5 Natural Ways to Keep Your Knees Healthy and Moving This Summer

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When you live in New England, summer is a short and precious season. And you don’t want something like nagging knee pain ruining it for you. Whether you’re walking the beach, gardening, playing a round of golf or pickle ball, or tackling your favorite hiking trail – knee pain can quickly turn your favorite summer activities into frustrating experiences. 

The good news?

There’s a lot you can do – starting right now – to protect and support your knees naturally. 

Here are five of my top tips for helping people keep their knees healthy and mobile – so you can enjoy your summer instead of worrying about knee pain:

  1. Strengthen Your Hips and Core

Your knees don’t operate in isolation. They rely on surrounding muscles – especially your hips and core – for proper support and alignment. When these areas are weak, your knees can become stiff and painful due to the extra strain they have to endure to compensate. Strengthening your hips and core improves not only how your knees feel and function, but how your entire body moves. And the better you move as a whole, the less likely you’ll be to place unwanted stress on your knees.

  1. Optimize Your Knee Mobility

One of the most important principles I share with patients is “mobility before stability.” If your joints are stiff, the muscles around them can’t function properly. When it comes to knees, that little bit of hyperextension or “give” at the end of your range isn’t just normal – it’s often a critical yet overlooked aspect of healthy knee function. I see this missed all the time in rehab protocols, especially after procedures like arthroscopy. It may seem minor at the time, but years later, that unaddressed stiffness can cause big problems. I also frequently see issues when one knee is significantly less mobile than the other – often due to a past injury – which can lead to imbalance and compensation elsewhere. When you optimize your knee mobility, your knees will move and feel better. So keep them moving – and stop “protecting” them so much. You may be doing more harm than good.

  1. Stop Sitting So Much

You hear this advice all the time when it comes to back health – but did you know that sitting too much isn’t great for your knees either? Prolonged sitting – whether at a desk, in the car, or lounging – can lead to stiffness and reduced circulation in your knees. It also tightens your hip flexors and hamstrings, which can place abnormal stress on your knee joints. Knees don’t like being in one position for too long. If you notice that your first few steps after sitting feel achy or painful, it’s a sign you need to move more. Make it a point to stand up, stretch, or take a short walk at least once every 30 minutes. These quick breaks go a long way in supporting knee health – and your spine will thank you, too.

  1. Choose Supportive Footwear

Footwear plays a significant role in how your knees feel. The shoes you wear impact how forces travel up through your legs – and summer favorites like flip-flops often provide little to no support. Poor footwear can alter your gait and posture, placing unnecessary strain on your knees. When choosing shoes, look for options that are comfortable and offer good arch support and cushioning – especially if you’ll be walking or standing for long periods. Also consider the width of your shoes, as feet tend to swell and widen in the heat during extended activity. Supportive sandals do exist – just be mindful of when and how long you wear less supportive styles.

  1. Work on Your Balance

Balance isn’t just important for fall prevention – it also plays a key role in how well your joints absorb and distribute force. Good balance ensures that your feet, ankles, and core work together to stabilize your movements. When that coordination is off, your knees often have to compensate, which can lead to pain and unwanted wear and tear over time. Simple balance exercises – or activities like yoga, which emphasize control and stability – can help retrain your neuromuscular system and reduce unnecessary strain on your knees. You’ll notice the benefits of improved balance in all areas of life, but especially during favorite summer activities like hiking, pickleball, beach walks, and paddleboarding.

If you’re dealing with persistent knee pain – even one or two of these strategies could make a noticeable difference.

And if your knee pain is keeping you from being active or doing your favorite summer activities, it might be time to seek expert help. A physical therapist who specializes in mechanical pain can assess your movement and identify the root cause – so you can get back to doing what you love – and without having to rely on pills or surgery.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Top 5 Arthritis Myths That Keep People in Pain

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If you or someone you love is living with arthritis — then you already know how frustrating it can be. Daily tasks become harder, favorite activities fall by the wayside, and you may start to wonder: “Will things ever get better?”

Even worse, many people living with arthritis fall victim to misguided advice.

Let’s look at five of the most common myths about arthritis management — and shed some light on what you can actually do instead:

Myth #1: “There’s nothing you can do — it’s just part of getting older.”

This is one of the biggest and most damaging myths of all.

While it’s true that arthritis becomes more common as you get older — and it’s considered a normal part of aging — it doesn’t mean you have to live with chronic pain or disability. In fact, many people with visible (even advanced) arthritis on X-rays and MRIs are living active, healthy lives with minimal to no pain at all.

Research supports this. A 2015 study published in Arthritis & Rheumatology found that more than 30% of adults over 60 had radiographic evidence of knee osteoarthritis — but only a portion of them had symptoms. In other words, just because your joints show signs of “wear and tear” doesn’t mean you’re doomed to pain.

The real issue is how you move — and how you use your joints. Strategic exercise, strength training, and natural therapies can drastically improve your mobility and reduce pain — regardless of your age or what your imaging says.

Doing nothing, on the other hand, is one of the worst things you can do.

Myth #2: “You should rest and avoid activity to protect your joints.”

If your joints hurt, don’t move them — right? That might make sense if you have an injury that requires an initial rest and healing phase. But that’s not the case with arthritis. When you avoid movement in an arthritic joint, you actually worsen your symptoms.

Too much rest leads to stiff joints, weakened muscles, and poor circulation — all of which contribute to more pain and less function over time. Movement helps lubricate joints, strengthen muscles, and prevent further degeneration.

I’m not sure why this myth is still so common — especially when just about every major orthopedic organization (including the CDC and the Arthritis Foundation) agrees that regular, low-impact physical activity is one of the best things you can do for arthritis.

The key is doing the right kind of movement. So if you’re struggling, work with an expert who can help you figure out the proper, targeted activity your body needs. But whatever you do — don’t fall for this myth.

Myth #3: “If your joint is bone-on-bone, surgery is the only option.”

Hearing the phrase “bone-on-bone” from your doctor can feel like a death sentence for your joint. And the typical recommendation? Joint replacement surgery.

But what if I told you that “bone-on-bone” isn’t always the actual reason for your pain — and that you’ve got options beyond a major procedure like surgery?

The first thing to understand is that what shows up on your imaging (like X-rays and MRIs) doesn’t always match up with your symptoms. A 2018 study in BMJ Open found that nearly half of people with severe osteoarthritis on imaging had little to no pain. And many people with significant joint pain showed only mild arthritic changes on their images.

Translation? “Bone-on-bone” isn’t necessarily the root cause of your problem. I’ve seen many people with this diagnosis successfully avoid major surgery and keep their original parts far longer than they thought possible.

When faced with this kind of diagnosis, the best thing you can do is pause — and explore your options. Surgery will always be there if you need it. But don’t rush into it or assume it’s your only option.

Myth #4: “Cortisone shots and medications are the best way to manage arthritis.”

Cortisone shots may provide short-term pain relief for arthritis — but they don’t actually fix anything. Worse, repeated cortisone injections have been shown to damage cartilage and accelerate joint degeneration over time.

One study published in JAMA (2017) showed that patients receiving cortisone injections for knee arthritis had worse cartilage loss at two-year follow-up than those who received a saline placebo — despite experiencing no significant difference in pain relief.

NSAIDs (like Advil) and prescription pain medications can also help dull pain, but they come with side effects — and, just like cortisone, do nothing to address the root cause of your symptoms.

If you’re relying on medication or repeated cortisone shots just to get through the day — or to delay surgery — it’s time to explore options that promote natural healing instead of just masking symptoms.

Shockwave Therapy and EMTT are two non-invasive regenerative therapies that do exactly that. These cutting-edge technologies enhance your body’s natural healing processes by targeting inflammation and tissue damage at the cellular level. And while more research is still needed, promising clinical evidence suggests these therapies may actually help reverse — or significantly delay — the progression of arthritis.

Do your own research — and be open to natural, forward-thinking treatment options that support your long-term joint health.

Myth #5: “Arthritis means you’ll never get back to the activities you love.”

This is one of the most heartbreaking myths — and it’s simply not true.

I’ve worked with countless clients who believed their days of hiking, gardening, traveling, or playing with grandkids were behind them — only to regain full function and freedom after following a personalized treatment plan.

And while surgery sometimes is the best option — especially if you’ve waited until your arthritis has become advanced — there’s a lot you can do to improve your outcome. Working with a specialist to build strength and prescribe targeted movement can make recovery faster and easier.

Plus, emerging research shows that using regenerative therapies like Shockwave and EMTT both before and after surgery may help accelerate healing and improve long-term outcomes.

Managing arthritis is absolutely possible when you take a natural, proactive, and personalized approach. You just need the right plan — and the right team to guide you.

Final Thoughts:

Arthritis is real — but don’t let myths and outdated advice keep you stuck. If you’re not sure where to start — or feel like you’ve already tried everything — speak with someone who specializes in mechanical pain and natural joint care. Often, the most effective solutions are the ones no one has told you about yet.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

How I’d Rehab Celtic Star’s Achilles Repair with Regenerative Therapy

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If I were lucky enough to be on Jayson Tatum’s rehab team following his Achilles tendon repair, I’d be pulling out all the stops to help him recover quickly, fully, and most importantly, safely. An Achilles injury is no joke – even for the fittest, most elite athletes in the world. But with the right approach and the right technology, a full recovery and return to play is possible. The key lies in combining solid, daily rehab with the best science-backed tools we have today. And in my opinion, regenerative therapy should be at the center of any post-surgical rehab protocol. That means making strategic use of shockwave therapy and EMTT (Extracorporeal Magnetotransduction Therapy) from day one.

The Challenges of Tendon Rehabilitation

The Achilles tendon is the strongest tendon in the human body – but also one of the most vulnerable, largely due to its poor blood supply. This, combined with the repetitive stress it endures, makes it especially prone to injury and rupture – particularly in a high-demand, explosive, and multidirectional sport like basketball. If not managed correctly, an injury to this tendon (like in Tatum’s case) can be career-altering.

Traditionally, rehab after Achilles tendon repair involves a slow progression – starting with immobilization and non-weight bearing, followed by conservative loading, manual therapy, and eventually a return-to-play protocol. But unless this process is executed meticulously, it often fails to fully restore tendon elasticity, strength, or neuromuscular timing – all of which are crucial for explosive power and returning to a sport like basketball, let alone elite-level competition. And when it comes to tendon rehab, there’s no shortcut. Tendons heal through a process of remodeling over time, and that healing requires precise, progressive loading. Most people don’t have the patience – or the team around them – to commit to this fully, which is why so many Achilles injuries become chronic and never quite the same.

What concerns me most in cases like Tatum’s isn’t just whether the tendon heals – but how well it heals. Does it remodel into a strong, elastic, load-ready structure? Or does it stiffen, weaken, and become vulnerable to future injury? This is exactly where regenerative therapy comes in. And hopefully for Tatum, he’ll not only have the right team around him – with the knowledge, tools, and strategy to deliver exceptional rehab – but one that’s also staying current on the latest advances in rehabilitation technology.

Why Shockwave and EMTT Are a Game-Changer

Both shockwave and EMTT are non-invasive regenerative technologies that stimulate your body’s natural healing processes. They don’t mask symptoms – they accelerate tissue regeneration, increase blood flow, and improve cellular repair at the source.

Shockwave therapy uses focused mechanical energy to create microtrauma in the tissue, which stimulates a healing cascade – increasing local circulation, activating fibroblasts, and promoting collagen production. A 2017 study published in The American Journal of Sports Medicine found that athletes recovering from Achilles tendinopathy who received shockwave therapy had significantly better outcomes than those who didn’t – with faster recovery times and greater functional improvement.

EMTT, on the other hand, uses high-frequency electromagnetic pulses to stimulate cellular metabolism and promote deep tissue healing at a cellular and mitochondrial level. It penetrates deeper than shockwave and operates on a different biological frequency, making it a perfect complement.

Used together, these therapies enhance each other’s effects – improving tissue oxygenation, reducing inflammation, and accelerating remodeling. A 2023 study in Orthopedic Reviews found that combining EMTT with shockwave improved tendon vascularity and collagen alignment in post-op Achilles patients, leading to faster return-to-sport metrics.

My Strategic Rehab Roadmap for Tatum

If I were working with Tatum, I’d coordinate with his surgical team to determine the ideal time to begin regenerative therapy – typically once the surgical site is closed and stable, within the first few weeks post-op.

In the early rehab phase – around weeks two to six – I’d focus on protection and early-stage regeneration. EMTT would begin two to three times per week to stimulate healing, reduce inflammation, and prevent early adhesions. It’s ideal during this phase because it’s non-contact, painless, and doesn’t interfere with the surgical site. I’d also initiate isometric activation of the calf and surrounding muscles and start gentle mobility work to nearby joints to minimize compensation.

As we progressed into weeks six to twelve – the tendon loading and remodeling phase – I’d introduce shockwave therapy once or twice a week to stimulate angiogenesis and collagen synthesis. EMTT would continue to support deeper tissue metabolism as the loading demands increase. At this point, I’d implement controlled eccentric loading of the calf complex – a well-documented method for rebuilding tendon strength. I’d also integrate targeted, low-load mobility and stability drills – including Pilates-based work on the Reformer – to restore foot and ankle mechanics and optimize posterior chain activation. The Reformer offers adjustable, low-impact resistance through full ranges of motion, allowing strategic reintroduction of load without overstressing the tendon.

By weeks twelve to twenty and beyond, the focus would shift to sport-specific training, plyometrics, and return-to-play. Regenerative therapy would continue as needed – not as a primary tool, but as support to keep the tendon adapting as the intensity ramps up. Many athletes feel ready before the tendon is fully remodeled, and this is where shockwave and EMTT help ensure tissue resilience. During this phase, I’d layer in multidirectional plyometrics, reactive balance drills, and functional movement assessments to restore proprioception and clean up any compensations.

Why This Matters (Even If You’re Not an NBA Star)

Maybe you’re not a professional athlete – but the same principles apply whether you’re trying to get back to the NBA Finals or just want to hike, run, or play with your kids pain-free. Tendon healing doesn’t change just because your jersey doesn’t say “Celtics.”

In my clinic, I’ve seen how combining regenerative therapy with intelligent loading strategies leads to better outcomes – fewer setbacks, stronger recoveries, and tendons that actually function. The result? Less scar tissue, better elasticity, and reduced risk of reinjury.

Final Thoughts

Rehabbing an elite athlete like Jayson Tatum takes precision, collaboration, and the best tools modern sports medicine has to offer. In 2025, that means going beyond traditional methods. It means using regenerative therapies like shockwave and EMTT to support faster, stronger, and more complete healing – from the inside out.

Whether you’re an NBA star or someone who just wants to stay active without setbacks, the principles are the same: treat the root cause, support your body’s natural healing, and never underestimate the power of regenerative healing.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.

Why Your Ab Exercises Aren’t Fixing Your Back Pain

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Why Your Ab Exercises Aren’t Fixing Your Back Pain

If you’ve been dealing with back pain for a while, chances are good that someone – whether a well-meaning friend, fitness influencer, or even your doctor – has told you to strengthen your core. It’s one of the most common recommendations I hear from people who come into my clinic. And while core strengthening can be helpful, it’s not the magic fix everyone hopes it will be.

Believe me, I wish it were that simple. But the truth is this: core strengthening alone rarely solves back pain – and in some cases, it can even make it worse.

Let’s unpack why.

Most persistent back pain is what we call “mechanical” in nature. That means the root of the problem is related to the way your spine moves (or doesn’t move) – not how strong it is. Mechanical back pain is typically the result of years of repetitive stress or poor movement habits. These issues can’t be fixed with planks, crunches, or “functional mobility strengthening.” Strengthening your core might make you feel a little better temporarily – but it won’t solve the deeper dysfunction.

Mechanical back pain tends to sneak up over time. It’s not the result of one big injury, but rather the accumulation of little things. Sitting all day at your desk. Constantly lifting and carrying your toddler. Spending weekends bent over in your garden or rotating through your golf swing. Eventually, these patterns start to cause subtle movement problems in your spine – and when left unresolved – those problems lead to pain.

Now here’s where things get even trickier.

When you go to your doctor – or get an MRI – you’re often told your back pain is from something structural: a disc issue, arthritis, or stenosis. But these findings are incredibly common, especially after age 50, and don’t always correlate with your actual pain. Plenty of people have these “abnormalities” and feel just fine. What’s more likely is that your mechanical problem is irritating these structures – not the other way around.

So if you’ve been religiously doing your core workouts but not seeing progress – this might be why. You’re treating the symptoms, not the cause. You have to relieve the mechanical irritation happening around these structures in order to get full pain relief. And core strengthening – not even surgery – will cut it.

To truly get rid of mechanical back pain, you need to address the underlying movement dysfunction. This requires a very specific and individualized approach – something you won’t find on YouTube, in a gym, and definitely not in a doctor’s office. Once that’s resolved, core strengthening does become incredibly valuable. In fact, it’s a key part of staying pain-free and preventing future flare-ups after your back pain is gone.

But timing matters – and I get it – most back pain sufferers have little patience when they’ve been in chronic pain. By the way – I don’t blame you. But if you jump into a core strengthening program too soon – or focus on the wrong exercises – you’re more likely to aggravate your symptoms rather than help them – and prolong your chronic pain.

Here’s the bottom line:

If you’ve been working on your core and not seeing results, don’t assume you’re doing it wrong or that you’re destined for a surgery or procedure. You might simply be skipping a crucial step – mobility before stability. Get your mechanical back pain properly diagnosed and addressed first. Once your mobility is restored and the foundation is solid – then your core strengthening efforts will stick. And your back will thank you.

Dr. Carrie Jose, Physical Therapy Specialist, and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If local to Portsmouth, NH, and looking for help – request a FREE Discovery Visit with one of her Specialists by CLICKING HERE.