCISE.

EXERCISE typically consists of repetitive motion in a specific area of the body for a specific amount of time. Think treadmill, for example. Our heart rate’s up, one foot in front of the other over and over. We drive to the gym, walk or run on the treadmill for an hour, then we drive back home or work. What are we doing the rest of the day?

MOVEMENT is leaving our car at home and walking to the store to buy our groceries. Our heart rate is up, we’re working our lower body and utilizing our upper body carrying groceries home. Now, that might not be feasible for all of us but it illustrates how our bodies are meant to function. Even if we can’t walk to the store, we just need to change things up a bit to add natural movement back into our lives.


Begin the day with your Egoscue ecises , take a walk with your coffee, stretch while you read the paper, or step on the trampoline while you watch the news. The more you move, the more your brain will encourage movement throughout the day.

We hear a lot about 10,000 steps. Instead of stressing over a number, seek any opportunity for movement – all types of movement. Park further away, walk to your destinations, take the stairs, work-in a zumba class – whatever you love to do. The movement will add up. Lasting results begin with subtle changes in the way you move through your life!

People ask us if standing work desks are really healthier than sitting. Absolutely! Also think about working from the floor, at a coffee table, on a pillow or in any other way you can imagine. If you can’t do this at the office, try it at home. Stand awhile, sit awhile. The take away is, this encourages your body to respond and move in the way it was intended. Your joints will be more fluid, increase your functionality and keep you moving well for a long, long time!

Why not encourage natural movement while taking care of business? Take a walk down the hall or up and down the stairs while you return phone calls. Your heart rate will increase, your feet will be happy, and your mind will be clear and rejuvenated from this much needed movement break. Stand a stretch every hour or so. Keep moving.

Home after a hard day, maybe you’re planning to catch up on your favorite Netflix series. Instead of plopping on the couch, try the floor. Put your back up against the couch. Cross your legs, or put them straight out in front of you, or pull your knees up to your chest. Better yet, do all of these periodically! Floor sitting allows your hips and knees to bend at angles that are lost in our culture. Using the floor, instead of chairs or the couch, stimulates your muscles to be more flexible, stronger, and more efficient.

It’s not movement OR exercise. While it’s important to know the difference, fill your life with both. As Postural Alignment Therapists at Pain Free Performance, certified by Egoscue University, we teach total body alignment to create your very best function without pain. Incorporate movement in your life the same way. More movement, of all kinds. All of your functional muscles and the resulting properly aligned joints need to be used all day every day in as many ways as possible. Total alignment, total movement, for a totally enjoyable healthy life!


At our clinic, we see several clients a week with scoliosis – a curvature of the spine.  Some people are born with scoliosis and for most it develops in puberty when the muscles can’t keep up with the bones during this intense period of growth.  This muscle imbalance is what pulls the spine into an unnatural curve.  Scoliosis can be very painful and without intervention can worsen.  Our clients with scoliosis have often  tried  everything including bracing, rounds of physical therapy  and even spinal surgery placing Harrington rods in the back in an attempt to correct the curve of their spine.  Despite these methods, they continue to have pain in their body caused by this muscular imbalance.

When Egoscue was developed, the idea was simple: activate muscles to pull the bones into an aligned position. When the body is given the correct stimulus, the muscles will pull the bones into a straight position. When the bones are aligned, the friction on our joints when we move will be decreased. Your spine is subject to the same rules!  By rebalancing the muscles of your back, your spine will load correctly and decrease the curve of scoliosis.

During the initial evaluation, your Egoscue therapist will analyze the curve of the spine by taking photos, palpating the joint position, and completing functional tests to see how the body obtains a specific movement. This will allow your Egoscue therapist to not only feel and see the curve, but also to determine which muscles are overworking and which are not doing enough to align your body and your spine correctly.  Your Egoscue e-cise menu will have a series of exercises designed to activate the specific muscle groups in your body that are needed to decrease the curve of your spine. When your body – including your spine – is aligned and symmetrical it will move with ease and without pain!


Spring in Charlottesville is here and it’s gorgeous out there!  Our clients are enjoying these beautiful days outside in their gardens, resuming their outdoor walking and running regime, or spending their weekends on long bike rides.  Inevitably, they ask us, “I don’t want to tweak my back pain, shoulder pain, neck pain with my activities so are there e-cises that I should do before I….?

The answer is always: YES!

Your Egoscue menu is designed to make your body more functional, and there are specific exercises that should be done before and after you complete an activity.  These exercises will work on correcting and aligning your joints while preventing pain symptoms often associated with that activity.  This will keep the back pain, knee pain, and shoulder pain at bay so that you can do the sports you love! Movement is essential!  We love that our clients want to be active!  Let’s keep your body healthy while in motion!

If you have questions about e-cises for your activity give us a buzz!  Have fun out there!

Back Pain

Last week a wonderful woman came to see me who has been struggling with extreme lower back pain for years. She has stenosis in her spine and has endured several injuries throughout her life. The pain in her back had gotten so bad that she couldn’t even walk without the back pain intensifying.

After evaluating her back pain, in order to see the response of the prescribed Egoscue program in her body, I asked her to walk after completing each stretch or position (E-cises). Watching her gait allowed me to see exactly how her body was responding and as importantly allowed her to feel the changes in her body.  Within ten minutes she had completed four Egoscue E-cises that encouraged the spine, shoulders, and pelvis to be in a better position. As she began to walk, she was overwhelmed with emotion. She couldn’t believe that her lower back didn’t hurt anymore!  This was the first time in years she did not have back pain.

Analyzing her gait, I could see that her shoulders were not as forward, she had increased range of motion in her hips, and she appeared lighter on her feet. As an Egoscue therapist, it is so exciting to see instant changes! While it doesn’t always happen this dramatically, when the E-cises are introduced the body changes.  Back pain is relieved.

In order to keep progressing toward a pain free body, these E-cises must become a way of life. You have to challenge the body as it evolves with new stimuli. You have to be dedicated. Doing the E-cises daily, even for as little as ten minutes, will benefit your body! Your back pain can be relieved.

For some people, the relief of back pain, shoulder pain, hip pain or knee pain might not happen in the first ten minutes, but over time the changes do add up and the pain retreats. The time and energy you’ve invested while doing your Egoscue program will decrease your pain and allow your body to function in the way that you desire! Walking, running, hiking, standing and sleeping without pain are within your reach! This result is emotional for our clients and for us.  Finally being pain free is life changing.  It’s what we do at Pain Free – we are here to help you realize the possibility of life without pain once and for all.



At Pain Free, a frequent topic of conversation is balance. Finding the right balance between work and home, healthy lifestyle and indulgence, and with needed relaxation and activity. It’s challenging to have one aspect of our lives come to the forefront decreasing the energy and care we are able to devote to other vital areas. Our bodies do the same thing! When one area of our body is not functioning correctly, it calls on its neighbor muscle groups to achieve an action. When the neighboring muscle groups continue to help, our body becomes imbalanced.

Do you have shoulder pain? Back pain? Knee pain? This is likely stemming from an imbalance somewhere else in the body. One shoulder or hip could be higher. One foot might turn out, while the other is straight. In order to make the body stable, the left and right side should be a reflection of the other.

So how do we restore balance to our muscles? To the muscles that haven’t functioned correctly in months or years? Restoring alignment to the body involves bilateral movements. Our bodies should be completing movements with both right and left sides of our bodies working in unison. The shoulders, hips, knees and ankles should line up vertically. It is the complex underlying muscle network that pulls the bones and makes proper alignment possible. We want to wake up the inactive muscles and remind them that they have a job to do. We want to quiet the muscles that are doing too much.

That’s what we do here at Pain Free Performance. We assist you in bringing your body back to its original design. Through Egoscue, allow us to bring your body and your life back into balance.

Things I Wish I Explained Better….

I often have a conversation with a client that causes me to think – “Wow, I didn’t do a very good job of covering all the information I wanted to!” There is a lot of information we share with clients and it’s a lot to absorb, especially in the beginning.  We also have such a smart group of people who come to Pain Free Performance, we sometimes assume people know things that they don’t.

Here is a smattering of random questions and topics that come up often and might be helpful as you continue your Egoscue journey toward a pain free body! Clients often ask or say….

Can I resume weightlifting?

At first, NO.  We don’t want to strengthen any misalignments.  When your body is ready, we will give you some pointers on how to start with weights again.  You will be surprised at the “work-out” you will get from your Egoscue!

Can I go to Yoga class? Pilates? Tai Chi? Can I jog?

We are all about getting you back to your fullest most pain free life – whatever you love to do! The easy answer is yes, of course.  Talk with your Egoscue therapist regarding your particular issues and your favorite class or activity to make the most of it!

I twisted my ankle (bruised my elbow, tweaked my back) so I’m just going to cancel my appointment.

No, just the opposite! That’s the perfect time for you to come in – this is what we do – treat people in pain!  So, keep your appointment and have your therapist assess the injury and create a program that will enable you to heal faster and keep your newly aligned body on track!

I may not be doing my E-cises correctly and it made my leg hurt so I just stopped doing the program.

Contact us immediately if you feel that your program is causing any pain. We want to know, ask you a few questions and tweak the program if necessary.

I do my e-cises when I get home in the afternoon ……

Do your program in the morning! I know, I know sometimes it’s just not possible but here’s the thing…if you do your E-cises in the morning, you are setting yourself up to have your most aligned body possible to carry out all of the living you have to do during the day!  This means better function, less pain and less possible injury.  Talk with your therapist about how to adjust your program to fit your schedule.

Don’t cherry-pick from your program – do all of the E-cises in the order only!

The order of your Egoscue program is key. The e-cises are prescribed to either wake up certain muscles that are not doing their job or quiet muscles that are overdoing which creates that pesky misalignment, poor function and pain! Depending on your specific issues, there is an important chain of events that must occur by doing the e-cises in order to get you to the best outcome….which is a pain free body!

Do I have to do everything on both sides?

Occasionally, I have a client who ran out of time, or thought because her pain was on the right side that she’d just do the e-cises on the right side. Not with Egoscue.  We are trying to get the two halves of the body to work together as intended.  What you do to one side, you must do to the other.  It is important for regaining muscle balance, symmetry and healing to do the complete program on both sides.  If you’re often running late, talk to us and we can tweak your program to fit those days that are just too busy!

Do I have to do Egoscue the rest of my life?

Yes, but a very doable, shorter version of your program. It will be as easy as brushing your teeth or bathing…a necessary and desirable habit to maintain your pain free functional body!  When you’re ready, your Egoscue therapist will instruct you on how to continue with abbreviated and rotating programs that will keep you aligned and living life to the fullest!

 Speaking of function….

One of the most important things I want our clients to understand is that our job is to improve the way your body functions. Pain relief is the amazing benefit of having a functional body. Pain is the symptom, not the cause.  When the joints in the body are in the proper position and the muscles are balanced – the pain goes away!



back-pain-picIf you have ever been faced with back pain, you will do anything for relief! You resort to injections, pain medication, even spinal fusion surgery…anything to stop the back pain.  But these options are all just masking the back pain, they are temporary.  To get lasting real results for your back pain, you must uncover the root of the problem – why do you have the back pain in the first place?

Our backs were designed to be flexible and able to carry weight. The time we spend sitting while working, studying, and relaxing greatly reduces the stimulus we are giving our body – and remember, our body is a stimulus response system.  This inactivity causes our back to loose full range of motion.  Muscles that do not move become muscles that cannot move. What happens? Back pain.

Back pain is a symptom of muscle imbalances over time. Your back pain could stem from something being off in the pelvis, over-contracted stomach muscles, or rounding of the upper back.  Whatever the imbalance, creating symmetry bilaterally and vertically restores proper alignment and your back pain is relieved!  That’s what we do at Pain Free Performance utilizing the Egoscue method.  Let us help you relieve your back pain.