Holding Knee with Arthritis

Arthroscopic Knee Surgery – Does it Even Work?

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While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still 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, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that 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?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely 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 shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures 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 and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to avoid surgery and heal your knee pain naturally and on your own – DOWNLOAD our Free Guide: 7 Ways to Get rid of Knee Pain Naturally.

Neck stretches

Why Your Neck Stretches Aren’t Working

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Do you suffer from chronic neck pain and ever wonder…

Why don’t my neck stretches work?

Even though you’ve Googled and YouTubed them about a hundred times…

There are a few reasons why stretching your neck might not be doing anything to help get rid of your neck pain.

  1. Your technique could be off
  2. You could be doing the wrong stretch
  3. It could be that you just shouldn’t be stretching your neck at all!

Let’s go over the different reasons why your neck stretches might not be working… and most importantly… what you can do about it.

1. You’re doing it wrong.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into the stretch. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work.

Some people (myself included) respond better to “moving stretches”. This is where instead of holding one static position for a prolonged period – you repeatedly move through one or several end-range stretches. Neck rolls are a great example of this.

If your neck stretches haven’t been working, try adjusting the way you’ve been stretching… if it works… then you were likely just using the wrong technique.

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

This one could be a little tougher to figure out on your own. There is a difference between corrective neck stretching and stretching to feel good.

For example, let’s say your neck is tightening up because you’ve been under a lot of stress or you just did a lot of activity that impacts your neck. Generic neck stretches such as bringing your chin to your chest, or pulling your chin to the opposite shoulder (known as an “upper trap stretch”) may be all you need.

In fact, I do stretches like this regularly because I’m constantly leaning over to help patients. I stretch my neck to PREVENT it from having problems and because it feels good.

But let’s say you already have a neck problem, or you have pain or numbness running down your arm.

In these instances, generic neck stretching could make you worse.

You likely need corrective stretches, like what we prescribe for patients in our office.

Corrective stretches are specifically prescribed to address your particular problem in your neck – and are very different from the generalized stretches that are designed to feel good and relieve tension.

If you think you might need corrective stretches for your neck – DO NOT google them – you must see a specialist and have them prescribed to you.

3. You shouldn’t be stretching your neck at all!

This is a very common problem we see… folks come in with complaints of chronic tightness and discomfort in their neck and no matter how often they stretch or massage, it doesn’t go away.

Did you know that chronic neck tightness can be a sign of a weak core?

It’s quite common – and if that is the case for you – no amount of stretching will help – and could even aggravate your problem!

The deep, stabilizing muscles of your neck are connected by fascia to the deep muscles of your core. If your deep core is not working properly, then your neck will often kick in and try to help.

Ever notice that your neck is always sore or tight after a good ab workout?

This could be a sign that your neck is compensating for your core.

Stop stretching your neck, learn how to strengthen your core the right way, and see a specialist who can help you.

In our office, our team of specialists work alongside our Pilates instructors to help folks improve their core strength from the inside out – so that their necks and backs stop getting involved.

If you’re dealing with chronic neck problems that aren’t’ responding to stretching…

There’s a good chance you could be not stretching correctly, the stretches aren’t right for you, or you’ve completely missed the root cause of your neck pain and you shouldn’t be stretching at all!

Want to work with our team of specialists and finally get some help for your neck problem?

CLICK HERE to request a free Discovery Session with one of our specialists.

They’ll set up a time to talk to you about what’s going on with your neck. If you’re a good fit for what we do, then they will help you get started!

This is only for people serious about getting help…

And for those that are finally ready for a long-term solution to their pain – one that will put an end to constantly relying on pain pills – and help you avoid expensive procedures and risky surgery.

Request a Discovery Session here.

PhysicalTherapy Porstmouth NH

Five Reasons to Include Pilates in Your Life

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Pilates has been around for about 100 years, yet so many people have NOT heard of this incredible exercise method. It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries.

But you don’t have to be a dancer to practice Pilates or enjoy the benefits. It’s become very mainstream over the years and for good reason.

I’ve been incorporating Pilates into my physical therapy practice for the last 11 years and it’s been transformational.

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength. It helps our clients connect to their bodies in a way they haven’t been able to achieve with traditional strengthening methods. Most of my clients are well into their 50’s and 60’s, and they love Pilates because it helps them have more energy, better balance, and improved strength and mobility. It allows them to participate in all the activities they love with more ease – and most importantly – significantly decreases the likelihood of injury.

But not all Pilates classes are created equal. And it’s important you choose your Pilates studio based on what your most important needs are.

Here are five reasons to consider adding Pilates to your life – and things to watch out for when choosing a program:

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We see a lot of folks in our office who’ve tried traditional physical therapists or chiropractors, and so many different kinds of core strengthening programs, but still have recurring back pain. They’ve been successful in getting rid of their pain in the short term, but they aren’t able to keep it gone for the long term.

Keeping pain GONE is what we specialize in – and one of the ways we do that is with Pilates. But “general/cookie-cutter” Pilates isn’t always enough.

For example, our Pilates instructors work closely with our PT team and get enhanced training on how to navigate back pain, and we keep our classes small so that we can pay close attention to everyone. If you’re recovering from an injury, or vulnerable to back pain, you’ll want to beware of classes that are overcrowded and not individualized. More than 5-6 people in a class when you’re trying to recover from back pain could be dangerous and increase your likelihood of re-injuring yourself. It’s impossible for your instructor to keep a close eye on you or give you individualized modifications when there are too many people in class.

2. Pilates strengthens your whole body, not just your core.

One of the keys to lifelong fitness is what I call “balanced strength.” In other words, each part of your body works together to produce the right amount of force, at the right time. I see lots of “strong” people in my office, but they can’t do the activities they love, because their muscles aren’t working together in the right way at the right time. This can result in compensatory patterns over time – that may predispose you to injury.

Pilates emphasizes full body strength that is coordinated. Coordinated strength is essential if you want balanced strength – which will give you the best shot at avoiding injury.

3. Pilates improves your flexibility.

Do you stretch your hamstrings every day but they never seem to improve?

It could be because you’re not stretching the right way – OR – it could be that you shouldn’t be stretching them at all! (Conversation for another day…)

Either way, the great thing about Pilates is that it improves your flexibility in a way that strengthens at the same time. The “old school” way of stretching was to find the most uncomfortable position for your muscle and just hold it for 30 seconds. Research has shown this is not effective in most cases. The best way to stretch is to do it dynamically with movement. In Pilates, you never stop moving, and one of the central concepts to the practice is “lengthening”. Basically, you use the concept of self-induced opposition to strengthen and stretch at the same time – this is how you end up with flexibility that lasts.

4. Pilates minimizes stress on your joints.

Aging is a real thing and along with it comes arthritis. But it’s not a death sentence like most people are led to believe. The key to combating arthritis is maintaining a mobile and well balanced joint. When you optimize everything that surrounds your arthritic joints, your symptoms decrease.

Pilates helps with all this – without causing any additional stress.

Since Pilates is based on the idea of constant opposition – lengthening while strengthening – you end up with a joint that is happy and balanced when you incorporate a regular practice of Pilates into your life. It helps to minimize the impacts of arthritis and even prevent the rate of degeneration.

5. Pilates trains your nervous system.

Say what? Is this even something I should care about?

Yes it is — and it’s almost ALWAYS a missing link I find for people who’ve been at a certain activity for a really long time, and then suddenly start having pain.

If you don’t train your nervous system, it gets lazy, and compensation patterns develop. When one part of your body is compensating for another, it ultimately leads to imbalance. The right type of Pilates will help with this.

Notice I said “right type.”

If you’re looking to just work out and have fun, then almost any Pilates will do. But if you’re wanting to truly correct your body’s imbalances and train your nervous system, Pilates is still your ticket but it needs to be with a qualified instructor.

If you’re not yet incorporating Pilates into your everyday routine… what are you waiting for!?

It’s my go-to exercise system for folks over the age of 40 and it’s my favorite way to help people keep their back pain gone.

 

5 Tips for Staying Active and Mobile as you Age

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Most of our clients are in their 50’s, 60’s and 70’s, and they want to stay as active as possible as they age. However, as we get older, our bodies do need more care and maintenance to age well and avoid injury. Here are some tips we like to give our clients to help them stay active and mobile, prevent injuries, and continue doing everything they love!

1. Keep Moving

I always tell my clients: “You don’t get stiff because you get old, you get old because you get stiff.”

If you want to stay healthy and mobile, you need to keep moving. One of the biggest questions I hear from folks aged 50+ is what to keep doing or stop doing because of arthritis. Remember, arthritis is normal as you age and it’s rarely a reason to stop doing certain exercises. Research has shown that activities like running, when done consistently and with proper form, can actually prevent knee arthritis! A similar and equally effective exercise is walking. Consistent walks will build up your strength and endurance, something that declines as you age, and it helps your balance and coordination. If you walk outside, you can get some fresh air and Vitamin D, which is highly beneficial for a strong immune system – something we all need right now.

2. Maintain a Healthy Diet

Tafeltennis Betting Sites Vergeleken: Winstwijzer’s Vergelijking van de Beste Opties

De wereld van het tafeltennissen is een opwindende en dynamische sport die miljoenen fans over de hele wereld aantrekt. Of je nu een doorgewinterde speler bent of gewoon geïnteresseerd in de spanning van de competitie, het wedden op tafeltennis kan een extra dimensie van opwinding en betrokkenheid toevoegen aan je ervaring. Maar met de vele online wedplatformen die beschikbaar zijn, kan het een uitdaging zijn om de juiste keuze te maken.

Gelukkig heeft Winstwijzer, een toonaangevend platform voor sportweddenschappen, een diepgaande vergelijking gemaakt van de beste tafeltennis weddenopties. In deze uitgebreide gids nemen we je mee op een reis door de wereld van het tafeltenniswedden, waarbij we de belangrijkste factoren belichten die je moet overwegen bij het kiezen van een betrouwbare en gebruiksvriendelijke wedsite. Of je nu op zoek bent naar de beste odds, uitgebreide live streaming, of een breed scala aan weddenschapsmogelijkheden, deze gids heeft alles wat je nodig hebt om een weloverwogen keuze te maken.

Betrouwbaarheid en Veiligheid

Als het gaat om tafeltennis betting sites, is het van cruciaal belang om een betrouwbare en veilige website te kiezen. Bij Winstwijzer hebben we een grondige vergelijking gemaakt van de beste opties op de markt. We hebben gelet op factoren zoals bonussen, inzetlimieten, live streaming, mobiele apps en klantenservice.

Eén van de topkeuzes is zonder twijfel Bet365, een gerenommeerde bookmaker met een uitstekende tafeltennis betting sectie. Ze bieden competitieve odds, live streaming van grote evenementen en een gebruiksvriendelijke interface. Een andere sterke optie is 888sport, bekend om hun gulle welkomstbonus en uitgebreide tafeltennis betting markten.

  • Bet365
  • 888sport
  • Unibet
  • Betway

Unibet en Betway verdienen ook een vermelding dankzij hun aantrekkelijke promoties, snelle uitbetalingen en uitstekende mobiele apps. Ongeacht welke tafeltennis betting site je kiest, zorg ervoor dat je de voorwaarden en bonusregels zorgvuldig doorneemt voordat je inzet.

Bonussen en Promoties

Tafeltennis is een populaire sport die steeds meer aandacht krijgt van gokkers. Met de groeiende belangstelling voor deze snelle en opwindende sport, is het aantal online tafeltennis weddenschap sites ook toegenomen. Bij Winstwijzer begrijpen we dat het vinden van de juiste site een uitdaging kan zijn, daarom hebben we de beste opties voor u vergeleken.

Onze experts hebben talloze factoren in overweging genomen, zoals de beschikbare wedopties, odds, bonussen en promoties, gebruiksvriendelijkheid van de site en mobiele compatibiliteit. We hebben ook gekeken naar de reputatie van de bookmakers, hun licenties en beveiligingsmaatregelen om ervoor te zorgen dat uw geld en persoonlijke gegevens veilig zijn. Bovendien hebben we de klantenservice en uitbetalingssnelheden geëvalueerd, zodat u een probleemloze ervaring kunt hebben.

  • Betcity: Een uitstekende keuze voor tafeltennis fans met een breed scala aan wedopties en aantrekkelijke odds.
  • Bet365: Een gevestigde naam in de gokwereld met een gebruiksvriendelijke site en een uitstekende mobiele app.
  • 22Bet: Een opkomende ster met een sterke focus op tafeltennis en regelmatige promoties voor trouwe spelers.

Live Streaming en In-Play Weddenschappen

Tafeltennis is een populaire sport die steeds meer aandacht krijgt van gokkers. Met de groeiende populariteit van deze sport zijn er ook steeds meer online wedkantoren die wedopties aanbieden op tafeltennis. Winstwijzer heeft een grondige vergelijking gemaakt van de beste tafeltennis betting sites, zodat jij als gokker de juiste keuze kunt maken.

Bij het vergelijken van de verschillende sites heeft Winstwijzer gekeken naar factoren zoals bonussen en promoties, odds en wedopties, live streaming, mobiele apps en gebruiksvriendelijkheid. Daarnaast zijn ook de reputatie, veiligheid en klantenservice van de bookmakers meegenomen in de beoordeling. Met deze uitgebreide vergelijking kun je eenvoudig de tafeltennis betting site vinden die het beste bij jouw wensen en voorkeuren past.

Mobiele Apps en Gebruiksvriendelijkheid

Tafeltennis is een razendpopulaire sport die wereldwijd miljoenen fans heeft. Het is dan ook geen verrassing dat er een groeiende vraag is naar betrouwbare tafeltennis betting sites waar sportweddenschappen kunnen worden geplaatst. Winstwijzer, een toonaangevende gids voor online gokken, heeft een grondige vergelijking gemaakt van de beste opties voor tafeltennis betting. Zij hebben diverse factoren in overweging genomen, waaronder de beschikbare wedopties, odds, bonussen, gebruiksvriendelijkheid en veiligheid.

Bij het evalueren van de tafeltennis betting sites heeft Winstwijzer gekeken naar:

  • De verscheidenheid aan wedopties, van wedden op individuele wedstrijden tot toernooien en meer
  • De competitiviteit van de odds, zodat spelers de beste waarde voor hun inzetten krijgen
  • Aantrekkelijke welkomstbonussen en promoties voor nieuwe en bestaande spelers
  • Een gebruiksvriendelijke interface en mobiele compatibiliteit voor gemakkelijk wedden
  • Veilige en betrouwbare betalingsmethoden en strikte licenties voor een veilige speelomgeving

Met deze criteria in gedachten heeft Winstwijzer de beste tafeltennis betting sites geselecteerd voor Nederlandse spelers, zodat ze met vertrouwen hun weddenschappen kunnen plaatsen.

Samenvattend kunnen we stellen dat de wereld van tafeltennis betting sites een breed scala aan opties biedt voor zowel recreatieve als serieuze gokkers. Door de uitgebreide vergelijking van Winstwijzer te bestuderen, krijgt u een duidelijk beeld van de sterke punten, bonussen en bijzonderheden van elke site. Of u nu op zoek bent naar de beste odds, live streaming, mobiele apps of aantrekkelijke welkomstbonussen, er is voor ieder wat wils. Neem de tijd om uw behoeften en voorkeuren te bepalen en maak vervolgens een weloverwogen keuze uit de top tafeltennis betting sites om uw gokervaring naar een hoger niveau te tillen.

What you eat directly affects your ability to keep moving. If you’re not keeping your bones and heart healthy, you’re not going to be able to exercise! Greens like kale, spinach, and arugula are awesome for your bones. Along with citrus fruits, fish, and nuts, these foods help your bones stay strong and durable, which is a big concern for our clients with osteoporosis.

When it comes to taking care of your heart, your diet can have a huge impact. According to Health magazine, “The risk of a heart attack climbs for men after age 45 and for women after age 55.” So as you enter middle-age, be sure to increase the presence of foods in your diet like unsalted nuts, unprocessed oatmeal, raisins, blueberries, and even dark chocolate (over 70% cacao) to help keep your heart healthy! If you have any comorbidities such as diabetes or kidney problems, be sure to check with your doctor or dietician before making any drastic changes to your diet.

3. Work on your Balance

Balance is one of the first things to go as a person gets older, and it’s one of the most crucial factors in helping you prevent falls and avoid injury. Slips and falls due to poor balance can lead to broken bones and fractures, which can be harder to recover from as you age. But if you’re diligent about exercising with the intention of improving your balance, you can maintain (and even improve) it far into your later years. As already mentioned, activities like walking regularly can help, along with activities such as Tai Chi and Yoga. And now, with everything so accessible via Zoom, you can take advantage of these types of activities right from your living room!

4. Strengthen your core

Having a strong core is beneficial at any age, but especially as you get older. Strong abs, hips and buttocks (all part of your core) help you to sit and stand more upright, prevent back and neck pain, and will help you feel stronger and more confident in just about everything that you do. In our office, our favorite core-strengthening activity is Pilates. We especially love it for folks aged 50+ because it’s easy on your joints and it helps to promote flexibility at the same time. We use specialized machines that are beneficial for folks recovering from an injury, and we’ve got Zoom classes requiring no equipment at all that people can do from home. Yet another reason to love Pilates is that it doesn’t just work your core, but your entire body. You can even do portions of Pilates in standing, which helps your balance and coordination! If you’ve never tried Pilates before, we’d love to help you get started.

5. Educate Yourself

Knowledge is power, and a lack of knowledge is one of the biggest reasons I see people decreasing their activity levels unnecessarily. People think that issues like arthritis, bulging discs, or a torn meniscus are reasons to decrease or cease certain activities altogether. But that’s not necessarily true! Most of the things I just mentioned are normal occurrences as we age, and having them show up on an x-ray or MRI is not a reason to change an activity you’ve been doing successfully for years. Plus, regular movement and exercise actually helps these problems.

If you have pain, that’s a different story. Talk to an expert who can help you figure out what’s going on so that you can quickly get back to your activities and not make your pain any worse. Whatever you do, try to avoid Dr. Google. It can send you down a rabbit hole and not all the advice you read will apply directly to you. If you’re dealing with pain that is keeping you from your favorite activities, reach out to experts like us. We offer a FREE 30 minute Discovery Session just so you can ask questions, get honest answers, and figure out if we’re the right fit for your lifestyle. 

back pain

Tight knots in your muscles? Do’s and Don’ts

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At one point or another, or perhaps even this very second, you’ve experienced tight knots in your muscles.

They are annoying, nagging, uncomfortable, and quite often painful.

The most common area to feel these knots is in your upper traps (the triangle shaped area between your shoulder blades and base of your neck). But other areas of your body that love to get knotted up include your mid and lower back, your hips and butt, the front and sides of your thighs, and the back of your lower legs.

The first thing people think to do when experiencing these tight knots or muscle spasms is to get a massage or try rolling them out with a foam roller. Lately, theraguns seem to be the craze. These devices look like power drills and use percussive therapy to reduce pain and relieve tightness in the affected area. In our office, for really stubborn and painful knots, we use something called dry needling, which is where you take a tiny acupuncture needle and insert it into the tight knot to bring blood flow to the area and release tension.

These are all great options, and for the most part, I put them in the category of “Do’s” when it comes to getting rid of tight knots in your muscles.

Sounds pretty simple, right? Well, not so fast. Not all muscle knots are meant to be released.

Spil for 10 Kr.: Casizoid’s Bedste Danske Casinoer i 2025

I en verden, hvor online casinoer blomstrer som aldrig før, kan det være en udfordring at finde de bedste og mest pålidelige udbydere. Men frygter ikke, for vi har gjort det hårde arbejde for dig. I denne artikel vil vi dykke ned i de førende danske casinoer i 2025 og afsløre, hvad der gør dem så unikke og attraktive for spilleglade entusiaster som dig.

Uanset om du er en erfaren gambler eller en nybegynder på jagt efter spænding, vil vores dybdegående analyse give dig et solidt fundament for at træffe de bedste valg. Vi vil dissekere alt fra spilleudvalg og bonusser til brugeroplevelse og sikkerhed, så du kan maksimere dine chancer for succes og undgå faldgruber. Vær parat til at blive overrasket, for de casinoer, vi har udvalgt, vil ikke kun underholde dig, men også sikre, at du får mest muligt ud af dine penge.

Sikkerhed og regulering af danske casinoer

I 2025 vil de bedste danske casinoer være dem, der tilbyder en uovertruffen spilleoplevelse med en bred vifte af spændende spil og generøse bonusser. Casizoid, en af de førende anmeldelsessider for online casinoer, har udpeget de mest lovende casinoer, der vil dominere markedet i de kommende år. Disse casinoer vil sætte nye standarder for brugeroplevelse, sikkerhed og ansvarligt spil.

Et af de fremtrædende casinoer på listen er CasinoXYZ, der allerede har vundet talrige priser for sin innovative tilgang til online gambling. Med en imponerende samling af over 2.000 spil, herunder de nyeste slotmaskiner, bordspil og live-dealer-spil, lover CasinoXYZ at give spillerne en uforglemmelig oplevelse. Derudover tilbyder de attraktive velkomstbonusser og loyalitetsprogrammer, der belønner dedikerede spillere.

Et andet casino, der har tiltrukket sig opmærksomhed, er VegasCasino. Dette casino er kendt for sin brugervenlighed og sin imponerende mobilkompatibilitet. Uanset om du spiller på din smartphone, tablet eller computer, vil VegasCasino give dig en flydende og underholdende oplevelse. Deres udvalg af spil er konstant opdateret med de seneste udgivelser fra de bedste softwareudviklere i branchen.

Endelig må man ikke glemme NordicCasino, der har specialiseret sig i at tilbyde en autentisk og sikker spilleoplevelse til nordiske spillere. Med en kundeservice, der taler flydende dansk, og betalingsmetoder, der er tilpasset det nordiske marked, har NordicCasino vundet tilliden hos mange lokale spillere. Deres spilbibliotek indeholder klassiske favoritspil såvel som innovative nye titler, der sikrer, at der er noget for enhver smag.

Populære spil og jackpotter

I 2025 vil online casinoer i Danmark have taget et enormt spring fremad i forhold til i dag. Spil for 10 Kr.: Casizoid’s Bedste Danske Casinoer i 2025 vil byde på en helt ny oplevelse med utroligt realistiske og immersive spil. Takket være den hastige teknologiske udvikling vil grafikken være så levende, at man næsten kan føle sig som om man sidder ved et rigtigt casinobord. Desuden vil udvalget af spil være enormt, og der vil være noget for enhver smag, uanset om man foretrækker klassiske casinospil eller de nyeste og mest innovative titler.

Et af de vigtigste aspekter ved casinoer med 10 kr. i 2025 vil være den forbedrede brugervenlighed. Hjemmesiderne vil være intuitive og nemme at navigere, og der vil være masser af nyttige funktioner som live chat-support og detaljerede vejledninger til spillene. Derudover vil sikkerheden være i top, og man kan føle sig tryg ved at spille på disse casinoer. Alt i alt lover Casizoid’s Bedste Danske Casinoer i 2025 at være en sand oplevelse for alle casinoentusiaster.

Mobilvenlige casinoer og apps

I 2025 vil online casinoer i Danmark være mere spændende end nogensinde før. Casizoid, den førende autoritet inden for anmeldelser af online casinoer, har allerede udpeget de bedste danske casinoer for det kommende år. Disse casinoer lover at tilbyde en uovertruffen spilleoplevelse med et bredt udvalg af spil, generøse bonusser og fremragende kundeservice.

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Kundeservice og bonustilbud

I 2025 vil Casizoid’s liste over de bedste danske casinoer være fyldt med spændende og innovative tilbud. Online casinobranchen udvikler sig konstant, og spillerne kan forvente endnu flere underholdende og belønningsrige oplevelser. De førende casinoer vil tilbyde en bred vifte af spil fra anerkendte udviklere, herunder de seneste slotmaskiner, bordspil og live casino-titler.

Sikkerheden og integriteten vil fortsat være en topprioritet for Casizoid’s anbefalede casinoer. Spillerne kan forvente robuste sikkerhedsforanstaltninger, herunder kryptering på højt niveau, ansvarlig spilpolitik og retfærdig spilafvikling. Desuden vil de bedste casinoer tilbyde hurtige og pålidelige indbetalings- og udbetalingsmetoder, så spillerne kan nyde en smidig og problemfri oplevelse.

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“Don’t” aggressively release a tight knot in your muscle until you know why it’s there. 

Sometimes, muscle knots form as a critical compensatory strategy. If released too quickly, they can set off an array of problems. I was just talking to my massage therapist about this, because she’s seen it happen to her own clients. Occasionally, she’ll work her magic to get rid of tight muscle knots only to find the client feels worse after the session. This can happen when the tight knot was there to compensate for a weak muscle elsewhere. 

Let me explain. 

Muscles are connected via highly innervated tissue called fascia. It looks like a spider web and one of its main functions is to connect organs and muscles together. Fascia is still being studied, but one of the theories is that if one muscle group in that fascial line is not doing its job, a different muscle will work extra hard in its place to take up the slack. Eventually, that muscle will get exhausted and tighten up into a knot, because it’s doing more work than it was designed to.

If you release a knot that is “holding the line” together, you’re asking for trouble.

In this example, what I’ve found is that the passive methods of releasing muscles (those I mentioned earlier) aren’t very effective at helping you get rid of the problem. You might actually end up feeling worse or having pain elsewhere. If your tight muscle knot is there to act as a survival mechanism, it’s going to take a more comprehensive and total body approach to resolve it. You’ll need to figure out which muscle or muscles the tight knot is compensating for and address them at the same time you work to release the tight knot. You can keep getting your weekly massage, but you’ve got to pair it up with correctly prescribed exercises.

To summarize, DO figure out WHY you have a tight knot in your muscle first.

Is it there because you overworked it in the gym? Maybe you’ve taken on a new project at home that is repetitive in nature?

If these are the reasons you’ve got tight knots in your muscles, then DO release them. You’ll likely feel better. And then correct the movement patterns, so the knot doesn’t come back.

If you feel worse after releasing the tight knots in your muscles, or the knot keeps coming back, then the problem likely involves more than just that muscle and you need a more comprehensive approach to get rid of it.

DON’T continue to release it over and over.

If you’re suffering from stubborn knots that won’t go away, get assessed by movement experts like us who can diagnose your problem accurately and help you get rid of the tight knots in your muscles for good.

 

Dr. Carrie Jose – back pain specialist and Pilates expert – owns CJ Physical Therapy & Pilates in Portsmouth, NH

Active and Mobile

Five Easy Ways to Keep Active and Moving this Thanksgiving

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Thanksgiving might look a lot different this year, but that doesn’t mean you can’t find ways to stay active during the holiday. And if you suffer from back or knee pain, it’s especially important to find ways to keep active and moving. Our spine and joints don’t like to be sedentary for prolonged periods. That’s especially true if you have arthritis. You may not notice any pain while you’re sitting or relaxing, but you WILL pay for it the next day. 

Here are five very easy ways to keep active and moving this Thanksgiving:

1. Interrupt your sitting.

This is quite possibly the easiest and most effective strategy to minimize pain and stiffness in your back and knees. I give this tip out all the time, not just for Thanksgiving. Our bodies were not designed to sit for prolonged periods, so getting up frequently (I recommend once every 30 min) keeps your knees, hips, and spine from getting painful and stiff. 

2. Do a Turkey Trot!

Thanksgiving Turkey Trots are a tradition for many. But just because races aren’t happening live and in person this year, doesn’t mean you still can’t get out there! Plus, many of these popular events have switched to virtual and have arranged ways for people to still participate but on their own time, and socially distanced. Turkey Trots are typically 5K’s – or 3.2 miles – so grab your dog, headphones, or favorite podcast or audiobook and start your morning off right. Whether you walk or jog, it will feel great to get your Thanksgiving Day started with lubricated joints and blood flowing. 

3. Stretch during Commercials.

Yes – the Macy’s Day parade is still happening (on TV only) and there will of course be football. A very easy way to keep yourself from sitting or slouching too much because you’re watching TV is to get up during commercials! I literally teach my clients to do “TV exercises”. Choose some very easy stretches or mobility exercises to do during the commercial breaks. 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, some heel raises, a set of planks, or back stretches on the floor or in standing. You can alternate through these during each commercial break.

4. Walk for Dessert.

Just because you did that Turkey Trot in the morning doesn’t mean you have to be done for the day! Skip the dessert (maybe) and go for a nice easy walking stroll after dinner. Walking is one of the best 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. Plus, it can’t hurt to work off some of those Thanksgiving calories!

5. Help with set up and clean up.

You may not like this tip, and your kids and grandkids might fight you on it, but it’s another easy way to keep moving on Thanksgiving Day. If you’re suffering from back problems, be careful bending and repetitively leaning over when you’re collecting or setting dishes down. And watch your posture when you’re cleaning dishes or loading the dishwasher. An easy fix for this, and a great way to protect your spine from the harmful effects of too much bending, is to remember to stand up straight and stretch backwards often and frequently whenever you’re doing an activity that requires a lot of bending forward. And remember to bend from your hips and knees instead of curving over from your spine.  And of course, if your back is so bad that it prevents you from being able to help clean up, or do any of the other activities I mentioned in this article, please reach out! 

I hope you enjoy your Thanksgiving, and that these tips help to give you some easy, practical ideas to stay active and moving!

Portsmouth NH physical therapist demonstrates proper raking posture to prevent back pain.

5 Tips to Avoid Back Pain While Raking Leaves

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Fall is officially in full swing here in New England. But as much as we love leaf peeping, leaf raking is turning into a literal pain! As more and more people start their fall clean ups over the next few weeks, we fully expect to be getting more calls and complaints in our office about back pain.

Here are 5 tips (plus a bonus tip!) to help you avoid back pain while raking leaves.

1. Warm up

Crisp, cool fall weather is perfect for walking. Before you start any activity, never mind a repetitive one like raking leaves, it’s a good idea to warm up your body first. Walking is an easy and practical way to get your legs, arms, and spine moving so that your joints feel lubricated and loose ahead of all that yard work.

2. Plan for stretch breaks

The biggest “danger” to your back when it comes to raking leaves is its repetitive nature — specifically the frequent bending of your spine. Our spines were designed to hold us upright, not to bend 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 the opposite way. Stand up tall and stretch backwards. Many of us do this instinctively, but typically not often enough. Best practice is to do this once or twice every 30 min. Your back will thank you.

3. Use 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 never hurts. Most back injuries occur when you least expect it… coughing, sneezing, picking something light off the floor. These activities are so mindless and automatic you’re not paying attention to your body or what it’s doing. The same thing can happen when you’re repetitively raking leaves. Each time you pull the rake toward you, think about engaging your abs and bracing your core. This will help keep your spine in a more supported and stable position while bent over. We help people in our office learn to engage and be more mindful of their core all the time. They are surprised at how beneficial this simple tip can be for them with all activities, not just raking leaves.

4. Bend with your knees and hips

After all the raking is done, you’ve got to pick up your leaves. It’s a good idea to be extra mindful of your posture here, especially because you’re more tired and fatigued at this point. The best way to pick anything up (not just leaves) is by squatting and using your legs. The perfect squat starts with your hips. Hinge back at your hips and bring yourself closer to the ground by bending your knees, not your spine. Once you’re in your squat, scoop up the leaves with your arms and use your legs and buttocks to stand upright. Even though the leaves aren’t heavy, this is a good habit to become proficient at. Remember that back pain almost always happens when you’re least expecting it, even picking up something light like a bunch of leaves.

5. Use a leaf blower

This is probably the best way to avoid all the repetitive bending that occurs with traditional leaf raking. However, you still want to be mindful of all the tips I just mentioned. Since it’s hard to stand perfectly upright when you’re blowing leaves, you want to be mindful of your core, take quick stretch breaks, and watch your posture. Holding the leaf blower for prolonged periods can also be quite strenuous on your neck, but all of these tips can help with that too!

Oh – and one more BONUS TIP…

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.

To learn more about back pain and how to prevent it, you can download our FREE back pain guide right here! 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.

 

Man getting knee pain treatment

Tight Hip Flexors? When Stretching isn’t Enough…

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When it comes to feeling stiff and immobile, tight hip flexors are the second most common complaint I hear – right after tight hamstrings.

Tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are tight, it can be painful or uncomfortable to walk, run, play golf, exercise, and even stand up straight!

Typically, the recommended treatments for this problem include lots of stretching, foam rolling, massage, and myofascial release.

But what if the stretching and all that other stuff doesn’t work?

What if no matter how often you stretch, the tightness just keeps coming back?

Sometimes – actually often – the tightness you feel in your hip flexors (or any other muscle group for that matter) can be due to weakness or overworking of the muscle.

If this is your problem, then no amount of stretching or foam rolling is going to help you.

Stretching and foam rolling will help to temporarily ease the stiffness from an overworking muscle, but it will only be a bandaid until you tackle the root cause.

You need to first identify WHY these muscles are weak or overworking, and THEN figure out the proper exercise and load that will help turn your hip flexors from feeling tight and overworked – to flexible and mobile.

Your hip flexors consist of the muscle group located in the front of your hip in the area of your groin. They are responsible for flexing or bending your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back… and this is where we see a lot of problems and confusion.

The rectus femoris, part of your quadriceps muscle group, and your psoas, part of your deep abdominal muscle group, are the two major hip flexors. Your rectus muscle is the one primarily responsible for lifting your thigh. When you are walking or running, and repetitively flexing your leg, this is the muscle you are using.

Your psoas, on the other hand, is much shorter and actually attaches to your lumbar spine. Because of this, it has more of a stability role. When functioning properly, it will assist in exercises like the crunch or sit up, and it helps to stabilize your pelvis during any of these movements as well as when you are standing upright. Your psoas, abdominals, and glute muscles all have to work together in harmony for you to have good posture.

Let’s talk about the psoas for a moment… because this is where many folks I speak with are misinformed.

The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle – then you will balance out your pelvis and your back pain will disappear.

Sadly – this is rarely the case. Read more

Five Ways Adding Pilates to your Life will Enhance your Fitness.

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Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method. It was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates — or enjoy the benefits. 

We’ve been incorporating Pilates into our physical therapy practice for the last 10 years and it’s been transformational for both our clients AND our practice.

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength. It helps our clients connect to their bodies in a way that they haven’t been able to achieve with traditional strengthening methods. Most of my clients are well into their 50’s, 60’s, and 70’s, and they love Pilates because it helps them have more energy, better balance, improved strength, and more mobility. It allows them to participate in all the activities they love with more ease, and most importantly, significantly decreases their risk for injury.

Here are five reasons why I personally love adding Pilates to any fitness routine, and why you should consider adding it to yours too!

1. Pilates helps prevent back pain.

Once you hit 40, your risk of back injury starts to climb. We specialize in back pain, so see a lot of folks with this problem in our office. They’ve often worked with traditional physical therapists or chiropractors in the past to successfully get rid of back pain in the short term, but it keeps coming back. And our clients want it gone for the long-term. A regular practice of Pilates is a safe and sustainable way to help keep your back pain-free. It focuses on core strength but is also a well-balanced exercise system. Full body strength and balance is a critical component for life-long back health, and it is not always addressed in traditional back rehabilitation programs or treatments.

2. Pilates strengthens your whole body, not just your core.

One of the keys to truly enhancing your fitness is what I call “balanced strength.” That’s when each part of your body works together to produce the right amount of force, at the right time, to do your favorite activity in the most efficient way possible. Efficiency means you’ll be able to do it for longer and with more ease. We see lots of strong people in our office, and they can’t understand why they’re in pain. It’s entirely possible to be “strong,” but still have certain muscles working harder than others. This creates an imbalance, which eventually leads to problems. Pilates emphasizes full body strength that is coordinated, which helps promote balanced strength throughout your body and leads to fewer injuries over time.

3. Pilates helps you get more flexible and mobile.

Do you stretch your hamstrings every single day and get frustrated because they’re still tight? It’s probably because you’re not stretching the right way. What I love about Pilates is that it stretches your body in a dynamic way – with movement – so that muscles lengthen the right way. The days of statically holding a stretch for 30 seconds are long gone. Plus, mobility is extremely important for strength. Muscles work better when your joints move fully and freely. “Mobility before stability” is a phrase you hear daily in our office. And Pilates is a great way to get your joints and muscles mobile while ALSO promoting stability.

4. Pilates puts minimal stress on your joints.

Aging is a real thing, and along with it comes arthritis. The key to combating arthritis is optimizing the area around the affected joint or joints. When you have good mobility, and balanced strength, you have less compressive forces around your joints.  Arthritis doesn’t like compressed, crowded joints. So when you strengthen and stretch your whole body in a good, balanced way – arthritis becomes less painful and stiff. Pilates helps with all this and doesn’t cause any added stress on your joints. There’s a good reason you see lots of folks in their 60’s and 70’s enjoying our classes.

5. Pilates trains your nervous system.

Huh? Is that even a thing? Yes it is – and it’s almost ALWAYS the missing link for people who feel stuck, or can’t seem to get beyond a certain point in their fitness. It can also be the reason why an activity you’ve been doing “for years” suddenly becomes problematic or painful. If you don’t train your nervous system, it gets lazy, and compensations will develop in your body. Compensations lead to problems when unchecked. Since Pilates is a mind-body exercise, it helps to keep the communication between your brain and your muscles fresh. Pilates emphasizes precise and coordinated movements, which enhance and reinforces this connection.  In other words, your nervous system can’t get lazy when you do Pilates!

If you’re not yet incorporating Pilates into your fitness or rehab routine — what are you waiting for?

As a specialist physical therapist it’s my go-to exercise system for folks over 40 and my favorite way to help people keep their back pain gone.  We’re actually re-launching our signature 8 week program, Pilates 101 ! Pilates 101 is completely dedicated to folks who are new to Pilates, or who have back pain and want to learn how to develop a safe core-strengthening routine. If you want more information, just click here!

 

 

Sciatica

Why Back Pain Keeps People from Exercising

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Did you know that eighty percent of the population suffers from what we call “non-specific low back pain” (NSLBP)?

You might have NSLBP if your back pain:

  • is often chronic
  • comes out of nowhere
  • comes and goes (you have good days and bad days)
  • is not due to a recent or major accident or fall

If you’re reading this right now, odds are very good that YOU are one of the 80% suffering from NSLBP.

Did you also know that research says exercise is the BEST treatment for this type of back pain?

But what do you do if back pain keeps you from doing the one thing that is best for you??

We have an 8-week program designed to tackle this very important problem… but before I get into that, let’s go over some reasons why back pain keeps so many people like you from exercising.

1. FEAR

Back pain is scary! This is the number one reason back pain sufferers don’t exercise. Is the pain you’re feeling good or bad? Should you be feeling any pain at all? Pain is confusing. And when you experience pain during exercise, it can be difficult to know if it’s normal or a warning sign. For many, the safest thing to do is avoid any exercise or movement that causes pain. But doing this can lead to a host of other issues, namely, loss of mobility and in-activity. When you become less mobile and active, your back pain gets worse, and now you’re in a vicious cycle.

2. BULGING DISCS

Most people who suffer from long-standing NSLBP pain eventually find themselves getting an MRI. And 60-70% of the time, it will show one or more bulging discs. If you’ve been following me for a while, you already know that most people over the age of 40 walk around with bulging discs – and that 65% of them feel no pain at all! In other words, if you’ve got a bulging disc, you can’t be certain it’s the cause of your back pain. Research proves this. And being told you’ve got a bulging disc is NOT a reason to avoid exercise. Movement is actually one of the best things you can do for a bulging disc. It may require some customization of your current exercise routine, but a movement specialist can help you with this. Don’t just stop or avoid exercise altogether without talking to one first.

3. YOU WERE TOLD TO REST

Well-meaning doctors and family members who aren’t up to date on the latest back pain research will advise you to rest every time you experience back pain. This might be reasonable advice when you’re dealing with an acute episode of back pain, but it’s terrible advice for chronic back pain sufferers. Rest is one of the worst things someone with chronic back pain can do. Since most people don’t have a thorough understanding of this concept, they find themselves in a yo-yo effect. They rest to “heal” their back pain. When it’s gone they return to exercise. When they hurt their back again they stop and return to rest… I’ve seen so many people fall victim to this perpetuating cycle and it’s a big reason why so many back pain sufferers find themselves with the NEXT problem on this list…

4. YOU’VE GOT A “BAD BACK”

I can’t tell you how many times I’ve heard this one and it makes me want to scream! First off, there is no such thing as a “bad back”. There are backs with problems, and there are backs more sensitive to pain than others, but there is no reason to believe your back is inherently “bad” or that you should stop exercising. Not exercising causes almost all back problems to become worse, but it can also turn a “bad back” into a strong and healthy one! For most people, once you get the right guidance, you can quickly find yourself safely and confidently exercising again.

5. INEFFECTIVE CORE STRENGTHENING

Interestingly enough the research on this topic is quite scattered. Much of the research says that targeted core work doesn’t have any added benefit compared to general exercise when it comes to reducing back pain. What the research doesn’t tell you is that your core strength can make or break how well you exercise. If you don’t exercise with good proper form, you’ll end up with back pain. Learning how to properly strengthen your core has a HUGE impact on your ability to exercise in a way that will not cause your back to hurt. I meet a lot of folks who start doing “core exercises” to get their abs stronger and reduce back pain, but they end up hurting their backs instead. That’s because there is a right and a wrong way to properly strengthen your core, especially if you’re prone to back problems.

On Sunday, September 6th, we’re opening enrollment to our Pilates 101: Get [Your] Back to Health™ program.

You MUST apply to join this program.

Click here to learn more.

Since this program fills up every time we offer it, we typically give the folks on our VIP waiting list an opportunity to sign up first.

Plus… when you sign up early, you can save up to $200 off the program!

If you’re suffering from NSLBP and you’ve stopped exercising, know that you’re not alone.

This is such a confusing topic and there are so many mixed messages out there about what the “right” and “wrong” thing to do is.

Don’t try to go at it alone!

Exercise is GOOD for your back, but you may just need a little help and guidance — and perhaps proper core strengthening — to get you there.