Tag Archive for: hip pain

tight hips

Tight Hips That Won’t Loosen Up? Why Stretching Isn’t Fixing the Problem | Portsmouth, NH Physical Therapy

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Tight Hips That Won’t Loosen Up?

If your hips feel tight no matter how often you stretch — you’re not alone.

A lot of active adults around Portsmouth and the Seacoast spend years trying to “open up” their hips with yoga, foam rolling, and daily stretching routines… only to feel the same stiffness come back the next day.

What’s even more frustrating?
That tightness often starts creeping into your lower back — making it harder to sit comfortably, walk, exercise, or even sleep.

Here’s the part most people don’t realize:

Tight muscles aren’t always tight because they need to be stretched.

That might sound backwards. But if stretching hasn’t worked for you yet — there’s a reason.

Why Stretching Isn’t Fixing Your Tight Hips

Most people assume tight hips = not enough flexibility.

So they stretch more. And more. And more.

But in many cases, that tightness is actually coming from overworked muscles — not short ones.

Take your hip flexors — especially the psoas.

This deep muscle connects your spine to your hips and plays a huge role in stability. When your core and glutes aren’t doing their job well, your psoas steps in to compensate.

Over time, it gets overworked and fatigued.

That fatigue is what feels like “tightness.”

So when you stretch it constantly, you’re not solving the issue — you’re putting even more stress on a muscle that’s already doing too much.

That’s why stretching feels good temporarily…
but never actually lasts.

It’s Not Just Your Hip Flexors

This same pattern shows up in other hip muscles too.

Muscles like your:

  • Piriformis
  • TFL (tensor fascia latae)

…often get overworked when your glutes aren’t firing properly.

Instead of addressing that root issue, most people:

  • Stretch more
  • Foam roll more aggressively
  • Push through discomfort

But here’s the problem:

Stretching and foam rolling are still forms of load.

If a muscle is already irritated from overuse, adding more load can actually keep it stuck in a cycle of tightness instead of helping it recover.

When Tight Hips Aren’t a Muscle Problem

There’s another layer most people miss entirely:

Sometimes the problem isn’t the muscle — it’s how your body is moving.

If your hips, pelvis, and lower back aren’t working well together, your body compensates.

Some muscles work overtime. Others shut down.

That imbalance creates the exact feeling people try to stretch away.

This is what we call a mechanical problem — not an injury, not damage, just a coordination issue in how your body moves.

And if that’s the case:

No amount of stretching alone will fix it.

What Actually Works for Lasting Relief

If your hips always feel tight no matter what you do, the better question isn’t:

“What should I stretch?”

It’s:

“Why does this feel tight in the first place?”

Real, lasting relief usually comes from:

  • Improving how your core and glutes support your body
  • Restoring proper movement between your hips, pelvis, and spine
  • Reducing compensation patterns
  • Addressing the root cause — not just the symptom

When that happens, those overworked muscles (like your psoas, piriformis, and TFL) can finally relax.

And the tightness?
It starts to go away on its own.

Why This Matters in Portsmouth & the Seacoast

Here in Portsmouth, Hampton, and the Seacoast, we see this all the time.

People want to stay active — walking along the beach, golfing, working out, or just keeping up with their kids and grandkids.

But tight hips start to get in the way.

And the frustrating part?
Most people feel like they’ve already tried everything.

If that sounds like you — it’s not that your body is broken.

It’s that you haven’t been shown what’s actually causing the problem yet.

Ready to Stop Chasing Temporary Fixes?

If you’re tired of stretching your hips every day with no real progress, it might be time to look at things differently.

At CJ Physical Therapy & Pilates, we focus on finding the root cause of your tightness — not just treating the symptoms.

👉 Explore our services: https://cjphysicaltherapy.com/services/
👉 Request a free discovery visit: https://cjphysicaltherapy.com/discovery-request-form/

If you’re tired of trying things that aren’t working, we can help you figure out what’s actually going on — and what to do about it.

Think Arthritis Means Slowing Down? Meet the Rise of the “Ultimate Boomer”

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For decades, arthritis has been treated like a life sentence.

Once joint pain appears or an X-ray shows “degeneration” — many adults are told to lower their expectations. Walk less. Avoid impact. Be cautious. Accept that pain and limitation are simply part of aging. In more severe cases, joint replacement is presented as the inevitable next step.

But here in Portsmouth and across the Seacoast, a different story is emerging — and it’s one I see every day in my physical therapy clinic.

Adults in their 50s, 60s, and 70s are refusing to accept the idea that osteoarthritis means slowing down. Instead, they’re hiking local trails, golfing, strength training, traveling, playing with their grandkids, and staying active in the lives they love. Many tell me they feel better now than they did years ago.

This growing group represents what I like to call the rise of the “Ultimate Boomer.”
Someone who understands that while aging is inevitable, decline doesn’t have to be.

Arthritis Is Common — But Feeling “Old” Is Optional

One of the most misunderstood facts about arthritis is this:
Most adults over 50 — and many in their 40s — show arthritic changes on imaging whether they have pain or not.

Just like wrinkles on your skin, joints change with time. But those changes alone do not determine how your body feels or functions.

Problems begin when a diagnosis of arthritis starts to define what people believe their body can tolerate.

When patients hear phrases like “bone-on-bone” or “degenerative joint disease,” fear naturally follows. Activity decreases — especially walking, lifting, and load-bearing movement. Over time, muscles weaken, circulation declines, and joints receive less nourishment — exactly the opposite of what arthritic joints need to stay healthy.

Even more damaging, people lose confidence in their bodies. That loss of trust accelerates stiffness, pain, and overall physical decline.

Arthritis doesn’t make you old. Inactivity does.

The Ultimate Boomer mindset recognizes this — and it’s the difference between aging with confidence and feeling fragile as the years go on.

Why Movement Is One of the Most Powerful Arthritis Treatments

At CJ Physical Therapy & Pilates in Portsmouth, NH, we focus on helping people move better — not less.

When done correctly, movement is protective for arthritic joints:

  • Walking improves joint lubrication and circulation
  • Strength training reduces stress on painful joints by building muscular support
  • Core stability and Pilates-based training improve posture, balance, and alignment so joints are loaded more evenly

These habits don’t “wear joints out.”
They help preserve joint health and reduce pain associated with osteoarthritis.

The Ultimate Boomer doesn’t stop moving because something hurts.
They learn how to move better.

Why Recovery Matters More as We Age

One key difference between a 30-year-old and a 65-year-old with joint pain is recovery speed.

As we age, circulation slows, tissue healing takes longer, and inflammation becomes more persistent. Improvement is still absolutely possible — but recovery needs to be supported intentionally.

This is where modern, non-invasive arthritis treatments are changing what’s possible.

At our Portsmouth physical therapy clinic, we use advanced technologies such as Shockwave Therapy and EMTT to help support healing in chronically irritated joints.

  • Shockwave therapy increases blood flow and stimulates cellular repair in stubborn, painful tissue
  • EMTT (Extracorporeal Magnetotransduction Therapy) works at a deeper cellular level, helping reduce chronic inflammation and improve tissue metabolism

When used together, these therapies can improve the internal environment of the joint — reducing inflammation, improving circulation, and making movement and strengthening possible again.

These treatments aren’t about masking pain.
They’re about restoring the conditions your body needs to respond to exercise, physical therapy, and daily activity.

For many adults with arthritis, this becomes the missing link between “I know I should move” and “my body finally lets me.”

Confidence Is the Real Anti-Aging Tool

When people tell me they want to feel younger, they’re rarely talking about appearance.

They want to:

  • Trust their knees on uneven ground
  • Lift without fear of weeks of pain
  • Stay active without worrying that soreness will spiral
  • Maintain independence

That confidence comes from a body that is strong, resilient, and supported by the right care.

The Ultimate Boomer understands that arthritis isn’t a reason to stop living fully — it’s a reason to get smarter about how you move and how you recover.

Arthritis Is Not the End of Your Story

Arthritis does not mean the end of your favorite activities.
It does not mean you are broken.
And it certainly doesn’t mean your best years are behind you.

Aging well isn’t about denying arthritis exists.
It’s about refusing to let it define you.

Because the real goal isn’t just to live longer —
It’s to live better, stronger, and more confidently at every stage of life.

That’s what it truly means to be an Ultimate Boomer.

About the Author

Dr. Carrie Jose, DPT, is a Physical Therapy Specialist and Regenerative Therapy Expert and the owner of CJ Physical Therapy & Pilates in Portsmouth, NH. She specializes in helping adults with arthritis, joint pain, and chronic injuries avoid unnecessary medications, injections, and surgery through expert physical therapy and non-invasive healing technologies.

Dr. Jose also writes for Seacoast Media Group.

To learn more about your options or request a free Discovery Visit CLICK HERE or call 603-380-7902.

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.

 

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

tight hips

Why Stretching Isn’t Solving Your Tight Hips

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If your hips always feel tight – whether during workouts, long walks, or just sitting at your desk – it can be incredibly frustrating. Not only is it uncomfortable, but tight hips often contribute to nagging lower back pain. And what’s even more confusing? No matter how much stretching you do, the tightness keeps coming back.

For me – that’s typically a clue that the problem isn’t what you think it is.

Muscles can feel tight for many different reasons – and not all of them have to do with flexibility. While some muscles truly are short and need to be lengthened – others feel tight because they’re overworked, weak, or compensating for something else. In those cases – stretching alone won’t solve the issue – and might even make things worse.

Let’s break this down…

Take your psoas muscle, for example. It’s one of your deep hip flexors and also plays a key role in spinal and pelvic stability. If your core and glutes (also spinal and pelvic stabilizers) aren’t doing their jobs – your psoas will kick in to help. That overcompensation can lead to it feeling chronically tight – even though it’s not technically “shortened”. So while the inclination will be to stretch your psoas – you’re actually putting an unintended strain on an already tired and stressed muscle. 

While stretching might give you a temporary break in this instance – it won’t address the real problem. You need to strengthen your deep abdominals, your core stability, and your glutes. When all of these systems kick in collectively, your psoas can finally relax – and your chronic tightness will resolve on its own.

But there’s one more thing most people don’t even think of –  and it’s that the tightness in your hip flexors could also be a symptom of a mechanical problem – not a muscular one.

Mechanical pain refers to pain (or tension) that’s caused by poor movement patterns or joint dysfunction, not necessarily tissue damage, compensation, or tightness. If the way your hips, pelvis, or lower back are moving is off – even slightly – your body will compensate. Over time, this leads to overuse of certain muscles – like your psoas, for example – which then feel constantly tight or strained. Unless the underlying movement problem is corrected, you’ll keep chasing symptoms instead of fixing the root cause by constantly stretching.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas isn’t the only culprit. Your piriformis and TFL (tensor fascia latae) can become victims of these patterns as well. In addition to your psoas muscle – your piriformis and/or TFL loves to pitch in and compensate for weak gluteal and core muscles as well. An overworked piriformis leads to difficulty sitting cross-legged – and a tight TFL can be painful and lead to IT band problems. You can stretch all you want – but if you don’t address the underlying cause and give these muscles a chance to relax – your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of the story? 

If your hips feel chronically tight – and stretching all the time isn’t making a lasting difference – it’s time to consider a different approach. Most people don’t think to strengthen a muscle that feels tight – but it might be exactly what your body needs. When it comes to your hips, the areas to assess are your deep abdominals and your glutes. Often, there’s an underlying weakness or movement dysfunction you just can’t see on your own. And if your muscle tightness stems from a mechanical issue – like poor joint alignment or faulty movement patterns – no amount of stretching or strengthening will fully work until that’s addressed.

A trained mechanical pain expert can help you identify whether it’s a strength problem, a movement problem, or a combination of both – so you can finally get lasting relief.

Feel free to reach out to our mechanical pain specialists if you’re local and looking for help 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.

tight hips

Tight hips? Try strengthening instead of stretching.

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

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

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

 

Let me explain.

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

But here’s the thing…

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

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

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

Unfortunately the psoas gets blamed for a lot of things – most notably – tilting your pelvis forward because it’s “tight” and causing lower back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis, and your back pain and hip tightness will disappear. But sadly, this is rarely the case. More often than not, your psoas is tight because it’s overworking to compensate for your deep abdominals/core not working properly.

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

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

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

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

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

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

Are you local to Portsmouth, NH?

Consider reaching out to one of my specialists by requesting a free discovery visit HERE.

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

Back Pain

Hip pain not going away? Three Reasons Why.

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Hip pain is not nearly as common as knee or back pain, but it still impacts much of the population and it can be quite debilitating – especially when it doesn’t go away.

People routinely report hip pain in the side of their hip and in their groin. They may even complain that it radiates into their back and down their thigh. When this goes unresolved, it impacts your ability to walk, play golf, squat, bear weight on one leg, and even sleep through the night.

The big question, though, is why does it go away from some and persist for others?

If your hip pain isn’t going away – here are three reasons why:

1. You need a hip replacement

This is probably the most legitimate reason your hip pain isn’t going away. Your hip joint has become so arthritic and worn down that it’s time to get a new one.

But here’s the thing to keep in mind, whether or not you need a hip replacement should not be decided by your X-ray – it should be decided by your symptoms. Far too many people rely on the “bone-on-bone” diagnosis from imaging to be the determining factor. But there are hundreds of people walking around with fully functioning hips that have bone-on-bone and don’t need joint replacements yet.

When you need a new hip, the presentation is typically constant, unrelenting pain along with severely restricted mobility. In these instances, getting a new hip is going to be life changing and it should have a significant impact on your hip pain.

2. You’ve been mis-diagnosed

This is the most common reason why hip pain doesn’t go away. Just about everyone I see in my office with hip pain tells me they’ve been diagnosed with “hip bursitis”, when in reality, only 15% of men and 8% of women have true hip bursitis.

Hip bursitis occurs when you have inflammation of the bursa on the side of your hip. It’s typically caused by blunt trauma to your hip, or overuse/imbalance of the musculature there. It’s actually extremely easy to resolve so if your hip pain is persisting, this is likely not the reason.

The other common mis-diagnosis I see is that your hip problem is actually coming from your lower back. If you’ve got radiating pain into your thigh, you must always rule out that it’s not coming from your spine. Because if it is – and you don’t address it – your pain will never go away.

3. You’ve got the wrong treatment approach

If you don’t need a hip replacement, and you’ve got the right diagnosis, your hip pain should go away. If not, then we need to consider the treatment approach.

The most common mistake I see with hip pain treatment is implementing strengthening and stabilization exercises way too soon. The hip joint is one of the most mobile joints in our bodies. Because of that, it can be hard to detect when you’ve got some restrictions there. Having optimized mobility in your hip joint is paramount.

Without good, adequate mobility, your muscles will struggle to function as well as they could, and this can impact strength. I have a saying in my office: “mobility before stability”. And it’s for a good reason. If you don’t check mobility first, you risk strengthening and stabilizing around a joint that isn’t moving as well as it could. This could be a reason why your pain isn’t going away.

If you’ve got hip pain that isn’t going away, I hope this article has given you some food for thought.

Approximately 70-80% of all musculoskeletal problems, including hip pain, can be resolved naturally and without relying on pills, procedures, or surgery.

If you’re not having success with getting rid of your hip pain, then it’s important to question what you’re doing and consider that something has been missed. You deserve to live an active and mobile lifestyle doing all the activities you love.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists. Tell them about your hip pain and they’ll get you on a treatment plan right away – at the very least you’ll leave with some helpful tips moving forward.

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

Man getting knee pain treatment

Tight Hip Flexors? When Stretching isn’t Enough…

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When it comes to feeling stiff and immobile, tight hip flexors are the second most common complaint I hear – right after tight hamstrings.

Tight hip flexors are annoying, achy, and they often contribute to lower back pain. When your hips are tight, it can be painful or uncomfortable to walk, run, play golf, exercise, and even stand up straight!

Typically, the recommended treatments for this problem include lots of stretching, foam rolling, massage, and myofascial release.

But what if the stretching and all that other stuff doesn’t work?

What if no matter how often you stretch, the tightness just keeps coming back?

Sometimes – actually often – the tightness you feel in your hip flexors (or any other muscle group for that matter) can be due to weakness or overworking of the muscle.

If this is your problem, then no amount of stretching or foam rolling is going to help you.

Stretching and foam rolling will help to temporarily ease the stiffness from an overworking muscle, but it will only be a bandaid until you tackle the root cause.

You need to first identify WHY these muscles are weak or overworking, and THEN figure out the proper exercise and load that will help turn your hip flexors from feeling tight and overworked – to flexible and mobile.

Your hip flexors consist of the muscle group located in the front of your hip in the area of your groin. They are responsible for flexing or bending your thigh up and toward your chest. But they also play a role in stabilizing your pelvis and lower back… and this is where we see a lot of problems and confusion.

The rectus femoris, part of your quadriceps muscle group, and your psoas, part of your deep abdominal muscle group, are the two major hip flexors. Your rectus muscle is the one primarily responsible for lifting your thigh. When you are walking or running, and repetitively flexing your leg, this is the muscle you are using.

Your psoas, on the other hand, is much shorter and actually attaches to your lumbar spine. Because of this, it has more of a stability role. When functioning properly, it will assist in exercises like the crunch or sit up, and it helps to stabilize your pelvis during any of these movements as well as when you are standing upright. Your psoas, abdominals, and glute muscles all have to work together in harmony for you to have good posture.

Let’s talk about the psoas for a moment… because this is where many folks I speak with are misinformed.

The psoas gets blamed for a lot of things – most notably – tilting your pelvis forward and being the cause of low back pain. The theory is that if you stretch, massage, and “release” your psoas muscle – then you will balance out your pelvis and your back pain will disappear.

Sadly – this is rarely the case. Read more

Knee pain? Top three causes and what to do about it.

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Knee pain is one of the most common complaints that brings people into our office.

Since most of our clients are in their 40’s, 50’s and 60’s, they start to really worry that knee pain could bring an end to their active lifestyle. But that doesn’t have to be the case! The good news is that unless you’ve had some serious trauma (like a major accident or fall), 80% of all knee problems can be resolved without any kind of procedure or surgery – and most importantly – you can learn how to continue managing them on your own so that they never get in the way of your favorite activities again.

Sound too good to be true?

It’s not – I promise – but the first step is figuring out where your knee pain is coming from. Once you know that, you can get on the right path to resolve it.

Here are three of the most common causes I see that make people suffer from knee pain and what you can do about them:

1. Iliotibial band syndrome

This is a very common problem that typically affects runners, avid walkers, and hikers. It is often misdiagnosed and confused with patellofemoral syndrome (see below). Your iliotibial band (IT band) is a very large thick band on the side of your knee that will often get overworked due to a muscular imbalance elsewhere in your body (usually your hips and core). When this happens, you’ll feel pain that is on the side of your knee that is usually very sore and tender to touch, and typically sharp and stabbing versus achy. It will impact you most when you’re going downhill or down the stairs.

It’s important to note that even though a tight, and painful IT band is the structure causing you to have pain – it is typically a symptom of an underlying problem. Like I said before, IT band problems are usually the result of your core and hips not stabilizing your pelvis properly – which ultimately results in your knee not receiving the support it needs when you’re running, walking, or hiking.

Getting rid of the actual pain is the easy part… in our office we use things like dry needling, soft tissue work, and sometimes even some taping. But if you want to keep the pain gone – you MUST address the underlying causes as well. This is what a lot of people miss. We love using Pilates-based exercises in our office because they not only target your core, but also get your muscles working in a coordinated, symmetrical fashion, helping to keep things balanced as you get back to your favorite activities.

2. Patellofemoral Knee syndrome

This problem is very similar to IT band syndrome, with just a few key differences. This first is that it can impact almost anyone – not just runners, hikers, and walkers. You’ll also experience the pain in the front of your knee – typically under your kneecap – and it will tend to be more achy than sharp. This problem will often come on very slowly and can be more chronic than its IT band cousin. You’ll feel this more when you’re going up stairs, up hills, and with squatting. You’ll also notice stiffness and pain in the front of your knee after sitting awhile – that usually will go away once you start moving.

Much like IT band syndrome – these are all symptoms of an underlying cause. A weak core and hips can cause this problem too, but I usually see more weaknesses in glutes and hamstrings with this one. When the backs of your hips and legs aren’t kicking in like they should, it can result in tight hip flexors or quads. This is a super common culprit for patellofemoral syndrome. So once again, you can get rid of the pain quite easily in most cases, but you must make sure to determine – and address – the root cause so that you can keep this pain gone for good.

3. Osteoarthritis

Many people hear that they have osteoarthritis in their knee and think there isn’t anything they can do about it. Not true!! Arthritis is often blamed for knee problems but it isn’t always the cause of what you’re feeling… Let me explain….

When arthritis is the true cause and culprit for your knee problem, it will be painful and stiff all the time. You’ll lack significant mobility and it will be almost impossible to walk and bear weight without support or a cane. When this is truly your problem – you are a great candidate for total knee replacement surgery. Now here’s the catch… sometimes your X-ray or MRI will show that you have terrible arthritis or that you have “bone-on-bone”… but that doesn’t mean you need to rush to surgery! Your symptoms should really decide that.

If your pain comes and goes (meaning you have good days and bad days), if you can walk around most days and go up and down the stairs and your knee just “catches”, or maybe you feel stiff a lot but this eases up with movement – you might have arthritis in your knee but it is not the root cause of your knee problem. Because here’s a hint – arthritis does NOT come and go – but other common musculoskeletal problems can. When your pain comes and goes, you know it can’t be entirely from arthritis.

So what should you do?

With arthritis, whether it’s partially to blame, or whether it’s just something that shows up on the X-ray and gets blamed… we still need to look at the surrounding structures and root cause of the problem.

If your quads are really tight, and the muscles around your knee are imbalanced, this can create compressive forces in your knee joint which will exacerbate what might normally just be “mild” arthritis (compression will aggravate arthritis). You could also have weakness or problems in your ankles, feet, or core that are causing your knee to work harder than it needs to. This can cause pain all on its own, OR aggravate your arthritis. The point is, get checked by a musculoskeletal expert – people trained like us – so that instead of just fishing for the problem or only treating symptoms, you are getting to the root cause of your problem and setting yourself up for success!

If any of this sounds familiar to you, you may benefit from working with a specialist physical therapist who can help you get back to the activities you love – without pain pills or unnecessary procedures. You can click right here to request a FREE Discovery session with one of our specialists. We’d love to help you figure out the root cause of your knee problem so that you can get back to doing everything you love – instead of spending time in the doctor’s office 🙂

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Where is your pain REALLY coming from?

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Don’t assume that where your pain is… is where the problem is!

This is a very common assumption and one that that we’ve been seeing a lot lately. If you watched our most recent Happy Hour on Facebook Live, then you know the story of the young guy who came to us looking for help with his heel pain. I checked out his heel, foot, and leg, but didn’t find any issues that would be causing the pain that he had been experiencing for four years.

I had planned on addressing the heel specifically before examining his back, but when he mentioned that he also felt a lot of tightness from his back into his leg, I decided to check it out. We did a test on his back and when he stood up, he immediately told me that his heel felt better! I was just as surprised as he was.  He was able to walk with less pain and his movement felt better overall. But when he started stretching his calf to his heel again, the pain came right back.

All that stretching he’d been doing day after day – to the area that he thought was the problem – may have actually been doing him more harm than good!

Now, it’s pretty clear that this young client doesn’t have a foot problem – where is pain actually was.  He has a back problem. And that’s something we can work through and fix! But if he never saw a specialist physical therapist like myself, he probably would’ve continued to believe that there was just something irreversibly wrong with his heel, and maybe even limited certain areas of his life, like football and sports, because of that.

Why should this matter to you?

You might not have heel pain or even noticeable back issues, but maybe you have pesky knee pain, a hip that hitches when you walk, or an achy ankle. Maybe you just feel muscle tension that never seems to go away, or weakness performing certain tasks.  These could all be indicators of a problem in your back!  Or somewhere else that just hasn’t been looked at yet, because it doesn’t match the main area of your pain.

If you’ve tried a lot of things and it’s not going away, it’s an indicator that your haven’t found the real source of your problem yet. Especially if you’ve gone to a doctor for pain in another part of your body and they’ve told you that there’s “nothing wrong.” Or maybe you’ve been stretching, massaging, and foam rolling religiously every day – only for it to keep coming back like a vicious cycle.  You might think that by doing this, you’re helping your problem and keeping it from getting worse – and you might be – but you certainly aren’t doing anything to actually address the problem and you aren’t any closer to a real solution. That’s why physical therapists are so important to have as part of your healthcare team – we’re trained to examine and treat the whole person – not just the foot/knee/hip/heel.

Getting Help

We know not everyone is ready to commit to regular physical therapy appointments, and that’s why we offer free Discovery Sessions out of our practice in Portsmouth, NH! All you have to do is fill out this brief form here and we’ll contact you. Discovery Sessions are a great opportunity to talk with a specialist about creating the best plan to get you healthy and feeling your best – without any obligation or commitment.

Feel free to reach out anytime, and be sure to like our Facebook page to stay up to date on Friday Happy Hour videos in the weeks to come!