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5 Reasons to Ditch the Pills and Embrace Exercise as Medicine

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Our bodies are built for movement, yet modern life has us sitting far more than we should.

Compared to our ancestors, we’re moving less and sitting more – sometimes for over half the day. While fitness trackers and smartwatches encourage us to stand and get more steps in, it still doesn’t seem to be enough to counteract the effects of a sedentary lifestyle.

Physical inactivity has now become a major health issue, and the consequences are clear: less movement leads to more musculoskeletal issues and chronic pain (among other things). And the unfortunate reality is that most folks turn to pain medication for relief, despite research increasingly pointing to regular exercise being just as effective and far healthier.

Here are 5 reasons to ditch the pills – and embrace exercise instead – as a powerful form of medicine to manage musculoskeletal pain naturally.

1. Exercise Mediates Pain

The way we perceive pain is complex. Many assume it’s a direct response to physical damage or injury – but it’s not that simple. The perception of pain involves numerous physiological and psychological factors that the brain must interpret. Depending on your general health, past experiences, and mental health condition, this can vary quite drastically from person to person. In other words – it’s your brain that decides how much or how little pain you experience.

Because of this complexity, external factors like exercise (and also pain medication) can alter how we perceive these signals. When we exercise, our bodies exhibit an increased tolerance towards pain, and a lower perception of pain intensity. This phenomenon is called “exercise-induced hypoalgesia” – and it works by closing down the gateways that allow pain signals to enter the brain. Certain medications can do this too, but when you exercise, you’re doing it naturally. 

2. Exercise Helps Inflammation

Inflammation is a normal part of your body’s healing process, and it occurs when inflammatory cells travel to a place of injury. However, if inflammatory cells stick around too long, it can result in chronic pain and irritation. This is where exercise can really help. 

When you exercise, your body experiences minor physiological stress, which triggers your body’s natural inflammatory reaction. During the inflammatory process, certain proteins called anti-inflammatory cytokines are produced. These protein chemicals help to modulate the body’s inflammatory response – ultimately reducing the level of inflammation associated with your pain. Inflammation can be both good and bad. When you exercise, you are creating “good” inflammation, which will naturally help to ease your pain.

3. Exercise Stimulates Endorphins

Ever wonder why a quick walk outside or a strenuous gym workout magically makes you feel better? It’s not your imagination. It’s something called endorphins – neurotransmitters released by your brain to alleviate pain and promote pleasure.

Endorphins are considered your body’s natural “opioids” because they interact with the same pain-inhibiting receptors in your brain that drugs like morphine do. But unlike morphine, endorphins are triggered naturally and don’t come with harmful side effects like addiction, drowsiness, or mental fog. Exercise stimulates the production of endorphins, boosting your mood, reducing stress, and giving you access to your very own stash of natural, healthy painkillers.

4. Exercise Improves your Mental Health 

Exercise and mental health share a powerful connection. It’s virtually impossible to influence one without the other.

Regular exercise stimulates the production of various mood-boosting chemicals, including endorphins (that we just spoke about) along with serotonin and norepinephrine. Aside from helping to control pain, endorphins are also considered a “feel-good hormone”. They trigger feelings of positivity that, once again, are similar to morphine. Serotonin and norepinephrine are instrumental in alleviating symptoms of depression and anxiety. Therefore – when you exercise – it’s virtually impossible not to feel better. And since we know that pain is controlled by your brain – anything that improves mental health is going to contribute positively to your relationship with pain.

5. Exercise as a Prescription

OK – so we’ve discussed the multitude of positive effects that exercise has on pain perception, inflammation, and mental health. But what if you’re currently suffering from an injury? Is it possible to still use exercise as a pain reliever? The short answer is yes. But it’s challenging to do on your own. You can’t just google “best exercises for back pain” and expect good results.

When it comes to using movement or exercise to rehab an already existing injury – it needs to be carefully prescribed. 

For all the reasons already discussed, physical activity will still help you modulate pain – but you must consider the role exercise is going to have on any potential tissue damage. With weakened or damaged tissue, exercise is still an effective pain reliever, but it has to be prescribed or you risk worsening your injury.

For these reasons, I always recommend working with a movement expert who truly understands the nature of musculoskeletal pain and tissue healing. If you start a general exercise routine because you want to feel better  – I applaud you – just make sure you’re getting your desired result. But if you start exercising to help with pain and don’t experience any noticeable improvement – or you catch yourself modifying to work around your pain – then it’s time to enlist the help of an expert. Otherwise, you risk ending up on pain pills, which is exactly what we want to avoid.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE.

Why Walking is Essential for Your Health After 50

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Walking is one of the most underestimated, yet accessible and beneficial forms of exercise for folks over 50.

As we age – the saying “use it or lose it” gets closer to home – and maintaining an active lifestyle becomes even more crucial. 

The good news is that a regular routine of walking offers a simple and low-impact way to not only maintain an active lifestyle – but combat the “use it or lose it” syndrome. A regular walking routine not only supports cardiovascular health, strengthens muscles and bones, and aids in weight management – but also boosts mental well-being and enhances balance and coordination. It’s not a surprise to me that more and more adults over 50 are lacing up their walking shoes and hitting the pavement… yet so many are still skeptical and/or disregard this great form of exercise.

Regardless of where you stand on walking for health… Here are 7 reasons to do it (especially if you’re over 50):

1. Enhances Cardiovascular Health

Cardiovascular disease remains the leading cause of death among older adults. A regular walking routine can significantly improve heart health by boosting blood circulation, reducing bad cholesterol levels, and increasing good cholesterol levels. The rhythmic nature of walking ensures that your heart pumps at a steady rate, which is beneficial for overall cardiovascular health.

2. Strengthens Muscles and Bones

Aging naturally leads to the loss of bone density and muscle mass. However, regular walking can counteract this process. As a weight-bearing activity, walking strengthens bones and reduces the risk of osteoporosis and fractures. It also engages multiple muscle groups simultaneously, helping them stay active and strong.

3. Boosts Mental Health

Walking isn’t just a physical activity – it’s also great for mental health. Walking has been shown to reduce symptoms of depression and anxiety significantly. It provides an opportunity to clear your mind, reflect, and even meditate. Walking with friends or loved ones adds a social aspect, which can be incredibly beneficial for your mood and mental well-being. For an extra mental boost, try walking in nature—the fresh air and tranquil environment can be rejuvenating for both mind and soul.

4. Aids in Weight Management

As you age, your metabolism naturally slows down, making weight management more challenging. Regular walking helps burn calories, maintain a healthy weight, and prevent chronic diseases like diabetes and heart disease. Being at a healthy weight also means increased energy levels, easier mobility, and less stress on your joints.

5. Improves Joint Health

Many people fear arthritis and avoid activities that might exacerbate it. However – despite some medical opinions – movement is one of the best remedies for arthritis. And walking is particularly beneficial for arthritis. It helps lubricate the joints, especially the knees and hips, and keeps the surrounding muscles and soft tissues loose and flexible. Regular walking is super beneficial for managing arthritis effectively.

6. Enhances Balance and Coordination

Falls are a significant concern as we age due to decreased bone density and the subsequent naturally occurring increased risk of fractures. Maintaining balance and coordination is easier than trying to regain them after they’ve diminished. Walking requires the coordination of several muscle groups – plus enhances the body’s ability to stabilize itself quickly – thereby reducing the risk of falls.

7. Low-Impact and Adaptable

One of the greatest advantages of walking for those over 50 is its low-impact nature. Unlike high-impact exercises such as jogging – walking is gentle on the joints and can be easily adapted to fit your fitness level. Whether you prefer a leisurely stroll around the neighborhood or a brisk hike in the park – walking can be tailored to meet your individual needs and goals.

If you’re over 50… and you haven’t yet incorporated a regular walking routine into your lifestyle…

What are you waiting for? It’s one of the most simple yet effective ways to stay active, healthy, and mobile after the age of 50. But if an injury or pain is holding you back from starting or continuing a regular walking routine – it’s time to consult a movement expert. 

Eighty percent of all musculoskeletal pain and injury is related to a movement problem that can be resolved naturally, and without procedures or surgery. But you can’t truly figure this out without consulting a movement expert, or physical therapy specialist who specializes in mechanical pain. Reach out if you need help finding one in your area.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE.

Avoiding Movement

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

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Fear is a natural, protective response to injury.

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

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

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

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

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

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

Let me explain…

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

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

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

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

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

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

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

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

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

Knee Pain Causes

Six Tips to Improve Knee Pain Naturally and on Your Own

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When you’ve got persistent, nagging knee pain – it can have quite the impact on your quality of life. But the good news is there is plenty you can do naturally and on your own to help relieve knee pain, even if you’ve been suffering for years.

Here are 6 of my top tips for how you can improve knee pain naturally and on you own:

  1. Strengthen Your Hips and Core:

Your hips and core provide essential support and stability to your entire body, but especially your lower limbs and knees. Strengthening this important muscle group is a key component for not only relieving knee pain, but preventing it as well. When you’ve got weakness or imbalance in your hips and core, it leads to poor alignment and compensatory stress on your knees during movements like walking, running, or squatting. Strengthening your hips and core will improve overall biomechanics, reducing the load placed on the knees and preventing excessive wear and tear.

  1. Get (and stay) Flexible:

One saying you’ll hear me repeat over and over is: “mobility before stability”. That’s because when you’ve got stiffness in your joints, the surrounding muscles will try to compensate. And muscles don’t work as well when the joint they are in charge of moving doesn’t have full and free mobility. Good and optimized joint mobility will enhance the body’s ability to move efficiently and with proper body mechanics, reducing the strain on your knees. By increasing (and maintaining) your flexibility and range of motion – your body will move more freely and distribute forces more evenly throughout your joints and muscles – thus – reducing the risk of overload on your knees.

  1. Interrupt Your Sitting:

Knee pain can come directly from your knee, but also from your spine (even when you don’t have any back pain). When you interrupt your sitting often throughout the day, this addresses both potential causes. For knees in particular, prolonged periods of sitting can cause stiffness, and lead to poor blood circulation in and around your knee joint. Sitting for extended periods can also lead to tightness in the hip flexors and hamstrings, which can negatively impact knee alignment and function. By taking regular breaks to stand up, stretch, or move around, you can relieve pressure on your knees, maintain good joint mobility, and prevent muscle imbalances that will only lead to more knee pain over time.

  1. Get (and keep) Moving:

Regular movement and exercise helps to stimulate blood flow. And if you’ve got inflammation in your knees causing pain, good blood flow helps to reduce inflammation by delivering essential nutrients and oxygen, while also removing waste products. If your knees are on the arthritic side, engaging in low-impact exercises like walking, swimming, cycling, or Pilates can help build strength and endurance around your knees without putting excessive stress on the joints. Regular movement also helps lubricate your knee joints, which can reduce friction and discomfort during daily activities. And perhaps the biggest benefit of regular exercise and movement is the release of endorphins – which are your body’s natural painkillers that can help alleviate discomfort in any joint, not just your knees.

  1. Choose Sensible Footwear:

The right (or wrong) footwear can make a huge difference in how your knees feel with walking, running, or standing. When you’ve got proper footwear, it provides the support and cushioning you need to reduce impact on your knees. Depending on the mechanics of your feet and ankles, footwear can also help to enhance or improve your alignment and stability. By choosing footwear that prioritizes comfort, support, and proper alignment, you can effectively reduce knee pain and improve your overall joint health.

  1. Improve Your Balance:

Good balance is important for a lot of reasons, namely, it allows you to have good stability and control during movement, and it reduces your fall risk. But having good balance can also reduce the strain in your knees. That’s because having good balance requires the coordination and strength of your postural muscles, feet, and ankles to all work together and distribute forces evenly. When that doesn’t happen, your knees tend to overcompensate and suffer. So working to improve and maintain balance can help to decrease the stress on your knees by getting other joints and muscle groups to “join the party”.

If you’ve been suffering from knee pain for awhile and not yet incorporating any of these 6 tips into your daily or weekly routine, get started now and see if it helps.

If knee pain is getting in the way of you even being able to incorporate some of these tips, then it’s time to speak with a physical therapy specialist. They will help you identify the root cause of your knee pain and come up with a treatment plan that is designed to get rid of your pain – and teach you how to keep it gone – naturally and on your own.

Are you local to Portsmouth, NH? Consider speaking with one of my specialists to see if we would be a good fit to help! CLICK HERE to request a free discovery visit.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected]

Holding Knee with Arthritis

Torn Meniscus? Is Surgery Worth it?

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It’s estimated that approximately 750,000 arthroscopic knee surgeries are performed every year – the majority of them being due to a torn meniscus.

But at a cost of about $4 billion per year – is this surgery even worth it?

Let’s investigate…

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. The biggest set of pro’s for this procedure is that it’s quick, recovery is fairly minimal, and you will typically experience an immediate relief of pain.

Sounds worth it – right?

Not so fast. There are many cons to this procedure as well, many of which are not realized until it’s too late. So it’s worth a second opinion and considering all of your options before you jump in.

First, as with any surgical procedure, even if it’s minimally invasive, there are risks. Complications include nerve damage, excessive bleeding, infection, reactions to anesthesia, persistent stiffness and swelling, or blood clots. While these risks tend to be rare, they don’t outweigh the other long-term considerations you should be aware of.

Looking to avoid a knee replacement in your future?

Then you’ll definitely want to think twice about getting arthroscopic meniscus surgery. Research tells us that people who undergo arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that quite possibly could have been avoided. This is because you’re removing vital cushioning and shock absorbing mechanisms (the meniscus) from your knee joint. Plus, a meta-analysis published in Oct 2020 in the Knee Surgery, Sports, Traumatology, Arthroscopy journal revealed a 36% failure rate by year two – and a 13% failure rate by year five for meniscus repairs – resulting in more surgery and eventual knee replacement.

And then there’s the elephant in the room…

It’s more common than you think for knee pain to be coming from somewhere other than your knee, even when your MRI shows a meniscus tear. Knee pain can be caused by problems in your ankle, hip, or back. One study showed that 40% of the time – knee pain comes from a source in your spine – even when you don’t have any back pain. MRI’s add even more confusion to this because degenerative changes, which are normal as we age and very commonly lead to a torn meniscus, make surgeons think your meniscus is the cause of your knee pain when it might not be. The only way to truly determine the cause of your knee pain (in the absence of trauma) is through a proper mechanical exam that involves repeated movement testing to reveal the actual pain generator. 

The truth is – 70-80% of all knee problems can be resolved naturally and without surgery.

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 to repair a torn meniscus?

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. 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 didn’t get physical therapy from a specialist – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery. 

If you’re young and involved in high-level sports, meniscus surgery is likely worth it for you.

But for most people, especially those over the age of 40, there’s a 70-80% chance you can get full relief of your knee pain, and full restoration of knee function without any type of surgery or procedure. This is not a popular opinion by the way, so be careful who you speak to for a second opinion. But for me, both the research as well as my 22 years of clinical experience tell me that most people (especially those over age 40) can resolve their knee pain naturally and with better long-term results if they avoid arthroscopic knee surgery – even when there’s a meniscus tear.

6 Reasons Your Back Surgery Failed

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Back surgery, often viewed as a last resort for those suffering from debilitating back pain, has become increasingly common in the last 15 years.

A quick Google search reveals that an estimated 1.5 million spinal fusions are performed annually in the United States alone. When you consider that 70-80% of all back pain is considered “non-specific” and does not require surgery – that number is staggering. Additionally, it’s been well documented that 20-40% of all back surgeries fail, resulting in what we call “Failed Back Surgery Syndrome”. So why then – do we continue to operate?

If you or a loved one is considering back surgery – I highly recommend you do your due diligence and research first.

To give you a head start – here are 6 reasons why back surgery often fails:

1. Incorrect Diagnosis

If the wrong diagnosis leads you to an unnecessary surgery – then your back surgery is going to fail. How does this happen? All too often we blame aging structures in the spine as the main source of our pain. But what many fail to understand is that arthritis and degenerating discs (for example) are a normal part of aging. Everyone has it – but not everyone has back pain. An aging spine is not a reason to get back surgery – so be cautious anytime someone blames arthritis or disc degeneration for your pain. It’s typically not the full story.

2. Surgical Complications

Surgical complications are a risk when you undergo any type of surgery – even when it’s coined “minimally invasive”. From anesthesia reactions, to accidentally nicking a nerve, to the possibility of infection – complications can occur – and some of them irreversible. Conservative therapy and natural treatments involving movement and exercise come with virtually no risk – and have better outcomes than surgery according to research. You want to make absolutely certain that a back surgery is warranted before you put yourself at risk for complications.

3. Scar Tissue

Scar tissue is an unavoidable consequence of any surgery and a necessary part of the healing process – but its impact is significantly underestimated. For some, scarring can get out of control and be excessive, manifesting itself similar to an auto-immune condition. For others, they simply have no clue that scars need to be managed and mobilized. Unmanaged scar tissue will become adhesive and may cause problems with your nerves, fascia, and general mobility. While there are treatments such as Shockwave therapy that can help regenerate damaged soft tissue from scarring – unmanaged scar tissue can be one reason your pain doesn’t resolve after back surgery.

4. False Expectations

A lot of folks go into back surgery with false expectations. They think they’ll be out of pain and back to their activities in no time. But proper healing from back surgery is deceivingly long. While most incisions will technically heal in about 2 weeks – your body has a different timeline. Most people grossly underestimate the impact their condition prior to surgery will have on their recovery. Your pain may be gone after surgery, but all of the underlying, compensatory problems that developed leading up to your surgery have not magically disappeared.

For example, it takes a minimum of 6-8 weeks to build and retrain muscle. If you had nerve impingement that was inhibiting a muscle from performing properly, it’s going to take several months to get that strength back. When this is not considered, and you jump back into activities too soon, you’re asking for trouble.

False or mismanaged expectations about recovery after back surgery is a big reason for poor outcomes.

5. Images are Misleading

X-rays and MRI’s do not tell the full story when it comes to back pain. And in most cases, they are misleading and can result in an incorrect diagnosis. For example, I already mentioned to you that most things you see in your images – such as arthritis, degenerative disc disease, and even bulging discs – occur naturally as you age.

But they don’t always lead to back pain.

Studies have shown that 60% of folks in their 50’s will have bulging discs on X-ray and 80% will have disc degeneration – regardless of whether back pain is present or not. These statistics only increase with age. If you allow your imaging alone to dictate your decision to get back surgery – you’re increasing your risk of it failing because it may not have been necessary in the first place.

6. Back Surgery Makes Money

At the end of the day, healthcare is a business. And back surgeries are among the most lucrative procedures in the medical industry. According to studies and statistical data, common back surgeries like lumbar fusion cost anywhere from $50,000 to $90,000. But it only costs hospitals a fraction of that amount to actually administer. Plus, despite its unethical nature, some surgeons have been reported to receive kickbacks for using certain medical devices and performing more surgeries. While this is an indirect reason for your back surgery failing, it’s not something you can ignore. The profitability of back surgery naturally lends itself to being overutilized when there could be better, natural solutions instead.


After all this, I hope you can see that back surgery isn’t a decision you should take lightly, and a good outcome should not be assumed.

Consider the statistics. Anywhere from 20-40% of all back surgeries fail and it could be due to any of the reasons we just looked at. Most back pain (70-80% to be exact) is considered non-specific and mechanical in nature, and can be resolved naturally with prescriptive exercises, lifestyle changes, and corrective movement strategies. It’s worth exhausting all of these options first before jumping into a surgical procedure that has a good chance of failing you.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain, CLICK HERE or to get in touch, email her at [email protected].