Tag Archive for: physical therapy

Why Stretching Isn’t Solving Your Tight Hips

May 3, 2025/in Chronic Pain, Movement/by Carrie Jose

If your hips always feel tight – whether during workouts, long walks, or just sitting at your desk – it can be incredibly frustrating. Not only is it uncomfortable, but tight hips often contribute to nagging lower back pain. And what’s even more confusing? No matter how much stretching you do, the tightness keeps coming back.

For me – that’s typically a clue that the problem isn’t what you think it is.

Muscles can feel tight for many different reasons – and not all of them have to do with flexibility. While some muscles truly are short and need to be lengthened – others feel tight because they’re overworked, weak, or compensating for something else. In those cases – stretching alone won’t solve the issue – and might even make things worse.

Let’s break this down…

Take your psoas muscle, for example. It’s one of your deep hip flexors and also plays a key role in spinal and pelvic stability. If your core and glutes (also spinal and pelvic stabilizers) aren’t doing their jobs – your psoas will kick in to help. That overcompensation can lead to it feeling chronically tight – even though it’s not technically “shortened”. So while the inclination will be to stretch your psoas – you’re actually putting an unintended strain on an already tired and stressed muscle.

While stretching might give you a temporary break in this instance – it won’t address the real problem. You need to strengthen your deep abdominals, your core stability, and your glutes. When all of these systems kick in collectively, your psoas can finally relax – and your chronic tightness will resolve on its own.

But there’s one more thing most people don’t even think of – and it’s that the tightness in your hip flexors could also be a symptom of a mechanical problem – not a muscular one.

Mechanical pain refers to pain (or tension) that’s caused by poor movement patterns or joint dysfunction, not necessarily tissue damage, compensation, or tightness. If the way your hips, pelvis, or lower back are moving is off – even slightly – your body will compensate. Over time, this leads to overuse of certain muscles – like your psoas, for example – which then feel constantly tight or strained. Unless the underlying movement problem is corrected, you’ll keep chasing symptoms instead of fixing the root cause by constantly stretching.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas isn’t the only culprit. Your piriformis and TFL (tensor fascia latae) can become victims of these patterns as well. In addition to your psoas muscle – your piriformis and/or TFL loves to pitch in and compensate for weak gluteal and core muscles as well. An overworked piriformis leads to difficulty sitting cross-legged – and a tight TFL can be painful and lead to IT band problems. You can stretch all you want – but if you don’t address the underlying cause and give these muscles a chance to relax – your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of the story?

If your hips feel chronically tight – and stretching all the time isn’t making a lasting difference – it’s time to consider a different approach. Most people don’t think to strengthen a muscle that feels tight – but it might be exactly what your body needs. When it comes to your hips, the areas to assess are your deep abdominals and your glutes. Often, there’s an underlying weakness or movement dysfunction you just can’t see on your own. And if your muscle tightness stems from a mechanical issue – like poor joint alignment or faulty movement patterns – no amount of stretching or strengthening will fully work until that’s addressed.

A trained mechanical pain expert can help you identify whether it’s a strength problem, a movement problem, or a combination of both – so you can finally get lasting relief.

Feel free to reach out to our mechanical pain specialists if you’re local and looking for help 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.

When exercise hurts your back instead of helps

Six Ways to Help Manage Knee Arthritis and Stay Active

March 11, 2025/in Knee Pain/by Carrie Jose

Knee arthritis is one of the most common forms of osteoarthritis, affecting more than 80% of cases and impacting at least 19% of Americans over the age of 45.

For many, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing their favorite activities. Sometimes it’s due to the limiting belief that once you have arthritis, you have “bad knees” for life. Other times it’s because you’ve been told you have “bone on bone” in your knee and that you should scale back on activity so you don’t make it worse.

This line of thinking is flawed and often leads to unnecessary injections, procedures, and surgery. Because being active is one of the best things you can do to manage your arthritis and protect your knees.

But what if movement and activity hurt?

Here are six ways to help manage arthritis in your knees so you can stay active and keep doing the things you love:

1. Strengthen Your Hips and Core

When you have poor control of your hip and core muscles, you get more stress through your knee joint. The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone (femur) connects your knee and your pelvis, and your core strength controls your pelvis. If your pelvis isn’t stable, your femur is going to have a difficult time staying in alignment, which will ultimately have an impact on your knee joint. If you’ve got arthritis in your knees – it’s critical you minimize any added stress to your knee joints. Strengthening your core and having good hip strength will help prevent and minimize the symptoms of arthritis – keeping you active for longer.

2. Keep Your Knees Mobile

Mobility before stability is my mantra. And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability, and there are those whose major function is mobility. Your knee needs to be mobile. Its major purpose is to bend all the way so you can squat and pick things up, and it needs to straighten all the way to give you stability when you need it. When either of these motions is lacking, your ligaments and surrounding muscles will suffer, adding more wear and tear to your joint, which can aggravate arthritis symptoms. When folks are told they have arthritis – a lot of folks just “accept” that their knees are stiff. But the truth is that even a 10% improvement in your knee mobility can lead to significant functional gains, help you better manage arthritic knee pain, and avoid major interventions.

3. Don’t Stop Your Activities

When people find out they have arthritis – and especially if they’ve been told it’s “bone on bone” – they often think that slowing down or stopping activity will help protect their knees. This couldn’t be farther from the truth. Study after study shows that severe joint pain among adults with arthritis is worse with inactivity. When you remain active, you keep blood flowing, your knee joints mobile, and your muscles strong. These are very important factors in managing your arthritis. Plus – sometimes the knee pain you feel when you’re doing certain activities has nothing to do with your arthritis. Statistics show that only 15% of patients with evidence of knee osteoarthritis on X-ray even had symptoms. That means that the other 85% are walking, biking, and running around enjoying their favorite activities – despite what their X-ray says. The point here is to keep doing your activities – it’s one of the best ways to prevent arthritis from advancing and protect your knee joints as you age. If you’re really struggling with this – it’s time to talk to a knee expert who can help you.

4. Optimize Your Footwear and Walking Mechanics

Many people don’t realize how much their feet impact their knees. If you’re wearing unsupportive shoes or walking with poor mechanics – your knee joints will absorb more stress than they should. Over time, this increased strain can exacerbate arthritis symptoms. Consider wearing supportive shoes that align your feet properly and provide adequate cushioning. Walking is a really good activity for your knees and arthritis. So if you’re experiencing frequent knee discomfort while walking, a professional gait assessment can help identify areas of weakness or imbalance that might be contributing to your pain as well as help you find the perfect pair of footwear.

5. Opt for Natural, Joint-Friendly Pain Relief

Your knees work hard every day. And if you have arthritis – finding relief without relying on medications or invasive treatments/injections can be a game-changer and minimize any downtime. There are plenty of natural pain relief strategies that will help minimize inflammation and keep you moving comfortably. Heat therapy and corrective stretching techniques are great for reducing stiffness by keeping blood flowing and muscles relaxed and flexible. Similarly massage and foam rolling can improve circulation and ease muscle tension around your knee joint. Regenerative treatments like shockwave therapy, EMTT, and dry needling are becoming popular alternatives to cortisone shots – as they work with your body’s own mechanisms to stimulate healing versus causing joint damage over time. By integrating natural pain relief methods into your routine, you can better manage knee arthritis and stay active without unnecessary reliance on medications or invasive procedures.

6. Manage Your Inflammation with Diet and Hydration

Chronic inflammation worsens arthritis symptoms, but the right diet can help. Anti-inflammatory foods like fatty fish, leafy greens, berries, and turmeric support joint health, while omega-3s from fish oil reduce inflammation at a cellular level. Collagen powder and glucosamine-chondroitin can support cartilage health and joint lubrication. Hydration is also key. Water keeps joints cushioned and prevents excess friction. Simple dietary changes, paired with the right supplements, can make a significant difference in managing knee arthritis.

Final Thoughts

Even if you’ve been told you have “bone on bone” or advanced arthritis, you can still improve your knee health. The best thing you can do for your knees is to keep moving. And if pain is getting in the way – I hope these strategies help you manage your symptoms naturally – so you can avoid resorting to medications, injections, or surgery.

Top Causes of Knee Pain and How to Get Lasting, Natural Relief

March 4, 2025/in Knee Pain/by Carrie Jose

Knee pain affects millions of people worldwide, often interfering with daily activities such as walking, squatting, climbing stairs, and even getting in and out of the car.

It is one of the most common musculoskeletal complaints, second only to back pain. Whether your knee pain started suddenly or has worsened over time – you might be wondering – what’s really causing it? And can you get rid of it naturally?

The good news is that, in most cases, yes. Many common causes of knee pain can be addressed without medications, injections, or surgery. Here are some of the top reasons behind knee pain and what you can do to find lasting, natural relief that doesn’t involve medication, injections, procedures, or surgery:

1. Patellofemoral Pain Syndrome (Runner’s Knee)

Also known as “runner’s knee,” patellofemoral pain syndrome (PFS) is characterized by pain in the front of the knee, usually just below or behind the kneecap. This condition is often caused by improper movement patterns and muscle imbalances that place excessive pressure on your kneecap, leading to inflammation and discomfort.

To alleviate PFS, it’s important to avoid excessive kneeling, squatting, or repetitive knee bending until the pain subsides. For long-term relief, focus on strengthening the muscles surrounding your knee, particularly the hips and thighs, to improve stability and reduce stress on your kneecap. Corrective exercises that promote proper kneecap tracking, such as step-ups and lateral band walks, can help to further optimize knee function and prevent future flare-ups.

2. Iliotibial Band Syndrome (ITBS)

ITBS causes pain on the outer side of the knee and is commonly seen in runners and cyclists. The iliotibial (IT) band is a thick band of connective tissue running from the hip to the knee, and when it becomes tight or inflamed, it can lead to irritation and pain.

While many people resort to foam rolling for relief, this only provides temporary symptom management. To address ITBS at its root, focus on strengthening the glutes and core, as weak glutes often lead to overcompensation and excessive strain on the IT band. Correcting pelvic imbalances and optimizing hip mobility will also be key for long-term relief. Additionally, taking a temporary break from any aggravating activities will allow the inflammation to subside and the tissues to heal properly, provided you’re taking an active approach to tissue healing versus rest only.

3. Tendinitis (Jumper’s Knee)

Tendinitis occurs when the patellar tendon, which connects the kneecap to the shinbone, becomes inflamed. This condition is common in athletes and individuals who engage in frequent jumping or repetitive knee movements.

A common treatment for tendinitis is cortisone injections, but these only provide temporary relief and may contribute to further tissue damage over time. Instead, consider regenerative treatments like Shockwave Therapy, which naturally enhances your body’s ability to reduce inflammation and accelerate tendon healing. Once inflammation is managed, strengthening the hamstrings, glutes, and calf muscles will provide better knee support and reduce tendon strain. Incorporating eccentric exercises, such as slow step-downs, can also help build tendon resilience and prevent future injuries.

4. Osteoarthritis

Osteoarthritis (OA) is the gradual degeneration of cartilage in the knee joint. While it is a natural part of aging, experiencing constant pain and limited mobility does not have to be. Many people believe that knee arthritis inevitably leads to surgery, but the truth is that optimizing movement and reducing inflammation can be powerful tools in managing OA long-term, even with “bone on bone” OA.

Rather than relying on cortisone injections and pain medication, consider alternative treatments such as Regenerative Therapy (specifically EMTT) to target inflammation deep at the cellular level. From there, implementing corrective exercises that strengthen the muscles surrounding the knee – particularly your quadriceps, hamstrings, and glutes – can reduce joint stress and help prevent inflammation from returning. Since inflammation is the primary driver of pain in OA, addressing it naturally through movement and strength training can help you avoid major surgery while still finding lasting relief.

5. Meniscus Tears

The meniscus is a piece of cartilage that cushions the knee joint. Over time, wear and tear can lead to meniscus tears – which cause pain, stiffness, and occasional knee locking. Many people assume that surgery is the only solution, but research has shown that placebo surgery can be just as effective as actual meniscus surgery, suggesting that natural recovery is possible.

Managing a meniscus tear naturally involves first addressing the inflammation caused by the tear. As previously mentioned, EMTT and Shockwave Therapy (especially when combined) can be particularly effective in reducing pain and inflammation, often providing immediate relief. Beyond that, focusing on proper knee mechanics is essential. In many cases, the issue isn’t the tear itself, but rather a lack of mobility and movement in the knee joint that continues to aggravate it. A mechanical knee pain specialist can help identify and correct these dysfunctions. Once inflammation is controlled and knee mechanics are optimized, strengthening and conditioning the surrounding muscles can provide long-term relief without the need for injections or surgery.

Finding Long-Term Relief Naturally

For most cases of knee pain, the key to lasting relief is movement – not rest, avoidance, injections, or surgery. Whether your pain is caused by an overuse injury, muscle imbalance, or arthritis – addressing the root cause with targeted exercises and mobility work is essential. Reducing inflammation naturally is also crucial for long-term joint health. If you’re struggling to determine the root cause of your knee pain or finding the right treatment approach – consider working with a mechanical knee pain specialist who can guide you toward the best non-invasive, long-term solutions.

Why Surgery should be your Last Resort for Knee Pain

February 26, 2025/in Knee Pain/by Carrie Jose

Arthroscopic knee surgery is one of the most common surgeries performed – despite research telling us that it’s not nearly as effective as most people are led to believe. Furthermore, the science tells us that people who do undergo arthroscopic knee surgery are more likely to have knee arthritis that advances rapidly – resulting in a total knee replacement that quite possibly could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

Well… it is until it isn’t.

The big problem is that arthroscopic knee surgery is actually not necessary for most cases of knee pain. If there is a complication – which exists even with “minimally invasive” procedures – you could end up being worse off than when you went in. Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70-80% of all knee pain cases.

An early research study from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment.

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery at a higher rate than ever?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain beforehand. If you’ve gotten physical therapy and it wasn’t effective, people are led to believe that the physical therapy “didn’t work”. But more often than not, you just haven’t found the right physical therapist yet – or seen a physical therapy specialist who is an expert in mechanical knee pain.

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee.

Knee pain can come from your ankle, hip, or back. One study showed that 25% of the time – knee pain is caused by a source in your spine – even when you don’t have any back pain. MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee. For example, in a study by Guermazi et al from 2012, they performed MRI’s on 504 people with pain-free knees. They found that 72% of these folks had bone osteophytes – indicating arthritis. And 25% of them had meniscus tears. So it’s important to not jump into knee surgery simply based on MRI findings.

My career has spanned over 2 decades, and I’ve seen many knee surgeries go wrong. Most of the time, it has nothing to do with the procedure itself, but everything to do with an incorrect diagnosis going in. If your knee pain can be resolved conservatively – and you put it through unnecessary trauma (surgery) – there’s a good chance you’re going to have more problems afterwards. If you get knee surgery when your knee problem isn’t even coming from your knee – then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that 1) your knee problem is really a knee problem and 2) you’ve fully exhausted all conservative therapy options (including specialized physical therapy) before going under the knife.

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

6 Tips to Protect Your Back When Shoveling Snow

February 11, 2025/in Back Pain, Lifestyle, Strength and Mobility/by Carrie Jose

6 Tips to Protect Your Back When Shoveling Snow

We’re finally getting some winter weather here on the seacoast. And although it’s beautiful – and the skiers are rejoicing – someone still has to shovel that snow and clear it out of the way. If that someone is you – then you’ll want to keep reading. Because repetitive bending and twisting of your back (the primary movement in shoveling) is the perfect recipe for unwanted back pain.

Here are 6 tips to protect your back when shoveling snow:

1. Warm Up First

Most people wouldn’t start a heavy workout without warming up first, yet when it comes to shoveling, we tend to just grab the shovel and go. That’s a mistake. Shoveling is a full-body activity that engages your legs, core, and upper body. If you don’t prepare your muscles, you’re more likely to strain something – especially your back.

Take five to ten minutes to warm up with light movements. Marching in place or jumping jacks help get blood flowing, while torso twists and squats loosen up your spine and legs. And don’t forget your upper body. Arm circles are a great way to warm up your shoulders – which can also get quite achy when shoveling. Taking just 10-15 min to warm up your body and lubricate your joints before shoveling can go a long way toward protecting your back.

2. Use Your Legs

Our spines weren’t designed to lift heavy things – that’s what our legs are for. Your spine’s main job is to provide structural support and stability so you can stand upright and move freely. When lifting or shoveling, your legs should be doing the work – not your back.

To ensure your legs are driving the power – it’s essential that you use proper lifting mechanics. Instead of bending or curving at your waist – hinge at your hips and bend your knees. From there, engage your hamstrings and glutes to lift the snow and use your core muscles to throw it away. Even with perfect form – your back might still get sore. That’s totally normal. But it’s far less likely to get injured – and that is what we’re trying to avoid.

3. Pivot Instead of Twist

One of the most vulnerable movements for your lower back is repetitive bending and twisting. The stress this puts on your spine makes it easy to “throw your back out.” Now let’s be clear – that doesn’t mean you should never bend or twist – your spine is designed to safely perform these motions. The problem occurs when you add load to this motion (like heavy snow) or do it repeatedly.

To protect your back – lead with your pelvis and hips instead of your torso. When turning to throw or push snow, keep your shovel and hips (use your belly button as a guide) pointing in the same direction. If they’re out of sync, it means you’re twisting from your torso instead of pivoting – and that’s a surefire way to hurt your back when shoveling.

4. Breathe to Engage Your Core

Holding your breath during exertion is common, but it can be a big problem – especially when it comes to core activation. When you hold your breath, your diaphragm can’t expand and contract properly, which is essential for engaging your deep core muscles. If your deep core isn’t firing, your larger abdominal and back muscles will struggle too.

Strengthening your core is beneficial for all activities – not just shoveling—but none of it matters if you forget to breathe. Without proper breathing, even the strongest core won’t do its job effectively, and this can set you up for a back injury over time.

5. Stay Hydrated

Even in cold weather, physical exertion can lead to dehydration. Just because you’re not sweating or feeling thirsty doesn’t mean you don’t need water. In colder temperatures, your thirst signals aren’t as strong, making it easy to overlook hydration. And even if you’re not sweating, you’re still losing fluids. Dehydration can lead to muscle fatigue, cramping, and stiffness – all of which increase your risk of a back injury while shoveling. Plus, when your muscles aren’t properly hydrated, they become less flexible and more prone to strains, making bending and lifting feel even harder.

To stay ahead of dehydration, drink water before, during, and after shoveling – even if you don’t feel thirsty. Sip small amounts frequently rather than chugging large amounts at once. Warm fluids like herbal tea or broth can help keep you hydrated while maintaining body temperature. Be mindful of caffeine and alcohol, as they contribute to dehydration. Staying hydrated keeps your muscles and joints working efficiently, making shoveling safer and easier for your whole body, not just your back.

6. Use Ergonomic Tools

Investing in an ergonomic shovel can reduce strain on your back and joints. These shovels promote better posture by minimizing bending. Many have curved handles or adjustable lengths, allowing you to maintain a more upright position. This distributes the workload more evenly, reducing stress on your back.

Now, you might be thinking, “I have a snow blower – my back will be fine.” Think again. It’s easy to push with your upper body instead of your legs, which puts strain on your spine. Poor technique makes your back more vulnerable to injury – even if you don’t feel pain in the moment. The real trouble comes later when you grab a shovel for a quick cleanup or simply sit down to relax. You may be in for a rude awakening when you stand up and realize your back is stiff and locked up. Ergonomic shovels and equipment like snow blowers go a long way in protecting you back – but they don’t replace the need for good posture and proper body mechanics.

Bonus tip: See a Specialist

If you’re already prone to back injuries and dread the thought of shoveling another snowstorm – it’s time to seek help. These tips are great for protecting a healthy back and preventing future injuries, but they won’t solve an ongoing back problem. You need expert care for that. Look for a back pain specialist who prioritizes natural solutions over pills and injections (such as a mechanical back pain specialist) so you can get back to doing all the activities you love. Oh—and shoveling too.

Are you local to Portsmouth, NH?

If so, consider speaking to one of my back pain specialists by clicking HERE.

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

January 30, 2025/in Chronic Pain, Movement/by Carrie Jose

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.

Exercise-induced Leg Soreness or Sciatica? How to Tell the Difference.

January 8, 2025/in Back Pain/by Carrie Jose

It’s that time of year – when people set goals and take action to improve their health, get back in shape, and ramp up exercise routines.

But what happens when your body isn’t ready for what your mind has planned? How can you tell if the soreness you feel is “good pain” – or a problem brewing?

This concept is particularly confusing when it comes to leg pain. Whether it’s ramping up your strength training, more frequent Peloton rides, or getting back to running/jogging… These activities will make your legs sore. The problem, however, is that leg soreness can mimic a common (and sneaky) condition called “sciatica” – that if missed or ignored – could completely derail you from your health and fitness goals. So it’s important you know the difference and what to watch out for – especially if you have a history of sciatica or back pain.

Here are some key things you to look out for – that will help you tell the difference between normal leg soreness from exercise – versus sciatic pain that’s caused from your back:

Exercise-induced leg soreness…

With exercise-induced leg soreness – you’ll typically feel pain deep in your muscles (especially those you specifically worked on) – and your legs may feel tender to touch or even “swollen”. This type of soreness comes from challenging your muscles beyond their usual capacity – something you want to do during exercise. The soreness is caused by microscopic damage to your muscle fibers – triggering an inflammatory response. This inflammatory response then triggers a repair phase in the area of the “damaged tissue” (aka your muscles). It’s in this repair phase that your body builds back stronger muscles – so that they’re more resilient the next time you exercise.

Another key characteristic of exercise-induced leg soreness is that it will typically occur anywhere from 24-72 hours after the activity. This phenomenon is known as “DOMS” (delayed onset muscle soreness) and it will usually dissipate in a similar amount of time. The soreness you feel from DOMS is often felt symmetrically (in both legs) – because most exercises are done using both sides of your body. But even if you’ve done an activity that favors one leg over another – the pain you experience during the DOMS period will occur when you’re moving or stretching the affected muscles – and not so much during periods of rest.

Now let’s look at sciatica…

Sciatica is a problem that comes from your spine and that causes pain in your buttock and/or leg. In between each vertebrae (the bones that make up your spine) are small spaces that allow the nerves originating from your spinal cord to exit. These nerves control everything from sensation, to pain, to muscle strength. If the nerves in your lower back get irritated – or structures around those nerves get irritated (for example, bulging discs) – anything in your leg (or butt) that those irritated nerves “touch” can also be affected. This is the phenomenon known as sciatica.

The tricky part about sciatica is that the timeline of your pain – and the feeling you experience – can be very similar to the leg soreness you get from exercise. Just like exercise-induced leg soreness – sciatic pain can include a deep ache in your muscles, tenderness to touch, and a feeling of swelling. People often describe to me a feeling of “heaviness” in their leg when they are experiencing a sciatic episode. Sciatic pain can also come on 24-72 hours after exercising or activity.

But with sciatica – one of the most important factors you need to pay attention to is how your pain behaves. Leg soreness from exercise arrives in a fairly predictable manner – and leaves in a fairly predictable manner. And you generally won’t have much pain at rest.

Sciatica, on the other hand, is more unpredictable.

Although it can come on in the same time frame as exercise-induced leg soreness – it won’t just “go away” in the same, predictable amount of time. Pain from sciatica can linger – particularly at rest – and with activities such as sitting, driving, standing too long, or walking. It can end up in just one leg even though it started in both – and it tends to come and go. For example – you’ll think it’s better – only to suddenly wake up with a sore leg again – or bend the wrong way and have the pain annoyingly return. And finally – sciatic pain won’t go away completely with stretching or massage (although it’s tempting to think it did).

But one of the most important things to notice about the behavior of sciatic pain versus exercise-induced leg pain is whether or not numbness or tingling is present. It’s possible to have sciatic pain without numbness and tingling – but it’s not possible to have it with healthy, exercise-induced leg soreness. That’s because only nerve irritation can cause the sensation of numbness and tingling in your leg. And speaking of nerve irritation… If your leg soreness “goes away” – but you’re left with a lingering back ache – your leg pain was almost certainly a sciatic episode that has temporarily resolved – and it’s only a matter of time before it returns with a vengeance.

So there you have it – next time you notice leg pain after exercising – pay attention to how your pain behaves.

How long does it last? Does it come and go? Is it only in one leg vs both? Do you have any numbness? Does it linger or return with mundane activities such as sitting or standing? If the answer to any of these questions is “yes” – and especially if you’ve got a history of back pain – you must consider that it could be sciatica. To make sure – seek out the help of a mechanical back pain specialist who can tell you for certain.

5 Tips for Wrapping Gifts Without Aggravating Neck or Back Pain

December 19, 2024/in Back Pain, Neck and Shoulder Pain/by Carrie Jose

If you’re anything like me – you’ve left your Holiday wrapping to the absolute last minute. And if that’s the case – there’s a very good chance you’re going to overdo it – and aggravate any existing neck or back pain you might have.

The good news?

There are things you can do to significantly mitigate the chances of your neck and back pain flaring up – and perhaps avoid it altogether.

Here are five great tips – and even a bonus recovery tip – to help you get through your last minute gift wrapping without aggravating your neck or back:

1. Create an Ergonomic Wrapping Station

The way you set up your wrapping station matters. Sitting on the floor or crouching over a low coffee table forces your spine into unnatural positions, creating stress on both your neck and back. Instead, wrap your gifts on a surface that allows you to sit or stand comfortably at waist height.

If you’re sitting, use a supportive chair along with a lumbar roll to keep your back and neck in their most natural position. For those who prefer standing, consider using an anti-fatigue mat to reduce strain on your back. Elevating your workspace ensures you’re not constantly hunching over, which is a common culprit for neck and back pain.

2. Don’t Sit or Stand Too Long – Move!

Sitting or standing in one position for extended periods can lead to stiffness and pain in your neck, shoulders, and back. Set a timer to remind yourself to take movement breaks every 20-30 minutes.

During these breaks, perform a few gentle stretches for your neck and back. Try rolling your shoulders backward, gently tilting your head side to side, or doing a seated spinal twist. Movement encourages blood flow, which helps reduce stiffness and tension. Plus, breaking up the task gives you a mental refresh so you can focus on getting your wrapping done instead of neck or back pain.

3. Use the Right Tools

The tools you use can make a big difference in minimizing strain. Opt for ergonomic scissors with padded handles to reduce stress on your hands and wrists. Tape dispensers are also a must-have to prevent repetitive wrist motions that can lead to discomfort.

If you’re wrapping on the floor, use a cushion to support your hips and lower back. For added neck relief, consider placing a rolled-up towel under your neck during floor session breaks to give it some relief and maintain its natural curve. These simple adjustments can help you avoid unnecessary strain while you focus on creating perfectly wrapped packages.

4. Check Your Posture

Poor posture is one of the biggest contributors to both neck and back pain. While wrapping, make a conscious effort to:

Relax Your Shoulders: Keep them down and away from your ears to avoid tension in your neck and upper back.
Maintain a Neutral Spine: Whether sitting or standing, ensure your lower back keeps its natural curve.
Align Your Head: Avoid craning your neck forward. Bring the gift closer to you instead of leaning toward it.

These small posture corrections can go a long way in keeping discomfort at bay and ensuring your body feels great long after the wrapping is done.

5. Spread Out Your Wrapping Tasks

Rather than saving all your wrapping for Christmas Eve, try wrapping a few gifts at a time over several days. This approach prevents prolonged periods of repetitive motion and reduces the overall strain on your neck and back.

Now – if you HAVE waited till Christmas Eve to wrap your gifts – then ignore this tip and move on to your bonus recovery tip 🙂

Bonus Recovery Tip: Treat Yourself to a Little TLC

Even with the best precautions, some muscle soreness and tension might still sneak in. Combat this by treating yourself to recovery techniques like foam rolling, deep breathing, a good stretching session, or one of our Regenerative Therapy Sessions!

And if your pain persists or worsens – don’t ignore it. Seeking advice from one of our mechanical pain specialists can help you address the root cause or your neck and back pain and prevent it from becoming a much bigger issue that impacts more than just wrapping gifts.

Live near Portsmouth, NH? Connect with one of our mechanical pain specialists 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.

What Your Doctor May be Missing About Your Pain’s True Source

November 13, 2024/in Movement/by Carrie Jose

Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body.

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem).

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan.

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all. I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit.

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

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.

6 Reasons NOT to miss our Black Friday Flash Sale

November 12, 2024/in Movement/by Carrie Jose

These will be our BEST deals – on our best services – for the whole year!

We wanted to give you a heads up that our Black Friday Sale is starting ELEVEN DAYS from now on Sunday – Nov 24th. This is our biggest sale of the year on our most popular services. And it’s your chance to save insane amounts of money (one of the packages gives away over $2500 of FREE services!!)

In order to get access to this amazing sale – you must sign up HERE.

On Sun Nov 24th the sale will start – and you’ll get daily emails updating you on the packages we have available, when things sell out, etc…

Now if saving BIG wasn’t enough…

Here are SIX very important reasons why you don’t want to miss out on our Black Friday specials this year…

1. Without your Health – you have nothing

When your health, independence, and mobility begin to decline – you start missing out on activities that you love. And It’s very easy to say to yourself… “I’ll just wait until the New Year” – or – “I’ll get started when I have more time” – or – “I’ve got so many other expenses right now so my health can wait”…

Nothing should EVER come between you and your health. Because if you wait (or ignore) it, you risk either losing it forever, or spending a lot of time and money to get it back. Whether it’s healing a nagging injury that regular physical therapy or cortisone shots have failed – or getting to the root cause of a back pain or sciatica problem that keeps coming back – we’ve got some amazing specials and huge savings that will make it easy for you NOT to have to wait any longer 🙂 Now is the time to address and invest in your health.

2. Use your left-over FSA money (before you lose it!)

Do you have a Flexible Spending Account (FSA) through work that you forgot about or maybe haven’t used? Well I have some good news for you… you can use your Flexible Spending money toward ALL of the services we have on sale this year. Typically you lose whatever is left in your FSA at the end of the year (Dec 31st) – so don’t let it go to waste!

Put it towards your health – and save a ton of money while doing it – by taking advantage of our Black Friday specials!

3. Help with your New Year’s Resolutions!

January is our busiest month every year, and for good reason… People LOVE to make health-related New Year’s resolutions for themselves. But what if you’ve got a nagging pain or injury? The last thing you want is for it to return or get worse just when you’re in the groove. Our Black Friday Specials can help you with that!

Work with our Physical Therapy Specialists to get to the root cause of your problem and finally get a treatment plan that works (and lasts). Or try Regenerative Shockwave Therapy to help speed up the healing of a stubborn injury that regular physical therapy or cortisone shots have failed. Whatever your health goals are for now or the New Year – get help from our experts at the best rates you’ll have access to ALL YEAR.

4. This only happens ONCE per year

This is our biggest sale of the year – PERIOD. And it only happens once. You’ll never see our prices this low.

If you’re new to our community – and the ONLY reason you haven’t started working with us yet is because of your budget – then you will be very pleased with the specials we have for you. Our regular clients already know the value we provide – and that is why they consistently choose us over the cheaper alternatives available. And it’s also why they are super excited about this sale – because they plan to stock up on their favorite services.

5. Try Out Services You’ve Been Curious About

Have you been eyeing one of our specialty services, like Regenerative Shockwave Therapy? This sale is the perfect time to explore them – at an unbeatable rate. Maybe you want to see how these services could change your mobility, pain, or recovery time? Here’s your permission slip to take the leap and see what you’ve been missing out on!

6. Recession-proof your Health

It may seem counterintuitive to spend money on your health right now given the economic state. Your insurance should pay for it – right? Well here’s why you might want to reconsider that thought – and put the control of your health back into your own hands…

Medicare and other health insurance companies have already cut their reimbursements for this year – and will continue to do so in years to come. Why should you care about this? Because it means the quality of your health care at traditional, insurance-based clinics only has one way to go – and that’s DOWN.

Providers are going to get paid less to take care of you, which means the quality of your care WILL suffer (just to “keep the lights on”). By investing in your own health – and not relying on an insurance company to do it for you – you stay in control of your health journey and have a better chance of avoiding the rabbit hole of expensive and unnecessary surgeries.

So… sign up for our Black Friday Sale… and join the CJPT revolution of getting active, healthy, and mobile – WITHOUT things like pills, procedures, or surgery 🙂

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 early access to the Black Friday Flash Sale!