Tag Archive for: Portsmouth New Hampshire

6 Tips for Healthy and Mobile Knees this Summer

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When you’ve got persistent, nagging knee pain, it can significantly impact your quality of life, and put a real damper on your summer. The good news is there are many things you can do naturally and on your own to help keep your knees healthy, especially with the increased activity that often comes with summer. 

Here are six of my top tips to ensure your knees stay strong and pain-free during your summer adventures:

1. Strengthen Your Hips and Core

Your hips and core provide essential support and stability to your entire body, but especially your lower limbs and knees. Strengthening these important muscle groups is key for not only relieving knee pain – but preventing it as well. Weakness or imbalance in your hips and core can lead to poor alignment and compensatory stress on your knees during movements like walking, running, or squatting. So when you focus on strengthening your hips and core – you’ll improve your overall biomechanics – and reduce the wear and tear by minimizing the load placed through your knees during summer activities.

2. Get (and Stay) Mobile

One saying you’ll hear me repeat over and over is: “mobility before stability.” When you’ve got stiffness in your joints, the surrounding muscles will try to compensate. Muscles don’t work as well when the joint they are in charge of moving doesn’t have full and free mobility. I see this a lot in people suffering from knee pain.

Good and optimized joint mobility will enhance your body’s ability to move efficiently and with proper body mechanics, thus, reducing the strain on your knees. By increasing (and maintaining) your flexibility and range of motion, your body will move more freely and distribute forces more evenly throughout your joints and muscles (including your knees).

3. Don’t Sit so Much

Knee pain can come directly from your knee, but also from your spine (even when you don’t have any back pain). Interrupting your sitting throughout the day (I recommend once every 30 min) addresses both potential causes. For knees in particular, prolonged periods of sitting can cause stiffness and lead to poor blood circulation in and around your knee joint. That’s why sometimes after sitting for a while, you can experience sharp stabbing pain in your knee when you go to move.

Sitting for extended periods can also lead to tightness in the hip flexors and hamstrings, which can negatively impact knee alignment and function. When you take regular breaks to stand, stretch, and move around – you relieve knee pressure, maintain good joint mobility, and prevent muscle imbalances that (when left unaddressed) can gradually creep up and ruin your summer.  

4. Keep Moving

Regular movement and exercise helps to stimulate blood flow. If you’ve got inflammation in your knees causing pain, good blood flow helps to actually reduce inflammation by delivering essential nutrients and oxygen while also removing waste products. If your knees are on the arthritic side, engaging in low-impact exercises like walking, swimming, cycling, or Pilates can help build strength and endurance around your knees without putting excessive stress on your joints.

Regular movement also helps lubricate your knee joints, which can reduce friction and discomfort during summer activities. Perhaps the biggest benefit of regular exercise and movement is the release of endorphins, which are your body’s natural painkillers that can help alleviate discomfort in any joint, not just your knees.

5. Wear Sensible Footwear

The right (or wrong) footwear can greatly impact how your knees feel when walking, running, or standing. Proper footwear provides the necessary support and cushioning to reduce knee strain. And depending on the mechanics of your feet and ankles, the right footwear can help improve overall alignment and stability. 

In the summer, people love wearing sandals and flip flops. However, if you’re prone to knee problems, you may want to reconsider this choice or only wear them for short periods when you won’t be standing or walking for long. Flip flops, in particular, offer little support and can exacerbate knee pain. By choosing shoes that prioritize comfort, support, and proper alignment, you can effectively reduce knee pain and enhance overall joint health for a happy and active summer.

6. Work on Your Balance

Good balance is crucial for stability, control during movement, and reducing fall risk, especially in summer activities like paddleboarding, pickleball, and walking on the beach. When you work on your balance, it helps reduce knee strain by ensuring your postural muscles, feet, and ankles work together to distribute forces evenly. Without this coordination, your knees overcompensate and suffer. When you make a conscious effort to improve and maintain balance – it will help to decrease the stress on your knees by getting other joints and muscle groups to “join the party.”

If you’ve been suffering from knee pain for a while and you’re worried about it ruining your summer – get started on any of these six tips and see if they help. Now, if knee pain is getting in the way of you being able to incorporate any of these tips, then it’s time to consider expert help and speak with a physical therapy specialist.

The right therapist will help you identify the root cause of your knee pain and come up with a treatment plan that not only gets rid of your knee pain, but teaches you how to keep it gone – naturally and on your own. 

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 to download her Free Report on Knee Pain – CLICK HERE.

Plantar Fasciitis

Enjoy Flip-Flop Season: Strategies to Prevent and Treat Foot Pain

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Flip-flop season is officially here – but unfortunately – that also means we are about to see an influx of foot pain – otherwise known as “plantar fasciitis”.

Here’s a question someone asked me just the other day… “I’ve been wearing my flip-flops for the past week and notice that the pain in my arch and heel has acted up. Is there anything I can do? Or do I need to just not wear flip-flops anymore?”
While wearing more supportive shoes would certainly help, staying on top of your plantar fasciitis and/or preventing it altogether means flip-flops don’t have to be an issue, and you can continue enjoying them all season long.

First – What is Plantar Fasciitis?

Quite simply, it’s inflammation of your plantar fascia—the tissue that makes up the arch (bottom) of your foot. Your plantar fascia runs from the base of your heel, down the length of your foot, and into your toes. It’s responsible for both the mobility and stability of your foot, enabling you to propel yourself during walking and running. When you land on your foot, your arch falls or flattens—this is called pronation. In response, your foot then stiffens or supinates, providing the power to push off. If any part of this mechanism is not functioning properly, your plantar fascia can become stressed and overworked, leading to what we call “plantar fasciitis”.

How Do Flip-Flops Contribute?

Footwear can either “protect” your arch or cause it to overwork. Technically, if your foot mechanics are sound and the arch of your foot is strong and mobile, footwear should have a negligible impact on your plantar fascia. However, due to prolonged sitting and limited barefoot walking, the bottoms of our feet are not as conditioned as they should be. This is the real problem—not so much what you put on your feet. If you’re used to wearing supportive and cushioned shoes and then suddenly switch to flatter, less supportive flip-flops, it can shock your foot. And if you’re already prone to plantar fasciitis, it will flare up easily and quickly.

What Can You Do?

The best way to prevent and treat plantar fasciitis is to not neglect your feet. Consistent mobility exercises for your toes and ankles are key, as is conditioning for the strength and stability of your arch. Balance exercises, toe exercises, and plyometric (jumping) exercises are all important. Additionally, make it a point to walk around without shoes as often as possible. Incorporating pelvic floor and core training exercises is also beneficial because the function of your deep core has an impact on your foot mechanics.

When Your Pain is Too Severe

If your plantar fasciitis is too painful, jumping into exercises may not help and could even aggravate it more. One effective treatment modality for particularly painful cases is something called Shockwave Therapy (Extracorporeal Pulse Activation Technology or EPAT). During a shockwave treatment, high-pressure sound waves are delivered directly to the affected tissue, bringing blood flow and accelerated healing to the injured and inflamed area (in this case, your plantar fascia and surrounding muscles). The treatment is non-invasive and penetrates deeply. Pain reduction can be seen in as little as one shockwave session, but research shows it to be most effective after a minimum of six. Shockwave therapy can significantly reduce pain and swelling from plantar fasciitis in the short term, allowing you to tolerate the exercises required to keep your plantar fasciitis at bay in the long term.

When addressed correctly, plantar fasciitis doesn’t have to be chronic, and it doesn’t have to dictate your footwear selection. If you’ve tried various treatments already for your plantar fasciitis without success, consider working with an expert who can accurately identify where your plantar fasciitis is coming from. They can also help you decide if incorporating something like shockwave therapy – in addition to the necessary exercises – is what’s needed to finally resolve your plantar fasciitis and get back to enjoying your flip-flops again.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or inquire further about Shockwave Therapy – CLICK HERE.

Woman sleeping facedown on a bed.

Tips and Solutions for Morning Back Pain

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One of the most common complaints from chronic back pain sufferers is back pain first thing in the morning.

For some folks, it rears its ugly head on occasion and appears out of nowhere – as if they’ve “thrown their back out”. For others, it’s like Groundhog Day – they go to bed feeling great but wake up every morning feeling stiff and achy.

Why does this happen? Shouldn’t your back feel better after a good night’s sleep?

Back pain impacts people in different ways and at different times of the day. When it comes to morning back pain – while the easiest thing to blame is your mattress – some of the more common causes of morning back pain include poor sleeping position, insufficient exercise, and bulging discs. 

Let’s go through each one and talk about tips to help minimize them.

Poor Sleeping Position

The sleeping position that aggravates you is going to depend on the underlying cause of your back pain. Sometimes sleeping on your back with legs elevated is what makes your back feel worse in the morning – even if it feels amazing while you’re in this position. For others, sleeping on their stomach is the thing that wreaks havoc on their spine. The most back-friendly position is to sleep on your side. Side-sleeping allows you to put your spine in a neutral position – which is where you get in the least amount of trouble. It’s really challenging to achieve a neutral spine when you’re on your back or stomach. If it bothers your hips or shoulders to sleep on your side – I recommend placing a pillow under your waist as well as your head – and if needed – also one between your thighs.

Insufficient Exercise

Another common culprit of morning back pain is insufficient exercise. A lack of regular physical activity can lead to weakened muscles and reduced flexibility, both of which can contribute to back pain. When your muscles are not strong enough to support your spine properly, your back is more susceptible to strain and discomfort. Incorporating regular exercise into your routine, especially exercises that strengthen your core and back muscles, can help reduce morning stiffness and pain. Activities such as yoga, Pilates, and even daily stretching can improve muscle tone and flexibility, thereby offering better support to your spine and reducing pain.

Bulging Discs

This is the most common reason I see for morning back pain. Your vertebral disc has three primary functions: 1) to absorb shock; 2) to help hold the vertebrae of your spine together; and 3) they contribute to the mobility in your spine. The interesting thing about vertebral discs is that they are made up primarily of water. Over the course of a normal day – and over the course of life – your discs will compress and decrease their water content. At night, your disc literally re-hydrates and can gain up to 17-25 mm of height.

While this may be beneficial to someone whose arthritis is to blame for their back pain, it is not beneficial for someone suffering from a bulging disc. Remember when I mentioned that your disc is partially responsible for mobility in your spine? When you have a bulging disc – that bulge restricts your mobility. If it fills up with fluid overnight – you’re going to wake up feeling a lot more restricted and in a lot more pain. Unfortunately, there is no quick fix I can reveal for you on this one. The best advice I can give you is that if you’re waking up every morning in a lot of pain and you’re afraid to move – there’s a good chance you’re suffering from bulging discs, and you should see someone who can help you with this.

If you’re waking up every morning with back pain, then hopefully this information helps you have a better understanding as to why it might be happening. Before you consider spending loads of cash on a new mattress – give one or more of these solutions a try and see if it helps. Because the good news is that 80% of the time there is a natural, movement-based solution that can address your back pain successfully. If you’re not having success with eliminating morning back pain on your own – then consider enlisting the help of a physical therapy specialist who is an expert in these kinds of solutions – and who can properly diagnose your back pain.

Dr. Carrie Jose, Physical Therapy Specialist and Mechanical Pain expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get a free copy of her guide to back pain – click here.

Headache sufferer

5 Signs your Headaches are coming from your Neck

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Headaches impact approximately 47% of the population and are one of the most common disorders of the nervous system. If you suffer from headaches regularly, then you already know how disruptive they can be on your work life, social life, daily activities, and just overall energy and well-being. 

But what makes headache management particularly challenging is how often they are misdiagnosed. The most common types of headache disorders are what’s known as primary headache disorders – and those include migraines, cluster headaches, and tension-type headaches. But you could also be suffering from a secondary headache disorder – which is caused by some other illness or physical issue. One of the most common forms of secondary headache is something called a “cervicogenic headache” – meaning it comes from your neck. They can be quite debilitating and are commonly confused with migraines – but there are some key signs to look for that make them different. 

Let’s look at 4 signs that might indicate your headache is coming from your neck:

1. Headaches worsen with certain neck movements

If you find that certain movements or positions of your neck exacerbate your headaches – it could be a sign that your headaches are coming from your neck. Sometimes it’s very specific movements that trigger a headache – such as tilting your head forward or backward – or turning it from side to side. But other times it’s less obvious and related to more prolonged postures. For example, I’ve had patients experience headaches from sitting at a bar for several hours and turning their head to a certain side to talk to their friend. Pay attention to whether certain neck movements or positions create discomfort in your neck that either precedes or worsens your headache. It could mean that your headache is coming from a source in your neck.

2. Your Neck is Stiff

Another telltale sign of neck-related headaches is limited mobility or range of motion of your cervical spine (neck). If you find yourself struggling to turn your head fully, or you experience pain and stiffness when attempting to do so, it could indicate an underlying issue in your neck that is causing your headache. A common saying in my office is “mobility before stability”. If the joints in your neck don’t move fully and freely, the structures around those joints (muscles and nerves) can become angry and irritated – and this could be the source of your headaches.

3. Tenderness in your neck muscles

If you routinely have sensitivity and tenderness in the muscles of your neck – it could indicate an underlying neck problem. If you notice that your headaches seem to get triggered whenever the tension or tenderness in your neck muscles worsens – then there’s a good chance your headaches are coming from your neck. The muscles of your neck can get tense and irritated for a number of reasons – most commonly because of poor posture or because they are being overused in some capacity. Since your neck muscles have direct and intricate attachments to the base of your skull – they can be a common cause of your headaches.

4. Location of your Pain

A headache that stems from the base of your skull and stays on one side of your head – often radiating into your temple or behind your eye – is a common sign that your headache is coming from your neck. If you tend to get associated shoulder or arm pain at the same time as your headache – it’s another indicator your headache could be cervicogenic. That’s because the nerves in your neck extend into these areas and are capable of radiating pain into these locations. If you suffer from chronic headaches, pay attention to where the pain is coming from or where it’s radiation. If it’s extending beyond your head – there’s a good chance your headaches are coming from your neck.

5. Massage and Chiropractic Manipulations Help.

If you find temporary relief from your headaches any time you get a massage or see a chiropractor, it’s almost certain your headaches are cervicogenic. While it’s great you’ve found pain relief – the problem with relying on these modalities is that they are completely “passive” – meaning – you don’t have an active role in the process of relieving your headaches. Passive modalities work great when paired with specialized, corrective exercises you can do on your own that are designed to prolong the effects of these treatments. But when passive treatments are used in isolation – the headache relief tends to be short-lived. The take home point here is that if you find treatments like massage and chiropractic treatment help – your headaches are almost certainly coming from your neck.

If you suffer from debilitating headaches and haven’t yet gotten your neck thoroughly checked out as a source – you should. Because when your headaches originate from a source in your neck, it’s entirely possible to learn how to treat it and manage it naturally and on your own. But you’ll need to work with a specialist who understands cervicogenic headaches as well as the associated mechanical joint components influencing them.

Are you local to Portsmouth, NH? CLICK HERE to speak with one of my specialists for free.

Knee Pain Causes

Six Tips to Improve Knee Pain Naturally and on Your Own

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

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

  1. Strengthen Your Hips and Core:

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

  1. Get (and stay) Flexible:

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

  1. Interrupt Your Sitting:

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

  1. Get (and keep) Moving:

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

  1. Choose Sensible Footwear:

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

  1. Improve Your Balance:

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

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

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

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

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

Holding Knee with Arthritis

Torn Meniscus? Is Surgery Worth it?

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

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

Let’s investigate…

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee. The biggest set of pro’s for this procedure is that it’s quick, recovery is fairly minimal, and you will typically experience an immediate relief of pain.

Sounds worth it – right?

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

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

Looking to avoid a knee replacement in your future?

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

And then there’s the elephant in the room…

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

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

An early research study from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment. 

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery to repair a torn meniscus?

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management of knee pain. If you’ve gotten physical therapy and it wasn’t effective, people are led to believe that the physical therapy “didn’t work”. But more often than not, you didn’t get physical therapy from a specialist – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery. 

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

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

7 Reasons Everyone over 50 Should be Walking

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A meet a lot of folks who think (or have been told) they need to “slow down” once they get into their 50’s and beyond – especially if they have arthritis or an injury. But this can’t be farther from the truth. As we age, regular movement and exercise becomes even more critical – especially if you’re injured or suffering from arthritis. 

If it’s been awhile since you’ve exercised, or you’re looking for something you can do that’s accessible and where you can be consistent, then let’s talk about all the benefits a walking routine can bring you – especially if you’re in your 50’s and beyond.

Here are 7 reasons why I think everyone over 50 should be walking:

  1. It’s good for your cardiovascular health

The leading cause of death in older adults continues to be cardiovascular disease. A regular walking routine can help combat this by improving your heart health, increasing your blood circulation, it reduces bad cholesterol, and raises the good cholesterol. Plus – the rhythmic nature of walking gets your heart pumping at a steady rate – which is great for your overall cardiovascular health.

  1. It makes your muscles and bones stronger

As we age, losing both bone density and muscle mass are normal and common. But there are things you can do to counteract this process – and regular walking is one of them. Since walking is a weight-bearing activity, it’s good for strengthening your bones and reducing the risk of osteoporosis and fractures. Walking also engages several of your muscle groups at once – which helps them to stay active and strong.

  1. It’s boosts your mental health

Ever heard of walking meditation? It’s a thing. Walking has been shown to significantly reduce symptoms of depression and anxiety, and it’s an opportunity to get your mind off the day to day, self reflect, and even meditate as I mentioned above. Plus – if you assume a regular walking routine with friends or loved ones, the social aspect can be so beneficial to your mood and mental health. To further enhance the mental benefits of walking – try to get out in nature. The fresh air – plus tranquil sounds and smells – is not only cleansing for your mind – but for your soul as well.

  1. It helps you manage weight

Along with bone density and muscle mass, your metabolism also takes a hit as you get older. But regular walking can help counteract this. Regular walking burns calories to help you maintain a healthy weight, which is critical for avoiding chronic diseases such as diabetes and heart disease. Plus, being at a healthy weight can increase your energy levels, it’s easier to move around and do your daily tasks, and you’ll have less stress on your joints.

  1. It improves your joint health

A lot of people don’t realize this – but arthritis is something that occurs naturally as you age and it’s not something to be feared. But because we fear it, we unknowingly avoid activities that are good for us and that actually help arthritis. Walking is one of these activities. Movement is one of the best things you can do for arthritis, and walking in particular helps to lubricate your joints, especially your knees and hips. Regular walking also helps to make the structures and soft tissue around your joints loose and flexible – which is important for successful management of arthritic joints.

  1. It helps enhance your balance and coordination

As we get older, falls become a major concern because lower bone density means you’re more prone to fractures. It gets more difficult to work on balance and coordination after you’ve lost it – so maintaining it is key. A regular walking routine does just that. Each step you take requires coordination of several muscles as well as balance – and the repetitiveness of wal

king helps enhance your body’s natural ability to quickly correct and stabilize itself – all helping you to decrease your risk of falling.

  1. It’s low impact and adaptable

One of the reasons I recommend walking for folks over 50 is because of its low-impact nature. Unlike jogging or other high-impact exercises, walking is gentle on the joints and can be easily adapted to your current fitness level. Whether it’s a slow-paced walk around the block or a brisk hike up a hill, walking can be tailored to suit your individual needs and goals

If you’re over 50 – incorporating regular walking into your routine can be a game-changer. It’s a simple yet profoundly effective way to get and stay fit – and you’ll find it improves your quality of life in ways that are beyond physical. Walking nurtures your mind and soul, is a great way to catch up with friends and stay social, and you can literally do it anywhere. If you’re not already incorporating a regular walking routine – what are you waiting for? And if an injury is what’s stopping you – talk to an expert who can help you get rid of your pain and get started in a way that is safe for your body.

Learn more about our next exclusive free live event – Fit After 50 – HERE.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

work out

5 Ways Working Out Can Aggravate Your Back

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The research continues to show that the best “treatment” for back pain is exercise. But for some, a work out is what actually aggravates their back. This is a common frustration I hear from clients. They know that strengthening their core and working out is good for their back. But when they do – they suffer. 

Here are five ways your work out is aggravating your back:

1. Misguided Exercise Choice

While the research isn’t wrong about exercising and back pain – not all exercises are appropriate depending on the type and severity of back pain you’re experiencing. For example, walking is considered one of the best activities for back pain sufferers, but for some, it’s excruciating. Strength training and lifting weights should be an essential part of back pain rehabilitation (and prevention). But if it’s done haphazardly, you’re going to have problems and likely aggravate your back. “Exercise” is not what causes problems for most people – it’s exercise choice. And when you make the wrong choice and aggravate your back, you tend to do the worst thing possible – rest and avoid exercise altogether. There is a middle ground when it comes to exercise and back pain. Working with an expert who understands this is essential.

2. Premature Stability Training

Stability training is an important part of back pain recovery – but I often see it introduced too soon. “Mobility before stability” is my mantra. If you don’t have full mobility in your spine, there is a reason, and it must be explored. When your spine doesn’t move well, you risk developing compensatory movement patterns that cause structures in and around your spine to get irritated. You don’t want to stabilize this scenario. You want to restore proper mobility first and then stabilize your spine. I can’t tell you how often I see people making this mistake. When it comes to back pain and working out, mobility-first is a must. If you’ve got a stiff back but have been trying to stabilize it – this could be why your back is getting aggravated when you work out. Stability work has been introduced too soon.

3. Poor Core Activation

Knowing how to properly activate your core is different from having good core strength. You can have the strongest abs in the world – but if you don’t use them when they count – your “6-pack abs” are useless.  Knowing how to properly activate your core is essential when you exercise, but especially when you have back pain. If you don’t activate your core properly when you’re lifting weights, or when performing complicated, coordinated movements such as tennis or golf – you’re setting yourself up for injury. The ability to activate your core properly is developed through motor control training. It’s where we teach your mind how to recognize and activate specific muscles, during specific activities, so that it eventually becomes habitual. If you’re constantly having back pain every time you work-out or exercise, it could be that you lack the ability to activate your core properly – and/or when you need it.

4. Poor (or non-existent) breathing technique

Not breathing properly – or not breathing at all – can significantly impact the effectiveness of your exercise routine and impede your ability to perform an exercise properly. As mentioned previously, knowing how to activate your core is crucial when you exercise, and in order to activate your core properly, you must be able to breathe properly. Your deep core is made up of four parts: your deep abdominals, deep back muscles, pelvic floor musculature, and your diaphragm. Your diaphragm is what controls your breathing. Let’s say you hold your breath when you exercise. This means your diaphragm isn’t expanding or contracting, which impacts the other four muscle groups in your deep core. All four muscle groups must work together in order for your core to be functional and strong. Plus – when your diaphragm – or any other muscle group in your deep core can’t work like it should – you get unnecessary pressure and strain on your back muscles. If you’re constantly aggravating your back every time you work out – make sure you’re breathing properly. Or at the very least, not holding your breath.

5. Improper form

Perhaps the most common reason working out aggravates your back is because you’re not using proper form. There’s a lot of people out there who think posture and form don’t really matter. But they do. When you lift weights, for example, you’re adding load to your spine. It’s essential you have good form and technique when your spine is under load or stress. The tricky thing about form, however, is that you can get away with poor form for a time. It might not hurt the first time you lift with improper form – or the fourth – but by your 100th rep – your back will start talking to you. Same goes for body weight exercises. Just because you aren’t adding load to your spine in the form of an external weight, doesn’t mean you can’t still aggravate it by doing the same movement over and over poorly. If you’re going to exercise – and you want to exercise daily – do it with proper form and posture. Otherwise – if you haven’t aggravated your back yet – it’s only a matter of time.

If you’re always hurting your back when you work out – it’s likely due to one of these five reasons.

Get expert help to figure out which one it might be – because at the end of the day – exercise is good for your back – and you don’t want to avoid it or dismiss it when there could be a perfectly reasonable explanation

Are you local to Portsmouth, NH and looking for help?

Consider speaking with one of my specialists – we will ask you all about what’s been going on with you and see if we would be a good fit to help! 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 request one of her free guides for getting rid of back pain – visit her website www.cjphysicaltherapy.com or call 603-605-0402

Neck stretches

3 Reasons Your Neck Stretches aren’t Working

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If you suffer from chronic neck stiffness or even pain – and you’ve done your due diligence when it comes to neck stretches – it’s time to consider you might be missing something.

It could be your stretching technique, you could be doing the wrong stretch altogether, or it could be that you shouldn’t be stretching your neck at all…

Let’s go over three reasons why your neck stretches might not be working and help you pinpoint where it’s going wrong…

 

1. You’re using the wrong stretching technique.

Although research studies are inconclusive regarding how long you should hold a particular stretch, most people feel good when they hold a stretch for 30-60 seconds. When it comes to technique, one of the biggest problems I see is not relaxing enough. If you’re tense, or gripping your muscles at the same time you’re stretching, it won’t work very well. It’s important to breathe and move easily into the stretch. If you try to force it or push through pain, you’ll likely tense up.

Now let’s say you’re doing everything right (not tensing or gripping) but your stretches still don’t seem to work. Some people (myself included) respond better to “moving stretches”. This is where instead of holding one static position for a prolonged period, you repeatedly move through one (or several) end-range stretches. Neck rolls are a great example of this. If your neck stretches haven’t been working, try adjusting the way you’ve been stretching. If you notice a difference right away then you have your answer – you were likely using the wrong stretching technique.

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

This one could be a little tougher to figure out on your own. There is a difference between corrective neck stretching and stretching to feel good.

For example, let’s say your neck is tightening up because you’ve been under a lot of stress or you just did a lot of activity that stressed your neck out. Generic neck stretches such as bringing your chin to your chest, or pulling your chin to the opposite shoulder (known as an upper trap stretch) may be all you need.

In fact, I do stretches like this regularly because I’m constantly leaning over to help patients. I stretch my neck to PREVENT it from having problems and because it feels good. But let’s say you already have a neck problem, or you have pain or numbness running down your arm. In these instances, generic neck stretching could make you worse. You likely need corrective stretches for your neck. Corrective stretches are specifically prescribed to address a particular problem, and prescribed at a specific frequency. They are different from the generalized stretches that are designed to feel good and relieve tension.

3. You shouldn’t be stretching your neck at all.

This is a very common problem we see here in our office. Folks come in with complaints of chronic tightness and discomfort in their neck and no matter how often they stretch or massage, it doesn’t go away.

Did you know that chronic neck tightness can be a sign of a weak core?

It’s quite common, and if that is the case for you, no amount of stretching will help (and can even aggravate your problem!) The deep, stabilizing muscles of your neck are connected by fascia to the deep muscles of your core. If your deep core is not working properly, then your neck will often kick in and try to help.

Ever notice that your neck is always sore or tight after a good ab workout?

This could be a sign that your neck is compensating for your core. Stop stretching your neck, learn how to strengthen your core the right way, and see a specialist who can help you.

If you’re dealing with chronic neck problems that aren’t responding to stretching, there’s a good chance you could be not stretching correctly, the stretches aren’t right for you, or you’ve completely missed the root cause of your neck pain and you shouldn’t be stretching at all.

Consider talking to a movement specialist who understands how to figure this out so you can get rid of your neck pain and back to all the activities you love!

Are you local to Portsmouth, NH?

Book a free discovery visit with one of my specialists HERE.

They will ask you all about what’s been going on – and help you make the best decision moving forward – whether that’s working with us not!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Pain when gardening

Six Ways to Protect your Knees and Back when Gardening

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Gardening is a favorite activity for a lot of folks – and lately I have been hearing many people having knee and back pain when gardening. To add more frustration to this topic, you might not even notice the pain until hours or days afterwards, which can make it challenging to address.

The good news is that there are several things you can do to protect your knees and back while gardening.

Here are 6 of my favorite tips to manage pain when gardening:

1. Warm up first

Before diving into any activity that you know you’ll be doing repetitively and for more than a few hours, it’s a good idea to warm-up. It doesn’t have to be anything crazy or excessive and 10 min is plenty.

Typically, you’ll only be gardening during nice weather. So enjoy it by taking a walk around your neighborhood first. Then do some easy light stretching to lubricate your joints before you begin. It won’t take long but your knees and back will thank you.

2. Avoid bending from the waist

Lifting and carrying heavy bags of soil or plants can put a lot of strain on your back and knees. You really want to make sure you’re using proper posture and body mechanics to avoid problems.

When lifting, be sure to use your legs instead of your back and hold objects close to your body. If you hinge only from your hips, for example, which a lot of people like to do, you will put extra strain on the back of your knees and lower back. Get in the habit of bending your ankles, knees, and hips in unison – kind of like an accordion – so that you build good muscle and body memory and don’t even have to think about it next time you’re gardening or lifting.

3. Take frequent breaks

It’s easy to get lost in the activity of planting and weeding. But even if you’re choosing good postures like I mentioned above – your back and knees still need a break. Our joints don’t enjoy anything when done repetitively or for prolonged periods, but especially too much bending or sitting on your knees. When you bend too much and too often, the discs in your lower back can get aggravated, and when you’re sitting on your knees, it’s a lot of pressure and can annoy your arthritis.

I recommend setting a timer and giving yourself a break every 30 min to change positions. Simply stand up and get out of the bent or sitting posture. Your back and knees will thank you and you’ll be able to garden for much longer and without risk of injury.

4. Pivot instead of twist

Your lower back and knees aren’t really designed to rotate, they are designed for bending and extending. So if you’re not careful – you can strain these areas with poor twisting and turning mechanics. When you have to rotate, you’ll want to pivot from your pelvis.

What does this look like?

Make sure your hips are always in line with the object you are moving and maneuvering. Keep your ribs in line with your pelvis and your pelvis in line with your knees and feet – and always move them as a unit. While it’s ok to bend and twist from your waist or legs on occasion – you’ll find yourself in some trouble when you do this over and over again – especially if you’re already prone to back or knee pain.

5. Use ergonomic gardening tools

The right gardening tools can be of significant help when it comes to maintaining good posture and avoiding overuse of your muscles and joints. Long-handled tools can help reduce the need for bending and stooping, which as already discussed, puts strain on your knees and back when overdone. Another consideration is the weight of your tools. It might be worth the investment to swap out your older, heavier tools for more modern, lightweight alternatives.

When you have to lift something heavy – especially repeatedly – use a wheelbarrow. This valuable gardening tool will allow you to lift and move heavy things with significantly less strain on your back. If you’ve got to be on your knees or squatting a lot – consider using a gardening bench and/or knee pads. These tools will make it easier to sustain activities that require prolonged bending or kneeling.

6. Use beds to raise your gardens

Raised garden beds not only look pretty but they are extremely ergonomic. Especially if you suffer from more chronic back and knee problems. Raised garden beds are elevated off the ground. They are easier to maintain and limit the amount of bending you have to do.

Raised garden beds are relatively simple to build and create. Even if you’re not having problems now with gardening, if it’s an activity you love to do, you might want to consider it. Making the investment in raised gardening beds now could go a long way in preventing knee and back problems in your future.

Gardening has so many positive benefits for both your mental and physical health – and the last thing I want is for back or knee pain to get in your way.

If you are experiencing pain when gardening – Give these tips a try.

But if it’s not enough, don’t give up.

Enlist the help of a musculoskeletal pain and movement expert who can help you figure out the source of your problem and provide you with practical solutions so that you can get back to gardening as quickly as possible.

If you are local to Portsmouth, NH – consider speaking to one of my specialists.

It’s a free, no-obligation call where you can tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you.

Click here to speak with a specialist.