Tag Archive for: Portsmouth New Hampshire

Stretching for lower back pain in Portsmouth NH that may not relieve stiffness

3 Reasons Your Lower Back Stretches Aren’t Working

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Why Your Lower Back Still Feels Tight — Even When You Stretch Every Day

If you’re dealing with lower back pain in Portsmouth NH and stretching every day — but still feel tight, stiff, or sore — you’re not alone.

At our physical therapy clinic in Portsmouth, New Hampshire, we see this all the time. People are consistent. They’re motivated. They stretch daily.
And yet — their back still feels tight, restricted, or painful.

The truth?
Stretching your lower back isn’t always the solution. And in many cases, stretching can actually make back pain worse instead of better.

If your lower back still feels tight despite everything you’ve tried, here are three common reasons why stretching may not be helping — and what you can do instead.

1. Your Stretching Technique Is Working Against You

Most people assume that simply doing the stretch is enough.
But how you stretch is just as important as what you stretch.

At our Portsmouth physical therapy office, we often see people stretching while:

  • Holding their breath
  • Tensing their glutes or shoulders
  • Forcing positions instead of easing into them

When your body feels strained, your nervous system responds by tightening — not relaxing. This makes tight muscles even tighter.

If this sounds familiar, try slowing your stretches down. Focus on calm breathing, gentle movement, and releasing tension instead of forcing range of motion.

Sometimes it’s not what you’re doing … it’s how you’re doing it.

2. You’re Stretching the Wrong Thing for the Problem You Actually Have

Generic stretches like child’s pose, hamstring stretches, or forward bends may help if your stiffness comes from:

  • Sitting all day
  • Muscle fatigue
  • General stress

But if your pain is mechanical — such as:

  • Disc irritation
  • Sciatic nerve involvement
  • Poor movement patterns
  • Hip or pelvic imbalance

… those same stretches may not help at all. In fact, they can aggravate lower back pain even more.

This is why one-size-fits-all routines fail.

As a mechanical pain specialist, I assess:

  • Which movements make pain better or worse
  • How your back responds to direction of motion
  • How your body compensates

This allows us to prescribe exact stretches and exercises for your condition — not generic ones. That’s what true corrective physical therapy looks like.

If your current routine hasn’t changed your symptoms, the issue may not be effort — It may be accuracy.

3. Your Lower Back May Not Need Stretching At All

This surprises many people.

A back that feels “tight” is often reacting to weakness or instability nearby —
especially in the hips, pelvis, or core.

When your body feels unsupported, it tightens muscles as a protective reflex.

If your back stiffens after:

  • Core workouts
  • Prolonged sitting
  • Busy days
  • Certain movements

…your real issue may be weakness, not flexibility.

In these cases, strengthening the right muscles — and teaching them to work together — provides far more relief than stretching ever will.

The Bottom Line: Lower Back Pain Is Fixable

If daily stretching hasn’t helped your lower back pain in Portsmouth NH, it’s time to stop guessing.

Your tightness may be happening because:

  • Your technique is off
  • Your stretches aren’t specific enough
  • Stretching isn’t what your body needs at all

Once the true mechanical reason behind your pain is identified, recovery becomes faster — and far less frustrating.

Get Expert Help for Lower Back Pain in Portsmouth NH

If your lower back stiffness or pain isn’t improving, working with a mechanical back pain specialist in Portsmouth NHmay be your next step.

Correct diagnosis leads to:
– Faster pain relief
– Fewer flare-ups
– Less trial-and-error
– Better long-term results

About the Author

Dr. Carrie Jose, DPT, is a Physical Therapy Specialist and Mechanical Back Pain Expert and the owner of CJ Physical Therapy & Pilates in Portsmouth, NH.

She regularly writes for Seacoast Media Group and helps residents throughout the Seacoast overcome back pain without medication, injections, or surgery.

To request a copy of her free guide: “5 Simple and Easy Ways to Get Rid of Back Pain”
Visit: www.cjphysicaltherapy.com
Or call: 603-380-7902

Physical therapy specialist treating frozen shoulder with non-invasive therapy in Portsmouth NH

Frozen Shoulder: Could Your Metabolism Be the Real Culprit?

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Frozen Shoulder: Could Your Metabolism Be the Real Culprit? (Portsmouth, NH Expert Explains)

If you’re dealing with a frozen shoulder, daily life can become difficult fast. Simple activities like putting on a jacket, reaching for a coffee mug, or sleeping comfortably can feel stiff, limited, or nearly impossible.

Traditionally, frozen shoulder has been viewed as a musculoskeletal issue caused by a tight shoulder capsule. Because of this, treatments often focused on aggressive stretching, cortisone injections, or even manipulation under anesthesia.

However, new research suggests frozen shoulder may actually be rooted in metabolic and immune system dysfunction— not just the shoulder itself.

New Research Shows Frozen Shoulder Is More Than a Shoulder Problem

A 2025 review published in the Journal of Clinical Medicine (Navarro-Ledesma et al.) proposes that frozen shoulder is influenced by:

  • chronic inflammation
  • metabolic dysregulation
  • hormonal changes
  • immune system imbalance

This supports something clinicians have observed for years:
frozen shoulder is a whole-body condition that shows up in the shoulder.

This also explains why standard treatments often don’t work long-term — because they fail to address the deeper biological factors influencing healing.

Why Frozen Shoulder Happens More in People Over 40

Frozen shoulder affects 2–5% of the population, especially women ages 40–60. What’s striking is how strongly it’s linked to metabolic issues:

  • Diabetes (10x higher risk)
  • Thyroid dysfunction
  • Obesity
  • Elevated inflammatory markers

These are no longer considered coincidences.

Another 2024 study (Healthcare, Hamed-Hamed et al.) found that individuals with elevated GGT (a liver enzyme linked to metabolic stress) or higher TSH (thyroid dysfunction) had worse stiffness and poorer outcomes.

This means your shoulder’s ability to heal is directly influenced by your whole-body biology, not just the joint itself.

Why Traditional Frozen Shoulder Treatments Often Fail

If frozen shoulder is driven by metabolic and immune changes, then forcing the shoulder to move aggressively can make symptoms worse.

Common treatments that fall short:

Cortisone injections
– Provide short-term relief
– Do not address systemic inflammation
– May weaken tissue with repeated use

Manipulation under anesthesia
– Can cause tearing or trauma
– May worsen inflammation
– Stiffness often returns

Aggressive stretching
– Overloads irritated tissue
– Increases inflammation
– Rarely works without addressing metabolic drivers

This is why many people go months or years without meaningful improvement.

A Smarter, More Effective Approach to Frozen Shoulder Treatment

At CJ Physical Therapy & Pilates in Portsmouth, NH, we use a whole-body, research-supported approach that calms inflammation, supports natural healing, and restores shoulder mobility safely.

Two of the most effective regenerative therapies include:

Shockwave Therapy (ESWT)

  • Stimulates blood flow
  • Softens tight, fibrotic tissue
  • Reduces chronic inflammation
  • Encourages natural mobility

EMTT (Electromagnetic Transduction Therapy)

  • Supports healthy cellular activity
  • Improves circulation
  • Reduces inflammatory signaling
  • Enhances tissue regeneration

These non-invasive therapies help your shoulder transition from the painful freezing phase into the healing thawing phase more effectively — without causing trauma.

Once inflammation calms, mobility exercises finally start to work as intended, allowing for faster and longer-lasting improvements.

Why This Matters for Seacoast Residents Over 40

Frozen shoulder rarely develops randomly. In your 40s, 50s, and 60s:

  • hormones shift
  • blood sugar regulation becomes more difficult
  • inflammation increases
  • connective tissue becomes more reactive

The right environment — not aggressive force — helps the shoulder heal.
Shockwave therapy, EMTT, and guided mobility exercises create the conditions your body needs to restore function naturally.

Final Thoughts

If you’ve been told to simply:

  • “wait it out,”
  • get another cortisone shot,
  • or undergo manipulation under anesthesia…

…it may be time to consider a more effective, biologically aligned solution.

Frozen shoulder may start in the shoulder, but the real drivers are systemic. Addressing these factors leads to quicker, safer, and more complete recovery.

Looking for Frozen Shoulder Treatment in Portsmouth, NH or the Seacoast?

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group.

If you want natural, research-backed solutions for frozen shoulder — without medication, injections, or aggressive procedures — we can help.

CJ Physical Therapy & Pilates — Portsmouth, NH –  cjphysicaltherapy.com –  603-380-7902

work out

6 Reasons Your Muscles Are the Secret to Staying Young

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When most people think about anti-aging, they picture creams, supplements, or the latest medical breakthroughs.

But one of the most powerful tools for staying young is something you’re born with – your muscles. Everyone knows muscles are key for strength and appearance, but research shows they do far more than that. Muscles act like living medicine inside your body. Every time they contract, they send out chemical signals that influence your brain, heart, bones, and immune system. In fact, researchers now recognize that maintaining muscle may be one of the most effective ways to protect your health, preserve independence, and extend your life.

So – what exactly makes building muscle such a potent anti-aging secret?

Here are six important ways your muscles act like medicine:

1. Muscles Fight Inflammation

One of the hallmarks of aging is something scientists call “inflammaging” – chronic, low-grade inflammation that damages tissues and raises the risk of cardiovascular disease, arthritis, and Alzheimer’s. But here’s what’s fascinating… When your muscles contract during exercise, they release anti-inflammatory chemicals known as myokines. One of the best studied is interleukin-6 (IL-6). Unlike the IL-6 produced by fat tissue, which fuels inflammation – muscle-derived IL-6 helps regulate the immune system and suppress harmful inflammatory signals.

This helps explain why U.S. studies, such as the long-running Alameda County Study, have consistently shown that physically active adults live longer and age with fewer health problems. In other words – every time you use your muscles – you’re helping your body reverse damaging inflammation.

2. Muscles Stabilize Blood Sugar

Muscle is the largest site of glucose disposal in your body. The more muscle you have – and the more you use it – the more efficiently your body processes sugar. Resistance training improves insulin sensitivity, which means your muscles can absorb glucose from the bloodstream more effectively.

A 2024 meta-analysis found that structured resistance training reduced HbA1c, a long-term marker of blood sugar control, by about half a percentage point – an effect comparable to some common diabetes drugs. For millions of Americans at risk for diabetes, maintaining and building muscle is one of the most powerful ways to keep blood sugar steady and prevent disease.

3. Muscles Strengthen Bones

Strong muscles don’t just move your body – they help to strengthen bone. Every time muscles contract against bone, they stimulate bone growth and increase bone density. This is one of the most effective natural defenses against osteoporosis, a disease that affects more than 10 million Americans and dramatically raises fracture risk.

As we age, fractures can mean the loss of independence. But by strengthening muscles through regular resistance training – you also strengthen the bones they attach to – creating a double layer of protection.

4. Muscles Protect Your Brain

Healthy muscles send protective signals to your brain. As previously mentioned – when you exercise and contract muscles – they release myokines. In addition to IL-6, myokines such as irisin and brain-derived neurotrophic factor (BDNF) stimulate the growth of new neurons, strengthen existing connections, and improve brain plasticity.

The benefits are measurable. Studies of older American adults have shown that maintaining muscle strength later in life is associated with sharper memory, slower cognitive decline, and reduced risk of dementia. Exercise also boosts endorphins, which elevate mood and help combat depression and anxiety. Keeping your muscles active is one of the most reliable ways to keep both your body and mind young.

5. Muscles Support Heart Health

We often think of walking or jogging as the best ways to support cardiovascular health. But research now shows that strength training deserves equal credit. Resistance exercise improves circulation, reduces arterial stiffness, and lowers blood pressure.

In a massive U.S. study of more than 116,000 adults – those who consistently met or exceeded physical activity guidelines – including strength training – had up to a 31 percent lower risk of death from any cause – and up to a 38 percent lower risk of dying from cardiovascular disease. These findings echo results from the British Journal of Sports Medicine, which showed that just 30 to 60 minutes of strength training per week reduced risk of chronic disease and early death. When it comes to your heart, strong muscles really are medicine.

6. Muscles Extend Longevity

Perhaps the most compelling evidence for the concept of “muscles are medicine” is its impact on survival. Studies consistently show that muscle mass and strength are stronger predictors of longevity than body weight or BMI. One U.S. study of college alumni found that those who maintained higher activity levels in midlife had significantly lower risks of heart disease and lived longer lives.

Muscle also serves as a critical protein reserve. When illness, surgery, or trauma strikes – your body draws on muscle stores to support healing, immune function, and tissue repair. People with greater muscle mass not only live longer but also recover more quickly when health challenges arise. Stronger muscles simply mean greater resilience.

The Bottom Line

Your muscles do far more than help you look fit or lift heavy things. They fight inflammation, regulate blood sugar, strengthen bones, protect your brain, support your heart, and extend your life. Best of all, you don’t need hours in the gym to see these benefits. Just 30 to 60 minutes of strength training per week, combined with regular movement, can produce profound results.

But if pain or injury is holding you back, don’t ignore it. The longer you wait, the harder it can be to bounce back – and the more you miss out on this natural anti-aging tool. If back, knee, hip, neck, or shoulder pain is keeping you from building muscle, talk to a physical therapy specialist who can help you return safely. With the right guidance, you can overcome those barriers and put your muscles to work – as they are your best-kept secret to staying young.

Looking for help and local to Portsmouth NH? Consider speaking to one of my 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.

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

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

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

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

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

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

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

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

Fuel Your Body With Anti-Inflammatory Foods

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

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

Prioritize Weight and Posture

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

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

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

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

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

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

Explore Longevity Treatments that Boost Healing

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

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

A Final Word of Encouragement

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

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

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

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

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

plantar fasciitis

Foot and Heel Pain: How to Move Beyond Short-Term Relief

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If you’ve ever stepped out of bed and felt a stabbing pain in your heel, there’s a good chance you were experiencing plantar fasciitis – one of the most common causes of heel pain in adults.

More than two million Americans struggle with it each year. Cortisone shots, orthotics, and rest are often prescribed, but these strategies usually provide only temporary relief – and in some cases, can even prolong the problem.

Recovering from plantar fasciitis starts with understanding why it happens in the first place. Once you know the root cause, the path forward becomes clearer – and today there are modern, natural options that focus on healing rather than simply masking pain. That’s the aim of this article. 

So let’s dive in: how do you move past short-term relief and get back to doing the activities you love, without heel pain holding you back?

What is Plantar Fasciitis?

The plantar fascia is a thick band of tissue running along the bottom of your foot, connecting your heel bone to your toes. Its job is to support your arch and absorb shock when you walk, run, or jump. When this tissue is overloaded, it can become irritated – and if that continues, the fascia begins to degenerate. The result is plantar fasciitis, marked by pain at the base of the heel, especially during the first few steps in the morning or after long periods of sitting.

Many assume plantar fasciitis is an inflammatory condition, but that isn’t the full picture. It’s more accurately a degenerative process, where the collagen fibers of the fascia weaken and lose their ability to tolerate load. This helps explain why treatments aimed only at reducing inflammation, such as cortisone shots, rarely provide lasting relief.

Why Traditional Treatments Fall Short

Cortisone injections have long been a standard treatment for heel pain. While they may reduce pain briefly, research shows the benefit is temporary – often only a few weeks or months. Repeated injections also carry risks. Cortisone does not repair the damaged fascia – in fact – it can weaken collagen and allow the problem to persist. Worse, by masking pain, injections often encourage continued activity that aggravates degeneration.

Custom orthotics are another common approach. These shoe inserts, often prescribed by podiatrists, can redistribute pressure and provide comfort in the short term. But research shows little difference between costly custom orthotics and high-quality prefabricated ones. More importantly, they do not address the underlying weakness or tissue degeneration. Once the initial benefit wears off, the pain often returns – and relying on orthotics indefinitely is impractical and prevents restoration of natural foot strength.

Both cortisone and orthotics may play a role in daily function. But if the goal is to truly heal the fascia and return to full activity, more is needed.

Stimulating Healing – Don’t Mask It

Instead of suppressing symptoms, you want to encourage true healing and pair it with corrective strengthening to keep the tissue healthy. Modern treatments such as shockwave therapy, EMTT, and PRP aim to jump-start your body’s own repair mechanisms instead of impeding them.

A good place to start is extracorporeal shockwave therapy, or ESWT. This non-invasive treatment sends acoustic waves into the fascia to create controlled “microtrauma,” which stimulates collagen regeneration and promotes tissue recovery.

An important complement is Extracorporeal Magnetotransduction Therapy, or EMTT. A 2022 multicenter study in the Journal of Clinical Medicine found that 80 percent of patients with chronic musculoskeletal conditions improved after EMTT, with more than 75 percent maintaining benefits six to twelve months later. In practice, EMTT appears to extend and amplify the positive effects of shockwave therapy by sustaining cellular activity long after treatment sessions.

For those needing an additional boost, platelet-rich plasma (PRP) injections are another option. Though invasive, PRP delivers concentrated growth factors directly into damaged tissue, enhancing the body’s natural healing. A 2023 randomized trial in BMC Musculoskeletal Disorders reported that PRP outperformed corticosteroid injections at reducing pain, improving function, and thinning the plantar fascia at six months. Case reports in the German Journal of Sports Medicine also show excellent outcomes when ESWT and PRP are combined, including full return to sport in runners who had failed other treatments.

Taken together, these therapies form a layered strategy: shockwave jump-starts the healing cascade, EMTT helps sustain it, and PRP provides an extra regenerative boost (if needed). When combined with a structured rehabilitation program, this approach offers a pathway to lasting recovery rather than temporary relief.

Beyond the Foot: Make the Healing Last

What many don’t realize is that chronic plantar fasciitis can also be linked to dysfunction higher up the chain. The pelvic floor, deep core muscles, and hip stabilizers all influence how forces travel through the legs and feet. If these areas are weak or poorly coordinated, the plantar fascia often absorbs stress it wasn’t designed to handle.

Clinical experience shows that individuals with weak core and pelvic floor control often develop altered gait mechanics, leading to excessive strain on the heel with each step. In these cases, treating only the fascia leaves the root cause unaddressed.

A comprehensive plan should therefore include strengthening of the core and pelvic floor, along with intrinsic foot training, alongside regenerative therapy. When these muscles are retrained to provide stability and load-sharing, the fascia is no longer forced to work alone. Over time, this reduces reinjury risk and creates a long-term fix. In essence, regenerative therapy jump-starts tissue healing, while strengthening ensures the fascia remains supported once it recovers.

The Bottom Line

Foot and heel pain can be stubborn, and plantar fasciitis in particular has a reputation for lingering. Cortisone shots and orthotics may provide temporary relief, but they do not restore the health of the fascia or solve the underlying problem. Regenerative therapies, especially shockwave, are supported by strong evidence for reducing pain and improving function in people with chronic plantar fasciitis. When combined with mobility, strength training, and – critically – core and pelvic floor retraining, they provide a durable solution that not only relieves pain but helps prevent it from coming back.

If your heel pain has been persisting for months, it’s worth considering a plan that goes beyond masking symptoms. Lasting relief comes when you treat both the tissue that hurts and the movement system that created the overload in the first place.

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.

Why Your Hamstring Isn’t Healing – 3 Signs It’s Something Else

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Hamstring Pain is common – especially in active adults over 40.

But what’s less commonly talked about is how often a hamstring injury is misdiagnosed. If you’ve been stretching, foam rolling, and rehabbing your “hamstring strain” for weeks or months with little to no improvement – there’s a good chance your pain isn’t coming from your hamstring at all.

That’s because certain types of back problems can mimic hamstring pain almost perfectly. And if you don’t recognize the signs, you may end up chasing the wrong problem for far too long.

So how can you tell when your hamstring isn’t healing because it’s not really your hamstring?

Let’s take a look at what a true hamstring strain typically looks like – and then go over three clear signs that something else is actually going on.

What a true hamstring injury looks like:

A hamstring strain usually happens suddenly – often during an explosive movement like sprinting or lunging. You’ll feel a sharp pain in the back of your thigh, and possibly notice swelling, bruising, or tenderness. In the early stages, walking or bending your knee might be difficult. But with the right combination of rest, movement, and strengthening – most hamstring injuries heal well and don’t linger – especially when properly diagnosed and rehabbed.

If your pain doesn’t follow that pattern – or seems to be sticking around far longer than expected – there’s a good chance your spine is actually to blame.

Here are three key signs your “hamstring strain” might be something else entirely:

1. The pain never really goes away

A true muscle injury will hurt when it’s injured – but it heals. If your pain feels dull, achy, and persistent – especially after long periods of sitting or standing still – that’s a red flag.

This type of pain often stems from nerve irritation in the lower back, not muscle damage in your leg. It’s common for certain spinal problems to refer pain down the back of the thigh, which is why this gets misdiagnosed so often. But unlike a muscle strain, nerve-related pain doesn’t improve with time or basic rehab – and may even get worse with certain types of movement or exercise.

2. You notice tingling, numbness, or odd sensations

Muscles don’t cause tingling. Nerves do. So if your hamstring injury is accompanied by numbness, tingling, or an odd “buzzing” feeling in your butt or leg – it’s almost certainly a nerve issue. The sciatic nerve, which originates in your lower spine, travels right through the area where most people feel hamstring tightness. When that nerve gets irritated, it can create sensations that feel like they are coming from your hamstring – but aren’t.

If you’re experiencing these kinds of nerve symptoms – it’s a strong indicator that your spine (not your hamstring) is the real source of the problem – and it needs to be addressed.

3. Your pain travels below your knee

This one’s especially important. Your hamstrings attach just above and behind the knee – so any pain you feel below your knee can’t be coming from your hamstring.

If your discomfort travels down your calf or even into your heel, the likely culprit is your spine. Research shows that as much as 40% of lower leg pain originates from the lower back – even when there’s no actual back pain. So it’s very possible to have a perfectly healthy hamstring – but still feel pain there due to a nerve referral from your spine.

What to do next

If any of these signs sound familiar – don’t keep treating your hamstring like a muscle strain – it won’t help – and could even worsen your problem. Plus, the longer you focus on the wrong issue, the longer it will take to get better.

Instead, seek out a physical therapy specialist who understands how to properly screen and assess your spine. They’ll be able to figure out if your lingering hamstring pain is related to a problem in your lower back. And once you identify the true root of your pain – you can finally get the treatment you need – and get back to doing the activities you love.

For the Dad Who Has Everything… Except Good Knees

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It’s that time of year when we celebrate the dads in our lives – and if the one in your life is anything like mine – then he’s probably a little tough to shop for. Maybe he already has all the tech toys and grilling gadgets he wants. Maybe he’s not one to ask for much. But if there’s one thing a lot of dads over 40 don’t have – but wish they did – is good knees.

Knee pain is one of the most common complaints I hear from the men over 40 who walk into my clinic – and it’s also the most common form of osteoarthritis. For some, it’s been a nagging issue for years. For others, it creeps in gradually – starting with a little stiffness when getting up from the couch, or a strange “click” here and there. Then one day, it hits you… Playing golf isn’t fun anymore, and going up and down stairs now feels more like a chore – because your knees just hurt all the time.

Yes, knee pain does become more common as we age – but not necessarily for the reasons you think.

People love to blame arthritis and “wear and tear” for just about everything. And while a previous injury or underlying arthritis might be present, they’re not always the primary culprits. What most people don’t realize – including dads – is that the root cause of knee pain is often mechanical. In other words, it has more to do with how your body moves (or doesn’t move) than what’s actually going on inside the joint.

Let me explain.

Your knees sit between your hips and ankles – two areas that are meant to move a lot and absorb shock. But if the hips or ankles aren’t doing their job properly (which is surprisingly common), that stress has to go somewhere – and the knees usually pay the price. Over time, poor mechanics can lead to pain, inflammation, and breakdown of the joint. But here’s the good news – if the pain is mechanical, it’s very treatable – and sometimes even reversible – all without drugs, injections, or surgery.

So why don’t more dads know about this?

For one, we’ve normalized knee pain – especially in men over 40. There are societal and cultural beliefs like, “You’re getting older, it’s supposed to hurt a little.” Or worse, “If it hurts too much, you can always replace it.” That kind of thinking is unproductive, unnecessary, and can even be dangerous. Yes, knee replacements are sometimes the right call – but far too often, they’re offered before the right conservative options have been fully explored. And with so many cutting-edge, non-invasive technologies now available that promote longevity and let you keep your original parts – dads should absolutely be exploring these options first.

But another big reason? Men – especially dads – tend to avoid asking for help. They’re used to being the fixers, not the ones getting fixed. Many try to “tough it out,” hoping the pain will go away on its own. Others pop ibuprofen or throw on a brace and carry on. But these strategies are just band-aids. They might provide temporary relief, but they don’t address the actual cause of the pain – and in some cases, they can even make things worse.

The real solution starts with a deeper understanding of why your knee pain is happening in the first place. Remember – 80% of all knee pain is mechanical in nature.

So if you or someone you love is dealing knee pain – here are a few important things to keep in mind:

  1. Rest isn’t always the answer.
    It might seem like common sense to rest an aching knee – but too much rest can lead to stiffness, weakness, and poor circulation. In many cases, strategic movement is far more helpful than immobilization.
  2. Pain doesn’t always mean damage.
    This is one of the most misunderstood aspects of musculoskeletal pain. Just because something hurts doesn’t mean it’s permanently damaged – and just because an X-ray shows “bone-on-bone” doesn’t mean surgery is inevitable.
  3. The site of the pain isn’t always the source.
    Knees often hurt because of a problem elsewhere – such as limited hip mobility, poor ankle mechanics, or even an undiagnosed problem in your spine. That’s why a full-body movement assessment is key to figuring out what’s really going on.
  4. Most knee pain is preventable – and fixable.
    With the right combination of movement-based therapy, strength training, hands-on treatment, and regenerative therapy – many people are able to not just reduce their pain – but eliminate it entirely.

So what does all of this have to do with Father’s Day?

If you’re looking to give your dad something meaningful this year, consider giving him a nudge to take care of himself.

Not with another gadget or tie – but with a shift in mindset. One that reminds him that pain isn’t something he just has to live with. One that encourages curiosity about his health, and reinforces that aging doesn’t have to mean giving up the activities he loves.

Because the truth is – most dads don’t want to sit on the sidelines. They want to stay active, strong, and capable. They want to travel, hike, golf, chase their grandkids around the yard, and keep doing the things that make life fun. And they can – if they learn to listen to their bodies and get the right kind of help.

So if the dad in your life has everything… except for good knees… Maybe this is the year to give him something more lasting than another toolset or polo shirt. Maybe this is the year to give him the reminder that his health is worth paying attention to. And that it’s never too late to move better, feel better, and get his knees back.

golf injuries

How to Stay Injury-Free on the Golf Course This Season

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Golf is a favorite pastime for millions – and now that the season is in full swing here in New England – many players are eager to hit the course as often as possible. But when back, knee, elbow, or shoulder pain creeps in – those 18 holes can quickly lose their appeal – and even become depressing. Pain doesn’t just interfere with your swing. It can drain the joy right out of your game.

The good news? Many of the injuries that golfers suffer from are preventable. With a bit of foresight, the right kind of movement, and smart preparation – you can keep your body strong and your game on point all season long.

Here are five of the most common injuries I see golfers facing – and what you can do to avoid or recover from them quickly:

1. Back Pain

This is by far the most frequent complaint among golfers. The constant bending, twisting, and rotational force of a golf swing can wreak havoc on your spine – especially if your back is stiff or you spend a lot of time sitting during the week.

The best way to keep your back pain-free? Focus on improving your spinal mobility – particularly extension and rotation. Even perfect swing mechanics can’t make up for a back that lacks movement. Try adding daily backward stretching and limit prolonged sitting – especially on the days you know you’ll be golfing. These small changes can make a big difference in keeping your spine mobile and resilient throughout the season.

2. Golfer’s Elbow (Medial Epicondylitis)

This injury happens when the tendons on the inside of your elbow become irritated – often due to repetitive swinging. But the root problem, however, frequently lies elsewhere. Weakness in your shoulder girdle or stiffness in your wrist can force your elbow to overcompensate.

To prevent and heal golfer’s elbow – don’t just focus on the elbow itself. Work on improving shoulder stability and wrist mobility as part of your regular conditioning. In more stubborn cases – regenerative therapies like Shockwave Therapy or EMTT can speed up healing and reduce inflammation – helping you stay on the course without resorting to cortisone shots or any downtime.

3. Knee Pain

Walking the course and rotating through your swing can put a lot of pressure on your knees – especially if you lack strength in your core and hips – or have unstable feet and ankles. Your knees aren’t designed to power your swing, but they often get overworked if other areas aren’t pulling their weight.

Most knee pain in golfers is mechanical, not structural. Meaning, it’s caused by faulty movement patterns rather than actual damage, even when imaging shows said “damage”. The good news? With the right strengthening and stabilization exercises, you can typically resolve your knee pain naturally – no injections or surgery required.

4. Rotator Cuff (Shoulder) Injuries

The rotator cuff is responsible for stabilizing your shoulder, and it’s highly involved during your golf swing. If it’s weak – or if your mid-back and core aren’t supporting it – your rotator cuff can easily become inflamed or irritated.

To prevent this, build strength not only in your shoulders, but also in your mid-back, lats, and core. These “powerhouse” muscles provide a solid foundation and reduce the strain on your shoulders. If your shoulder pain is persistent, regenerative Shockwave Therapy and EMTT (like in the case of golfer’s elbow) can be an excellent way to accelerate healing and reduce the need for medication, rest, or downtime.

5. Wrist and Hand Injuries

Sprains, strains, and other wrist or hand injuries are common in golf – often due to grip issues or poorly fitted equipment. But one commonly overlooked factor is your neck. Research shows that nearly half of all upper extremity pain can be traced back to the cervical spine – even if you don’t feel any neck pain.

If nerve irritation or stiffness in your neck is the true culprit – no amount of wrist strengthening will help – because the root cause has been missed. If your wrist or hand symptoms persist despite traditional mobility, strength and even manual work, it may be time for a full-body assessment by a mechanical pain specialist who can identify whether the issue is actually coming from somewhere else.

Final Thoughts

Golf injuries can be frustrating – but they’re often preventable and highly treatable when you know what to do or where to turn for the right help. By addressing problems early, using targeted movement strategies, and supporting your body with proper mechanics – you can keep playing pain-free all season long.

And when more advanced treatment is needed – especially for tendon or joint inflammation – non-invasive regenerative therapies like Shockwave Therapy and EMTT can offer fast, effective relief and accelerate recovery.

As a physical therapist who specializes in mechanical pain and movement dysfunction, I’ve helped countless golfers who thought their playing days were over – only to return to the course stronger and better than before. The key is addressing the true source of pain, not just masking the symptoms.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth, NH and writes for Seacoast Media Group. To request one of her free guides for back or knee pain – visit her website: cjphysicaltherapy.com – or call 603-380-7902

Physical therapy specialist treating frozen shoulder with non-invasive therapy in Portsmouth NH

Top 5 Arthritis Myths That Keep People in Pain

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If you or someone you love is living with arthritis — then you already know how frustrating it can be. Daily tasks become harder, favorite activities fall by the wayside, and you may start to wonder: “Will things ever get better?”

Even worse, many people living with arthritis fall victim to misguided advice.

Let’s look at five of the most common myths about arthritis management — and shed some light on what you can actually do instead:

Myth #1: “There’s nothing you can do — it’s just part of getting older.”

This is one of the biggest and most damaging myths of all.

While it’s true that arthritis becomes more common as you get older — and it’s considered a normal part of aging — it doesn’t mean you have to live with chronic pain or disability. In fact, many people with visible (even advanced) arthritis on X-rays and MRIs are living active, healthy lives with minimal to no pain at all.

Research supports this. A 2015 study published in Arthritis & Rheumatology found that more than 30% of adults over 60 had radiographic evidence of knee osteoarthritis — but only a portion of them had symptoms. In other words, just because your joints show signs of “wear and tear” doesn’t mean you’re doomed to pain.

The real issue is how you move — and how you use your joints. Strategic exercise, strength training, and natural therapies can drastically improve your mobility and reduce pain — regardless of your age or what your imaging says.

Doing nothing, on the other hand, is one of the worst things you can do.

Myth #2: “You should rest and avoid activity to protect your joints.”

If your joints hurt, don’t move them — right? That might make sense if you have an injury that requires an initial rest and healing phase. But that’s not the case with arthritis. When you avoid movement in an arthritic joint, you actually worsen your symptoms.

Too much rest leads to stiff joints, weakened muscles, and poor circulation — all of which contribute to more pain and less function over time. Movement helps lubricate joints, strengthen muscles, and prevent further degeneration.

I’m not sure why this myth is still so common — especially when just about every major orthopedic organization (including the CDC and the Arthritis Foundation) agrees that regular, low-impact physical activity is one of the best things you can do for arthritis.

The key is doing the right kind of movement. So if you’re struggling, work with an expert who can help you figure out the proper, targeted activity your body needs. But whatever you do — don’t fall for this myth.

Myth #3: “If your joint is bone-on-bone, surgery is the only option.”

Hearing the phrase “bone-on-bone” from your doctor can feel like a death sentence for your joint. And the typical recommendation? Joint replacement surgery.

But what if I told you that “bone-on-bone” isn’t always the actual reason for your pain — and that you’ve got options beyond a major procedure like surgery?

The first thing to understand is that what shows up on your imaging (like X-rays and MRIs) doesn’t always match up with your symptoms. A 2018 study in BMJ Open found that nearly half of people with severe osteoarthritis on imaging had little to no pain. And many people with significant joint pain showed only mild arthritic changes on their images.

Translation? “Bone-on-bone” isn’t necessarily the root cause of your problem. I’ve seen many people with this diagnosis successfully avoid major surgery and keep their original parts far longer than they thought possible.

When faced with this kind of diagnosis, the best thing you can do is pause — and explore your options. Surgery will always be there if you need it. But don’t rush into it or assume it’s your only option.

Myth #4: “Cortisone shots and medications are the best way to manage arthritis.”

Cortisone shots may provide short-term pain relief for arthritis — but they don’t actually fix anything. Worse, repeated cortisone injections have been shown to damage cartilage and accelerate joint degeneration over time.

One study published in JAMA (2017) showed that patients receiving cortisone injections for knee arthritis had worse cartilage loss at two-year follow-up than those who received a saline placebo — despite experiencing no significant difference in pain relief.

NSAIDs (like Advil) and prescription pain medications can also help dull pain, but they come with side effects — and, just like cortisone, do nothing to address the root cause of your symptoms.

If you’re relying on medication or repeated cortisone shots just to get through the day — or to delay surgery — it’s time to explore options that promote natural healing instead of just masking symptoms.

Shockwave Therapy and EMTT are two non-invasive regenerative therapies that do exactly that. These cutting-edge technologies enhance your body’s natural healing processes by targeting inflammation and tissue damage at the cellular level. And while more research is still needed, promising clinical evidence suggests these therapies may actually help reverse — or significantly delay — the progression of arthritis.

Do your own research — and be open to natural, forward-thinking treatment options that support your long-term joint health.

Myth #5: “Arthritis means you’ll never get back to the activities you love.”

This is one of the most heartbreaking myths — and it’s simply not true.

I’ve worked with countless clients who believed their days of hiking, gardening, traveling, or playing with grandkids were behind them — only to regain full function and freedom after following a personalized treatment plan.

And while surgery sometimes is the best option — especially if you’ve waited until your arthritis has become advanced — there’s a lot you can do to improve your outcome. Working with a specialist to build strength and prescribe targeted movement can make recovery faster and easier.

Plus, emerging research shows that using regenerative therapies like Shockwave and EMTT both before and after surgery may help accelerate healing and improve long-term outcomes.

Managing arthritis is absolutely possible when you take a natural, proactive, and personalized approach. You just need the right plan — and the right team to guide you.

Final Thoughts:

Arthritis is real — but don’t let myths and outdated advice keep you stuck. If you’re not sure where to start — or feel like you’ve already tried everything — speak with someone who specializes in mechanical pain and natural joint care. Often, the most effective solutions are the ones no one has told you about yet.

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.

tight hips

Why Stretching Isn’t Solving Your Tight Hips

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

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

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

Let’s break this down…

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

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

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

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

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

The moral of the story? 

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

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

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

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