Tag Archive for: cjphysicaltherapyandpilates

Physical therapist helping patient with natural knee pain relief in Portsmouth NH

Six Tips for Managing Knee Pain without Medication

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6 Natural Ways to Manage Knee Pain Without Medication or Surgery

When you’re suffering from lingering knee pain that just won’t go away, it can deeply affect your day-to-day life. And when this happens – it’s easy to become desperate and resort to daily medication – or “quick fix” procedures or surgery. But there’s good news – there are plenty of natural, non-medicated ways to manage knee pain successfully and improve how you feel – even if you’ve been dealing with knee pain for years. You don’t always need medication or invasive treatments to find relief – despite what the medical community tells you.

Introduction

When you’re suffering from lingering knee pain that just won’t go away, it can deeply affect your day-to-day life. And when this happens, it’s easy to become desperate and resort to daily medication or “quick fix” procedures or surgery.

But there’s good news — there are plenty of natural, non-medicated ways to manage knee pain successfully and improve how you feel, even if you’ve been dealing with knee pain for years. You don’t always need medication or invasive treatments to find relief — despite what the medical community tells you.

Understanding the Problem: Why Knee Pain Lingers

Knee pain often develops gradually due to muscle imbalances, stiffness, or overuse. It can also stem from poor movement patterns that put excess strain on your knees. Many people turn to medication for temporary relief, but this doesn’t fix the underlying cause.

By addressing the true source of your discomfort — how your body moves, supports, and aligns itself — you can find lasting relief naturally.

Common Causes of Ongoing Knee Pain

  • Weak hips or core muscles that lead to poor alignment

  • Stiffness in the hips, hamstrings, or quadriceps

  • Prolonged sitting or sedentary habits

  • High-impact or improper exercise routines

  • Unsupportive footwear

  • Poor balance or coordination

Understanding these root causes allows you to take meaningful, proactive steps toward recovery — without medications or procedures.

Natural Solutions: 6 Proven Tips to Relieve Knee Pain

1. Strengthen Your Hips and Core

Your hips and core play a crucial role in providing stability and support for your knees. When these muscles are weak or unbalanced, your knees bear the brunt of poor mechanics during movements like walking, running, and squatting.

Strengthening your hips and core improves body alignment, reduces strain on your knees, and promotes long-term joint health. Try exercises such as glute bridges, side leg lifts, and planks for better stability and reduced pain over time.

2. Improve Your Flexibility

Mobility comes before stability when it comes to joint health. Stiff joints force surrounding muscles to overcompensate, leading to more discomfort and inefficiency in movement.

Improving flexibility—especially in your hips, hamstrings, and quadriceps—helps distribute forces evenly through your body and reduces strain on your knees. Regular stretching, yoga, or mobility exercises can enhance your joint motion and reduce chronic knee discomfort.

3. Don’t Sit Too Long

Sitting for extended periods can cause stiffness in your knees and reduce circulation. It may also create or worsen imbalances in your hips and back that contribute to knee pain.

Make it a habit to stand up and move every 30 minutes. Light stretching, short walks, or even standing for a few minutes can help keep your knees flexible and pain-free.

4. Stay Active

Regular, low-impact exercise is one of the best ways to manage knee pain naturally. Activities like swimming, cycling, and walking increase blood flow, reduce inflammation, and lubricate the joints.

If arthritis is a concern, consider Pilates or resistance band exercises to build strength without overloading your knees. Avoid high-impact movements that cause pain and focus on maintaining flexibility, balance, and muscle endurance.

5. Wear Supportive Footwear

Footwear plays a big role in knee health. Shoes that don’t support your feet properly can cause poor alignment and extra stress on your knees.

Choose shoes with good arch support, cushioning, and proper alignment. Replace worn-out footwear regularly, and consider custom orthotics if needed to optimize foot and knee mechanics.

6. Optimize Your Balance

Good balance isn’t just about preventing falls—it also helps your knees function efficiently. When your body is well-balanced, the load is distributed evenly across muscles and joints.

Practice simple balance exercises such as standing on one leg, using a balance board, or doing yoga. Improving your balance helps reduce knee strain, enhances coordination, and promotes overall stability.

Next Steps: Find Natural Relief in Portsmouth, NH

If you’ve been dealing with knee pain for a while and haven’t incorporated these tips yet, now is a great time to start. Try these strategies first before resorting to something invasive—or accepting a life on daily pain medication.

And if you need guidance, it’s a good idea to consult with a physical therapy specialist who focuses on natural treatments for knee pain.

Are you local to Portsmouth, NH?

 CLICK HERE to speak with one of our specialists at CJ Physical Therapy & Pilates. We’ll help you figure out which strategies will get you back to doing all the activities you love—while avoiding medications and procedures.

About Dr. Carrie Jose

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Pain Expert, and owner of CJ Physical Therapy & Pilates in Portsmouth, NH. She also writes for Seacoast Media Group.

To get in touch—or to request a free copy of her guide, “7 Easy Ways to Get Rid of Knee Pain”— CLICK HERE.

Back MRI

Do You Really Need an MRI for That?

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

“Should I get an MRI for that?”

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

Not so fast!

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

Don’t get me wrong… 

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

Let me explain…

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

Sound familiar?

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

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

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

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

So what IS the root cause of the problem?

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

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

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

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

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

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

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

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

Active and Mobile

Six Ways to Keep Your Thanksgiving Festive and Fit

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Six Ways to Keep Your Thanksgiving Festive and Fit (Portsmouth NH Healthy Holiday Tips)

Thanksgiving is one of my absolute favorite holidays here on the Seacoast. I love the food, the sweets, family time, the Macy’s Day Parade, afternoon naps, and football. Traditionally, Thanksgiving means slowing down and indulging—but more and more people in Portsmouth, NH and across the Seacoast are looking for ways to stay active and feel good throughout the holiday.

And the benefits are real: improved digestion, better energy, happier joints (hips, knees, back, neck, shoulders), and a healthier balance to the extra calories you may enjoy.

If you want a festive and more active Thanksgiving this year, here are six simple, healthy Thanksgiving tips to help you stay moving and feeling great.

1. Practice Mindful Eating

You can enjoy every part of your Thanksgiving meal—while still supporting your digestion and energy—with mindful eating.

Mindful eating involves slowing down, savoring each bite, and paying attention to hunger and fullness cues. Studies show this can reduce calorie intake by up to 25%, simply by giving your brain time to register fullness.

It also helps digestion by encouraging thorough chewing and reducing the bloating or discomfort that often comes with holiday meals. Instead of loading your plate immediately, take your time, taste every dish, and enjoy the experience.

2. Interrupt Your Sitting

Even if you don’t feel overly full after practicing mindful eating, long periods of sitting can make your hips, back, and knees stiff—especially on soft couches.

Aim to stand up at least once every 30 minutes. This can be a fun job for a younger family member—let them be responsible for making everyone stand!

Regular movement breaks are one of the easiest ways to keep your spine and joints happy throughout Thanksgiving Day.

3. Sign Up for a Turkey Trot (or Create Your Own)

Turkey Trots are popular across New Hampshire and the Seacoast, and they’re a fun activity for the whole family. Most are 5Ks (3.1 miles), but even creating your own neighborhood walk or jog counts.

A morning walk or run boosts circulation, lubricates your joints, and elevates your metabolism for hours afterward. It’s one of the best ways to balance your Thanksgiving Day indulgence while giving your body a healthy start.

4. Be Active During Commercials

Whether you’re watching the Macy’s Day Parade or football, hours on the couch can wreak havoc on your back and neck.

A simple solution? Do something active during commercial breaks. It doesn’t have to be complicated:

  • Squats

  • Heel raises

  • Planks

  • Back or hip stretches

Turn it into a family challenge if you’ve got competitive relatives—you know who they are.

5. Walk Your Dessert Off

Skipping dessert is optional—but walking afterward is highly recommended. Even a short 10–20 minute walk supports digestion, stabilizes blood sugar, and offsets stiffness from sitting.

Walking is one of the most natural, joint-friendly exercises you can do, and it’s especially beneficial after a big Thanksgiving meal.

6. Stay Hydrated

Hydration matters every day—but especially on Thanksgiving. Drinking water helps with digestion, nutrient absorption, and energy levels.

We often confuse thirst with hunger, so staying hydrated before and during your meal can help you feel more in control of your portions. Hydration also keeps your mind clear and your body energized, making healthier choices easier throughout the day.

Final Thoughts

There you have it—six easy ways to keep your Thanksgiving festive, active, and healthy. If back, hip, knee, neck, or shoulder issues are getting in the way of enjoying the holiday—or even these simple tips—it may be time to talk with a mechanical pain expert.

They can help you find the root cause of what’s bothering you and keep it gone—so by next Thanksgiving, you can enjoy the day fully.

And—it’s the perfect time to take advantage of our Black Friday Sale!
We’re offering our lowest prices of the year on sessions with our Physical Therapy Specialists and our Regenerative Shockwave Therapy.

👉 CLICK HERE to get full access to the Black Friday deals — packages are limited and only available while deals last!

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

What Your Doctor May be Missing About Your Pain’s True Source

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Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body. 

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem). 

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan. 

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all.  I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?  

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit. 

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.  

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

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

Knee Pain

How Mobility and Strength Are Key to Resolving a Meniscus Tear Naturally

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A meniscus tear is one of the most common knee injuries, and it’s known for causing significant pain, swelling, and restriction of movement that can seriously disrupt an active lifestyle.

While surgery may seem like the only solution – and perhaps that’s what you’ve been told – many people (80% in fact) can successfully avoid invasive procedures like cortisone and surgery if they want to. 

The key?

Focusing on specialized mobility and strength training of your knee. But first – what exactly is a meniscus tear and how does it cause problems for your knee?

The meniscus is a cartilaginous structure in your knee joint that acts as a shock absorber. It sits between your thigh bone (femur) and shin bone (tibia) and you have two of them: one on the inside of your knee joint (medial) and one on the outside (lateral). Together, they help distribute weight and cushion your knee during activities like walking, running, and jumping.

So how do meniscus tears happen?

You can get a meniscus tear suddenly from twisting or pivoting motions, or it can develop gradually over time due to age or wear and tear.

But here’s the thing… Sometimes – especially when your meniscus tear develops slowly – it can be damaged without feeling any knee pain or symptoms. For example, a study published in the New England Journal of Medicine found that 35% of people over the age of 50 had meniscus tears on their MRI, but no knee pain or other symptoms. In another study, published in the Journal of the American Medical Association – it was reported that 60% of men and women over the age of 65 who had a meniscus tear on their MRI also had no symptoms in their knees. What is the significance of this? It means that it’s entirely possible to “live” with a meniscus tear and not have any knee pain – which means it’s also entirely possible to avoid surgery and cortisone shots.

So why do some meniscus tears cause pain when others don’t? 

When you have a meniscus tear – it has the potential to disrupt your knee’s natural mechanics – but not all tears do.

When the mechanics of your knee are compromised, that’s when you experience symptoms. Why? Because faulty knee mechanics (over time) will cause compensatory strategies to happen in the joint itself – as well as the surrounding muscles and structures.

This is what actually causes pain – not necessarily the tear itself.

Simply going in and “cutting out” the meniscus tear will not solve the problem of faulty knee joint mechanics. It’s why so many people end up with no relief at all after surgery – or just temporary relief of pain that returns anywhere from months to years later. In 80% of knee pain cases that involve a meniscus tear – the faulty knee mechanics are what truly cause the problems and pain – not the tear itself. That’s why focusing on the joint mechanics and mobility first is more important – because if you can restore that – the tear often becomes a non-issue – just like all the people in those research studies.

Now – when I talk about knee mechanics – I’m referring to both knee mobility and strength – and how they work harmoniously together. 

Mobility refers to the ability of your knee joint to move smoothly and freely through its full range of motion. Strength refers to the stability around your knee joint – which comes from muscles and tendons. When a meniscus tear causes your knee joint mobility to be blocked and disrupted – meaning it’s unable to bend and extend properly – it puts stress on the surrounding structures and muscles – causing a cascade of events that eventually lead to pain and swelling.

To achieve natural knee pain relief after a meniscus tear – restoring mobility is the first critical first step – followed by strengthening. But a lot of people get this wrong. That’s why it’s important you work with a mechanical knee pain specialist who understands the intricate nature of a meniscus tear and how it impacts your knee mechanics. You can’t just do random strength and mobility exercises. They need to be prescribed to you in a specific and strategic manner so that you can “free” the tear and restore your knee mechanics. In other words, YouTube and Google won’t be able to help you.

If you’re confused – I don’t blame you – but the research doesn’t lie.

For most people, especially those over the age of 40, there’s a 70-80% chance you can get full relief of your knee pain after a meniscus tear, without any type of surgery or procedure. This is not a popular opinion by the way. Arthroscopic meniscus surgery is one of the most common (and profitable) surgeries out there. If a meniscus tear appears on your MRI – a common recommendation will be surgery. But if that’s not what you want – I’m here to tell you it’s entirely possible to resolve pain and dysfunction from your meniscus tear naturally. But you’ll want to work with a mechanical knee pain specialist to do that. Reach out if you need help finding one in your area.

Are you local to Portsmouth, NH? If so, consider speaking to one of my specialists in a Free Discovery Session. This 30-min session is a designed to: 1. Make sure we can help you 2. Make sure you’re a good fit for what we do. 3. Make sure we’re a good fit for you. Click here to speak with a specialist.

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 sign up for her upcoming Masterclass for Knee Pain Sufferers – CLICK HERE or call 603-380-7902

Holding Knee with Arthritis

Four Overlooked Reasons Your Knee Pain Won’t Go Away

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If you’re one of the many people out there suffering from chronic knee pain – and wondering why it won’t just go away – you’re not alone.

Most of the folks I speak with in this situation have been told it’s simply due to arthritis, old age, or general wear and tear – and there isn’t much that can be done about it. First of all, that’s not true. But second – one of the biggest reasons people are led to believe that there’s nothing that can be done about their chronic knee pain is because they’ve tried just about every treatment out there – and nothing has worked.

What’s the biggest culprit for that? Almost always – it’s misdiagnosis.  Meaning, something crucial was overlooked when it comes to the underlying reason for your knee pain (and structures in and around your knee joint get blamed instead).

Here are 5 of the most common overlooked reasons that can lead to misdiagnosis of your knee pain – causing it to linger and not go away:

1. You’re Focusing On Knee Strength Over Mobility

Focusing on knee strength and overlooking mobility is something I see far too often – and it’s a big reason knee pain lingers longer than it should.  Mobility refers to the joint’s ability to move through its full range of motion, which is crucial for proper alignment and injury prevention. Without sufficient mobility, strength exercises can place undue stress on the knee, leading to compensations and pain.

When it comes to mobility, it’s important to compare right and left knees, as well as look at “hypermobility” – because it all matters. You want to make sure you’re optimizing mobility according to the person, and not a “textbook” definition. By improving and optimizing mobility in your knee first, you ensure that your knee can move freely and efficiently, reducing the risk of strains or overuse injuries when you begin to load the joint with strength training.

2. The Real Culprit Could Be Your Back

Did you know that 25% of the time – pain in your knee can come from a source in your lower back – even when you don’t have any back pain? Pain that moves around your knee, is challenging to pinpoint, or aches into your thigh or lower leg are all signs that your knee pain could actually be a back problem. Specialized movement screening of your lower back should be required for anyone suffering from any kind of knee pain – but it’s not.

Precautionary low back screening by a mechanical pain expert is rarely done – and it’s one of the biggest reasons I see for knee pain misdiagnosis. When knee pain is coming from your back – and you miss it – people not only suffer from knee pain longer than they should – but they risk being prescribed unnecessary cortisone shots, procedures, and surgeries in knees that never even had a problem to begin with.

If your knee pain isn’t going away and especially if the pain moves around – consider your lower back.

3. Your Knees Are Compensating For Weak Core Muscles

Your core – made up of four major muscle groups (your abdominals, lower back muscles, glutes, and hip muscles) plays a critical role in stabilizing your body, supporting proper posture, and distributing weight evenly during movement. When any part of your core is weak or not functioning optimally, your body will compensate by placing excess strain on other areas, such as your knees. Workload that is normally better handled and supported by say – your hips and glutes – will be taken over by your knees.

The result is increased stress in your knee joints and surrounding structures – which can lead to pain, inflammation, and even injury over time. Additionally, when you lack adequate core strength, your body lacks the stability needed to control movements efficiently, which can be another factor in forcing your knees to work harder than they should. If you’ve got lingering knee problems and never looked at strengthening your core properly – get started now. This could be one of the overlooked factors leading to a misdiagnosis of your knee problem and subsequent chronic knee pain.

4. Stiff Ankles Are Putting Stress on Your Knees

We already talked about how important it is to focus on knee mobility. But it’s equally important to focus on the mobility of joints above and below your knees, namely, your ankles. Ankle stiffness can be due to a number of factors – such as footwear, poorly rehabilitated injuries (like chronic ankle sprains), and repetitive/overuse activities that involve heavy use of your feet, ankles, and calves.

When your ankles are stiff, especially during activities like running, squatting, or even walking – your knees will compensate.

The result may not be noticeable right away – but over time – this extra compensation can result in unwanted knee pain. And if you never identify that the cause might be stiff, overused ankles – then you’ll continue to blame the irritated structures of your knee joint instead. If your ankles always feel tight, or your lower legs get fatigued frequently during repetitive movements, this could be a sign that your lingering knee pain is the result of compensation for stiff ankles. Improving ankle mobility might be the missing solution to freeing up your knees.

Chronic knee pain does not have to be something you accept – and it certainly doesn’t require a cortisone shot, procedure, or surgery to fix it. Most knee pain (at least 80%) can be resolved naturally. But it starts with the correct diagnosis. If you’ve been suffering from knee pain for a long time and feel like you’ve already tried everything – consider one of these four overlooked reasons. And to be sure – visit a mechanical knee pain specialist who can check all of these things out and give you an accurate diagnosis of your lingering knee pain.

Are you a local to Portsmouth, NH?

If so, CLICK HERE to speak to one of my specialists. They can help you discover effective strategies to finally relieve your knee pain and get back to doing what you love!

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Knee Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or request a seat in her upcoming Masterclass to end Knee Pain naturally – without pills, procedures, or surgery – CLICK HERE.

Hiking with Bidue

Three Lessons Learned from Hiking with my Pup

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I have a 10.5-year-old Black Lab/Hound-mix rescue pup (named Bodie) who I bring with me everywhere when I’m allowed. But our favorite place to hang out? Hiking trails.

Bodie and I have been slowly working on finishing our “NH48”. For those of you not familiar – we’re trying to hike all of the NH White Mountain peaks that are over 4000 feet in elevation – and there are 48 of them. This past weekend we hiked Owl’s Head, which was number 31, and the weekend before, we checked off Mount Zealand for number 30. If you’ve ever hiked these peaks, then you already know these two hikes are pretty long – especially as day hikes. Owl’s Head was 17 miles, and Zealand was 12. And we did them back-to-back weekends!

I planned to hike again this weekend, but after watching and learning from Bodie over the years, I’ve realized some powerful lessons that I wanted to share with you that can absolutely be carried over into everyday life.

Here are three Lessons I’ve Learned from Hiking with my Pup:

1. Nature is the ultimate natural remedy for anxiety.

Bodie can be a bit anxious, and when he doesn’t get outdoors enough, it gets worse. Spending extended time in nature is one of the most powerful and natural anxiety remedies I’ve experienced – and I see it in Bodie. After our hikes, he’s much calmer and even barks less at neighborhood dogs. 

Bodie is also my mirror – when I’m anxious and haven’t spent enough time outside – he notices and mirrors my energy. Have you noticed this in your life? If so, try getting out in nature more – it works wonders. Bodie and I keep ourselves pretty active – but there’s just something about hitting those trails that is magical. Bodie reminds me daily to spend quality time moving outdoors.

2. Bodie knows how to listen to his body.

It’s remarkable to watch Bodie on the trails – he knows exactly what his body can handle and when to rest. Can you imagine if we all had that kind of awareness? Life would be so different.

As a PT specialist for over 22 years, I’ve learned how to listen to my body, and it’s one of the most important skills I’ve taught clients over the years. When you truly understand what your body is telling you, you can challenge it without being reckless. This is important because we only improve when we appropriately challenge ourselves.

Shying away from every ache and pain can actually teach your nervous system to fear pain, which does more harm than good.

Watching Bodie, I realize this instinct is built into him. His nervous system is so in tune – it just knows. While we may not have the same instincts,it is possible to improve our relationship with our nervous systems, which will help us do more of the activities we love and prevent injuries. If you struggle with recurring injuries or fear of movement because of pain, I highly recommend working with a movement expert who can help you work through this. Your body awareness will improve and your nervous system will thank you.

3. Recovery is critically underrated.

Bodie is a pro at recovery. After every hike, he takes a day or two to rest – lounging around, sleeping more, and letting his body recover. It’s a reminder that recovery is just as important as the effort we put in. Whether it’s hiking, exercising, or going through daily routines, our bodies need time to repair and strengthen. I take this lesson from Bodie and make sure I’m giving my body the rest it needs.

Recovery is key to maintaining strength, mobility, and long-term health – not to mention injury prevention. 

If you’re struggling with recovery or feel like your body isn’t bouncing back after adequate, it could be a sign of a bigger issue. I recommend working with a movement specialist who can help you. You don’t have to let stubborn aches, pain, or injury linger or keep you from doing what you love.

We’d love to help you figure that out!

Work with someone who specializes in finding natural ways to get rid of pain – and who can help you to keep it gone – so you can keep enjoying all of the activities you love to do. For me and Bodie – that’s hiking.

All you have to do is request a free appointment with one of our specialists to see if we can help and if you’re a good fit for what we do 🙂


Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE or call 603-380-7902.

Sciatica

Why Cortisone Shots Don’t Work for Sciatica

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If you’ve ever suffered from sciatica – then you don’t need me to tell you how debilitating the condition can be.

From shooting and searing pain into your buttocks that can run all the way down to your foot – to numbness, tingling and loss of strength… sciatica has the ability to significantly impact your quality of life. What’s worse? It typically comes out of nowhere – making this condition even more frustrating to deal with.

It’s no wonder that a majority of people resort to “quick fixes” like cortisone shots – in hopes it will put an end to their back pain and sciatica suffering. According to the American Academy of Family Physicians (AAFP), epidural steroid injections (a type of cortisone shot) are among the most common interventions for chronic low back pain and sciatica. In a study published in The Spine Journal in 2015 – it was reported that approximately 50% of patients with sciatica opted for cortisone shots for pain relief as part of their treatment plan. 

But just because cortisone shots for sciatica are popular and considered “standard” – it doesn’t mean they are best practice.

First of all – even if a cortisone shot “works” (almost 50% of the time they don’t) – the results are typically temporary.  Only 20-30% of patients have been able to report sustained relief past a few month’s time. Everyone else reports anywhere from a few weeks to 3 months relief. The problem with the majority of people only experiencing temporary relief from cortisone shots in their spine – is that  you risk “chasing the pain” with more cortisone shots (or prescription meds), acceptance of your condition and continued suffering (I call it “bad back syndrome”), or opting for spine surgery, that in most cases, is totally preventable.

OK – statistics aside – why exactly don’t cortisone shots work for sciatica?

The reason cortisone shots don’t work is because they are attacking symptoms instead of the root cause of your sciatica. Cortisone shots are great when you have an out of control inflammatory reaction to an injury. This presentation is distinct and rare. We call it “chemical  pain” and it’s essentially the result of your body’s natural inflammatory process going a bit haywire.

What makes chemical pain distinct from mechanical pain (which accounts for 80% of all sciatica/low back pain) is that most “mechanical” sciatica will come and go throughout the day – and will be better or worse during certain activities and positions. For a simple example – your sciatica may “scream” at you if you’ve been sitting for too long – but will ease up and feel better if you stand up and stretch. This is a classic presentation of mechanical sciatica.

Chemical pain does not behave like that. It literally hurts all the time and the only thing to relieve it is drugs.

And even that is temporary – thus – justifying the more invasive cortisone shot when accurately diagnosed. The tricky thing about mechanical sciatica/low back pain is that it occurs slowly over time and is the result of abnormal stress and strain on your discs and spinal nerves. It’s a “lifestyle” and movement condition at its root – not an inflammatory condition. While the cortisone shot may succeed in temporarily getting rid of the inflammation – it won’t ever get rid of the mechanical cause – which means you’re more likely to prolong the true problem over time. A cortisone shot, at its best, puts a bandaid on your sciatica. And this is the number one reason why so many people end up in a vicious cycle of treatments, and end up getting both unnecessary and preventable spine surgery.

So what should you do for your sciatica instead of a cortisone shot?

First, trust the research and evidence – which says there’s an 80% chance your sciatica has a mechanical root cause – and that the inflammation you’re experiencing is instead – a symptom. Research aside, I can vouch for this over the 22 years I’ve been helping people get rid of sciatica naturally. 

Second, medical doctors (unfortunately) are not trained in recognizing, diagnosing, or even treating mechanical pain. You need a mechanical pain specialist to help diagnose and get rid of mechanical sciatica – if you want it done the right way and for the long term. Plus – the best thing about working with a properly trained mechanical pain expert first – is that it’s fool-proof. If it’s not a mechanical cause – and it indeed is an inflammatory process “gone wrong” inside your spine – they will rule it out quickly – and refer you for a cortisone shot (appropriately).

So here’s the good news…

There’s an 80% chance your back pain or sciatica is a mechanical problem at its source. Which means that when working with the right medical professional(s) – you can successfully get rid of it naturally – and avoid cortisone shots altogether. I’m a huge advocate of natural, DIY treatment approaches whenever possible – because although small – there are real risks associated with invasive procedures like cortisone/epidural injections. And when those adverse reactions occur – they are often irreversible. 

Why not give yourself the shot at a natural approach to your sciatica before diving into an invasive one?

I’m not talking YouTube exercises and Google – I’m talking actually mechanical pain specialists. I know a lot of them. So if you’re struggling to find one in your area – please reach out. I’d love to help.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media group. To get in touch, or grab a seat in her upcoming Masterclass: “Put an end to back pain naturally – without surgery, procedures, or pills – CLICK HERE.

5 Reasons to Ditch the Pills and Embrace Exercise as Medicine

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Our bodies are built for movement, yet modern life has us sitting far more than we should.

Compared to our ancestors, we’re moving less and sitting more – sometimes for over half the day. While fitness trackers and smartwatches encourage us to stand and get more steps in, it still doesn’t seem to be enough to counteract the effects of a sedentary lifestyle.

Physical inactivity has now become a major health issue, and the consequences are clear: less movement leads to more musculoskeletal issues and chronic pain (among other things). And the unfortunate reality is that most folks turn to pain medication for relief, despite research increasingly pointing to regular exercise being just as effective and far healthier.

Here are 5 reasons to ditch the pills – and embrace exercise instead – as a powerful form of medicine to manage musculoskeletal pain naturally.

1. Exercise Mediates Pain

The way we perceive pain is complex. Many assume it’s a direct response to physical damage or injury – but it’s not that simple. The perception of pain involves numerous physiological and psychological factors that the brain must interpret. Depending on your general health, past experiences, and mental health condition, this can vary quite drastically from person to person. In other words – it’s your brain that decides how much or how little pain you experience.

Because of this complexity, external factors like exercise (and also pain medication) can alter how we perceive these signals. When we exercise, our bodies exhibit an increased tolerance towards pain, and a lower perception of pain intensity. This phenomenon is called “exercise-induced hypoalgesia” – and it works by closing down the gateways that allow pain signals to enter the brain. Certain medications can do this too, but when you exercise, you’re doing it naturally. 

2. Exercise Helps Inflammation

Inflammation is a normal part of your body’s healing process, and it occurs when inflammatory cells travel to a place of injury. However, if inflammatory cells stick around too long, it can result in chronic pain and irritation. This is where exercise can really help. 

When you exercise, your body experiences minor physiological stress, which triggers your body’s natural inflammatory reaction. During the inflammatory process, certain proteins called anti-inflammatory cytokines are produced. These protein chemicals help to modulate the body’s inflammatory response – ultimately reducing the level of inflammation associated with your pain. Inflammation can be both good and bad. When you exercise, you are creating “good” inflammation, which will naturally help to ease your pain.

3. Exercise Stimulates Endorphins

Ever wonder why a quick walk outside or a strenuous gym workout magically makes you feel better? It’s not your imagination. It’s something called endorphins – neurotransmitters released by your brain to alleviate pain and promote pleasure.

Endorphins are considered your body’s natural “opioids” because they interact with the same pain-inhibiting receptors in your brain that drugs like morphine do. But unlike morphine, endorphins are triggered naturally and don’t come with harmful side effects like addiction, drowsiness, or mental fog. Exercise stimulates the production of endorphins, boosting your mood, reducing stress, and giving you access to your very own stash of natural, healthy painkillers.

4. Exercise Improves your Mental Health 

Exercise and mental health share a powerful connection. It’s virtually impossible to influence one without the other.

Regular exercise stimulates the production of various mood-boosting chemicals, including endorphins (that we just spoke about) along with serotonin and norepinephrine. Aside from helping to control pain, endorphins are also considered a “feel-good hormone”. They trigger feelings of positivity that, once again, are similar to morphine. Serotonin and norepinephrine are instrumental in alleviating symptoms of depression and anxiety. Therefore – when you exercise – it’s virtually impossible not to feel better. And since we know that pain is controlled by your brain – anything that improves mental health is going to contribute positively to your relationship with pain.

5. Exercise as a Prescription

OK – so we’ve discussed the multitude of positive effects that exercise has on pain perception, inflammation, and mental health. But what if you’re currently suffering from an injury? Is it possible to still use exercise as a pain reliever? The short answer is yes. But it’s challenging to do on your own. You can’t just google “best exercises for back pain” and expect good results.

When it comes to using movement or exercise to rehab an already existing injury – it needs to be carefully prescribed. 

For all the reasons already discussed, physical activity will still help you modulate pain – but you must consider the role exercise is going to have on any potential tissue damage. With weakened or damaged tissue, exercise is still an effective pain reliever, but it has to be prescribed or you risk worsening your injury.

For these reasons, I always recommend working with a movement expert who truly understands the nature of musculoskeletal pain and tissue healing. If you start a general exercise routine because you want to feel better  – I applaud you – just make sure you’re getting your desired result. But if you start exercising to help with pain and don’t experience any noticeable improvement – or you catch yourself modifying to work around your pain – then it’s time to enlist the help of an expert. Otherwise, you risk ending up on pain pills, which is exactly what we want to avoid.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE.

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.