Tag Archive for: Portsmouth New Hampshire

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

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.

Knee Pain

Top Causes of Knee Pain and How to Get Lasting, Natural Relief

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Knee pain affects millions of people worldwide, often interfering with daily activities such as walking, squatting, climbing stairs, and even getting in and out of the car.

It is one of the most common musculoskeletal complaints, second only to back pain. Whether your knee pain started suddenly or has worsened over time – you might be wondering – what’s really causing it? And can you get rid of it naturally?

The good news is that, in most cases, yes. Many common causes of knee pain can be addressed without medications, injections, or surgery. Here are some of the top reasons behind knee pain and what you can do to find lasting, natural relief that doesn’t involve medication, injections, procedures, or surgery:

1. Patellofemoral Pain Syndrome (Runner’s Knee)

Also known as “runner’s knee,” patellofemoral pain syndrome (PFS) is characterized by pain in the front of the knee, usually just below or behind the kneecap. This condition is often caused by improper movement patterns and muscle imbalances that place excessive pressure on your kneecap, leading to inflammation and discomfort.

To alleviate PFS, it’s important to avoid excessive kneeling, squatting, or repetitive knee bending until the pain subsides. For long-term relief, focus on strengthening the muscles surrounding your knee, particularly the hips and thighs, to improve stability and reduce stress on your kneecap. Corrective exercises that promote proper kneecap tracking, such as step-ups and lateral band walks, can help to further optimize knee function and prevent future flare-ups.

2. Iliotibial Band Syndrome (ITBS)

ITBS causes pain on the outer side of the knee and is commonly seen in runners and cyclists. The iliotibial (IT) band is a thick band of connective tissue running from the hip to the knee, and when it becomes tight or inflamed, it can lead to irritation and pain.

While many people resort to foam rolling for relief, this only provides temporary symptom management. To address ITBS at its root, focus on strengthening the glutes and core, as weak glutes often lead to overcompensation and excessive strain on the IT band. Correcting pelvic imbalances and optimizing hip mobility will also be key for long-term relief. Additionally, taking a temporary break from any aggravating activities will allow the inflammation to subside and the tissues to heal properly, provided you’re taking an active approach to tissue healing versus rest only.

3. Tendinitis (Jumper’s Knee)

Tendinitis occurs when the patellar tendon, which connects the kneecap to the shinbone, becomes inflamed. This condition is common in athletes and individuals who engage in frequent jumping or repetitive knee movements.

A common treatment for tendinitis is cortisone injections, but these only provide temporary relief and may contribute to further tissue damage over time. Instead, consider regenerative treatments like Shockwave Therapy, which naturally enhances your body’s ability to reduce inflammation and accelerate tendon healing. Once inflammation is managed, strengthening the hamstrings, glutes, and calf muscles will provide better knee support and reduce tendon strain. Incorporating eccentric exercises, such as slow step-downs, can also help build tendon resilience and prevent future injuries.

4. Osteoarthritis

Osteoarthritis (OA) is the gradual degeneration of cartilage in the knee joint. While it is a natural part of aging, experiencing constant pain and limited mobility does not have to be. Many people believe that knee arthritis inevitably leads to surgery, but the truth is that optimizing movement and reducing inflammation can be powerful tools in managing OA long-term, even with “bone on bone” OA.

Rather than relying on cortisone injections and pain medication, consider alternative treatments such as Regenerative Therapy (specifically EMTT) to target inflammation deep at the cellular level. From there, implementing corrective exercises that strengthen the muscles surrounding the knee – particularly your quadriceps, hamstrings, and glutes – can reduce joint stress and help prevent inflammation from returning. Since inflammation is the primary driver of pain in OA, addressing it naturally through movement and strength training can help you avoid major surgery while still finding lasting relief.

5. Meniscus Tears

The meniscus is a piece of cartilage that cushions the knee joint. Over time, wear and tear can lead to meniscus tears – which cause pain, stiffness, and occasional knee locking. Many people assume that surgery is the only solution, but research has shown that placebo surgery can be just as effective as actual meniscus surgery, suggesting that natural recovery is possible.

Managing a meniscus tear naturally involves first addressing the inflammation caused by the tear. As previously mentioned, EMTT and Shockwave Therapy (especially when combined) can be particularly effective in reducing pain and inflammation, often providing immediate relief. Beyond that, focusing on proper knee mechanics is essential. In many cases, the issue isn’t the tear itself, but rather a lack of mobility and movement in the knee joint that continues to aggravate it. A mechanical knee pain specialist can help identify and correct these dysfunctions. Once inflammation is controlled and knee mechanics are optimized, strengthening and conditioning the surrounding muscles can provide long-term relief without the need for injections or surgery.

Finding Long-Term Relief Naturally

For most cases of knee pain, the key to lasting relief is movement – not rest, avoidance, injections, or surgery. Whether your pain is caused by an overuse injury, muscle imbalance, or arthritis – addressing the root cause with targeted exercises and mobility work is essential. Reducing inflammation naturally is also crucial for long-term joint health. If you’re struggling to determine the root cause of your knee pain or finding the right treatment approach – consider working with a mechanical knee pain specialist who can guide you toward the best non-invasive, long-term solutions.

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.

Could Regenerative Therapy be the Future of Healing for Active Adults?

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Staying fit and injury-free is essential for maintaining an active lifestyle – especially when you’re over 40.

And the more active you are, the better your quality of life tends to be. But here’s the unavoidable reality… As your body ages, so do your natural healing processes. Translation? Recovery times take longer than when you were in your 20s – and you become more vulnerable to injuries as you age.

Fortunately, an emerging field in medicine is gaining popularity and could be the solution to longevity you’ve been searching for. It’s called regenerative therapy. This cutting-edge field focuses on harnessing the body’s natural ability to heal and regenerate itself. Regenerative therapy includes treatments like stem cell therapy, platelet-rich plasma (PRP) therapy, regenerative shockwave therapy, and electromagnetic therapies such as Pulsed Electromagnetic Field Therapy (PEMF) and Extracorporeal Magnetotransduction Therapy (EMTT). These therapies aim to repair damaged tissues, reduce inflammation, and stimulate the production of new, healthy cells.

For the purposes of this article – let’s focus on two of these regenerative therapies – Shockwave Therapy and EMTT – and how when used together – deliver incredible results for active adults over 40.

Compared to some of the other regenerative therapy options out there – this treatment combo is non-invasive, highly accessible, and affordable. Plus – it comes with minimal side effects, no contraindications for most people, and virtually no downtime required – making it a game-changer for those who want to stay active without interruptions to their daily lives.

Let me introduce you to Regenerative Shockwave Therapy and EMTT…

What is Shockwave Therapy?

Extracorporeal Shockwave Therapy (Shockwave Therapy) is a non-invasive procedure that uses acoustic shockwave energy to stimulate healing in tendons and soft tissues. Radial Shockwave Therapy (EPAT) disperses energy broadly over an area – while Focused Shockwave Therapy (ESWT) concentrates energy on a smaller, more precise area. Both types of shockwave therapy stimulate healing by enhancing blood flow, promoting cell and tissue regeneration, reducing inflammation, and breaking down scar tissue. Originally developed to break up kidney stones, shockwave therapy has been used for decades to treat musculoskeletal conditions like tendinitis and plantar fasciitis.

What is EMTT?

Extracorporeal Magnetotransduction Therapy (EMTT) is an advanced, non-invasive, cutting-edge treatment that uses high-energy electromagnetic fields to accelerate healing and alleviate pain. It’s often compared to Pulsed Electromagnetic Field Therapy (PEMF), but it’s much more powerful. While both therapies rely on electromagnetic fields to stimulate natural repair processes – EMTT operates at frequencies up to 100 times higher than PEMF – enabling it to penetrate deeper into tissues and deliver more targeted therapeutic effects. EMTT has the capability to heal at the cellular level by enhancing your cell’s metabolic activity, which helps to reduce inflammation, promote faster healing, and accelerate the regeneration of damaged tissue. EMTT’s increased energy and intensity make it so powerful it can penetrate through clothing and even a cast (when bone healing is needed). Its high frequency also makes it virtually painless. EMTT is particularly effective for chronic pain, joint injuries, and degenerative conditions like arthritis

The Power of Shockwave Therapy and EMTT combined:

While Shockwave Therapy has been around for over 40 years – EMTT is fairly new to the market of regenerative therapies. The first EMTT device, the Magnetolith, was FDA-approved in the United States in 2010. Since then – the two therapies have proven to be a perfect pair. When combined – Shockwave Therapy and EMTT offer a powerful, synergistic approach to healing. While Shockwave Therapy focuses on mechanical stimulation of your tissues and improving circulation – EMTT works at a cellular level, resetting inflammation and promoting deeper tissue repair. Together – these therapies amplify each other’s effects – resulting in faster and more comprehensive healing.

Evidence Supporting the Combo:

A 2018 study by Kluter et al. examined the effects of Shockwave Therapy alone versus Shockwave Therapy combined with EMTT on 86 patients with rotator cuff tendinopathy. The results showed that patients receiving the combined therapy experienced significantly greater pain reduction and improved function compared to those treated with Shockwave Therapy alone. Although EMTT is relatively new, preliminary studies and case reports highlight its potential. For example – regenerative therapy using Shockwave Therapy and EMTT has shown promise in improving surgical outcomes. Case studies demonstrate that pre- and post-operative use of this combo significantly enhances scar healing, bone healing, and recovery times. And patients undergoing major procedures like Achilles tendon repairs returned to activity almost two months faster when these therapies were included as part of their recovery.

So Who Can Benefit?

The short answer is literally anyone. But active adults over 40 are prime candidates for this combination of regenerative therapies. Post-surgical patients recovering from orthopedic surgeries – including joint replacements – can experience faster healing and improved outcomes. Chronic pain sufferers dealing with conditions like arthritis or tendinopathies can find relief where other treatments have failed. Athletes or active adults with sports injuries, muscle strains, or overuse injuries will also benefit. And finally – if you’re someone who’s recovery has stalled with traditional physical therapy or cortisone injections  – you might just find renewed hope with this advanced, cutting-edge treatment.

As research into regenerative medicine advances – I believe the combined use of Shockwave Therapy and EMTT is poised to become a cornerstone of modern healthcare for active adults. These therapies not only address the symptoms of injury and degeneration – but also tackle the underlying causes – promoting true healing and long-term recovery. For active adults over 40 who want to maintain their mobility, independence, and active lifestyles – regenerative therapy offers a promising future. By harnessing the body’s natural healing capabilities through advanced, non-invasive techniques – Shockwave Therapy and EMTT provide a path to faster recovery, improved surgical outcomes, and a pain-free life.

If you’re over 40 and facing chronic pain, injury, or the prospect of surgery – consider exploring regenerative therapy.

The combination of Shockwave Therapy and EMTT isn’t just about managing symptoms – it’s about restoring your body’s ability to heal itself.

With growing evidence supporting their effectiveness, these therapies are paving the way for a healthier, more active future for adults everywhere.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists to see if you could be a good fit for our Regenerative Therapies 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.

5 Tips for Wrapping Gifts Without Aggravating Neck or Back Pain

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If you’re anything like me – you’ve left your Holiday wrapping to the absolute last minute. And if that’s the case – there’s a very good chance you’re going to overdo it – and aggravate any existing neck or back pain you might have.

The good news?

There are things you can do to significantly mitigate the chances of your neck and back pain flaring up – and perhaps avoid it altogether.

Here are five great tips – and even a bonus recovery tip – to help you get through your last minute gift wrapping without aggravating your neck or back:

1. Create an Ergonomic Wrapping Station

The way you set up your wrapping station matters. Sitting on the floor or crouching over a low coffee table forces your spine into unnatural positions, creating stress on both your neck and back. Instead, wrap your gifts on a surface that allows you to sit or stand comfortably at waist height.

If you’re sitting, use a supportive chair along with a lumbar roll to keep your back and neck in their most natural position. For those who prefer standing, consider using an anti-fatigue mat to reduce strain on your back. Elevating your workspace ensures you’re not constantly hunching over, which is a common culprit for neck and back pain.

2. Don’t Sit or Stand Too Long – Move!

Sitting or standing in one position for extended periods can lead to stiffness and pain in your neck, shoulders, and back. Set a timer to remind yourself to take movement breaks every 20-30 minutes.

During these breaks, perform a few gentle stretches for your neck and back. Try rolling your shoulders backward, gently tilting your head side to side, or doing a seated spinal twist. Movement encourages blood flow, which helps reduce stiffness and tension. Plus, breaking up the task gives you a mental refresh so you can focus on getting your wrapping done instead of neck or back pain.

3. Use the Right Tools

The tools you use can make a big difference in minimizing strain. Opt for ergonomic scissors with padded handles to reduce stress on your hands and wrists. Tape dispensers are also a must-have to prevent repetitive wrist motions that can lead to discomfort.

If you’re wrapping on the floor, use a cushion to support your hips and lower back. For added neck relief, consider placing a rolled-up towel under your neck during floor session breaks to give it some relief and maintain its natural curve. These simple adjustments can help you avoid unnecessary strain while you focus on creating perfectly wrapped packages.

4. Check Your Posture

Poor posture is one of the biggest contributors to both neck and back pain. While wrapping, make a conscious effort to:

  • Relax Your Shoulders: Keep them down and away from your ears to avoid tension in your neck and upper back.
  • Maintain a Neutral Spine: Whether sitting or standing, ensure your lower back keeps its natural curve.
  • Align Your Head: Avoid craning your neck forward. Bring the gift closer to you instead of leaning toward it.

These small posture corrections can go a long way in keeping discomfort at bay and ensuring your body feels great long after the wrapping is done.

5. Spread Out Your Wrapping Tasks

Rather than saving all your wrapping for Christmas Eve, try wrapping a few gifts at a time over several days. This approach prevents prolonged periods of repetitive motion and reduces the overall strain on your neck and back.

Now – if you HAVE waited till Christmas Eve to wrap your gifts – then ignore this tip and move on to your bonus recovery tip 🙂 

Bonus Recovery Tip: Treat Yourself to a Little TLC

Even with the best precautions, some muscle soreness and tension might still sneak in. Combat this by treating yourself to recovery techniques like foam rolling, deep breathing, a good stretching session, or one of our Regenerative Therapy Sessions! 

And if your pain persists or worsens – don’t ignore it. Seeking advice from one of our mechanical pain specialists can help you address the root cause or your neck and back pain and prevent it from becoming a much bigger issue that impacts more than just wrapping gifts.

Live near Portsmouth, NH? Connect with one of our mechanical 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.

low back pain

3 Reasons Your Lower Back Stretches Aren’t Working

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If you suffer from chronic lower back stiffness or pain – and you’ve been diligent with your stretching routine – it might be time to re-evaluate your approach.

Whether it’s your stretching technique, the type of stretch, or even the idea that you might not need to stretch at all, it’s important to understand why your current regimen might not be helping.

Here are three common reasons why your lower back stretches might not be working and how to address them:

1. You’re using the wrong stretching technique.

Research varies on how long to hold a stretch, but many people find that holding a stretch for 30-60 seconds is effective. However, technique is everything. One common mistake is not fully relaxing into the stretch. It won’t be effective if you’re holding tension in your body or gripping your muscles as you stretch. Make sure you’re breathing deeply and easing into each movement. Forcing the stretch or pushing through pain can trigger muscle tension and defeat the purpose.

If you’ve relaxed fully and your stretches still don’t seem to work, consider trying “dynamic” or “moving” stretches. Rather than holding one static position, move gently through a series of stretches, like pelvic tilts or cat-cow stretches. These can help your muscles stay loose without becoming rigid. Adjusting your stretching approach can make a noticeable difference and reveal that your technique might have been the issue.

2. You’re doing the wrong type of stretch.

Determining the right type of stretch can be tricky without expert guidance. There’s a distinction between general stretches meant for relaxation and specific corrective stretches for targeted issues.

For example, let’s say your lower back tightens up after a long day or due to stress, general stretches like a child’s pose or a seated forward fold may relieve tension. I often use these stretches to keep my own back healthy when I’m on my feet all day helping patients.

However, if you’re dealing with lower back pain or symptoms like sciatica (pain or tingling running down your leg), generic stretches like these might not help and could even worsen your condition. In these cases, corrective stretches tailored to your specific problem are necessary. These stretches are usually prescribed by a specialist who considers your body mechanics and underlying issues, recommending the best type and frequency for you.

3. You shouldn’t be stretching your lower back at all.

One surprising reason your lower back stretches might not be helping is that you may not need to stretch it in the first place. Chronic lower back tightness can sometimes indicate a weak core or hip instability.

This is more common than you might think, and if this is your situation, stretching your back repeatedly can lead to more frustration and even worsen the problem. The deep stabilizing muscles in your lower back are closely connected to your core muscles. If your core isn’t functioning properly, your lower back muscles might compensate, leading to persistent tightness and discomfort.

Ever notice your lower back feels sore after a day of ab exercises or after certain workouts? This could be a sign that your lower back is overcompensating. Instead of stretching more, it’s time to focus on core strengthening and proper movement techniques. Seek guidance from a specialist to assess and correct your form and make sure your core is doing its job.

Lower back pain is common – but having to constantly suffer from it isn’t. If your lower back pain or tightness isn’t improving despite regular stretching – it’s possible that your technique needs adjusting, you’re using the wrong type of stretches, or stretching isn’t what your body needs at all. Finding the root cause of your lower back issues is key.

Consulting with a physical therapy specialist who is an expert in mechanical pain can help you identify the root cause of your back pain and the best course of action – so you can stop wasting time on ineffective stretches and get back to your favorite activities without pain. Need help finding one? Reach out – I’m happy to help.

Are you local to Portsmouth, NH?

Book a free discovery visit with one of our specialists HERE. Our team will listen to your story and help you make the best decision moving forward – whether that means working with us or finding the right plan for you 🙂

What Your Doctor May be Missing About Your Pain’s True Source

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Pain can be frustrating and overwhelming, especially when it doesn’t go away.

It’s only natural to seek answers – and for many – that means a trip to the doctor. But here’s the thing. Even the best doctors can miss the true source of your pain.

Why?

Because too often they rely on imaging (like MRIs or X-rays) focused on the location of your pain – rather than considering the true source of your pain – and that it could be coming from somewhere else in your body. 

I often see this with pain in areas like the hips, knees, elbows, arms, and legs. Take persistent knee pain, for example. Most doctors will start by ordering an MRI of your knee – which might show things like arthritis or a torn meniscus. But what you may not realize is that these findings are common as we age and often appear in people who don’t have knee pain at all.

The problem is

– once something shows up on your MRI – it grabs your doctor’s attention – and becomes the full focus for treatment (even if it’s not the real problem). 

This misdiagnosing of pain like this is a huge reason why so many people suffer longer than necessary. It also leads to unnecessary surgeries, procedures, and treatments that never address the root cause of the problem. Back to our knee pain example, your doctor might not even consider that your knee pain could be coming from somewhere else (such as your lower back). And if that’s the case – no amount of knee-focused treatment will solve your knee pain – all because we allowed the MRI to make assumptions about the root cause of pain and dictate the treatment plan. 

What most medical doctors miss is this: The way your body moves and reacts to pain is often a much more reliable way to determine its true source than what shows up on an image. I’m not blaming your doctor – it’s just not how they are trained to examine and look at pain. But it is important for you to be aware of this – especially when your pain isn’t going away. You have to at least consider that the root cause was missed and could be coming from elsewhere.

Let me explain a little more.

Over my 22-year career, I’ve worked with people who suffered from persistent tennis elbow for years – despite trying every recommended protocol – only to discover their pain was actually coming from their neck. I’ve met patients who underwent major knee surgery that failed to bring relief – because the problem wasn’t in their knee at all.  I’ve seen patients replace their entire hip – only to find out their real problem was coming from their lower back the entire time.

And this isn’t just my experience. Research backs this up.

A study in the Journal of Manipulative Therapy found that on average, 40% of isolated extremity pain (like your hip, knee, shoulder, elbow, etc) is actually caused by your spine, even when there’s no pain in the spine itself. In these cases, imaging of your knee, shoulder, etc. would only show “normal abnormalities” associated with aging – and not ever show you the true source of your problem – which could be your spine.

So how do you figure out the real cause of your pain?  

The key is with specialized movement testing – designed to take into account your whole body, as well as everyday movement patterns and lifestyle. When you work with a mechanical pain specialist who is trained in this type of movement testing, they don’t just look at static images of your body – they look at how your body functions as a whole.

For example – by moving your spine in specific directions and seeing how that movement affects the pain in your knee, shoulder, or elbow – they can determine whether the spine is the real culprit. 

So if you’ve been struggling with persistent pain anywhere in your body and it’s not going away – you must at least consider that the location of your pain may not be its source. This is particularly common with pain in your extremities. The problem with traditional medical approaches is that they rely heavily on imaging and assume that what you see on an X-ray or MRI is the cause of the pain.

But pain doesn’t work that way. It’s more complex than a picture can reveal, and it often requires a deeper understanding of how your body moves and responds to find the source.  

Pain can be complicated, but finding the source doesn’t have to be. When you consider how your body moves – not just what shows up on an image – you’ll get closer to the answers you need.

Are you in the Portsmouth, NH area?

CLICK HERE to connect with one of our specialists to see if we would be a good fit to help you uncover what may be the real source of your pain.

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.

Knee Pain

How Mobility and Strength Are Key to Resolving a Meniscus Tear Naturally

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A meniscus tear is one of the most common knee injuries, and it’s known for causing significant pain, swelling, and restriction of movement that can seriously disrupt an active lifestyle.

While surgery may seem like the only solution – and perhaps that’s what you’ve been told – many people (80% in fact) can successfully avoid invasive procedures like cortisone and surgery if they want to. 

The key?

Focusing on specialized mobility and strength training of your knee. But first – what exactly is a meniscus tear and how does it cause problems for your knee?

The meniscus is a cartilaginous structure in your knee joint that acts as a shock absorber. It sits between your thigh bone (femur) and shin bone (tibia) and you have two of them: one on the inside of your knee joint (medial) and one on the outside (lateral). Together, they help distribute weight and cushion your knee during activities like walking, running, and jumping.

So how do meniscus tears happen?

You can get a meniscus tear suddenly from twisting or pivoting motions, or it can develop gradually over time due to age or wear and tear.

But here’s the thing… Sometimes – especially when your meniscus tear develops slowly – it can be damaged without feeling any knee pain or symptoms. For example, a study published in the New England Journal of Medicine found that 35% of people over the age of 50 had meniscus tears on their MRI, but no knee pain or other symptoms. In another study, published in the Journal of the American Medical Association – it was reported that 60% of men and women over the age of 65 who had a meniscus tear on their MRI also had no symptoms in their knees. What is the significance of this? It means that it’s entirely possible to “live” with a meniscus tear and not have any knee pain – which means it’s also entirely possible to avoid surgery and cortisone shots.

So why do some meniscus tears cause pain when others don’t? 

When you have a meniscus tear – it has the potential to disrupt your knee’s natural mechanics – but not all tears do.

When the mechanics of your knee are compromised, that’s when you experience symptoms. Why? Because faulty knee mechanics (over time) will cause compensatory strategies to happen in the joint itself – as well as the surrounding muscles and structures.

This is what actually causes pain – not necessarily the tear itself.

Simply going in and “cutting out” the meniscus tear will not solve the problem of faulty knee joint mechanics. It’s why so many people end up with no relief at all after surgery – or just temporary relief of pain that returns anywhere from months to years later. In 80% of knee pain cases that involve a meniscus tear – the faulty knee mechanics are what truly cause the problems and pain – not the tear itself. That’s why focusing on the joint mechanics and mobility first is more important – because if you can restore that – the tear often becomes a non-issue – just like all the people in those research studies.

Now – when I talk about knee mechanics – I’m referring to both knee mobility and strength – and how they work harmoniously together. 

Mobility refers to the ability of your knee joint to move smoothly and freely through its full range of motion. Strength refers to the stability around your knee joint – which comes from muscles and tendons. When a meniscus tear causes your knee joint mobility to be blocked and disrupted – meaning it’s unable to bend and extend properly – it puts stress on the surrounding structures and muscles – causing a cascade of events that eventually lead to pain and swelling.

To achieve natural knee pain relief after a meniscus tear – restoring mobility is the first critical first step – followed by strengthening. But a lot of people get this wrong. That’s why it’s important you work with a mechanical knee pain specialist who understands the intricate nature of a meniscus tear and how it impacts your knee mechanics. You can’t just do random strength and mobility exercises. They need to be prescribed to you in a specific and strategic manner so that you can “free” the tear and restore your knee mechanics. In other words, YouTube and Google won’t be able to help you.

If you’re confused – I don’t blame you – but the research doesn’t lie.

For most people, especially those over the age of 40, there’s a 70-80% chance you can get full relief of your knee pain after a meniscus tear, without any type of surgery or procedure. This is not a popular opinion by the way. Arthroscopic meniscus surgery is one of the most common (and profitable) surgeries out there. If a meniscus tear appears on your MRI – a common recommendation will be surgery. But if that’s not what you want – I’m here to tell you it’s entirely possible to resolve pain and dysfunction from your meniscus tear naturally. But you’ll want to work with a mechanical knee pain specialist to do that. Reach out if you need help finding one in your area.

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

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch or sign up for her upcoming Masterclass for Knee Pain Sufferers – CLICK HERE or call 603-380-7902