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Active and Mobile

Six Ways to Keep Your Thanksgiving Festive and Fit

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Thanksgiving is one of my absolute favorite Holidays.

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

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

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

1. Practice Mindful Eating

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

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

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

2. Interrupt your sitting.

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

3. Sign up for a Turkey Trot

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

4. Be Active during Commercials.

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

5. Walk your Dessert Off

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

6. Stay hydrated

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

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

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

Are local to Portsmouth, NH?

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

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

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a copy of her free guide: 5 Simple and Easy Ways to Get Rid of Back Pain, CLICK HERE or call 603-380-7902

Back Pain MRI

The Hidden Risks of Relying on Back MRIs

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If you’ve ever experienced acute or chronic back pain, or perhaps you’re suffering right now, you’ve likely wanted to “see inside” to know what’s going on.

You’re not alone.

Many people share this desire, and most medical doctors agree with this approach. But what if I told you that getting a back MRI too soon could actually lead you to more (and often unnecessary) injections, procedures, and even surgery?

What if I told you that 80% of all types of back pain, even debilitating sciatica, can be resolved naturally? 

This isn’t just my opinion. The research shows that getting an MRI for back pain too early may actually lead to more invasive treatments – like injections, procedures, or surgeries – which can do more harm than good in the long run. Moreover, relying on MRI results alone to determine your treatment plan often steers people away from natural, non-invasive treatments that could effectively manage, or even resolve your pain, for the long-term instead of short-term.

What the research says:

A 2023 study published in The Journal of Orthopaedic Research found that patients who received early MRIs within the first six weeks of back pain – without any red flag symptoms – were significantly more likely to undergo surgical procedures and use opioid medications. These patients also reported poorer pain outcomes and a higher incidence of disability at their one-year follow-up compared to those who delayed imaging. This growing body of evidence suggests that premature MRI scans not only lead to more aggressive treatments but also contribute to a more negative outlook on recovery, potentially worsening overall outcomes.

So, when is an MRI necessary?

An MRI is crucial when you have alarming symptoms, often referred to as “red flags.” These include signs of cancer, infection, inflammatory diseases, potential fractures, or severe neurological deficits. Healthcare professionals, including physical therapy specialists, are trained to identify these red flags, but it’s important to note that they occur in only about 5-10% of all back pain cases. To put this in perspective, in my two decades of treating patients with back pain, only three have presented with such serious symptoms. In which case, I knew to immediately refer them for an MRI.

Now, I’m not telling you this to minimize the severity of back pain. But instead, to highlight that most people do not need an MRI of their back to receive an accurate diagnosis and effective treatment. If you undergo an MRI without a clear need, you have a greater risk for undergoing unnecessary procedures or surgeries, and a greater potential for opioid prescriptions – none of which have great long-term outcomes compared to a natural treatment approach.

Let me explain:

When you get an MRI of your back, the issue is that it reveals everything – bulging discs, arthritis, stenosis, and degenerative discs – all of which are common findings and a normal part of aging (though medical doctors don’t always tell you that). After a certain age, typically in your mid-40s to early 50s, these conditions are present in almost everyone, regardless of whether they have back pain. Research supports this. For instance, a 2015 study by Brinjikji et al. found that 50% of people in their 40’s had disc bulges, and 88% of people in their 60’s had disc degeneration – and none of them were experiencing back pain. Because these findings haven’t been effectively normalized, they’re often mistakenly blamed for back pain when seen on an MRI. Why?

Because most people only get an MRI when they have back pain.

However, research like this shows that you can’t reliably correlate MRI findings with the actual cause of your pain. More and more studies continue to indicate that people with and without back pain can have nearly identical MRI results. As Martin Underwood, MD, co-author of the Lancet series and professor at Warwick Medical School, stated: “If you start treating disc degeneration just because it appears on an MRI, the likelihood is that, for most people, it isn’t contributing to their back pain at all.“

Feeling confused? You’re not alone.

The reality is that 70-80% of all back problems, including sciatica, are what we call “mechanical” in nature. This means your pain will fluctuate – you’ll have good days and bad days – and movement has the ability to bring you both relief and make your condition worse. Frustrating – right? Or maybe it’s comforting because this sounds just like what you’re experiencing?

Regardless – here’s the thing – mechanical back pain can’t be accurately diagnosed with an MRI.

Instead, it’s accurately identified through specialized repeated movement testing (by a mechanical pain specialist) to determine what triggers and alleviates your pain. From there, corrective movement strategies can be prescribed to eliminate your pain and prevent it from returning. While this approach may take longer, it offers much better long-term results than any procedure or surgery. If you undergo an MRI for what is most likely mechanical pain, you risk receiving unnecessary treatments that could worsen your condition. It’s important to remember that back surgery is irreversible, and complications from surgery can be challenging to manage.

You owe it to yourself to explore all conservative treatment options first.

If you’re currently dealing with back pain or sciatica – or have been dealing with it for years – I understand how frustrating that can be. Consider consulting a mechanical back pain specialist who can help you pinpoint the true cause of your back pain and address it with corrective movement strategies instead of relying on an MRI. Give yourself the opportunity to resolve your back pain naturally, without resorting to invasive procedures or surgery.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media group. To get in touch, or request a seat in her upcoming Masterclass: “Put an end to back pain naturally – without procedures or surgery – CLICK HERE.

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.

Will a Cortisone Shot Help Your Nagging Shoulder Pain?

Are Cortisone Shots the Best Option for Chronic Shoulder Pain?

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Nagging shoulder pain can be extremely annoying.

But when it starts to interfere with things you love to do – you can’t help but wonder – is it time to get a cortisone shot? 

When you’ve got dull, nagging shoulder pain that just won’t go away, cortisone shots suddenly seem very attractive. They’re quick, easy, and seemingly harmless – right? Not so fast. Just because cortisone shots for shoulders are routine, popular, and often effective at getting rid of pain – it doesn’t mean they are the best or right thing to do.

What is a cortisone shot and how does it work?

Cortisone shots are typically administered to reduce localized inflammation inside a joint or tendon. In shoulders, it’s very common to use this procedure to reduce pain from arthritis, bursitis, rotator cuff tendonitis, and even frozen shoulders. When inflammation is confirmed to be the root source of your shoulder problem, and it’s not going away with medication, on its own, or with physical therapy – a cortisone shot may be the right course of action. But what if inflammation is not the root source of your problem? What if inflammation is actually a secondary symptom? This is where most of the confusion lies in the medical community. While it might not seem like a big deal (pain is pain, right?) – you put yourself at risk for irreversible damage to your joints and tendons if you keep getting cortisone shots when you don’t actually need them. 

So how do you know if a cortisone shot is best for your shoulder pain?

Step one is making sure you’ve correctly identified the root source of your shoulder pain. Is it a chemical source – where the inflammatory process to heal something injured within your shoulder has gone haywire? Or is it a mechanical source – meaning the source of your pain is due to poor movement habits and imbalances in your body.  The difference matters – and will determine whether or not a cortisone shot is, indeed, the best option for your chronic shoulder pain.  Let’s look at the differences between the two sources of pain to help you figure out when a cortisone shot is best for your shoulder pain – versus when you should hold off.

“Chemical pain”

Chemical pain is normal (until it isn’t) – and it’s the result of your body’s natural inflammatory response to injury. When your body is trying to heal from an acute injury or tissue damage, a complex chemical reaction occurs between your blood and other cells that involves the releasing of chemicals to “flush out” the injured area and start the healing process. A good example of this is when you fall and sprain something. The sprain causes tissue damage – so your body creates inflammation to heal it. Normally this process has a start and an end. As your pain subsides, so does this chemical process called inflammation. But sometimes this inflammatory process can get out of control for various reasons. And the accumulation of toxic chemicals sticks around (they don’t ever flush out or go away). The result is constant irritation to your nerve endings and surrounding tissues. You’ll experience constant, dull pain (even at rest) that will appear extremely sensitive to any and all movements. There will be no reliability as to what makes your shoulder feel better – or worse. As you’ll read below – the presentation of shoulder pain due to an underlying chemical cause behaves quite differently from shoulder pain due to a mechanical cause. When it’s chemical – a cortisone shot is often necessary – and the best option for your shoulder pain 

“Mechanical pain”

Mechanical pain is responsible for 80% of all shoulder pain. The hallmark sign of mechanical pain is that your pain will come and go based on certain activities, movements, or positions. It’s not constant and throbbing like with chemical pain. You’ll find, for example, that your shoulder pain eases with exercise, movement, and certain positions – while other times it seems to have a mind of its own and will hurt constantly. But typically, you’ll have some sense about things you can do to ease and/or aggravate your shoulder pain. And this is what makes mechanical pain so confusing  – because when you’ve aggravated it – your shoulder will feel inflamed. But the presentation is different from that I’ve just described above, namely, your pain comes and goes. This type of inflammation is a symptom – and not the root cause of your shoulder pain. A cortisone shot may work temporarily to abolish this type of shoulder pain, but it’s going to keep coming back until you address the root mechanical reason that is causing the shoulder inflammation. What you risk here is getting repeated cortisone shots in your shoulder because you think they are working – when they are only serving as bandaids. 

The verdict?

For chemical pain, a cortisone shot is likely the best option for getting rid of your shoulder pain. But for mechanical pain – it’s not. For shoulder pain that is mechanical, you fix it naturally, with specialized and corrective movement strategies. The tricky part here is distinguishing between primary inflammation that’s gone haywire versus secondary inflammation that is responding to activities, overdoing it, or simply the way you move. Don’t try to figure it out yourself – let a mechanical pain expert do that for you.

Are you local to Portsmouth, NH?

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

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or reserve a seat in her upcoming free Masterclass for headaches, neck & shoulder pain – email [email protected] or call 603-380-7902

Osteoporosis

5 Ways Pilates can help Manage Osteoporosis

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Osteoporosis is a “silent” disease of the bones that makes them weaker and far more susceptible to breaking.

The Bone Health & Osteoporosis Foundation estimates that approximately 10 million Americans suffer from this disease, and another 44 million have low bone density. Osteoporosis affects one in two women and one in four men. A woman’s risk of breaking a bone when she has osteoporosis is equal to her combined risk of breast, uterine and ovarian cancer. For men, they are more likely to break a bone than get prostate cancer. Hip fractures are common with osteoporosis, and of the nearly 300,000 folks who fall and break their hips, 25% end up in nursing homes and never get back to their previous function.

If these statistics don’t scare you, they should. But the good news is there are plenty of things you can do – starting right now – to help protect yourself from this condition. When you research osteoporosis, diet and exercise consistently come up as key prevention strategies. When it comes to exercise, you want to make sure it focuses on healthy resistance exercises, mobility, flexibility, and balance. 

Well… there happens to be one exercise system that accomplished all of this. It’s called Pilates.

Here are 5 Ways Pilates can help manage your Osteoporosis:



1. It’s a weight bearing exercise

One of the primary recommendations for preventing and managing osteoporosis is to engage in weight-bearing exercises. Well here’s the amazing thing about Pilates – the entire exercise system is based on bearing your own weight through various movements. Pilates gradually progresses you through postures of lying, kneeling, and standing – on both hands and feet – allowing you to bear weight through multiple planes and postures. This makes Pilates an excellent choice for those wanting to better manage their osteoporosis.


2. It improves muscle strength

You might be wondering… how does improving muscle strength help with bone strength? As your muscles become stronger, they pull harder on your bones, which helps improve the inherent strength of your bone. Plus, stronger muscles provide more support to your skeletal system as a whole, putting you at less risk of a fracture. Pilates in particular focuses on core strength – which is key for providing support to all your other muscles. And when you use the Pilates equipment to enhance your practice, you’ve got the resistance of springs putting special focus on all your tiny muscles, which helps strengthen areas of your body that might be inaccessible via traditional strength training methods.

3. It enhances flexibility and range of motion

It’s quite common for your joints to get stiffer and your flexibility to be impacted when you’ve got osteoporosis. You may think this is inconsequential – but stiffness and immobility can actually create more stress on your bones – which is what we’re trying to avoid. Pilates exercises emphasize the stretching and elongation of muscles, which inherently improves your range of motion. This will not only make you feel better – but makes doing everyday tasks a lot easier and they’ll feel less stressful on your body – which is important when you’re dealing with osteoporosis.


4. It encourages proper alignment and posture

Over time, osteoporosis can lead to unwanted changes in your spine, such as a stooped or kyphotic posture. Not only will these changes make it more difficult and uncomfortable to sit upright and move around, but they can make the bones (vertebrae) in these deformed areas of your spine more susceptible to damage. Pilates can help prevent and reverse these changes. Pilates emphasizes lengthened and proper spinal alignment and helps you to become more aware of your posture during the day. If you want to avoid (or even reverse) a slumped and kyphotic posture – with or without osteoporosis – Pilates can help.

5. It helps improve your balance and stability

Fall prevention is critical for those living with osteoporosis. And one of the best ways to prevent falls is to work on your balance. One might not think of Pilates as playing a key factor in this, however, Pilates is an exercise system that not only focuses on your core, but your feet as well. Everyone knows that a stronger core is going to make your whole body feel more stable. But when you’ve got feet that are more mobile and more in-tune with the ground – it dramatically improves your balance – making Pilates a safe and healthy way to not only improve your balance but decrease your risk of falling.

The best management of osteoporosis requires a multifaceted approach – and factors such as diet, nutrition, and exercise modifications must all be considered. Pilates is just one factor in the mix. But I like it because it hits on so many areas that are critical for the successful management of osteoporosis. If you’ve never tried Pilates before, I’d highly recommend giving it a whirl.

But be sure to get approval from your doctor first, and enlist the help of a movement specialist who understands how to work with someone suffering with osteoporosis.

Local to Portsmouth, NH? Consider speaking with one of my specialists by clicking HERE.

 Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media group. To get in touch, or enroll in her upcoming OsteoCore Strong Bones Program – visit her website www.cjphysicaltherapy.com or call 603-605-0402