Tag Archive for: Portsmouth NH

Tight hips? Try strengthening instead of stretching.

May 15, 2023/in Movement/by Carrie Jose

When you’ve got tight hips, it can interfere with your ability to enjoy walking, running, golfing, and just exercise in general.

Tight hips are not only annoying and achy, but they often contribute to lower back pain as well. But perhaps more frustrating than the tight hips themselves is the fact that no matter how much stretching you do – they never seem to loosen up. Typically when I hear this, it’s a big red flag for me that tight hip muscles aren’t actually your problem.

In other words, just because it feels like you’ve got tight hips – doesn’t mean they actually are tight.

Let me explain.

Your hip muscles can literally be shortened and constricted – in which case – they need lots of stretching. But they can also be “tight” due to weakness or being overworked. When muscles are overtaxed or undertaxed during an activity, they aren’t going to function well and they will find a way to compensate. And this compensation strategy can lead to chronically tight hips over time.

But here’s the thing…

When your hips are tight due to weakness and overcompensation, stretching will not help. Stretching might feel good in the moment, or give you temporary relief, but the tightness in your hips will continue to return until you identify and fix the real underlying problem.

Let’s take your psoas (one of your hip flexors and pelvic stabilizers) as an example to illustrate this concept…

Your psoas is one of your deep hip flexors that also has a connection to your lower back. Although it is capable of flexing (bending) your hip in some capacity – it has more of a stability role. When functioning properly it will assist in exercises like the crunch or sit up, and also work alongside your deep abdominals and glute muscles to help you maintain good upright posture when you’re sitting or standing.

Unfortunately the psoas gets blamed for a lot of things – most notably – tilting your pelvis forward because it’s “tight” and causing lower back pain. The theory is that if you stretch, massage, and “release” your psoas muscle, then you will balance out your pelvis, and your back pain and hip tightness will disappear. But sadly, this is rarely the case. More often than not, your psoas is tight because it’s overworking to compensate for your deep abdominals/core not working properly.

Do your hips ever cramp or feel achy during abdominal work?

Your inclination will be to stretch them but this will simply not work. You have to get your abdominals and deep core to start working properly so that your psoas can actually relax. Once your hip flexors are no longer doing all the work, they won’t feel tight anymore.

This concept of tightness due to overworking and compensation can happen to any muscle in your body. With hips in particular, your psoas along with your piriformis and TFL (tensor fascia latae) are the most common victims. We’ve already spoken about your psoas, but your piriformis and TFL love to compensate for weak gluteal (butt) muscles.

An overworked piriformis leads to difficulty sitting cross-legged and a tight TFL can be painful and lead to IT band problems. You can stretch all you want, but if you don’t address the underlying cause and give these muscles a chance to relax, your hips will constantly feel tight. Plus, stretching in and of itself is a form of load on your muscle. You don’t want to add more load to an already tired and angry muscle.

The moral of this story is that if you’ve got chronically tight hips and stretching all the time isn’t solving your problem, then consider a different approach. Most people don’t consider strengthening an area that feels tight but this could be what you’re missing.

When it comes to hips – the things to look at are your deep abdominals/core and your glutes/butt muscles. Often there’s an underlying weakness in one or more of these areas that you just can’t recognize. Do yourself a favor and talk to an expert who gets this.

Are you local to Portsmouth, NH?

Consider reaching out to one of my specialists by requesting a free discovery visit HERE.

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

Medicare cuts coming in Jan. Why you should pay attention.

December 12, 2022/in Lifestyle, Physical Therapy/by Carrie Jose

On Nov 1st, the Federal government issued a final ruling that’s going to result in Medicare cuts of 4.5%. In an already dysfunctional and overcrowded healthcare system – this is going to be a problem for you (the consumer) – and here’s why…

Healthcare is ultimately a business. And its goal is to make a profit. Revenue and profit come from things like procedures, tests, images, and surgery – not from disease prevention and keeping people healthy.

What does that mean for you?

Health care specialities such as orthopedic surgery, neurology, and gastroenterology (for example) – those that are procedurally-driven – generate higher revenues and get paid more for their services.

On the flip side – disciplines like primary care physicians, rehab therapies (like physical therapy), and endocrinologists (those that manage chronic conditions like diabetes and osteoporosis) – get paid less.

The consequence is that the disciplines who actually need more time with you- so they can get to know you and your lifestyle – because that’s what is required to give you a good strategy for disease and injury prevention- are forced to do more work for less.

Eventually, something has to give…

Family medicine doctors have to see patients every 10 minutes and that’s if you can even get in to see them in a timely fashion. Physical therapists have to see multiple patients per hour, resulting in 12-16 patients per day.

These caseloads and demands are not supportive of a health care practitioner truly getting to know you as a person, what your concerns are, or what your particular lifestyle and burdens are. (A recent commentary by Shirlene Obuobi, MD in the Washington Post illustrates this dilemma quite well.)

These are all critically important factors if you want to get effective treatment and advice that’s going to match your needs and deliver the outcome you want.

The consequence is sub-par preventative care. And you risk unnecessarily getting shuffled off to the “specialist” who uses fancy tests and procedures (instead of getting to know you and asking questions) to make (often costly) decisions about your health.

Now, my intention here is not to paint specialists who use procedures and tests as their norm of examination as the “bad guys”.

The problem is you, the patient, is getting pawned off on them too soon because the people who are meant to protect you and help you defend against disease and injury are getting crushed (and not valued) by the health insurance companies.

Medicare tends to be the leader and everyone else follows suit. If these 2023 cuts go through, commercial insurers will be next.

So what can you do?

First, you must do everything in your power to become educated about health and wellness. Then, you can prevent disease and injuries on your own.

This may require hiring certain, key, preventative health care professionals to guide you – such as getting your own dietician, your own physical therapist, and your own mental health professional. Ironically, we already do this without even thinking about it when it comes to our dental care.

Why wouldn’t we want to do this with other aspects – like digestive, mental, and musculoskeletal health?

Health insurance companies add red-tape when it comes to accessing these services. An example is requiring a referral. Referrals that our already overburdened primary care physicians don’t have time to give. This leads me to my second recommendation. Start thinking outside the box. Be willing and able to invest in the health care you both desire and need.

Going outside of insurance and paying out of pocket for preventative care services is not as expensive as you think. Your options could open up exponentially. Especially if you budget and plan for it. At some point, it’s not going to be in your favor to rely on your health insurance to fund all your healthcare needs anymore. It’s clear they’re not interested. Instead, look at your finances and start budgeting.

One of the best ways to do this is to open up a health savings account. If your health plan doesn’t allow for that, then open up a separate savings account to save on your own. More and more practitioners are ditching insurance – if not leaving their respective professions altogether. Do you want to stay out of the hospital? Or big corporate health care systems and see someone private who has the time to care about you? You will have to pay. Personally, I believe this is the way to go but I understand it’s not for everyone.

However, with some planning and foresight, it could be.

I hope things do eventually change for the long-term. Stay educated, take control over the administration and funding of your health care in the short term. This is a far better alternative than heading to Washington and fighting Congress on your own.

Are you local to Portsmouth, NH? CLICK HERE to request a Free Discovery Session with us – we’ll ask you what’s been going on – and see if we’re the right fit to help you.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or request a free copy of one of her guides to back, neck, knee, or shoulder pain, email her at [email protected].

Are Flip flops Aggravating Your Plantar Fasciitis?

July 5, 2022/in Chronic Pain, Movement/by Carrie Jose

Now that summer is here – it’s flip flop and sandal season for many. Unfortunately, this also typically results in a rise in foot pain and plantar fasciitis cases. One of my readers recently wrote to me and asked about this.

Here’s what Jennifer wanted to know:

“Now that I’m wearing flip flops again, I noticed that my plantar fasciitis is acting up. Is there anything I can do? Do I need to stop wearing flip flops?”

This is a great question Jennifer. In order to answer your question, let’s look at a few reasons why plantar fasciitis occurs in the first place. Ideally, if you can stay on top of your plantar fasciitis and/or prevent it all together, flip flops won’t even be an issue.

First – what is plantar fasciitis?

It’s inflammation of your plantar fascia – the tissue that makes up the arch (bottom) of your foot. Your plantar fascial 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 so that you can propel yourself during walking and running. When you land on your foot your arch falls or flattens – this is called pronation. The response to this action is that your foot then stiffens or supinates – this is where your foot gets 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 inflammation/plantar fasciitis.

What causes your plantar fascia to become overworked?

Basically anything that impacts or disrupts the natural mechanics of your foot to pronate and supinate. Most commonly, poor mobility in either your ankle or 1st toe is the culprit – but even tight hips and weak glutes can cause problems all the way down to your foot. Anything that impacts the way your foot hits the ground has an opportunity to influence the level of force and energy transmitted through your foot and arch when you walk, which in turn impacts the natural pronation/supination mechanism. When disrupted, your plantar fascia will attempt to compensate for the pronation/supination mechanism. If this continues to happen, your plantar fascia eventually becomes angry and irritated – resulting in plantar fasciitis.

Flip flops, or any other shoe for that matter, can either “protect” your arch, or cause it to overwork. Technically speaking, 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. Sadly, this is rarely the case for many people. Because of how much we sit, and how little we walk around barefoot, the bottoms of our feet are simply not as conditioned as they could be. This is really the problem – not so much what you put on your feet. If you’re accustomed to wearing supportive and cushioned shoes all the time, and then suddenly switch to flatter, less supportive flip flops in the summer, it’s going to be a shock to your foot. And if you’re prone to plantar fasciitis, it’s going to flare up during flip flop season.

The best thing you can do to prevent and treat plantar fasciitis is to not neglect your feet.

Performing consistent mobility exercises for your toes and ankles is key, as well as conditioning for the strength and stability of your arch. Balance exercises, toe exercises, and plyometric (jumping) exercises are all important, as well as making it a point to walk around without shoes as often as you can. If you’ve already got an ongoing problem with your foot, then I wouldn’t recommend haphazardly incorporating these exercises into your routine without guidance. Talk to an expert who can help you. Plantar fasciitis, when addressed correctly, is very treatable, and you could be back to enjoying flip flops in no time.

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

CLICK HERE to request a discovery call with our Client Success Team to see if we would be a good fit for you!

5 Benefits of Adding Pilates to Your Fitness Routine

March 2, 2022/in Movement/by Carrie Jose

5 Benefits of Adding Pilates to Your Fitness Routine

Pilates has been around for about 100 years, and it still amazes me how many people have NOT heard of this incredible exercise method.

If you didn’t already know – it was first created by Joseph Pilates and initially gained popularity among the dance community as a way to recover from and prevent injuries. But you don’t have to be a dancer to practice Pilates or enjoy the benefits. It has become increasingly popular for the over 50 crowd – and for good reason…

Unlike what’s often touted in the media, the benefits of a regular Pilates practice go way beyond a lean beach body and 6-pack abs.

For Mr. Pilates, his method was created out of a quest to improve his overall health in a holistic way that went beyond what could be achieved with traditional strength-training methods. He suffered from various health ailments – and thanks to his incessant curiosity and fascination of the human body and what it was capable of – he eventually came up with his transformational method of total body conditioning.

Personally, I’ve been incorporating Pilates into my own work as a physical therapist for over 10 years, and I practice Pilates myself weekly. I love and believe in it so much that I’ve designed my entire business model around it!

Pilates is a full body strengthening system that emphasizes breath, precision, coordination, and core strength.

The better you can understand and connect to your body, the easier it is to prevent injury and push your body to limits you otherwise may not have thought possible.

Here are 5 Benefits of Adding Pilates to Your Fitness Routine – and why you should consider adding a regular Pilates practice to YOUR fitness routine as well…

1. Pilates helps with back pain.

Once you hit 40, your risk of back injury starts to climb, and a regular practice of Pilates is a safe and sustainable way to help keep your back pain-free and strong. Pilates focuses on core strength but is also a well-balanced exercise system. Full body strength and balance is a critical component for life-long back health – something that isn’t always addressed in traditional back pain rehabilitation programs or strength-training regimens. We even have specific Pilates classes geared towards people with back pain!

2. Pilates strengthens your whole body – not just your core.

Pilates is known as the staple of core training – but it doesn’t just stop there. Pilates strengthens your arms, glutes, hips, and legs in a way that helps them to not only be strong – but work together in a balanced and coordinated fashion. I call this “balanced strength” – and it’s one of the keys to truly enhancing your fitness and performance levels.

3. Pilates improves your flexibility and mobility.

People use these terms synonymously but they are actually quite different. Flexibility refers to muscle length and pliability. Mobility refers to joint range of motion. Flexibility without mobility is useless – and you need a balance of strength and flexibility to optimize mobility. In other words – a balanced joint – one that is strong and flexible – allows the joint to move fully and freely – which optimizes its mobility. Pilates emphasizes continuous, slow, and precise movements through a large range of mobility. This allows you to work on both strength and flexibility simultaneously – and thus – your mobility as well.

4. Pilates puts minimal stress on your joints.

Aging is a real thing and along with it comes arthritis. The key to combating arthritis is optimizing the area around the affected joint or joints. When you have good mobility, and balanced strength, you have less compressive forces on your joints. Arthritis doesn’t like compressed, crowded joints. So when you strengthen and stretch your whole body in a good, balanced way – arthritis becomes less painful and stiff. Pilates helps with all this while not causing any added stress on your joints in the meantime.

5. Pilates trains your nervous system.

Your nervous system is responsible for conducting messages from your brain to your muscles. If that’s not in-tune – you could develop compensations and inefficient movement patterns that eventually lead to pain and injury. Pilates emphasizes precise and coordinated movements, which enhances and reinforces this brain to muscle connection. You can’t just go through the motions when you do Pilates. You have to use your brain and really concentrate on what you’re doing. This helps to train your nervous system – resulting in smoother, more coordinated movements – and better balance as well.

Are you interested in learning more about pilates and seeing if it’s a good fit for you?

CLICK HERE to check out our in studio pilates offerings!

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group.

Questions About Your Shoulder Pain? Here are Some Real Answers.

June 29, 2019/in Neck and Shoulder Pain/by CJ Physical Therapy

Often when clients come to us with shoulder pain, they’ve already tried several approaches without success. But the real issue is that everyone they’ve seen up to that point has failed to give them an accurate diagnosis.

Without an accurate diagnosis, treatment fails.

It’s not surprising. The true cause of shoulder pain is missed by many and can actually be difficult to diagnose. Sometimes it really is your shoulder, but in other cases the pain is actually caused by a problem in your neck. If there is irritation or inflammation in your neck, but someone is aggressively treating your shoulder, guess what? You aren’t going to see results and your pain may even worsen.

Here are a few questions to ask if you’re wondering if really have a shoulder problem… or if you should be getting help for your neck instead.

Where is your pain?

When you have an actual shoulder problem, the pain is always going to be just in your shoulder. The most common areas to experience pain are directly in front of your shoulder, directly on top of your shoulder, or in a more involved shoulder problem – like a rotator cuff injury – you might feel achiness on the side of your shoulder and down into the side of your arm a little. If the pain goes past your elbow, is above your shoulder and into your neck (the upper trap area), deep inside of your shoulder, or in the back into the shoulder blade, it’s entirely possible (and maybe even likely) that your neck is involved or totally responsible for your “shoulder pain.”

Do you have numbness, tingling or burning?

These are signs of nerve compression or irritation. If that’s happening in your neck – say due to a bulging disc or restricted/faulty movement patterns that irritate your nerve roots – you can feel it into your shoulder, shoulder blade, or even down into your arm.

What’s particularly misleading is that all of this nerve difficulty in the neck will only be felt in your shoulder or arm.

When do you feel stiff?

Lack of mobility and stiffness are common symptoms associated with a rotator cuff injury or the dreaded “frozen shoulder.” If your neck moves well, is pain free, and your shoulder is stiff, odds are that the problem is in your shoulder. Now, let’s say you’ve got stiffness in your neck as well as your shoulder. It’s possible the neck stiffness is a result of your shoulder not moving properly. However, you’ll never know for sure without a proper assessment. If there is even a hint of a neck issue being fully or partially responsible for your shoulder problem, it must be addressed or you will never achieve full recovery.

I do everything I’m told, why won’t my shoulder get better?

This is probably the number one sign that your shoulder problem is not really a shoulder problem at all. If you’ve had pain for months, or if you fix your pain but it keeps coming back, then there is a very good chance someone has missed something. Quite possibly, it’s a hidden neck problem. I can’t tell you how many times I’ve seen this happen. I’ve seen people try three different therapists who’ve prescribed the best rotator cuff exercises on the planet. I’ve seen people get multiple cortisone injections in their shoulder. And worse, I’ve seen people get surgery – only for their shoulder to problem return months or years later. If this sounds like you, then someone has missed the boat and your shoulder problem may not be a shoulder problem at all. You need to find a physical therapist who is a specialist and can properly assess you. They’ll know the right questions to ask, take their time doing a thorough and proper assessment, and get you on the right track to getting better.