Tag Archive for: physical therapy portsmouth

Holiday Stress

Don’t Let Holiday Stress Turn Into Pain: 3 Simple Strategies

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Don’t Let Holiday Stress Turn Into Pain: 3 Simple Strategies to Stay Healthy in Portsmouth, NH

The holidays are meant to feel warm, festive, and joyful. But for many people here in Portsmouth and the Seacoast area, they also bring a level of stress your body can’t help but absorb. Between shopping, hosting, traveling, and trying to squeeze everything in, your nervous system can go into overdrive. And when that happens, stress often shows up physically — tight shoulders, a stiff neck, a cranky low back, or even tension headaches.

The good news? You can interrupt this cycle with a few simple habits. These strategies can help you keep holiday stress from turning into neck, shoulder, or back pain — and they’re easy to start right away.

1. Try Belly Breathing to Reset Your Body’s Alarm System

When stress rises, your breathing becomes shallow. You might not notice it, but your brain definitely does. Shallow breathing tells your nervous system that you’re under pressure, and your muscles respond by tightening. I personally feel this tension through my rib cage and into my neck when it gets bad enough.

Just one or two minutes of deep, intentional breathing can reverse this entire pattern.

Wherever you are — in the car, standing in line on Congress Street, or even at a holiday party — try this:

✔ Take a slow inhale.
Fill your belly, sides, and lower back with air.

✔ Exhale naturally.
Let the air fall out without force.

Each deep breath acts like a reset button for your nervous system. It helps stop tension from turning into knots, spasms, or lingering pain in your neck or lower back.

2. Practice Gratitude (It Physically Changes Your Stress Levels)

Gratitude isn’t just a feel-good idea. It’s a simple mindset shift that has measurable effects on your body.

When you pause to focus on something positive, your brain reduces its release of cortisol — your main stress hormone. Lower cortisol leads to:

  • Lower muscle tension
  • Happier blood pressure
  • Better sleep
  • Less strain on your neck, back, and hips

A gratitude practice doesn’t need to be fancy. It can be as simple as:

  • Thinking of one thing you appreciate while drinking your morning coffee
  • Writing a single sentence in a journal before bed
  • Setting a daily alarm to remind yourself of something good

These tiny moments tell your body: “You’re safe. You can relax.” Your muscles respond in kind.

3. Move Daily to Break the Stress Cycle

Chronic stress triggers your fight-or-flight system. It’s helpful if you’re running from danger — but in modern life, most of our stress comes from calendars, inboxes, and long to-do lists. If that stress energy has nowhere to go, it lingers in your body as muscle tension.

Movement is how you release it.

Personally, I love walking around Portsmouth and the Seacoast. I aim for 10,000 steps a day. When the weather is too cold or I’m stuck on Zoom, I use a walking pad. I always feel better afterward.

But walking isn’t the only option. You can also:

  • Go to the gym
  • Stretch for a few minutes
  • Run up and down your stairs
  • Do 30–60 seconds of jumping jacks

Just 5–10 minutes at a time is enough to tell your brain the stress has passed. Once that happens, your cortisol levels naturally come back down — and tension is less likely to settle in your joints, neck, or back.

Your Body Will Thank You

You may not be able to eliminate holiday stress (and if you figure out how, please let me know!) — but you can prevent it from turning into pain. Small habits, repeated throughout the season, make a huge difference. And you can keep using these same habits long after the holidays.

But if you’re already dealing with significant tightness or pain that isn’t improving, these strategies might not be enough on their own. A mechanical pain specialist can help you identify the true root cause, calm things down quickly, and give you a clear plan so you enter the New Year feeling better — not worse.

If you need help or guidance, we’re here for you.

Dr. Carrie Jose, Physical Therapy Specialist & Mechanical Pain Expert, writes for Seacoast Media Group and helps people on the Seacoast get rid of back, neck, hip, and shoulder pain naturally.

For more resources or to get in touch, visit www.cjphysicaltherapy.com or call 603-380-7902.

5 Things I Learned Walking in Italy

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

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

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

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

1. Comfortable Footwear is Non-Negotiable

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

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

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

2. Mobile Hips Make Your Steps Easier

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

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

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

3. Breathing Activates Your Core

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

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

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

4. The Right Stretch – at the Right Time

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

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

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

5. Recovery Is Just as Important as Movement

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

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

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

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

My Takeaway

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

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

 

 

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH, and writes for Seacoast Media Group. If you’re local to Portsmouth, NH or the Seacoast area and want to stay active, healthy, and pain-free as you age — request a FREE Discovery Visit with one of our specialists at CJ Physical Therapy & Pilates.

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

Six Tips for Managing Knee Pain without Medication

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6 Natural Ways to Manage Knee Pain Without Medication or Surgery

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

Introduction

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

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

Understanding the Problem: Why Knee Pain Lingers

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

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

Common Causes of Ongoing Knee Pain

  • Weak hips or core muscles that lead to poor alignment

  • Stiffness in the hips, hamstrings, or quadriceps

  • Prolonged sitting or sedentary habits

  • High-impact or improper exercise routines

  • Unsupportive footwear

  • Poor balance or coordination

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

Natural Solutions: 6 Proven Tips to Relieve Knee Pain

1. Strengthen Your Hips and Core

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

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

2. Improve Your Flexibility

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

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

3. Don’t Sit Too Long

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

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

4. Stay Active

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

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

5. Wear Supportive Footwear

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

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

6. Optimize Your Balance

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

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

Next Steps: Find Natural Relief in Portsmouth, NH

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

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

Are you local to Portsmouth, NH?

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

About Dr. Carrie Jose

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

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

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

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

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

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

  1. Rake Leaves with Care

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

  1. Safely Pick Up and Carry Pumpkins

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

  1. Use Good Posture When Apple and Pumpkin Picking

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

  1. Move Often and Stay Hydrated

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

  1. Cool Down After Activities

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

Enjoy Fall the Pain-Free Way

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

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

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

Arthritis Pain Isn’t the End – How to Stay Active for the Long Haul

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Arthritis is one of the most common conditions I see in my clinic – and one of the most misunderstood.

Many people assume it’s just an inevitable part of aging, but what’s often overlooked is how much can actually be done to manage it naturally and effectively.

What frustrates me most is the message many people still hear – that arthritis pain is something you just have to “live with,” managed only through pills, injections, or eventually surgery. But the truth is that while arthritis may not be something you can erase or reverse – there are countless ways to manage your symptoms naturally, safely, and effectively – without becoming dependent on quick fixes that often backfire in the long run.

Here are just a few of the approaches I recommend to my patients who want to stay active and independent well into their later years – even with arthritis.

Move Every Day (Even When You Don’t Feel Like It)

When your joints ache, movement is usually the last thing you want to do. But ironically, it’s one of the best things you can do. Gentle, consistent exercise increases circulation, nourishes your cartilage, and keeps inflammation from settling in. Walking, biking, or swimming are excellent choices because they don’t put excess stress on your joints. Practices like yoga or Pilates improve balance and mobility, making daily activities easier and reducing the strain on your joints. And strength training – despite what many believe – is actually good for arthritis because it takes pressure off your joints by making the muscles around them stronger.

Even five to ten minutes of daily activity can mean the difference between feeling stiff all day or moving with more freedom. The less you move, the worse arthritis tends to get – so finding ways to stay active is one of the best investments you can make in your future health.

Fuel Your Body With Anti-Inflammatory Foods

What you eat matters. An anti-inflammatory diet can help reduce the swelling and stiffness that drive arthritis pain. Omega-3 rich foods like salmon or flax seeds, antioxidant-packed fruits and vegetables, and spices such as turmeric and ginger all have powerful healing effects. At the same time, cutting back on processed foods, refined sugars, and fried items can significantly improve how your joints feel – and it brings benefits for your overall health as well.

Think of food as medicine, because for arthritis it truly can be. Many of my patients notice a big difference in their pain levels and energy simply by reducing sugar and processed foods while adding more colorful fruits, vegetables, and healthy fats.

Prioritize Weight and Posture

Every extra pound you carry puts additional strain on your hips, knees, and back. Even small amounts of weight loss can dramatically reduce pressure on your joints and give you noticeable relief. But here’s something many people miss – posture can play just as big a role.

When you sit, stand, or walk with poor posture, you create uneven forces through your joints. Over time, this increases wear and tear, and can be aggravating to an already arthritic joint. Learning how to align your body correctly can protect your joints just as effectively as losing weight. The way you move every day, whether you’re getting out of a chair or bending to pick something up, can either help your arthritis or make it worse.

Don’t Let MRIs or X-rays Dictate Your Treatment

One of the biggest mistakes I see is when people let imaging results control their decisions. While MRIs and X-rays are useful in certain situations, they are not the whole story. Numerous studies have shown that people with severe degenerative changes on their scans often have no pain at all. In fact, research suggests that as many as 60–70% of people over the age of 50 show some level of arthritis or disc degeneration on imaging – even if they feel perfectly fine.

This matters because once you’re told your pain is due to what’s seen on a scan, you’re far more likely to be funneled toward procedures you may not need. Cortisone injections, for example, only mask pain and actually weaken tissue when used repeatedly. Arthroscopic surgery for knee arthritis has been shown to accelerate the very degenerative changes it’s supposed to help.

And then there’s the dreaded phrase: “bone-on-bone.” While this sounds scary, it does not automatically mean you need a joint replacement. Many people live full, active lives with joints that appear “bone-on-bone” on imaging, as long as they are moving well and keeping their surrounding muscles strong. If you rely only on what the picture shows, you risk missing out on safe, natural solutions that can help you stay mobile and independent.

Explore Longevity Treatments that Boost Healing

One of the most exciting developments in arthritis care right now is the rise of non-invasive therapies that actually help your joints heal and last longer. The combination of Shockwave Therapy (ESWT) and EMTT (Extracorporeal Magnetotransduction Therapy), for example, helps to stimulate blood flow, reduce inflammation, and restore mobility at the cellular level deep inside your joint.

Unlike cortisone shots, which only provide temporary relief while weakening tissue, these therapies encourage your body’s natural ability to repair itself. Many of my patients have experienced less pain, more mobility, and faster recovery – without downtime or drugs. Instead of masking symptoms, these treatments support long-term joint health and help you stay active well into the future.

A Final Word of Encouragement

If you live with arthritis – it doesn’t mean you are destined for a life of pain or dependence on invasive treatments or pills. Your body has an amazing capacity to heal when given the right environment. Whether it’s moving a little more each day, adjusting your diet, improving your posture, questioning unnecessary procedures, or exploring longevity treatments – there are always steps you can take to improve your quality of life.

Arthritis may be common, but it doesn’t have to define you or your future.

With the right strategies, you can stay active, independent, and doing the things you love for years to come. Local to Portsmouth, NH and looking for help?

Consider speaking to one of my specialists. CLICK HERE to book a free discovery visit.

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.

Shockwave Therapy

Four Non-Invasive Ways to Get Rid of Arthritic Knee Pain

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Knee arthritis is one of the most common and debilitating causes of joint pain for adults over 50. As the protective cartilage in the knee joint gradually wears down, many people experience stiffness, swelling, and chronic pain that can make everyday activities—like walking the dog, climbing stairs, or getting out of the car—feel frustrating and exhausting.

For years, conventional treatments such as traditional physical therapy, cortisone injections, and pain medications have been the go-to options for knee arthritis relief. While these approaches may provide temporary symptom relief, they often fail to address the underlying mechanical and inflammatory causes of knee pain. For many people, the results are short-lived—or nonexistent.

The good news? There are effective, non-invasive, and drug-free solutions available that focus on improving joint function, reducing inflammation, and supporting your body’s natural healing process—especially for those who want to avoid injections or surgery.

Here are four non-invasive ways to relieve arthritic knee pain naturally, used successfully by many adults in Portsmouth and throughout the Seacoast of New Hampshire.

1. Corrective, Therapeutic Movement Strategies for Knee Arthritis

Movement is one of the most accessible—and powerful—tools for managing arthritic knee pain. While it may seem counterintuitive to move a painful knee, not all knee pain is caused by arthritis alone.

In many cases, pain is driven by joint stiffness, poor mechanics, and long-standing compensatory movement patternsthat place excess stress on the knee. When the joint doesn’t move well, surrounding tissues are forced to work harder, increasing irritation and discomfort.

By identifying and correcting faulty movement patterns with specifically prescribed therapeutic exercises, it’s often possible to significantly reduce pain—even in arthritic knees. These targeted strategies focus on improving knee mobility, restoring proper alignment, and optimizing how forces move through the joint.

Working with a specialist trained in mechanical pain assessment is key. Once the right movements are identified, they can be used long-term to help manage symptoms—without ongoing costs, medications, or injections.

2. Weight Management to Reduce Knee Joint Stress

Excess body weight places a significant load on the knee joints during everyday activities like walking, standing, and climbing stairs. In fact, research from Wake Forest University led by Dr. Stephen Messier found that for every pound of weight lost, there is a four-pound reduction in knee joint stress during daily movement.

That means losing just 10 pounds can reduce pressure on your knees by 40 pounds with every step.

Healthy, sustainable weight management—through smart nutrition and regular movement—can dramatically reduce knee pain and improve function. Beyond your knees, weight loss also decreases strain on the hips, ankles, and lower back, supporting overall joint health and long-term mobility.

3. Adopt an Anti-Inflammatory Lifestyle

While knee arthritis is often described as “wear and tear,” chronic inflammation plays a major role in pain, stiffness, and joint degeneration.

Reducing inflammation through lifestyle changes—especially nutrition—can lead to noticeable improvements in how your knees feel. An anti-inflammatory diet emphasizes whole, unprocessed foods rich in antioxidants and healthy fats, including:

  • Fatty fish like salmon, sardines, and mackerel
  • Dark leafy greens such as spinach and kale
  • Berries, walnuts, chia seeds, and flaxseed
  • Extra virgin olive oil
  • Anti-inflammatory spices like turmeric and ginger

At the same time, limiting refined sugars, processed grains, and fried foods is essential, as these are known to promote inflammation.

Beyond diet, other daily habits that help reduce inflammation include getting 7–8 hours of quality sleep, managing stress through walking or breathing exercises, and staying well-hydrated. These foundational changes not only support knee arthritis relief—but overall health and energy as well.

4. Explore Non-Invasive Regenerative Therapy for Knee Arthritis

One of the most exciting advances in non-surgical knee arthritis treatment is the use of non-invasive regenerative therapies, including Shockwave Therapy and EMTT (Extracorporeal Magnetotransduction Therapy).

These cutting-edge technologies work with your body’s natural healing mechanisms rather than masking pain.

  • Shockwave Therapy uses mechanical sound waves to improve blood flow, break down damaged tissue, and stimulate dormant healing cells within the knee joint.
  • EMTT uses high-frequency electromagnetic energy to reduce inflammation at the cellular level, boost mitochondrial activity, and accelerate tissue repair—making it especially effective for chronic joint inflammation and bone marrow lesions commonly seen with knee arthritis.

Recent research supports the combined use of these therapies. A 2021 clinical study published in Orthopedic Reviewsfound that using Shockwave Therapy and EMTT together led to greater improvements in pain relief and functional mobility than either treatment alone, with longer-lasting results.

For individuals who have already tried traditional physical therapy or cortisone injections without success, this non-invasive combination offers a powerful, drug-free alternative—without surgery.

Take Control of Your Knee Arthritis Pain—Naturally

If you’re living with knee arthritis and feel like you’ve exhausted your options, don’t lose hope. Pills, injections, and surgery are not your only choices.

By combining corrective movement strategies, healthy weight management, anti-inflammatory lifestyle changes, and advanced non-invasive regenerative therapies, many people are able to reduce knee pain and regain confidence in their movement—naturally and safely.

The key is addressing the root cause of your pain and choosing solutions that support long-term joint health, not just short-term relief.

About the Author

Dr. Carrie Jose, Doctor of Physical Therapy and Mechanical Pain Expert, is the owner of CJ Physical Therapy & Pilates in Portsmouth, New Hampshire. She specializes in helping adults over 40 overcome chronic knee, hip, and back pain—without relying on medication, injections, or surgery.

 

When your Back Hurts – is Rest Helping or Hurting?

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

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

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

Why Rest Doesn’t Work

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

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

Movement is Medicine

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

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

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

But What If Movement Feels Impossible?

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

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

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

Finding the Middle Ground

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

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

The better alternative?

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

Are you local to Portsmouth, NH?

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

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

Back Pain

5 Simple Tips for Keeping Back Pain Gone

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5 Simple Tips for Keeping Back Pain Gone

Almost half of U.S. adults (39% according to the CDC) suffer from back pain. With the prevalence increasing as we age – folks over age 65 are more likely to experience back pain than any other age group. Economically speaking – back pain accounts for roughly $50B annually – and is the number one cause of missed work days – 83 million each year according to the National Council on Aging (NCOA).  

Given these staggering figures, you might think the title of this article is nuts. If it were that easy to get rid of back pain on your own – why do so many suffer? Well – that is the million dollar question (or rather $50B question). The problem is that the traditional medical approach focuses on symptom management rather than addressing the underlying causes of back pain. This oversight leads to persistent discomfort and recurring issues for many – because the underlying, root cause is never properly addressed.

So what is the root cause of most back pain? 

Eighty percent of back pain is what we call “mechanical” in nature. That means it comes from poor or imbalanced movement habits and postures that are years in the making. This also explains why back pain shows up a lot more in older populations. The root cause of back pain is rarely structural (aka: bulging discs, stenosis, arthritis, etc). Those structures, and structures around the stenotic or arthritic joints, become irritated because of the poor movement habits that slowly wreak havoc on your body. They don’t typically cause problems all on their own. How do I know? Because more than 60% of older adults with zero back pain will have one or more of these findings on their MRI.

The good news is that since most back pain is due to poor movement and postural habits – you can alleviate it with some good movement and postural habits. Here are 5 simple tips for keeping back pain gone on your own:

1. Stop Sitting So Much

Sitting puts a surprising amount of pressure on your spine – even if it feels good in the moment. Compressive forces on your spine increase by 40% when you sit – and even more if you’re slouching. Over time, this pressure can unknowingly aggravate your spinal ligaments and discs without you even realizing it.

One of the simplest ways to counteract this is by breaking up your sitting time. Set a timer to stand up and move every 30 minutes. Even a quick stretch or walk around your office can make a big difference. By interrupting prolonged sitting, you’ll reduce the cumulative stress on your spine and keep your back healthier.

2. Walk More

Walking is one of the best activities for your spine. It promotes mobility, improves blood flow, and acts as a natural lubricant for your spinal structures. Regular walking also helps prevent tightness in your hips, which can aggravate your back due to abnormal forces on your pelvis and spine.

Aim for at least 10-15 minutes of walking each day. If you’re dealing with back pain, start with short, gentle walks and gradually increase your duration and pace. And focus on maintaining good posture while walking. If walking even short bursts continues to aggravate your back – then it’s time to talk to a mechanical back pain specialist who can help you sort out why.

3. Vary Your Posture

Did you notice that I didn’t say: “maintain good posture”?. That’s because maintaining perfect posture all the time is quite impractical and not very realistic. The truth is – no posture is perfect if you stay in it too long. Even the best looking postures can lead to stiffness and discomfort over time. 

Instead of obsessing over perfect posture, aim to vary your positions throughout the day. Your spine is made to be quite resilient – and a healthy spine can tolerate any posture (even bad posture) for a short amount of time. So if you’re sitting or slouching – be sure to move around and change your position. If you’re standing for a while – try shifting your weight side to side. Your spine wants to keep moving – so finding opportunities in any position is going to be beneficial.

4. Strengthen Your Core

Your core muscles include your abdominals, obliques, and glutes – and they provide support and stability for your spine – and go a long way in preventing back pain. But when these muscles are weak, your spine takes on more stress, thus increasing your risk for pain and injury.

Pilates is one of the best overall ways to strengthen your core while also promoting good spinal movement and mobility. But exercises like bridges, planks, and full body functional exercises are also effective for targeting your core. Incorporating core strength into your routine a few times per week will not only help your back feel better – but it goes a long way in preventing future back pain episodes. If exercising or strengthening your core hurts your back pain – then you should seek the help of a mechanical back pain specialist who can help you get back to moving and exercising naturally, and without procedures or cortisone shots.

5. Education is Power

There’s a lot of misinformation out there when it comes to both diagnosing and treating back pain. So one of the most important steps you can take is to educate yourself on this. You’re already off to a good start because you’re reading this article. But the second most important thing to keep in mind is to never let your MRI or X-ray alone make a diagnosis and dictate your treatment plan. I’ve already alluded to this concept previously – but structures in your spine rarely cause problems spontaneously. They get irritated over several years – but it’s not the structure itself that’s the problem. When you are educated on this nuanced concept – you’ll realize it’s possible to treat back pain on your own – and are less likely to become a victim of unnecessary procedures, cortisone shots, and back surgery.

Just remember – 80% of all back pain is mechanical – and comes from poor movement patterns, habits, and postures over several years. The solution lies in correcting these movement patterns and habits – and for the most part – they are very “correct-able” and reversible. A mechanical back pain specialist is the best person to help you with. They are experts in back pain and won’t rely on MRIs or X-rays to dictate your treatment plan.

Local to Portsmouth, NH?

Consider speaking to one of my back 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.

person holding lower back due to pain during holiday season in Portsmouth NH

How Ignoring Back pain could ruin your New Year’s Goals

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Now is the time when people shift their focus to the New Year and start thinking about new and exciting goals for themselves.

According to statista.com – the three most popular New Year’s goals are 1) doing more exercise and improving their fitness, 2) losing weight, and 3) saving money.

Would you be surprised to know that if you are currently suffering from back pain – and you continue to ignore it – it could significantly impact your chances of success at achieving any of these goals?

Let me explain.

Let’s start with doing more exercise and improving fitness. Most people think that if they start exercising more – especially their core – it will solve their back problem. Not necessarily. While the research studies show (overwhelmingly) that exercise is one of the best treatments for back pain – what they don’t reveal is that there are typically some key things that must be in place in order for exercise to be effective. For example, you must have good mobility before you start focusing on stability (or strengthening). If you’ve got a stiff back, general exercise could be all you need, and you’ll notice improvement. But you won’t know until you get going and by then it could be too late.

What if your back is stiff because it’s compensating for something – say a bulging disc or muscle weakness?

If that’s the case, and you go all in with an exercise program in January, it’s only a matter of time (usually about 3 months in) before your back becomes worse, forcing you to abort your grand plan for the new year. When stability is there for a compensatory reason, it’s important to figure that out before adding more exercise or strengthening to the mix. This is one way back pain could derail your New Year’s resolution of doing more exercise and improving your fitness.

Say you want to lose weight. This is a fabulous goal. And if you’ve got back pain, losing weight will surely help. But once again, it’s critical to understand why you’ve got back pain in the first place. For example, being overweight is rarely the cause of back pain. A few extra pounds can certainly exacerbate your back problem, but it doesn’t usually cause back pain all on its own. The most common causes of back pain are mechanical (movement) problems.

In other words – bad movement habits such as sitting all the time, bending and rotating too much, or having terrible posture can all lead to back pain slowly over time.

If you lose weight, but never correct these mechanical/movement problems, your back pain isn’t going to improve. When it comes to the process of losing weight, in addition to watching your diet, more exercise is often incorporated into a weight loss plan. If you’ve got back pain, it’s more than likely due to poor movement habits. More exercise will not address these, and worse, could exacerbate the problem. If your back pain increases, not only will you not want to exercise, but you could be more inclined to sit at home and eat more – completely derailing your New Year’s resolution of losing weight.

Finally – we come to saving money. What on earth could back pain have to do with this? Well, you’ve probably heard the saying: “If you think wellness is expensive, try illness”. And this couldn’t be truer. When you ignore back pain, it’s only going to get more expensive to address later. As back pain worsens, you’ll have less willpower to bear it, and you’ll be more likely to opt for expensive fixes such as outpatient procedures and surgery. Not to mention the rehab that needs to take place afterwards for an optimal recovery and the expensive tests that need to take place before-hand to ensure you’re ready for surgery.

When you ignore a back problem it’s only a matter of time before it becomes unbearable.

And when we’re desperate, we make poor decisions, which often leads to more money spent than necessary. All that money (and more) that you set out to save as part of your New Year’s goals eventually goes to waste. Instead, get in front of your back pain. For 80% of back pain cases, there is a natural, movement-based solution. Natural solutions are far less expensive – and much safer long term compared to something like surgery. While the impact of ignoring back pain may seem indirect when it comes to a New Year’s resolution of saving money – it will impact you in some way – at some point – in a monetary way if you don’t address it now.

When you’ve got back pain (or any pain for that matter) that isn’t going away, it’s your body trying to tell you something. Don’t ignore it. It’s only a matter of time before it gets worse and starts to derail more than just your New Year’s goals.

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

Back MRI

Do You Really Need an MRI for That?

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Possibly the number one question I get from clients on a daily basis is…

“Should I get an MRI for that?”

Hey… I get it… you’ve got pain that won’t go away and you want to see what’s going on inside… why not?

Not so fast!

What if I told you that getting an MRI too soon (or when you don’t even need one) can actually lead you to getting unnecessary procedures, or even surgery! 

Don’t get me wrong… 

MRI’s are an amazing advancement in medical technology that have saved many lives. And if you’ve had trauma – like a major fall or accident – or you’re exhibiting symptoms that we call “red flags” (progressive/serious neurological deficits, bowel and bladder issues, unrelenting/unexplainable pain) –  then you want to get an MRI. But when it comes to musculoskeletal pain (back, neck, knee, hip, shoulder, etc) – again – unless you’ve had a major fall or trauma – you typically DO NOT need an MRI.

Let me explain…

When it comes to musculoskeletal pain – 80% of the time it’s what we call “mechanical” in nature. That means it’s due to the way you are (or aren’t) moving. For example, let’s say you’re suffering from low back pain and terrible sciatica. Most people in this situation want to get an MRI. And it will reveal anything from a bulging disc, to stenosis, to arthritis, to degenerative discs. Whichever one of these “ailments” shows up on your MRI will typically get blamed as the source of your problem. From there – you’ll typically be prescribed some type of procedure (or surgery) to “fix” said ailment.

Sound familiar?

Well… here’s the thing… research has shown over and over that these so-called ailments appear in the MRI’s of just about everyone over the age of 50. In a 2015 study by Brinkjiki et al – they did MRI’s on over 3000 people who had NO back pain. And you know what they found? For people in their 60’s – they found that 70% of them had disc bulges – 88% had disc degeneration – and 50% had facet degeneration (something you often see with arthritis). And as the age groups increased – so did these ailments!  

The meaning of this and other studies like it is profound…

It means that you absolutely can NOT rely on your MRI to diagnose your problem.

It also means that many people are getting procedures on these normally occurring structural ailments when it’s not even the root cause of the problem.

So what IS the root cause of the problem?

 Typically – it’s “mechanical” – meaning your problem has to do with the way you move, bad postural habits learned over the years, muscular and joint imbalances, or “wear and tear” issues. It’s also why we tend to see more mechanical problems show up in people once they hit age 40 and beyond – because these problems take awhile to manifest.

Although the pain you experience may be coming from one of those ailments we spoke about earlier (for example – a bulging disc irritating your nerve route – a meniscus tear irritating your knee when it moves) – the root cause is how your movement habits are irritating the structure. When you fix the movement problem – the structural issue becomes irrelevant – at least 80% of the time.

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

Most medical doctors are not trained in what mechanical pain truly is or what it means. They are trained to diagnose problems using images such as Xrays and MRIs. Nothing wrong with that of course – but it can become a problem when you do an MRI too soon – without first ruling out if your pain is due to a mechanical cause.

If you’re currently suffering from back, neck, hip, knee, shoulder, ankle pain, etc… and you’ve been told you need an MRI to “figure out what’s going on” – hold that thought!

Why don’t you first consult with a mechanical pain specialist. There’s an 80% chance your problem will fall into this category. And you can save yourself from unnecessary treatments that might not work.

You can talk to one of our mechanical pain specialists for free by clicking HERE. It’s a completely free, no-obligation appointment that will give you all the information you need to make the best decision for YOUR health – whether that’s working with us or not!

Dr. Carrie Jose is a Physical Therapy Specialist and Mechanical Pain Expert, and owner of CJ Physical Therapy & Pilates in Portsmouth, NH. To get in touch – or inquire about getting help – CLICK HERE or call 603-380-7902