physical therapists Archives - CJ Physical Therapy & Pilates

When you’ve got persistent, nagging knee pain, it can significantly impact your quality of life, and put a real damper on your summer. The good news is there are many things you can do naturally and on your own to help keep your knees healthy, especially with the increased activity that often comes with summer.

Here are six of my top tips to ensure your knees stay strong and pain-free during your summer adventures:

1. Strengthen Your Hips and Core

Your hips and core provide essential support and stability to your entire body, but especially your lower limbs and knees. Strengthening these important muscle groups is key for not only relieving knee pain – but preventing it as well. Weakness or imbalance in your hips and core can lead to poor alignment and compensatory stress on your knees during movements like walking, running, or squatting. So when you focus on strengthening your hips and core – you’ll improve your overall biomechanics – and reduce the wear and tear by minimizing the load placed through your knees during summer activities.

2. Get (and Stay) Mobile

One saying you’ll hear me repeat over and over is: “mobility before stability.” When you’ve got stiffness in your joints, the surrounding muscles will try to compensate. Muscles don’t work as well when the joint they are in charge of moving doesn’t have full and free mobility. I see this a lot in people suffering from knee pain.

Good and optimized joint mobility will enhance your body’s ability to move efficiently and with proper body mechanics, thus, reducing the strain on your knees. By increasing (and maintaining) your flexibility and range of motion, your body will move more freely and distribute forces more evenly throughout your joints and muscles (including your knees).

3. Don’t Sit so Much

Knee pain can come directly from your knee, but also from your spine (even when you don’t have any back pain). Interrupting your sitting throughout the day (I recommend once every 30 min) addresses both potential causes. For knees in particular, prolonged periods of sitting can cause stiffness and lead to poor blood circulation in and around your knee joint. That’s why sometimes after sitting for a while, you can experience sharp stabbing pain in your knee when you go to move.

Sitting for extended periods can also lead to tightness in the hip flexors and hamstrings, which can negatively impact knee alignment and function. When you take regular breaks to stand, stretch, and move around – you relieve knee pressure, maintain good joint mobility, and prevent muscle imbalances that (when left unaddressed) can gradually creep up and ruin your summer.

4. Keep Moving

Regular movement and exercise helps to stimulate blood flow. If you’ve got inflammation in your knees causing pain, good blood flow helps to actually reduce inflammation by delivering essential nutrients and oxygen while also removing waste products. If your knees are on the arthritic side, engaging in low-impact exercises like walking, swimming, cycling, or Pilates can help build strength and endurance around your knees without putting excessive stress on your joints.

Regular movement also helps lubricate your knee joints, which can reduce friction and discomfort during summer activities. Perhaps the biggest benefit of regular exercise and movement is the release of endorphins, which are your body’s natural painkillers that can help alleviate discomfort in any joint, not just your knees.

5. Wear Sensible Footwear

The right (or wrong) footwear can greatly impact how your knees feel when walking, running, or standing. Proper footwear provides the necessary support and cushioning to reduce knee strain. And depending on the mechanics of your feet and ankles, the right footwear can help improve overall alignment and stability.

In the summer, people love wearing sandals and flip flops. However, if you’re prone to knee problems, you may want to reconsider this choice or only wear them for short periods when you won’t be standing or walking for long. Flip flops, in particular, offer little support and can exacerbate knee pain. By choosing shoes that prioritize comfort, support, and proper alignment, you can effectively reduce knee pain and enhance overall joint health for a happy and active summer.

6. Work on Your Balance

Good balance is crucial for stability, control during movement, and reducing fall risk, especially in summer activities like paddleboarding, pickleball, and walking on the beach. When you work on your balance, it helps reduce knee strain by ensuring your postural muscles, feet, and ankles work together to distribute forces evenly. Without this coordination, your knees overcompensate and suffer. When you make a conscious effort to improve and maintain balance – it will help to decrease the stress on your knees by getting other joints and muscle groups to “join the party.”

If you’ve been suffering from knee pain for a while and you’re worried about it ruining your summer – get started on any of these six tips and see if they help. Now, if knee pain is getting in the way of you being able to incorporate any of these tips, then it’s time to consider expert help and speak with a physical therapy specialist.

The right therapist will help you identify the root cause of your knee pain and come up with a treatment plan that not only gets rid of your knee pain, but teaches you how to keep it gone – naturally and on your own.

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 to download her Free Report on Knee Pain – CLICK HERE.

I recently polled my readers regarding their most important concerns when it comes to their musculoskeletal health. In other words, what questions were they desperately seeking answers for related to back, neck, knee, hip, shoulder, or ankle pain?

Here is a great question I received from John:

“I’m getting Physical Therapy for lower back pain and sciatica that is said to be from my piriformis. My PT treatment has consisted of various exercises and some massage. Eight sessions in and no change at all. I’m still having pain when sitting or walking a distance. What now? Do I need an Ultrasound or MRI to see if there is any damage or tear to my piriformis?”

First, John, I’m so sorry to hear you’re still having pain and not seeing any change after a good amount of physical therapy. When it comes to back pain and sciatica, it’s critical that you receive a thorough mechanical and movement examination by your PT before any treatment begins. This should involve repeated testing and retesting of movement and range of motion to determine:

1) where your pain is coming from and

2) what movement patterns trigger and relieve your symptoms

Without this first critical step, you risk missing the root cause of your pain and treating just symptoms. This type of testing is also essential to determine if physical therapy can even resolve your problem. If your physical therapist simply read the prescription from your doctor and dove into generalized treatment protocols – there’s your first problem right there – and it could explain why after 8 sessions you’re seeing no change in your condition.

In your case, it sounds like the massage is intended to treat your symptoms – perhaps your tight, tender piriformis that is believed to be causing your back pain and sciatica. This is perfectly appropriate, however, it’s important to incorporate targeted, therapeutic movement to make the most of what your manual therapy (massage) just did.

In other words, movement is the real “medicine”. Manual therapy is designed to enhance blood flow to and prepare your soft tissue (muscles and ligaments) to be better equipped to tolerate and perform the movement/exercise that is going to have a long-lasting effect.

If the massage and exercise are not done in a specific and targeted way – they aren’t going to have their intended effect. It’s possible this could be happening to you. If you’re not totally clear on what your exercise is for and what the intended effect is – chances are high your exercises haven’t been prescribed to you properly. If you suspect this to be the case, it’s worth your while to try for a different, perhaps more specialized physical therapist before you go jumping into diagnostic tests that could lead you down a rabbit hole of unnecessary procedures or surgery.

Now, let’s assume for a moment that you did receive targeted and high-quality physical therapy treatment and it’s simply not working. This does happen from time to time – but it should only be approximately 20% of the time for the majority of musculoskeletal problems such as back pain and sciatica. And in my opinion, it should be caught well before 8 sessions. In my experience, it takes about 5-6 (quality) PT sessions to figure out if a problem can be resolved with movement and natural means. If not, then a referral to another specialty is necessary.

Are you there yet? I can’t be certain.

But to answer your question about whether or not you need an MRI or Ultrasound…

If quality, targeted physical therapy has been truly exhausted then yes – either of these diagnostic tests would be the next step in providing valuable information as to what more might be going on.

Ultrasound is a non-invasive diagnostic tool designed to visualize both organs and soft tissue. It could be a good option for examining your piriformis if you are certain that is where your problem is coming from. But piriformis syndrome only accounts for about 30% of all sciatica cases. And typically a tear in your piriformis will not cause pain to radiate down your leg. Most of the time, sciatica is caused by nerve impingement occuring in your lumbar spine (low back). If conservative treatment, like physical therapy, has been fully explored – an MRI could be helpful to see how badly a nerve is being pinched or irritated and whether or not a procedure or surgery is warranted. But in general, the research has shown time and time again that spine surgery is really only successful when you’ve got serious and progressive neurological deficits and symptoms.

In other words, you might have symptoms like foot drop, and your leg is getting weaker and numb by the minute. Otherwise, physical therapy – although it may be slower to work – has equal if not better results compared to surgery and it’s a lot safer.

The caveat, however, is you need to find a good physical therapist.

I hope this helps answer your question. Most importantly – don’t give up hope!

For the next few months I’ll be answering questions like these each week in my articles. If you’ve got your own questions regarding musculoskeletal aches or pains that you want answers for, reach out via the information below.

Local to Portsmouth and feeling frustrated with your current physical therapy treatment just like John?

Reach out – we’d be happy to provide a second opinion. CLICK HERE to request a Free Discovery call with one of my specialists.

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].

Tag Archive for: physical therapists

6 Tips for Healthy and Mobile Knees this Summer