Tag Archive for: Portsmouth NH

When your Back Hurts – is Rest Helping or Hurting?

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Whenever someone finds out I’m a physical therapist, the next question is almost always something like… “What can I do for [insert the blank] injury?” And when it comes to back pain specifically, people often ask me: “Should I be resting it?”

It’s no surprise that the vast majority of folks I speak with about back pain have been told by well-meaning friends, family, or even doctors that rest is the best thing for back pain — especially when you first hurt it. But what if I told you that rest might actually be the worst thing you can do? That resting and doing nothing — even when you’ve acutely hurt your back — can actually delay recovery and even make your back pain worse in the long-term.

Conventional advice tells us that back pain should be treated with ice, inactivity, and as little movement as possible — and when it feels better — to start slowly moving it. That advice makes sense on the surface — after all, if something hurts, shouldn’t you avoid using it? But research (and decades of clinical experience) shows us that this approach can actually prolong healing, increase pain sensitivity, and make it more likely that your back pain will return again and worse, become a long-term issue.

Why Rest Doesn’t Work

Modern health research is very clear on this: too much rest after a musculoskeletal injury like back pain leads to muscle deconditioning, joint stiffness, poor circulation, and even heightened pain sensitivity. A well-known review published in The Lancet concluded that staying active is one of the best things you can do for non-specific (mechanical) low back pain. In fact, people who remain as active as possible — within reason — recover faster and are less likely to develop chronic symptoms.

Here’s why: your joints and tissues thrive on movement. Motion promotes circulation, reduces inflammation, and helps your muscles and nerves return to normal function. When you stop moving, the opposite happens. Your muscles tighten, your joints stiffen, and your brain becomes more sensitized to pain signals. That’s how a small tweak in your back can turn into months (or years) of recurring pain if you’re not careful.

Movement is Medicine

Now, this doesn’t mean you should ignore your pain and go back to the gym, golf, or even all your daily house chores the next day. There’s a difference between smart movement and overdoing it. But most people fall on the other side of the spectrum — they stop moving entirely, waiting for the pain to just “go away.”

What I recommend instead is gentle, intentional movement that keeps your body active without making things worse. Walking, for example, is one of the best low-impact ways to get your spine moving and your blood flowing. If walking feels okay, it’s a great first step toward healing.

Specific exercises tailored to your pain are also incredibly powerful. These movements help “reset” your nervous system, calm down overactive muscles, and restore balance to the structures around your spine. In my clinic, I call these “first-aid movements.” They’re often simple, but highly specific — and they can help you move from debilitating pain to something much more manageable.

But What If Movement Feels Impossible?

I get it — sometimes your back pain is so bad that even getting out of bed or walking across the room feels unbearable. If you’re stuck in this kind of pain cycle, you may not be able to figure out on your own what’s safe to do. And in those cases, the worst thing you can do is wait it out or rely on generic advice from Google or YouTube.

This is where working with a mechanical back pain specialist can be a game changer. A trained expert can evaluate your pain based on movement patterns — not just an image or MRI — and guide you toward the exact movement your body needs to start calming the pain down. In fact, I often see patients go from 10/10 pain to 3/10 in their very first session, simply by finding and repeating the movement that’s right for their spine.

That kind of progress might seem like magic — but it’s just smart biomechanics. The body wants to heal, but it needs the right inputs. A movement-based mechanical specialist knows how to give your body those inputs safely and effectively.

Finding the Middle Ground

The key takeaway is this: while you may need to modify your activity levels when your back flares up, the goal should never be total rest. There is always some kind of movement you can do — and the sooner you find it, the sooner your healing process will begin.

If you’ve been dealing with back pain for more than a few days, and especially if it’s stopping you from doing the things you love, don’t wait around hoping rest will fix it.

The better alternative?

Talk to a professional who understands movement, mechanics, and pain. A customized plan — not a generic rest-and-wait approach — is what truly sets people on the path to lasting relief. Movement is powerful medicine — especially when it’s prescribed correctly.

Are you local to Portsmouth, NH?

Consider speaking to one of my specialists for free 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.

Back Pain, Herniated Discs, and Cortisone Shots: What You Need to Know

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A recent conversation about cortisone shots and back pain due to herniated discs inspired me to write this article.

The person I was speaking with was quite misinformed about when cortisone shots are useful – and when they aren’t. By the way, it’s a very common misunderstanding. But since I hate seeing people undergo unnecessary injections or procedures – I’m here to educate. 

So let’s break it down: when is a cortisone shot a good idea, and when should you think twice?

When Cortisone Shots Work

Cortisone shots can be highly effective if your pain is primarily caused by inflammation, which is what I call “chemical pain.” Chemical pain results from your body’s inflammatory response to an injury. This response produces chemicals and nutrients that help heal the area, but sometimes the process gets “stuck”. The lingering chemicals cause persistent pain that doesn’t respond to movement or rest.

If your back pain is constant, feels hot and inflamed, and doesn’t improve with positional changes, you might have chemical pain. In these cases, a cortisone shot can eliminate the chemicals causing the pain and provide relief. 

In other words – exercise – which is the best treatment for herniated discs and back pain – won’t work well when you have chemical pain. Historically that’s when cortisone shots are necessary. But in 2021 – an amazing technology called Electrocorporeal Magnetotransduction Therapy (EMTT) came to the United States and works just as well (if not better) than cortisone, except it’s natural and non-invasive. EMTT uses a high-frequency magnetic field that can penetrate up to 6 inches into the body – so it can heal inflammation in places like your lower back down to the cellular level. I’ve seen great results from it – so I’m starting to recommend this over a cortisone shot for anyone that needs it. 

When Cortisone Shots Don’t Work

Most back pain (even those related to herniated discs) – aren’t chemical in nature. It’s mechanical, meaning it stems from issues with mobility and movement patterns. Mechanical pain – responsible for 70-80% of all musculoskeletal issues (including back pain) – will improve and resolve with precisely prescribed corrective-movement exercises. How do you know if you’re in this category? If your back generally feels better after walking, stretching, or changing positions – it’s almost certainly mechanical – because it’s responding to movement. If this sounds like you – a cortisone shot won’t address the root cause.

The key to resolving mechanical pain is identifying and correcting mobility restrictions and faulty movement patterns. Once you do this, the structural issue (like the herniated disc) becomes less relevant. Many people live symptom-free with herniated discs once they’ve addressed their underlying movement pattern problems and mobility.

The Gray Area

Here’s where it gets tricky: a herniated disc can irritate surrounding structures like muscles and nerves, causing localized inflammation. This type of pain can feel intense, but it’s not quite the same as chemical pain. But it will be tempting to get a cortisone shot for quick relief. The thing is – it will only be a temporary fix. The shot won’t address the underlying mechanical issues that caused the disc to “act up” in the first place. Worse, masking the pain can lead you to unknowingly worsen your problem, potentially leading to more procedures or surgery. In most cases, this type of inflammation can resolve naturally without drugs. Something like EMTT that I already mentioned, and other regenerative therapies like Shockwave Therapy work great for this type of inflammation.

Take Home Points:

Before you consider cortisone shots, take a moment to evaluate your pain:

  1. Does movement or activity influence your pain? If yes, it’s likely mechanical and won’t benefit from a cortisone shot.
  2. Is your pain constant, hot, and unresponsive to movement? If yes, you might benefit from a cortisone shot to calm the inflammation and enable movement to help.
  3. There are some amazing Regenerative Therapy Treatment technologies available now that serve as natural, non-invasive alternatives to cortisone shots if you are really inflamed. Plus – they work with your body’s own anti-inflammatory systems by giving them a boost.

Ultimately, cortisone shots don’t fix structural problems – they temporarily eliminate pain due to inflammation. While this can be useful in specific situations, it’s crucial to address the root cause of your pain to prevent long-term issues and seek healthier alternatives when you can.

Local to Portsmouth, NH? Schedule a free discovery visit with us today and take the first step toward lasting relief and better movement.

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.

When exercise hurts your back instead of helps

Six Ways to Help Manage Knee Arthritis and Stay Active

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Knee arthritis is one of the most common forms of osteoarthritis, affecting more than 80% of cases and impacting at least 19% of Americans over the age of 45.

For many, a diagnosis of knee osteoarthritis leads to chronic, debilitating knee pain that stops them from doing their favorite activities. Sometimes it’s due to the limiting belief that once you have arthritis, you have “bad knees” for life. Other times it’s because you’ve been told you have “bone on bone” in your knee and that you should scale back on activity so you don’t make it worse.

This line of thinking is flawed and often leads to unnecessary injections, procedures, and surgery. Because being active is one of the best things you can do to manage your arthritis and protect your knees.

But what if movement and activity hurt?

Here are six ways to help manage arthritis in your knees so you can stay active and keep doing the things you love:

1. Strengthen Your Hips and Core

When you have poor control of your hip and core muscles, you get more stress through your knee joint. The strength of your upper leg muscles is very much dependent on your hip and core strength. Your thigh bone (femur) connects your knee and your pelvis, and your core strength controls your pelvis. If your pelvis isn’t stable, your femur is going to have a difficult time staying in alignment, which will ultimately have an impact on your knee joint. If you’ve got arthritis in your knees – it’s critical you minimize any added stress to your knee joints. Strengthening your core and having good hip strength will help prevent and minimize the symptoms of arthritis – keeping you active for longer.

2. Keep Your Knees Mobile

Mobility before stability is my mantra. And I say this for just about every joint in your body. But it’s especially true for your knees. There are joints whose primary function is stability, and there are those whose major function is mobility. Your knee needs to be mobile. Its major purpose is to bend all the way so you can squat and pick things up, and it needs to straighten all the way to give you stability when you need it. When either of these motions is lacking, your ligaments and surrounding muscles will suffer, adding more wear and tear to your joint, which can aggravate arthritis symptoms. When folks are told they have arthritis – a lot of folks just “accept” that their knees are stiff. But the truth is that even a 10% improvement in your knee mobility can lead to significant functional gains, help you better manage arthritic knee pain, and avoid major interventions.

3. Don’t Stop Your Activities

When people find out they have arthritis – and especially if they’ve been told it’s “bone on bone” – they often think that slowing down or stopping activity will help protect their knees. This couldn’t be farther from the truth. Study after study shows that severe joint pain among adults with arthritis is worse with inactivity. When you remain active, you keep blood flowing, your knee joints mobile, and your muscles strong. These are very important factors in managing your arthritis. Plus – sometimes the knee pain you feel when you’re doing certain activities has nothing to do with your arthritis. Statistics show that only 15% of patients with evidence of knee osteoarthritis on X-ray even had symptoms. That means that the other 85% are walking, biking, and running around enjoying their favorite activities – despite what their X-ray says. The point here is to keep doing your activities – it’s one of the best ways to prevent arthritis from advancing and protect your knee joints as you age. If you’re really struggling with this – it’s time to talk to a knee expert who can help you.

4. Optimize Your Footwear and Walking Mechanics

Many people don’t realize how much their feet impact their knees. If you’re wearing unsupportive shoes or walking with poor mechanics – your knee joints will absorb more stress than they should. Over time, this increased strain can exacerbate arthritis symptoms. Consider wearing supportive shoes that align your feet properly and provide adequate cushioning. Walking is a really good activity for your knees and arthritis. So if you’re experiencing frequent knee discomfort while walking, a professional gait assessment can help identify areas of weakness or imbalance that might be contributing to your pain as well as help you find the perfect pair of footwear.

5. Opt for Natural, Joint-Friendly Pain Relief

Your knees work hard every day. And if you have arthritis – finding relief without relying on medications or invasive treatments/injections can be a game-changer and minimize any downtime. There are plenty of natural pain relief strategies that will help minimize inflammation and keep you moving comfortably. Heat therapy and corrective stretching techniques are great for reducing stiffness by keeping blood flowing and muscles relaxed and flexible. Similarly massage and foam rolling can improve circulation and ease muscle tension around your knee joint. Regenerative treatments like shockwave therapy, EMTT, and dry needling are becoming popular alternatives to cortisone shots – as they work with your body’s own mechanisms to stimulate healing versus causing joint damage over time. By integrating natural pain relief methods into your routine, you can better manage knee arthritis and stay active without unnecessary reliance on medications or invasive procedures.

6. Manage Your Inflammation with Diet and Hydration

Chronic inflammation worsens arthritis symptoms, but the right diet can help. Anti-inflammatory foods like fatty fish, leafy greens, berries, and turmeric support joint health, while omega-3s from fish oil reduce inflammation at a cellular level. Collagen powder and glucosamine-chondroitin can support cartilage health and joint lubrication. Hydration is also key. Water keeps joints cushioned and prevents excess friction. Simple dietary changes, paired with the right supplements, can make a significant difference in managing knee arthritis.

Final Thoughts

Even if you’ve been told you have “bone on bone” or advanced arthritis, you can still improve your knee health. The best thing you can do for your knees is to keep moving. And if pain is getting in the way – I hope these strategies help you manage your symptoms naturally – so you can avoid resorting to medications, injections, or surgery.

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

Why Your Knee Pain Isn’t Going Away – And What You Might Be Missing

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Knee pain can be stubborn. If you’ve tried stretching, strengthening, injections, or even surgery with little to no relief – it might be time to consider looking beyond your knee. Many people are told their pain is due to “wear and tear,” arthritis, or simply aging. But here’s the thing… There are plenty of people out there with these very same conditions who have no knee pain at all.

So, what gives?

It turns out that knee pain isn’t always a knee problem.

If you’re still dealing with persistent discomfort despite following every piece of conventional advice, one of these four lesser-known culprits might be the real reason behind your lingering knee pain.

1. It’s Not Your Knee—It’s Your Back

Did you know that nearly 40% of extremity pain actually originates from the spine – even if you don’t have back pain? The nerves that control your knee function start in your lower back. If they’re irritated, compressed, or not functioning properly, your knee could suffer the consequences.

A key sign that your knee pain is actually coming from your back is if your pain moves around, travels up or down your leg, or worsens when you sit for long periods. If your knee treatments aren’t working, it’s worth investigating whether your back is the real issue by talking to a mechanical back pain specialist.

2. Your Core is Weaker Than You Think

When people hear “core strength,” they usually think about back pain or six-pack abs – but your core plays a massive role in knee health, too. Your core, hips, and glutes work together to stabilize your lower body. If these muscles are weak, your knees pick up the slack, leading to unnecessary strain and chronic discomfort.

Signs of a weak core affecting your knees include feeling unstable on one leg, difficulty maintaining good posture, or knee pain that worsens after prolonged activity. The solution? Strengthening your core and hips can take the pressure off your knees and keep them moving the way they should.

3. Your Ankles Might Be the Problem

Your ankles act as the foundation for your entire lower body. If they lack mobility or stability – your knees will compensate – leading to stiffness, pain, and dysfunction. Poor ankle mobility can make everyday movements like walking, running, and squatting much harder on your knees.

If you struggle with ankle flexibility or feel unsteady during activities like hiking, running, or sports – your knee pain may actually stem from weak or restricted ankles. Addressing ankle stability and mobility could be the missing link to finally getting relief.

4. Your Knee Isn’t Moving the Way It Should

One of the most overlooked aspects of knee pain is mobility. There might actually be nothing at all wrong with your knee – but if it doesn’t move as well as it should – structures within and around your knee joint will slowly start to get irritated. Most rehab programs focus on bending the knee – but proper knee function also requires slight hyperextension – and this is where I see a lot of problems for people. If your knee stops at “just straight,” it may still be restricted, causing long-term dysfunction and discomfort.

Pro-tip: This is especially common after surgery, where full mobility isn’t always restored. If one knee doesn’t move like the other, it’s time to work with a mechanical knee pain specialist who can prescribe corrective movements to help you regain that lost range of motion.

What to Do Next

If you’ve been dealing with knee pain that just won’t go away – there’s a good chance you either have the wrong diagnosis – or the wrong treatment plan. You may need to stop focusing on the knee and start to look elsewhere in your body. The real problem might be coming from your back, core, ankles, or mobility restrictions somewhere leading to secondary stress on your knee joint.

A mechanical pain specialist who understands the bigger picture can help pinpoint the true cause of your pain and create a plan that actually works to finally get your knee pain resolved.

Are you local to Portsmouth, NH?

Consider speaking to one of my mechanical knee 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.

knee pain source

Six Natural Ways to Relieve Arthritis Pain – Without Meds or Surgery

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Arthritis is a widespread and debilitating condition that affects over 350 million people worldwide.

In the U.S. alone, nearly 58.5 million people live with some form of arthritis, making it one of the leading causes of disability. Until recently, conventional treatments like medication, injections, and surgery were the go-to options for managing arthritis-related pain and immobility. However, more people are seeking natural, non-invasive alternatives to reduce their reliance on these treatments and avoid potential side effects.

From lifestyle changes to cutting-edge therapies like Regenerative Therapy, there are many ways to manage arthritis naturally and effectively for lasting relief. Here are six that top my list:

Anti-Inflammatory Diet

One of the best ways to combat arthritis is through dietary changes aimed at minimizing inflammation, which plays a key role in joint pain and stiffness. Research suggests that bone edema (swelling within the bone marrow) is a primary source of pain in arthritis. Since inflammation fuels this process, an anti-inflammatory diet can help reduce discomfort and slow progression. Foods rich in omega-3 fatty acids like salmon, mackerel, and sardines counteract inflammation and may ease arthritis symptoms. Leafy greens, berries, and nuts provide powerful antioxidants that protect joint tissues, while turmeric and ginger contain natural compounds that act as pain relievers. Healthy fats like olive oil further support joint health by reducing inflammation. On the other hand – processed foods, excessive sugar, refined carbohydrates, and fried foods can worsen symptoms and should be limited.

Regular Exercise and Movement

Many people avoid movement when they have arthritis – but it’s actually one of the best ways to relieve joint pain and stiffness. Movement increases blood flow, which flushes out inflammatory toxins while also delivering oxygen and nutrients to nourish cartilage and surrounding tissues. Without regular activity, joints become stagnant, leading to more stiffness, inflammation, and degeneration – ultimately making arthritis feel worse. Low-impact exercises like walking, biking, and swimming improve circulation without excessive strain on joints. Yoga and Pilates enhance flexibility and stability, reducing stiffness and strain. Strength training keeps muscles strong, reducing pressure on the joints and minimizing arthritic symptoms. The more you move – the more you promote healing – making daily activities easier and reducing long-term discomfort.

Weight Management

Maintaining a healthy weight is key to managing arthritis. Excess weight puts added stress on joints – especially in weight-bearing areas like the knees, hips, and lower back. You’d be surprised to know that even a small weight loss can make a big difference. Research shows that losing just one pound reduces knee joint stress by four pounds, easing arthritis pain. One of the most effective and accessible ways to manage weight is walking. It’s simple, low-impact, and helps burn calories. Aiming for 10,000 steps per day is a great goal – but even small increases in daily movement can lead to lasting improvements in joint health and overall well-being.

Herbal Remedies and Supplements

Before medication existed, nature was our primary source of medicine. The good news is that today – there are countless herbal remedies and supplements that can naturally and effectively help manage arthritis symptoms. Glucosamine and chondroitin are among the most widely used for supporting cartilage health and reducing joint pain. Turmeric, particularly its active compound curcumin, has powerful anti-inflammatory properties. Omega-3 fatty acids, found in fish oil and supplements, help reduce both inflammation and stiffness. Other beneficial herbs include Boswellia (Indian Frankincense), which improves joint function and reduces swelling – and Vitamin D, which supports bone health and may alleviate joint pain. If you’re new to herbs and supplements, consult a medical professional trained in herbal medicine to find the best options for you.

Acupuncture and Massage Therapy

Acupuncture and massage therapy have been providing relief for arthritis symptoms for centuries. Acupuncture, an ancient Chinese practice, involves inserting thin needles into specific points on the body to promote energy flow and reduce pain. Many arthritis sufferers find that regular acupuncture sessions help manage discomfort and improve joint function. Massage therapy works by relieving muscle tension, improving circulation, and increasing joint mobility through soft tissue manipulation. Techniques like cupping and hot stones can further enhance results. Sometimes we need extra help managing arthritis symptoms – and these two treatments are not only safe and non-invasive – but also highly effective (especially when combined with the right type of exercise and movement).

Regenerative Shockwave Therapy and EMTT

One of the most exciting advancements in arthritis treatment is Regenerative Therapy. While some regenerative treatments (like PRP and stem cell injections) are invasive – highly effective non-invasive options like Shockwave Therapy and Extracorporeal Magnetotransduction Therapy (EMTT) are gaining popularity. These therapies stimulate the body’s natural healing process without surgery or medication.

Shockwave Therapy uses acoustic waves to promote blood flow, reduce inflammation, and encourage tissue regeneration. EMTT employs high-energy electromagnetic fields to accelerate cellular repair and relieve pain. Together, these therapies provide a drug-free, surgery-free solution for arthritis sufferers. Many patients experience reduced pain, increased mobility, and faster recovery times with no downtime. Unlike cortisone shots, which provide temporary relief but can also weaken joint tissue over time – EMTT and Shockwave Therapy heal at the cellular level – leading to lasting improvements in pain and function.

Final Thoughts…

If you’re suffering from arthritis, it doesn’t mean you have to settle for a lifetime of pain or dependence on medication. By embracing natural treatment methods – such as an anti-inflammatory diet, regular exercise, weight management, herbal supplements, and cutting-edge therapies like Regenerative Shockwave Therapy and EMTT – you can take control of your joint health and improve your quality of life. If you or someone you know is struggling with arthritis – consider exploring these drug-free, non-invasive approaches to healing. The body has an incredible ability to repair itself when given the right support and environment. Taking proactive steps today can lead to a more pain-free, active future.

Local to Portsmouth, NH?

Consider speaking to a mechanical pain specialist 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.

Exercise-induced Leg Soreness or Sciatica? How to Tell the Difference.

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It’s that time of year – when people set goals and take action to improve their health, get back in shape, and ramp up exercise routines.

But what happens when your body isn’t ready for what your mind has planned? How can you tell if the soreness you feel is “good pain” – or a problem brewing?

This concept is particularly confusing when it comes to leg pain. Whether it’s ramping up your strength training, more frequent Peloton rides, or getting back to running/jogging… These activities will make your legs sore. The problem, however, is that leg soreness can mimic a common (and sneaky) condition called “sciatica” – that if missed or ignored – could completely derail you from your health and fitness goals. So it’s important you know the difference and what to watch out for – especially if you have a history of sciatica or back pain. 

Here are some key things you to look out for – that will help you tell the difference between normal leg soreness from exercise – versus sciatic pain that’s caused from your back:

Exercise-induced leg soreness…

With exercise-induced leg soreness – you’ll typically feel pain deep in your muscles (especially those you specifically worked on) – and your legs may feel tender to touch or even “swollen”. This type of soreness comes from challenging your muscles beyond their usual capacity – something you want to do during exercise. The soreness is caused by microscopic damage to your muscle fibers – triggering an inflammatory response. This inflammatory response then triggers a repair phase in the area of the “damaged tissue” (aka your muscles). It’s in this repair phase that your body builds back stronger muscles – so that they’re more resilient the next time you exercise. 

Another key characteristic of exercise-induced leg soreness is that it will typically occur anywhere from 24-72 hours after the activity. This phenomenon is known as “DOMS” (delayed onset muscle soreness) and it will usually dissipate in a similar amount of time. The soreness you feel from DOMS is often felt symmetrically (in both legs) – because most exercises are done using both sides of your body. But even if you’ve done an activity that favors one leg over another – the pain you experience during the DOMS period will occur when you’re moving or stretching the affected muscles – and not so much during periods of rest.

Now let’s look at sciatica…

Sciatica is a problem that comes from your spine and that causes pain in your buttock and/or leg. In between each vertebrae (the bones that make up your spine) are small spaces that allow the nerves originating from your spinal cord to exit. These nerves control everything from sensation, to pain, to muscle strength. If the nerves in your lower back get irritated – or structures around those nerves get irritated (for example, bulging discs) – anything in your leg (or butt) that those irritated nerves “touch” can also be affected. This is the phenomenon known as sciatica.

The tricky part about sciatica is that the timeline of your pain – and the feeling you experience – can be very similar to the leg soreness you get from exercise. Just like exercise-induced leg soreness – sciatic pain can include a deep ache in your muscles, tenderness to touch, and a feeling of swelling. People often describe to me a feeling of “heaviness” in their leg when they are experiencing a sciatic episode. Sciatic pain can also come on 24-72 hours after exercising or activity.

But with sciatica – one of the most important factors you need to pay attention to is how your pain behaves. Leg soreness from exercise arrives in a fairly predictable manner – and leaves in a fairly predictable manner. And you generally won’t have much pain at rest.

Sciatica, on the other hand, is more unpredictable.

Although it can come on in the same time frame as exercise-induced leg soreness – it won’t just “go away” in the same, predictable amount of time. Pain from sciatica can linger – particularly at rest – and with activities such as sitting, driving, standing too long, or walking. It can end up in just one leg even though it started in both – and it tends to come and go. For example – you’ll think it’s better – only to suddenly wake up with a sore leg again – or bend the wrong way and have the pain annoyingly return. And finally – sciatic pain won’t go away completely with stretching or massage (although it’s tempting to think it did). 

But one of the most important things to notice about the behavior of sciatic pain versus exercise-induced leg pain is whether or not numbness or tingling is present. It’s possible to have sciatic pain without numbness and tingling – but it’s not possible to have it with healthy, exercise-induced leg soreness. That’s because only nerve irritation can cause the sensation of numbness and tingling in your leg. And speaking of nerve irritation… If your leg soreness “goes away” – but you’re left with a lingering back ache – your leg pain was almost certainly a sciatic episode that has temporarily resolved – and it’s only a matter of time before it returns with a vengeance.

So there you have it – next time you notice leg pain after exercising – pay attention to how your pain behaves.

How long does it last? Does it come and go? Is it only in one leg vs both? Do you have any numbness? Does it linger or return with mundane activities such as sitting or standing?  If the answer to any of these questions is “yes” – and especially if you’ve got a history of back pain – you must consider that it could be sciatica. To make sure – seek out the help of a mechanical back pain specialist who can tell you for certain.

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.

Holiday Stress

3 Tips to Manage Holiday Stress and Unwanted Aches and Pain

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The holiday season should be a time of celebration, joy, and cherished moments with loved ones. But it tends to bring with it a flurry of activities and responsibilities – and for many of us – that equals stress. The pressure to create the perfect holiday experience – coupled with the hustle and bustle of shopping, cooking, and entertaining – can lead to elevated and unwanted stress levels. And uncontrolled, heightened stress can start to manifest itself physically in the form of aches and pains in our body.

The good news is there are things you can do to avoid this – or at the very least – significantly minimize aches and pains caused by stress.

Here are three of my top tips for reducing Holiday Stress to help you avoid unwanted physical aches and pain.

  1. Prioritize Intentional Breathing

Breathing is one of the most powerful tools at your disposal for rapidly reducing and interrupting stress. The act of taking a deep breath sends a signal to your brain to calm down and relax. This simple yet effective technique can have a dramatic impact on your stress levels in as little as 30 seconds. The beauty of intentional breathing is that you can do it anywhere and at any time – whether you’re stuck in traffic, at your desk, in a crowded store, or in the privacy of your own home.

The premise behind intentional breathing is to interrupt the accumulation of stress. By doing so, you decrease the overall toll it takes on both your body and mind. When stress is allowed to build up past a certain threshold – it can take the form of muscle tension, headaches, and even neck and back pain. Therefore, taking a moment to practice intentional deep breathing can help to break up that stress cycle, and make a significant difference in how you feel during the holiday season.

  1. Practice Gratitude

Gratitude is a powerful antidote to stress. Studies have shown that practicing gratitude can lower cortisol levels in the body by approximately 23 percent. Cortisol, often referred to as the “stress hormone”, is responsible for many of the negative effects of chronic stress, including high blood pressure and an increased risk of heart disease.  Chronic stress can also be responsible for unwanted muscle tension – especially in areas like your neck, back, and hips.

When we focus on things we appreciate (aka: practice gratitude) – we activate the parasympathetic nervous system – which is responsible for calming the body and returning it to its natural rhythm. When your parasympathetic nervous system is activated – stress dissipates. So by consciously practicing gratitude, you actively lower your stress levels. This not only benefits your mental well-being – but also has a positive impact on your physical health. When your stress is reduced – it leads to lower blood pressure, improved sleep quality, and you’ll notice decreased muscle tension throughout your body.

  1. Get Physical

Physical activity is a powerful stress-reduction tool with numerous benefits for both body and mind. Engaging in regular exercise helps boost your mood and decrease muscle aches by releasing endorphins – your body’s natural stress and pain relievers. 

Another benefit of physical activity is that it helps put an end to the “fight or flight” response triggered by stress. In ancient times, our fight or flight response served to protect us from immediate danger – such as being chased by a predator (aka Lion). The physical activity of running away signaled to your brain that the fight or flight response could end – because you were out of danger. But in our modern world, the fight or flight response hasn’t fully adapted yet, and chronic everyday stress can simulate it.

The problem now is we don’t “run away” from our stress anymore (although many of us wish we could). So we need to make a conscious effort during the day to do physical movement to help break up our stress – and effectively disrupt this flight or flight response that’s occurring. So when you feel that stress heightening – get moving – it will help your body and your nervous system to feel better.

I hope these simple and practical tips help you to get a bit more control over your Holiday Stress this Season – and by consequence – less aches and pains.

The key is not necessarily to prevent stress altogether – but to instead – learn to break up the cycle and manage it better – so it doesn’t consume your body. And if you’re thinking to yourself – “I wish I read this article weeks ago” – because perhaps your aches and pains are already out of control – you might need some expert help. I suggest speaking with a mechanical pain expert who can help you figure out where your pain is coming from, help you get rid of it, and get you on a physical regimen that is designed to keep your pain gone – and give you better control over your stress as an added benefit.

Are you local to Portsmouth, NH?

Consider speaking to one of my mechanical pain specialists by clicking here. They will ask you all about what’s been going on and see if we would be a good fit to work together 🙂

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 request a free discovery visit with one of her mechanical pain specialists, CLICK HERE or call 603-380-7902

Black Friday

6 Reasons NOT to miss our Black Friday Flash Sale

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These will be our BEST deals – on our best services – for the whole year!

We wanted to give you a heads up that our Black Friday Sale is starting ELEVEN DAYS from now on Sunday – Nov 24th. This is our biggest sale of the year on our most popular services. And it’s your chance to save insane amounts of money (one of the packages gives away over $2500 of FREE services!!)

In order to get access to this amazing sale – you must sign up HERE.

On Sun Nov 24th the sale will start – and you’ll get daily emails updating you on the packages we have available, when things sell out, etc…

Now if saving BIG wasn’t enough…

Here are SIX very important reasons why you don’t want to miss out on our Black Friday specials this year…

1. Without your Health – you have nothing

When your health, independence, and mobility begin to decline – you start missing out on activities that you love. And It’s very easy to say to yourself… “I’ll just wait until the New Year” – or – “I’ll get started when I have more time” – or – “I’ve got so many other expenses right now so my health can wait”…

Nothing should EVER come between you and your health. Because if you wait (or ignore) it, you risk either losing it forever, or spending a lot of time and money to get it back. Whether it’s healing a nagging injury that regular physical therapy or cortisone shots have failed – or getting to the root cause of a back pain or sciatica problem that keeps coming back – we’ve got some amazing specials and huge savings that will make it easy for you NOT to have to wait any longer 🙂 Now is the time to address and invest in your health.

2. Use your left-over FSA money (before you lose it!)

Do you have a Flexible Spending Account (FSA) through work that you forgot about or maybe haven’t used? Well I have some good news for you… you can use your Flexible Spending money toward ALL of the services we have on sale this year. Typically you lose whatever is left in your FSA at the end of the year (Dec 31st) – so don’t let it go to waste!

Put it towards your health – and save a ton of money while doing it – by taking advantage of our Black Friday specials!

3. Help with your New Year’s Resolutions!

January is our busiest month every year, and for good reason… People LOVE to make health-related New Year’s resolutions for themselves. But what if you’ve got a nagging pain or injury? The last thing you want is for it to return or get worse just when you’re in the groove. Our Black Friday Specials can help you with that!

Work with our Physical Therapy Specialists to get to the root cause of your problem and finally get a treatment plan that works (and lasts). Or try Regenerative Shockwave Therapy to help speed up the healing of a stubborn injury that regular physical therapy or cortisone shots have failed.  Whatever your health goals are for now or the New Year – get help from our experts at the best rates you’ll have access to ALL YEAR.

4. This only happens ONCE per year

This is our biggest sale of the year – PERIOD. And it only happens once. You’ll never see our prices this low.

If you’re new to our community – and the ONLY reason you haven’t started working with us yet is because of your budget – then you will be very pleased with the specials we have for you. Our regular clients already know the value we provide – and that is why they consistently choose us over the cheaper alternatives available. And it’s also why they are super excited about this sale – because they plan to stock up on their favorite services.

Sign up for our Black Friday Sale NOW and see for yourself what all the hype is about 🙂

5. Try Out Services You’ve Been Curious About

Have you been eyeing one of our specialty services, like Regenerative Shockwave Therapy? This sale is the perfect time to explore them – at an unbeatable rate. Maybe you want to see how these services could change your mobility, pain, or recovery time? Here’s your permission slip to take the leap and see what you’ve been missing out on!

6. Recession-proof your Health

It may seem counterintuitive to spend money on your health right now given the economic state. Your insurance should pay for it – right? Well here’s why you might want to reconsider that thought – and put the control of your health back into your own hands…

Medicare and other health insurance companies have already cut their reimbursements for this year – and will continue to do so in years to come. Why should you care about this? Because it means the quality of your health care at traditional, insurance-based clinics only has one way to go – and that’s DOWN.

Providers are going to get paid less to take care of you, which means the quality of your care WILL suffer (just to “keep the lights on”). By investing in your own health – and not relying on an insurance company to do it for you – you stay in control of your health journey and have a better chance of avoiding the rabbit hole of expensive and unnecessary surgeries.

So… sign up for our Black Friday Sale… and join the CJPT revolution of getting active, healthy, and mobile – WITHOUT things like pills, procedures, or surgery 🙂

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, call 603-380-7902, or CLICK HERE to get early access to the Black Friday Flash Sale!

avoid back pain when raking leaves

6 Tips to Protect your Back when Raking Leaves

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Leaves are everywhere right now in New England, which means for many, the tedious task of raking leaves is right around the corner.

I love Fall – but I don’t love raking leaves.

And raking leaves is even worse when you’re suffering from back pain. The good news is there are many things you can do to protect your back when raking leaves. 

Here are 6 of my most popular tips to protect your back when raking leaves:

1. Warm up before you start.

Just as athletes warm up before a game, so should you before raking. Beginning any physical activity without preparing your body can lead to unwanted strains and injuries. For raking, focus on warm up activities that target your back, shoulders, and legs. Something like a quick walk around the block before you start is an excellent way to warm up. It gets blood flowing to your legs and arms, and the gentle rotational aspect of walking is great for your spine and torso. You could also include some basic stretches into your warmup such as torso twists, shoulder shrugs, and arm circles. This gets some lubrication into your joints and spine to help protect your back once you start raking.

2. Choose the Right Rake.

With any repetitive activity such as raking – good ergonomics is essential. Ergonomics refers to how safe and efficient you are in your working environment. Bad ergonomics will typically cost you unnecessary energy and labor – and can often result in an injury. When it comes to raking, choose a rake with a handle that is long enough so that you can maintain upright posture while using it, and go for one that is light in weight yet still durable. A good, ergonomic rake might require a bit more investment than you were intending, but it will be worth it in the long run because ultimately, a back injury will cost you much more. And knowing how to protect your back from injury is priceless.

3. Bend with your legs and hips  

When performing repetitive activities or lifting something heavy, one of the most vulnerable postures for your back to be in is the combined position of flexed (bent forward) and rotated. To protect your back and avoid injury, you want to use your legs and hips to bend and lift. If you’ve got the right rake, it will be easy to maintain an upright posture while raking. And then when it’s time to scoop up the leaves and deposit them, you’ll want to squat using your hips and knees, and pivot with your trunk and pelvis. Avoid lifting with a curved back and twisting from your waist or spine. Maintaining these habits on a regular basis (not just when raking) will help you protect your back from strain or injury that could otherwise be very easily avoided.

4. Take regular breaks

Continuous and repetitive raking can tire out your muscles and make them more susceptible to injury. Plus, when you get into the monotony of raking, the mindlessness of the activity makes it easy to not pay attention to things like maintaining good posture and using good body mechanics. An easy way to combat this is by taking regular breaks. I recommend at least once every 30 min. Set an alarm on your phone or watch to remind you – and when it goes off – stop what you’re doing, put the rake down, and give yourself a quick upright back stretch. This very simple and easy strategy will go a long way in protecting your back when raking leaves.

5. Engage your Core

You don’t need six-pack abs to protect your back while raking leaves, but simply being mindful of your core can be super helpful and certainly won’t hurt you. Most back injuries occur when you least expect it – and when you aren’t paying attention. When you’re raking leaves, or any other mindless, repetitive activity for that matter, make an effort to think about gently drawing in your lower abdominals while you perform the activity. It’s a subtle move, and you should be able to easily breathe and talk while doing it. If you struggle to breathe and talk normally – you’re overdoing it.  This simple act of engaging your core will help keep your spine more supported and stable while raking and it will help protect your back.

6. Keep Moving Afterwards

What you do after raking is equally as important as what you do during to help protect your back from pain and injury. One of the biggest mistakes people make after a repetitive or strenuous activity (like raking) is to slump on the couch or recliner and “rest”. This is one of the worst things you can do to your spine because it’s more pliable and vulnerable right after strenuous activity. And when you put your spine in a relaxed, flexed position while it’s vulnerable – you’re just asking for an injury. You won’t notice it while you’re resting – but you might feel a tweak or strain when you go to stand up – or even up to several hours later.

Do yourself a favor and perform some gentle stretching after raking, or go for another walk to help relax your back. And be mindful of your resting postures for a few hours after raking.

This is an easy way to protect your back during raking season.

Hopefully these tips give you a few things to think about before you go raking all those leaves in your yard – but most importantly – help you protect your back and avoid unwanted back pain this fall season.

Are you a local in Portsmouth, NH?

CLICK HERE to connect with one of our specialists who can help you manage back pain from raking leaves so you can enjoy the fall season to the fullest!

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 get her free guide for preventing back pain, CLICK HERE or call 603-380-7902.