Tag Archive for: New Hampshire physical therapy

Why Your Knee Pain Isn’t Going Away – And What You Might Be Missing

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Knee Pain in Portsmouth, NH? 4 Hidden Causes Most People Overlook

Knee pain can be stubborn – especially if you’ve already tried stretching, strengthening, injections, or even surgery with little to no relief.

If you live in Portsmouth, NH or the Seacoast area, and you’ve been told your pain is simply “wear and tear,” arthritis, or aging – you’re not alone.

But here’s something most people aren’t told…

There are plenty of people with arthritis and age-related changes who have no knee pain at all.

So what’s really going on?

At our Portsmouth physical therapy clinic, we often find that knee pain isn’t always a knee problem. If your pain keeps coming back despite following conventional advice, one of these four lesser-known causes may be the real reason your knee pain won’t go away.

1. Your Knee Pain Might Actually Be Coming From Your Lower Back

Many Portsmouth residents are surprised to learn that nearly 40% of extremity pain originates from the spine – even when there’s no back pain present.

The nerves that control your knee function begin in your lower back. If those nerves are irritated or compressed, you may feel pain in your knee instead.

Signs your knee pain could be coming from your back:

  • Pain that moves up or down your leg
  • Discomfort that worsens with prolonged sitting
  • Knee treatments that don’t seem to work

This is why working with a mechanical back pain specialist in Portsmouth, NH can make all the difference. Treating the source — not just the symptoms – is key.

2. Weak Core and Hips Can Lead to Chronic Knee Pain

When most people think about core strength, they think about abs – not knees. But your core, hips, and glutes stabilize your entire lower body.

If these muscles are weak, your knees absorb extra stress. Over time, this can lead to:

  • Knee pain when walking or running
  • Instability on one leg
  • Pain after prolonged activity
  • Recurring knee flare-ups

At our Portsmouth physical therapy clinic, we frequently see knee pain resolve once proper hip and core stability is restored.

3. Limited Ankle Mobility Could Be Causing Your Knee Pain

Your ankles are the foundation of your lower body. If they lack mobility or stability, your knees compensate.

This is especially common in active adults in the Seacoast area who enjoy:

  • Running
  • Hiking
  • Golf
  • Tennis
  • Gym workouts

If your ankles are stiff or unstable, your knees take the hit. Improving ankle mobility can dramatically reduce stress on the knee joint.

4. Your Knee May Not Be Moving the Way It Should

One of the most overlooked causes of knee pain is mobility restriction – especially loss of slight hyperextension.

Most rehab programs focus on bending the knee. But proper knee mechanics require full extension – and often slight hyperextension. If your knee stops at “just straight,” it may still be restricted.

This is extremely common after knee surgery in Portsmouth-area patients, where full mobility isn’t always restored.

If one knee doesn’t move like the other, it may be time to work with a mechanical knee pain specialist who can restore proper joint motion.

Why Your Knee Pain Isn’t Going Away

If you’ve been dealing with persistent knee pain in Portsmouth, NH, there’s a strong possibility that:

  • You were given the wrong diagnosis
  • You’ve been treating the wrong area
  • Or your rehab plan didn’t address the root cause

The true problem may be coming from your back, hips, ankles, or movement restrictions that are placing secondary stress on your knee.

A mechanical pain specialist trained to assess the entire body can identify the real source and create a personalized plan to finally resolve your knee pain – without unnecessary injections or procedures.

Looking for Knee Pain Treatment in Portsmouth, NH?

If you’re local to Portsmouth or the Seacoast area and want answers, consider speaking with one of the specialists at CJ Physical Therapy & Pilates.

Led by Dr. Carrie Jose, our team specializes in mechanical knee pain treatment and helping active adults get back to walking, exercising, and living fully – without relying on injections or surgery.

Request a FREE Discovery Visit with one of our specialists to determine the true cause of your knee pain.

If you’re searching for:

  • Knee pain specialist in Portsmouth, NH
  • Physical therapy for knee pain near me
  • Natural knee pain treatment in Seacoast NH
  • Help for chronic knee pain after surgery

 

5 Things I Learned Walking in Italy

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When I travel, I love to walk. There’s no better way to experience a new country than on foot – and Italy was no different.

During my recent two-week trip, I averaged about 14,000 steps per day. Between the cobblestone streets, uneven stairs, and endless hills, my body got quite the workout.

Back home here in Portsmouth, New Hampshire, I realized how much those lessons from Italy apply right here on the Seacoast – from long walks downtown to exploring the trails along the waterfront.

Here are five of the biggest lessons I learned walking through Italy – and what they can teach you about keeping your body active and pain-free, no matter where life takes you.

1. Comfortable Footwear is Non-Negotiable

Let’s start with the obvious – shoes. Your feet are your foundation, especially when you’re walking all day. The wrong footwear can ruin your trip. Most people don’t realize how much their feet influence the rest of their body. Poor support, tight toe boxes, or too-flat soles can change how your hips and spine move – and not in a good way.

I brought one good pair of supportive sneakers that went with everything (including my dresses) and a pair of flexible, cushioned sandals for the occasional, fancier nights out. This allowed my feet to move naturally while still absorbing shock from all those ancient stone streets. Investing in proper footwear isn’t vanity – it’s injury prevention.

When your feet move well, your hips and back have a fighting chance at doing the same.

2. Mobile Hips Make Your Steps Easier

Italy is full of hills, uneven terrain, and stairs – lots of stairs. Without good hip mobility, that’s a recipe for soreness and fatigue. One of the biggest things I noticed while walking was how much easier it was to climb, descend, and cover long distances because my hips moved freely.

When your hip joints are mobile, your glutes can actually do their job. They engage more easily, which means your legs and back don’t have to work as hard. Most people with “tight hips” don’t have a flexibility problem – they have a mechanical one. If your hip joint doesn’t move fully, your muscles are forced to compensate and structures within your hip can become aggravated.

Simple corrective movements that restore hip motion can make a world of difference – not just for walking in Italy, but for walking pain-free through everyday life.

3. Breathing Activates Your Core

The more I traveled, the more I realized how important my breath was – especially on steep climbs or long walking days. Most people think “core stability” means planks and crunches, but your diaphragm – your breathing muscle – is at the center of it all.

When you breathe properly, your deep core and pelvic floor activate and stabilize your spine without effort. That stability supports your hips and pelvis, keeps your posture tall, and prevents strain on your back.

The way you breathe sets the tone for your entire body. When you’re breathing well, everything else – from your stride to your balance – improves.

4. The Right Stretch – at the Right Time

Just before my trip, I had a mild flare-up of back pain. The last thing I wanted was for it to follow me to Italy. What helped me most wasn’t stretching constantly just to “feel good,” but using corrective, targeted movements that actually did good – and helped fix the problem.

After long flights or train rides, I’d take a few minutes to gently extend my back and open my hips – small, specific movements designed to restore joint motion after sitting too long. During long walking days, I focused on keeping my hips and ankles mobile instead.

Overstretching the wrong things, in the wrong way, and at the wrong time can make matters worse by putting extra strain on already tired muscles and joints. The key is to stretch with intention. Don’t just chase the tightness. Understand what’s causing it – and address the source instead.

5. Recovery Is Just as Important as Movement

After walking all day, it was tempting to collapse into bed. But the best thing I did for my body was take a few minutes each evening to move gently – especially through my spine and hips. I’d lie on the floor, breathe deeply, and let my body unwind from the day.

Walking loads your body just like exercise does – and your tissues need time and movement to recover. Restoring motion and blood flow at the end of the day helps prevent stiffness the next morning and keeps your joints healthy in the long run.

And now that I’m home, I’ve been putting these lessons into practice at my clinic in Downtown Portsmouth.

Whether it’s walking around Prescott Park, heading up the local trails, or just keeping up with daily life, recovery is key. My go-to? A quick session of shockwave therapy to help heal sore, overworked muscles, plus EMTT (high pulsed magnetic therapy) to boost recovery and cellular repair — all available right here at CJ Physical Therapy & Pilates in Portsmouth, NH.

My Takeaway

Italy reminded me of something I teach my Seacoast patients every day: when your body moves well, life feels better. Whether you’re walking downtown, hiking Mount Agamenticus, or strolling along the coast, your mobility determines how much you enjoy it.

The right shoes, mobile hips and spine, a strong core, and a little recovery time can be the difference between loving every step and counting down the minutes until you can sit down.

 

 

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 you’re local to Portsmouth, NH or the Seacoast area and want to stay active, healthy, and pain-free as you age — request a FREE Discovery Visit with one of our specialists at CJ Physical Therapy & Pilates.

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

Six Tips for Managing Knee Pain without Medication

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6 Natural Ways to Manage Knee Pain Without Medication or Surgery

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

Introduction

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

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

Understanding the Problem: Why Knee Pain Lingers

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

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

Common Causes of Ongoing Knee Pain

  • Weak hips or core muscles that lead to poor alignment

  • Stiffness in the hips, hamstrings, or quadriceps

  • Prolonged sitting or sedentary habits

  • High-impact or improper exercise routines

  • Unsupportive footwear

  • Poor balance or coordination

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

Natural Solutions: 6 Proven Tips to Relieve Knee Pain

1. Strengthen Your Hips and Core

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

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

2. Improve Your Flexibility

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

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

3. Don’t Sit Too Long

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

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

4. Stay Active

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

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

5. Wear Supportive Footwear

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

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

6. Optimize Your Balance

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

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

Next Steps: Find Natural Relief in Portsmouth, NH

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

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

Are you local to Portsmouth, NH?

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

About Dr. Carrie Jose

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

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

A Physical Therapy Expert’s Guide to Enjoying Fall Activities Pain-Free

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A Physical Therapy Expert’s Guide to Enjoying Fall Activities Pain-Free

Fall is my favorite season-and I know it is for many of you too. Crisp air, colorful leaves, pumpkin patches, and cozy outdoor gatherings are some things that come to mind. But there’s also raking leaves, picking apples, chopping wood, and moving heavy things like hay bales or pumpkins. Any of these activities can produce unwelcome strain on your body if you’re not careful. 

Here’s a guide to enjoying all that fall has to offer-from a back pain and mechanical pain expert-so you can do as much as you want this fall season while keeping your back and joints pain-free.

  1. Rake Leaves with Care

Raking is a quintessential fall activity, but it’s also repetitive and strenuous, which can lead to back pain if done improperly. To protect yourself, begin by warming up. Just as athletes warm up before a game, you should warm up before raking. Try a brisk 5-10 minute walk around your yard or neighborhood to get your blood flowing, followed by gentle stretches for your back, shoulders, and legs. A few torso twists and arm circles will help loosen up your muscles and prepare them for the repetitive motions of raking. Next, choose a lightweight rake with a long handle that allows you to stand upright. Avoid bending forward too much, and alternate sides regularly to avoid overusing one side of your body. When bending to gather or bag leaves, squat using your legs and keep your core engaged. Avoid twisting from your waist, as this puts your spine in a vulnerable position. Instead, pivot your entire body to avoid strain. Raking for extended periods can tire out your muscles, making you more susceptible to injury, so set a timer for every 20-30 minutes and take a short break to stretch your back and shoulders.

  1. Safely Pick Up and Carry Pumpkins

Pumpkin picking is a fall favorite, but carrying heavy or awkwardly shaped pumpkins can strain your back and shoulders if you’re not careful. Here’s how to keep things safe and pain-free. First, when lifting a pumpkin, bend at your knees and use your leg muscles to power the lift. Keep the pumpkin close to your body and avoid twisting as you lift. If possible, use a cart or wagon to transport heavier pumpkins and prevent carrying strain. Many farms and pumpkin patches provide carts-take advantage of them! If you’re decorating with multiple pumpkins or other fall items, consider limiting the number of trips you make to and from your car or home to avoid repetitive strain. This advice applies to picking up and carrying anything-whether it’s hay bales, fall decorations, or putting away summer furniture.

  1. Use Good Posture When Apple and Pumpkin Picking

Apple orchards and pumpkin patches can be so much fun, but both activities involve a lot of bending, reaching, and lifting. Use these tips to protect your body. Instead of overstretching to reach that perfect apple, use a ladder or stool. Overreaching can lead to shoulder and back strains, so play it safe and keep a good base of support as you reach up. When standing or walking for extended periods in the orchard or patch, practice standing tall, with your weight evenly distributed between both feet. This not only helps reduce fatigue but also protects your lower back. Additionally, if you know you’ll be walking and standing for prolonged periods, wear good, supportive shoes. This will go a long way in helping your spine and the rest of your joints absorb the load of your body as well as those pumpkins and apples.

  1. Move Often and Stay Hydrated

All-day outdoor fall activities can wear you out, especially if you’re standing, bending, or lifting frequently. Staying mindful of your body can make a big difference. Make a point to take a stretch break every hour or so. Focus on simple movements that lengthen your spine and open up your chest and shoulders, such as reaching your arms overhead and gently twisting your torso side-to-side. Cooler weather can make you feel less thirsty, but it’s still essential to stay hydrated. Dehydration can lead to muscle stiffness, fatigue, and even unwanted spasms and cramps, increasing the risk of strains.

  1. Cool Down After Activities

Once you’ve wrapped up your fall fun, give your body a few minutes to cool down and recover properly. A little bit of post-activity care can go a long way in keeping pain at bay. After raking, decorating, or any heavy lifting, spend five minutes stretching your back, legs, and shoulders. Simple stretches like extending your spine backward or pulling your knees to your chest can help relieve tension. After a full day of physical activity, it’s tempting to sink into a couch or recliner, but try to avoid slumping immediately afterward. Instead, sit with a straight back, or go for a light walk. This can help prevent stiffness and reduce the likelihood of soreness.

Enjoy Fall the Pain-Free Way

Fall activities are a great way to enjoy the season and embrace the outdoors, but they don’t have to come with pain and strain. Taking a few preventive measures, such as warming up, being aware of your body, and using proper lifting techniques, can make a significant difference in how you feel afterward. With these tips, you’ll be ready to fully enjoy apple-picking, pumpkin patches, and all the beauty that fall has to offer-with a lot less ache. That being said, if you try every tip I’ve mentioned and don’t notice any difference in how you feel or tolerate these activities, your problem might need expert help. Reach out so we can help you find a mechanical pain expert in your area who can work with you.

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

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, call 603-380-7902, or CLICK HERE to get a free guide for preventing back pain.

For the Dad Who Has Everything… Except Good Knees

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It’s that time of year when we celebrate the dads in our lives – and if the one in your life is anything like mine – then he’s probably a little tough to shop for. Maybe he already has all the tech toys and grilling gadgets he wants. Maybe he’s not one to ask for much. But if there’s one thing a lot of dads over 40 don’t have – but wish they did – is good knees.

Knee pain is one of the most common complaints I hear from the men over 40 who walk into my clinic – and it’s also the most common form of osteoarthritis. For some, it’s been a nagging issue for years. For others, it creeps in gradually – starting with a little stiffness when getting up from the couch, or a strange “click” here and there. Then one day, it hits you… Playing golf isn’t fun anymore, and going up and down stairs now feels more like a chore – because your knees just hurt all the time.

Yes, knee pain does become more common as we age – but not necessarily for the reasons you think.

People love to blame arthritis and “wear and tear” for just about everything. And while a previous injury or underlying arthritis might be present, they’re not always the primary culprits. What most people don’t realize – including dads – is that the root cause of knee pain is often mechanical. In other words, it has more to do with how your body moves (or doesn’t move) than what’s actually going on inside the joint.

Let me explain.

Your knees sit between your hips and ankles – two areas that are meant to move a lot and absorb shock. But if the hips or ankles aren’t doing their job properly (which is surprisingly common), that stress has to go somewhere – and the knees usually pay the price. Over time, poor mechanics can lead to pain, inflammation, and breakdown of the joint. But here’s the good news – if the pain is mechanical, it’s very treatable – and sometimes even reversible – all without drugs, injections, or surgery.

So why don’t more dads know about this?

For one, we’ve normalized knee pain – especially in men over 40. There are societal and cultural beliefs like, “You’re getting older, it’s supposed to hurt a little.” Or worse, “If it hurts too much, you can always replace it.” That kind of thinking is unproductive, unnecessary, and can even be dangerous. Yes, knee replacements are sometimes the right call – but far too often, they’re offered before the right conservative options have been fully explored. And with so many cutting-edge, non-invasive technologies now available that promote longevity and let you keep your original parts – dads should absolutely be exploring these options first.

But another big reason? Men – especially dads – tend to avoid asking for help. They’re used to being the fixers, not the ones getting fixed. Many try to “tough it out,” hoping the pain will go away on its own. Others pop ibuprofen or throw on a brace and carry on. But these strategies are just band-aids. They might provide temporary relief, but they don’t address the actual cause of the pain – and in some cases, they can even make things worse.

The real solution starts with a deeper understanding of why your knee pain is happening in the first place. Remember – 80% of all knee pain is mechanical in nature.

So if you or someone you love is dealing knee pain – here are a few important things to keep in mind:

  1. Rest isn’t always the answer.
    It might seem like common sense to rest an aching knee – but too much rest can lead to stiffness, weakness, and poor circulation. In many cases, strategic movement is far more helpful than immobilization.
  2. Pain doesn’t always mean damage.
    This is one of the most misunderstood aspects of musculoskeletal pain. Just because something hurts doesn’t mean it’s permanently damaged – and just because an X-ray shows “bone-on-bone” doesn’t mean surgery is inevitable.
  3. The site of the pain isn’t always the source.
    Knees often hurt because of a problem elsewhere – such as limited hip mobility, poor ankle mechanics, or even an undiagnosed problem in your spine. That’s why a full-body movement assessment is key to figuring out what’s really going on.
  4. Most knee pain is preventable – and fixable.
    With the right combination of movement-based therapy, strength training, hands-on treatment, and regenerative therapy – many people are able to not just reduce their pain – but eliminate it entirely.

So what does all of this have to do with Father’s Day?

If you’re looking to give your dad something meaningful this year, consider giving him a nudge to take care of himself.

Not with another gadget or tie – but with a shift in mindset. One that reminds him that pain isn’t something he just has to live with. One that encourages curiosity about his health, and reinforces that aging doesn’t have to mean giving up the activities he loves.

Because the truth is – most dads don’t want to sit on the sidelines. They want to stay active, strong, and capable. They want to travel, hike, golf, chase their grandkids around the yard, and keep doing the things that make life fun. And they can – if they learn to listen to their bodies and get the right kind of help.

So if the dad in your life has everything… except for good knees… Maybe this is the year to give him something more lasting than another toolset or polo shirt. Maybe this is the year to give him the reminder that his health is worth paying attention to. And that it’s never too late to move better, feel better, and get his knees back.

When your Back Hurts – is Rest Helping or Hurting?

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Whenever someone finds out I’m a physical therapist, the next question is almost always something like… “What can I do for [insert the blank] injury?” And when it comes to back pain specifically, people often ask me: “Should I be resting it?”

It’s no surprise that the vast majority of folks I speak with about back pain have been told by well-meaning friends, family, or even doctors that rest is the best thing for back pain — especially when you first hurt it. But what if I told you that rest might actually be the worst thing you can do? That resting and doing nothing — even when you’ve acutely hurt your back — can actually delay recovery and even make your back pain worse in the long-term.

Conventional advice tells us that back pain should be treated with ice, inactivity, and as little movement as possible — and when it feels better — to start slowly moving it. That advice makes sense on the surface — after all, if something hurts, shouldn’t you avoid using it? But research (and decades of clinical experience) shows us that this approach can actually prolong healing, increase pain sensitivity, and make it more likely that your back pain will return again and worse, become a long-term issue.

Why Rest Doesn’t Work

Modern health research is very clear on this: too much rest after a musculoskeletal injury like back pain leads to muscle deconditioning, joint stiffness, poor circulation, and even heightened pain sensitivity. A well-known review published in The Lancet concluded that staying active is one of the best things you can do for non-specific (mechanical) low back pain. In fact, people who remain as active as possible — within reason — recover faster and are less likely to develop chronic symptoms.

Here’s why: your joints and tissues thrive on movement. Motion promotes circulation, reduces inflammation, and helps your muscles and nerves return to normal function. When you stop moving, the opposite happens. Your muscles tighten, your joints stiffen, and your brain becomes more sensitized to pain signals. That’s how a small tweak in your back can turn into months (or years) of recurring pain if you’re not careful.

Movement is Medicine

Now, this doesn’t mean you should ignore your pain and go back to the gym, golf, or even all your daily house chores the next day. There’s a difference between smart movement and overdoing it. But most people fall on the other side of the spectrum — they stop moving entirely, waiting for the pain to just “go away.”

What I recommend instead is gentle, intentional movement that keeps your body active without making things worse. Walking, for example, is one of the best low-impact ways to get your spine moving and your blood flowing. If walking feels okay, it’s a great first step toward healing.

Specific exercises tailored to your pain are also incredibly powerful. These movements help “reset” your nervous system, calm down overactive muscles, and restore balance to the structures around your spine. In my clinic, I call these “first-aid movements.” They’re often simple, but highly specific — and they can help you move from debilitating pain to something much more manageable.

But What If Movement Feels Impossible?

I get it — sometimes your back pain is so bad that even getting out of bed or walking across the room feels unbearable. If you’re stuck in this kind of pain cycle, you may not be able to figure out on your own what’s safe to do. And in those cases, the worst thing you can do is wait it out or rely on generic advice from Google or YouTube.

This is where working with a mechanical back pain specialist can be a game changer. A trained expert can evaluate your pain based on movement patterns — not just an image or MRI — and guide you toward the exact movement your body needs to start calming the pain down. In fact, I often see patients go from 10/10 pain to 3/10 in their very first session, simply by finding and repeating the movement that’s right for their spine.

That kind of progress might seem like magic — but it’s just smart biomechanics. The body wants to heal, but it needs the right inputs. A movement-based mechanical specialist knows how to give your body those inputs safely and effectively.

Finding the Middle Ground

The key takeaway is this: while you may need to modify your activity levels when your back flares up, the goal should never be total rest. There is always some kind of movement you can do — and the sooner you find it, the sooner your healing process will begin.

If you’ve been dealing with back pain for more than a few days, and especially if it’s stopping you from doing the things you love, don’t wait around hoping rest will fix it.

The better alternative?

Talk to a professional who understands movement, mechanics, and pain. A customized plan — not a generic rest-and-wait approach — is what truly sets people on the path to lasting relief. Movement is powerful medicine — especially when it’s prescribed correctly.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists for free by clicking HERE.

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

Back Pain, Herniated Discs, and Cortisone Shots: What You Need to Know

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A recent conversation about cortisone shots and back pain due to herniated discs inspired me to write this article.

The person I was speaking with was quite misinformed about when cortisone shots are useful – and when they aren’t. By the way, it’s a very common misunderstanding. But since I hate seeing people undergo unnecessary injections or procedures – I’m here to educate. 

So let’s break it down: when is a cortisone shot a good idea, and when should you think twice?

When Cortisone Shots Work

Cortisone shots can be highly effective if your pain is primarily caused by inflammation, which is what I call “chemical pain.” Chemical pain results from your body’s inflammatory response to an injury. This response produces chemicals and nutrients that help heal the area, but sometimes the process gets “stuck”. The lingering chemicals cause persistent pain that doesn’t respond to movement or rest.

If your back pain is constant, feels hot and inflamed, and doesn’t improve with positional changes, you might have chemical pain. In these cases, a cortisone shot can eliminate the chemicals causing the pain and provide relief. 

In other words – exercise – which is the best treatment for herniated discs and back pain – won’t work well when you have chemical pain. Historically that’s when cortisone shots are necessary. But in 2021 – an amazing technology called Electrocorporeal Magnetotransduction Therapy (EMTT) came to the United States and works just as well (if not better) than cortisone, except it’s natural and non-invasive. EMTT uses a high-frequency magnetic field that can penetrate up to 6 inches into the body – so it can heal inflammation in places like your lower back down to the cellular level. I’ve seen great results from it – so I’m starting to recommend this over a cortisone shot for anyone that needs it. 

When Cortisone Shots Don’t Work

Most back pain (even those related to herniated discs) – aren’t chemical in nature. It’s mechanical, meaning it stems from issues with mobility and movement patterns. Mechanical pain – responsible for 70-80% of all musculoskeletal issues (including back pain) – will improve and resolve with precisely prescribed corrective-movement exercises. How do you know if you’re in this category? If your back generally feels better after walking, stretching, or changing positions – it’s almost certainly mechanical – because it’s responding to movement. If this sounds like you – a cortisone shot won’t address the root cause.

The key to resolving mechanical pain is identifying and correcting mobility restrictions and faulty movement patterns. Once you do this, the structural issue (like the herniated disc) becomes less relevant. Many people live symptom-free with herniated discs once they’ve addressed their underlying movement pattern problems and mobility.

The Gray Area

Here’s where it gets tricky: a herniated disc can irritate surrounding structures like muscles and nerves, causing localized inflammation. This type of pain can feel intense, but it’s not quite the same as chemical pain. But it will be tempting to get a cortisone shot for quick relief. The thing is – it will only be a temporary fix. The shot won’t address the underlying mechanical issues that caused the disc to “act up” in the first place. Worse, masking the pain can lead you to unknowingly worsen your problem, potentially leading to more procedures or surgery. In most cases, this type of inflammation can resolve naturally without drugs. Something like EMTT that I already mentioned, and other regenerative therapies like Shockwave Therapy work great for this type of inflammation.

Take Home Points:

Before you consider cortisone shots, take a moment to evaluate your pain:

  1. Does movement or activity influence your pain? If yes, it’s likely mechanical and won’t benefit from a cortisone shot.
  2. Is your pain constant, hot, and unresponsive to movement? If yes, you might benefit from a cortisone shot to calm the inflammation and enable movement to help.
  3. There are some amazing Regenerative Therapy Treatment technologies available now that serve as natural, non-invasive alternatives to cortisone shots if you are really inflamed. Plus – they work with your body’s own anti-inflammatory systems by giving them a boost.

Ultimately, cortisone shots don’t fix structural problems – they temporarily eliminate pain due to inflammation. While this can be useful in specific situations, it’s crucial to address the root cause of your pain to prevent long-term issues and seek healthier alternatives when you can.

Local to Portsmouth, NH? Schedule a free discovery visit with us today and take the first step toward lasting relief and better movement.

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

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Cortisone Shots for Knee Pain? Why You Should Think Twice.

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Knee pain can be incredibly disruptive – turning simple, everyday activities like walking, climbing stairs, or even standing up from a chair into painful challenges. In search of quick relief, many people turn to cortisone shots. By targeting inflammation in the knee joint, cortisone injections can temporarily ease pain and swelling, making them an appealing option when you’re hurting.

But cortisone shots are just that – a temporary fix. And they come with significant risks and downsides that are often overlooked. Let’s take a closer look at why relying on cortisone injections may not be the best long-term solution for your knee pain – and what you can do instead to find natural, healthier, and lasting relief.

The Problems with Cortisone Shots:

1. Temporary Relief Without Addressing the Root Cause

Cortisone injections can offer pain relief that lasts for weeks or even months – but they don’t address the underlying issue of your knee pain. Instead, they mask your symptoms, allowing conditions like osteoarthritis, tendonitis, or mechanical imbalances to quietly worsen over time. By simply numbing your knee pain, cortisone shots act as a band-aid – covering up the real problem while harmful movement patterns and joint stress continue unchecked. This can eventually lead to more serious, long-term damage without you even realizing it.

2. Risk of Joint Damage

Since cortisone injections only offer short-term relief, many people end up getting them repeatedly. But over time, frequent cortisone shots can actually do more harm than good – leading to cartilage breakdown and weakening the tendons and ligaments around your knee. Research shows that repeated cortisone injections can accelerate joint deterioration, increasing your risk of needing knee replacement surgery down the line. This is especially concerning for active individuals who want to stay mobile, avoid major surgery, and protect their joint health for the long run. Many people aren’t aware of this – so it’s important to know the risks.

3. Disrupts Natural Healing

Inflammation, while painful and uncomfortable, is a vital part of your body’s natural healing process. It increases blood flow, delivers nutrients, and recruits immune cells to repair damaged tissue. Cortisone injections suppress this natural inflammatory response – easing pain and swelling temporarily, but at a cost. By interfering with inflammation, cortisone limits the delivery of key nutrients and healing cells needed to repair cartilage, tendons, or ligaments. Over time, this leaves your knee joint and surrounding tissues weakened, making full recovery harder to achieve. When knee inflammation does get out of control, it’s far better to choose natural healing accelerants that support your body’s repair process – rather than disrupt it.

4. Potential Side Effects and Complications

As with any injection or invasive procedure, cortisone shots come with potential risks, including infection. Other side effects can include increased blood sugar levels, skin thinning, and changes in pigmentation around the injection site. While these risks may seem minor, they deserve serious consideration – especially when the relief they offer is only temporary. Over time, repeated cortisone use increases the likelihood of experiencing these complications. It’s important to ask yourself if short-term relief is worth the growing list of potential long-term consequences.

What to Try Instead of Cortisone Injections:

When it comes to knee pain, I always advocate for natural and effective alternatives that not only alleviate discomfort but also promote true healing. Here are three proven methods that address the root cause of knee pain rather than just suppressing symptoms:

1. Regenerative Shockwave Therapy

Shockwave therapy is a non-invasive treatment that uses acoustic sound waves to stimulate the body’s natural healing processes. By creating micro-traumas in the affected tissues, shockwave therapy boosts blood flow and encourages tissue regeneration. This treatment has been shown to improve mobility, reduce pain, and help with conditions like calcific tendonitis and osteoarthritis. Unlike cortisone injections, which only mask symptoms and can contribute to tissue breakdown, shockwave therapy actively supports healing and long-term relief. When combined with EMTT (Electromagnetic Transduction Therapy), the effectiveness of shockwave therapy is further enhanced – EMTT penetrates deeper into tissues, increases cellular activity, and accelerates the healing process, giving you even faster and more lasting results.

2. Dry Needling for Muscle Imbalances

Dry needling is a highly effective technique for targeting muscle tightness and trigger points around your knee joint. By inserting thin needles into specific areas, this therapy helps release muscle tension, improve circulation, and restore proper function. Dry needling is particularly beneficial for individuals suffering from tendonitis, chronic stiffness, or muscular imbalances that contribute to knee pain. It encourages natural healing by allowing muscles to function more efficiently, reducing strain on your knee joint.

3. Working with a Mechanical Knee Pain Specialist

A mechanical knee pain specialist is trained to analyze movement patterns and pinpoint the underlying causes of your knee discomfort. Unlike general healthcare providers who may prescribe pain medications or generic exercises, these specialists take a customized approach – identifying joint misalignments, muscle imbalances, and faulty movement patterns to develop a personalized rehabilitation plan. They assess how the entire body contributes to knee mechanics, ensuring all contributing factors are addressed. This comprehensive, root-cause approach not only restores knee function and prevents future pain but also leads to more effective, lasting results compared to the temporary relief offered by cortisone shots.

A Smarter Path to Knee Pain Relief:

While cortisone shots may seem like a convenient and quick option, they do little to promote true healing of your knee pain and can actually cause long-term harm. Natural treatments – such as regenerative shockwave therapy, dry needling, and working with a mechanical knee pain specialist – offer a more effective and safer path to knee pain relief. Instead of masking pain, these alternative treatments address the root cause, restore function, and help prevent future injury – giving you real, lasting relief.

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Six Natural Ways to Relieve Arthritis Pain – Without Meds or Surgery

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Arthritis is a widespread and debilitating condition that affects over 350 million people worldwide.

In the U.S. alone, nearly 58.5 million people live with some form of arthritis, making it one of the leading causes of disability. Until recently, conventional treatments like medication, injections, and surgery were the go-to options for managing arthritis-related pain and immobility. However, more people are seeking natural, non-invasive alternatives to reduce their reliance on these treatments and avoid potential side effects.

From lifestyle changes to cutting-edge therapies like Regenerative Therapy, there are many ways to manage arthritis naturally and effectively for lasting relief. Here are six that top my list:

Anti-Inflammatory Diet

One of the best ways to combat arthritis is through dietary changes aimed at minimizing inflammation, which plays a key role in joint pain and stiffness. Research suggests that bone edema (swelling within the bone marrow) is a primary source of pain in arthritis. Since inflammation fuels this process, an anti-inflammatory diet can help reduce discomfort and slow progression. Foods rich in omega-3 fatty acids like salmon, mackerel, and sardines counteract inflammation and may ease arthritis symptoms. Leafy greens, berries, and nuts provide powerful antioxidants that protect joint tissues, while turmeric and ginger contain natural compounds that act as pain relievers. Healthy fats like olive oil further support joint health by reducing inflammation. On the other hand – processed foods, excessive sugar, refined carbohydrates, and fried foods can worsen symptoms and should be limited.

Regular Exercise and Movement

Many people avoid movement when they have arthritis – but it’s actually one of the best ways to relieve joint pain and stiffness. Movement increases blood flow, which flushes out inflammatory toxins while also delivering oxygen and nutrients to nourish cartilage and surrounding tissues. Without regular activity, joints become stagnant, leading to more stiffness, inflammation, and degeneration – ultimately making arthritis feel worse. Low-impact exercises like walking, biking, and swimming improve circulation without excessive strain on joints. Yoga and Pilates enhance flexibility and stability, reducing stiffness and strain. Strength training keeps muscles strong, reducing pressure on the joints and minimizing arthritic symptoms. The more you move – the more you promote healing – making daily activities easier and reducing long-term discomfort.

Weight Management

Maintaining a healthy weight is key to managing arthritis. Excess weight puts added stress on joints – especially in weight-bearing areas like the knees, hips, and lower back. You’d be surprised to know that even a small weight loss can make a big difference. Research shows that losing just one pound reduces knee joint stress by four pounds, easing arthritis pain. One of the most effective and accessible ways to manage weight is walking. It’s simple, low-impact, and helps burn calories. Aiming for 10,000 steps per day is a great goal – but even small increases in daily movement can lead to lasting improvements in joint health and overall well-being.

Herbal Remedies and Supplements

Before medication existed, nature was our primary source of medicine. The good news is that today – there are countless herbal remedies and supplements that can naturally and effectively help manage arthritis symptoms. Glucosamine and chondroitin are among the most widely used for supporting cartilage health and reducing joint pain. Turmeric, particularly its active compound curcumin, has powerful anti-inflammatory properties. Omega-3 fatty acids, found in fish oil and supplements, help reduce both inflammation and stiffness. Other beneficial herbs include Boswellia (Indian Frankincense), which improves joint function and reduces swelling – and Vitamin D, which supports bone health and may alleviate joint pain. If you’re new to herbs and supplements, consult a medical professional trained in herbal medicine to find the best options for you.

Acupuncture and Massage Therapy

Acupuncture and massage therapy have been providing relief for arthritis symptoms for centuries. Acupuncture, an ancient Chinese practice, involves inserting thin needles into specific points on the body to promote energy flow and reduce pain. Many arthritis sufferers find that regular acupuncture sessions help manage discomfort and improve joint function. Massage therapy works by relieving muscle tension, improving circulation, and increasing joint mobility through soft tissue manipulation. Techniques like cupping and hot stones can further enhance results. Sometimes we need extra help managing arthritis symptoms – and these two treatments are not only safe and non-invasive – but also highly effective (especially when combined with the right type of exercise and movement).

Regenerative Shockwave Therapy and EMTT

One of the most exciting advancements in arthritis treatment is Regenerative Therapy. While some regenerative treatments (like PRP and stem cell injections) are invasive – highly effective non-invasive options like Shockwave Therapy and Extracorporeal Magnetotransduction Therapy (EMTT) are gaining popularity. These therapies stimulate the body’s natural healing process without surgery or medication.

Shockwave Therapy uses acoustic waves to promote blood flow, reduce inflammation, and encourage tissue regeneration. EMTT employs high-energy electromagnetic fields to accelerate cellular repair and relieve pain. Together, these therapies provide a drug-free, surgery-free solution for arthritis sufferers. Many patients experience reduced pain, increased mobility, and faster recovery times with no downtime. Unlike cortisone shots, which provide temporary relief but can also weaken joint tissue over time – EMTT and Shockwave Therapy heal at the cellular level – leading to lasting improvements in pain and function.

Final Thoughts…

If you’re suffering from arthritis, it doesn’t mean you have to settle for a lifetime of pain or dependence on medication. By embracing natural treatment methods – such as an anti-inflammatory diet, regular exercise, weight management, herbal supplements, and cutting-edge therapies like Regenerative Shockwave Therapy and EMTT – you can take control of your joint health and improve your quality of life. If you or someone you know is struggling with arthritis – consider exploring these drug-free, non-invasive approaches to healing. The body has an incredible ability to repair itself when given the right support and environment. Taking proactive steps today can lead to a more pain-free, active future.

Local to Portsmouth, NH?

Consider speaking to a mechanical pain specialist by clicking HERE.

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

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

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

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

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

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

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

Let me introduce you to Regenerative Shockwave Therapy and EMTT…

What is Shockwave Therapy?

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

What is EMTT?

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

The Power of Shockwave Therapy and EMTT combined:

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

Evidence Supporting the Combo:

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

So Who Can Benefit?

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

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

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

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

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

Are you local to Portsmouth, NH?

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

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

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