Tag Archive for: pilates

6 Tips to Protect Your Back When Shoveling Snow

/in , , /by

6 Tips to Protect Your Back When Shoveling Snow

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

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

1. Warm Up First

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

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

2. Use Your Legs

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

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

3. Pivot Instead of Twist

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

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

4. Breathe to Engage Your Core

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

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

5. Stay Hydrated

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

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

6. Use Ergonomic Tools

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

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

Bonus tip: See a Specialist

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

Are you local to Portsmouth, NH?

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

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.

knees

Spooky creaks and cracks coming from your knees?

/in , , /by

Do your joints crack or make noises every time you move a certain way?

If you’re like most people, these noises concern you.  Does it mean something is wrong with your knees?  Are your joints deteriorating? What happens if it continues? First of all, cracking in your knees (as well as your other joints) is quite common, and most of the time there’s a reasonable explanation for it. 

Crepitus is the term used to describe any grinding, creaking, cracking, grating, crunching, or popping that occurs when you move a joint like your knee. You can experience this at any age, but it’s certainly more common as you get older. 

So what causes crepitus and should it be a concern?

The most common causes of crepitus include air bubbles popping inside your joint, tendons or ligaments snapping over your joint’s bony structures, or the degeneration of your joint’s cartilage that generally occurs with arthritis. You may experience uncomfortable sensations, or even a tiny bit of pain when this happens, but in most cases, none of this should scare or concern you.

It’s all a normal part of aging and wear and tear.

But if the cracking in your joints starts to become more regular, is accompanied by joint swelling and more constant pain, or if the cracking turns to “clunking” and your knee starts to feel unstable – then you’re smart to be concerned and it’s possible something more serious could be going on.  In this case, get your knees checked out by an expert. 

Assuming you haven’t let your knees get to the “concerned stage” yet, and the most annoying thing to you right now is the cracking, grinding, or crunching – there are things you can do to minimize this problem and prevent it from getting worse. 

The best way to minimize these noises is to keep moving.

Motion is lotion. Regular movement throughout the day keeps your joints lubricated – kind of like applying WD-40 to a creaky door hinge. You also want to make sure your biomechanics are sound. If you’ve got imbalances between your muscles and joints, it will impact the way your joints move and function, causing more creaking and cracking.

For example, let’s say your hips are on the weak side. How your knees tolerate various activities depends a lot on how strong your hips are. I’ve experienced this firsthand. I love to hike. And if my hips aren’t doing their part, I feel the entire hike in my knees, especially on the way down. And you know what else happens? My knees crack a lot more on the days after I hike.

The imbalances in my body cause more stress on my knees and the result is they crack a lot more. Now, as I mentioned previously, this isn’t a big concern for me yet. My knees don’t hurt – they are just very noisy. However, I make a conscious effort to regularly stretch my quads, and strengthen my hips and core, so that I can keep this problem at bay and not let it get worse.

Moral of this story

The “spooky” noises in your knees are often quite normal – and not just a Halloween prank. However, there are things you can do to minimize this, and you want to pay close attention to make sure those noises aren’t progressing into something more serious.  

If you notice more cracking and crunching during or after certain activities, like with me and my hiking, then it’s an opportunity for you to get ahead of it and work on some of the imbalances in your body that could be contributing to this. And of course – get moving. In so many cases, movement can be your medicine, and help you avoid something like procedures or surgery as the solution instead.

Are you a local in Portsmouth, NH? CLICK HERE to talk to one of our specialists and get a full joint and movement analysis of your knees to fully explore the “spooky” creaking and cracking.

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 get a free copy of her guide to knee pain, CLICK HERE or call 603-380-7902.

 

Sciatica

Why Cortisone Shots Don’t Work for Sciatica

/in /by

If you’ve ever suffered from sciatica – then you don’t need me to tell you how debilitating the condition can be.

From shooting and searing pain into your buttocks that can run all the way down to your foot – to numbness, tingling and loss of strength… sciatica has the ability to significantly impact your quality of life. What’s worse? It typically comes out of nowhere – making this condition even more frustrating to deal with.

It’s no wonder that a majority of people resort to “quick fixes” like cortisone shots – in hopes it will put an end to their back pain and sciatica suffering. According to the American Academy of Family Physicians (AAFP), epidural steroid injections (a type of cortisone shot) are among the most common interventions for chronic low back pain and sciatica. In a study published in The Spine Journal in 2015 – it was reported that approximately 50% of patients with sciatica opted for cortisone shots for pain relief as part of their treatment plan. 

But just because cortisone shots for sciatica are popular and considered “standard” – it doesn’t mean they are best practice.

First of all – even if a cortisone shot “works” (almost 50% of the time they don’t) – the results are typically temporary.  Only 20-30% of patients have been able to report sustained relief past a few month’s time. Everyone else reports anywhere from a few weeks to 3 months relief. The problem with the majority of people only experiencing temporary relief from cortisone shots in their spine – is that  you risk “chasing the pain” with more cortisone shots (or prescription meds), acceptance of your condition and continued suffering (I call it “bad back syndrome”), or opting for spine surgery, that in most cases, is totally preventable.

OK – statistics aside – why exactly don’t cortisone shots work for sciatica?

The reason cortisone shots don’t work is because they are attacking symptoms instead of the root cause of your sciatica. Cortisone shots are great when you have an out of control inflammatory reaction to an injury. This presentation is distinct and rare. We call it “chemical  pain” and it’s essentially the result of your body’s natural inflammatory process going a bit haywire.

What makes chemical pain distinct from mechanical pain (which accounts for 80% of all sciatica/low back pain) is that most “mechanical” sciatica will come and go throughout the day – and will be better or worse during certain activities and positions. For a simple example – your sciatica may “scream” at you if you’ve been sitting for too long – but will ease up and feel better if you stand up and stretch. This is a classic presentation of mechanical sciatica.

Chemical pain does not behave like that. It literally hurts all the time and the only thing to relieve it is drugs.

And even that is temporary – thus – justifying the more invasive cortisone shot when accurately diagnosed. The tricky thing about mechanical sciatica/low back pain is that it occurs slowly over time and is the result of abnormal stress and strain on your discs and spinal nerves. It’s a “lifestyle” and movement condition at its root – not an inflammatory condition. While the cortisone shot may succeed in temporarily getting rid of the inflammation – it won’t ever get rid of the mechanical cause – which means you’re more likely to prolong the true problem over time. A cortisone shot, at its best, puts a bandaid on your sciatica. And this is the number one reason why so many people end up in a vicious cycle of treatments, and end up getting both unnecessary and preventable spine surgery.

So what should you do for your sciatica instead of a cortisone shot?

First, trust the research and evidence – which says there’s an 80% chance your sciatica has a mechanical root cause – and that the inflammation you’re experiencing is instead – a symptom. Research aside, I can vouch for this over the 22 years I’ve been helping people get rid of sciatica naturally. 

Second, medical doctors (unfortunately) are not trained in recognizing, diagnosing, or even treating mechanical pain. You need a mechanical pain specialist to help diagnose and get rid of mechanical sciatica – if you want it done the right way and for the long term. Plus – the best thing about working with a properly trained mechanical pain expert first – is that it’s fool-proof. If it’s not a mechanical cause – and it indeed is an inflammatory process “gone wrong” inside your spine – they will rule it out quickly – and refer you for a cortisone shot (appropriately).

So here’s the good news…

There’s an 80% chance your back pain or sciatica is a mechanical problem at its source. Which means that when working with the right medical professional(s) – you can successfully get rid of it naturally – and avoid cortisone shots altogether. I’m a huge advocate of natural, DIY treatment approaches whenever possible – because although small – there are real risks associated with invasive procedures like cortisone/epidural injections. And when those adverse reactions occur – they are often irreversible. 

Why not give yourself the shot at a natural approach to your sciatica before diving into an invasive one?

I’m not talking YouTube exercises and Google – I’m talking actually mechanical pain specialists. I know a lot of them. So if you’re struggling to find one in your area – please reach out. I’d love to help.

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 grab a seat in her upcoming Masterclass: “Put an end to back pain naturally – without surgery, procedures, or pills – CLICK HERE.

Woman sleeping facedown on a bed.

Tips and Solutions for Morning Back Pain

/in , /by

Tips and Solutions for Morning Back Pain: Causes and How to Fix it

One of the most common complaints from people suffering from chronic back pain is how stiff and sore their back feels first thing in the morning. For some, it seems random – almost like they’ve “thrown their back out” overnight. For others, it’s a daily struggle, waking up achy no matter how good they felt before bed.

But why does morning back pain happen? Isn’t sleep supposed to be restorative to help your body heal?

The truth is, back pain shows up differently for everyone. And while it’s easy to blame your mattress, the real causes of morning back pain could be due to other factors – like your sleeping position, lack of regular exercise, and bulging dics. 

Let’s dive into each of these potential triggers and look at ways you can address them naturally:

 

Poor Sleeping Position

Your sleep posture can make or break how your back feels when you wake up. But what’s interesting is that the “wrong” sleeping position really depends on the root cause of your back pain. There is no one-size-fits-all. For example, some people find that lying on their back with legs elevated feels wonderful, yet for others, this position leaves them feeling stiff and sore come morning. Others experience tremendous relief sleeping on their stomach, while for some this position places a lot of strain on their spine and they wake up very stiff and achy.

Generally, the most back-friendly sleeping position is on your side. Side-sleeping makes it easier to keep your spine in a neutral, supported position, which reduces stress and tension while you sleep. It’s more challenging to find a neutral spine position when on your back or stomach. If lying on your side bothers your hips or shoulders, you can try placing a pillow under your waist and head, along with one between your thighs, to provide extra support and maintain better alignment. A pillow topper over a firm mattress makes side-sleeping a lot more comfortable as well. Small adjustments like these can significantly improve how your back feels in the morning and allow you to wake up feeling more refreshed.

Lack of Regular Exercise

A lack of regular exercise is one of the most overlooked reasons for waking up with a stiff, sore back. When you’re not moving enough during the day, your muscles (especially those supporting your spine) become weak and tight. Inactivity also reduces circulation, which means less blood flow delivering oxygen and nutrients to your muscles, joints, and discs. Without this nourishment, your tissues stiffen, and when you’re sleeping overnight, that stiffness builds. But regular movement doesn’t just strengthen muscles and nourish tissues – it keeps essential body systems like circulation, digestion, and even your nervous system running smoothly – setting the stage for more restful, regenerative sleep.

Incorporating consistent activity into your daily routine helps break this cycle. Simple exercises like walking, yoga, strength-training, and stretching encourage better blood flow throughout your body. The result? You’re less likely to experience that locked-up, achy feeling when you wake up – and you’ll likely notice deeper, better quality of sleep, too. Movement during the day primes your body to recover more efficiently overnight, reducing the likelihood of morning back pain.

Bulging Discs

This is one of the most common causes of morning back pain that I see. Your vertebral discs play a crucial role in your spine’s health by absorbing shock, holding your vertebrae together, and allowing for movement. What many people don’t realize is that your discs are made up mostly of water. Over the course of a typical day, your discs compress and lose some of that water content. But at night, while you’re lying down, they re-hydrate and can regain up to 17-25 millimeters in height.

While that might sound beneficial, it can actually be problematic if you’re dealing with an irritating, bulging disc. A bulging disc already has the potential to limit movement in your spine. But when it fills up with fluid overnight, it becomes even stiffer, leading to increased restriction and pain when you wake up.

If you’re consistently waking up feeling locked up, in significant pain, or hesitant to move – there’s a strong chance a bulging disc is contributing to your discomfort. Seeking guidance from a mechanical back pain specialist can help you get a proper diagnosis and develop a plan to manage and treat your bulging discs effectively and naturally – so you can avoid resorting to injections or procedures right away.

Don’t Always Blame your Mattress

If you’re dealing with morning back pain, hopefully this article has helped shed some light on why it’s happening. Before you go out and spend a fortune on a new mattress – consider addressing these common causes first. Take a look at your sleeping posture, evaluate whether you’re moving enough throughout the day, and rule out whether bulging discs might be part of the problem.

The good news is that 80 percent of all back pain cases can be treated naturally – and without the need for injections, procedures, or surgery. More often than not, the solution to a pain free back lies in simple, movement-based approaches that strengthen, support, and restore your body’s natural function.

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 a free copy of her guide to back pain – click here.

Pain when gardening

Pain-Free Gardening: How to Protect Your Back and Love Your Garden

/in /by

Gardening season is finally here – and with all of gardening’s positive benefits – it’s no surprise that gardening is such a huge passion for so many. 

Tending to plants and watching them flourish offers a profound sense of accomplishment. The connection to nature is therapy for your soul. And the meditative practice of gardening reduces stress, gives you a break from the hustle, bustle and stress of daily life, and enhances your mental well being. Plus – let’s not forget all the physical benefits of gardening. Anything that gets you moving, active and mobile I’m a fan of.

But how do you continue to pursue your gardening passion when your back hurts? It’s been a very common concern as of late. The good news is that it’s entirely possible to spend more time loving your garden than tending to your back.

Here are 5 of my top tips to protect your back when gardening:

1. Avoid bending from the waist

A common gardening posture I see is folks standing with straight or slightly bent knees and bending over from their waist – creating an “L-shape” with their body. While this posture is acceptable to do from time to time – it’s not a good idea to do this over and over again while gardening. This particular posture puts a lot of strain on your lower back as well as the backs of your knees. Over time, your lower back muscles will become very sore and tight, which can make them susceptible to injury when you least expect it. What to do instead? Get in the habit of squatting and bending from your knees. If you must do a particular gardening activity for a sustained period – try being on all-fours – and switch your hands periodically. These positions are much better for your back and you’ll be able to sustain the activity for much longer.

2. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back still needs a break. Our spines do not enjoy being bent forward for prolonged periods and when you do this for too long without taking a break – it puts a lot of stress on the vertebral discs in your spine and makes them more likely to bulge. I recommend setting a timer and giving yourself a break every 30 min. Simply stand up and get out of the bent over posture. Your back will thank you and you’ll be able to garden for much longer without risk of injuring your spine.

3. Pivot instead of twist

One of the most vulnerable positions for your back is the combination of bending and rotating. And when done repetitively, you’re almost guaranteed an injury to your spine. When you’re doing things like digging or planting – activities that have you bending and twisting – you want to pivot instead. Keep your body in line with the activity you’re doing. Don’t rotate or twist from your waist. How do you do this? Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and always move them as a unit. While it’s ok to bend and twist from your waist on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you have a history of back pain episodes happening to you in the past.

4. Use gardening tools wisely

Gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench. This will make it easier to sustain activities that require prolonged bending or kneeling. Lastly, use tools with longer handles to help avoid crouched over postures. If you can maintain a more upright posture while gardening, you’ll be able to tolerate it longer and with less back pain. 

5. Raise your gardens

Let’s face it, gardening involves bending over and lots of it. Activities like this are just not good for your back when done over and over. Consider modifying your garden to include more raised boxes and beds. This is going to make it so much easier to tend to your plants without having to bend over so much. And when you need to create a work surface – make sure that is raised too. Bending forward isn’t “bad” for your spine – but when you bend all the time without giving your back a break – you’re asking for trouble. Modifying your garden to make it more ergonomic can make a huge difference in the health of your spine.

Gardening has so many positive benefits and it’s a true passion for so many folks I speak with. The last thing I want is for back pain to be the thing that stops you from doing something you love. Hopefully these tips give you some important things to consider – and more importantly – help you protect your back so you can focus on loving your garden.

Are you local to Portsmouth, NH?

CLICK HERE to speak with a specialist for free.

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 get a free copy of her guide to back pain – click here or call 603-380-7902

Active and Mobile

Seven Tips for an Active and Healthy Thanksgiving

/in /by

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 (which can make your day even more enjoyable), improved digestion, happier hips, knees, and back, and you’ll offset some of the extra calories you may have consumed.

If you’re looking to be more active and healthy this Thanksgiving – here are seven tips to make it easy for you:

  1. Interrupt your sitting

We were not 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 back, hip, and knee stiffness. I recommend standing up at least once every 30 min. This could be a fun “job” to give a young child. Make them accountable for watching the clock and remind you to stand up. This is quite possibly the easiest and most effective strategy to keep your knees, hips, and spine from getting painful and stiff – and it’s an easy way to stay a bit more active this Thanksgiving.

  1. 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, it will help offset some of those extra Thanksgiving calories. 

  1. Stretch 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. 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 during commercials. It’s the perfect opportunity to do a quick 2 min exercise or stretch.  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.

  1. Walk your Dessert Off

While skipping dessert is of course an option – why not just walk it off instead? Choosing to walk off your dessert rather than skipping it strikes a balance between indulgence and staying healthy. Plus, opting for a post-meal walk has many benefits. It aids digestion, helps regulate blood sugar levels, and it’s good for your hips, back and knees. 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 a length of time. It’s also 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.

  1. Help with clean-up

Don’t be shamed into “just sit down and relax” because you’re a guest. Helping with clean-up (or set-up) is an easy and effective way to keep moving during your Thanksgiving Holiday. Not only will your Thanksgiving host love you – but your body will too. If you’re suffering from back problems, be careful bending and leaning over – especially if it’s repetitive – when you’re collecting or washing dishes. But otherwise, carrying heavy plates, moving chairs, and wiping down tables can burn quite a few calories and it’s good for your body.

  1. 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 during this holiday. Plus, water aids in breaking down food, allowing for better nutrient absorption and preventing digestive discomfort. Staying hydrated also helps with maintaining your energy levels and keeping your mind clear. When it comes to appetite, we often mistake thirst for hunger, so when you stay hydrated, 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 making healthier choices becomes easier – which will contribute to a more balanced and enjoyable Thanksgiving Day.

  1. Make your dishes health-conscious

It’s easier than ever to make your traditional Thanksgiving recipes more health conscious. Start by reducing the amount of sugar and salt in recipes, and consider natural sweeteners like honey or maple syrup instead. When it comes to stuffing and flour – opt for whole grains instead of refined ones. Incorporating more fruits and veggies can boost the nutritional value of traditional dishes, and sticking to lean meats such as turkey breast is a healthier choice compared to something like ham. Lastly, watch your portion sizes. Don’t dump everything you see onto your plate – however tempting it might be – and eat slowly. The faster you eat – the more you tend to eat. 

There you have it – seven easy tips to make your Thanksgiving more active and healthy.

I hope you have a wonderful Holiday and get to spend it with those you love most.

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, email her at [email protected].

Medicare cuts

Medicare cuts coming in Jan. Why you should pay attention.

/in , /by

On Nov 1st, the Federal government issued a final ruling that’s going to result in Medicare cuts of 4.5%. In an already dysfunctional and overcrowded healthcare system – this is going to be a problem for you (the consumer) – and here’s why…

Healthcare is ultimately a business. And its goal is to make a profit. Revenue and profit come from things like procedures, tests, images, and surgery – not from disease prevention and keeping people healthy.

What does that mean for you?

Health care specialities such as orthopedic surgery, neurology, and gastroenterology (for example) – those that are procedurally-driven – generate higher revenues and get paid more for their services.

On the flip side – disciplines like primary care physicians, rehab therapies (like physical therapy), and endocrinologists (those that manage chronic conditions like diabetes and osteoporosis) – get paid less.

The consequence is that the disciplines who actually need more time with you- so they can get to know you and your lifestyle – because that’s what is required to give you a good strategy for disease and injury prevention- are forced to do more work for less.

Eventually, something has to give…

Family medicine doctors have to see patients every 10 minutes and that’s if you can even get in to see them in a timely fashion. Physical therapists have to see multiple patients per hour, resulting in 12-16 patients per day.

These caseloads and demands are not supportive of a health care practitioner truly getting to know you as a person, what your concerns are, or what your particular lifestyle and burdens are. (A recent commentary by Shirlene Obuobi, MD in the Washington Post illustrates this dilemma quite well.)

These are all critically important factors if you want to get effective treatment and advice that’s going to match your needs and deliver the outcome you want.

The consequence is sub-par preventative care. And you risk unnecessarily getting shuffled off to the “specialist” who uses fancy tests and procedures (instead of getting to know you and asking questions) to make (often costly) decisions about your health.

Now, my intention here is not to paint specialists who use procedures and tests as their norm of examination as the “bad guys”.

The problem is you, the patient, is getting pawned off on them too soon because the people who are meant to protect you and help you defend against disease and injury are getting crushed (and not valued) by the health insurance companies.

Medicare tends to be the leader and everyone else follows suit. If these 2023 cuts go through, commercial insurers will be next.

So what can you do?

First, you must do everything in your power to become educated about health and wellness. Then, you can prevent disease and injuries on your own.

This may require hiring certain, key, preventative health care professionals to guide you – such as getting your own dietician, your own physical therapist, and your own mental health professional. Ironically, we already do this without even thinking about it when it comes to our dental care.

Why wouldn’t we want to do this with other aspects – like digestive, mental, and musculoskeletal health?

Health insurance companies add red-tape when it comes to accessing these services. An example is requiring a referral. Referrals that our already overburdened primary care physicians don’t have time to give. This leads me to my second recommendation. Start thinking outside the box. Be willing and able to invest in the health care you both desire and need.

Going outside of insurance and paying out of pocket for preventative care services is not as expensive as you think. Your options could open up exponentially. Especially if you budget and plan for it. At some point, it’s not going to be in your favor to rely on your health insurance to fund all your healthcare needs anymore. It’s clear they’re not interested. Instead, look at your finances and start budgeting.

One of the best ways to do this is to open up a health savings account. If your health plan doesn’t allow for that, then open up a separate savings account to save on your own. More and more practitioners are ditching insurance – if not leaving their respective professions altogether. Do you want to stay out of the hospital? Or big corporate health care systems and see someone private who has the time to care about you? You will have to pay. Personally, I believe this is the way to go but I understand it’s not for everyone.

However, with some planning and foresight, it could be.

I hope things do eventually change for the long-term. Stay educated, take control over the administration and funding of your health care in the short term. This is a far better alternative than heading to Washington and fighting Congress on your own.

Are you local to Portsmouth, NH? CLICK HERE to request a Free Discovery Session with us – we’ll ask you what’s been going on – and see if we’re the right fit to help you.

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 request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

Active and Mobile

Five Easy Ways to Stay Active and Mobile this Thanksgiving

/in , , /by

Thanksgiving is one of my favorite Holidays and it’s right around the corner. Rest and relaxation might be top of mind for you. But, it’s still important to stay active and mobile throughout the day. 

Our spine and joints don’t like to be sedentary for prolonged periods. And that’s especially true if you’ve got arthritis, back or knee pain.

You may not notice any pain while you’re sitting or relaxing, but you will pay for it the next day if you don’t find ways to keep moving.

So here are five very easy ways to help you stay active and mobile this Thanksgiving:

  1. Interrupt Your Sitting.

Our bodies were not 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 back and knee stiffness. I recommend standing up at least once every 30 min.

This could be a fun assignment to give a young child. Make them accountable for watching the clock and remind you to stand up. This is quite possibly the easiest and most effective strategy to keep your knees, hips, and spine from getting painful and stiff throughout Turkey Day.

  1. Do 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.

If you can’t coordinate a time to do this in a group, take a virtual trot together and stay connected via your smartphone. Either way, whether you walk or jog, it will feel great to get your Thanksgiving Day started with lubricated joints and blood flowing. 

  1. Stretch During Commercials.

Whether it’s the Macy’s Day parade, football, or both – it’s easy to find yourself sitting for hours on a soft sofa or recliner. 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 during commercials.

It’s the perfect opportunity to do a quick 2 min exercise or stretch.  It doesn’t have to be complicated. Choose from a quick set of squats, heel raises, planks, or back stretches. You can alternate through these during each commercial break and your body will thank you for it.

  1. Walk Your Dessert Off.

Just because you did that Turkey Trot in the morning doesn’t mean you have to be done for the day. Rather than feeling like you need to skip dessert – just plan to walk it off afterwards.

Walking is one of the best and most natural exercises you can do. And it gives you many of the same benefits of running (only slower).

Walking is very functional, and it’s good for your hips, back and knees. Since we tend to sit and bend so much during the day, walking is a very natural and active way to get some much needed lengthening and stretching into our bodies before we settle in for the evening. 

  1. Help With Cleaning Up.

Don’t be shamed into “just sit down and relax” because you’re a guest. Helping with clean-up (or set-up) is an easy and effective way to keep moving during your Thanksgiving Holiday.

Not only will your Thanksgiving host love you – but your body will too.

If you’re suffering from back problems, be careful bending and leaning over – especially if it’s repetitive – when you’re collecting or washing dishes. But otherwise, carrying heavy plates, moving chairs, and wiping down tables can burn quite a few calories and it’s good for your body.

There you have it – if you don’t want your Thanksgiving Day to be sedentary – you now have five easy ways to stay active and mobile.

I hope you have a wonderful Holiday and get to spend it with those you love most.

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 request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

knees

Spooky creaks and cracks coming from your knees?

/in , , /by

Do your joints crack or make noises every time you move a certain way?

If you’re like most people, these noises concern you.  Does it mean something is wrong with your knees?  Are your joints deteriorating? What happens if it continues? First of all, cracking in your knees (as well as your other joints) is quite common, and most of the time there’s a reasonable explanation for it. 

Crepitus is the term used to describe any grinding, creaking, cracking, grating, crunching, or popping that occurs when you move a joint like your knee. You can experience this at any age, but it’s certainly more common as you get older. 

So what causes crepitus and should it be a concern?

The most common causes of crepitus include air bubbles popping inside your joint, tendons or ligaments snapping over your joint’s bony structures, or the degeneration of your joint’s cartilage that generally occurs with arthritis. You may experience uncomfortable sensations, or even a tiny bit of pain when this happens, but in most cases, none of this should scare or concern you.

It’s all a normal part of aging and wear and tear.

But if the cracking in your joints starts to become more regular, is accompanied by joint swelling and more constant pain, or if the cracking turns to “clunking” and your knee starts to feel unstable – then you’re smart to be concerned and it’s possible something more serious could be going on.  In this case, get your knees checked out by an expert. 

Assuming you haven’t let your knees get to the “concerned stage” yet, and the most annoying thing to you right now is the cracking, grinding, or crunching – there are things you can do to minimize this problem and prevent it from getting worse. 

The best way to minimize these noises is to keep moving.

Motion is lotion. Regular movement throughout the day keeps your joints lubricated – kind of like applying WD-40 to a creaky door hinge. You also want to make sure your biomechanics are sound. If you’ve got imbalances between your muscles and joints, it will impact the way your joints move and function, causing more creaking and cracking.

For example, let’s say your hips are on the weak side. How your knees tolerate various activities depends a lot on how strong your hips are. I’ve experienced this firsthand. I love to hike. And if my hips aren’t doing their part, I feel the entire hike in my knees, especially on the way down. And you know what else happens? My knees crack a lot more on the days after I hike.

The imbalances in my body cause more stress on my knees and the result is they crack a lot more. Now, as I mentioned previously, this isn’t a big concern for me yet. My knees don’t hurt – they are just very noisy. However, I make a conscious effort to regularly stretch my quads, and strengthen my hips and core, so that I can keep this problem at bay and not let it get worse.

Moral of this story

The “spooky” noises in your knees are often quite normal – and not just a Halloween prank. However, there are things you can do to minimize this, and you want to pay close attention to make sure those noises aren’t progressing into something more serious.  

If you notice more cracking and crunching during or after certain activities, like with me and my hiking, then it’s an opportunity for you to get ahead of it and work on some of the imbalances in your body that could be contributing to this. And of course – get moving. In so many cases, movement can be your medicine, and help you avoid something like procedures or surgery as the solution instead.

Are you a local in Portsmouth, NH? CLICK HERE to talk to one of our specialists and get a full joint and movement analysis of your knees to fully explore the “spooky” creaking and cracking.

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 get a free copy of her guide to knee pain, CLICK HERE or call 603-380-7902.

 

When You Can’t Feel Your Abs

/in , /by

I’ve been a physical therapist for 20 years, a Pilates instructor for 11, and have been specializing in back pain for the past 10 years of my career. When it comes to core strength and preventing back pain, I am an expert in my field. Yet for some reason this morning, during my Pilates workout, I just couldn’t feel my abs. I teach people how to do this every single day yet this morning, I couldn’t seem to access my own.

What was happening?

And more importantly – if it can happen to someone like me – it can certainly happen to someone with less training than I have. I started to think about all the reasons this could be happening to me. Had I gotten enough sleep? What had I eaten the day before? Could it be stress?

And then it hit me.

I had just come back from a 2-day course where I’d been sitting far more than usual. I sat for 8 hours straight. Two days in a row. Not to mention all the very cramped sitting I did on the plane to and from this course. When one of my clients is about to have a few days like this, this is what I recommend. Get up from your chair and stretch backwards as frequently as possible every few hours.

But guess what – I didn’t follow any of my own advice. The result? A stiff back and sleepy abs upon my return.

Our bodies are highly intelligent and have every capacity to heal themselves when given the right environment. Conversely, when in the wrong environment, our bodies will also do what it takes to naturally protect from harm and injury. In my case, I came home from this course with a stiff lower back.

Back stiffness is the first sign that your back is not happy. This means your chances of tweaking it or exacerbating an old back injury are higher. When any joint is stiff and not moving well the muscles surrounding that joint will become naturally inhibited or weakened. This occurs on purpose as a protection mechanism. Your body doesn’t want a fully contracted muscle compressing an unhappy joint. In the case of your lower back, the muscles that can get inhibited when your back is not happy include your abdominals as well as back muscles.

So what can you do when you feel less core strength?

The good news is I’ve already helped you with step one: awareness. Inhibited muscles are not the same as weak muscles. In my case, I do have strong abdominals. My weekly routine consists of a regular Pilates practice, lifting weights, and I perform activities like hiking and running that engage my core. Yet despite all this, my abs were simply not having it this particular morning. They were not set up for a successful workout.

The combination of my stiff back and having sat for several days just meant that I needed to do something different to prepare my lower back and abdominals for this workout – so that I wouldn’t injure myself. My sleepy abs and stiff back were, in effect, trying to tell me just that.

All I needed to do was have the awareness this was happening so I could take appropriate action.

It’s no different than when you go on vacation and you get off your routine by eating more than usual. You might return a bit bloated and not feeling your best self. This kind of feeling we are accustomed to. And might respond by getting a bit strict with our diets until feeling back on track. Our joints can react similarly to a change in routine – we’re just not as accustomed to the signs and symptoms that let us know. But once you are – you can easily manage this and avoid injury. Had I pushed through my Pilates routine as normal this morning despite sensing that my back and abdominal function was off – there’s a good chance I’d be sitting here writing to you with full on back pain instead of just some lingering stiffness.

If you’re reading this, and you’re over the age of 40, odds are pretty good that you’ve experienced back pain at some point in your life. The odds are also pretty good that you’ve experienced back pain more than once.

If this is a recurring pattern for you, your abdominals and deep core may not be functioning at their best.

You could be caught in a vicious cycle of trying to improve your core strength only to keep hurting your back.

The missing solution for you might be that nobody has fully examined your back in a way to ensure that it’s moving fully and freely like it should. Once your back moves well, you can usually start to strengthen your abdominals without a problem.

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

The take home point here is that if you keep experiencing weakness in a particular area despite trying to strengthen it consistently, it’s possible you could have a problem in your joints that is keeping your muscles from fully activating like they should.

Talk to one of my specialists about it.

Someone from my client success team will call you right away and see if you are a good fit for what we do. At the end of the day – we’re here to help.

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].