Tag Archive for: Portsmouth New Hampshire

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

5 Reasons to Ditch the Pills and Embrace Exercise as Medicine

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Our bodies are built for movement, yet modern life has us sitting far more than we should.

Compared to our ancestors, we’re moving less and sitting more – sometimes for over half the day. While fitness trackers and smartwatches encourage us to stand and get more steps in, it still doesn’t seem to be enough to counteract the effects of a sedentary lifestyle.

Physical inactivity has now become a major health issue, and the consequences are clear: less movement leads to more musculoskeletal issues and chronic pain (among other things). And the unfortunate reality is that most folks turn to pain medication for relief, despite research increasingly pointing to regular exercise being just as effective and far healthier.

Here are 5 reasons to ditch the pills – and embrace exercise instead – as a powerful form of medicine to manage musculoskeletal pain naturally.

1. Exercise Mediates Pain

The way we perceive pain is complex. Many assume it’s a direct response to physical damage or injury – but it’s not that simple. The perception of pain involves numerous physiological and psychological factors that the brain must interpret. Depending on your general health, past experiences, and mental health condition, this can vary quite drastically from person to person. In other words – it’s your brain that decides how much or how little pain you experience.

Because of this complexity, external factors like exercise (and also pain medication) can alter how we perceive these signals. When we exercise, our bodies exhibit an increased tolerance towards pain, and a lower perception of pain intensity. This phenomenon is called “exercise-induced hypoalgesia” – and it works by closing down the gateways that allow pain signals to enter the brain. Certain medications can do this too, but when you exercise, you’re doing it naturally. 

2. Exercise Helps Inflammation

Inflammation is a normal part of your body’s healing process, and it occurs when inflammatory cells travel to a place of injury. However, if inflammatory cells stick around too long, it can result in chronic pain and irritation. This is where exercise can really help. 

When you exercise, your body experiences minor physiological stress, which triggers your body’s natural inflammatory reaction. During the inflammatory process, certain proteins called anti-inflammatory cytokines are produced. These protein chemicals help to modulate the body’s inflammatory response – ultimately reducing the level of inflammation associated with your pain. Inflammation can be both good and bad. When you exercise, you are creating “good” inflammation, which will naturally help to ease your pain.

3. Exercise Stimulates Endorphins

Ever wonder why a quick walk outside or a strenuous gym workout magically makes you feel better? It’s not your imagination. It’s something called endorphins – neurotransmitters released by your brain to alleviate pain and promote pleasure.

Endorphins are considered your body’s natural “opioids” because they interact with the same pain-inhibiting receptors in your brain that drugs like morphine do. But unlike morphine, endorphins are triggered naturally and don’t come with harmful side effects like addiction, drowsiness, or mental fog. Exercise stimulates the production of endorphins, boosting your mood, reducing stress, and giving you access to your very own stash of natural, healthy painkillers.

4. Exercise Improves your Mental Health 

Exercise and mental health share a powerful connection. It’s virtually impossible to influence one without the other.

Regular exercise stimulates the production of various mood-boosting chemicals, including endorphins (that we just spoke about) along with serotonin and norepinephrine. Aside from helping to control pain, endorphins are also considered a “feel-good hormone”. They trigger feelings of positivity that, once again, are similar to morphine. Serotonin and norepinephrine are instrumental in alleviating symptoms of depression and anxiety. Therefore – when you exercise – it’s virtually impossible not to feel better. And since we know that pain is controlled by your brain – anything that improves mental health is going to contribute positively to your relationship with pain.

5. Exercise as a Prescription

OK – so we’ve discussed the multitude of positive effects that exercise has on pain perception, inflammation, and mental health. But what if you’re currently suffering from an injury? Is it possible to still use exercise as a pain reliever? The short answer is yes. But it’s challenging to do on your own. You can’t just google “best exercises for back pain” and expect good results.

When it comes to using movement or exercise to rehab an already existing injury – it needs to be carefully prescribed. 

For all the reasons already discussed, physical activity will still help you modulate pain – but you must consider the role exercise is going to have on any potential tissue damage. With weakened or damaged tissue, exercise is still an effective pain reliever, but it has to be prescribed or you risk worsening your injury.

For these reasons, I always recommend working with a movement expert who truly understands the nature of musculoskeletal pain and tissue healing. If you start a general exercise routine because you want to feel better  – I applaud you – just make sure you’re getting your desired result. But if you start exercising to help with pain and don’t experience any noticeable improvement – or you catch yourself modifying to work around your pain – then it’s time to enlist the help of an expert. Otherwise, you risk ending up on pain pills, which is exactly what we want to avoid.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE.

Why Walking is Essential for Your Health After 50

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Walking is one of the most underestimated, yet accessible and beneficial forms of exercise for folks over 50.

As we age – the saying “use it or lose it” gets closer to home – and maintaining an active lifestyle becomes even more crucial. 

The good news is that a regular routine of walking offers a simple and low-impact way to not only maintain an active lifestyle – but combat the “use it or lose it” syndrome. A regular walking routine not only supports cardiovascular health, strengthens muscles and bones, and aids in weight management – but also boosts mental well-being and enhances balance and coordination. It’s not a surprise to me that more and more adults over 50 are lacing up their walking shoes and hitting the pavement… yet so many are still skeptical and/or disregard this great form of exercise.

Regardless of where you stand on walking for health… Here are 7 reasons to do it (especially if you’re over 50):

1. Enhances Cardiovascular Health

Cardiovascular disease remains the leading cause of death among older adults. A regular walking routine can significantly improve heart health by boosting blood circulation, reducing bad cholesterol levels, and increasing good cholesterol levels. The rhythmic nature of walking ensures that your heart pumps at a steady rate, which is beneficial for overall cardiovascular health.

2. Strengthens Muscles and Bones

Aging naturally leads to the loss of bone density and muscle mass. However, regular walking can counteract this process. As a weight-bearing activity, walking strengthens bones and reduces the risk of osteoporosis and fractures. It also engages multiple muscle groups simultaneously, helping them stay active and strong.

3. Boosts Mental Health

Walking isn’t just a physical activity – it’s also great for mental health. Walking has been shown to reduce symptoms of depression and anxiety significantly. It provides an opportunity to clear your mind, reflect, and even meditate. Walking with friends or loved ones adds a social aspect, which can be incredibly beneficial for your mood and mental well-being. For an extra mental boost, try walking in nature—the fresh air and tranquil environment can be rejuvenating for both mind and soul.

4. Aids in Weight Management

As you age, your metabolism naturally slows down, making weight management more challenging. Regular walking helps burn calories, maintain a healthy weight, and prevent chronic diseases like diabetes and heart disease. Being at a healthy weight also means increased energy levels, easier mobility, and less stress on your joints.

5. Improves Joint Health

Many people fear arthritis and avoid activities that might exacerbate it. However – despite some medical opinions – movement is one of the best remedies for arthritis. And walking is particularly beneficial for arthritis. It helps lubricate the joints, especially the knees and hips, and keeps the surrounding muscles and soft tissues loose and flexible. Regular walking is super beneficial for managing arthritis effectively.

6. Enhances Balance and Coordination

Falls are a significant concern as we age due to decreased bone density and the subsequent naturally occurring increased risk of fractures. Maintaining balance and coordination is easier than trying to regain them after they’ve diminished. Walking requires the coordination of several muscle groups – plus enhances the body’s ability to stabilize itself quickly – thereby reducing the risk of falls.

7. Low-Impact and Adaptable

One of the greatest advantages of walking for those over 50 is its low-impact nature. Unlike high-impact exercises such as jogging – walking is gentle on the joints and can be easily adapted to fit your fitness level. Whether you prefer a leisurely stroll around the neighborhood or a brisk hike in the park – walking can be tailored to meet your individual needs and goals.

If you’re over 50… and you haven’t yet incorporated a regular walking routine into your lifestyle…

What are you waiting for? It’s one of the most simple yet effective ways to stay active, healthy, and mobile after the age of 50. But if an injury or pain is holding you back from starting or continuing a regular walking routine – it’s time to consult a movement expert. 

Eighty percent of all musculoskeletal pain and injury is related to a movement problem that can be resolved naturally, and without procedures or surgery. But you can’t truly figure this out without consulting a movement expert, or physical therapy specialist who specializes in mechanical pain. Reach out if you need help finding one in your area.

Dr. Carrie Jose, Physical Therapist and Mechanical Pain Expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch – or to request a free Discovery Visit to explore a solution for your pain or injury with a mechanical pain expert – CLICK HERE.

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.