Tag Archive for: knee pain specialist

syringe

Why You Should Avoid a Cortisone Shot in Your Knee (And What to Do Instead)

/in /by

Knee pain can be debilitating, making simple tasks like walking, climbing stairs, or even standing up a painful experience.

For many, the quick fix seems to be a cortisone shot – an anti-inflammatory injection that offers temporary relief from knee pain. When injected into the knee, the cortisone (a type of steroid) targets the inflamed tissues and aims to reduce the symptoms of pain and swelling.

But there are significant risks and downsides to this approach to resolving knee pain that are often overlooked. Let’s take a look at why you should avoid a cortisone shot in your knee and what you can do instead…

The Problem with Cortisone Shots:

1. Temporary Relief, Not a Cure

Cortisone shots offer pain relief for a limited period, ranging from a few weeks to a few months. The problem? They don’t address the underlying cause of the knee pain. Instead, they mask the symptoms, allowing the root problem – whether it’s osteoarthritis, tendonitis, or a mechanical imbalance in the knee joint – to worsen over time. By numbing the pain, cortisone shots may allow you to continue harmful activities that could exacerbate your condition, leading to long-term damage.

2.  Potential for Joint Damage

Since the relief from cortisone shots is temporary – they are often repeated. And repeated cortisone injections can lead to cartilage degeneration and weaken the tendons and ligaments in your knee. Studies have shown that frequent cortisone use can accelerate the wear-and-tear process, potentially hastening the need for knee replacement surgery down the line. This is particularly alarming for active individuals who are hoping to preserve their knees for as long as possible so they can keep doing all the activities they love and enjoy.

3. Delayed Healing

Cortisone’s anti-inflammatory effects can actually interfere with the body’s natural healing processes. Inflammation, while uncomfortable, is an essential part of how the body repairs itself. Reducing inflammation with steroids (like cortisone) can disrupt tissue repair, meaning that any existing damage to your knee could take longer to heal. And when you mask your symptoms with cortisone – it makes this even harder to detect.

4. Risks of Infection and Other Side Effects

Like any injection, cortisone shots come with the risk of infection. Additionally, they may cause side effects such as increased blood sugar levels, skin thinning, or changes in pigmentation around the injection site. While these risks may seem minimal to some, they should be weighed carefully against the short-term benefits of temporary pain relief.

So… What Should You Do Instead?

I’m a huge fan of natural treatments whenever possible. And when it comes to knee pain, there are plenty of natural alternatives that not only promote healing , but address the root cause of your knee pain – allowing for more long-term relief instead of short-term.

1. Shockwave Therapy

Shockwave therapy is a non-invasive treatment that uses acoustic sound waves to stimulate the body’s natural healing processes. The waves create micro-traumas in the tissues surrounding your knee joint, which triggers increased blood flow and promotes tissue regeneration. Shockwave therapy has been shown to reduce pain, improve mobility, and even help with conditions like calcific tendonitis and knee osteoarthritis.

What’s especially beneficial about shockwave therapy is that it not only reduces pain but also works to heal the damaged tissues. Unlike cortisone shots, which only offer symptom relief and can even damage tissue, shockwave therapy targets the underlying problem, making it a great option for those looking to fix their knee pain for the long term.

2. Dry Needling

Dry needling is another natural treatment that can help alleviate knee pain by targeting trigger points in the muscles around the joint. This technique involves inserting thin needles in and around your knee joint to release tension and improve blood flow. By relieving muscle tightness, dry needling helps restore proper alignment and function in your knee joint, reducing pain and preventing further injury.

This approach works particularly well for those with knee pain caused by muscle imbalances, tendonitis, or chronic stiffness. Since dry needling promotes muscle relaxation and better circulation, it helps the knee heal from within, supporting long-term recovery.

3. Work with a Mechanical Knee Pain Specialist

A mechanical knee pain specialist is a healthcare professional trained to assess and diagnose the root cause of your knee pain through specialized movement analysis. Unlike traditional healthcare providers who may prescribe pain relief or general exercises without fully understanding the mechanics of your knee, mechanical pain specialists take a deep dive into how your body moves. By pinpointing issues such as improper joint alignment, muscle imbalances, or overuse patterns, they can design a customized treatment plan to address the root cause of your pain, versus just chasing symptoms.

The key benefit of working with a mechanical knee pain specialist is that they focus on the underlying biomechanics of your knee as well as surrounding joints/muscle groups that may be contributing to your pain. It’s a more holistic approach designed to restore normal function in your knee joint, alleviate pain, and teach you how to prevent future injuries as well.

While a cortisone shot is routinely recommended by medical doctors, and may offer quick relief, they don’t contribute to the healing process and can, in fact, cause long-term harm.

Opting for natural treatments like shockwave therapy, dry needling, or working with a mechanical knee pain specialist who can often integrate these treatments in with corrective, targeted exercises – has several advantages – and it’s much healthier for your knees. Most importantly, these natural approaches address the root cause of your knee pain rather than just masking it. 

If you’re suffering from knee pain, and need help finding reputable healthcare providers in your area who can offer these natural treatment alternatives with success and expertise – reach out – we can help direct you toward what to look for – and what to watch out for.

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

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

Holding Knee with Arthritis

Four Overlooked Reasons Your Knee Pain Won’t Go Away

/in /by

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

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

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

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

1. You’re Focusing On Knee Strength Over Mobility

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

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

2. The Real Culprit Could Be Your Back

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

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

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

3. Your Knees Are Compensating For Weak Core Muscles

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

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

4. Stiff Ankles Are Putting Stress on Your Knees

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

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

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

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

Are you a local to Portsmouth, NH?

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

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

tendinitis and tendinosis

Six Tips for Managing Knee Pain without Medication

/in /by

When you’re suffering from lingering knee pain that just won’t go away, it can deeply affect your day-to-day life.

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

Here are six effective tips to help you manage knee pain naturally:

1. Strengthen Your Hips and Core

Your hips and core play a crucial role in providing stability and support for your knees, as these muscles work together to ensure proper alignment of your entire lower body. When these muscle groups are weak or unbalanced, your knees bear the brunt of poor mechanics during movements like walking, running, and squatting. This leads to unnecessary strain, which can worsen knee pain over time. By strengthening your hips and core, you can improve your overall body mechanics, reduce stress on your knees, and promote long-term joint health. Over time, not only will this help alleviate current knee pain, but it will also significantly reduce the risk of recurrence. Incorporating exercises such as glute bridges, side leg lifts, and planks into your routine can make a noticeable difference in your strength and stability.

2. Improve your Flexibility

Mobility comes before stability when it comes to joint health. Stiff joints force surrounding muscles to overcompensate, which can lead to even more discomfort and inefficiency in movement. Improving your flexibility – particularly in the hips, hamstrings, and quadriceps – helps distribute forces evenly through your body and reduce strain on your knees. Regular stretching, yoga, and specific mobility exercises are great ways to maintain flexibility and keep your knee joints moving freely. A regular mobility practice is essential for reducing chronic knee pain and discomfort, preventing injuries, and enhancing overall athletic performance, balance, and coordination in your daily activities and exercise routines.

3. Don’t Sit too Long

Sitting for extended periods can cause stiffness in your knees and reduce circulation, which can lead to more pain. Additionally, knee pain might stem from your back or hips, even if you don’t feel pain there, and sitting for too long accentuates problems in these areas as well. By standing up and moving regularly throughout the day, you can prevent the muscles around your knees from tightening up and maintain better alignment. Simple actions like standing every 30 minutes, doing some light stretches, or walking around your space can make a big difference. Even if you don’t have knee pain right now – this is a good practice to get into – because it will go a long way in preventing it.

4. Stay Active

Regular, low-impact exercise is one of the best ways to manage knee pain naturally. Activities like swimming, cycling, and walking increase blood flow, which helps reduce inflammation and promotes joint lubrication. Movement also releases endorphins – your body’s natural pain relievers. If arthritis is a concern, consider activities that build strength without overloading the knee, like Pilates or resistance band exercises. Movement is key, but be sure to avoid high-impact exercises that could exacerbate your pain. Focus on activities that maintain flexibility, balance, and muscle endurance for overall joint support in your knee..

5. Wear Supportive Footwear

Footwear is often overlooked when it comes to knee pain, but wearing shoes that provide adequate support and cushioning can make a huge difference. Shoes that don’t support your feet properly can cause poor alignment, which translates to extra stress on your knees. Opt for shoes that prioritize comfort, good arch support, and alignment to help reduce the impact on your knees. If necessary, consider custom orthotics to improve foot and knee mechanics, as well as periodically replacing worn-out shoes to maintain optimal support and prevent further strain.

6. Optimize Your Balance

Good balance is about more than just preventing falls – it helps your knees by reducing strain during movement. When your body is well-balanced, the load is distributed evenly across your muscles and joints. Poor balance, on the other hand, can cause your knees to overcompensate, leading to pain and increased wear and tear. Simple exercises like standing on one leg, using a balance board, or practicing yoga can improve your balance and take the pressure off your knees. Incorporating these exercises into your routine can also enhance coordination, prevent injuries, and promote overall stability for the rest of your body as well.

If you’ve been dealing with knee pain for a while and haven’t incorporated any of these tips yet, now is a great time to start. Try these first before resorting to something invasive – or accepting a life on daily pain medication. Additionally, it’s a good idea to consult with a physical therapy specialist who is an expert in natural treatments for knee pain.

Are you a local to Portsmouth, NH?

If so, CLICK HERE to speak to one of my specialists. They can help you figure out which strategies will successfully get you back to all the activities you love – while avoiding medications and procedures.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free copy of her guide: 7 Easy Ways to Get Rid of Knee Pain – CLICK HERE.

Man getting knee pain treatment

Four Surprising Contributors to Lingering Knee Pain

/in /by

Approximately 25% of adults suffer from lingering, chronic knee pain without any clear reason why.  For some, aging and arthritis is to blame, and it’s something to just “live” with. For others, they’re told it’s due to “wear and tear”. Yet despite one or more surgeries to “clean out the knee” – the pain lingers and persists. 

So why then, do some folks age, get arthritis, and put tons of wear and tear on their knees without any issue – where others suffer from chronic knee pain? The answers may surprise you. 

Let’s look at four lesser-known (and often overlooked) contributors that cause knee pain to linger and not go away.

1. “Hyper” mobility is lacking

I remember early on in my career (22 years ago) when “hyper” mobility was considered a bad thing. But since then, both research and experience have proven me wrong. If you’ve followed me for a while – then you know one of my favorite sayings is “mobility before stability”. That’s because a joint that moves fully and freely feels and functions better – and allows the muscles around that joint to work at their best. Too often, people mistakenly look at muscular strength first as the solution to solving pain, when they should be looking a bit deeper.  Regarding knees, you need a bit of what we call “hyper-extension”. But most practitioners tend to focus only on how well a knee is bending. For knees – just getting to straight isn’t good enough. You need a certain amount of “more than straight” – otherwise known as hyperextension. I see this problem most in knees that have had surgery.  If their full knee extension (hyperextension) wasn’t restored properly during rehab, or perhaps they didn’t have any rehab at all (common practice now after most arthroscopic knee surgeries), knee pain will persist. And it won’t go away no matter how much you try and strengthen it. Moral of this story – make sure you have full knee extension – which includes a bit of hyperextension – and that it matches your other knee. This could be a reason your knee pain isn’t going away.

2. It’s really a back problem

Did you know that 40% of the time, an extremity problem (aka: knee, shoulder, etc) comes from the spine – even when you don’t have any neck or back pain? It’s more common than you think for knee pain to be caused from your lower back, and when this gets missed, it’s a huge reason for lingering knee pain that never seems to get resolved. With a true knee problem, your symptoms tend to be pretty specific and localized to just your knee joint. But if your pain tends to move around your knee, or travels up and down your leg, there’s a good chance your knee pain is coming from your back. If you’ve been treating your knee for months (or years) – and it’s not going away –  consider that your knee problem is actually a back problem. This could be especially true if you’ve had cortisone injections and/or various procedures done to your knee with little or no effect.

3. Poor core strength

When it comes to core strength, most people associate it with something that’s important for resolving and preventing back pain. But good core strength is vital to good knee health as well. Your abdominals, low back muscles, hips, and glutes all make up what we call your “powerhouse” – otherwise known as your core. Your powerhouse – specifically your hips and glutes – have a huge influence on how well your lower extremities function. If your core is weak, your legs will need to work harder and eventually overcompensate. And knee joints often take the brunt of all this. The truth is, although your knees require a certain amount of stability to function well – they aren’t designed to be a stabilizing joint. That’s what your hips and ankles are for. If your core is weak (particularly hips and glutes), and your knees start trying to help out as an extra stabilizer, this could be the reason why they keep hurting. If you haven’t yet gotten your core strength properly assessed – do it – this could be the culprit.

4. Weak ankles

As I alluded to above – if your ankles aren’t strong enough to stabilize your foot and lower leg, your knees will kick in to help. If this pattern is allowed to continue – your knees will start to hurt – and will keep hurting until the pattern is discovered and fixed. Another interesting phenomenon that can occur in any joint (not just your ankles) is that when a joint lacks strength or stability – it will stiffen up to compensate. So in terms of your ankles – if they lack range of motion on top of being weak – your knees will really pay the price. This is particularly evident during activities such as running, hiking, pickleball, or tennis. You need really good mobility and stability of your ankles for these activities – or your knees will suffer in response. If you’ve got lingering knee pain and haven’t yet taken a look at your ankles – I recommend doing so – they could be the overlooked issue. 

Knee pain can be tricky to figure out – especially if it’s chronic. The key to successfully getting rid of knee pain starts with correctly identifying the cause. And from my experience – arthritis, age, and wear and tear serve as “excuses” when a practitioner doesn’t know where to look. If you’re suffering from chronic knee pain and haven’t yet explored any of the four lesser-known contributors I mentioned in this article – talk to a specialist who knows how to look at the big picture instead of just your knee – because the true cause could be elsewhere.

Are you local to Portsmouth, NH?

CLICK HERE to speak with one of my specialists for free.

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