Tag Archive for: emtt

Love to Hike? 7 Strategies for Healthy Knees

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Love to Hike? 7 Strategies for Healthy Knees

Hiking isn’t just good for the soul – it’s one of the best forms of exercise for longevity. Long, steady hikes typically put you in Zone 2 cardio, that sweet spot where your heart rate is elevated but you can still hold a conversation. Research shows Zone 2 training is one of the most powerful ways to build endurance, improve metabolic health, and protect your heart as you age. When you combine that with fresh air, nature, and the mental reset that hiking provides, you’ve got a recipe for living longer and healthier.

But here’s the catch…

If your knees hurt, you’re far less likely to get out on the trails and enjoy those benefits. For many adults in their 40s, 50s, and beyond, it’s knee pain – not lack of motivation – that sidelines them. Personally, I love to hike. My pup Bodie and I have already tackled 33 of the 48 White Mountain 4,000-footers together – and the last thing I want is for knee pain to derail that journey. Over the years, both in the clinic and on the trails, I’ve learned that protecting your knees isn’t just about avoiding injury – it’s about building mobility, balance, and strength so you can keep hiking and keep hitting that Zone 2 target for decades.

Here are 7 of my top strategies to keep your knees healthy on the trails:

1. Strengthen More Than Just Your Legs

Most hikers know strong legs matter. But what often gets overlooked is the role of your hips and core. Your glutes and hip muscles stabilize your pelvis, which in turn keeps your thigh bone – and your knee – aligned. If these areas are weak, your knee takes the brunt of every single step. On a typical 4K-footer, I rack up around 27,000 steps. Imagine your knee compensating on each one. Prioritize exercises that target glutes, hip stabilizers, and core muscles. Think bridges, planks, side steps, and single-leg work. The stronger your foundation, the better your knees will perform under pressure.

2. Keep Your Knees (and Hips) Mobile

Lack of mobility in your knees and hips – even a subtle loss – can impact the way your knees function. Your knees should fully straighten, bend deeply, and even hyperextend a little. Without this range, your knees can’t absorb the demands of steep inclines, rock scrambles, or uneven terrain. But don’t just focus on your knees – your hips and ankles need to move freely too. When one joint stiffens, another (often your knee) has to compensate. If your knees feel achy, check to make sure stiffness isn’t the reason.

3. Optimize Your Balance

Uneven trails, water crossings, and rocky descents demand excellent balance. Without it, your knees may end up working overtime to stabilize you. You can improve balance by practicing single-leg activities, such as standing on one foot while brushing your teeth, then progressing to single-leg squats and step-downs. Dynamic drills like walking heel-to-toe on a line or using a balance pad to mimic trail conditions can also be effective.

4. Train Eccentric Strength (Downhill Prep)

Most people’s knees flare up going downhill, not uphill. That’s because downhill hiking demands eccentric strength – the ability of your quads and even hips to control your descent while resisting gravity. Exercises like slow step-downs, controlled squats, and reverse lunges train your body for this exact stress, protecting your knees from strain when descending steep terrain.

5. Don’t Neglect Recovery

It’s easy to focus only on training for the hike, but recovery is just as important for keeping knees healthy long-term. Muscles and connective tissues adapt and get stronger when you give them time to repair. Simple recovery practices like foam rolling, stretching, and staying hydrated and prioritizing sleep all help reduce inflammation and improve resilience for the next hike. And if your knees are particularly sensitive after a hike – regenerative treatments like shockwave therapy and EMTT can help your joints recover quickly and naturally.

6. Choose Footwear That Supports Your Mechanics

Footwear can make or break your knees on the trails. Poor support or worn-out soles force your knees to work harder with every step. Good shoes aren’t just about cushioning – they should work with the way you move and give you stability when the trail gets rough. Keep in mind that your feet often widen and swell as you hike, which can change how your shoes fit and affect your mechanics. Choosing shoes with enough room in the toe box and proper support for your arches can prevent your knees from picking up the slack. Don’t forget the basics either – replacing trail shoes regularly (every 300–500 miles) is just as important as any strengthening exercise.

7. Get Checked Before It’s Too Late

One of the most overlooked strategies for preventing knee pain is early intervention. If you notice stiffness, swelling, or pain that doesn’t improve with movement, it’s better to get evaluated sooner rather than later. The longer you push through, the more compensations build up – and the harder it is to fix. In the same way you wouldn’t wait for your car to break before servicing it – you don’t want to wait for your knees to fail before seeking help.

Knee pain doesn’t have to stop you.

Hiking is one of the simplest and most enjoyable ways to support your health. It builds strength and endurance, keeps your heart and lungs working efficiently, and connects you to nature. But none of those benefits matter if knee pain keeps you on the sidelines. By strengthening your hips and core, improving mobility, training balance and eccentric control, choosing the right footwear, recovering properly, and seeking help early if pain persists – you’ll give your knees the best chance to keep carrying you up (and down) the trails for years to come.

 

plantar fasciitis

Foot and Heel Pain: How to Move Beyond Short-Term Relief

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If you’ve ever stepped out of bed and felt a stabbing pain in your heel, there’s a good chance you were experiencing plantar fasciitis – one of the most common causes of heel pain in adults.

More than two million Americans struggle with it each year. Cortisone shots, orthotics, and rest are often prescribed, but these strategies usually provide only temporary relief – and in some cases, can even prolong the problem.

Recovering from plantar fasciitis starts with understanding why it happens in the first place. Once you know the root cause, the path forward becomes clearer – and today there are modern, natural options that focus on healing rather than simply masking pain. That’s the aim of this article. 

So let’s dive in: how do you move past short-term relief and get back to doing the activities you love, without heel pain holding you back?

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue running along the bottom of your foot, connecting your heel bone to your toes. Its job is to support your arch and absorb shock when you walk, run, or jump. When this tissue is overloaded, it can become irritated – and if that continues, the fascia begins to degenerate. The result is plantar fasciitis, marked by pain at the base of the heel, especially during the first few steps in the morning or after long periods of sitting.

Many assume plantar fasciitis is an inflammatory condition, but that isn’t the full picture. It’s more accurately a degenerative process, where the collagen fibers of the fascia weaken and lose their ability to tolerate load. This helps explain why treatments aimed only at reducing inflammation, such as cortisone shots, rarely provide lasting relief.

Why Traditional Treatments Fall Short

Cortisone injections have long been a standard treatment for heel pain. While they may reduce pain briefly, research shows the benefit is temporary – often only a few weeks or months. Repeated injections also carry risks. Cortisone does not repair the damaged fascia – in fact – it can weaken collagen and allow the problem to persist. Worse, by masking pain, injections often encourage continued activity that aggravates degeneration.

Custom orthotics are another common approach. These shoe inserts, often prescribed by podiatrists, can redistribute pressure and provide comfort in the short term. But research shows little difference between costly custom orthotics and high-quality prefabricated ones. More importantly, they do not address the underlying weakness or tissue degeneration. Once the initial benefit wears off, the pain often returns – and relying on orthotics indefinitely is impractical and prevents restoration of natural foot strength.

Both cortisone and orthotics may play a role in daily function. But if the goal is to truly heal the fascia and return to full activity, more is needed.

Stimulating Healing – Don’t Mask It

Instead of suppressing symptoms, you want to encourage true healing and pair it with corrective strengthening to keep the tissue healthy. Modern treatments such as shockwave therapy, EMTT, and PRP aim to jump-start your body’s own repair mechanisms instead of impeding them.

A good place to start is extracorporeal shockwave therapy, or ESWT. This non-invasive treatment sends acoustic waves into the fascia to create controlled “microtrauma,” which stimulates collagen regeneration and promotes tissue recovery.

An important complement is Extracorporeal Magnetotransduction Therapy, or EMTT. A 2022 multicenter study in the Journal of Clinical Medicine found that 80 percent of patients with chronic musculoskeletal conditions improved after EMTT, with more than 75 percent maintaining benefits six to twelve months later. In practice, EMTT appears to extend and amplify the positive effects of shockwave therapy by sustaining cellular activity long after treatment sessions.

For those needing an additional boost, platelet-rich plasma (PRP) injections are another option. Though invasive, PRP delivers concentrated growth factors directly into damaged tissue, enhancing the body’s natural healing. A 2023 randomized trial in BMC Musculoskeletal Disorders reported that PRP outperformed corticosteroid injections at reducing pain, improving function, and thinning the plantar fascia at six months. Case reports in the German Journal of Sports Medicine also show excellent outcomes when ESWT and PRP are combined, including full return to sport in runners who had failed other treatments.

Taken together, these therapies form a layered strategy: shockwave jump-starts the healing cascade, EMTT helps sustain it, and PRP provides an extra regenerative boost (if needed). When combined with a structured rehabilitation program, this approach offers a pathway to lasting recovery rather than temporary relief.

Beyond the Foot: Make the Healing Last

What many don’t realize is that chronic plantar fasciitis can also be linked to dysfunction higher up the chain. The pelvic floor, deep core muscles, and hip stabilizers all influence how forces travel through the legs and feet. If these areas are weak or poorly coordinated, the plantar fascia often absorbs stress it wasn’t designed to handle.

Clinical experience shows that individuals with weak core and pelvic floor control often develop altered gait mechanics, leading to excessive strain on the heel with each step. In these cases, treating only the fascia leaves the root cause unaddressed.

A comprehensive plan should therefore include strengthening of the core and pelvic floor, along with intrinsic foot training, alongside regenerative therapy. When these muscles are retrained to provide stability and load-sharing, the fascia is no longer forced to work alone. Over time, this reduces reinjury risk and creates a long-term fix. In essence, regenerative therapy jump-starts tissue healing, while strengthening ensures the fascia remains supported once it recovers.

The Bottom Line

Foot and heel pain can be stubborn, and plantar fasciitis in particular has a reputation for lingering. Cortisone shots and orthotics may provide temporary relief, but they do not restore the health of the fascia or solve the underlying problem. Regenerative therapies, especially shockwave, are supported by strong evidence for reducing pain and improving function in people with chronic plantar fasciitis. When combined with mobility, strength training, and – critically – core and pelvic floor retraining, they provide a durable solution that not only relieves pain but helps prevent it from coming back.

If your heel pain has been persisting for months, it’s worth considering a plan that goes beyond masking symptoms. Lasting relief comes when you treat both the tissue that hurts and the movement system that created the overload in the first place.

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.

Plantar Fasciitis

How to Survive Flip-Flop Season Without Wrecking Your Feet

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Flip-flop season is here – which means sunshine, beach days, and pool time. But it can also mean extra foot pain. And every summer around this time, we see an influx of people dealing with aching arches and stabbing heel pain – most commonly known as “plantar fasciitis”

What is Plantar Fasciitis?

Quite simply, it’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot, enabling you to propel yourself during walking and running. When you land on your foot, your arch falls or flattens – this is called pronation. In response, your foot then stiffens or supinates, providing the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked, leading to what we call “plantar fasciitis”.

How Do Flip-Flops Contribute?

Footwear can either “protect” your arch or cause it to overwork. Technically, if your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. However, due to prolonged sitting and limited barefoot walking, the bottoms of our feet are not as conditioned as they should be. This is the real problem – not so much what you put on your feet. If you’re used to wearing supportive and cushioned shoes and then suddenly switch to flatter, less supportive flip-flops, it can shock your foot. And if you’re already prone to plantar fasciitis, it will flare up easily and quickly.

What Can You Do?

The good news is you don’t have to give up your favorite summer footwear entirely – you just need to be smart about how you wear them and how you care for your feet. Here are five simple tips and strategies to help you get through flip-flop season without completely wrecking your feet.

1. Choose Supportive Styles

Not all flip-flops are created equal. Those flat, flimsy styles you can pick up at the drugstore for five bucks? Probably not doing your feet any favors. They offer little to no support, and if your foot mechanics aren’t perfect, you’re asking a lot of your plantar fascia every time you take a step. A better choice is a flip-flop that gives you a bit of arch support and structure. Look for ones with a cushioned sole, some contouring through the arch, and even a slight heel cup to help stabilize your foot and keep it from sliding around. The right pair makes a big difference – a key factor for enjoying flip-flops pain-free.

2. Save Them for Short Distances

Even the most supportive flip-flop has its limits. They’re not designed for long walks, hours of standing, or sightseeing on vacation. Think of them like you would a slipper – something you wear for convenience or comfort in short bursts, not as your all-day shoe. If you’re going out for a full day of walking, or standing at an outdoor event, it’s better to switch to something more structured that supports your foot and ankle. Use your flip-flops strategically – around the house, to and from the pool, or for short errands. Giving your feet the right support when it matters most can go a long way in keeping them pain-free.

3. Strengthen Your Feet (and Your Core)

One of the best ways to prevent plantar fasciitis – or keep it from coming back – is to strengthen the muscles that support your arch and stabilize your entire lower body. Most people don’t think about exercising their feet, but they absolutely should. Working on things like toe strength, arch activation, ankle mobility, and balance helps condition your feet so they can handle different surfaces and demands. But don’t stop at your feet – your core matters too. The way your pelvis and deep abdominal muscles function has a direct impact on how forces move through your body when you walk. A weak or poorly functioning core can lead to poor movement patterns that put extra stress on your feet. Strengthening both your feet and your core can transform the way you move – and reduce the load on your plantar fascia dramatically.

4. Stretch and Massage Regularly

One of the most underrated things you can do to prevent or treat plantar fasciitis is to stretch and massage your feet on a regular basis. Tight calves, stiff ankles, and tension through the soles of your feet can all contribute to pain and inflammation. A few minutes of daily stretching – focusing on your calves and toes – combined with massage using your hands, a lacrosse ball, or a mobility tool, can make a huge difference. This kind of soft tissue work helps relieve tension, improves circulation, and keeps your plantar fascia mobile and healthy. 

5. Don’t Ignore Persistent Pain – Treat It Early

If you’re already feeling pain in your heel or arch that just won’t go away, don’t wait around hoping it gets better on its own. Plantar fasciitis becomes harder to treat the longer it sticks around, and it can quickly go from annoying to chronic. When that happens, exercise and stretching might not be enough to get you out of pain – and that’s where regenerative therapy comes in. Shockwave therapy (EPAT) is a non-invasive treatment that uses high-energy sound waves to stimulate blood flow and break up tight, inflamed tissue. It helps jumpstart healing in a way that rest and stretching can’t. EMTT (Extracorporeal Magnetotransduction Therapy) takes this even further. It uses pulsed magnetic fields to penetrate deeper into tissues and promote healing at the cellular level. Together, shockwave and EMTT are incredibly effective at reducing pain, accelerating recovery, and allowing you to tolerate the exercises and movement you need to fully resolve your plantar fascitis.

Bottom Line

Flip-flops don’t have to be the enemy. But if you’re not taking care of your feet, wearing them can easily lead to pain and frustration. By choosing the right styles, wearing them in moderation, and taking the time to strengthen and care for your feet – you can enjoy them all summer long without paying the price. And if foot pain does creep in, don’t ignore it. Get the right help early. Treatments like shockwave and EMTT, combined with expert-guided movement and strengthening, could be exactly what you need to survive flip-flop season pain-free – and keep your feet happy long after summer ends.

Knee Pain Causes

PRP for Knee Pain? What You Need to Know Before You Try

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If you’ve been dealing with knee pain that just won’t go away – chances are you’ve come across Platelet-Rich Plasma injections – also known as “PRP.”

Although PRP has been around for decades, it gained popularity in the early 2000s when high-profile athletes began using it to accelerate healing. More recently, it’s become more well-known thanks to the “longevity craze” – where people are actively searching for natural solutions and cutting-edge technologies to improve healing and avoid procedures, surgery, or medication.

Like other regenerative therapies, I appreciate PRP because it works with your body’s own healing abilities. It offers a healthier alternative to cortisone injections and medications, which can damage joints and organs over time. In some cases, PRP has even helped people avoid major surgery – an option that carries its own risks. PRP treatment involves taking a small blood sample, spinning it in a centrifuge to isolate the platelets, and injecting the concentrated solution into the knee joint. Platelets are rich in growth factors that support tissue repair – which is why proponents believe PRP can accelerate healing.

But despite its benefits, the real question is: “Is PRP the best first course of action for my knee pain?” It’s expensive, it’s invasive, and results can take months to appear. Let’s take a closer look at the pros and cons so you can make the best decision for yourself.

PRP outcomes aren’t always predictable.

Some people experience relief and improved function, while others feel little to no difference. A 2023 meta-analysis published in Annals of Medicine and Surgery found that PRP outperformed both corticosteroid and hyaluronic acid injections at the six-month mark. But that relief was not immediate. PRP is a waiting game. Results can take several months, and in some cases, may never fully arrive. This delayed response and unpredictability often pushes people toward cortisone shots for their fast – though temporary – relief. Ultimately, PRP success varies widely depending on your condition, the protocol used, and the provider’s skill.

Another factor to consider with PRP is cost.

Most regenerative therapies aren’t covered by insurance. One PRP injection can range from $500 to $2,000, and many protocols recommend two or three injections. Add in the long waiting period for results, and it may be wise to explore other options first. One of the biggest complaints I hear from patients is that they jumped to PRP too fast, spent the money, and either stayed in pain or the pain came back a few years later.

The good news is that the growing interest in longevity has brought other effective technologies to market. When people ask me about PRP – I often say it’s a great treatment – but if you haven’t yet explored some of the precursors to PRP – it might be worthwhile. Regenerative therapies like shockwave (high-pressure soundwaves) and EMTT (extracorporeal magnetotransduction therapy, using high-frequency magnetic energy) stimulate blood flow, activate tissue repair, and reduce inflammation. Like PRP, these treatments are natural and enhance your body’s ability to heal. But unlike PRP, they’re non-invasive, require no downtime, and often deliver results more quickly. I typically recommend trying these options first. For many people, they’re enough to get healing and moving again – fast – so you’ll know whether you even need PRP.

While relatively new to the market, both shockwave and EMTT have shown promising results – especially when compared to more invasive options like PRP.

A 2024 meta-analysis published in Scientific Reports found that shockwave therapy significantly reduced pain and improved function in patients with mild-to-moderate knee osteoarthritis. And unlike PRP – which can take months to show results – shockwave and EMTT often begin working within just a few sessions, sometimes as quickly as two to four weeks. Studies comparing shockwave to cortisone have also found that while cortisone may provide faster short-term relief, shockwave offers better long-term outcomes – typically within one to three months – but without the harmful side effects. Even more encouraging is emerging evidence that combining shockwave with EMTT yields even better outcomes than using shockwave alone.

Though research on knee pain is still developing, early studies and clinical experience suggest the two therapies work synergistically to accelerate healing, reduce pain and inflammation more effectively, and help people return to activity faster. For many, this combination offers a more efficient, less invasive alternative to PRP – in both outcome and timeline.

Cost is another important consideration. While shockwave and EMTT aren’t necessarily “cheap,” they’re generally more affordable and lower-risk than PRP. A full course of treatment typically costs around $2,000, and most people notice improvement within a few weeks. Compare that to PRP – where the total cost may be similar or higher – but you’re waiting months just to know if it worked. This is why shockwave and EMTT are often a smarter first step. You get faster feedback and, in many cases, relief without needles or downtime.

But what if you’ve already had PRP and didn’t get the results you hoped for?

A 2023 study published in Cureus compared PRP alone to PRP combined with shockwave in patients with chronic patellar tendinopathy. The group that received both had significantly better outcomes, especially in the first month. This suggests that even if PRP is part of your treatment plan, combining it with shockwave – and potentially EMTT – can improve your outcome and shorten recovery time.

Of course, no treatment works for everyone. The right solution depends on your condition, goals, and how much time and money you’re willing to invest. But when weighing your options, it often makes sense to start with less invasive, more affordable treatments. Shockwave and EMTT cost less than PRP, involve no injections, and carry far fewer risks. They also pair well with movement-based therapy or rehab – helping address not just your knee pain – but also its root cause (typically underlying mechanical joint dysfunction).

In the end, PRP injections may be helpful for some – especially those with mild joint degeneration who have exhausted other options. But they shouldn’t be the first thing you try. Evidence shows that non-invasive regenerative therapies like shockwave and EMTT are not only safe and effective, but may work faster and at a lower cost. And unlike PRP, they can be part of a broader plan that restores whole-body movement and function – so your knees stay strong and pain-free long after treatment ends.

If you’re considering PRP for knee pain, make sure you understand the full picture – what it costs, how long it takes, what the science says, and whether less invasive options could help you feel better sooner. Because when it comes to staying active and mobile as you age, getting the right diagnosis – and choosing the right first step – makes all the difference.

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.

golf injuries

How to Stay Injury-Free on the Golf Course This Season

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Golf is a favorite pastime for millions – and now that the season is in full swing here in New England – many players are eager to hit the course as often as possible. But when back, knee, elbow, or shoulder pain creeps in – those 18 holes can quickly lose their appeal – and even become depressing. Pain doesn’t just interfere with your swing. It can drain the joy right out of your game.

The good news? Many of the injuries that golfers suffer from are preventable. With a bit of foresight, the right kind of movement, and smart preparation – you can keep your body strong and your game on point all season long.

Here are five of the most common injuries I see golfers facing – and what you can do to avoid or recover from them quickly:

1. Back Pain

This is by far the most frequent complaint among golfers. The constant bending, twisting, and rotational force of a golf swing can wreak havoc on your spine – especially if your back is stiff or you spend a lot of time sitting during the week.

The best way to keep your back pain-free? Focus on improving your spinal mobility – particularly extension and rotation. Even perfect swing mechanics can’t make up for a back that lacks movement. Try adding daily backward stretching and limit prolonged sitting – especially on the days you know you’ll be golfing. These small changes can make a big difference in keeping your spine mobile and resilient throughout the season.

2. Golfer’s Elbow (Medial Epicondylitis)

This injury happens when the tendons on the inside of your elbow become irritated – often due to repetitive swinging. But the root problem, however, frequently lies elsewhere. Weakness in your shoulder girdle or stiffness in your wrist can force your elbow to overcompensate.

To prevent and heal golfer’s elbow – don’t just focus on the elbow itself. Work on improving shoulder stability and wrist mobility as part of your regular conditioning. In more stubborn cases – regenerative therapies like Shockwave Therapy or EMTT can speed up healing and reduce inflammation – helping you stay on the course without resorting to cortisone shots or any downtime.

3. Knee Pain

Walking the course and rotating through your swing can put a lot of pressure on your knees – especially if you lack strength in your core and hips – or have unstable feet and ankles. Your knees aren’t designed to power your swing, but they often get overworked if other areas aren’t pulling their weight.

Most knee pain in golfers is mechanical, not structural. Meaning, it’s caused by faulty movement patterns rather than actual damage, even when imaging shows said “damage”. The good news? With the right strengthening and stabilization exercises, you can typically resolve your knee pain naturally – no injections or surgery required.

4. Rotator Cuff (Shoulder) Injuries

The rotator cuff is responsible for stabilizing your shoulder, and it’s highly involved during your golf swing. If it’s weak – or if your mid-back and core aren’t supporting it – your rotator cuff can easily become inflamed or irritated.

To prevent this, build strength not only in your shoulders, but also in your mid-back, lats, and core. These “powerhouse” muscles provide a solid foundation and reduce the strain on your shoulders. If your shoulder pain is persistent, regenerative Shockwave Therapy and EMTT (like in the case of golfer’s elbow) can be an excellent way to accelerate healing and reduce the need for medication, rest, or downtime.

5. Wrist and Hand Injuries

Sprains, strains, and other wrist or hand injuries are common in golf – often due to grip issues or poorly fitted equipment. But one commonly overlooked factor is your neck. Research shows that nearly half of all upper extremity pain can be traced back to the cervical spine – even if you don’t feel any neck pain.

If nerve irritation or stiffness in your neck is the true culprit – no amount of wrist strengthening will help – because the root cause has been missed. If your wrist or hand symptoms persist despite traditional mobility, strength and even manual work, it may be time for a full-body assessment by a mechanical pain specialist who can identify whether the issue is actually coming from somewhere else.

Final Thoughts

Golf injuries can be frustrating – but they’re often preventable and highly treatable when you know what to do or where to turn for the right help. By addressing problems early, using targeted movement strategies, and supporting your body with proper mechanics – you can keep playing pain-free all season long.

And when more advanced treatment is needed – especially for tendon or joint inflammation – non-invasive regenerative therapies like Shockwave Therapy and EMTT can offer fast, effective relief and accelerate recovery.

As a physical therapist who specializes in mechanical pain and movement dysfunction, I’ve helped countless golfers who thought their playing days were over – only to return to the course stronger and better than before. The key is addressing the true source of pain, not just masking the symptoms.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. To request one of her free guides for back or knee pain – visit her website: cjphysicaltherapy.com – or call 603-380-7902

How I’d Rehab Jayson Tatum’s Achilles Repair with Regenerative Therapy

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If I were lucky enough to be on Jayson Tatum’s rehab team following his Achilles tendon repair, I’d be pulling out all the stops to help him recover quickly, fully, and most importantly, safely. An Achilles injury is no joke – even for the fittest, most elite athletes in the world. But with the right approach and the right technology, a full recovery and return to play is possible. The key lies in combining solid, daily rehab with the best science-backed tools we have today. And in my opinion, regenerative therapy should be at the center of any post-surgical rehab protocol. That means making strategic use of shockwave therapy and EMTT (Extracorporeal Magnetotransduction Therapy) from day one.

The Challenges of Tendon Rehabilitation

The Achilles tendon is the strongest tendon in the human body – but also one of the most vulnerable, largely due to its poor blood supply. This, combined with the repetitive stress it endures, makes it especially prone to injury and rupture – particularly in a high-demand, explosive, and multidirectional sport like basketball. If not managed correctly, an injury to this tendon (like in Tatum’s case) can be career-altering.

Traditionally, rehab after Achilles tendon repair involves a slow progression – starting with immobilization and non-weight bearing, followed by conservative loading, manual therapy, and eventually a return-to-play protocol. But unless this process is executed meticulously, it often fails to fully restore tendon elasticity, strength, or neuromuscular timing – all of which are crucial for explosive power and returning to a sport like basketball, let alone elite-level competition. And when it comes to tendon rehab, there’s no shortcut. Tendons heal through a process of remodeling over time, and that healing requires precise, progressive loading. Most people don’t have the patience – or the team around them – to commit to this fully, which is why so many Achilles injuries become chronic and never quite the same.

What concerns me most in cases like Tatum’s isn’t just whether the tendon heals – but how well it heals. Does it remodel into a strong, elastic, load-ready structure? Or does it stiffen, weaken, and become vulnerable to future injury? This is exactly where regenerative therapy comes in. And hopefully for Tatum, he’ll not only have the right team around him – with the knowledge, tools, and strategy to deliver exceptional rehab – but one that’s also staying current on the latest advances in rehabilitation technology.

Why Shockwave and EMTT Are a Game-Changer

Both shockwave and EMTT are non-invasive regenerative technologies that stimulate your body’s natural healing processes. They don’t mask symptoms – they accelerate tissue regeneration, increase blood flow, and improve cellular repair at the source.

Shockwave therapy uses focused mechanical energy to create microtrauma in the tissue, which stimulates a healing cascade – increasing local circulation, activating fibroblasts, and promoting collagen production. A 2017 study published in The American Journal of Sports Medicine found that athletes recovering from Achilles tendinopathy who received shockwave therapy had significantly better outcomes than those who didn’t – with faster recovery times and greater functional improvement.

EMTT, on the other hand, uses high-frequency electromagnetic pulses to stimulate cellular metabolism and promote deep tissue healing at a cellular and mitochondrial level. It penetrates deeper than shockwave and operates on a different biological frequency, making it a perfect complement.

Used together, these therapies enhance each other’s effects – improving tissue oxygenation, reducing inflammation, and accelerating remodeling. A 2023 study in Orthopedic Reviews found that combining EMTT with shockwave improved tendon vascularity and collagen alignment in post-op Achilles patients, leading to faster return-to-sport metrics.

My Strategic Rehab Roadmap for Tatum

If I were working with Tatum, I’d coordinate with his surgical team to determine the ideal time to begin regenerative therapy – typically once the surgical site is closed and stable, within the first few weeks post-op.

In the early rehab phase – around weeks two to six – I’d focus on protection and early-stage regeneration. EMTT would begin two to three times per week to stimulate healing, reduce inflammation, and prevent early adhesions. It’s ideal during this phase because it’s non-contact, painless, and doesn’t interfere with the surgical site. I’d also initiate isometric activation of the calf and surrounding muscles and start gentle mobility work to nearby joints to minimize compensation.

As we progressed into weeks six to twelve – the tendon loading and remodeling phase – I’d introduce shockwave therapy once or twice a week to stimulate angiogenesis and collagen synthesis. EMTT would continue to support deeper tissue metabolism as the loading demands increase. At this point, I’d implement controlled eccentric loading of the calf complex – a well-documented method for rebuilding tendon strength. I’d also integrate targeted, low-load mobility and stability drills – including Pilates-based work on the Reformer – to restore foot and ankle mechanics and optimize posterior chain activation. The Reformer offers adjustable, low-impact resistance through full ranges of motion, allowing strategic reintroduction of load without overstressing the tendon.

By weeks twelve to twenty and beyond, the focus would shift to sport-specific training, plyometrics, and return-to-play. Regenerative therapy would continue as needed – not as a primary tool, but as support to keep the tendon adapting as the intensity ramps up. Many athletes feel ready before the tendon is fully remodeled, and this is where shockwave and EMTT help ensure tissue resilience. During this phase, I’d layer in multidirectional plyometrics, reactive balance drills, and functional movement assessments to restore proprioception and clean up any compensations.

Why This Matters (Even If You’re Not an NBA Star)

Maybe you’re not a professional athlete – but the same principles apply whether you’re trying to get back to the NBA Finals or just want to hike, run, or play with your kids pain-free. Tendon healing doesn’t change just because your jersey doesn’t say “Celtics.”

In my clinic, I’ve seen how combining regenerative therapy with intelligent loading strategies leads to better outcomes – fewer setbacks, stronger recoveries, and tendons that actually function. The result? Less scar tissue, better elasticity, and reduced risk of reinjury.

Final Thoughts

Rehabbing an elite athlete like Jayson Tatum takes precision, collaboration, and the best tools modern sports medicine has to offer. In 2025, that means going beyond traditional methods. It means using regenerative therapies like shockwave and EMTT to support faster, stronger, and more complete healing – from the inside out.

Whether you’re an NBA star or someone who just wants to stay active without setbacks, the principles are the same: treat the root cause, support your body’s natural healing, and never underestimate the power of regenerative healing.

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.

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Four Non-Invasive Ways to Get Rid of Arthritic Knee Pain

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Knee arthritis is one of the most common and debilitating forms of joint pain affecting adults over 50. It’s a condition that slowly wears down the protective cartilage in your knee joint – leading to stiffness, swelling, and pain that can make even simple activities like walking the dog or climbing stairs feel like a chore. 

While conventional treatments like traditional physical therapy, cortisone injections, and pain medication have been used for years to offer temporary relief – they don’t always work for everyone – and they fail to address the root cause . The good news is that there are several non-invasive, natural, and cutting-edge alternatives that go beyond masking symptoms and instead aim to support your body’s ability to heal and repair itself – especially when traditional treatments have come up short.

Corrective, Therapeutic Movement Strategies:

Perhaps the most accessible (and free) non-invasive solution is movement. Now, it might sound counterintuitive – and even laughable – to consider this as a viable strategy for arthritic knee pain, especially when your knee hurts. But not all arthritic knee pain is due to the arthritis itself.

Let me explain.

Much of the pain you experience when you’ve got arthritis is due to joint immobility and the compensatory patterns that develop over time. When you can identify these faulty movement patterns—and correct them with specifically prescribed therapeutic movement strategies designed to fix the mechanics in your knee joint – you can get significant pain reduction in your arthritic knee. You’ll need to work with a specialist to figure out which specific movements (or set of movements) your knee needs, but once you know what they are, you can use them forever to manage your knee pain – and it won’t cost you a dime.

Weight Management

Extra weight – even just a few pounds – can significantly increase the load placed on your knees when you’re walking, climbing stairs, and moving through your day. In fact, research from Dr. Stephen Messier and colleagues at Wake Forest University found that for every pound of weight lost, there is a four-pound reduction in knee joint stress during daily activities. In other words, losing just 10 pounds can reduce pressure on your knees by a remarkable 40 pounds with every step you take. Healthy, manageable weight loss – through a combination of smart nutrition and regular activity – can make a meaningful difference in pain levels and joint function. And the benefits aren’t limited to your knees. Losing weight reduces mechanical strain throughout your body, supporting the health and longevity of other joints as well.

Adopt an Anti-inflammatory lifestyle

While most people associate knee arthritis with “wear and tear,” it’s also a condition fueled by chronic inflammation. When you reduce inflammatory triggers – especially through your diet – it can lead to noticeable improvements in how your knees (and other joints) feel. Eating more whole, unprocessed foods that are rich in omega-3 fatty acids, antioxidants, and healthy fats is a powerful way to calm inflammation naturally. Aim to incorporate fatty fish like salmon, sardines, and mackerel at least twice per week, along with daily servings of dark leafy greens (like spinach and kale), berries, walnuts, chia seeds, and extra virgin olive oil. Spices like turmeric and ginger have natural anti-inflammatory properties and can easily be added to meals or smoothies.

On the flip side – it’s important to avoid refined sugars, processed grains (such as white bread and pastries), and fried foods – which are all known to promote inflammation. Beyond food, other daily habits that support lower inflammation include getting 7–8 hours of quality sleep, managing stress with activities like deep breathing or walking in nature, and drinking enough water – typically half your body weight in ounces per day. These foundational habits not only help reduce knee pain – but they’ll support your overall health and energy levels as well.

Explore non-invasive Regenerative Therapy

One of the most exciting technologies to hit the market in recent years – and that’s quickly gaining popularity – is the use of non-invasive regenerative therapies like Shockwave Therapy and EMTT. What I love about these treatment options is that they work with (not against) your body’s natural healing ability to regenerate degenerated or inflamed tissue – a major contributor to the pain and stiffness associated with knee arthritis. Shockwave Therapy uses mechanical sound waves to increase blood flow, break down scarred or damaged tissue, and reawaken dormant healing cells in the affected area. EMTT (Extracorporeal Magnetotransduction Therapy), on the other hand, uses high-frequency electromagnetic energy to reduce inflammation at the cellular level – boosting mitochondrial activity, improving cellular metabolism, and accelerating tissue repair. It’s particularly effective at targeting bone marrow lesions and chronic joint inflammation – both of which are commonly seen in knee arthritis.

While each of these therapies can be effective on its own, recent studies have shown that using EMTT and Shockwave together significantly enhances treatment outcomes. A 2021 clinical study published in Orthopedic Reviews found that the combination of EMTT and Shockwave Therapy led to greater improvements in pain relief and functional mobility compared to either treatment alone – while also providing longer-lasting results. For individuals who have already tried traditional physical therapy or cortisone injections without success – this combination of cutting-edge technology offers a powerful, drug-free solution that doesn’t just mask symptoms – it promotes actual healing.

Take Control of your Knee Pain – Naturally

If you’re struggling with knee arthritis and feel like you’ve tried everything – don’t give up hope. Medications and injections aren’t your only options. And surgery does not have to be your next step. By combining strategic movement, healthy weight management, anti-inflammatory lifestyle choices, and cutting-edge non-invasive regenerative therapies – it’s absolutely possible to reduce knee pain and reclaim your mobility naturally – without having to rely on pills, injections, or surgery. The key is finding the right combination that works for you – and being proactive about exploring alternatives that go beyond standard prescriptions and treatment strategies.

Are you local to Portsmouth, NH?

If so, consider speaking to one of my specialists for free by CLICKING HERE.

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

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

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

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

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

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

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

Let me introduce you to Regenerative Shockwave Therapy and EMTT…

What is Shockwave Therapy?

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

What is EMTT?

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

The Power of Shockwave Therapy and EMTT combined:

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

Evidence Supporting the Combo:

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

So Who Can Benefit?

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

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

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

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

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

Are you local to Portsmouth, NH?

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

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

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How Regenerative Therapy Speeds Healing After Injury and Surgery

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

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

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

Pain Relief That Gets You Moving Again

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

Enhanced Mobility and Flexibility

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

Accelerated Healing with Better Blood Flow

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

Tackling Scar Tissue and Restoring Function

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

A Recovery Companion for Every Stage of Healing

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

Get Back to the Activities You Love Faster

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

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