Tag Archive for: physical therapist

Active and Mobile

Six Ways to Keep Your Thanksgiving Festive and Fit

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Thanksgiving is one of my absolute favorite Holidays.

I love all the food, sweets, time with family, the Macy’s Day Parade, afternoon naps, and football. While it’s historically been a time for indulgence and relaxation, more and more people are opting for a more active and healthier Thanksgiving Day.

And there are numerous benefits for doing so…boosted mood and energy levels, improved digestion, happier joints (hips, knees, back, neck, shoulders), and you’ll offset some of the extra calories you may have consumed.

If you’re looking to have a festive, but perhaps more fit Thanksgiving Holiday this year – read on for seven tips and ideas:

1. Practice Mindful Eating

You can still enjoy your Thanksgiving meal – but simultaneously support your health and digestion – with mindful eating. Mindful eating is the practice of paying full attention to the experience of eating and drinking. It involves slowing down, savoring each bite, and tuning into your hunger and fullness cues to create a more enjoyable and intentional eating experience.

Studies show that eating slowly and savoring each bite can reduce calorie intake by up to 25%, as it gives your brain time to register fullness. Mindful eating also improves digestion because it promotes thorough chewing and reduces overeating, which can lead to bloating and discomfort.

Instead of piling your plate first-thing, focus on tasting each dish, and enjoying every moment of your feast.

2. Interrupt your sitting.

Hopefully after you’ve practiced mindful eating – you won’t feel so full – and will be less inclined to slump on the couch. But full or not, our bodies weren’t designed to sit for prolonged periods, so getting up frequently is an easy way to not only incorporate movement throughout your day, but to help keep away lower back and joint stiffness. I recommend standing up once every 30 min. This could be a fun “job” to give a young child at your Thanksgiving table. Make them accountable for watching the clock and remind you to stand up. Interrupting your sitting is possibly the easiest and most effective strategy to keep your knees, hips, and spine from getting painful and stiff on Thanksgiving Day.

3. Sign up for a Turkey Trot

Thanksgiving Turkey Trots are a popular event in most towns and it can be a really fun event for the whole family. Turkey Trots are typically 5K’s – or 3.2 miles. If you’re not able to sign up for an actual race, grab your friends and family and create your own Turkey Trot within your neighborhood. This is a great way to get your blood flowing and joints lubricated first thing in the morning. Plus, morning exercise kickstarts fat oxidation and can keep your metabolism elevated for hours afterwards – so this is a great way to energize your body while also balancing Thanksgiving Day indulgence.

4. Be Active during Commercials.

Whether it’s the Macy’s Day parade, football, or both – it’s easy to find yourself lounging for hours on a soft sofa or recliner – which can wreak havoc on your back if you’re not careful. A very easy way to keep yourself from sitting or slouching too much, and to incorporate some healthy movement into your day, is to get up and do something active during commercials. It’s the perfect opportunity to do a quick 2 min exercise or stretch – and it doesn’t have to be complicated. Choose from a quick set of squats, heel raises, planks, or back stretches. And make it fun. Get a plank or squat competition going with your most competitive family members – you know who they are.

5. Walk your Dessert Off

While skipping dessert is of course an option – you can also choose to walk it off. Opting for a post-meal walk has many benefits (even if you already did a Turkey Trot in the morning). It aids digestion, helps regulate blood sugar levels, and it’s good for your hips, back and knees. Plus – a post-meal walk is an opportunity to get some much needed lengthening and stretching of our muscles and joints after being parked in a chair for any length of time. Walking also happens to be one of the best and most natural exercises you can do for yourself – but it’s especially great to do after a big meal like Thanksgiving – and before you settle in for the evening.

6. Stay hydrated

Staying hydrated is important all of the time – but especially on a day like Thanksgiving. Good hydration will help regulate your digestion, which is particularly important given the heavy and often rich foods we typically consume on this day. Plus, water aids in breaking down food, allowing for better nutrient absorption and preventing digestive discomfort.

When it comes to appetite, we often mistake thirst for hunger, so when you stay hydrated (especially prior to your big meal), you have more control over your portions and are less likely to overeat. When you stay hydrated – it not only supports your body’s essential functions – but makes healthy choices easier – because your energy levels will be higher and your mind clear – two more things that staying hydrated helps with.

Well there you have it – seven easy ways to keep your Thanksgiving festive – while also helping you to stay a bit more fit and healthy. If you’ve got any kind of back, hip, knee, neck, or shoulder pain that is keeping you from practicing these easy tips – I recommend talking to a mechanical pain expert. They’ll help you figure out the root cause of your problem and most importantly – help you keep it gone – so that by next Thanksgiving – we won’t even be having this conversation. 

Are local to Portsmouth, NH?

CLICK HERE to connect with one of our specialists—just in time to enjoy the Thanksgiving holiday to the fullest!

It’s also the perfect time to take advantage of our BLACK FRIDAY SALE! Get our lowest prices of the year with our Physical Therapy Specialists and Regenerative Shockwave Therapy. CLICK HERE to sign up today to get full access to these deals – packages are limited and available only while deals last!

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 request a copy of her free guide: 5 Simple and Easy Ways to Get Rid of Back Pain, CLICK HERE or call 603-380-7902

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

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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 fall 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 enjoy fall activities this 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. Here are a few ways to protect yourself:

  • Warm Up First: 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.
  • Choose an Ergonomic Rake: Look for 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.
  • Use Your Legs and Core: 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.
  • Take Regular Breaks: Raking for extended periods can tire out your muscles, making you more susceptible to injury. Set a timer for every 20-30 minutes and take a short break to stretch your back and shoulders.

2. 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:

  • Lift with Your Legs, Not Your Back: 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.
  • Use a Cart or Wagon: Many farms and pumpkin patches provide carts—take advantage of them! Use a cart to transport heavier pumpkins and prevent carrying strain.
  • Limit Carrying Distance: 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.
  • Pro Tip: This advice applies to picking up and carrying anything. Whether it be hay bales, fall decorations, or putting away summer furniture.

3. 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:

  • Stay Grounded: 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.
  • Mind Your Posture: 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.
  • Wear Supportive Footwear: If you know you’ll be walking and standing for prolonged periods – you’ll want to have good, supportive shoes. This will go along way in helping your spine and the rest of your joints absorb the load of your body as well as those pumpkins and apples

4. 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:

  • Take Stretch Breaks: If you’re spending a long day outdoors, 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.
  • Stay Hydrated: 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.

5. Cool Down After Fall 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.

  • Gentle Stretching: After raking, decorating, or any heavy lifting, spend five minutes stretching your back, legs, and shoulders. Simple stretches like extending our spine backwards or pulling your knees to your chest can help relieve tension.
  • Mind Your Posture When Resting: 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 Activities 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 aches.

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.

tendinitis and tendinosis

Six Tips for Managing Knee Pain without Medication

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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.

Avoiding Movement

How Fear Can Worsen Your Injury: The Hidden Dangers of Avoiding Movement

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Fear is a natural, protective response to injury.

But sometimes it can do more harm than good if you’re not careful. Reason being… When we experience pain or injury of any kind – while the pain can range from mild to excruciating – the real “pain” comes from not knowing what you just did. 

Was it anything serious? Will it go away on its own? What should I do?

All these questions compound the unknown which tends to manifest itself as some version of fear and trepidation. And the degree at which this occurs is highly variable among individuals. On one end of the spectrum – the fear of making an injury worse can lead to behaviors that hinder recovery. But on the opposite end – the fear of not doing enough and being cavalier about “no pain no gain” could also impede your recovery.

The good news is that with the right knowledge, tools, and team of experts – you can “train your nervous system” to interpret pain appropriately and avoid the hidden dangers of not moving enough. If fear is caused by the unknown of what’s happening when you feel pain or have been injured – then a better understanding of pain (what it is, what it’s telling you, and how it behaves) and how your body naturally heals from injury is going to help lessen that. I always say: “Movement is medicine – but knowledge is power”

So… as I’ve alluded to… one of the most common misconceptions about injury recovery is the need for prolonged rest.

When we get injured, our instinct is to “protect” the affected area, which typically translates to avoiding movement altogether. While this may seem a prudent strategy, it can actually delay your body’s natural healing process. 

Let me explain…

Yes, an initial resting period makes sense in some cases, especially after an acute injury where you’ve experienced some form of trauma to your tissues. But as soon as that initial inflammatory period ends – you’ve got to start moving. This is crucial for the proper healing of tissues that have been damaged from an injury. Plus – a lot of injuries don’t occur traumatically. They happen slowly over time. This type of pain requires a totally different approach to healing.

In either case – resting for too long and not moving enough can lead to all sorts of problems such as muscle atrophy, joint stiffness, and reduced overall function. Plus – you’re teaching your nervous system that it’s “safer” to not move – which can cause problematic adaptations over time if you’re not careful. In other words, you need movement, and even a little bit of pain to occur for proper recovery from an injury. But you’ve got to balance this. Too much too soon could re-injury you – while not doing enough will put your body and nervous system into “protective mode” – making it harder to incorporate necessary and healthy movement later on.

So how do you balance this process? How do you know if the pain you’re feeling during movement is good or bad?

Understanding how pain behaves is key. Generally speaking, pain during movement that doesn’t last is considered “safe”. We call this hurting versus harming. It’s generally ok to hurt, but never ok to harm. As your mind and body experience this phenomena together – you’re effectively coaching your nervous system to not react to the sensation of “hurting” in such a sensitive way. The more you move, and the more your nervous system realizes the painful feeling is not resulting in harm or more injury, the more that hurt sensation fades. Your nervous system no longer interprets it as pain. This is a normal and healthy response to pain when dealing with any injury – but especially those that are chronic and didn’t come on so suddenly.

The danger you run into when you never allow hurt to happen and avoid any amount of pain altogether – is that you encourage fear to run the show. Your nervous system never “learns” what good pain is vs bad pain – and it starts to get confused. Before you know it, any kind of sensation is perceived as pain (danger) by your nervous system – which only serves to fuel the fear of movement even more. It becomes a vicious cycle that is hard to break.

If you’re confused right now I don’t blame you.

This can be a nuanced and complicated concept to understand – and it’s why I don’t recommend going at it alone. Working with a movement expert who truly understands the process of healing and how your nervous system plays into all this will help take the guesswork out of all this and build confidence in this process.

Movement really is medicine and it’s a powerful one – when you’ve got the knowledge to use it properly.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To book a free discovery visit with one of our specialists CLICK HERE.

Headache sufferer

5 Signs your Headaches are coming from your Neck

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Headaches impact approximately 47% of the population and are one of the most common disorders of the nervous system. If you suffer from headaches regularly, then you already know how disruptive they can be on your work life, social life, daily activities, and just overall energy and well-being. 

But what makes headache management particularly challenging is how often they are misdiagnosed. The most common types of headache disorders are what’s known as primary headache disorders – and those include migraines, cluster headaches, and tension-type headaches. But you could also be suffering from a secondary headache disorder – which is caused by some other illness or physical issue. One of the most common forms of secondary headache is something called a “cervicogenic headache” – meaning it comes from your neck. They can be quite debilitating and are commonly confused with migraines – but there are some key signs to look for that make them different. 

Let’s look at 4 signs that might indicate your headache is coming from your neck:

1. Headaches worsen with certain neck movements

If you find that certain movements or positions of your neck exacerbate your headaches – it could be a sign that your headaches are coming from your neck. Sometimes it’s very specific movements that trigger a headache – such as tilting your head forward or backward – or turning it from side to side. But other times it’s less obvious and related to more prolonged postures. For example, I’ve had patients experience headaches from sitting at a bar for several hours and turning their head to a certain side to talk to their friend. Pay attention to whether certain neck movements or positions create discomfort in your neck that either precedes or worsens your headache. It could mean that your headache is coming from a source in your neck.

2. Your Neck is Stiff

Another telltale sign of neck-related headaches is limited mobility or range of motion of your cervical spine (neck). If you find yourself struggling to turn your head fully, or you experience pain and stiffness when attempting to do so, it could indicate an underlying issue in your neck that is causing your headache. A common saying in my office is “mobility before stability”. If the joints in your neck don’t move fully and freely, the structures around those joints (muscles and nerves) can become angry and irritated – and this could be the source of your headaches.

3. Tenderness in your neck muscles

If you routinely have sensitivity and tenderness in the muscles of your neck – it could indicate an underlying neck problem. If you notice that your headaches seem to get triggered whenever the tension or tenderness in your neck muscles worsens – then there’s a good chance your headaches are coming from your neck. The muscles of your neck can get tense and irritated for a number of reasons – most commonly because of poor posture or because they are being overused in some capacity. Since your neck muscles have direct and intricate attachments to the base of your skull – they can be a common cause of your headaches.

4. Location of your Pain

A headache that stems from the base of your skull and stays on one side of your head – often radiating into your temple or behind your eye – is a common sign that your headache is coming from your neck. If you tend to get associated shoulder or arm pain at the same time as your headache – it’s another indicator your headache could be cervicogenic. That’s because the nerves in your neck extend into these areas and are capable of radiating pain into these locations. If you suffer from chronic headaches, pay attention to where the pain is coming from or where it’s radiation. If it’s extending beyond your head – there’s a good chance your headaches are coming from your neck.

5. Massage and Chiropractic Manipulations Help.

If you find temporary relief from your headaches any time you get a massage or see a chiropractor, it’s almost certain your headaches are cervicogenic. While it’s great you’ve found pain relief – the problem with relying on these modalities is that they are completely “passive” – meaning – you don’t have an active role in the process of relieving your headaches. Passive modalities work great when paired with specialized, corrective exercises you can do on your own that are designed to prolong the effects of these treatments. But when passive treatments are used in isolation – the headache relief tends to be short-lived. The take home point here is that if you find treatments like massage and chiropractic treatment help – your headaches are almost certainly coming from your neck.

If you suffer from debilitating headaches and haven’t yet gotten your neck thoroughly checked out as a source – you should. Because when your headaches originate from a source in your neck, it’s entirely possible to learn how to treat it and manage it naturally and on your own. But you’ll need to work with a specialist who understands cervicogenic headaches as well as the associated mechanical joint components influencing them.

Are you local to Portsmouth, NH? CLICK HERE to speak with one of my specialists for free.

Want to lose weight in the New Year? Don’t let knee or back pain get in your way.

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If you google “Top 3 New Year’s Resolutions” – you’re sure to find “losing weight” as one of them. While I’m not a dietician or nutritionist, I know that the majority of weight loss has to do with what you eat. However, exercise plays a role too, and that I am an expert in. 

Exercise stimulates endorphins and makes you feel better all around. The better you feel, the easier it will be to stay motivated about your weight loss goal.

Exercise also helps you burn more calories – which certainly isn’t going to hurt your weight loss journey.

But if you’ve got unchecked knee or back pain, not only will you find it challenging to exercise, you are going to be more stressed about it. Stress increases cortisol which interferes with your ability to manage weight. And if you can’t exercise at all because of pain, that will make it even harder to manage stress, never mind your weight. You can see how this vicious cycle from unwanted knee and back pain could completely derail your New Year’s goals.

Here are four tips to help you not let knee or back pain get in the way of your weight loss in the New Year:

1. Mobility Before Stability

Your muscles can’t function at their best if you don’t have optimal joint mobility. In other words, you don’t want to strengthen around a joint that isn’t moving at its best, or you’ll encourage compensation. If your nagging back or knee pain is due to inadequate mobility, you’ll run into problems. You will be in more pain if you suddenly increase your exercise or activity level. We saw this happen at the beginning of the pandemic. People started walking and exercising more and we saw a huge influx of unexpected back and knee pain as a result. Their joints weren’t accustomed to moving so much and it highlighted the lack of mobility and compensations. Don’t let the same thing happen to you. Make sure all of your joints, including your spine, can move fully and freely without any pain before you begin a new exercise program.

2. Pace Yourself

It’s very tempting to go “all in” on your new exercise or weight loss goal… but remember… the tortoise (not the hare) won the race. It’s important to not beat yourself up if you’re not seeing immediate results. If you’ve been out of shape for a while and doing something completely new, expect to be sore. But if you’re limping around for days or experiencing sharp pain in your back or knee, there is a chance you overdid it or worse case injured yourself.

My general rule of thumb is to monitor your soreness on a scale of 1 – 10. I tell my clients to not let their pain go above a five when they are pushing themselves or returning to an exercise they haven’t tried in a while. If you find that your pain level goes above a 5, or persists at that level (or higher) for more than a day, there’s a chance you’re overdoing it and setting yourself up for an unwanted injury. When in doubt, listen to your body. And if you’re not sure what it’s saying – enlist the help of an expert.

3. Stay Hydrated

Most people don’t drink enough water during their regular day, never mind when they increase their activity level. Drinking lots of water has two great benefits: It will give you the extra hydration you need if you’re planning to be more active; and it will help you lose weight by curbing your appetite. Some additional benefits of staying hydrated include increased muscle strength and stamina, more lubrication in your joints, more supple skin, better cardiovascular function, and improved energy and mental alertness. One really easy tip to jumpstart your day is to begin with 10 oz of water first thing upon waking. And a good rule of thumb when you’re trying to stay adequately hydrated is to drink at least half your body weight (in ounces) of water every day.  

4. Get Assessed by a Mechanical Pain Expert

If you’ve got nagging back and knee pain, see a mechanical pain expert before you begin your new exercise routine. Your first thought might be to go see your medical doctor. However, it’s important to understand how different medical professionals assess different problems. Medical doctors are trained to screen your whole body and typically rely on imaging to make their diagnosis. This is a great approach if you’ve had an accident or trauma. Or if you are presenting with what could be a serious pathology. But for 80% of musculoskeletal pain – including knee and back pain – X-rays and MRI’s are overkill.  They put you at risk of being led down a path of unnecessary referrals, treatments, and procedures. They will definitely put you at risk of being told not to exercise at all.

A mechanical pain expert, on the other hand, is trained to assess your pain with movement tests – not imaging. This is going to reveal a much more realistic picture of what you can and can’t do. It will also reveal what movements will make you better or worse. This allows you to go into a new exercise routine with a more informed approach. Also, with a plan to exercise around your pain and make it better.

Is exercising and losing weight is part of your New Year plan? If so, I hope these tips help you go into 2023 with confidence. If you’ve got lingering or unwanted knee or back pain that’s not going away on its own – get it checked.

 

Are you local to Portsmouth, NH? – CLICK HERE to speak with one of my specialists. We will ask you about what’s been going on – and see if we would be a good fit to help!

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, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

work out

Why More People are Paying out of Pocket for Healthcare…even during an economic downturn

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More People are Paying out of Pocket for Healthcare…even during a recession

If you’ve ever had an injury or dealt with chronic pain, you’ve probably followed a pretty traditional course of action to address it that might have looked like this:

  • You went to your primary care doctor and they sent you to the lab for x rays, prescribed medication, or both.
  • You may have gotten a referral to a specialist or even a surgeon.
  • You went to that appointment and were either told that you needed surgery or that you needed to modify your physical activity and avoid certain activities in order to not exacerbate the problem.

Basically, you were thrust into the assembly line that has become “modern healthcare”.

But did you know that you could bypass all of this hassle – and get faster results – by going directly to a physical therapist?

Physical therapists are trained to diagnose your problem and provide a fully customized treatment option. One that doesn’t involve prescription medications or procedures.

In almost all states (including NH) you don’t even need a prescription to see a physical therapist.

The problem is that for many people, traditional physical therapy has not produced the results they are looking for.

Physical therapy DOES work. But what often doesn’t work is the model of care.

There have been many limitations insurance companies have placed on reimbursement over the years. Most traditional physical therapy clinics (those that take insurance) have been forced to see more patients. Just so they can pay the bills and keep the lights on!

Additionally, insurance companies and healthcare have essentially taken over your care.

They decide who you can see, what type of treatment you will get, and how many visits you are allowed to have.

These decisions are being made by someone who’s never even spoken to you, met you, or actually looked at you.

Because of this, “physical therapy” has gotten a bad reputation and a lot of people find that it’s a waste of time, or that it consists of just a bunch of exercises.

It’s not the physical therapist’s fault, it’s the insurance company’s fault.

The good news is that you’ve got options and alternatives when it comes to taking care of your back or knee pain.

You don’t want to be prescribed medication and you don’t want to deal with procedures like injections or surgery. Or you don’t want to go to traditional physical therapy and feel like you’re wasting your time. The answer is to go outside of your insurance and pay out of pocket.

This is known as going “out of network”.

More people are doing it because they are fed up with the traditional models. Models of healthcare and physical therapy that don’t give them the results they are looking for.

But isn’t that expensive? Not at all, and it really depends on what you value.

For me, and for most of the folks that we work with, it’s far more costly to live with chronic back pain. You have to miss out on activities you love, and end up with a surgery you never even wanted.

It’s also far more costly to spend years going to weekly chiropractic and massage therapy appointments. Just so that you can function and manage your pain.

When it comes to musculoskeletal problems, you NEED a physical therapist in your corner and as part of your healthcare team.

But it can’t be the traditional kind where all you get is cookie cutter treatment plans. Physical therapists who don’t contract with insurance companies are able to spend more time with you. Allowing them to create a truly customized plan of care.

We focus on getting to know you and your body. Not what paperwork needs to be filled out for your next healthcare insurance authorization.

Our clients like this model because they get long-term success instead of short-term pain relief. Our therapists like this model. They are free to use their brains and actually do what they were trained to do.

Everyone should have their own, personal physical therapist to call and come see anytime you need. Just like you would a chiropractor, dentist, doctor, or massage therapist.

The only way to do this, is to go outside your insurance. If you are curious about whether or not this model of physical therapy is right for you just give us a call!

It’s not for everyone, but more and more people are finding that it is.

Most of the folks we meet and work with say: “I wish I had found you first”.

If this is something you are interested in – or are seeking more information on – CLICK HERE to speak to one of my specialists.

They will give you all the information you need to make the BEST decision for YOUR health. Whether that’s working with us or not!

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, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

Avoid Pills. Use Movement as Medicine Instead

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Avoid Pills. Use Movement as Medicine Instead

In the 1990’s, it started becoming widely accepted to prescribe opioids for people recovering from surgery or injury. As well as those suffering with moderate-to-severe musculoskeletal pain (such as back pain and osteoarthritis). Although effective for managing pain, we would soon find out how highly addictive these drugs are. Statistics show that one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. And once addicted, it’s very hard to stop. Keep reading to lear why movement as medicine is a better option.

The Centers for Disease Control and Prevention (CDC) found in their 2018 Annual Survey Report of Drug-Related Risks and Outcomes that in 2016, more than 11.5 million Americans reported misusing prescription opioids. And despite efforts to curb these statistics, this number started to creep up again during the pandemic.

In response, the medical community established more strict control around the prescription of opioids. Many are avoiding prescribing them all together. For patients with severe back pain and arthritis, for example, injections and minor procedures have become far more common and recommended.

While this approach prevents you from becoming addicted to opioids, there are still inherent risks any time you have an injection or undergo a procedure.

So what’s the alternative?

Prescriptive movement strategies are the alternative. Specialized, custom-fit “exercises” that are designed to have a very specific (and noticeable) effect on your pain.

But what’s the difference between generalized exercises that make you feel good vs prescriptive movements that also make you feel good?

Well, the distinguishing factor is both in:

1) how your pain responds to the movement while you’re doing it, and more importantly

2) how it behaves afterward. Lots of exercises feel good while doing them, but not all exercises give you the long-lasting effect you’re truly looking for.

For example, let’s say you’ve got back pain. Perhaps stretching your back a certain way makes you feel good and temporarily eases your pain. But an hour or two later, or the moment you perform an activity that typically aggravates your back, your pain comes right back. The stretch makes you feel better, but it doesn’t do a good enough job to make you stay better.

Over time, you might find that your back pain comes and goes often. Although this stretch always helps, nothing really takes away your problem completely. Instead, you get stuck in that vicious cycle of stopping all activities every time you hurt your back. Or worse – start avoiding certain activities altogether for fear of hurting your back. This is no way to live and it’s not an example of a good prescriptive movement strategy.

So what would a prescriptive movement as medicine strategy look like?

Let’s take the same example above. But this time – you find that a particular stretch not only makes your back pain go away in the moment, but it stays gone the more you do it. Whenever your back pain returns, you can reliably use this stretch to take your back pain away every time. This is an example of a prescriptive movement strategy. You know exactly what to do, how often to do it, when to do it. And it works without fail every time. Plus, once you know what your prescriptive movement is, you can use it to prevent pain as well.

The good news is that 70-80% of all musculoskeletal pain responds to a prescriptive movement strategy. It works in all joints and muscles. You just have to work with someone who knows how to help you find it and then use it over the course of time. I can’t tell you how often I meet people who have the right movement, they just weren’t applying it correctly to get the long-term relief they were looking for.

Too good to be true?

It’s not – I promise. The problem is there’s a lot of mis-information out there and not every health care or fitness professional is trained in discovering the prescriptive movement that you need – or teaching you how to use it properly. The second problem – to be frank – is that hospitals make a lot of money from procedures and surgeries. There’s no real incentive for them to support conservative, natural treatments that you can do on your own at home.

With procedures and surgery, the results are faster, which makes for happier patients (in the short term). But studies show that 2-3 years out from surgery your results are no better or worse than if you were properly prescribed movement as your treatment. And after 10 years, those who’ve managed to avoid surgery for the same problem, actually have much better outcomes than those who went under the knife.

The greatest benefit of taking the time to go slow at first, and find a prescriptive movement strategy that works, is that you’ll have this movement “medicine” at your disposal at all times. It’s always in your “medicine cabinet” and you never need a prescription or pharmacy to refill it.

Hopefully I’ve got you thinking. And encouraged you, at the very least, to explore whether or not movement really can be your medicine. If you’re already tried and failed at this, it’s quite possible you just didn’t have the right approach.

Consider talking to someone from my team if you’re serious about getting help.

We’re trained to help you find YOUR prescriptive movement as medicine strategy and are up to date on the latest research.

CLICK HERE to request a Free Discovery Call with my team to see if you’re a good fit for what we do.

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 guide to back pain CLICK HERE or to get in touch, email her at [email protected].

When You Can’t Feel Your Abs

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I’ve been a physical therapist for 20 years, a Pilates instructor for 11, and have been specializing in back pain for the past 10 years of my career. When it comes to core strength and preventing back pain, I am an expert in my field. Yet for some reason this morning, during my Pilates workout, I just couldn’t feel my abs. I teach people how to do this every single day yet this morning, I couldn’t seem to access my own.

What was happening?

And more importantly – if it can happen to someone like me – it can certainly happen to someone with less training than I have. I started to think about all the reasons this could be happening to me. Had I gotten enough sleep? What had I eaten the day before? Could it be stress?

And then it hit me.

I had just come back from a 2-day course where I’d been sitting far more than usual. I sat for 8 hours straight. Two days in a row. Not to mention all the very cramped sitting I did on the plane to and from this course. When one of my clients is about to have a few days like this, this is what I recommend. Get up from your chair and stretch backwards as frequently as possible every few hours.

But guess what – I didn’t follow any of my own advice. The result? A stiff back and sleepy abs upon my return.

Our bodies are highly intelligent and have every capacity to heal themselves when given the right environment. Conversely, when in the wrong environment, our bodies will also do what it takes to naturally protect from harm and injury. In my case, I came home from this course with a stiff lower back.

Back stiffness is the first sign that your back is not happy. This means your chances of tweaking it or exacerbating an old back injury are higher. When any joint is stiff and not moving well the muscles surrounding that joint will become naturally inhibited or weakened. This occurs on purpose as a protection mechanism. Your body doesn’t want a fully contracted muscle compressing an unhappy joint. In the case of your lower back, the muscles that can get inhibited when your back is not happy include your abdominals as well as back muscles.

So what can you do when you feel less core strength?

The good news is I’ve already helped you with step one: awareness. Inhibited muscles are not the same as weak muscles. In my case, I do have strong abdominals. My weekly routine consists of a regular Pilates practice, lifting weights, and I perform activities like hiking and running that engage my core. Yet despite all this, my abs were simply not having it this particular morning. They were not set up for a successful workout.

The combination of my stiff back and having sat for several days just meant that I needed to do something different to prepare my lower back and abdominals for this workout – so that I wouldn’t injure myself. My sleepy abs and stiff back were, in effect, trying to tell me just that.

All I needed to do was have the awareness this was happening so I could take appropriate action.

It’s no different than when you go on vacation and you get off your routine by eating more than usual. You might return a bit bloated and not feeling your best self. This kind of feeling we are accustomed to. And might respond by getting a bit strict with our diets until feeling back on track. Our joints can react similarly to a change in routine – we’re just not as accustomed to the signs and symptoms that let us know. But once you are – you can easily manage this and avoid injury. Had I pushed through my Pilates routine as normal this morning despite sensing that my back and abdominal function was off – there’s a good chance I’d be sitting here writing to you with full on back pain instead of just some lingering stiffness.

If you’re reading this, and you’re over the age of 40, odds are pretty good that you’ve experienced back pain at some point in your life. The odds are also pretty good that you’ve experienced back pain more than once.

If this is a recurring pattern for you, your abdominals and deep core may not be functioning at their best.

You could be caught in a vicious cycle of trying to improve your core strength only to keep hurting your back.

The missing solution for you might be that nobody has fully examined your back in a way to ensure that it’s moving fully and freely like it should. Once your back moves well, you can usually start to strengthen your abdominals without a problem.

If you’re confused right now – I don’t blame you.

The take home point here is that if you keep experiencing weakness in a particular area despite trying to strengthen it consistently, it’s possible you could have a problem in your joints that is keeping your muscles from fully activating like they should.

Talk to one of my specialists about it.

Someone from my client success team will call you right away and see if you are a good fit for what we do. At the end of the day – we’re here to help.

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 guide to back pain CLICK HERE or to get in touch, email her at [email protected].

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Shoulder Still Hurting After Your Covid-19 Booster?

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Shoulder pain is quite normal after any vaccine.

But prolonged shoulder pain isn’t.

Shoulder injuries related to vaccine administration (otherwise known as “SIRVA”) is a rare, but possible occurrence when you get a vaccine or booster shot. Shoulder injections should enter the deltoid muscle. But SIRVA occurs when a healthcare professional administers the vaccine too high, or too deep into your shoulder.

When not properly administered, your next booster shot could graze your bone or nerve, or even puncture your bursa (a fluid-filled sac that protects your shoulder tendons).

Pain from SIRVA can be really difficult to distinguish from the normal pain that occurs after a shot in your arm. But it’s critical you know what to look for. Because if left untreated, SIRVA can cause prolonged problems in your shoulder over time.

I’ve seen folks end up with entirely preventable rotator cuff tears, bursitis, and tendonitis – all because someone didn’t take their complaints of shoulder pain after getting a Covid shot in their arm seriously enough.

Normal shoulder pain after a Covid vaccine or booster shot:

Mild skin sensitivity and localized shoulder pain is quite normal after a Covid vaccine or booster shot. Some people experience what is now known as “Covid arm” – a mild rash and skin sensitivity that can occur anywhere from a few days to even a week after receiving your shot. You’ll experience skin sensitivity and/or swelling that might look similar to cellulitis.

While annoying, Covid arm is not considered dangerous or threatening.

The symptoms will typically go away after a week or two and in the meantime, talk to your doctor or pharmacist about over the counter or prescription remedies that can address the symptoms of itchiness or swelling.

Localized shoulder pain at the site of your vaccine or booster shot is also normal. The pain you feel is from the mild trauma caused by the needle being inserted into the soft tissue (muscle) of your arm. It often feels like a bruise, and you may experience a little bit of swelling. It will typically go away after 2-3 days. Even though your arm can be quite sore, the important distinction here is that you’ll still have full, normal function of your arm. In other words, despite the soreness, you can still move your arm freely up and down if you had to without restriction.

Your arm soreness will go away with time, but gently massaging the area of pain, and even some easy movement or exercise can help the soreness go away faster.

Abnormal shoulder pain after a Covid vaccine or booster shot:

The symptoms of SIRVA are different, and typically more severe than what I’ve just described above. If not addressed, some of these symptoms could lead to long lasting shoulder problems or compensatory problems elsewhere.

As I’ve already alluded to, one of the main distinctions between “normal” shoulder pain after a vaccination shot and SIRVA is how well your arm functions. If the needle was accidentally inserted into your joint capsule, for example, you will notice limited mobility and possibly limited strength. If unaddressed, symptoms like this can manifest into more serious shoulder problems down the line such as adhesive capsulitis or frozen shoulder.

If the needle was inserted too high or too deeply, and beyond your muscular layer, it could have injured your bursa. This could cause it to become inflamed, turning into shoulder bursitis. Your mobility may or may not be impacted when this happens, but you’ll notice prolonged shoulder pain that doesn’t subside after 2-3 days like it should. Bursitis is actually a really simple injury to treat. But with SIRVA, it’s often dismissed as normal pain after the shot.

When ignored – shoulder bursitis can lead to compensatory movements due to pain – and cause problems later on in places like your neck, shoulder blade or even elbow.

One last common problem we see as a result of SIRVA is rotator cuff tendonitis. Much like bursitis, you may have normal motion in your shoulder, but what you’ll notice with this is again, the pain will persist longer than it should. But unlike bursitis, you’ll also have pain and weakness when you exert force through that tendon – particularly with overhead movements or lifting something with an outstretched arm.

This is also not a complicated injury to rehabilitate, but if not addressed, could turn into a more serious problem such as a rotator cuff tear or chronic tendonosis – conditions that are more difficult to treat.

To recap – your shoulder will hurt after getting a vaccine.

It’s normal. And you may even experience Covid arm. But these symptoms should go away and not remain.

And you should still have normal function of your shoulder, despite the pain.

If you have shoulder pain that persists, and especially if you’re noticing limited mobility, it’s something worth getting checked out. The last thing you want is for these symptoms to go on longer than needed, or turn into compensatory, more complicated problems.

The good news is that even with SIRVA, your shoulder pain can be successfully treated naturally, and without medications or procedures. Don’t let a healthcare professional brush off your concerns and blame your prolonged shoulder pain on your booster shot.

Talk to a musculoskeletal expert who understands this sort of thing and get some help!

CLICK HERE to request a Free Discovery Call with our Client Success Team.

They’ll let you know if we can help – and if you’re a good fit for our services – get you scheduled as soon as possible.

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 one of her guide to neck and shoulder pain CLICK HERE or to get in touch, email her at [email protected].