When your Back Hurts – is Rest Helping or Hurting?

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Whenever someone finds out I’m a physical therapist, the next question is almost always something like… “What can I do for [insert the blank] injury?” And when it comes to back pain specifically, people often ask me: “Should I be resting it?”

It’s no surprise that the vast majority of folks I speak with about back pain have been told by well-meaning friends, family, or even doctors that rest is the best thing for back pain — especially when you first hurt it. But what if I told you that rest might actually be the worst thing you can do? That resting and doing nothing — even when you’ve acutely hurt your back — can actually delay recovery and even make your back pain worse in the long-term.

Conventional advice tells us that back pain should be treated with ice, inactivity, and as little movement as possible — and when it feels better — to start slowly moving it. That advice makes sense on the surface — after all, if something hurts, shouldn’t you avoid using it? But research (and decades of clinical experience) shows us that this approach can actually prolong healing, increase pain sensitivity, and make it more likely that your back pain will return again and worse, become a long-term issue.

Why Rest Doesn’t Work

Modern health research is very clear on this: too much rest after a musculoskeletal injury like back pain leads to muscle deconditioning, joint stiffness, poor circulation, and even heightened pain sensitivity. A well-known review published in The Lancet concluded that staying active is one of the best things you can do for non-specific (mechanical) low back pain. In fact, people who remain as active as possible — within reason — recover faster and are less likely to develop chronic symptoms.

Here’s why: your joints and tissues thrive on movement. Motion promotes circulation, reduces inflammation, and helps your muscles and nerves return to normal function. When you stop moving, the opposite happens. Your muscles tighten, your joints stiffen, and your brain becomes more sensitized to pain signals. That’s how a small tweak in your back can turn into months (or years) of recurring pain if you’re not careful.

Movement is Medicine

Now, this doesn’t mean you should ignore your pain and go back to the gym, golf, or even all your daily house chores the next day. There’s a difference between smart movement and overdoing it. But most people fall on the other side of the spectrum — they stop moving entirely, waiting for the pain to just “go away.”

What I recommend instead is gentle, intentional movement that keeps your body active without making things worse. Walking, for example, is one of the best low-impact ways to get your spine moving and your blood flowing. If walking feels okay, it’s a great first step toward healing.

Specific exercises tailored to your pain are also incredibly powerful. These movements help “reset” your nervous system, calm down overactive muscles, and restore balance to the structures around your spine. In my clinic, I call these “first-aid movements.” They’re often simple, but highly specific — and they can help you move from debilitating pain to something much more manageable.

But What If Movement Feels Impossible?

I get it — sometimes your back pain is so bad that even getting out of bed or walking across the room feels unbearable. If you’re stuck in this kind of pain cycle, you may not be able to figure out on your own what’s safe to do. And in those cases, the worst thing you can do is wait it out or rely on generic advice from Google or YouTube.

This is where working with a mechanical back pain specialist can be a game changer. A trained expert can evaluate your pain based on movement patterns — not just an image or MRI — and guide you toward the exact movement your body needs to start calming the pain down. In fact, I often see patients go from 10/10 pain to 3/10 in their very first session, simply by finding and repeating the movement that’s right for their spine.

That kind of progress might seem like magic — but it’s just smart biomechanics. The body wants to heal, but it needs the right inputs. A movement-based mechanical specialist knows how to give your body those inputs safely and effectively.

Finding the Middle Ground

The key takeaway is this: while you may need to modify your activity levels when your back flares up, the goal should never be total rest. There is always some kind of movement you can do — and the sooner you find it, the sooner your healing process will begin.

If you’ve been dealing with back pain for more than a few days, and especially if it’s stopping you from doing the things you love, don’t wait around hoping rest will fix it.

The better alternative?

Talk to a professional who understands movement, mechanics, and pain. A customized plan — not a generic rest-and-wait approach — is what truly sets people on the path to lasting relief. Movement is powerful medicine — especially when it’s prescribed correctly.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists for free by clicking HERE.

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

Back Pain, Herniated Discs, and Cortisone Shots: What You Need to Know

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A recent conversation about cortisone shots and back pain due to herniated discs inspired me to write this article.

The person I was speaking with was quite misinformed about when cortisone shots are useful – and when they aren’t. By the way, it’s a very common misunderstanding. But since I hate seeing people undergo unnecessary injections or procedures – I’m here to educate. 

So let’s break it down: when is a cortisone shot a good idea, and when should you think twice?

When Cortisone Shots Work

Cortisone shots can be highly effective if your pain is primarily caused by inflammation, which is what I call “chemical pain.” Chemical pain results from your body’s inflammatory response to an injury. This response produces chemicals and nutrients that help heal the area, but sometimes the process gets “stuck”. The lingering chemicals cause persistent pain that doesn’t respond to movement or rest.

If your back pain is constant, feels hot and inflamed, and doesn’t improve with positional changes, you might have chemical pain. In these cases, a cortisone shot can eliminate the chemicals causing the pain and provide relief. 

In other words – exercise – which is the best treatment for herniated discs and back pain – won’t work well when you have chemical pain. Historically that’s when cortisone shots are necessary. But in 2021 – an amazing technology called Electrocorporeal Magnetotransduction Therapy (EMTT) came to the United States and works just as well (if not better) than cortisone, except it’s natural and non-invasive. EMTT uses a high-frequency magnetic field that can penetrate up to 6 inches into the body – so it can heal inflammation in places like your lower back down to the cellular level. I’ve seen great results from it – so I’m starting to recommend this over a cortisone shot for anyone that needs it. 

When Cortisone Shots Don’t Work

Most back pain (even those related to herniated discs) – aren’t chemical in nature. It’s mechanical, meaning it stems from issues with mobility and movement patterns. Mechanical pain – responsible for 70-80% of all musculoskeletal issues (including back pain) – will improve and resolve with precisely prescribed corrective-movement exercises. How do you know if you’re in this category? If your back generally feels better after walking, stretching, or changing positions – it’s almost certainly mechanical – because it’s responding to movement. If this sounds like you – a cortisone shot won’t address the root cause.

The key to resolving mechanical pain is identifying and correcting mobility restrictions and faulty movement patterns. Once you do this, the structural issue (like the herniated disc) becomes less relevant. Many people live symptom-free with herniated discs once they’ve addressed their underlying movement pattern problems and mobility.

The Gray Area

Here’s where it gets tricky: a herniated disc can irritate surrounding structures like muscles and nerves, causing localized inflammation. This type of pain can feel intense, but it’s not quite the same as chemical pain. But it will be tempting to get a cortisone shot for quick relief. The thing is – it will only be a temporary fix. The shot won’t address the underlying mechanical issues that caused the disc to “act up” in the first place. Worse, masking the pain can lead you to unknowingly worsen your problem, potentially leading to more procedures or surgery. In most cases, this type of inflammation can resolve naturally without drugs. Something like EMTT that I already mentioned, and other regenerative therapies like Shockwave Therapy work great for this type of inflammation.

Take Home Points:

Before you consider cortisone shots, take a moment to evaluate your pain:

  1. Does movement or activity influence your pain? If yes, it’s likely mechanical and won’t benefit from a cortisone shot.
  2. Is your pain constant, hot, and unresponsive to movement? If yes, you might benefit from a cortisone shot to calm the inflammation and enable movement to help.
  3. There are some amazing Regenerative Therapy Treatment technologies available now that serve as natural, non-invasive alternatives to cortisone shots if you are really inflamed. Plus – they work with your body’s own anti-inflammatory systems by giving them a boost.

Ultimately, cortisone shots don’t fix structural problems – they temporarily eliminate pain due to inflammation. While this can be useful in specific situations, it’s crucial to address the root cause of your pain to prevent long-term issues and seek healthier alternatives when you can.

Local to Portsmouth, NH? Schedule a free discovery visit with us today and take the first step toward lasting relief and better movement.

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

knee pain source

Six Natural Ways to Relieve Arthritis Pain – Without Meds or Surgery

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Arthritis is a widespread and debilitating condition that affects over 350 million people worldwide.

In the U.S. alone, nearly 58.5 million people live with some form of arthritis, making it one of the leading causes of disability. Until recently, conventional treatments like medication, injections, and surgery were the go-to options for managing arthritis-related pain and immobility. However, more people are seeking natural, non-invasive alternatives to reduce their reliance on these treatments and avoid potential side effects.

From lifestyle changes to cutting-edge therapies like Regenerative Therapy, there are many ways to manage arthritis naturally and effectively for lasting relief. Here are six that top my list:

Anti-Inflammatory Diet

One of the best ways to combat arthritis is through dietary changes aimed at minimizing inflammation, which plays a key role in joint pain and stiffness. Research suggests that bone edema (swelling within the bone marrow) is a primary source of pain in arthritis. Since inflammation fuels this process, an anti-inflammatory diet can help reduce discomfort and slow progression. Foods rich in omega-3 fatty acids like salmon, mackerel, and sardines counteract inflammation and may ease arthritis symptoms. Leafy greens, berries, and nuts provide powerful antioxidants that protect joint tissues, while turmeric and ginger contain natural compounds that act as pain relievers. Healthy fats like olive oil further support joint health by reducing inflammation. On the other hand – processed foods, excessive sugar, refined carbohydrates, and fried foods can worsen symptoms and should be limited.

Regular Exercise and Movement

Many people avoid movement when they have arthritis – but it’s actually one of the best ways to relieve joint pain and stiffness. Movement increases blood flow, which flushes out inflammatory toxins while also delivering oxygen and nutrients to nourish cartilage and surrounding tissues. Without regular activity, joints become stagnant, leading to more stiffness, inflammation, and degeneration – ultimately making arthritis feel worse. Low-impact exercises like walking, biking, and swimming improve circulation without excessive strain on joints. Yoga and Pilates enhance flexibility and stability, reducing stiffness and strain. Strength training keeps muscles strong, reducing pressure on the joints and minimizing arthritic symptoms. The more you move – the more you promote healing – making daily activities easier and reducing long-term discomfort.

Weight Management

Maintaining a healthy weight is key to managing arthritis. Excess weight puts added stress on joints – especially in weight-bearing areas like the knees, hips, and lower back. You’d be surprised to know that even a small weight loss can make a big difference. Research shows that losing just one pound reduces knee joint stress by four pounds, easing arthritis pain. One of the most effective and accessible ways to manage weight is walking. It’s simple, low-impact, and helps burn calories. Aiming for 10,000 steps per day is a great goal – but even small increases in daily movement can lead to lasting improvements in joint health and overall well-being.

Herbal Remedies and Supplements

Before medication existed, nature was our primary source of medicine. The good news is that today – there are countless herbal remedies and supplements that can naturally and effectively help manage arthritis symptoms. Glucosamine and chondroitin are among the most widely used for supporting cartilage health and reducing joint pain. Turmeric, particularly its active compound curcumin, has powerful anti-inflammatory properties. Omega-3 fatty acids, found in fish oil and supplements, help reduce both inflammation and stiffness. Other beneficial herbs include Boswellia (Indian Frankincense), which improves joint function and reduces swelling – and Vitamin D, which supports bone health and may alleviate joint pain. If you’re new to herbs and supplements, consult a medical professional trained in herbal medicine to find the best options for you.

Acupuncture and Massage Therapy

Acupuncture and massage therapy have been providing relief for arthritis symptoms for centuries. Acupuncture, an ancient Chinese practice, involves inserting thin needles into specific points on the body to promote energy flow and reduce pain. Many arthritis sufferers find that regular acupuncture sessions help manage discomfort and improve joint function. Massage therapy works by relieving muscle tension, improving circulation, and increasing joint mobility through soft tissue manipulation. Techniques like cupping and hot stones can further enhance results. Sometimes we need extra help managing arthritis symptoms – and these two treatments are not only safe and non-invasive – but also highly effective (especially when combined with the right type of exercise and movement).

Regenerative Shockwave Therapy and EMTT

One of the most exciting advancements in arthritis treatment is Regenerative Therapy. While some regenerative treatments (like PRP and stem cell injections) are invasive – highly effective non-invasive options like Shockwave Therapy and Extracorporeal Magnetotransduction Therapy (EMTT) are gaining popularity. These therapies stimulate the body’s natural healing process without surgery or medication.

Shockwave Therapy uses acoustic waves to promote blood flow, reduce inflammation, and encourage tissue regeneration. EMTT employs high-energy electromagnetic fields to accelerate cellular repair and relieve pain. Together, these therapies provide a drug-free, surgery-free solution for arthritis sufferers. Many patients experience reduced pain, increased mobility, and faster recovery times with no downtime. Unlike cortisone shots, which provide temporary relief but can also weaken joint tissue over time – EMTT and Shockwave Therapy heal at the cellular level – leading to lasting improvements in pain and function.

Final Thoughts…

If you’re suffering from arthritis, it doesn’t mean you have to settle for a lifetime of pain or dependence on medication. By embracing natural treatment methods – such as an anti-inflammatory diet, regular exercise, weight management, herbal supplements, and cutting-edge therapies like Regenerative Shockwave Therapy and EMTT – you can take control of your joint health and improve your quality of life. If you or someone you know is struggling with arthritis – consider exploring these drug-free, non-invasive approaches to healing. The body has an incredible ability to repair itself when given the right support and environment. Taking proactive steps today can lead to a more pain-free, active future.

Local to Portsmouth, NH?

Consider speaking to a mechanical pain specialist by clicking HERE.

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

Could Regenerative Therapy be the Future of Healing for Active Adults?

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Staying fit and injury-free is essential for maintaining an active lifestyle – especially when you’re over 40.

And the more active you are, the better your quality of life tends to be. But here’s the unavoidable reality… As your body ages, so do your natural healing processes. Translation? Recovery times take longer than when you were in your 20s – and you become more vulnerable to injuries as you age.

Fortunately, an emerging field in medicine is gaining popularity and could be the solution to longevity you’ve been searching for. It’s called regenerative therapy. This cutting-edge field focuses on harnessing the body’s natural ability to heal and regenerate itself. Regenerative therapy includes treatments like stem cell therapy, platelet-rich plasma (PRP) therapy, regenerative shockwave therapy, and electromagnetic therapies such as Pulsed Electromagnetic Field Therapy (PEMF) and Extracorporeal Magnetotransduction Therapy (EMTT). These therapies aim to repair damaged tissues, reduce inflammation, and stimulate the production of new, healthy cells.

For the purposes of this article – let’s focus on two of these regenerative therapies – Shockwave Therapy and EMTT – and how when used together – deliver incredible results for active adults over 40.

Compared to some of the other regenerative therapy options out there – this treatment combo is non-invasive, highly accessible, and affordable. Plus – it comes with minimal side effects, no contraindications for most people, and virtually no downtime required – making it a game-changer for those who want to stay active without interruptions to their daily lives.

Let me introduce you to Regenerative Shockwave Therapy and EMTT…

What is Shockwave Therapy?

Extracorporeal Shockwave Therapy (Shockwave Therapy) is a non-invasive procedure that uses acoustic shockwave energy to stimulate healing in tendons and soft tissues. Radial Shockwave Therapy (EPAT) disperses energy broadly over an area – while Focused Shockwave Therapy (ESWT) concentrates energy on a smaller, more precise area. Both types of shockwave therapy stimulate healing by enhancing blood flow, promoting cell and tissue regeneration, reducing inflammation, and breaking down scar tissue. Originally developed to break up kidney stones, shockwave therapy has been used for decades to treat musculoskeletal conditions like tendinitis and plantar fasciitis.

What is EMTT?

Extracorporeal Magnetotransduction Therapy (EMTT) is an advanced, non-invasive, cutting-edge treatment that uses high-energy electromagnetic fields to accelerate healing and alleviate pain. It’s often compared to Pulsed Electromagnetic Field Therapy (PEMF), but it’s much more powerful. While both therapies rely on electromagnetic fields to stimulate natural repair processes – EMTT operates at frequencies up to 100 times higher than PEMF – enabling it to penetrate deeper into tissues and deliver more targeted therapeutic effects. EMTT has the capability to heal at the cellular level by enhancing your cell’s metabolic activity, which helps to reduce inflammation, promote faster healing, and accelerate the regeneration of damaged tissue. EMTT’s increased energy and intensity make it so powerful it can penetrate through clothing and even a cast (when bone healing is needed). Its high frequency also makes it virtually painless. EMTT is particularly effective for chronic pain, joint injuries, and degenerative conditions like arthritis

The Power of Shockwave Therapy and EMTT combined:

While Shockwave Therapy has been around for over 40 years – EMTT is fairly new to the market of regenerative therapies. The first EMTT device, the Magnetolith, was FDA-approved in the United States in 2010. Since then – the two therapies have proven to be a perfect pair. When combined – Shockwave Therapy and EMTT offer a powerful, synergistic approach to healing. While Shockwave Therapy focuses on mechanical stimulation of your tissues and improving circulation – EMTT works at a cellular level, resetting inflammation and promoting deeper tissue repair. Together – these therapies amplify each other’s effects – resulting in faster and more comprehensive healing.

Evidence Supporting the Combo:

A 2018 study by Kluter et al. examined the effects of Shockwave Therapy alone versus Shockwave Therapy combined with EMTT on 86 patients with rotator cuff tendinopathy. The results showed that patients receiving the combined therapy experienced significantly greater pain reduction and improved function compared to those treated with Shockwave Therapy alone. Although EMTT is relatively new, preliminary studies and case reports highlight its potential. For example – regenerative therapy using Shockwave Therapy and EMTT has shown promise in improving surgical outcomes. Case studies demonstrate that pre- and post-operative use of this combo significantly enhances scar healing, bone healing, and recovery times. And patients undergoing major procedures like Achilles tendon repairs returned to activity almost two months faster when these therapies were included as part of their recovery.

So Who Can Benefit?

The short answer is literally anyone. But active adults over 40 are prime candidates for this combination of regenerative therapies. Post-surgical patients recovering from orthopedic surgeries – including joint replacements – can experience faster healing and improved outcomes. Chronic pain sufferers dealing with conditions like arthritis or tendinopathies can find relief where other treatments have failed. Athletes or active adults with sports injuries, muscle strains, or overuse injuries will also benefit. And finally – if you’re someone who’s recovery has stalled with traditional physical therapy or cortisone injections  – you might just find renewed hope with this advanced, cutting-edge treatment.

As research into regenerative medicine advances – I believe the combined use of Shockwave Therapy and EMTT is poised to become a cornerstone of modern healthcare for active adults. These therapies not only address the symptoms of injury and degeneration – but also tackle the underlying causes – promoting true healing and long-term recovery. For active adults over 40 who want to maintain their mobility, independence, and active lifestyles – regenerative therapy offers a promising future. By harnessing the body’s natural healing capabilities through advanced, non-invasive techniques – Shockwave Therapy and EMTT provide a path to faster recovery, improved surgical outcomes, and a pain-free life.

If you’re over 40 and facing chronic pain, injury, or the prospect of surgery – consider exploring regenerative therapy.

The combination of Shockwave Therapy and EMTT isn’t just about managing symptoms – it’s about restoring your body’s ability to heal itself.

With growing evidence supporting their effectiveness, these therapies are paving the way for a healthier, more active future for adults everywhere.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists to see if you could be a good fit for our Regenerative Therapies by clicking HERE.

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

Shockwave Therapy

How Regenerative Therapy Speeds Healing After Injury and Surgery

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As we age, our bodies naturally experience wear and tear.

Degenerative conditions, arthritis, and the aftermath of surgeries can all make it challenging to stay active. Many people assume this means they have to give up their favorite activities, but nothing could be further from the truth. With the right approach, including proper hydration, nutritious food, regular movement, and now advanced therapies like Regenerative Shockwave Therapy (RSWT) and Extracorporeal Magnetotransduction Therapy (EMTT), staying active and vibrant well into your later years is entirely possible.

While both therapies use cutting-edge technology, the real story is about the benefits they provide—helping clients heal faster, reduce pain, and regain mobility so they can get back to doing the things they love.

Pain Relief That Gets You Moving Again

Pain is one of the biggest barriers to recovery and activity. Both RSWT and EMTT work synergistically to target pain at its source. RSWT uses sound waves to stimulate deep tissue healing, while EMTT employs high-energy magnetic pulses to reduce inflammation and promote cellular repair. Together, they accelerate the body’s natural healing processes, reducing discomfort and giving clients the confidence to move freely again.

Enhanced Mobility and Flexibility

Stiffness and restricted movement can become significant problems, particularly after surgery. Shockwave therapy enhances collagen production, while EMTT helps improve tissue elasticity and overall function. By addressing the root causes of stiffness and encouraging healthy tissue regeneration, these therapies ensure you can move more freely and avoid the compensatory patterns that often lead to further issues.

Accelerated Healing with Better Blood Flow

Healthy circulation is critical for recovery. Shockwave therapy promotes vasodilation, increasing blood flow and delivering essential nutrients to injured areas. EMTT complements this by stimulating cellular activity, speeding up the repair of both soft tissues and bones. For individuals recovering from surgery, this combination can significantly shorten the healing timeline, allowing for a faster return to normal activities.

Tackling Scar Tissue and Restoring Function

Post-surgical scars can cause long-term discomfort and mobility issues if not properly managed. RSWT breaks down dense scar tissue, while EMTT encourages the formation of new, healthy tissue. This duo not only improves the appearance of scars but also restores functionality to the affected area, preventing complications and ensuring you’re back on your feet sooner.

A Recovery Companion for Every Stage of Healing

One of the most exciting aspects of combining RSWT and EMTT is how they support healing at every stage. Whether you’re preparing for surgery, recovering immediately afterward, or dealing with lingering issues months later, these therapies adapt to your needs. They amplify your body’s natural ability to heal, making them a perfect companion to any rehabilitation program.

Get Back to the Activities You Love Faster

If you’ve been struggling with pain, stiffness, or prolonged recovery after surgery, RSWT and EMTT might be the missing pieces in your healing journey. These innovative therapies not only accelerate recovery but also improve overall quality of life by reducing pain, improving mobility, and restoring functionality. With these tools, you can confidently reclaim the activities you love and enjoy a fuller, more active lifestyle.

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

Holiday Stress

3 Tips to Manage Holiday Stress and Unwanted Aches and Pain

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The holiday season should be a time of celebration, joy, and cherished moments with loved ones. But it tends to bring with it a flurry of activities and responsibilities – and for many of us – that equals stress. The pressure to create the perfect holiday experience – coupled with the hustle and bustle of shopping, cooking, and entertaining – can lead to elevated and unwanted stress levels. And uncontrolled, heightened stress can start to manifest itself physically in the form of aches and pains in our body.

The good news is there are things you can do to avoid this – or at the very least – significantly minimize aches and pains caused by stress.

Here are three of my top tips for reducing Holiday Stress to help you avoid unwanted physical aches and pain.

  1. Prioritize Intentional Breathing

Breathing is one of the most powerful tools at your disposal for rapidly reducing and interrupting stress. The act of taking a deep breath sends a signal to your brain to calm down and relax. This simple yet effective technique can have a dramatic impact on your stress levels in as little as 30 seconds. The beauty of intentional breathing is that you can do it anywhere and at any time – whether you’re stuck in traffic, at your desk, in a crowded store, or in the privacy of your own home.

The premise behind intentional breathing is to interrupt the accumulation of stress. By doing so, you decrease the overall toll it takes on both your body and mind. When stress is allowed to build up past a certain threshold – it can take the form of muscle tension, headaches, and even neck and back pain. Therefore, taking a moment to practice intentional deep breathing can help to break up that stress cycle, and make a significant difference in how you feel during the holiday season.

  1. Practice Gratitude

Gratitude is a powerful antidote to stress. Studies have shown that practicing gratitude can lower cortisol levels in the body by approximately 23 percent. Cortisol, often referred to as the “stress hormone”, is responsible for many of the negative effects of chronic stress, including high blood pressure and an increased risk of heart disease.  Chronic stress can also be responsible for unwanted muscle tension – especially in areas like your neck, back, and hips.

When we focus on things we appreciate (aka: practice gratitude) – we activate the parasympathetic nervous system – which is responsible for calming the body and returning it to its natural rhythm. When your parasympathetic nervous system is activated – stress dissipates. So by consciously practicing gratitude, you actively lower your stress levels. This not only benefits your mental well-being – but also has a positive impact on your physical health. When your stress is reduced – it leads to lower blood pressure, improved sleep quality, and you’ll notice decreased muscle tension throughout your body.

  1. Get Physical

Physical activity is a powerful stress-reduction tool with numerous benefits for both body and mind. Engaging in regular exercise helps boost your mood and decrease muscle aches by releasing endorphins – your body’s natural stress and pain relievers. 

Another benefit of physical activity is that it helps put an end to the “fight or flight” response triggered by stress. In ancient times, our fight or flight response served to protect us from immediate danger – such as being chased by a predator (aka Lion). The physical activity of running away signaled to your brain that the fight or flight response could end – because you were out of danger. But in our modern world, the fight or flight response hasn’t fully adapted yet, and chronic everyday stress can simulate it.

The problem now is we don’t “run away” from our stress anymore (although many of us wish we could). So we need to make a conscious effort during the day to do physical movement to help break up our stress – and effectively disrupt this flight or flight response that’s occurring. So when you feel that stress heightening – get moving – it will help your body and your nervous system to feel better.

I hope these simple and practical tips help you to get a bit more control over your Holiday Stress this Season – and by consequence – less aches and pains.

The key is not necessarily to prevent stress altogether – but to instead – learn to break up the cycle and manage it better – so it doesn’t consume your body. And if you’re thinking to yourself – “I wish I read this article weeks ago” – because perhaps your aches and pains are already out of control – you might need some expert help. I suggest speaking with a mechanical pain expert who can help you figure out where your pain is coming from, help you get rid of it, and get you on a physical regimen that is designed to keep your pain gone – and give you better control over your stress as an added benefit.

Are you local to Portsmouth, NH?

Consider speaking to one of my mechanical pain specialists by clicking here. They will ask you all about what’s been going on and see if we would be a good fit to work together 🙂

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free discovery visit with one of her mechanical pain specialists, CLICK HERE or call 603-380-7902

7 Healthy Habits to Improve your Immunity, Movement, and Mindset

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As the seasons change, it’s the perfect time to focus on habits that not only keep your immune system strong, but also enhance your movement and mindset. Whether you’re juggling holiday events, managing a busy schedule, traveling, or simply trying to stay healthy and feeling well – a balanced approach to health is key. 

The following 7 healthy habits are those that I try to live by personally, but also routinely coach my clients on. These habits are designed to help you feel your best and keep sickness at bay – while also supporting your overall vitality and well-being.

Here’s 7 healthy habits to improve your immune system, movement, and mindset:

1. Stay Hydrated

You hear it all the time. But why is it so important? Water does more than quench your thirst – it’s a vital part of your immune system’s function. Staying hydrated flushes out toxins and ensures your cells, including those critical for fighting infections, operate at their best. Besides water – you can also resort to teas, broths, or other low-sugar beverages that are also excellent for hydration.

My personal favorite? A soothing thermos of hot water with lemon and honey. Packed with vitamin C and comforting warmth – it’s my go-to when I feel a cold coming on – plus it tastes refreshing and delicious.

2. Exercise Regularly

Movement is medicine. Because exercise boosts your immunity by increasing blood flow and circulating immune cells more effectively. But regular movement also sharpens your mind, lifts your mood, and reduces stress. Whether it’s a brisk walk, a yoga class, or weight training, staying active helps you feel more empowered and connected to your body.

On low-energy days, or even when you’re under the weather, prioritizing gentle exercise and light movement such as stretching or walking can aid in recovery and clear your mind. On healthy days, focus on building strength and more robust cardiovascular exercise to maintain resilience and stay motivated.

3. Prioritize Restful Sleep

Sleep is the foundation of health – both physically and mentally. While you sleep, your body repairs itself and produces the cells needed to fight infection. Sleep also refreshes your brain, improves memory, and helps regulate your emotions.

Lack of sleep can leave you feeling foggy, irritable, and more prone to illness. To set yourself up for a great night’s rest – stick to a consistent bedtime, limit screen time before bed, and create a calming nighttime routine. Good sleep equals a strong immune system, sharper mind, and better overall mood.

4. Eat a Nutrient-Rich Diet

Food is fuel, not just for your immune system but for your energy levels and mental clarity as well. A colorful diet full of fruits, vegetables, lean proteins, and healthy fats helps your body stave off infections and illness, while also giving you the daily stamina to stay active and focused.

Probiotic-rich foods like yogurt and kimchi are great for gut health, which influences both your immunity and your mood. A healthy gut also means better digestion and less inflammation – which will naturally put you in a happier state of mind. When you eat well, you’ll feel energized and ready to take on whatever the day brings, and will be less likely to get sick.

5. Be Social

Human connection is one of the most overlooked aspects of health. Positive relationships not only boost your immune system but also improve your emotional resilience and mental well-being. Whether it’s a shared laugh or a heartfelt conversation, spending time with others helps you feel grounded and supported.

When you’re feeling good, make an effort to connect in person – perhaps during a walk or an exercise class. And when you’re under the weather, pick up the phone or hop on Zoom. Staying connected keeps your mindset strong, even when your body needs a rest.

6. Get Outside

Fresh air and natural light are some of nature’s best medicines to improve your immune system and mood. Stepping outside reduces stress, gives you a boost of vitamin D, and encourages more physical activity. Even a short walk outdoors can improve your focus, energize your body, and clear your mind.

In colder months, it’s tempting to stay indoors, but bundling up and getting outside – even briefly – can make a big difference. Nature has a way of lifting your spirits and making you feel more alive. When you do get outside and walk – try to aim for 10K steps throughout the day – your body will thank you.

7. Incorporate Daily Stretching and Breathing

Gentle, daily stretching will increase your blood flow, reduce muscle tension, and help calm your nervous system. And when paired with mindful breathing or meditation – a daily stretching routine can be just the thing to reset your body and mind – any time of day you need it. 

Take five to ten minutes each day to stretch. Focus on areas where you feel tight, like your shoulders or hips, and breathe deeply as you move. Stretching not only prepares your body for activity but also creates a moment of mindfulness to calm your brain and center yourself.

How many of these habits do you already incorporate into your daily lifestyle? Which ones will you try?

This time of year can be tough to get any kind of consistency going, never mind all seven of these habits daily. But even just focusing on a few of them – each day – will add up. In no time – you’ll find yourself feeling healthier, stronger, and with more energy.

Local to Portsmouth, NH? Looking for a team of movement experts to help you stay strong and healthy?

👉 Connect with us HERE!

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 discovery visit with one of her mechanical pain specialists, CLICK HERE or call 603-380-7902

Back Pain MRI

Do You Really Need an MRI for That?

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

“Should I get an MRI for that?”

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

Not so fast!

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

Don’t get me wrong… 

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

Let me explain…

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

Sound familiar?

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

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

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

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

So what IS the root cause of the problem?

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

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

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

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

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

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

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

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

Active and Mobile

Six Ways to Keep Your Thanksgiving Festive and Fit

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Thanksgiving is one of my absolute favorite Holidays.

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

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

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

1. Practice Mindful Eating

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

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

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

2. Interrupt your sitting.

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

3. Sign up for a Turkey Trot

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

4. Be Active during Commercials.

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

5. Walk your Dessert Off

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

6. Stay hydrated

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

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

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

Are local to Portsmouth, NH?

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

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

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

low back pain

3 Reasons Your Lower Back Stretches Aren’t Working

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

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

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

1. You’re using the wrong stretching technique.

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

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

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

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

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

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

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

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

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

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

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

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

Are you local to Portsmouth, NH?

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