Tag Archive for: balance

How to Prevent Knee Pain When Hiking

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Hiking is a popular way to stay active during the summer months – but it can also wreak havoc on your knees.

Personally, I love to hike. My pup (Bodie) and I are currently in the process of conquering the 48 4K footers of the White Mountains – and the very last thing I want is for knee pain to get in the way of that journey.

The good news is that there is quite a bit you can do to prevent knee pain when hiking. So when one of my readers asked this week – “How do I prevent knee pain when hiking?” – I couldn’t wait to answer it.

Here are 4 of my top tips to help you prevent knee pain when hiking.

 

1. Strengthen your hips and core

Your hips and core provide much needed support for your knee joint to function properly. The large bone in your thigh, called your femur, makes up your knee joint on the bottom, and your hip joint on the top. Your hip joint is connected to your pelvis, which houses major core muscles groups like your glutes.

Let’s say your glutes (part of your core) and hip muscles aren’t as strong as they could be. When you’re trying to climb up a large rock or steep trail, for example, your glutes and hip muscles are supposed to stabilize your pelvis so that your femur can easily extend your hip. When not strong enough, your pelvis will tilt to compensate – which impacts the alignment of your femur – and ultimately the alignment of your knee.

When I hike a 4k footer – I get in approximately 27,000 steps. If your knee is compensating for every one of those steps – it’s eventually going to hurt. If hiking is something you love to do, it’s critical that you strengthen your hips and core.

2. Keep your knees mobile

One of the biggest mistakes I see when it comes to knee problems is a lack of full mobility. Your knee shouldn’t just straighten, it should be able to hyperextend a little bit. When you bend your knee, you should be able to tolerate a full deep squat without any pain. These full end range movements are pretty essential to have when it comes to hiking. Your knee needs to be able to squat, pivot, and tolerate stress on those uneven trails. When you lack full mobility, it impacts your knee’s ability to tolerate these micro-stresses and over time – your knees will ache.

If you’ve got pain or stiffness in your knee in either direction of movement – it’s important to try and push that movement and work through it rather than avoid it – even if your knee seems painful at first. More often than not, the more you move your knee joint, the better it will feel. If that doesn’t happen – then you know it’s time to talk to an expert about it and have them take a closer look at your knee.

3. Work on your balance

Hiking can involve everything from uneven terrain, water crossings, and rock hopping. Good balance is essential for these activities and without it – your knees will suffer.

So how do you work on your balance?

Aside from the obvious (practicing balance exercises), it’s also important to look at a few other things – namely – the mobility of your toes, foot and ankle joints as well as the strength of your arch (plantar fascia). These structures all play a role in how well you’re going to be able to balance. You can do all the balancing exercises in the world, but if you’ve got faulty mobility in your ankle, for example, or a flat, weakened arch – balance is always going to be really difficult for you.

Perform regular stretching of your ankle and calf muscles, Be sure to move those toes – can you lift your big toe up by itself when you’re standing? And use a small ball to regularly massage the arch of your foot to keep it flexible. These small activities can play a huge role in helping you to be able to balance with more ease – especially on the trials.

4. Use Trekking Poles

Even if you implement every single tip I mentioned above, depending on your overall level of fitness, and the condition of your knees prior to when you decided to get into hiking, you could still have some knee pain despite doing “everything right”.

Trekking poles can be a real life saver – or should I say knee-saver.

They help take away some of the stress from your knees and lower legs – especially on really long hikes and technically challenging trails. Plus, if you’re carrying a backpack, trekking poles help to disperse that extra weight away from your knees and into your arms. And added bonus – hiking with poles gives your arms a little extra workout at the same time and keeps your hands and fingers from getting puffy on those extra hot and humid days.

If you love hiking as much as Bodie and I do – then I know the last thing you want is for knee pain to keep you from hiking. I hope these tips help you to ease any knee pain you might currently have as well as prevent future knee pain on the trails.

Do you love to hike but knee pain is currently getting in the way? CLICK HERE to talk to one of our specialists. 

They’ll let you know if we can help – and if you’re a good fit for what we do – they’ll get you on our schedule right away.

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

Holding Knee with Arthritis

3 Tips to Protect Your Knees as you Age

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3 Tips to Protect Your Knees as you Age

Knee pain is the second most common musculoskeletal complaint behind back pain. It impacts one-third of all Americans at one time or another – and its prevalence has increased substantially over the last 20 years. These statistics indicate that it’s more important than ever to find ways to protect your knees as you age – so you can continue doing things you love – especially if you want to avoid major procedures or surgery.

Here are three tips to help you protect your knees as you age – so that you can stay active and mobile as you age – and hopefully avoid major procedures and surgery:

 

  1. Strengthen your Hips and Core

Your knee joint is situated just below your hips and core. And doctors have found through research that when you have poor control of your upper leg muscles – you get more stress through your knee joint. The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone – or femur – connects your knee and your pelvis – and your core strength controls your pelvis.  If your pelvis isn’t stable – your femur is going to have a difficult time staying in alignment. This will ultimately have a direct stress on your knee joint – causing it to compensate in some way.

Additionally – your outer hip muscles – which include your glute muscles – also play a major role in how well your femur is positioned and stabilized. If you’re wanting to protect your knees and give them the best shot at remaining pain free and mobile as you age – you must strengthen your hips and core.

  1. Mobility before Stability

Mobility before stability is my mantra. And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability – and there are those whose major function is mobility. Your knee needs to be mobile. It’s major purpose is to bend all the way so you can squat and pick things up – and it needs to straighten all the way to give you stability when you need it. When either of these motions are lacking – your ligaments and surrounding muscles will suffer. A lot of folks just “accept” that their knees are stiff – especially if you’ve been told you have arthritis in your knees. 

The limiting belief is that stiffness is par for the course.  But the truth is that if you keep your knees mobile as you age – you can not only maintain the mobility you have but improve what is lacking. If your knees are stiff – start moving them. The thing to understand about arthritis is that it’s a normal part of aging. Debilitating mobility is not. Even a 10% improvement in your knee mobility – which most people don’t realize – can make a huge difference in your function. This can be the difference between a natural solution to knee pain vs undergoing a major surgery like knee replacement.

  1. Work on your balance

The last joint we need to talk about when it comes to protecting your knees is your ankle. Much like your hips and core – if your ankles aren’t stable enough to help you maintain adequate balance – your knees will suffer. But another interesting thing about your ankle joint is that poor mobility can also impact your ability to balance. Let’s say you have stiffness when you squat. Many times this is due to inadequate mobility in your ankles. You’ll know this because you’ll feel a strain in the front of your shins when you try to deeply squat – or you may notice your feet and knees turn in. These are mechanisms your body uses to compensate – which if repeated over and over – will cause problems in your knees.

But how does squatting relate to balance? Well – if your ankle doesn’t flex enough – say in a deep squat – then that means your lower calf and achilles are being overstretched and compromised. Your lower calf muscles are extremely important when it comes to balance – and if they are overstretched or inadequately accessed – because your ankle is too tight – then your balance will be affected. In order to protect your knee joints and balance as you age – be sure you’re being mindful of both ankle mobility and stability.

So – let’s summarize…

If you want to optimize your knee health as you age – which you still can even if you’ve been told you have “advanced arthritis” – prioritize the mobility of your knees and ankles – strengthen your hips and core – and work on your balance.

Focusing on these three things can have a significant impact on the health of your knees as you age and help you to avoid major surgery.

Ready to get help with your pain?

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

 

 

Back Pain

Tips to Avoid Injury When You’re Over 50

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Most of our clients are aged 50 or above, and staying as active as possible while they age is a big priority for them. As we get older, our bodies do need more care and maintenance to not only age well but avoid injury. 

Here are some of my top tips I like to give clients to help them stay active and mobile, avoid injuries, and continue doing everything they love.

1. Keep Moving

You’ll often hear me say: “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 concerns I hear from folks aged 50+ is whether they should start modifying what they do because of arthritis. Remember, arthritis is normal. It happens to everyone as they age, and it’s rarely a reason to stop doing your favorite activities. In fact, research has shown that activities like running, when done consistently and with proper form, can prevent knee arthritis! The effects of arthritis worsen when you don’t move, which is when I typically see people having problems. Common “injuries” like meniscal tears and bulging discs are more likely to occur in arthritic joints. But the more active you stay, the less likely you are to be impacted by ailments such as this — and the better your joints will feel.

2. Maintain a Healthy Diet

Both osteoporosis and heart health become bigger concerns as we age, and what you eat can have a direct and positive influence. With osteoporosis, your risk of injury, especially from a fall, becomes much greater. 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. According to Health magazine, “The risk of a heart attack climbs for men after age 45 and for women after age 55.” As you enter middle-age, increasing the presence of foods like unsalted nuts, unprocessed oatmeal, raisins, blueberries, and even dark chocolate (over 70% cacao) can help keep your heart healthy. Before making any drastic changes to your diet, especially if you’ve got comorbidities such as diabetes or kidney disease, you’ll want to check with your doctor or dietician. But otherwise, paying attention to your diet can have a big impact on how healthy you keep your heart and bones.

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 become more common and harder to recover from as you age. But if you’re intentional about improving your balance when you exercise, it’s not too late to improve it. While there are many great balance exercises you can do at home, I always recommend incorporating balance strategies with movement and activity. Because rarely do we fall when just standing still. Try standing on one leg when you brush your teeth, place one foot up on a stool when washing dishes, walk around on your toes and heels during commercials. These are really easy strategies to incorporate into your daily living. And of course, activities like walking regularly, Tai Chi, Yoga, and our favorite — Pilates — are also great to promote good balance.

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. But what I love most about Pilates is that it teaches you how to strengthen your core properly and safely, two important things at any age, not just when you’re over 50. When you know how to properly engage and use your core, you start to incorporate it more into other exercises. Suddenly walking, running, Yoga, and lifting weights all become that much more effective, and you’re far less likely to get injured doing them.

5. Educate Yourself

Knowledge is power, and lack of it, is one of the biggest reasons I see people decreasing their activity levels when there is no reason to. People think that things like arthritis, bulging discs, or a torn meniscus are reasons to decrease or cease certain activities. 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 something you’ve been successfully doing for years. Plus, regular movement and exercise actually helps these problems. If you’ve got 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 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. 

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. 

knees

Happy Halloween! Spooky Noises coming from your Knees?

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“What are those cracks and noises coming from my knees? Is there something wrong??”

Our clients come in with this question all the time. They usually feel nervous and fearful that the noises they hear may indicate something more serious is going on within the joint. Is there damage occurring whenever they hear this sound? Do they need to avoid activities that provoke these symptoms? Will they need to rely on pain pills and surgeries in order to maintain their mobility if their joints deteriorate? 

Crepitus refers to these clicking, popping, and creaking sounds that a large portion of the population experience on a regular basis.  This phenomenon can occur at any joint, but is most commonly reported in the knees, shoulders, ankles, hips, and spine. 

Although these noises often don’t produce any pain, they can cause anxiety. Individuals start to develop their own beliefs about what is going on, and ultimately alter their behavior to avoid these cracking or popping sensations.

What causes these noises?

Many structural factors can contribute to joint noises.  Some of the most common are:

  • Tendons rubbing along bony prominences (bumps on bones)
  • Nitrogen bubbles popping due to pressure changes within the joint
  • Small labral or meniscus tears that get caught or pinched as we move

However, we don’t have the luxury of utilizing x-ray goggles during our examinations.  This means that we often cannot be certain of exactly which structures are creating these sounds.  What we do know is they aren’t a reason to be highly concerned as long as they aren’t associated with pain or swelling in the affected joint.  

How can I prevent it from getting worse?

The best way  to prevent these symptoms is to keep moving!! Motion is lotion. Regular movement throughout the day allows our joints to lubricate themselves, kind of like applying WD-40 to a creaky door hinge.  Additionally, it’s important to keep the muscles surrounding your knees strong and balanced. This helps to offload the forces through the joint, which limits “typical” wear and tear on cartilage and bony structures.

What if I’m noticing pain or inflammation in the joint that’s making these noises?

If you have a specifically noisy joint that’s also painful or swollen, it’s best to come in for a formal examination with a physical therapist – ideally someone who specializes in movement mechanics.  We train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.

If finding the solution to your problem is something you’re interested in, you can come in for a free Discovery Session at our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are great for people who want to talk with a specialist about what might be causing their problem, and we’ll help you figure out what the next best steps are.  Our goal is to give you all the information you need so that you can make the best decision for your health – without any obligation or commitment.

We also know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free health and posture classes!  These events are for people in our community who want really valuable, expert information about movement, pain, and overall wellness. We know it’s confusing out there with all of the information floating around on Google and Facebook, and this is a valuable first step towards getting some answers for your problem.

Hopefully you found this information helpful, and the only thing scaring you this Halloween will be haunted houses instead of the noises coming from your joints!

PS – If you found this information helpful, please share this with a friend or on your Facebook feed.

Setting Goals for the New Year: Part One – What to address FIRST?

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New Year’s may still seem pretty far away, but if you plan on setting any resolutions or goals for 2019, you should start now. The earlier you set your goals, the more likely you are to achieve them. But choosing meaningful and positive goals is a process. That’s why we’re launching this four-part blog series to be your guide as we head into the end of 2018!

The first step is identifying what you want to change – FIRST.

A typical New Year’s resolution might be to lose weight or be more active. But before you can address those goals, it’s important to take a quick inventory of your body and identify obstacles that might get in the way.  The last thing you want is to get all excited about a goal, only to have those aspirations quickly deflated because you neglected to see the whole picture.

Let’s take the weight loss goal for example. Coming from a physical therapist’s point of view, that might mean asking yourself, “what hurts?” or “what has physically been bothering me?”  What are one or two things that could possibly get in your way of completing this goal?  Maybe your body is feeling great, you could still be struggling on other levels. It’s important to be honest with yourself and identify anything and everything that could be an obstacle to your goal. Once you can recognize and become aware of this issue, you have the opportunity to resolve it!

But how do you do that?  First, you have to get specific. For example, if you want to address your back pain in the New Year, so that you can be more active and lose weight in 2019, it’s not enough to simply say “I have a problem with back pain.”  When we get specific, we are able to take what may seem like a big, overwhelming problem – and turn it into bit size actionable chunks….

Start with focusing on the what, when, where, and why of the problem.

“Back pain” in itself is a general term. It’s more likely that instead of your entire back hurting at the same level all the time, you have a specific area (or areas) that hurts during specific activities. For instance, your “what” (the specific problem at hand) could be low back pain. The “when” could be in the evening after a long day on your feet. “Where” could be your living room when you’re trying to get up off the couch, or the golf course after a swing. “Why” could be a combination of factors that are causing you to experience the pain. For example, your body mechanics might be off to the point where it’s causing degradation of your vertebrae. Learning to move properly (for instance, with a physical therapist) would be a logical way to address that “why.”

Next, write down your focused description of the problem.

The simple act of writing something down will clarify and solidify your intentions. In this example, we started with the general statement “I have a problem with back pain.” We broke that down into parts, so that now you might say:

“I am experiencing severe low back pain. It typically occurs in the evenings after I’ve spent a long day on my feet, particularly when I’m moving from sitting to standing. This is likely a result of poor body mechanics, as I have never been instructed in proper movement to relieve back pain. This is the issue I intend to resolve so that I can be more active in 2019 and lose 20 lbs.”

Our next blog post will consider this series and discuss how to set a specific long term goal.

Stay tuned for this post coming out on 11/20! In the meantime, you may want to consider how physical therapy could help you in improving your overall health this upcoming New Year. You may not have a specific physical complaint like the one we described in this post, but working with a physical therapist can actually help you PREVENT these issues from arising later on! As we continue to age, it becomes more likely that we will experience back pain and numerous other issues. The great thing about PT is that it strengthens your body in all the right ways to guard against joint degeneration, stiffness, achiness, muscular weakness, and loss of balance (just to name a few benefits).

If you want to know if one of our specialists can help you, apply for one of our FREE Discovery Visits right here in Portsmouth!