Do You Really Need an MRI for That?

November 27, 2024/in Movement/by Carrie Jose

Possibly the number one question I get from clients on a daily basis is…

“Should I get an MRI for that?”

Hey… I get it… you’ve got pain that won’t go away and you want to see what’s going on inside… why not?

Not so fast!

What if I told you that getting an MRI too soon (or when you don’t even need one) can actually lead you to getting unnecessary procedures, or even surgery!

Don’t get me wrong…

MRI’s are an amazing advancement in medical technology that have saved many lives. And if you’ve had trauma – like a major fall or accident – or you’re exhibiting symptoms that we call “red flags” (progressive/serious neurological deficits, bowel and bladder issues, unrelenting/unexplainable pain) – then you want to get an MRI. But when it comes to musculoskeletal pain (back, neck, knee, hip, shoulder, etc) – again – unless you’ve had a major fall or trauma – you typically DO NOT need an MRI.

Let me explain…

When it comes to musculoskeletal pain – 80% of the time it’s what we call “mechanical” in nature. That means it’s due to the way you are (or aren’t) moving. For example, let’s say you’re suffering from low back pain and terrible sciatica. Most people in this situation want to get an MRI. And it will reveal anything from a bulging disc, to stenosis, to arthritis, to degenerative discs. Whichever one of these “ailments” shows up on your MRI will typically get blamed as the source of your problem. From there – you’ll typically be prescribed some type of procedure (or surgery) to “fix” said ailment.

Sound familiar?

Well… here’s the thing… research has shown over and over that these so-called ailments appear in the MRI’s of just about everyone over the age of 50. In a 2015 study by Brinkjiki et al – they did MRI’s on over 3000 people who had NO back pain. And you know what they found? For people in their 60’s – they found that 70% of them had disc bulges – 88% had disc degeneration – and 50% had facet degeneration (something you often see with arthritis). And as the age groups increased – so did these ailments!

The meaning of this and other studies like it is profound…

It means that you absolutely can NOT rely on your MRI to diagnose your problem.

It also means that many people are getting procedures on these normally occurring structural ailments when it’s not even the root cause of the problem.

So what IS the root cause of the problem?

Typically – it’s “mechanical” – meaning your problem has to do with the way you move, bad postural habits learned over the years, muscular and joint imbalances, or “wear and tear” issues. It’s also why we tend to see more mechanical problems show up in people once they hit age 40 and beyond – because these problems take awhile to manifest.

Although the pain you experience may be coming from one of those ailments we spoke about earlier (for example – a bulging disc irritating your nerve route – a meniscus tear irritating your knee when it moves) – the root cause is how your movement habits are irritating the structure. When you fix the movement problem – the structural issue becomes irrelevant – at least 80% of the time.

If you’re confused – I don’t blame you.

Most medical doctors are not trained in what mechanical pain truly is or what it means. They are trained to diagnose problems using images such as Xrays and MRIs. Nothing wrong with that of course – but it can become a problem when you do an MRI too soon – without first ruling out if your pain is due to a mechanical cause.

If you’re currently suffering from back, neck, hip, knee, shoulder, ankle pain, etc… and you’ve been told you need an MRI to “figure out what’s going on” – hold that thought!

Why don’t you first consult with a mechanical pain specialist. There’s an 80% chance your problem will fall into this category. And you can save yourself from unnecessary treatments that might not work.

You can talk to one of our mechanical pain specialists for free by clicking HERE. It’s a completely free, no-obligation appointment that will give you all the information you need to make the best decision for YOUR health – whether that’s working with us or not!

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Pain Expert, and owner of CJ Physical Therapy & Pilates in Portsmouth, NH. To get in touch – or inquire about getting help – CLICK HERE or call 603-380-7902

Six Ways to Keep Your Thanksgiving Festive and Fit

November 21, 2024/in Movement/by Carrie Jose

Thanksgiving is one of my absolute favorite Holidays.

I love all the food, sweets, time with family, the Macy’s Day Parade, afternoon naps, and football. While it’s historically been a time for indulgence and relaxation, more and more people are opting for a more active and healthier Thanksgiving Day.

And there are numerous benefits for doing so…boosted mood and energy levels, improved digestion, happier joints (hips, knees, back, neck, shoulders), and you’ll offset some of the extra calories you may have consumed.

If you’re looking to have a festive, but perhaps more fit Thanksgiving Holiday this year – read on for seven tips and ideas:

1. Practice Mindful Eating

You can still enjoy your Thanksgiving meal – but simultaneously support your health and digestion – with mindful eating. Mindful eating is the practice of paying full attention to the experience of eating and drinking. It involves slowing down, savoring each bite, and tuning into your hunger and fullness cues to create a more enjoyable and intentional eating experience.

Studies show that eating slowly and savoring each bite can reduce calorie intake by up to 25%, as it gives your brain time to register fullness. Mindful eating also improves digestion because it promotes thorough chewing and reduces overeating, which can lead to bloating and discomfort.

Instead of piling your plate first-thing, focus on tasting each dish, and enjoying every moment of your feast.

2. Interrupt your sitting.

Hopefully after you’ve practiced mindful eating – you won’t feel so full – and will be less inclined to slump on the couch. But full or not, our bodies weren’t designed to sit for prolonged periods, so getting up frequently is an easy way to not only incorporate movement throughout your day, but to help keep away lower back and joint stiffness. I recommend standing up once every 30 min. This could be a fun “job” to give a young child at your Thanksgiving table. Make them accountable for watching the clock and remind you to stand up. Interrupting your sitting is possibly the easiest and most effective strategy to keep your knees, hips, and spine from getting painful and stiff on Thanksgiving Day.

3. Sign up for a Turkey Trot

Thanksgiving Turkey Trots are a popular event in most towns and it can be a really fun event for the whole family. Turkey Trots are typically 5K’s – or 3.2 miles. If you’re not able to sign up for an actual race, grab your friends and family and create your own Turkey Trot within your neighborhood. This is a great way to get your blood flowing and joints lubricated first thing in the morning. Plus, morning exercise kickstarts fat oxidation and can keep your metabolism elevated for hours afterwards – so this is a great way to energize your body while also balancing Thanksgiving Day indulgence.

4. Be Active during Commercials.

Whether it’s the Macy’s Day parade, football, or both – it’s easy to find yourself lounging for hours on a soft sofa or recliner – which can wreak havoc on your back if you’re not careful. A very easy way to keep yourself from sitting or slouching too much, and to incorporate some healthy movement into your day, is to get up and do something active during commercials. It’s the perfect opportunity to do a quick 2 min exercise or stretch – and it doesn’t have to be complicated. Choose from a quick set of squats, heel raises, planks, or back stretches. And make it fun. Get a plank or squat competition going with your most competitive family members – you know who they are.

5. Walk your Dessert Off

While skipping dessert is of course an option – you can also choose to walk it off. Opting for a post-meal walk has many benefits (even if you already did a Turkey Trot in the morning). It aids digestion, helps regulate blood sugar levels, and it’s good for your hips, back and knees. Plus – a post-meal walk is an opportunity to get some much needed lengthening and stretching of our muscles and joints after being parked in a chair for any length of time. Walking also happens to be one of the best and most natural exercises you can do for yourself – but it’s especially great to do after a big meal like Thanksgiving – and before you settle in for the evening.

6. Stay hydrated

Staying hydrated is important all of the time – but especially on a day like Thanksgiving. Good hydration will help regulate your digestion, which is particularly important given the heavy and often rich foods we typically consume on this day. Plus, water aids in breaking down food, allowing for better nutrient absorption and preventing digestive discomfort.

When it comes to appetite, we often mistake thirst for hunger, so when you stay hydrated (especially prior to your big meal), you have more control over your portions and are less likely to overeat. When you stay hydrated – it not only supports your body’s essential functions – but makes healthy choices easier – because your energy levels will be higher and your mind clear – two more things that staying hydrated helps with.

Well there you have it – seven easy ways to keep your Thanksgiving festive – while also helping you to stay a bit more fit and healthy. If you’ve got any kind of back, hip, knee, neck, or shoulder pain that is keeping you from practicing these easy tips – I recommend talking to a mechanical pain expert. They’ll help you figure out the root cause of your problem and most importantly – help you keep it gone – so that by next Thanksgiving – we won’t even be having this conversation.

Are local to Portsmouth, NH?

CLICK HERE to connect with one of our specialists—just in time to enjoy the Thanksgiving holiday to the fullest!

It’s also the perfect time to take advantage of our BLACK FRIDAY SALE! Get our lowest prices of the year with our Physical Therapy Specialists and Regenerative Shockwave Therapy. CLICK HERE to sign up today to get full access to these deals – packages are limited and available only while deals last!

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a copy of her free guide: 5 Simple and Easy Ways to Get Rid of Back Pain, CLICK HERE or call 603-380-7902

3 Reasons Your Lower Back Stretches Aren’t Working

November 18, 2024/in Movement/by Carrie Jose

If you suffer from chronic lower back stiffness or pain – and you’ve been diligent with your stretching routine – it might be time to re-evaluate your approach.

Whether it’s your stretching technique, the type of stretch, or even the idea that you might not need to stretch at all, it’s important to understand why your current regimen might not be helping.

Here are three common reasons why your lower back stretches might not be working and how to address them:

1. You’re using the wrong stretching technique.

Research varies on how long to hold a stretch, but many people find that holding a stretch for 30-60 seconds is effective. However, technique is everything. One common mistake is not fully relaxing into the stretch. It won’t be effective if you’re holding tension in your body or gripping your muscles as you stretch. Make sure you’re breathing deeply and easing into each movement. Forcing the stretch or pushing through pain can trigger muscle tension and defeat the purpose.

If you’ve relaxed fully and your stretches still don’t seem to work, consider trying “dynamic” or “moving” stretches. Rather than holding one static position, move gently through a series of stretches, like pelvic tilts or cat-cow stretches. These can help your muscles stay loose without becoming rigid. Adjusting your stretching approach can make a noticeable difference and reveal that your technique might have been the issue.

2. You’re doing the wrong type of stretch.

Determining the right type of stretch can be tricky without expert guidance. There’s a distinction between general stretches meant for relaxation and specific corrective stretches for targeted issues.

For example, let’s say your lower back tightens up after a long day or due to stress, general stretches like a child’s pose or a seated forward fold may relieve tension. I often use these stretches to keep my own back healthy when I’m on my feet all day helping patients.

However, if you’re dealing with lower back pain or symptoms like sciatica (pain or tingling running down your leg), generic stretches like these might not help and could even worsen your condition. In these cases, corrective stretches tailored to your specific problem are necessary. These stretches are usually prescribed by a specialist who considers your body mechanics and underlying issues, recommending the best type and frequency for you.

3. You shouldn’t be stretching your lower back at all.

One surprising reason your lower back stretches might not be helping is that you may not need to stretch it in the first place. Chronic lower back tightness can sometimes indicate a weak core or hip instability.

This is more common than you might think, and if this is your situation, stretching your back repeatedly can lead to more frustration and even worsen the problem. The deep stabilizing muscles in your lower back are closely connected to your core muscles. If your core isn’t functioning properly, your lower back muscles might compensate, leading to persistent tightness and discomfort.

Ever notice your lower back feels sore after a day of ab exercises or after certain workouts? This could be a sign that your lower back is overcompensating. Instead of stretching more, it’s time to focus on core strengthening and proper movement techniques. Seek guidance from a specialist to assess and correct your form and make sure your core is doing its job.

Lower back pain is common – but having to constantly suffer from it isn’t. If your lower back pain or tightness isn’t improving despite regular stretching – it’s possible that your technique needs adjusting, you’re using the wrong type of stretches, or stretching isn’t what your body needs at all. Finding the root cause of your lower back issues is key.

Consulting with a physical therapy specialist who is an expert in mechanical pain can help you identify the root cause of your back pain and the best course of action – so you can stop wasting time on ineffective stretches and get back to your favorite activities without pain. Need help finding one? Reach out – I’m happy to help.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of our specialists HERE. Our team will listen to your story and help you make the best decision moving forward – whether that means working with us or finding the right plan for you 🙂

What Your Doctor May be Missing About Your Pain’s True Source

November 13, 2024/in Movement/by Carrie Jose

Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body.

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem).

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan.

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all. I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit.

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or get access to her free guide: 5 Easy Ways to Get Rid of Back Pain – CLICK HERE – or call 603-380-7902

6 Reasons NOT to miss our Black Friday Flash Sale

November 12, 2024/in Movement/by Carrie Jose

These will be our BEST deals – on our best services – for the whole year!

We wanted to give you a heads up that our Black Friday Sale is starting ELEVEN DAYS from now on Sunday – Nov 24th. This is our biggest sale of the year on our most popular services. And it’s your chance to save insane amounts of money (one of the packages gives away over $2500 of FREE services!!)

In order to get access to this amazing sale – you must sign up HERE.

On Sun Nov 24th the sale will start – and you’ll get daily emails updating you on the packages we have available, when things sell out, etc…

Now if saving BIG wasn’t enough…

Here are SIX very important reasons why you don’t want to miss out on our Black Friday specials this year…

1. Without your Health – you have nothing

When your health, independence, and mobility begin to decline – you start missing out on activities that you love. And It’s very easy to say to yourself… “I’ll just wait until the New Year” – or – “I’ll get started when I have more time” – or – “I’ve got so many other expenses right now so my health can wait”…

Nothing should EVER come between you and your health. Because if you wait (or ignore) it, you risk either losing it forever, or spending a lot of time and money to get it back. Whether it’s healing a nagging injury that regular physical therapy or cortisone shots have failed – or getting to the root cause of a back pain or sciatica problem that keeps coming back – we’ve got some amazing specials and huge savings that will make it easy for you NOT to have to wait any longer 🙂 Now is the time to address and invest in your health.

2. Use your left-over FSA money (before you lose it!)

Do you have a Flexible Spending Account (FSA) through work that you forgot about or maybe haven’t used? Well I have some good news for you… you can use your Flexible Spending money toward ALL of the services we have on sale this year. Typically you lose whatever is left in your FSA at the end of the year (Dec 31st) – so don’t let it go to waste!

Put it towards your health – and save a ton of money while doing it – by taking advantage of our Black Friday specials!

3. Help with your New Year’s Resolutions!

January is our busiest month every year, and for good reason… People LOVE to make health-related New Year’s resolutions for themselves. But what if you’ve got a nagging pain or injury? The last thing you want is for it to return or get worse just when you’re in the groove. Our Black Friday Specials can help you with that!

Work with our Physical Therapy Specialists to get to the root cause of your problem and finally get a treatment plan that works (and lasts). Or try Regenerative Shockwave Therapy to help speed up the healing of a stubborn injury that regular physical therapy or cortisone shots have failed. Whatever your health goals are for now or the New Year – get help from our experts at the best rates you’ll have access to ALL YEAR.

4. This only happens ONCE per year

This is our biggest sale of the year – PERIOD. And it only happens once. You’ll never see our prices this low.

If you’re new to our community – and the ONLY reason you haven’t started working with us yet is because of your budget – then you will be very pleased with the specials we have for you. Our regular clients already know the value we provide – and that is why they consistently choose us over the cheaper alternatives available. And it’s also why they are super excited about this sale – because they plan to stock up on their favorite services.

5. Try Out Services You’ve Been Curious About

Have you been eyeing one of our specialty services, like Regenerative Shockwave Therapy? This sale is the perfect time to explore them – at an unbeatable rate. Maybe you want to see how these services could change your mobility, pain, or recovery time? Here’s your permission slip to take the leap and see what you’ve been missing out on!

6. Recession-proof your Health

It may seem counterintuitive to spend money on your health right now given the economic state. Your insurance should pay for it – right? Well here’s why you might want to reconsider that thought – and put the control of your health back into your own hands…

Medicare and other health insurance companies have already cut their reimbursements for this year – and will continue to do so in years to come. Why should you care about this? Because it means the quality of your health care at traditional, insurance-based clinics only has one way to go – and that’s DOWN.

Providers are going to get paid less to take care of you, which means the quality of your care WILL suffer (just to “keep the lights on”). By investing in your own health – and not relying on an insurance company to do it for you – you stay in control of your health journey and have a better chance of avoiding the rabbit hole of expensive and unnecessary surgeries.

So… sign up for our Black Friday Sale… and join the CJPT revolution of getting active, healthy, and mobile – WITHOUT things like pills, procedures, or surgery 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, call 603-380-7902, or CLICK HERE to get early access to the Black Friday Flash Sale!

6 Tips to Protect your Back when Raking Leaves

November 7, 2024/in Movement/by Carrie Jose

Leaves are everywhere right now in New England, which means for many, the tedious task of raking leaves is right around the corner.

I love Fall – but I don’t love raking leaves.

And raking leaves is even worse when you’re suffering from back pain. The good news is there are many things you can do to protect your back when raking leaves.

Here are 6 of my most popular tips to protect your back when raking leaves:

1. Warm up before you start.

Just as athletes warm up before a game, so should you before raking. Beginning any physical activity without preparing your body can lead to unwanted strains and injuries. For raking, focus on warm up activities that target your back, shoulders, and legs. Something like a quick walk around the block before you start is an excellent way to warm up. It gets blood flowing to your legs and arms, and the gentle rotational aspect of walking is great for your spine and torso. You could also include some basic stretches into your warmup such as torso twists, shoulder shrugs, and arm circles. This gets some lubrication into your joints and spine to help protect your back once you start raking.

2. Choose the Right Rake.

With any repetitive activity such as raking – good ergonomics is essential. Ergonomics refers to how safe and efficient you are in your working environment. Bad ergonomics will typically cost you unnecessary energy and labor – and can often result in an injury. When it comes to raking, choose a rake with a handle that is long enough so that you can maintain upright posture while using it, and go for one that is light in weight yet still durable. A good, ergonomic rake might require a bit more investment than you were intending, but it will be worth it in the long run because ultimately, a back injury will cost you much more. And knowing how to protect your back from injury is priceless.

3. Bend with your legs and hips

When performing repetitive activities or lifting something heavy, one of the most vulnerable postures for your back to be in is the combined position of flexed (bent forward) and rotated. To protect your back and avoid injury, you want to use your legs and hips to bend and lift. If you’ve got the right rake, it will be easy to maintain an upright posture while raking. And then when it’s time to scoop up the leaves and deposit them, you’ll want to squat using your hips and knees, and pivot with your trunk and pelvis. Avoid lifting with a curved back and twisting from your waist or spine. Maintaining these habits on a regular basis (not just when raking) will help you protect your back from strain or injury that could otherwise be very easily avoided.

4. Take regular breaks

Continuous and repetitive raking can tire out your muscles and make them more susceptible to injury. Plus, when you get into the monotony of raking, the mindlessness of the activity makes it easy to not pay attention to things like maintaining good posture and using good body mechanics. An easy way to combat this is by taking regular breaks. I recommend at least once every 30 min. Set an alarm on your phone or watch to remind you – and when it goes off – stop what you’re doing, put the rake down, and give yourself a quick upright back stretch. This very simple and easy strategy will go a long way in protecting your back when raking leaves.

5. Engage your Core

You don’t need six-pack abs to protect your back while raking leaves, but simply being mindful of your core can be super helpful and certainly won’t hurt you. Most back injuries occur when you least expect it – and when you aren’t paying attention. When you’re raking leaves, or any other mindless, repetitive activity for that matter, make an effort to think about gently drawing in your lower abdominals while you perform the activity. It’s a subtle move, and you should be able to easily breathe and talk while doing it. If you struggle to breathe and talk normally – you’re overdoing it. This simple act of engaging your core will help keep your spine more supported and stable while raking and it will help protect your back.

6. Keep Moving Afterwards

What you do after raking is equally as important as what you do during to help protect your back from pain and injury. One of the biggest mistakes people make after a repetitive or strenuous activity (like raking) is to slump on the couch or recliner and “rest”. This is one of the worst things you can do to your spine because it’s more pliable and vulnerable right after strenuous activity. And when you put your spine in a relaxed, flexed position while it’s vulnerable – you’re just asking for an injury. You won’t notice it while you’re resting – but you might feel a tweak or strain when you go to stand up – or even up to several hours later.

Do yourself a favor and perform some gentle stretching after raking, or go for another walk to help relax your back. And be mindful of your resting postures for a few hours after raking.

This is an easy way to protect your back during raking season.

Hopefully these tips give you a few things to think about before you go raking all those leaves in your yard – but most importantly – help you protect your back and avoid unwanted back pain this fall season.

Are you a local in Portsmouth, NH?

CLICK HERE to connect with one of our specialists who can help you manage back pain from raking leaves so you can enjoy the fall season to the fullest!

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or get her free guide for preventing back pain, CLICK HERE or call 603-380-7902.