Tag Archive for: knee problems

Pilates Class at CJPT & Pilates

When Gyms Reopen — Will Your Body be Ready?

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The state of New Hampshire is slowly reopening, and we are so excited that small-group fitness classes can return to gyms and studios on June 1st! While many businesses, including ours, have adapted by offering online services — most clients we speak with can’t wait to get back in the studio again. 

The big question is — will your body be ready?

If you’ve stuck with your strength and mobility routine and have been working out regularly from home, then you have a better chance than most to bounce right back.

But not everyone has taken advantage of online virtual exercise services, and many I speak with have opted to do nothing and just wait. Many have resorted to more frequent walking, running, or biking as a substitute for their usual exercise routines.

Any physical activity is better than no physical activity, but daily cardio is not the same as strength training. It’s just not going to be enough to get you by if your plan is to jump right back into the same pre-Covid workout routine that you left behind.

It takes months to gain appreciable muscle strength and improve mobility… but it only takes two to three weeks to lose it all.

The biggest mistake that I expect to see once gyms and even our own Pilates studio reopens is that people will assume their body is ready to pick back up exactly where it left off. And within about two to three weeks of that, injuries WILL start to happen.

What can you do?

If you’re not in any pain, but all you’ve been doing is cardio, then it’s a good idea to start incorporating strength and mobility back into your routine now. Your body will be much happier when it gets back into the gym or studio, and you’ll be less likely to experience some kind of injury. My best recommendation is to utilize the online services that your favorite gym or studio already offers — or find a facility that is offering them. In our studio, for example, we have online virtual Pilates classes daily. We guide you through the movements using precise cueing, and watch you while you’re moving. This allows us to give you in the moment corrections and make sure that you’re getting the most out of your workout. While it’s not exactly the same as your instructor being right there next to you, it’s the next best thing.

If you’re already experiencing pain or stiffness, perhaps because you’ve been walking or running more than you’re used to, you’ll want to talk to a movement specialist like us before you jump back into your previous exercise routine.

We know how to screen your muscles and joints properly, and can guide you toward not only getting rid of your pain, but we will also ensure that you’re set up to thrive in your workouts once we’re allowed to reopen again. Another big misconception I see is that people assume their pain will just go away once they start exercising again. While that may be true for some, most of the time it goes the other way, and your pain either gets worse or manifests itself somewhere else because your body starts to compensate for the problem.

I spoke with a gentleman earlier this week who was suffering from knee pain and stiffness because he went from walking 2-3 miles per week to walking 2-3 miles per DAY with his wife. He wants to get back on the golf course, and due to the restrictions on using golf carts, more walking is going to be necessary. His knee won’t be able to handle that in its current state, plus it will get worse if he pushes it. So I’m excited that he took us up on our offer to talk for free about what was going on with his knee. Now we’re going to get him the help he needs!

If you have any questions about pain that you might be experiencing, or want to ask about getting into a Pilates class this June, give us a call!

We are still offering FREE Zoom or in-person consultations to help people figure out what to do about their pain while they are stuck at home or slowly re-entering the world.

Noticing More Knee Pain during Quarantine?

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Aside from back pain, the second most common complaint bringing people into our office these days is knee pain, and lately, I’ve seen a little surge.

Here’s why…

People are sitting a lot more, which leads to increased stiffness in your knees. And a lot of us are doing different kinds of activities than we did 6 weeks ago, which for some, is exposing knee problems they never knew they had.

I spoke to one gentleman last week (we’ll call him “Jack”) who had started walking every day, and running a little bit, because his gym had closed. After about 4 weeks of this, he began experiencing pain in the front of his knee. He put some ice on it, took a break from his daily walks and running, and also resumed some stretches that a former physical therapist had told him to do. This seemed to help, so he resumed his walks and running again. Three days into it… bam… his knee pain returned.

Our specialist team has opened up our schedules to answer people’s questions about what they can do at home right now to take care of any aches or pains.

So Jack took us up on that, because he wanted to know if his knee pain was something to worry about. Did he need to see a doctor? Did he need to let it rest some more? Were there specific exercises he could do?

He did NOT want to stop his walking and running routine, but he definitely didn’t want his knee to get so bad that it would keep him from returning to the gym when it opened back up. He’s 55 years old and staying active and mobile is VERY important to him. We spoke for about 20 minutes and I knew immediately that rest wasn’t going to work, and that X-rays or medication from a doctor wouldn’t do anything either. Those things would only mask the problem. They would take care of the pain in his knee – but wouldn’t correct the source of his problem.

Ironically, the truth about knee problems is that they’re often not actually knee problems!  

With most knee pain, we can trace the underlying issues to a locality directly below the knee (the ankle or foot) or directly above it (the pelvis, hips, core, and low back). If you don’t engage your core throughout your daily movement, it actually puts a huge amount of strain on your knees. As your legs swing and rotate, the torque that should be occurring through your pelvis and hips gets overloaded onto your knees. So as we age, we may start feeling a sense of wear and tear or weakness in our knees that actually comes from a lifetime of improper movement.

The mainstream medical model is focused largely on treating symptoms rather than identifying the root cause of WHY the problem is occuring in the first place.

Pain pills, injections, and even surgery are often recommended before more conservative and natural treatments! And because these quick fixes are merely addressing the symptoms, the physical problems return for the majority of affected individuals. That’s because those knee issues actually stemmed from a different part of the body, and the knee will continue to be overloaded until those biomechanical problems are addressed directly!

Yes – we were able to figure ALL of this out from a FREE phone session.

The next step for Jack was an evaluation with our knee specialist. We scheduled a virtual session over Zoom, she was able to confirm the source of the problem. Turns out the muscles in his hips weren’t firing like they should and it was causing his knees to compensate and work harder than they needed to, which resulted in pain. So we got him doing the correct stretches and specific exercises that would train his hip and pelvis to work like they are supposed to.

In no time, Jack will be back to his walking and running routine, but he will ALSO be in better shape to return to the gym. One of his frustrations before was not being able to do as many squats as he wanted – because they hurt his knees. He had no idea that the problem was actually coming from his hips! So he is pretty excited to try his squats again once his gym opens back up.

If Jack’s story sounds familiar to you, schedule a call with us.

There is no point in sitting at home worrying, or scouring Google for what you should do to fix your pain. We can figure out what’s going on with you over the phone and I’ll let you know if you need to schedule a session with us, see a doctor, or if it’s something you can take care of on your own.

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 🙂

knee pain source

When Your Knee Problem Isn’t Really a Knee Problem…

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Knee pain is one of the most common complaints that brings people to physical therapy.  Since most of our clients are in their 40’s, 50’s, and 60’s, many of them fear that knee problems could bring an end to their active lifestyles. But that doesn’t have to be the case!

Ironically, the truth about knee problems is that they’re often not actually knee problems!  

There are many folks out there who struggle with chronic pain, instability, and stiffness in their knees. Naturally, they wonder why after countless treatments — sometimes even surgery — their knees still hurt.  Even worse, they start to accept having “bad knees” as a way of life. But if treating the knee directly has been consistently ineffective, it’s time to look elsewhere. Sometimes, even though you may experience pain in your knees, the root of the problem is elsewhere.

Let me explain…

With most knee pain, we can trace the underlying issues to a locality directly below the knee (the ankle or foot) or directly above it (the pelvis, hips, core, and low back). If you don’t engage your core throughout your daily movement, it actually puts a huge amount of strain on your knees. As your legs swing and rotate, the torque that should be occurring through your pelvis and hips gets overloaded onto your knees. So as we age, we may start feeling a sense of wear and tear or weakness in our knees that actually comes from a lifetime of improper movement.

The mainstream medical model is focused largely on treating symptoms rather than identifying the root cause of WHY the problem is occuring in the first place.  Pain pills, injections, and even surgery are often recommended before more conservative and natural treatments! And because these quick fixes are merely addressing the symptoms, the physical problems return for the majority of affected individuals. That’s because those knee issues actually stemmed from a different part of the body, and the knee will continue to be overloaded until those biomechanical problems are addressed directly!

So how do you I figure out what’s causing my knee pain?

Physical therapists go through extensive training in order to analyze your strength, mobility, and body mechanics. These factors allow them to figure out exactly what deficits are contributing to your knee pain, and develop a plan to optimize your movement patterns.

The purpose of a physical therapist is to train you in correct, healthy movement that both relieves your body of pain in the short term and protects it from further damage in the long term.  

Poor balance is a common symptom of a weak core, and being off balance in your movement is bound to affect crucial joints such as your knees — especially in simple everyday activities like climbing stairs and walking. That’s one of the many reasons why we like to combine physical therapy with Pilates in our practice. Pilates-based rehabilitation is a unique, core-centric approach to teaching healthy movement patterns. We love seeing our clients become stronger, balanced, and pain free as they are able to combine the full body workout of Pilates with the practiced eyes of a physical therapist who can identify movement problems and guide the client through correcting them.

The fact is, knee problems are rarely just knee problems, and if you have chronic knee pain, it’s worth asking a physical therapist to help out! If you want more accessible information about knee pain, check out our Facebook Happy Hour video right here! Then you can even request a free discovery session with us to see what PT is all about, and how we can work together to create a customized plan of action for your individual needs. We’d love to hear from you!

Is Running Bad for Your Knees when you’re Over 50?

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Is Running Bad for Your Knees when you’re Over 50?

This is a question we get asked a lot — especially by patients at our specialized physical therapy practice in Portsmouth, New Hampshire — who are getting older and worried that they won’t be able to keep running into their 50s and 60’s.

The short answer? No!

If you experience knee pain when you run, it’s not that you’ve “aged out” of the sport! It’s probably just a biomechanical issue that can be fixed with proper education and strengthening (best offered by a specialist physical therapist).

In fact, research supports that running may actually be GOOD for your knees!

Here are some factors that could be responsible for knee pain when you run:

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can in turn impact your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.”
A physical therapist can help you improve ankle mobility in order to prevent long term damage to the joints, tendons, and ligaments of your knees. This might be especially important for you if you’ve ever sprained or twisted an ankle in the past!

2) Weakness

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing strong lower limb muscles is critical. The hamstring and quadriceps groups play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

3) Unstable core

It may seem like running is all in the legs, but in reality, every physical action begins at the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — especially your knees. A stable core is key for maintaining balance and rhythm. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees.
Our favorite way to improve core strength is Pilates! If you are a runner but think you could benefit from a stronger core (let’s be honest, we all could), consider giving it a try — for FREE.

4) Running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — running form is important. It determines where and how the impact of every step is distributed throughout your body. If your body mechanics are compromised — for instance, you’re dragging your feet or running with your shoulders tense and shrugged — you’re more likely to suffer from chronic knee pain, or even experience a serious injury. Work with a movement specialist – like the PT’s in our office – to analyze your form and help you be more efficient when you run.

Running is good for you at any age, if you do it right!

Research shows running can actually slow knee arthritis. According to an article published by Outside Online, “animal models show that exercise promotes cartilage thickening and protects its stretchy properties… instead of wearing down your bearings, running may grease them. That’s key, because cartilage thinning and the loss of elasticity are both prominent causes of osteoarthritis.”

Want to make sure you’re running right? Get in touch!

If you are local to the Seacoast region and considering physical therapy in Portsmouth, NH – you can schedule a FREE Discovery Session if you have chronic knee pain (or any type of pain) to talk about what you’re dealing with and figure out the course of action that works best for you.

You’ll get the opportunity to tell one of my specialists everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

Looking for more information on Knee Pain? – Download our free guide “7 Ways to Stop Knee Pain” 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].