Pickleball

Six Reasons to Try Pickleball this Father’s Day

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If you’re looking for something fun and active to do this Father’s Day – why not try a game of Pickleball?

If you haven’t yet heard of pickleball – it’s quickly become one of the most popular racket sports in the country. It’s a paddle sport that combines elements of tennis, badminton, and ping-pong. Since the rules are fairly straightforward, it tends to attract people of all ages and skill levels – but it’s been a huge hit in the over-50 crowd. You can find both outdoor and indoor courts just about anywhere – and it provides a fantastic opportunity for the whole family to engage in a fun-filled day of friendly competition – while also honoring your favorite active dad.

Pickle ball also comes with a ton of health benefits. 

Here are 6 of my favorite reasons why pickleball is good for your health – and why I think you should give it a try this Father’s Day:

1. Get’s the Heart Pumping:

Since Pickleball is a dynamic sport – it keeps you on the move – making it an excellent cardiovascular workout. When you play pickleball regularly – it can improve heart health, increase endurance, and strengthen your cardiovascular system. Pickleball consists of both aerobic exercises as well as bursts of anaerobic activity – such as quick sprints and lunging on the court. This helps to elevate your heart rate in a way that is great for promoting overall hearth health and cardiovascular fitness.

2. Weight Management:

Everyone knows you need both diet and exercise to effectively manage your weight. When it comes to exercise – why not pick something fun that you know you’re more likely to do because it’s enjoyable. The continuous movement involved in the sport of pickleball helps to burn calories and increase your metabolic rate. But it’s not just cardio that pickleball is known for – there is a strength component too. This combination of both strength and cardio only adds to your calorie-burning – making it not only fun – but an efficient way to manage your weight.

3. Improved Balance and Coordination:

Pickleball requires you to move quickly, change direction, and react to the ball’s trajectory. These dynamic movements help to improve balance and coordination because they force the engagement of multiple muscle groups at once. When you have to anticipate shots from any angle, pivot at a moment’s notice, and reach for the ball – this helps to enhance something called proprioception – your body’s ability to sense position in space. Since pickleball is super popular with the over 50 crowd, anything that works on balance and coordination is something I support – since these two areas only tend to decline as you age.

4. Increased Strength and Endurance:

When you play pickleball – you have to do everything from swing the paddle, lunge at the ball, and reach for shots. These varied physical movements help to engage just about all the muscles in your body – particularly your arms, shoulders, legs, and core. When you play pickleball regularly – it’s going to lead to improved muscular strength and endurance. Plus, pickleball is generally low-impact – so you get to improve your strength and endurance while not having a huge negative impact on your joints.

5. Cognitive and Mental Benefits:

The strategic aspects of pickleball – such as shot placement, anticipating your opponent’s moves, and the adaptation to different playing styles – challenges your brain and enhances mental agility in a fun and active way. For example, just the hand-eye coordination required to track the ball and make split-second decisions sharpens your cognitive skills and improves your reaction time to things. When you play pickleball regularly – you’ll find that your focus, concentration, and overall mental well-being will simply improve.

6. Social Interaction and Emotional Well-being:

This is probably my most favorite health benefit of pickleball. For the younger crowd (30’s and 40’s) – it’s quickly becoming one of the hottest business and networking events out there. And for everyone else, it’s a fabulous social sport that encourages interaction and camaraderie. Regardless of who you play with – whether it be friends, family, or in a community league – pickleball fosters a sense of belonging and enhances social connections. Plus, the positive connections you find on the court can easily extend off the court – so it becomes a fun and active way to quickly expand your social circles and overall well-being. Your new pickleball buddy could suddenly double as your gym and walking buddy too.

So there you have it – six healthy reasons to try Pickleball if haven’t already.

And why not use Father’s Day as the perfect excuse to to make it a family affair. With any new activity, there’s always a risk of injury, so make sure you warm-up properly and go into  it with ease – especially if it’s your first time. And if you’re currently suffering from an injury that is keeping you from wanting to even try this super fun and accessible sport – consider talking to a movement or mechanical pain expert who can help you sort out what’s going on.

Are you local Portsmouth, NH?

Consider speaking to one of my specialists. Tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. 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!

CLICK HERE to request a Free Discovery Session with one of my specialists.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media group. To get in touch, or request a free copy of one of her guides to back, knee, neck or shoulder pain, visit her website www.cjphysicaltherapy.com or call 603-605-0402

morning neck pain

Three Causes of Morning Neck Pain and What to Do

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Waking up with morning neck pain puts a huge damper on your day right from the start. While neck pain may not be at the top of the list when it comes to debilitating musculoskeletal problems (aka people tend to just “live” with it) – it still impacts between 10-20% of the population at any given time – so it’s worth discussing. 

One of the most common problems I see with those suffering from neck issues is that seemingly out of nowhere they can go to bed feeling great – but wake up with a stiff and painful neck that can last up to a day or two. When this pattern starts to repeat itself and goes on for too long – you can end up with a chronic neck problem that doesn’t just show up in the morning – but will start to impact your day-to-day life and get in the way of things you love to do.

Here are Three Common Causes of Morning Neck Pain and What you can Do:

1. Sleeping position

Any joint – including those that make up your neck – will feel strained after being in a prolonged position for too long. In a healthy, uncompromised neck – this is fine if it happens on occasion. But if it’s happening once per month or more – it’s time to address your sleeping position.

Those that like to sleep on their stomachs, or with multiple pillows under their head, are going to have the biggest problems. When you sleep, you want to get your neck as close to what I call a “neutral spine” as possible. That means your neck feels relaxed, maintains its natural curves, and your ears, neck, and shoulder will be aligned on top of one another.  I find the best way to achieve this is by sleeping on your side – or on your back with just one pillow. If you’re a multi-pillow type of person – make sure you’re using the second pillow to hug and support your arm – or in between your legs – not underneath your head.

2. Clenching Your Teeth

While many people tend to associate clenching your teeth with TMJ – or jaw dysfunction, it can cause neck problems as well. When you clench your teeth, you’re also tensing the muscles around your neck. If you do this every night, and for prolonged periods, your neck is going to become very unhappy and start to have problems of its own.

Many folks are unaware they are clenching their teeth at night. But some signs this could be happening to you  include tense or fatigued jaw muscles in the morning, walking up with headaches, or a stiff and painful neck and shoulder when you first wake up. Clenching teeth is often a reaction to stress – so having a good end of day routine could really help with this problem. Be sure to shut off TV and electronics at least one hour before bedtime. Practicing some meditation and/or relaxation breathing just before bed could help too. If all else feels, a night guard could help as well. It won’t stop you from clenching completely, but it will protect your teeth and could minimize your neck pain.

3. A Bulging Disc

This isn’t spoken about too often, but if you’ve got a bulging or problematic disc in your neck – this could be the reason you’re waking up with a stiff and painful neck in the morning. When you lie down and “unload” your spine for a period of time – such as at night while sleeping – our intervertebral discs hydrate and actually get larger. If you wake up with a sudden movement – this could be all it takes to “pinch” that disc and cause your neck to feel “locked up” and with sudden pain.

Now, don’t feel like you need to go running to the doctor for an MRI to figure this out. It’s not necessary. Most people have bulging dics occurring normally as they age throughout their entire spine. They only become a problem when you don’t take care of your spine. When it comes to your neck, the biggest risk factors for turning a normal bulging disc into a painful and problematic one include behaviors such as looking down at your phone, tablet, or computer for too long and not being respectful of the fact that a healthy neck needs to move in all directions – not just forward and down. Doing some simple chin tucks frequently throughout the day and making sure your upper back stays flexible can go a long way in preventing (normal) bulging discs from becoming a problem.

I hope these tips help shed some light on why you might be waking up with morning neck pain and most importantly – what you can do about it. If you try some of these remedies and still find yourself unsuccessful – then it’s time to talk to a mechanical pain expert. There’s no need to rely on pain pills or expensive tests and procedures to resolve morning neck pain. Most of the time, problems like I’ve just described can 100% be resolved naturally and with the right “movement therapy”.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists. Tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you.

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!

Click here to book a free Discovery Visit.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of one of her guide to neck and shoulder pain CLICK HERE or to get in touch, email her at [email protected].

Shoulder Impingement Syndrome

Shoulder Impingement Syndrome – Treat the cause not symptoms

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Have you ever had pain in your shoulders when you try to raise your arms overhead, pull off a sweatshirt, grab a gallon of milk from the fridge?  Or place grocery bags on the counter?  You were likely dealing with shoulder impingement syndrome – also known as rotator cuff impingement.

They call it impingement syndrome because your rotator cuff tendons literally get “impinged” between the round head of your shoulder joint and a hook-shaped bone in the front of your shoulder joint (called the acromion) that is part of your shoulder blade.

This can occur for a number of reasons…

You could have a deformity that causes this, an injury could lead to this, arthritis could contribute to this, or poor posture can cause it.

Any of these scenarios can cause crowding in the space where your rotator cuff tendon passes in front of your shoulder. If this happens often enough – it’s going to get irritated every time you raise your arm past 90 degrees.

When this first begins to happen, it will typically cause acute inflammation. You may be diagnosed with rotator cuff tendonitis. But eventually, the more constant pain and irritation of tendonitis subsides and you only feel pain when you go to raise your arm or reach in certain directions.

This is more commonly known as shoulder impingement.

With the exception of a deformity, almost all cases of shoulder impingement can (and should) be resolved naturally.

The tempting and easy fix is to get a cortisone shot to calm the inflammation.

But what you need to understand is that impingement syndrome – in most cases – is actually the symptom of a more overarching problem. And injecting the tendon with cortisone will often cause more harm than good.

The cortisone will temporarily mask your problem. It will eventually cause damage to your tendon if you keep getting injections. Remember, impingement is caused by crowding of the space where your tendon passes through. You can temporarily take the inflammation away and it will feel better. But, unless you address the reason for the crowded space, your problem will keep coming back.

So how do you naturally get rid of shoulder impingement for the long term?

First, you must address the reason for the crowded space in your shoulder joint where your tendon passes through. Most often – it’s due to poor postural habits and immobility around your shoulder joint – specifically your neck and upper back.

For example, if your upper back is stiff, curved, and lacks adequate mobility – it’s going to impact how your shoulder blades move and are positioned.

With a stiff and curved upper back, your shoulder blades will respond by moving out and up. This scenario makes that hook-like bone (the acromion) sit more forward and down than it should. When this happens, there isn’t enough room for your tendon when you lift your arm above shoulder height. The bony surfaces above and below your tendon create friction and this eventually turns into pain and inflammation. This can happen slowly over time. Or, more quickly if you’ve got something like arthritis where that space might have naturally already narrowed.

Another common scenario is after a shoulder injury. Your neck and upper back may have learned to compensate for a time while you were healing from your injury. The result is some unwanted postural deformities that can lead to impingement of your rotator cuff tendon.

When it comes to shoulder pain, always make sure to examine your neck and upper back FIRST.

If there are poor postural habits there, your shoulder will undoubtedly be impacted.

If you really want to get rid of your shoulder impingement – and back to lifting, reaching, and carrying things without any worry – it’s essential that you identify and address the root cause, not just the symptoms (inflammation of the tendon).

Next time you go to the doctor complaining of shoulder pain – and you hear the words “impingement syndrome” or “rotator cuff tendonitis” – don’t assume you need rest, ice, a cortisone shot, or surgery to resolve it.

None of these solutions will give you the long-term solution you’re looking for.

The very last thing you want to do is choose passive treatment interventions or procedures. These either mask the pain or prolong the problem because they only address symptoms.

You want to do everything possible to preserve the integrity of your tendon. The best way to do that is by optimizing the mobility and strength around your shoulder joint first. Do this before resorting to more aggressive measures like cortisone or surgery.

Are you currently suffering from shoulder pain (or anything else) that is keeping you from doing things you love?

Are you contemplating surgery or a cortisone shot because you have been told it’s your best and only option?

Let me know and let us help!

We’re happy to provide a second opinion for you.

We will examine your shoulder and see how it responds to certain movement tests. Then we’ll be able to tell you – and show you – if your problem can be resolved naturally with movement instead of a procedure like a cortisone shot or surgery.

Our patients find that if they end up needing a procedure (which is rare) – they do so with peace of mind. This is because they’ve exhausted a natural, movement-based solution with us FIRST.

If you want to talk to us and see if what we do is right for you – CLICK HERE to request a Discovery Call with my client success team.

They’ll let you know if we can help and get you on our schedule as quickly as possible!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of one of her guide to neck and shoulder pain CLICK HERE or to get in touch, email her at [email protected].

Neck stretches

3 Reasons Your Neck Stretches aren’t Working

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If you suffer from chronic neck stiffness or even pain – and you’ve done your due diligence when it comes to neck stretches – it’s time to consider you might be missing something.

It could be your stretching technique, you could be doing the wrong stretch altogether, or it could be that you shouldn’t be stretching your neck at all…

Let’s go over three reasons why your neck stretches might not be working and help you pinpoint where it’s going wrong…

 

1. You’re using the wrong stretching technique.

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 you notice a difference right away then you have your answer – you were likely using the wrong stretching 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 stressed your neck out. 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 for your neck. Corrective stretches are specifically prescribed to address a particular problem, and prescribed at a specific frequency. They are different from the generalized stretches that are designed to feel good and relieve tension.

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

This is a very common problem we see here in our office. 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 can 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.

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.

Consider talking to a movement specialist who understands how to figure this out so you can get rid of your neck pain and back to all the activities you love!

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists HERE.

They will ask you all about what’s been going on – and help you make the best decision moving forward – whether that’s working with us not!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Shoulder Pain

Persistent Shoulder Pain could mean Misdiagnosis

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Persistent Shoulder Pain could mean Misdiagnosis

We’ve been hearing a lot of complaints lately about shoulder pain. Your shoulder joint is one of the most complex and mobile joints in your body. It’s made up and supported by an intricate structure of bones, tendons, ligaments, muscles and connective tissue. They all work in unison to keep it functional.

You’ve got the head of your shoulder joint (looks like a round ball) inserting into a socket within your shoulder blade (your “wing”). This makes up your shoulder joint and is supported by a joint capsule, ligaments, and your rotator cuff muscles.

Surrounding and supporting your shoulder blade and shoulder joint is your cervical and thoracic spine. (neck and upper back). This has both large and small muscles helping to support your ability to push, pull, reach, and raise your arms overhead.

Intertwined within all of that is a delicate web of nerves and blood vessels… No wonder shoulder pain can be a challenge to treat – never mind diagnose.

If you see your doctor about shoulder pain, they will typically want to take a closer look via X-rays and/or MRI’s. X-rays will show you all the bony parts of your joint – to see if anything is broken and check for arthritis. MRI’s will see if anything is torn or worn away, such as rotator cuff or labral tears.

Relying on imaging to diagnose your shoulder pain can be tough. Or any joint pain for that matter.  It’s entirely possible to have arthritis, a torn rotator cuff, or torn labrum – and still have a perfectly functioning shoulder. The problem is we only get things looked at when we are in pain. So, there is no way to know for sure if you’ve had these “abnormalities” already, and if they are the true reason for your shoulder pain.

For example, it’s estimated that between 20-50% of people over aged 50 have “asymptomatic rotator tears”. Meaning – they walk around with a torn rotator cuff and have zero pain in their shoulder. Just because an X-ray or MRI says so – doesn’t mean it is so. And it’s a big reason why so many folks suffer unnecessarily with persistent shoulder pain.

If I meet someone with shoulder pain that hasn’t gone away – the first thing I question is whether or not we have the correct diagnosis. With shoulders, misdiagnosis is all too common given the complex nature of the joint and surrounding structures.

Here are some clues to help you figure out if your persistent shoulder pain has been misdiagnosed:

 

Where is your pain?

When pain is coming from the shoulder, the pain will typically be felt directly in three places. In front of your shoulder, on top of your shoulder, or in a more involved shoulder problem (like a rotator cuff injury) down the side of your upper arm. But it will never go below your elbow. If the pain goes past your elbow and into your forearm or hand – radiates above your shoulder into your neck (the upper trap area) – or deep inside your shoulder blade or middle back – odds are pretty good you’re dealing with a neck problem – and not just a shoulder problem.

If you don’t address your neck, your shoulder pain will continue to persist. I can’t tell you how many people I’ve seen get unnecessary rotator cuff surgery because of this misdiagnosis.

Have you lost mobility in your shoulder?

Lack of mobility is a common symptom associated with a rotator cuff injury or the dreaded “frozen shoulder.” These are, indeed, shoulder problems. So if your pain is persisting, you probably have the correct diagnosis, just the wrong treatment approach.

However, one overlooked area when it comes to shoulder stiffness is your middle back (thoracic spine). If your thoracic spine has mobility restrictions – or even weakness that leads to stiffness (our joints stiffen up to compensate for weakness/instability) – it will impact your shoulder joint. Stiffness in your thoracic spine can inhibit your shoulder mobility. Over time, this lack of mobility will irritate structures within your shoulder joint, causing pain.

If you’ve got persistent shoulder pain and feel like you’ve tried everything, get your middle back checked out. This could be your misdiagnosis.

Do your symptoms involve numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening – it’s likely coming from your neck or upper portion of your middle back (cervicothoracic junction). It could be due to a bulging disc or a restricted/faulty movement pattern that is irritating nerve roots (or discs) in your spine. An isolated shoulder problem typically does not involve nerve root compression or irritation. Sometimes certain trigger points in your rotator cuff muscles can refer pain. But this usually feels quite different from what I’m referring to.

Do you consistently feel pain, numbness, tingling or burning in your shoulder blade, middle back, or down your arm? Especially if it seems to move around during the day? Then it’s likely not a shoulder problem. In the medical world we call this presentation “cervical radiculopathy”. If you continue to experience persistent shoulder pain and you’ve got any of the symptoms I just mentioned, this is probably your misdiagnosis.

Confused? I don’t blame you.

The moral of this story is that if you’ve got persistent shoulder pain and given treatment your best shot, then you’ve likely been misdiagnosed. Shoulder pain loves to disguise itself as a spine problem (neck and/or middle back) even when you don’t feel pain in your spine.

Whatever you do, don’t resort to any surgery or major procedures until you’ve thoroughly explored these areas with a mechanical pain expert who knows where to look.

If you are local to Portsmouth, NH…

Consider reaching out to one of my specialists by requesting a free discovery visit HERE. They will ask you all about what’s been going on – and see if we would be the best fit to help you.

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, email her at [email protected].

tight hips

Tight hips? Try strengthening instead of stretching.

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When you’ve got tight hips, it can interfere with your ability to enjoy walking, running, golfing, and just exercise in general.

Tight hips are not only annoying and achy, but they often contribute to lower back pain as well. But perhaps more frustrating than the tight hips themselves is the fact that no matter how much stretching you do – they never seem to loosen up. Typically when I hear this, it’s a big red flag for me that tight hip muscles aren’t actually your problem.

In other words, just because it feels like you’ve got tight hips – doesn’t mean they actually are tight.

 

Let me explain.

Your hip muscles can literally be shortened and constricted – in which case – they need lots of stretching. But they can also be “tight” due to weakness or being overworked. When muscles are overtaxed or undertaxed during an activity, they aren’t going to function well and they will find a way to compensate. And this compensation strategy can lead to chronically tight hips over time.

But here’s the thing…

When your hips are tight due to weakness and overcompensation, stretching will not help. Stretching might feel good in the moment, or give you temporary relief, but the tightness in your hips will continue to return until you identify and fix the real underlying problem.

Let’s take your psoas (one of your hip flexors and pelvic stabilizers) as an example to illustrate this concept…

Your psoas is one of your deep hip flexors that also has a connection to your lower back. Although it is capable of flexing (bending) your hip in some capacity – it has more of a stability role. When functioning properly it will assist in exercises like the crunch or sit up, and also work alongside your deep abdominals and glute muscles to help you maintain good upright posture when you’re sitting or standing.

Unfortunately the psoas gets blamed for a lot of things – most notably – tilting your pelvis forward because it’s “tight” and causing lower 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 and hip tightness will disappear. But sadly, this is rarely the case. More often than not, your psoas is tight because it’s overworking to compensate for your deep abdominals/core not working properly.

Do your hips ever cramp or feel achy during abdominal work?

Your inclination will be to stretch them but this will simply not work. You have to get your abdominals and deep core to start working properly so that your psoas can actually relax. Once your hip flexors are no longer doing all the work, they won’t feel tight anymore.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas along with your piriformis and TFL (tensor fascia latae) are the most common victims. We’ve already spoken about your psoas, but your piriformis and TFL love to compensate for weak gluteal (butt) muscles.

An overworked piriformis leads to difficulty sitting cross-legged and a tight TFL can be painful and lead to IT band problems. You can stretch all you want, but if you don’t address the underlying cause and give these muscles a chance to relax, your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of this story is that if you’ve got chronically tight hips and stretching all the time isn’t solving your problem, then consider a different approach. Most people don’t consider strengthening an area that feels tight but this could be what you’re missing.

When it comes to hips – the things to look at are your deep abdominals/core and your glutes/butt muscles. Often there’s an underlying weakness in one or more of these areas that you just can’t recognize. Do yourself a favor and talk to an expert who gets this.

Are you local to Portsmouth, NH?

Consider reaching out to one of my specialists by requesting a free discovery visit 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, email her at [email protected].

Pain when gardening

Six Ways to Protect your Knees and Back when Gardening

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Gardening is a favorite activity for a lot of folks – and lately I have been hearing many people having knee and back pain when gardening. To add more frustration to this topic, you might not even notice the pain until hours or days afterwards, which can make it challenging to address.

The good news is that there are several things you can do to protect your knees and back while gardening.

Here are 6 of my favorite tips to manage pain when gardening:

1. Warm up first

Before diving into any activity that you know you’ll be doing repetitively and for more than a few hours, it’s a good idea to warm-up. It doesn’t have to be anything crazy or excessive and 10 min is plenty.

Typically, you’ll only be gardening during nice weather. So enjoy it by taking a walk around your neighborhood first. Then do some easy light stretching to lubricate your joints before you begin. It won’t take long but your knees and back will thank you.

2. Avoid bending from the waist

Lifting and carrying heavy bags of soil or plants can put a lot of strain on your back and knees. You really want to make sure you’re using proper posture and body mechanics to avoid problems.

When lifting, be sure to use your legs instead of your back and hold objects close to your body. If you hinge only from your hips, for example, which a lot of people like to do, you will put extra strain on the back of your knees and lower back. Get in the habit of bending your ankles, knees, and hips in unison – kind of like an accordion – so that you build good muscle and body memory and don’t even have to think about it next time you’re gardening or lifting.

3. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back and knees still need a break. Our joints don’t enjoy anything when done repetitively or for prolonged periods, but especially too much bending or sitting on your knees. When you bend too much and too often, the discs in your lower back can get aggravated, and when you’re sitting on your knees, it’s a lot of pressure and can annoy your arthritis.

I recommend setting a timer and giving yourself a break every 30 min to change positions. Simply stand up and get out of the bent or sitting posture. Your back and knees will thank you and you’ll be able to garden for much longer and without risk of injury.

4. Pivot instead of twist

Your lower back and knees aren’t really designed to rotate, they are designed for bending and extending. So if you’re not careful – you can strain these areas with poor twisting and turning mechanics. When you have to rotate, you’ll want to pivot from your pelvis.

What does this look like?

Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and your pelvis in line with your knees and feet – and always move them as a unit. While it’s ok to bend and twist from your waist or legs on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you’re already prone to back or knee pain.

5. Use ergonomic gardening tools

The right gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. Long-handled tools can help reduce the need for bending and stooping, which as already discussed, puts strain on your knees and back when overdone. Another consideration is the weight of your tools. It might be worth the investment to swap out your older, heavier tools for more modern, lightweight alternatives.

When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench and/or knee pads. These tools will make it easier to sustain activities that require prolonged bending or kneeling.

6. Use beds to raise your gardens

Raised garden beds not only look pretty but they are extremely ergonomic. Especially if you suffer from more chronic back and knee problems. Raised garden beds are elevated off the ground. They are easier to maintain and limit the amount of bending you have to do.

Raised garden beds are relatively simple to build and create. Even if you’re not having problems now with gardening, if it’s an activity you love to do, you might want to consider it. Making the investment in raised gardening beds now could go a long way in preventing knee and back problems in your future.

Gardening has so many positive benefits for both your mental and physical health – and the last thing I want is for back or knee pain to get in your way.

If you are experiencing pain when gardening – Give these tips a try.

But if it’s not enough, don’t give up.

Enlist the help of a musculoskeletal pain and movement expert who can help you figure out the source of your problem and provide you with practical solutions so that you can get back to gardening as quickly as possible.

If you are local to Portsmouth, NH – consider speaking to one of my specialists.

It’s a free, no-obligation call where you can tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you.

Click here to speak with a specialist.

The Right and Wrong Way to Strengthen Your Core

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Good core strength is an important and vital component to life long health. Everyone knows that it’s an important factor in preventing low back pain, but having good core strength also helps you with your balance, overall stability, posture, and it can be crucial in helping you prevent injuries. Not only that, but when you have good core strength, you simply feel better, and have more confidence to do all the activities you love.

But when it comes to core strength, there’s a right and a wrong way about it.

And when you get it wrong, you’re looking at more back problems, pelvic health issues, and even neck and shoulder pain.

Here are some of the most common ways I see people getting core strength wrong – and what you can do to make it right:

 

1. All you do is crunches

Crunches are often considered to be a staple exercise when it comes to core strengthening. But growing evidence tells us that too many crunches may actually be detrimental to the health of your spine. When you perform an abdominal crunch – it typically involves lying on your back, bending your knees, and lifting your shoulders off the ground towards your knees.

This movement puts a lot of stress on your spine – especially when done incorrectly. If your core strengthening routine consists entirely of crunching – the repeated flexion of your spine will eventually lead to wear and tear on the discs in both your back and your neck.

What to do instead…

First – crunches aren’t “bad” for you. The problem is that people inherently do them wrong. I’ve been a back pain expert for over 10 years and I constantly see people doing this exercise incorrectly. If you’re going to incorporate crunches into your core strengthening routine – make sure you are doing them with proper form, proper technique, and with proper breathing. But even if you are doing crunches perfectly, you still need to include other exercises into your core strengthening routine. You have to balance out the forces on your spine and target other muscle groups that are equally important to a good, strong core.

Exercises such as planks, bird dogs, and bridges are some of my favorites. These exercises target your glutes and back muscles, and will reverse some of the stress caused by over-flexing of your spine.

2. You’re not breathing

You can’t activate your deep core if you don’t breathe properly. Your deep core consists of four parts: your deepest abdominal muscles; pelvic floor muscles, deepest back muscles, and your diaphragm. These four muscle groups work together to control intra-abdominal pressure – which is essential to facilitating a strong deep core connection. If something is off in this system, your intra-abdominal pressure will be distorted, which can create more pressure on structures such as your lumbar discs and pelvic floor region. Also, your bigger core muscles (like your outer abdominals, psoas, larger back muscles, and hips) will overwork or not work correctly.

What to do instead…

While there are good, better, and best ways to breathe when performing core exercises – I always say that when in doubt – just breathe. If you’re breathing, you give your deep core a fighting chance at activating properly. The reason being is because your diaphragm is your main breathing muscle. It relaxes and contracts with normal breath. When you hold your breath, your diaphragm stays contracted. That’s part of what disrupts the intra-abdominal pressure in your deep core. It’s also a good idea to incorporate Yoga or Pilates into your core routine. Both of these exercise practices emphasize breath as a central component and it can teach you how to breathe properly when exercising.

3. You aren’t incorporating rotational movements

Our bodies don’t interact with the world via straight-planed motions. We are constantly twisting, turning, and reacting to our environment in a variety of different ways. One of the biggest mistakes I see when it comes to core training is that people keep it very straight forward (no pun intended) and too simple. You can have a perfectly planned core strengthening routine that hits every muscle group but if you don’t challenge those muscle groups with different angles and combined multi-plane movements, your body gets lazy.

What to do instead…

Well, the obvious answer is to add rotational movements into your core routine.

But what does that look like?

You can add rotation as a challenge to almost anything. If you’re in a plank – rotate to your side and twist your arm up to the ceiling in between each rep. When you’re doing crunches – add cross body reaches each time you lift your head and chest. Rotational movements can also be incorporated into balance work – which inherently works your core.

Once you’ve mastered single leg activities – whether it be standing, stepping up, or lunging – you can add a twist or a reach to the end posture as you hold the movement. The possibilities are quite endless and you can get really creative. The point here is to not be “square”, and add variety to your core strengthening routine so that you mimic real life.

So how does your core strength training routine measure up? Have you been doing it right or wrong?

Here at CJPT & Pilates our favorite way to strengthen the core and whole body is through Pilates. If you’re struggling with pain or just getting started, I recommend consulting with an expert. They’ll be able to guide you in the right direction and set you up for success.

Are you local to Portsmouth, NH and interested in trying Pilates? CLICK HERE to schedule a call with one of my specialists. Learn more about Pilates and see if you would be a good fit!

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, email her at [email protected].

Plantar Fasciitis

Don’t let Plantar Fasciitis Ruin Flip Flop Season

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Good weather is on its way and if you haven’t already broken out your flip flops – it’s only a matter of time before you do. The only unfortunate thing about flip flop season is the coinciding rise in plantar fasciitis that typically comes with it.

Someone I was speaking with the other day recently asked:

“Now that I’m wearing flip flops again, my plantar fasciitis is acting up. Is there anything I can do? Or do I need to stop wearing flip flops altogether?”

This is a great question.

While yes, wearing more supportive shoes would certainly help. Ideally, if you can stay on top of your plantar fasciitis and/or prevent it all together, flip flops don’t have to be an issue at all and you can continue enjoying them all season long.

First – what is plantar fasciitis?

Quite simply, it’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot so that you can propel yourself during walking and running. When you land on your foot your arch falls or flattens – this is called pronation.

The response to this action is that your foot then stiffens or supinates. This is where your foot gets the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked. This leads to inflammation/plantar fasciitis.

What causes your plantar fascia to become inflamed?

Basically, it can be anything that impacts or disrupts the natural mechanics of your foot to pronate and supinate. Most commonly, poor mobility in either your ankle or 1st toe is the culprit. Even tight hips and weak glutes can cause problems all the way down to your foot. Anything that impacts the way your foot hits the ground has an opportunity to influence the level of force and energy transmitted through your plantar fascia when you walk.

When the natural pronation/supination mechanism is disrupted, your plantar fascia will attempt to compensate. If this goes on uncorrected, your plantar fascia eventually becomes angry and irritated – resulting in a very painful case of plantar fasciitis.

So what do flip flops have to do with this?

Footwear can either “protect” your arch, or cause it to overwork. If your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. But because of how much we sit, and how little we walk around barefoot, the bottoms of our feet are simply not as conditioned as they should be.

This is really the problem – not so much what you put on your feet. If you’re accustomed to wearing supportive and cushioned shoes all the time, and then suddenly switch to flatter, less supportive flip flops, it’s going to be a shock to your foot. And if you’re prone to plantar fasciitis already, it will flare up easily and quickly.

What can you do?

The best thing you can do to prevent and treat plantar fasciitis is to not neglect your feet. Performing consistent mobility exercises for your toes and ankles is key, as well as conditioning for the strength and stability of your arch.

Balance exercises, toe exercises, and plyometric (jumping) exercises are all important. Also, making it a point to walk around without shoes as often as you can. Along with all of this, it’s a good idea to incorporate pelvic floor and core training exercises. The function of your pelvis can have a significant impact on your foot mechanics.

But what if your plantar fasciitis is too painful?

If this is the case, jumping into exercises may not help, and could even aggravate your plantar fasciitis.

But one treatment modality that is known to be effective for particularly painful cases is something called Shockwave Therapy (Extracorporeal Pulse Activation Technology or EPAT).

During a shockwave treatment, high pressure sound waves are delivered directly to the affected tissue to bring blood flow and accelerated healing to the injured and inflamed area (in this case your plantar fascia and surrounding muscles).

The treatment is non-invasive and gets very deep. Pain reduction can be seen in as little as one shockwave session, but the research shows the most effectiveness after six.

Shockwave therapy can help to significantly reduce your pain – and even swelling – from plantar fasciitis in the short-term. It will allow you to tolerate the exercises required to keep your plantar fasciitis gone for the long-term.

When addressed correctly, plantar fasciitis doesn’t have to be chronic and it doesn’t have to dictate your footwear selection.

Are you local to Portsmouth, NH?

CLICK HERE to learn more about our Shockwave Therapy treatment – one of my specialists will reach out to you and see if you would be a good fit.

If you’ve already tried a lot of different treatments for your plantar fasciitis and they haven’t helped – consider working with an expert. They can incorporate something like shockwave therapy. This combined with the exercises you need will make a difference and get you back to enjoying your flip flops again.

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, email her at [email protected].

golf injuries

Five Common Golf Injuries and How to Avoid Them

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Golf is a beloved passion enjoyed by millions around the world, and the season has officially begun here in New England. Let’s talk about golf injuries. Most golfers won’t let anything get in the way of tee time – but when you’re dealing with back, knee, elbow, or shoulder pain – playing 18-holes is just not as fun.

An injury of any kind during golf season not only impacts your performance – but it keeps you from enjoying the game to the fullest.

Your buddies are walking the course while you have to drive the cart… Instead of focusing on your swing, you’re thinking about your pain and whether or not you should push through it…

The good news is that with the right knowledge and preparation, you can avoid some of the most common injuries impacting golfers.

Here are five of the most common golf injuries and what you can do to avoid them:

1. Back Pain

Back pain is the most common injury to plague golfers. Repetitive bending and twisting is a well-known source of back problems – and that’s literally all you’re doing when you play golf. While practicing proper swing mechanics can help, it might not be enough.

If you lack adequate mobility in your spine, for example, the best swing in the world won’t compete. It’s important that you take time to optimize and maintain good spinal mobility during golf season.

Stretching backwards regularly, and avoiding excessive sitting during the day, are two things alone that could make a huge difference in your back mobility – and pain – and help you to get through golf season injury-free.

2. Elbow Tendonitis (Golfer’s Elbow)

Golfer’s elbow occurs when the tendons on the inside of your elbow become inflamed from the repetitive swinging motion of the golf club. Once again, good swing mechanics can go a long way in preventing this from happening. But it’s also important to consider what’s happening above and below your elbow joint.

If you’ve got a weak rotator cuff, or weak and stiff wrists for example, your elbows will experience added and unwanted strain when trying to do something like swing a golf club. It’s important that you perform regular conditioning of these areas (both mobility and strength) during golf season to keep your elbows from suffering the consequences.

3. Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints.

If you lack adequate mobility or stability in and around your knees, you could develop pain as the season goes on. The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees could take the brunt and eventually suffer.

Much like the elbow, the most common source of knee pain comes from the joints above and below, and not necessarily from the knee itself. To keep your knees mobile and healthy, and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as the stability in your feet and ankles.

4. Rotator cuff (shoulder) Injuries

Another common injury for golfers is strain, tendinitis, or impingement of the rotator cuff. Your shoulder is the most mobile joint in your body, and the rotator cuff’s job is to provide strength and stability to your shoulder joint. If it’s weak, or compromised in any way, you could eventually see problems during golf season.

There’s quite a bit of stability required from your shoulder joint to withstand the acceleration and deceleration forces that come with a golf swing. The repetitive swinging of a golf club could take a rotator cuff on its last leg and push it over the edge.

As mentioned several times already, work on your golf swing. But given you don’t want your shoulder girdle or rotator cuff bearing all the strain, you have to make sure your core is strong, as well as your mid back muscles and upper thighs and hips.

This group of “powerhouse” muscles will give you a stable foundation so the more distal areas of your body (knees, elbows, and even shoulders) don’t get injured from having to work so hard.

5. Wrist and Hand injuries

Wrist and hand injuries – such as sprains, strains, and even fractures – are also quite common in golf due to the gripping and twisting of the club.

Using proper grip technique when holding your club is paramount, but you’ll also want to make sure the club you’re using isn’t too heavy or long. And as mentioned previously, make certain you’ve got a strong and stable shoulder girdle, because much like the elbow, your wrists can compensate for weakness above the chain.

But one overlooked area when it comes to wrist and hand problems is your neck.

Did you know that 47% of upper extremity pain (including wrists and hands) can come from a source in your neck?

An underlying neck problem could be the cause of your weak hands and wrists, if this is the case, working on grip strength will not make a difference. You must first resolve what’s going on in your neck.

Hopefully these tips help you to understand why golf injuries happen and most importantly, how to prevent them.

If you try these tips and are unsuccessful, then it might be time to talk to an expert who can help you work through these aches and pains so you can be back on the course in no time.

Are you dealing with pain now and local to Portsmouth, NH?

Consider talking to one of my specialists for free. Tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. CLICK HERE to speak with a specialist.