3 Reasons Your Vertigo Gets Worse in Winter

If you’ve ever suffered from an episode of vertigo, then you already know how debilitating it can be, and you never want it to happen again.

Vertigo is a sensation where the environment around you spins, making you feel dizzy and off-balance. When you’re experiencing a severe episode of vertigo, it can be a real feeling of helplessness. The feeling of dizziness can be so severe that you can’t even get out of bed, never mind walk or drive anywhere.

Vertigo attacks can happen at any age and any time.

Nearly 40% of Americans will experience vertigo at least once in their lifetime, it’s more common in folks over age 65, it affects women more than men, and we see more occurrences in Winter than Summer. Technically, vertigo is a symptom and not a condition itself. A common cause of vertigo is from something called Benign Paroxysmal Positional Vertigo (BPPV).

BPPV occurs when a clump of crystals in your inner ear moves, causing a severe spinning sensation when moving your head. It’s “benign” to those who have never experienced an episode – but since Winter is coming – there’s a good chance it could get triggered.

Here are three reasons why Vertigo is worse in Winter:

1. Low Vitamin D Levels

Vitamin D is made in the skin when it’s exposed to sunlight – therefore – sun exposure is our best way to keep Vitamin D levels high. If you live in an area like New England, keeping your Vitamin D levels adequate all year long (especially in Winter) can be challenging. Studies have shown a close correlation between low levels of Vitamin D and BPPV.

This could explain why we see more cases of vertigo in the Winter.

In one North Korean study, they looked at 957 people who suffered from BPPV and were already being treated successfully with specific head movements. About half the group (who had low Vitamin D levels to begin with) started taking Vitamin D supplements. After one year – they compared the two groups – and found the supplement-taking folks had lower occurrences of their BPPV compared to the non-supplement-taking group.

If you’re prone to BPPV, and you live in a climate that gets lower sunlight this time of year, it might help your vertigo if you start supplementing with Vitamin D.

2. Less Physical Activity

Another unintended consequence of Winter is less physical activity. When it’s dark upon rising, and dark again by 4:30p, you’re just not as motivated to get out and walk, run, or bike ride.

Therefore, we tend to get a bit more sedentary in the Winter.

Prolonged periods of rest in reclined, sedentary positions is a known trigger for BPPV. That’s another reason we see an uptick in vertigo during Winter. People are simply not as active and lying down more.

Making an extra effort to stay active in Winter could go a long way in helping decrease your vertigo. Try scheduling an exercise class you’re held accountable to. This could help you resist the urge to hit the snooze button or go straight home to your recliner.

3. More Ear Infections

Winter allergies are a “thing” and can lead to fluid buildup in your inner ear. This creates a prime breeding ground for bacteria and can turn into an ear infection.

Your vestibular system is located deep within your inner ear and something like an ear infection can disrupt its function. Think of it as a stereo system. The left and right ears work together but send separate signals to your brain. If the signal from one ear is disrupted by an infection – our brains will get confused. This will trigger symptoms of dizziness and loss of balance (vertigo).

If you already know you’re prone to episodes of vertigo or BPPV, you’ll want to take extra precaution in the Winter to try and avoid ear infections. If your vertigo tends to flare up every Winter – hopefully this information helps you to understand better why this could be happening – and more importantly – what you can do to avoid it.

But regardless of whether you suffer from vertigo more during Winter or not – the good news is that it’s a very treatable condition any time of year. BPPV is the most common cause of vertigo and it can be treated in as little as four sessions by a Vestibular Specialist.

Are you local to Portsmouth, NH? 

Our vestibular specialist has a few openings available for the rest of the year. CLICK HERE to schedule your discovery visit and we will see if we’re a good fit to help – and get you on a treatment plan right away.

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, or get her free guide for getting rid of vertigo naturally, visit CLICK HERE or email info@cjphysicaltherapy.com.

How Stress Leads to Pain

How Stress Leads to Pain

How Stress Leads to Pain

People are dealing with more stress than ever right now and it’s impacting people in different ways. Many folks I speak with have been experiencing a rollercoaster of emotions — and their bodies are reflecting that.

Stress impacts everything from your gut, to your immune system, to your mental health, to your musculoskeletal system.

When it comes to musculoskeletal pain – common areas in your body that easily get impacted include your shoulders, jaw, head, and lower back.

Stress is your human response to physical, emotional, or mental changes in your body or living environment.

According to internal medicine physician Richard Lang, MD, PhD from the Cleveland Clinic: “Stress doesn’t necessarily cause certain conditions, but it can make the symptoms of those conditions worse.” And it’s easy to fall into a vicious cycle – whereas your physical symptoms worsen – your stress increases – and so on and so on. 

We know without a doubt that stress impacts our bodies – but exactly how or why this happens is an interesting phenomenon that is still being researched.

But for now – here are some of the working theories on how stress leads to physical pain.

Social conditioning 

Many of us are taught from a young age that expressing emotions, particularly negative emotions, is “bad” or “unacceptable.” The result is that you may have learned to hold stress inside your body when faced with a stressful situation. Researchers who study this believe that the muscle tension we develop is the result of “unspoken social beliefs” that we adopted as children in order to feel accepted or liked. This pattern carries into adulthood and becomes embedded into our subconscious systems, i.e. our nervous system. Later on, when faced with any type of stress, our muscles react based on how we’ve taught them. If you grew up learning to bury emotions and tension somewhere in your body as a response to stress, it’s easy to continue that pattern into adulthood.


When we think of trauma – we often associate it with one big event or injury – such as an accident, major fall, or perhaps a violent crime or incident. This type of trauma typically results in obvious physical damage such as broken bones, bruises, or soft tissue and organ injuries. But trauma can also be more emotional in nature and less obvious. Emotional “micro-traumas” typically occur over the course of a lifetime and go unrealized for years. And regardless of the type of trauma or its perceived severity, your body reacts and “remembers” the emotional impact. But these memories are rarely conscious. Similar to what happens with social conditioning, if you’re faced with a stressful situation later in life that reminds your brain of a previous trauma, your body may still react like it did when the actual trauma occurred, except you won’t consciously know it.

For some folks, until they’re able to associate their physical symptoms with the deep, often emotional trauma that happened much earlier in life, they may continue to suffer or worse, resort to lifelong medications to manage their pain. If you’ve suffered from chronic pain and been told there is no “logical” evidence or reason for it, it’s possible it could be related to undiagnosed trauma. Find a therapist (psychology today is a great resource) who’s been specifically trained in this to help you.

Environmental Stressors and Habits 

Your environment and daily habits can have a huge impact on how your body feels from day to day, and they can also influence both physical and emotional stress. For example, if you’ve been reading my articles for awhile, you know that sitting too much is a number one cause of back and neck pain. Sitting too much could be the result of your job – or stress.

When you’re stressed, you tend to be less motivated and you may opt for unhealthy coping mechanisms, such as more TV and more couch time. You’ll be less reluctant to exercise or go for a walk. How you set up your environment can play a big role in combating stress at home. If you’re working from home – choose a set up where you can stand at your computer for part of the day and reduce the physical stress that sitting has on your body. Get the TV out of your bedroom so you’re more likely to get a good night’s sleep and less likely to turn the news on first thing in the morning – which can be a source of stress in and of itself. The take home point is that life is hard enough, set yourself up for success by creating an environment that encourages good daily habits.

Regardless of how or why stress impacts your body, there is one thing I know for certain, movement helps.

Start there and see what happens. Regular, every day movement helps you both physically and mentally and I have yet to see any negative consequences from a daily movement or exercise habit. If musculoskeletal pain is currently keeping you from daily movement – then talk to an expert who can help. 

Request to talk to one of my specialists to see if we would be the right fit to help you get out of pain. CLICK HERE to request a Free Discovery visit with one of my specialists.

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, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at info@cjphysicaltherapy.com.

stay mobile this thanksgiving

Five Easy Ways to Stay Active and Mobile this Thanksgiving

Thanksgiving is one of my favorite Holidays and it’s right around the corner.

While rest and relaxation might be top of mind for you – it’s still important to incorporate some movement and activity into your day.  Our spine and joints don’t like to be sedentary for prolonged periods. And that’s especially true if you’ve got arthritis, back or knee pain.

You may not notice any pain while you’re sitting or relaxing, but you will pay for it the next day if you don’t find ways to keep moving.

So here are five very easy ways to help you stay active and moving this Thanksgiving:

  1. Interrupt Your Sitting.

Our bodies were not 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 back and knee stiffness. I recommend standing up at least once every 30 min.

This could be a fun assignment to give a young child. Make them accountable for watching the clock and remind you to stand up. This is quite possibly the easiest and most effective strategy to keep your knees, hips, and spine from getting painful and stiff throughout Turkey Day.

  1. Do 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.

If you can’t coordinate a time to do this in a group, take a virtual trot together and stay connected via your smartphone. Either way, whether you walk or jog, it will feel great to get your Thanksgiving Day started with lubricated joints and blood flowing. 

  1. Stretch During Commercials.

Whether it’s the Macy’s Day parade, football, or both – it’s easy to find yourself sitting for hours on a soft sofa or recliner. 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 during commercials.

It’s the perfect opportunity to do a quick 2 min exercise or stretch.  It doesn’t have to be complicated. Choose from a quick set of squats, heel raises, planks, or back stretches. You can alternate through these during each commercial break and your body will thank you for it.

  1. Walk Your Dessert Off.

Just because you did that Turkey Trot in the morning doesn’t mean you have to be done for the day. Rather than feeling like you need to skip dessert – just plan to walk it off afterwards.

Walking is one of the best and most natural exercises you can do. And it gives you many of the same benefits of running (only slower).

Walking is very functional, and it’s good for your hips, back and knees. Since we tend to sit and bend so much during the day, walking is a very natural and active way to get some much needed lengthening and stretching into our bodies before we settle in for the evening. 

  1. Help With Cleaning Up.

Don’t be shamed into “just sit down and relax” because you’re a guest. Helping with clean-up (or set-up) is an easy and effective way to keep moving during your Thanksgiving Holiday.

Not only will your Thanksgiving host love you – but your body will too.

If you’re suffering from back problems, be careful bending and leaning over – especially if it’s repetitive – when you’re collecting or washing dishes. But otherwise, carrying heavy plates, moving chairs, and wiping down tables can burn quite a few calories and it’s good for your body.

There you have it – if you don’t want your Thanksgiving Day to be sedentary – you now have five easy ways to stay active and moving.

I hope you have a wonderful Holiday and get to spend it with those you love most.

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, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at info@cjphysicaltherapy.com.

avoid back pain when raking leaves

5 Tips to Avoid Back Pain when Raking Leaves

We are in peak leaf-raking season right now in New England.

Leaves are everywhere – and the daily sound of leaf blowers in my neighborhood has become somewhat meditative.

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 – it’s not as hard as you think to avoid back pain while doing this repetitive, monotonous activity…

Here are 5 tips to help you avoid back pain when you’re raking leaves:

1. Take a walk before you start.

Walking is a really great activity for your back in general, but it’s also a really easy way to warm-up your entire body ahead of an hour or more of repetitive raking. Personally, I love nothing more than taking a walk in the cool, crisp Fall air.

Why not take a quick walk around the block before you get into your raking?

This simple activity will bring blood flow to your arms, legs, and spine – and get all your joints moving and warm ahead of the full body activity that is raking.

2. Stretch every 30 minutes.

The biggest “danger” to your back when it comes to raking leaves is the repetitive nature of it – specifically the frequent bending and rotation of your spine.

Our spines were designed to hold us upright, not to bend and twist over and over again in the same direction. One of the simplest ways to protect your back while raking leaves, or any other repetitive activity, is to take quick and frequent rest periods to stretch. Every 30 min or so, stop what you’re doing, and give yourself a simple stretch backwards. This very simple action can go a long way in avoiding excessive back pain while raking.

3. Bend with your legs and hips.

As mentioned above – one of the worst activities for your lower back is repetitive bending and rotation – which is very easy to do if you’re not paying attention while raking leaves.

One way to avoid this is to use your hips and legs to bend and rotate. Using your legs and hips to bend and get lower to the ground when raking minimizes the bending at your spine – and pivoting at your pelvis to throw the leaves away minimizes the rotation to your spine.

Don’t get me wrong, your back will still likely be sore after taking even when “doing everything right” – but the stress will be significantly less and can help you avoid throwing out your back a day or two later – because yes – this is the timeframe when it will usually occur if you didn’t use good habits while raking your leaves.

4. Engage your core.

You don’t need six-pack abs to prevent back pain while raking leaves, but being mindful of your core can be super beneficial and it certainly won’t hurt you. Most back injuries occur when you least expect it… coughing, sneezing, picking something light off the floor.

These activities are so mindless and automatic that you’re typically not paying attention to what your core might be doing – or not doing. Raking leaves is an equally mindless activity. Each time you pull the rake toward you or lift it, think about drawing your belly in and engaging your abs. This will help keep your spine more supported and stable while raking.

5. Keep moving afterwards.

What you do after raking is equally as important as what you do during to help prevent back pain.

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 after strenuous activity. When you put yourself in a relaxed and sustained bending position – after all that repetitive bending – it can be the icing on the cake.

You go to stand up and “boom” – there goes your back. I see it all the time. Do yourself a favor and go for another walk after raking to cool down, and be mindful of the posture you rest in after all that hard work.

Hopefully these tips give you a few things to think about before you go raking, and most importantly, avoid unwanted back pain so you can enjoy this beautiful fall season.

Are you local to Portsmouth, NH and looking for help with your back pain?

Consider speaking to one of my specialists.

You can tell us everything thats been going on and we’ll see if we’re fit to help you – and give you all of the information you need to make the best decisions for your health.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at info@cjphysicaltherapy.com

Physical Therapy Session

Why More People are Paying out of Pocket for Healthcare…even during a recession

If you’ve ever had an injury or dealt with chronic pain, you’ve probably followed a pretty traditional course of action to address it that might have looked like this:

  • You went to your primary care doctor and they sent you to the lab for x rays, prescribed medication, or both.
  • You may have gotten a referral to a specialist or even a surgeon.
  • You went to that appointment and were either told that you needed surgery or that you needed to modify your physical activity and avoid certain activities in order to not exacerbate the problem.

Basically, you were thrust into the assembly line that has become “modern healthcare”.

But did you know that you could bypass all of this hassle – and get faster results – by going directly to a physical therapist?

Physical therapists are trained to diagnose your problem and provide a fully customized treatment option that doesn’t involve prescription medications or procedures.

In almost all states (including NH) you don’t even need a prescription to see a physical therapist.

The problem is that for many people, traditional physical therapy has not produced the results they are looking for.

Physical therapy DOES work. But what often doesn’t work is the model of care.

Because of all the limitations insurance companies have placed on reimbursement over the years, most traditional physical therapy clinics (those that take insurance) have been forced to see more patients than they would like at any one time – just so they can pay the bills and keep the lights on!

Additionally, insurance companies have essentially taken over your care.

They decide who you can see, what type of treatment you will get, and how many visits you are allowed to have.

These decisions are being made by someone who’s never even spoken to you, met you, or actually looked at you.

Because of this, “physical therapy” has gotten a bad reputation and a lot of people find that it’s a waste of time, or that it consists of just a bunch of exercises.

It’s not the physical therapist’s fault, it’s the insurance company’s fault.

The good news is that you’ve got options and alternatives when it comes to taking care of your back or knee pain.

If you don’t want to be prescribed medication, you don’t want to deal with procedures like injections or surgery, and you don’t want to go to traditional physical therapy and feel like you’re wasting your time because you are ignored or are doing the same exercises over and over – the answer is to go outside of your insurance and pay out of pocket.

This is known as going “out of network”.

And more and more people are doing it because they are fed up with the traditional models of healthcare and physical therapy that don’t give them the results they are looking for.

But isn’t that expensive? Not at all, and it really depends on what you value.

For me, and for most of the folks that we work with, it’s far more costly to live with chronic back pain, have to miss out on activities you love, and end up with a surgery you never even wanted.

It’s also far more costly to spend years going to weekly chiropractic and massage therapy appointments just so that you can function and manage your pain.

When it comes to musculoskeletal problems, you NEED a physical therapist in your corner and as part of your health care team.

But it can’t be the traditional kind where all you get is cookie cutter treatment plans. Physical therapists who don’t contract with insurance companies are able to spend more time with you and create a truly customized plan of care.

We focus on getting to know you and your body instead of what paperwork needs to be filled out for your next insurance authorization.

Our clients like this model because they get long-term success instead of short-term pain relief. Our therapists like this model because they are free to use their brains and actually do what they were trained to do.

Everyone should have their own, personal physical therapist to call and come see anytime you need, just like you would a chiropractor, dentist, doctor, or massage therapist.

The only way to do this, is to go outside your insurance. If you are curious about whether or not this model of physical therapy is right for you just give us a call!

It’s not for everyone, but more and more people are finding that it is.

Most of the folks we meet and work with say: “I wish I had found you first”.

If this is something you are interested in – or are seeking more information on – CLICK HERE to speak to one of my specialists.

They 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, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at info@cjphysicaltherapy.com.


Spooky creaks and cracks coming from your knees?

Do the cracks in your knees “spook” you out?

Yes – it’s Halloween – and we’re having some fun over here…

But in all seriousness – when it comes to cracking in your knees (or any joint for that matter) – people get nervous.

First of all, cracking in your knees (as well as your other joints) is quite common – and most of the time there’s a reasonable explanation for it.

Crepitus is the term used to describe any grinding, creaking, cracking, grating, crunching , or popping that occurs when you move a joint like your knee. You can experience this at any age – but it’s certainly more common as you get older.

So what causes crepitus – and should it be a concern…

The most common causes of crepitus include air bubbles popping inside your joint, tendons or ligaments snapping over your joint’s bony structures, or the degeneration of your joint’s cartilage that generally occurs with arthritis. You may experience uncomfortable sensations, or even a tiny bit of pain when this happens, but in most cases, none of this should scare or concern you.

It’s all a normal part of aging and wear and tear.

But if the cracking in your joints starts to become more regular – is accompanied by joint swelling and more constant pain – or if the cracking turns to “clunking” and your knee starts to feel unstable… then you’re smart to be concerned and it’s possible something more serious could be going on.

If you suspect something like this could be happening – get your knees checked out by an expert.

But assuming you haven’t let your knees get to the “concerned stage” yet… and the most annoying thing to you right now is the cracking, grinding, or crunching…

There are things you can do to prevent it from getting worse.

The first thing I always recommend is to keep moving.

Motion is lotion.

And regular movement throughout the day helps keep your joints lubricated. It’s like applying WD-40 to a creaky door hinge – when your joints creak – move them to lubricate them.

The second important thing to consider if you want to reduce crepitus and prevent it from becoming something more serious is your biomechanics.

Biomechanics refers to how well your muscles and joints function together.

If you’ve got imbalances – it will impact the way your joints move and function – causing more creaking and cracking.

For example, let’s say your hips are on the weak side. How your knees tolerate various activities depends a lot on how strong your hips are. I’ve experienced this first hand… I love to hike. And if my hips aren’t doing their part, I feel the entire hike in my knees, especially on the way down.

And you know what else happens?

My knees crack a lot more on the days after I hike.

The imbalances in my body cause more stress on my knees and the result is they crack a lot more. Now, as I mentioned previously, this isn’t a big concern for me… yet. My knees don’t hurt – they are just very noisy. But in the interest in prevention – I make a conscious effort to regularly stretch my quads, and strengthen my hips and core – so that I can keep this problem at bay and not let it get worse.

My FAVORITE way to do this is with Pilates.

Specifically… on the Pilates Reformer!

When you use the Pilates Reformer – it allows you to both strengthen and lengthen at the same time – as well as focus on your coordination. These three things – when combined together – help to significantly optimize your biomechanics.

If you’ve never used the Pilates Reformer and want to give it a try – check out our Pilates program HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth. To get a FREE copy of her guide to knee pain – CLICK HERE

Failed Knee Surgery

Knee Surgery Gone Wrong? It’s More Common Than You Think.

Arthroscopic knee surgery is one of the most common surgeries performed – despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, the science tells us that people who do undergo arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that quite possibly could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

Well… it is until it isn’t.

The big problem is that arthroscopic knee surgery is not necessary for most cases of knee pain.

If there is a complication – which there are many even with “minimally invasive” procedures – you could end up being worse off than when you went in.

Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70% of all knee pain cases.

An early research study from 2002 by JB Moseley and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery.

Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment.

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery more than ever?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain. If you’ve gotten physical therapy and it wasn’t effective, people are led to believe that the physical therapy “didn’t work”.

But more often than not, you just haven’t found the right physical therapist yet – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery.

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee. Knee pain can come from your ankle, hip, or back. One study showed that 40% of the time – knee pain is caused by your back – even when you don’t have any back pain.

MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee.

Over the course of my 20 year career, I’ve seen many knee surgeries go wrong.

Most of the time, it has nothing to do with the procedure itself, but everything to do with an incorrect diagnosis going in. If your knee pain can be resolved conservatively – and you put it through unnecessary trauma (surgery) – there’s a good chance you’re going to have more problems afterwards. If you get knee surgery when your knee problem isn’t even coming from your knee – then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that:

1) Your knee problem is really a knee problem and

2) You’ve fully exhausted all (quality) conservative therapy options before going under the knife.

Remember that 70% of all knee pain cases do not need surgery.

Science has proven this. Don’t resort to knee surgery unless you’re 100% sure you really need it. Because it can go wrong and when it does – it’s much harder to come back from then if you had avoided it to begin with.

Want help with your pain now? CLICK HERE to talk to one of my specialists for free – you can tell them all about your knee pain and we’ll let you know if we can help. 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at info@cjphysicaltherapy.com.

Holding Knee with Arthritis

Three Tips to Protect Your Knees From Arthritis

Knee arthritis is one of the most common forms of osteoarthritis.

Knee arthritis accounts for more than 80% of all osteoarthritis and impacts at least 19% of Americans over the age of 45.

For many, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing all of their favorite activities. Sometimes it’s simply due to the limiting belief that once you have arthritis – you’ve got “bad knees” for life.

Other times it’s because you’ve been told you have “bone on bone” in your knee and there’s nothing you can do – except to scale back on activity so that you don’t make it worse. This line of thinking is flawed and often leads people to unnecessary procedures and surgery. One of the best things you can do to protect your knees from the debilitating effects of arthritis is to keep moving.

Here are three tips to help you protect your knees from arthritis as you age – so that you can keep doing all of your favorite activities and avoid any major procedures or surgery:

1. Strengthen Your Hips and Core

Your knee joint is situated just below your hips and core. And research has shown that when you have poor control of your upper leg muscles – you get more stress through your knee joint.

The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone – or femur – connects your knee and your pelvis – and your core strength controls your pelvis.

If your pelvis isn’t stable – your femur is going to have a difficult time staying in alignment – which will ultimately have an impact on your knee joint. If you’ve got arthritis in your knees, it’s critical you minimize any added stress to your knee joints.

Strengthening your core and having good hip strength is going to help prevent and minimize the symptoms of arthritis and keep you doing activities you love longer.

2. Keep Your Knees Mobile

Mobility before stability is my mantra.

And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability – and there are those whose major function is mobility.

Your knee needs to be mobile.

Its major purpose is to bend all the way so you can squat and pick things up – and it needs to straighten all the way to give you stability when you need it. When either of these motions are lacking – your ligaments and surrounding muscles will suffer.

A lot of folks just “accept” that their knees are stiff – especially if you’ve been told you have arthritis in your knees. The limiting belief is that stiffness is par for the course. But the truth is that if you keep your knees mobile as you age – you can not only maintain the mobility you have but improve what is lacking.

If your knees are stiff – start moving them. The thing to understand about arthritis is that it’s a normal part of aging. Debilitating mobility is not. Even a 10% improvement in your knee mobility – which can happen even if you’ve got arthritis – will result in huge improvements in your knee function.

It can be the difference between a natural solution to knee pain vs undergoing a major surgery like knee replacement.

3. Don’t Stop Your Activities

When people find out they have arthritis – and especially if they’re in pain – they often think that slowing down or stopping activity will help protect their knees.

This couldn’t be farther from the truth.

Study after study – including one from the Center for Disease Control – shows that severe joint pain among adults with arthritis is worse with inactivity. When you remain active, you keep blood flowing, your knee joints mobile, and your muscles strong. These are very important factors in managing your arthritis. Sometimes, the knee pain you feel when you’re doing certain activities has nothing to do with your arthritis. Statistics show that only 15% of patients with evidence of knee osteoarthritis on X-ray even had symptoms.

That means that the other 85% is walking, biking, and running around enjoying their most favorite activities – despite the fact their X-ray showed arthritis too. The point here is to keep doing your activities – whether you’ve got arthritis already or not – it’s one of the best ways to prevent and protect your knee joints as you age.

So – to review…

If you want to optimize your knee health as you age – which you still can even if you’ve been told you have “advanced arthritis” – prioritize your core strength, the mobility of your knees, and stay active.

Focusing on these three things can have a significant impact on how arthritis affects you – and can help you avoid major (often unnecessary) surgery in your future.

Is knee pain keeping you from doing your favorite activities? Are you considering a major procedure or surgery but not sure if you need it?

Join us on Tuesday Oct. 25th from 6-7pm for our Free Masterclass for Knee Pain Sufferers.

Sign up using this link —> Knee Pain Masterclass.

We hope to see you there!

Can’t make it live? All participants will receive a complimentary replay of the class 🙂

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at info@cjphysicaltherapy.com.

Man getting knee pain treatment

Four Reasons Your Knee Pain isn’t Going Away

Approximately 25% of adults suffer from chronic knee pain and for many, they don’t have a clear reason or diagnosis as to why. They’ve been told to accept that their knee pain is due to arthritis, age, or wear and tear.

So why then, are some people able to get rid of their knee pain with proper treatment while others continue to suffer? It starts with the correct diagnosis. And for many chronic knee pain sufferers, this is the problem.

Here are four reasons why your knee pain might not be going away:


1. Mobility Before Stability

I’m a firm believer in this concept.

Our joints function better when they have full and free mobility. With knees in particular, everyone tends to focus on how well a knee is bending, but a lot of people miss when a knee isn’t fully straightening. Most knees have a certain amount of what we call hyperextension.

For example, your knee might look and feel straight, but if it’s naturally capable of “over-straightening”, and you don’t restore that completely, your knee will have problems.

I see it all the time, especially in folks who’ve had previous knee surgeries. If their full knee motion wasn’t restored properly during rehab, or perhaps they didn’t have any rehab at all (common practice now after most arthroscopic knee surgeries), knee pain will persist, and won’t go away no matter how much you strengthen it.

This isn’t something that can be seen on an Xray or MRI. Only a trained expert who knows how to look for this will be able to detect it, teach you how to restore it, and finally help you get rid of your chronic knee pain.

2. It’s Really a Back Problem

When the source of your pain is truly coming from your knee, it tends to be pretty specific and very localized to the knee joint itself. But if your pain tends to move around your knee, or perhaps travel up and down your leg, there’s a good chance your knee pain is coming from your back.

A recent study found that 40% of all extremity pain (including knees) comes from a source in your spine – even when you don’t have any back pain.

How does this happen? Typically it’s due to an irritated nerve that sends pain primarily to your knee and nowhere else. If you’ve been treating your knee for months and it’s either not going away or perhaps getting worse, consider that your knee problem is not a knee problem. Get your spine checked by a proper movement/mechanical therapist who can screen for this and figure it out.

3. Poor Core Strength

Your abdominals, low back muscles, hips, and glutes all make up what we call your “powerhouse” or core.

We all know that a strong core is important to help prevent back pain, but it’s equally important for healthy knees. If your core is weak, or doesn’t activate properly, it will have an impact on how fluid your joints will move during activities.

If you aren’t stabilizing yourself well with a strong core, your knees might try to help out by adding stability. Knees aren’t really meant to do this – they are meant to be mobile. But when your body lacks stability, your joints stiffen up in response, which can cause knee pain over time or aggravate arthritis that’s already there.

If your knees chronically ache – especially during activities – this could be why. You can treat your knees all you want, but if you don’t also address the deficits in your core, your knees will continue to hurt.

4. Stiff Ankles

When your ankles are stiff it will have an impact on your knees.

If one or both of your ankles lack mobility during certain activities – especially running, hiking, and squatting – your knees may strain themselves trying to help out and compensate.

Over time, this pattern will lead to knee pain. If you notice a lot of stiffness in the front of your ankles, or pain/fatigue in the front of your lower legs after repetitive walking or running, this could be a sign that the real problem is coming from stiffness in your ankles.

Stop working on your knees and start mobilizing your ankles instead. Your knees should start to feel better in no time. Knee pain can be tricky to figure out – especially if it’s chronic. Arthritis, age, and wear and tear aren’t common reasons for chronic knee pain. But they are definitely reasons that mislead people into thinking they’ve just got “bad knees”.

At least 70% of the time, knee pain can be resolved naturally and with movement – but you must make sure you’ve got the correct diagnosis nailed down first.

Want some help getting rid of YOUR knee pain?

Talk to one of my specialists for free by CLICKING HERE.

Not ready for help just yet? Join us for our Knee Pain Masterclass happening Tues. Oct 25th via Zoom. We will be going over how you can finally get rid of knee pain on your own – without pills, procedures, injections, or surgery! Reserve your seat and learn more about the Masterclass HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at info@cjphysicaltherapy.com.

Knee Pain Causes

Top 3 Causes of Knee Pain and What To Do.

Knee pain is the second most common complaint when it comes to musculoskeletal problems – right behind back pain – and it impacts one-third of all Americans at any given time.

I speak to a lot of folks in their 50’s and 60’s who love to ski, run, hike and bike.

Their biggest fear is that ongoing knee pain – when unchecked – could bring an eventual end to their active lifestyles.

The good news is that eighty percent of all knee problems can be resolved without procedures or surgery – but it starts with accurately identifying the root cause.

Here are three common Knee Pain Causes and what you can do to resolve it.

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, Patellofemoral Knee Syndrome (PFS) is characterized by pain in the front of your knee, usually just below or behind your knee cap.

With PFS, the source of the pain typically comes from unwanted pressure around your knee cap – that eventually results in inflammation and pain. It’s very tempting to just get a cortisone shot or take pain pills to quickly reduce the inflammation and relieve your pain. But unless you’re certain where the inflammation is coming from in the first place – you’re really only addressing the symptoms of your knee problem.

In other words, what causes the pressure in your knee cap to begin with?

It doesn’t just happen spontaneously. If you truly want to put an end to PFS, you’ll need to find the root cause of your problem.

Typically, PFS is the result of an imbalance somewhere in your body that over time, has resulted in poor form and movement habits that ultimately cause more pressure at your knee.

If your hips, quads (front of the thigh), and hamstrings (back of the thigh) aren’t balanced and working together harmoniously, for example, you could end up with problems in your knee.

Once you figure out the true culprit behind the pressure and inflammation at your knee cap, you’ll be able to both resolve and manage PFS naturally and for the long-term.

2. Iliotibial band syndrome

The causes of iliotibial band syndrome are very similar to that of PFS – except that your pain and symptoms will be experienced on the side of your knee instead of the front.

Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called the tensor fascia latae (TFL). When your TFL gets overworked, your ITB suffers, and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage, and while these are great modalities to relieve your symptoms, they don’t address the root problem.

You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis.

Your TFL is neighbor to your glutes so when they decide to be lazy, your TFL loves to help out, and eventually overdoes it. When you can get these two groups of muscles working properly together, you’ll put an end to ITB syndrome.

3. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get a total knee replacement.

First, arthritis is normal and it happens to everyone as they age. What is not normal is for you to think you’re helpless or have to avoid your favorite activities because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process, there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement. The more mobility you have, and the more stability you have around your knees, the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core and hip strength, and good flexibility in your hips and ankles.

If anything is off in these areas, your knees will want to compensate, which could result in compression at your knee joint and aggravation of your arthritic symptoms.

“Motion is lotion” isn’t just a saying.

It very well could be the difference between you suffering from debilitating knee symptoms versus living an active lifestyle despite your osteoarthritis.

If you’re suffering from knee pain, remember that there is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills, or believe that procedures and surgery are your only options. As you can see, three of the most common causes of knee pain are due to movement problems.

Therefore – movement should be your solution – not something you avoid.

Are you Local to Portsmouth, New Hampshire and experiencing knee or any other type of pain?

CLICK HERE to book a discovery visit with one of my specialists. Someone from my team will reach out to you, find out what’s been going on, and see if we’re a good fit for you to get you back to doing the activities that you love.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at info@cjphysicaltherapy.com.