Tag Archive for: arthritis

Holding Knee with Arthritis

Arthroscopic Knee Surgery – Does it Even Work?

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

The title of this study is telling.

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

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

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

Sounds pretty simple and harmless – right?

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

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

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

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

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

But what’s the big deal really?

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

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

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

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

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

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

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

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

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

PhysicalTherapy Porstmouth NH

Five Reasons to Include Pilates in Your Life

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

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

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

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

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

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

1. Pilates helps prevent back pain.

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

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

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

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

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

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

3. Pilates improves your flexibility.

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

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

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

4. Pilates minimizes stress on your joints.

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

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

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

5. Pilates trains your nervous system.

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

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

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

Notice I said “right type.”

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

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

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

 

5 Tips for Staying Active and Mobile as you Age

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

1. Keep Moving

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

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

2. Maintain a Healthy Diet

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

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

3. Work on your Balance

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

4. Strengthen your core

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

5. Educate Yourself

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

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

Tips to Combat Arthritis this Winter

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People tell me all the time: “I don’t need to check the weather anymore, my joints tell me what’s coming.” And as winter approaches, I know I’m going to be hearing more and more of this.

So why is it that arthritis sufferers tend to be impacted more during the colder, wetter months?

The actual science on this is inconclusive. Some studies have completely debunked the myth that weather can affect your joint pain, while others have shown that arthritis sufferers do indeed have what we call “weather sensitivity” — and they feel worse in the cold, especially when it’s about to rain or snow. The working theory behind this is related to barometric pressure. As a storm system develops, barometric pressure (atmospheric pressure) begins to drop. Some scientists believe that this results in expansion and contraction of tissue in and around your joints (tendons, muscles, bones, and even scar tissue). If those tissues are already sensitive due to arthritis, this could irritate them further. Additionally, the lower temperatures of winter are thought to increase the thickness of fluid inside your joints, making them stiffer and perhaps more sensitive to pain during movement.

Regardless of whether this phenomenon is myth or fact, it doesn’t make your pain any less real! The good news is there are things you can do to minimize pain related to arthritis as winter gets closer. 

There are two types of arthritis, inflammatory and non-inflammatory. Rheumatoid arthritis is the most common form of inflammatory arthritis, and osteoarthritis is the most common form of non-inflammatory arthritis. Although they have very different causes, weather changes can still have an impact, and there are still things you can do to minimize that impact.

Both forms of arthritis are characterized by one or more of your joints being inflamed.

Inflamed joints do not like to be compressed or irritated. It’s often why people will tend to rest and decrease their activity when they have pain. Add cold winter temps and weather to the mix (along with a pandemic), people just naturally do less this time of year. They think if they take the weight off their joints, or move less, they are protecting their joints. That’s actually not true. What protects your joints is strength and flexibility. The more mobile you are, the less likely your joints will get irritated, even arthritic ones. Have you ever worn a piece of clothing that’s too tight? You get irritated. Same with your joints! If they aren’t free to move, they get angry. The muscles around your joints and how strong they are also play a huge role in minimizing irritation.

In the absence of strength and stability, your body will do what it needs to compensate. The structures around your joint will contract to make your joints stiff and tighter in an attempt to give your joints the stability they are lacking. But arthritic joints don’t want to be stiff and tight, they want to be free and mobile! So if you suffer from arthritis, it’s critical that you have good mobility and good strength — period.

In general, the most important thing you can do for your arthritis any time of year, not just in winter, is to keep moving.

And you will move better when you’re strong and flexible. Movement gets blood flowing, which is our best and most natural form of anti-inflammation. Walking is the easiest and most practical way to get healthy movement daily, but biking and swimming are great choices too. You’ll also want to engage in some form of activity, such as Yoga, Pilates, or Tai Chi, that allows you to move your limbs, body and joints in a full range of movement. Cardiovascular activities like walking and biking won’t do that. Pilates is great because it emphasizes both full body strength (which helps balance out your joints) and it promotes flexibility at the same time. It’s why we like to use it in our office. Although it’s easy to just stretch and get more flexible, it’s important that you incorporate strength training into your routine also. Achieving good mobility AND strength is the secret to combating arthritis. Folks tend to only focus on the flexibility part, which is one of the common mistakes I see. 

I hope this helps you better understand why your arthritis might feel worse in winter, and what you can do about it! If you’re suffering from any kind of back or knee pain that is preventing you from being more active and mobile and therefore worsening your arthritis, check out our FREE Back Pain and Knee Pain guides. Just click to have the guide sent straight to your inbox with no obligations or strings attached!

Knee Pain while Running? Don’t Blame Arthritis

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Knee Pain while Running? Don’t Blame Arthritis

Is running bad for your knees? Does it cause arthritis?

We get asked these questions a lot, especially by clients who are in their 50s and 60’s and wondering if it’s safe to keep running.

The short answer is no — running is NOT bad for your knees! If you experience knee pain while running, it’s not that you’ve “aged out” of the sport or that it’s causing arthritis in your knees. This is a very common misconception. In fact, research supports that running may actually be GOOD for your knees!

Staying strong, active, and mobile is your best defense against osteoarthritis.

Therefore runners, because they are typically active and healthy individuals, often have healthier knees compared to non-runners.

Ok then — so if not arthritis — what really causes knee pain in runners?

In most cases, it’s simply a biomechanical issue that goes unaddressed over time. But the GOOD news is that once identified, these issues can actually be fixed with proper education and strengthening (best offered by movement specialists like us!).

Here are three of the most common factors we see that cause knee pain while running:

 

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can impact your knee. If your ankle doesn’t move fully, freely, and adequately, excess forces will be shifted up to your knee. The knee may be forced to flex, rotate, and/or tilt more than it needs to. This, in turn, may result in unwanted loads that the tissues of the knee can’t handle. An expert in biomechanics and movement can not only help you identify if this is the true root of your “knee problem,” but can also help you improve your ankle mobility. This will help prevent long term damage to the joints, tendons, and ligaments in your knees. We actually see this as a very common problem. Specifically, in those that have sprained or twisted their ankles in the past. If that’s you, this could be a reason why you’re suffering from knee pain while you run.

2) Weakness in your hips and thighs

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing good, balanced strength in your hips and thighs is critical. The hamstring and quadriceps muscles play a crucial role in stabilizing the patella, otherwise known as your kneecap. Since running is extremely repetitive on your joints, especially your knees, it requires they have good durability and endurance — something that is lost quickly when you neglect proper strength training. Often “wear and tear” in your knees (otherwise known as arthritis) will get blamed for your knee pain when in actuality, the loss of strength around your knees is what’s causing that wear and tear to feel worse than it needs to.

3) Unstable core

It may seem like running is all in the legs, but the stability of your pelvis and trunk have a huge influence on how your legs perform. You derive the majority of your power, speed, and stamina from your core muscles and glutes. Much like with ankle mobility, if your core is not performing adequately or efficiently – your legs will have to work harder. A stable core is key for developing and maintaining good balance and rhythm with any activity – but especially running.

With a repetitive activity like running, efficiency and form is everything. Without a strong core, it’s impossible for your leg muscles and knee joints to work as efficiently as they were designed to. It will be really difficult for you to maintain good and proper running form. When your core strength is weak, and doesn’t have enough endurance to sustain the amount of miles you want to run, your knees will suffer.

What’s important for you to remember is that arthritis is NORMAL — everyone gets it as they age. 

What doesn’t have to be “normal” is for arthritis to stop you from running, or doing any other activity that you love. You can get surgery to fix the “wear and tear” in your knees, or injections to decrease the inflammation, but if you don’t check and address any underlying biomechanical issues, these fixes will be temporary and your knee pain will keep coming back. And worse… they could force you to stop running all together!

If you’re local to Portsmouth, NH and suffering from knee pain that’s starting to impact your ability to run or do any other activity that you love, you might want to consider speaking to one of my specialists.

In this FREE Discovery Session 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. 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.

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

Pilates Class at CJPT & Pilates

When Gyms Reopen — Will Your Body be Ready?

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The state of New Hampshire is slowly reopening, and we are so excited that small-group fitness classes can return to gyms and studios on June 1st! While many businesses, including ours, have adapted by offering online services — most clients we speak with can’t wait to get back in the studio again. 

The big question is — will your body be ready?

If you’ve stuck with your strength and mobility routine and have been working out regularly from home, then you have a better chance than most to bounce right back.

But not everyone has taken advantage of online virtual exercise services, and many I speak with have opted to do nothing and just wait. Many have resorted to more frequent walking, running, or biking as a substitute for their usual exercise routines.

Any physical activity is better than no physical activity, but daily cardio is not the same as strength training. It’s just not going to be enough to get you by if your plan is to jump right back into the same pre-Covid workout routine that you left behind.

It takes months to gain appreciable muscle strength and improve mobility… but it only takes two to three weeks to lose it all.

The biggest mistake that I expect to see once gyms and even our own Pilates studio reopens is that people will assume their body is ready to pick back up exactly where it left off. And within about two to three weeks of that, injuries WILL start to happen.

What can you do?

If you’re not in any pain, but all you’ve been doing is cardio, then it’s a good idea to start incorporating strength and mobility back into your routine now. Your body will be much happier when it gets back into the gym or studio, and you’ll be less likely to experience some kind of injury. My best recommendation is to utilize the online services that your favorite gym or studio already offers — or find a facility that is offering them. In our studio, for example, we have online virtual Pilates classes daily. We guide you through the movements using precise cueing, and watch you while you’re moving. This allows us to give you in the moment corrections and make sure that you’re getting the most out of your workout. While it’s not exactly the same as your instructor being right there next to you, it’s the next best thing.

If you’re already experiencing pain or stiffness, perhaps because you’ve been walking or running more than you’re used to, you’ll want to talk to a movement specialist like us before you jump back into your previous exercise routine.

We know how to screen your muscles and joints properly, and can guide you toward not only getting rid of your pain, but we will also ensure that you’re set up to thrive in your workouts once we’re allowed to reopen again. Another big misconception I see is that people assume their pain will just go away once they start exercising again. While that may be true for some, most of the time it goes the other way, and your pain either gets worse or manifests itself somewhere else because your body starts to compensate for the problem.

I spoke with a gentleman earlier this week who was suffering from knee pain and stiffness because he went from walking 2-3 miles per week to walking 2-3 miles per DAY with his wife. He wants to get back on the golf course, and due to the restrictions on using golf carts, more walking is going to be necessary. His knee won’t be able to handle that in its current state, plus it will get worse if he pushes it. So I’m excited that he took us up on our offer to talk for free about what was going on with his knee. Now we’re going to get him the help he needs!

If you have any questions about pain that you might be experiencing, or want to ask about getting into a Pilates class this June, give us a call!

We are still offering FREE Zoom or in-person consultations to help people figure out what to do about their pain while they are stuck at home or slowly re-entering the world.

Five Foods that are Great for Your Joints

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One of the most important factors in living an active lifestyle is the health and endurance of your joints. If you’re in pain, you’re much less likely to exercise, and joint pain will likely keep you much more sedentary than is healthy. But did you know that there are several foods that can make a huge difference for your joints? The following are some examples of nutritious foods that can help get you moving pain-free.

1. Nuts

You can’t go wrong with a healthy assortment of nuts. Being so high in protein, they’ll give you long-lasting energy, but they’re also great for repairing damage due to inflammation in your joints. They’re also full of healthy fats- something your body needsto repair itself!

2. Red Apples

Apples are red because of a type of compound called anthocyanins, which also happen to be strong anti-inflammatories! They’re also full of antioxidants that have been linked to arthritis prevention, cancer cell inhibition, and decreased cholesterol. Apples can be an easy to-go snack, or you can mix them into oatmeal, make a fruit salad, or even add thin apple slices to your favorite sandwich for a refreshing crunch and flavor.

3. Salmon

Salmon and other oily fish have an abundance of omega-3 fatty acids, which are an integral component of joint health. They help keep your cartilage strong and your whole body flexible! Omega – 3 is something your body needs to function, but can’t make on its own – so it’s crucial that you give your body these fatty acids through your food!

4. Carrots and Other Orange Veggies

Vitamin A is key when it comes to fighting inflammation – and carrots have tons of Vitamin A! So do other orange vegetables like sweet potatoes and butternut squash. Vitamin A also helps keep your immune system, skin, and vision at their best. Carrots are an easy and tasty snack when eaten raw, either solo or combined with ranch dip and other veggies. You can also bake these orange veggies together for a delicious dinner side dish!

5. Berries

First of all, berries are delicious. They can be eaten so many ways, and are an especially sweet pick me up in the morning! The health benefits are awesome – berries contain anthocyanins, which are antioxidant compounds that fight inflammation. Berries are known as a food that both combats arthritis and leaves you feeling full, without overeating! Plus, they’re sweet enough to serve as a dessert, and definitely healthier than most other dessert options. What’s not to love?

If you struggle with occasional or chronic joint pain, and want to combine these awesome foods with a concrete plan that will get you moving at your best, get in touch. At CJ Physical Therapy and Wellness, we’re all about helping people make the best decisions for their health and living life to the fullest – without pain pills, procedures, or expensive surgeries!