Tag Archive for: running

Is running bad for your knees?

Turns out – Running isn’t Bad for your Knees

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Is Running Bad For Your Knees?

I love to play family-feud style trivia. And if there was ever a question – “Name an activity that is bad for your knees” – I know that running would be the number one answer. 

But this is simply not true – and there is research to prove it.

There is a common myth that continued running will eventually cause, or accelerate arthritis in your joints. But in a 2013 study published in Medicine & Science in Sports & Exercise (the American College of Sports Medicine’s flagship journal) this theory was debunked. The results of the study concluded that runners were statistically less likely to develop knee and hip arthritis compared to other types of exercise. In a more recent study from 2020, published in PeerJ, it was found that although running does indeed create a lot more “pounding” in your knees compared to something like walking – this process actually helps to “build-up” your cartilage and make it stronger – which is a huge factor in helping to slow down arthritis.

But what about those that do get knee pain when they run? What’s the explanation?

Healthy running comes down to having optimized running form and body mechanics – otherwise it could become problematic for your knees.

So if you’re having knee pain when you run – instead of blaming the sport – consider one or more of the following:

Check your ankle mobility

Ankle mobility is going to influence the way force from the ground hits your foot, which can in turn impact how force (load) impacts your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.” Everything from the types of shoes you were to old ankle sprains can all have an impact on how well your ankle moves. A specialist in movement and joint mechanics can help you test and improve your ankle mobility – and let you know if it’s impacting your knees when running.

Don’t just run – strength train too.

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing strong lower limb muscles is critical. The hamstrings and quadriceps play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

How’s your core?

It may seem like running is all in the legs, but in reality, so many of our physical actions stem from the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — including your knees. A stable core is key for maintaining balance and rhythm while running. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees. My favorite way to improve core strength is Pilates, especially for runners, because this exercise system gives your joints a nice break. But any core strengthening routine that focuses on using your body weight and minimizing stress on your joints is going to be beneficial for you if you’re a runner.

Practice good running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — good running form is essential. It determines where and how the impact of every step is distributed throughout your body. But here’s the thing… Good running form is dependent on optimized joint mobility and strength – so simply changing your form might not be enough – and could even cause you more problems. You want to figure out why you’re running with a “bad” or inefficient form – correct what’s causing it – and then work to train your body to run in a more efficient way. This will not only help your knees – but all your other joints as well.

If you’re someone who loves to run and wants to keep running – I have good news for you – it’s not bad for your knees. But if you’re currently having knee pain while running – you’ll want to look at and consider one more of these strategies to figure out why. The best thing to do is enlist the help of an expert – such as a specialist physical therapist or movement expert – who can help you diagnose where your knee pain is coming from and get you on a path to fix it.

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

Running Over 50: Top 3 Injuries and What you can Do

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If you love to run, then you’re probably no stranger to running injuries.

But if you love to run and you’re over 50, not only are you more likely to suffer a running-related injury compared to runners half your age, but you’ll tend to suffer from different categories of injuries as well. In older runners, we tend to see more soft-tissue related injuries versus problems with joints and stress fractures. Part of this is due to the fact that older runners may have been running longer. This predisposes them to more long-term wear and tear that is typically associated with soft tissue injuries like tendinopathy and plantar fasciitis. Older runners also are more likely to have altered their running mechanics over time, another factor that leads to injury. Either way, the good news is that once you know what to look for, you can take proactive measures to prevent these common running injuries as well as treat them naturally.

Here are the top 3 running injuries I see in people over 50 and what you can do:

1. Plantar Fasciitis

Plantar fasciitis is a condition characterized by a sharp, stabbing pain in your heel or bottom of your foot. It often worsens with the first steps in the morning or after long periods of rest. This discomfort comes from inflammation in your plantar fascia, a thick band of tissue running across the bottom of your foot from your heel to your toes. Factors such as overuse, improper footwear, high arches, flat feet, and tight calf muscles can all contribute to the development of plantar fasciitis, whether you’re a runner or not.

Prevention measures for plantar fasciitis include incorporating regular stretching and self-massaging of your plantar fascia and calf muscles before and after running. Balance exercises that focus on strengthening the intrinsic muscles of your foot, along with maintaining a healthy weight can also help – as it will allow you to better control and manage the load that gets transmitted through your plantar fascia. But what if you’re already suffering from pain due to plantar fasciitis? Don’t just resort to rest and ice, which has been known to impede healing. Plantar fasciitis requires prescriptive loading of your muscles in order to remodel the damaged tissue. This, along with non-invasive treatments such as Shockwave Therapy designed to enhance blood flow to the tissue, can aid in accelerating your healing.

2. Runner’s Knee (Patellofemoral Pain Syndrome)

Runner’s knee is a term used to describe a variety of conditions that cause pain around the kneecap (patella) – and is often synonymous with patellar tendonitis. You’ll notice your runner’s knee most during activities that require knee bending, walking downhill, or descending stairs. Overuse of your quadriceps muscles, poor tracking of your patella, and any other muscle or joint imbalance that results in increased load to the front of your knee can all result in runner’s knee. 

Regular and balanced strength training of the muscles around your knee – particularly of the quadriceps, hamstrings, and hip muscles – is a key prevention strategy. Making sure you have good ankle and foot mobility is also important. Because if your foot doesn’t move well when you run, unwanted forces move up the chain into your knee, eventually leading to runner’s knee. If you’re already suffering from runner’s knee, then you’ll want to first mitigate your pain. Similar to plantar fasciitis – rest and ice won’t do much for you. Getting blood flow to the area – followed by carefully prescribed exercises designed to restore your mechanics and properly load your patella tendon – is what’s going to heal the irritated tissue in and around your knee and make it stronger.

3. Achilles Tendinitis

Achilles tendinitis presents as pain and swelling in the back of your heel or lower calf. Right where your Achilles tendon connects your calf muscles to your heel bone. Your Achilles pain will typically be most prominent during or after running. It may be accompanied by stiffness when flexing your foot. While the causes of Achilles tendinitis are very similar to that of plantar fasciitis, we see this occur most often with sudden increases in intensity or duration of training. Particularly, this happens when your body is not adequately prepared.

A gradual increase in training load, regular calf strengthening and stretching exercises, and proper warm-up and cool-down regimens can go a long way in preventing Achilles tendinitis. Be cautious of your footwear as well. Minimalist running shoes have become extremely popular. But, if you move into them too quickly, your Achilles tendon could become irritated due to the sudden change in load and force. If you’re already suffering from Achilles tendinitis, the treatment is quite similar to that of plantar fasciitis. The exception is that when it comes to tissue loading, you’ll want to focus more on your lower calf and Achilles tendon, versus the plantar fascia.

With all of these conditions, keeping yourself healthy and in good shape is crucial for prevention.

Enlisting the help of a running coach is also a good idea. They can address any potential issues with your running mechanics that may have occurred over the years. If you’re picking up running for the first time, or returning to it later in life, take it slow and easy. Consider talking to a movement expert who can detect and analyze any imbalances in your body. They can ensure that you’re moving and exercising correctly. Imbalances will cause you to compensate. This is not something that will be immediately obvious to you – until it’s too late.

Are you overdoing it on “Vitamin I”?

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A few weeks ago, I asked a new client what he had already tried for his back pain. He surprised me by replying with “Vitamin I.”

He could see I was puzzled, so he quickly clarified — Ibuprofen.

It’s the first I’d heard of this term, but is it NOT the first time I’ve heard of people taking Ibuprofen routinely or for prolonged periods. For some it’s because they are in pain already… but for others it’s to prevent pain when they are about to do something they know will hurt.

Ibuprofen is a type of NSAID (non-steroidal anti-inflammatory drug) that is commonly used to reduce inflammation and pain.

Some reasons you might take it are because you’ve had an acute injury such as a sprain or strain, to deal with headaches, because your arthritis flared up, or because you need to bring a fever down.

When you absolutely can’t get control over pain or inflammation naturally (such as with ice, rest, or therapeutic movement) taking Ibuprofen can be helpful.

But when you’re taking it on a regular basis to control and manage pain, or if you find you’re always taking it before certain types of exercise or activity just so you can prevent pain… it’s something to be concerned about.

Long-term use of Ibuprofen has its consequences. Plus, being in pain all the time, or experiencing pain every time you exercise or do a certain activity, is not normal and you should get it checked out.

So what are the consequences of too much “Vitamin I?”

The consequences are minimal if you’re just grabbing Advil every now and then to ease a headache or take the edge off of a particularly painful back pain episode. You’ll always want to check with your doctor or pharmacist first before taking any type of medication — even one like Ibuprofen that is easily accessible over the counter — but assuming you’ve been cleared, it’s rare that you’ll experience any harmful effects from the occasional dose of “Vitamin I.”

The problem is when you’re always reaching for that Advil.

At some point you want to consider what might be causing your pain to keep coming back.

Every time you resort to something like Ibuprofen as a way to control recurring pain, you’re only putting a bandaid on the problem. When it comes to musculoskeletal pain, such as back, knee, hip, shoulder pain or headaches…

Remember that 80% of the time it can be resolved with movement instead of medication.

So consider talking to one of our movement experts who can help you naturally resolve your pain and get you off that “Vitamin I” regimen.

Another common reason people resort to regular use of Ibuprofen is to prevent inflammation or muscle soreness before exercise or vigorous activity. This has become especially common with athletes and weekend warriors.

This is never a good idea.

Research has shown that taking “Vitamin I” ahead of exercise can actually hurt your performance and hinder your recovery. Not to mention the long-term health implications of using Ibuprofen in this manner!

In a study published my Medicine and Science in Sports and Exercise, researchers discovered that when distance runners took 600mg of Ibuprofen before an event, they ended up with more tissue-damaging oxidative stress afterwards compared to those who took nothing, thus debunking the theory that “Vitamin I” can help you avoid inflammation.

In this case it increased!

Another study done on cyclists found that Ibuprofen can damage your gut during exercise and lead to a leaky small intestine.

And finally, scientists have conducted animal research that shows taking “Vitamin I” as a prophylactic for muscle soreness actually hinders your recovery.

If you’re finding yourself constantly in pain or very sore after or during certain types of exercises and activities, you may want to look at how you’re warming up or preparing for these things.

If you have consistent problem areas such as back or knee pain, there are corrective exercises you can learn that will better prepare your joints for repetitive and strenuous activities.

In many cases, corrective movements can help you avoid pain entirely.

But at the very least, they’ll help to reduce any pain you do experience much faster, and you’ll recover more quickly.

And for tissue inflammation, there are great natural alternatives that are safe to consume before a particularly strenuous workout. Tea, tart cherry juice, and turmeric are all considered natural anti-inflammatories that are safe, and don’t come with the harmful side-effects of “Vitamin I.”

While I’m a huge advocate of avoiding pain medication whenever possible, there are times when taking Ibuprofen makes sense. But it should be occasional and minimal and you should always be checking in with your doctor to make sure it’s safe.

But even when your doctor says it’s ok to use right now, know that long-term use of Ibuprofen can damage your digestive system, interfere with your hormones, and increase your risk of heart attacks and stroke.

It’s always best to look for natural ways to ease pain first.

Movement is my favorite form of medicine.

If you want to find the movement that is YOUR medicine, so you can stop using “Vitamin I” as a bandaid…

Request a FREE Discovery Session with one of my specialists.

They’ll talk to you first to make sure you’re even a good fit for what we do… and if so… let you know how we can help!

Avoiding Movement

Getting and Staying Fit when you’re Over 50

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The importance of being healthy and fit has taken center stage these last 18 months, but especially for the over 50 crowd. Most people aged 50+ who want to get and stay fit struggle, because what might work for someone in their 20’s or 30’s just doesn’t make sense for them in their 50’s. As you age, both your needs AND your priorities change. 

By the time you hit age 50, you may start to suffer from things like arthritis, degenerative and aging joints, and more back and knee pain. And if you aren’t suffering from them yet, you’re worried about when you will. First, let me just tell you that it is 100% possible to get and stay fit after 50. I have the joy of working with folks aged 50+ every day who are the healthiest they’ve ever been in their lives. So what’s their secret?

Here are 5 habits my healthiest clients aged 50+ stick to so they can get and stay fit:

1. Get enough sleep

The myth that you don’t need as much sleep as you get older is false. Most research indicates that even when you’re over 50, you should still be aiming for 7-9 hours of sleep per night. When you don’t get enough sleep, it catches up to you. You lack energy, making you less motivated to exercise and more likely to eat sugary, unhealthy foods. Lack of sleep lowers your immune system, affects your memory and ability to focus, impacts your balance, and increases your chances of developing high blood pressure. In general, lack of sleep is going to significantly impact your ability to eat well and exercise, two essential ingredients for getting and staying fit after age 50. 

2. Keep Nutrition Simple

If you’re over age 50, you’ve likely seen every cleanse, crash diet, health shake, weight loss pill, or gimmick known to man.  There literally isn’t a trick left in the book you haven’t seen.  At age 50+ you also typically aren’t in the mood to be a nutritional extremist either. It’s a good idea to just keep things simple. Focus on eating nutritious whole foods (things that are unprocessed) and drink plenty of water. Start your day with an 8oz glass of water and then aim to drink at least 3 more bottles after that. When you’re planning meals, make your plate up with half vegetables, one quarter protein, and one quarter whole grains. Adding a little bit of healthy fat consisting of plant oils is a good idea too. Good nutritional habits give you the energy and stamina you need to get and stay fit!

3. Lift Weights

I can’t tell you how often I get asked “is it safe to be lifting heavy weights at my age?” People worry that lifting heavy weights could be “bad” for their spine or knees once they’re aged 50+. Lifting weights is not only good for you, but perfectly safe when done correctly. But it’s important that your workout is customized and takes into account any injuries or ailments you may have. Arthritis in your joints, bulging discs, and even meniscus tears are all normal things that occur as you age. They don’t mean you can’t exercise — but you do want to make sure your strength training routine reflects this.

As a physical therapist, the two biggest things I look at when I’m examining someone’s strength routine are form and loading strategies. Good and proper form is critical to protect your joints and back. “Loading” refers to how much weight you lift and how often (reps). This changes as you age because the integrity of your soft tissue (muscles and ligaments) is different. Loading strategies also need to be adapted if you’re injured or in pain. A good strength coach and physical therapist, especially when working together, can make sure that you have a strength training routine that is not only safe but perfect for your age and ability.

4. Strengthen your Core

After age 50 things like balance and reaction times start to become more compromised, and the likelihood of back pain increases. Maintaining good core strength helps with all of this and becomes more important than ever at age 50+. The biggest problem I see with people trying to strengthen their core is that they just don’t know how to do it properly. They may be doing all the right things, but with all the wrong muscles. If you’re new to core strengthening, or perhaps you’ve been doing it awhile but your core strength still isn’t where you want it to be, consider trying Pilates. It’s long been known as the staple of core strengthening because it requires you to perform very controlled and precise movements while focusing on your breath. Having proper control over your breath, body, and movement are the cardinal signs of a truly functioning and strong core. 

5. Address Pain

This may seem obvious, but I can’t tell you how many people either ignore or just work around their pain. When you ignore your pain, you risk developing other problems due to your body compensating. These compensation strategies may last you for a short time, but eventually they will catch up to you. When you’re over 50, recovering from injury is harder and takes longer. So although preventing injury is your best strategy, don’t just ignore pain if you’re experiencing it. When you work around pain, it’s impossible to get the most you can out of your workouts and this delays your ability to get and stay fit. If you’re always having to modify exercise or compensate for pain, not only is this frustrating, but you delay getting to the root cause of your problem. Simply put, if you’re experiencing musculoskeletal pain — get it addressed.

We are a team of specialists who are specifically trained to help you address these issues. If you’re interested in an assessment, consultation, or simply want a couple questions answered — sign up for one of our FREE Discovery Sessions! This 30 minute session allows you to talk one-on-one with a movement expert to figure out what you want, need, and how you’re going to get there.

Holding Knee with Arthritis

Arthroscopic Knee Surgery – Does it Even Work?

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While researching for my latest article in the Portsmouth Herald, I came across an interesting study titled: “Arthroscopy for degenerative knees – a difficult habit to break.”

The title of this study is telling.

Arthroscopic knee surgery is still one of the most common surgeries performed, despite research telling us that it’s not nearly as effective as most people are led to believe.

Furthermore, studies now indicate that people who get arthroscopic knee surgery are likely to have knee arthritis that advances more rapidly – resulting in a total knee replacement that could have been avoided.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint if you’ve got degenerative arthritis, or to clip out pieces of a torn meniscus that might be irritating your knee.

Sounds pretty simple and harmless – right?

But over the years, research has shown that this procedure is really not necessary in most cases.

Most people can get pain relief and restore function in their knees without ever getting surgery.

One of the earliest studies from 2002 by JB Mosely and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery. Since then, numerous studies have shown similar results. Even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment like physical therapy.

Despite all this research, surgeons are still performing these procedures more than ever.

In some cases it’s just what the surgeon knows, and they haven’t kept up with the research. Other times, it’s due to poor conservative management and not giving therapy enough time to work.

In our office, we often see people after they’ve tried regular physical therapy first. Since we have a more specialized approach, and we’re able to spend more time with our clients, we tend to get better results and can help clients avoid surgery all together.

But not all physical therapy clinics are afforded that luxury. In those cases, people are led to believe that the physical therapy “didn’t work,” and they get scheduled for surgery.

But what’s the big deal really?

If outcomes are the same regardless of whether you get surgery or not – why not just get it? It’s quicker, and far more convenient than going to weekly therapy appointments…

But despite the term “minimally invasive,” it’s still surgery.

You will have bleeding, swelling, and recovery time. There is trauma that is caused to the soft tissue in and around your knee that has to heal. There’s also the risk of infection, which comes with a whole set of different complications.

And then of course there’s the elephant in the room that nobody likes to talk about…

I’ve seen many of these arthroscopic surgeries performed that had clients feeling WORSE than before surgery. Because it turns out the procedure wasn’t even necessary. Luckily, we’re still able to rehabilitate them. But it’s completely demoralizing and discouraging for our clients.

In general, despite how small the procedure may seem, you want to avoid surgery whenever possible.

Although small, the risks that can happen with surgery simply aren’t worth it – especially when you can get the same results from natural, conservative treatment.

For some, arthroscopic knee surgery really is necessary. But for most, it can be avoided.

If you’re currently suffering from knee pain and want to learn more about what you can do to avoid surgery and heal your knee pain naturally and on your own – DOWNLOAD our Free Guide: 7 Ways to Get rid of Knee Pain Naturally.

knee pain source

Three Causes of Knee Pain and What to Do

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Knee pain has been the hot topic around our office this week!

With the nicer weather we’ve been having – more people are outside – and their knees are “talking” to them.

Knee pain is the second most common complaint of musculoskeletal pain (back pain is number one) and it impacts one-third of all Americans at one time or another.

Most of our clients are in their 50’s and 60’s and love to ski, run, hike and bike. They worry that knee pain could bring an end to their active lifestyles.

The good news is that eighty percent of ALL knee problems can be resolved without procedures or surgery – but it starts with accurately identifying the root cause.

Here are three of the most common causes of knee pain and what you can do to resolve it.

1. Patellofemoral Knee syndrome

Also known as “runner’s knee”, patellofemoral knee syndrome (PFS) is characterized by pain in the front of your knee – usually just below or behind your knee cap. With PFS, the source of the problem typically has to do with unwanted pressure in the front of your knee… that eventually results in pain.

It’s very tempting to just get a cortisone shot – or take pain pills – to reduce the inflammation caused by this wear and tear. But then you’re only addressing the symptoms…

If you truly want to put an end to PFS, you’ll need to find the cause of this problem.

Typically, it’s poor form and movement habits that are the result of an imbalance somewhere between your hips, quads (front of the thigh), and hamstrings (back of the thigh). When you figure that out, you’ll restore healthy, balanced movement in your knee again – and reduce the aggravation at your knee cap.

2. Iliotibial band syndrome

This is a very common problem that is similar to PFS except that you’ll experience pain on the side of your knee instead of the front. Your iliotibial band (ITB) is a large, thick band of tissue that runs along the side of your thigh to the bottom of your knee. Your ITB is formed from a muscle in your hip called tensor fascia latae (TFL).

When your TFL gets overworked – your ITB suffers – and will result in what often feels like stabbing pain at the side of your knee.

The most common treatment I see for this is foam rolling and massage – and while these are great modalities to relieve your symptoms – they do NOT address the root problem.

You must figure out why your TFL is being stressed and overworked if you really want to get rid of your pain. Typically, it’s due to weak glute muscles, the deep ones designed to stabilize your pelvis. Your TFL is neighbor to your glutes so when they decide to be lazy – your TFL loves to help out – and eventually overdoes it.

When you can get these two groups of muscles working properly together – you’ll put an end to ITB syndrome 🙂

3. Osteoarthritis

Many people find out they have osteoarthritis in their knees and think there’s nothing that can be done. They either have to “live with it” or get surgery to replace their knees.

Not true!

First of all… arthritis is normal and it happens to everyone as they age. What is NOT normal is for you to think you’re helpless because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. While there isn’t anything you can do to reverse this process – there is plenty you can do to minimize the symptoms you get because of this condition.

It all comes down to balanced joints and movement.

The more mobility you have – and the more stability you have around your knees – the less symptomatic your arthritis will be.

Some key areas to focus on when you’ve got arthritis in your knees is good core strength, and good flexibility in your hips and ankles. If anything is off in these areas – your knees will want to compensate – which could result in aggravation of arthritic symptoms.

“Motion is lotion” is not just a saying – it works! Especially when it comes to arthritis.

If you’re currently suffering from knee pain, remember that there is a very good chance you fall into the eighty percent of people who can successfully get rid of it completely on their own.

There is no need to rely on pain pills – or think that procedures and surgery are your only options!

If you’re looking for help here in Portsmouth, New Hampshire CLICK HERE to Request a Free Discovery Session. One of our specialist will reach out to you, ask you about everything that’s been going on, and determine if we’re the best people 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 request a free copy of her Knee Pain Report CLICK HERE  or to get in touch, email her at [email protected].

5 Tips for Staying Active and Mobile as you Age

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Most of our clients are in their 50’s, 60’s and 70’s, and they want to stay as active as possible as they age. However, as we get older, our bodies do need more care and maintenance to age well and avoid injury. Here are some tips we like to give our clients to help them stay active and mobile, prevent injuries, and continue doing everything they love!

1. Keep Moving

I always tell my clients: “You don’t get stiff because you get old, you get old because you get stiff.”

If you want to stay healthy and mobile, you need to keep moving. One of the biggest questions I hear from folks aged 50+ is what to keep doing or stop doing because of arthritis. Remember, arthritis is normal as you age and it’s rarely a reason to stop doing certain exercises. Research has shown that activities like running, when done consistently and with proper form, can actually prevent knee arthritis! A similar and equally effective exercise is walking. Consistent walks will build up your strength and endurance, something that declines as you age, and it helps your balance and coordination. If you walk outside, you can get some fresh air and Vitamin D, which is highly beneficial for a strong immune system – something we all need right now.

2. Maintain a Healthy Diet

Tafeltennis Betting Sites Vergeleken: Winstwijzer’s Vergelijking van de Beste Opties

De wereld van het tafeltennissen is een opwindende en dynamische sport die miljoenen fans over de hele wereld aantrekt. Of je nu een doorgewinterde speler bent of gewoon geïnteresseerd in de spanning van de competitie, het wedden op tafeltennis kan een extra dimensie van opwinding en betrokkenheid toevoegen aan je ervaring. Maar met de vele online wedplatformen die beschikbaar zijn, kan het een uitdaging zijn om de juiste keuze te maken.

Gelukkig heeft Winstwijzer, een toonaangevend platform voor sportweddenschappen, een diepgaande vergelijking gemaakt van de beste tafeltennis weddenopties. In deze uitgebreide gids nemen we je mee op een reis door de wereld van het tafeltenniswedden, waarbij we de belangrijkste factoren belichten die je moet overwegen bij het kiezen van een betrouwbare en gebruiksvriendelijke wedsite. Of je nu op zoek bent naar de beste odds, uitgebreide live streaming, of een breed scala aan weddenschapsmogelijkheden, deze gids heeft alles wat je nodig hebt om een weloverwogen keuze te maken.

Betrouwbaarheid en Veiligheid

Als het gaat om tafeltennis betting sites, is het van cruciaal belang om een betrouwbare en veilige website te kiezen. Bij Winstwijzer hebben we een grondige vergelijking gemaakt van de beste opties op de markt. We hebben gelet op factoren zoals bonussen, inzetlimieten, live streaming, mobiele apps en klantenservice.

Eén van de topkeuzes is zonder twijfel Bet365, een gerenommeerde bookmaker met een uitstekende tafeltennis betting sectie. Ze bieden competitieve odds, live streaming van grote evenementen en een gebruiksvriendelijke interface. Een andere sterke optie is 888sport, bekend om hun gulle welkomstbonus en uitgebreide tafeltennis betting markten.

  • Bet365
  • 888sport
  • Unibet
  • Betway

Unibet en Betway verdienen ook een vermelding dankzij hun aantrekkelijke promoties, snelle uitbetalingen en uitstekende mobiele apps. Ongeacht welke tafeltennis betting site je kiest, zorg ervoor dat je de voorwaarden en bonusregels zorgvuldig doorneemt voordat je inzet.

Bonussen en Promoties

Tafeltennis is een populaire sport die steeds meer aandacht krijgt van gokkers. Met de groeiende belangstelling voor deze snelle en opwindende sport, is het aantal online tafeltennis weddenschap sites ook toegenomen. Bij Winstwijzer begrijpen we dat het vinden van de juiste site een uitdaging kan zijn, daarom hebben we de beste opties voor u vergeleken.

Onze experts hebben talloze factoren in overweging genomen, zoals de beschikbare wedopties, odds, bonussen en promoties, gebruiksvriendelijkheid van de site en mobiele compatibiliteit. We hebben ook gekeken naar de reputatie van de bookmakers, hun licenties en beveiligingsmaatregelen om ervoor te zorgen dat uw geld en persoonlijke gegevens veilig zijn. Bovendien hebben we de klantenservice en uitbetalingssnelheden geëvalueerd, zodat u een probleemloze ervaring kunt hebben.

  • Betcity: Een uitstekende keuze voor tafeltennis fans met een breed scala aan wedopties en aantrekkelijke odds.
  • Bet365: Een gevestigde naam in de gokwereld met een gebruiksvriendelijke site en een uitstekende mobiele app.
  • 22Bet: Een opkomende ster met een sterke focus op tafeltennis en regelmatige promoties voor trouwe spelers.

Live Streaming en In-Play Weddenschappen

Tafeltennis is een populaire sport die steeds meer aandacht krijgt van gokkers. Met de groeiende populariteit van deze sport zijn er ook steeds meer online wedkantoren die wedopties aanbieden op tafeltennis. Winstwijzer heeft een grondige vergelijking gemaakt van de beste tafeltennis betting sites, zodat jij als gokker de juiste keuze kunt maken.

Bij het vergelijken van de verschillende sites heeft Winstwijzer gekeken naar factoren zoals bonussen en promoties, odds en wedopties, live streaming, mobiele apps en gebruiksvriendelijkheid. Daarnaast zijn ook de reputatie, veiligheid en klantenservice van de bookmakers meegenomen in de beoordeling. Met deze uitgebreide vergelijking kun je eenvoudig de tafeltennis betting site vinden die het beste bij jouw wensen en voorkeuren past.

Mobiele Apps en Gebruiksvriendelijkheid

Tafeltennis is een razendpopulaire sport die wereldwijd miljoenen fans heeft. Het is dan ook geen verrassing dat er een groeiende vraag is naar betrouwbare tafeltennis betting sites waar sportweddenschappen kunnen worden geplaatst. Winstwijzer, een toonaangevende gids voor online gokken, heeft een grondige vergelijking gemaakt van de beste opties voor tafeltennis betting. Zij hebben diverse factoren in overweging genomen, waaronder de beschikbare wedopties, odds, bonussen, gebruiksvriendelijkheid en veiligheid.

Bij het evalueren van de tafeltennis betting sites heeft Winstwijzer gekeken naar:

  • De verscheidenheid aan wedopties, van wedden op individuele wedstrijden tot toernooien en meer
  • De competitiviteit van de odds, zodat spelers de beste waarde voor hun inzetten krijgen
  • Aantrekkelijke welkomstbonussen en promoties voor nieuwe en bestaande spelers
  • Een gebruiksvriendelijke interface en mobiele compatibiliteit voor gemakkelijk wedden
  • Veilige en betrouwbare betalingsmethoden en strikte licenties voor een veilige speelomgeving

Met deze criteria in gedachten heeft Winstwijzer de beste tafeltennis betting sites geselecteerd voor Nederlandse spelers, zodat ze met vertrouwen hun weddenschappen kunnen plaatsen.

Samenvattend kunnen we stellen dat de wereld van tafeltennis betting sites een breed scala aan opties biedt voor zowel recreatieve als serieuze gokkers. Door de uitgebreide vergelijking van Winstwijzer te bestuderen, krijgt u een duidelijk beeld van de sterke punten, bonussen en bijzonderheden van elke site. Of u nu op zoek bent naar de beste odds, live streaming, mobiele apps of aantrekkelijke welkomstbonussen, er is voor ieder wat wils. Neem de tijd om uw behoeften en voorkeuren te bepalen en maak vervolgens een weloverwogen keuze uit de top tafeltennis betting sites om uw gokervaring naar een hoger niveau te tillen.

What you eat directly affects your ability to keep moving. If you’re not keeping your bones and heart healthy, you’re not going to be able to exercise! Greens like kale, spinach, and arugula are awesome for your bones. Along with citrus fruits, fish, and nuts, these foods help your bones stay strong and durable, which is a big concern for our clients with osteoporosis.

When it comes to taking care of your heart, your diet can have a huge impact. According to Health magazine, “The risk of a heart attack climbs for men after age 45 and for women after age 55.” So as you enter middle-age, be sure to increase the presence of foods in your diet like unsalted nuts, unprocessed oatmeal, raisins, blueberries, and even dark chocolate (over 70% cacao) to help keep your heart healthy! If you have any comorbidities such as diabetes or kidney problems, be sure to check with your doctor or dietician before making any drastic changes to your diet.

3. Work on your Balance

Balance is one of the first things to go as a person gets older, and it’s one of the most crucial factors in helping you prevent falls and avoid injury. Slips and falls due to poor balance can lead to broken bones and fractures, which can be harder to recover from as you age. But if you’re diligent about exercising with the intention of improving your balance, you can maintain (and even improve) it far into your later years. As already mentioned, activities like walking regularly can help, along with activities such as Tai Chi and Yoga. And now, with everything so accessible via Zoom, you can take advantage of these types of activities right from your living room!

4. Strengthen your core

Having a strong core is beneficial at any age, but especially as you get older. Strong abs, hips and buttocks (all part of your core) help you to sit and stand more upright, prevent back and neck pain, and will help you feel stronger and more confident in just about everything that you do. In our office, our favorite core-strengthening activity is Pilates. We especially love it for folks aged 50+ because it’s easy on your joints and it helps to promote flexibility at the same time. We use specialized machines that are beneficial for folks recovering from an injury, and we’ve got Zoom classes requiring no equipment at all that people can do from home. Yet another reason to love Pilates is that it doesn’t just work your core, but your entire body. You can even do portions of Pilates in standing, which helps your balance and coordination! If you’ve never tried Pilates before, we’d love to help you get started.

5. Educate Yourself

Knowledge is power, and a lack of knowledge is one of the biggest reasons I see people decreasing their activity levels unnecessarily. People think that issues like arthritis, bulging discs, or a torn meniscus are reasons to decrease or cease certain activities altogether. But that’s not necessarily true! Most of the things I just mentioned are normal occurrences as we age, and having them show up on an x-ray or MRI is not a reason to change an activity you’ve been doing successfully for years. Plus, regular movement and exercise actually helps these problems.

If you have pain, that’s a different story. Talk to an expert who can help you figure out what’s going on so that you can quickly get back to your activities and not make your pain any worse. Whatever you do, try to avoid Dr. Google. It can send you down a rabbit hole and not all the advice you read will apply directly to you. If you’re dealing with pain that is keeping you from your favorite activities, reach out to experts like us. We offer a FREE 30 minute Discovery Session just so you can ask questions, get honest answers, and figure out if we’re the right fit for your lifestyle. 

Knee Pain while Running? Don’t Blame Arthritis

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Knee Pain while Running? Don’t Blame Arthritis

Is running bad for your knees? Does it cause arthritis?

We get asked these questions a lot, especially by clients who are in their 50s and 60’s and wondering if it’s safe to keep running.

The short answer is no — running is NOT bad for your knees! If you experience knee pain while running, it’s not that you’ve “aged out” of the sport or that it’s causing arthritis in your knees. This is a very common misconception. In fact, research supports that running may actually be GOOD for your knees!

Staying strong, active, and mobile is your best defense against osteoarthritis.

Therefore runners, because they are typically active and healthy individuals, often have healthier knees compared to non-runners.

Ok then — so if not arthritis — what really causes knee pain in runners?

In most cases, it’s simply a biomechanical issue that goes unaddressed over time. But the GOOD news is that once identified, these issues can actually be fixed with proper education and strengthening (best offered by movement specialists like us!).

Here are three of the most common factors we see that cause knee pain while running:

 

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can impact your knee. If your ankle doesn’t move fully, freely, and adequately, excess forces will be shifted up to your knee. The knee may be forced to flex, rotate, and/or tilt more than it needs to. This, in turn, may result in unwanted loads that the tissues of the knee can’t handle. An expert in biomechanics and movement can not only help you identify if this is the true root of your “knee problem,” but can also help you improve your ankle mobility. This will help prevent long term damage to the joints, tendons, and ligaments in your knees. We actually see this as a very common problem. Specifically, in those that have sprained or twisted their ankles in the past. If that’s you, this could be a reason why you’re suffering from knee pain while you run.

2) Weakness in your hips and thighs

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing good, balanced strength in your hips and thighs is critical. The hamstring and quadriceps muscles play a crucial role in stabilizing the patella, otherwise known as your kneecap. Since running is extremely repetitive on your joints, especially your knees, it requires they have good durability and endurance — something that is lost quickly when you neglect proper strength training. Often “wear and tear” in your knees (otherwise known as arthritis) will get blamed for your knee pain when in actuality, the loss of strength around your knees is what’s causing that wear and tear to feel worse than it needs to.

3) Unstable core

It may seem like running is all in the legs, but the stability of your pelvis and trunk have a huge influence on how your legs perform. You derive the majority of your power, speed, and stamina from your core muscles and glutes. Much like with ankle mobility, if your core is not performing adequately or efficiently – your legs will have to work harder. A stable core is key for developing and maintaining good balance and rhythm with any activity – but especially running.

With a repetitive activity like running, efficiency and form is everything. Without a strong core, it’s impossible for your leg muscles and knee joints to work as efficiently as they were designed to. It will be really difficult for you to maintain good and proper running form. When your core strength is weak, and doesn’t have enough endurance to sustain the amount of miles you want to run, your knees will suffer.

What’s important for you to remember is that arthritis is NORMAL — everyone gets it as they age. 

What doesn’t have to be “normal” is for arthritis to stop you from running, or doing any other activity that you love. You can get surgery to fix the “wear and tear” in your knees, or injections to decrease the inflammation, but if you don’t check and address any underlying biomechanical issues, these fixes will be temporary and your knee pain will keep coming back. And worse… they could force you to stop running all together!

If you’re local to Portsmouth, NH and suffering from knee pain that’s starting to impact your ability to run or do any other activity that you love, you might want to consider speaking to one of my specialists.

In this FREE Discovery Session you can tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

CLICK HERE to request a free discovery session.

Dr. Carrie Jose – back pain specialist and Pilates expert – owns CJ Physical Therapy & Pilates in Portsmouth, NH.

Is Running Bad for Your Knees when you’re Over 50?

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Is Running Bad for Your Knees when you’re Over 50?

This is a question we get asked a lot — especially by patients at our specialized physical therapy practice in Portsmouth, New Hampshire — who are getting older and worried that they won’t be able to keep running into their 50s and 60’s.

The short answer? No!

If you experience knee pain when you run, it’s not that you’ve “aged out” of the sport! It’s probably just a biomechanical issue that can be fixed with proper education and strengthening (best offered by a specialist physical therapist).

In fact, research supports that running may actually be GOOD for your knees!

Here are some factors that could be responsible for knee pain when you run:

1) Poor ankle mobility

Ankle mobility affects the way force hits your foot, which can in turn impact your knee. According to Trail Runner Magazine, “if your ankle can’t move adequately, then excess forces are shifted up to the knee. The knee may be forced to flex, and/or rotate, and/or tilt more than it should. This may result in loads that the tissues of the knee can’t handle.”
A physical therapist can help you improve ankle mobility in order to prevent long term damage to the joints, tendons, and ligaments of your knees. This might be especially important for you if you’ve ever sprained or twisted an ankle in the past!

2) Weakness

There’s a widely perpetuated myth out there that runners don’t need to strength train. That’s simply not true! Adding strength training to your running regimen makes it way less likely that you’ll suffer an injury. When it comes to protecting your knees, developing strong lower limb muscles is critical. The hamstring and quadriceps groups play a crucial role in stabilizing the patella, otherwise known as the kneecap. Running is an extremely repetitive action and consequently requires durability and endurance from your joints — something that is lost quickly when you neglect strength training.

3) Unstable core

It may seem like running is all in the legs, but in reality, every physical action begins at the core. You derive all your power, speed, and stamina from your core muscles, and if they are weak, all your joints suffer — especially your knees. A stable core is key for maintaining balance and rhythm. It also keeps your weight distributed between your legs and prevents undue stress from resting on your knees.
Our favorite way to improve core strength is Pilates! If you are a runner but think you could benefit from a stronger core (let’s be honest, we all could), consider giving it a try — for FREE.

4) Running form

It doesn’t matter if you’re a marathon runner or an occasional jogger — running form is important. It determines where and how the impact of every step is distributed throughout your body. If your body mechanics are compromised — for instance, you’re dragging your feet or running with your shoulders tense and shrugged — you’re more likely to suffer from chronic knee pain, or even experience a serious injury. Work with a movement specialist – like the PT’s in our office – to analyze your form and help you be more efficient when you run.

Running is good for you at any age, if you do it right!

Research shows running can actually slow knee arthritis. According to an article published by Outside Online, “animal models show that exercise promotes cartilage thickening and protects its stretchy properties… instead of wearing down your bearings, running may grease them. That’s key, because cartilage thinning and the loss of elasticity are both prominent causes of osteoarthritis.”

Want to make sure you’re running right? Get in touch!

If you are local to the Seacoast region and considering physical therapy in Portsmouth, NH – you can schedule a FREE Discovery Session if you have chronic knee pain (or any type of pain) to talk about what you’re dealing with and figure out the course of action that works best for you.

You’ll get the opportunity to tell one of my specialists everything that’s been going on with you, and determine for yourself if we’re the best people to help you. It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health – whether that’s working with us or not!

Looking for more information on Knee Pain? – Download our free guide “7 Ways to Stop Knee Pain” 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].

Setting Goals for the New Year: Part One – What to address FIRST?

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New Year’s may still seem pretty far away, but if you plan on setting any resolutions or goals for 2019, you should start now. The earlier you set your goals, the more likely you are to achieve them. But choosing meaningful and positive goals is a process. That’s why we’re launching this four-part blog series to be your guide as we head into the end of 2018!

The first step is identifying what you want to change – FIRST.

A typical New Year’s resolution might be to lose weight or be more active. But before you can address those goals, it’s important to take a quick inventory of your body and identify obstacles that might get in the way.  The last thing you want is to get all excited about a goal, only to have those aspirations quickly deflated because you neglected to see the whole picture.

Let’s take the weight loss goal for example. Coming from a physical therapist’s point of view, that might mean asking yourself, “what hurts?” or “what has physically been bothering me?”  What are one or two things that could possibly get in your way of completing this goal?  Maybe your body is feeling great, you could still be struggling on other levels. It’s important to be honest with yourself and identify anything and everything that could be an obstacle to your goal. Once you can recognize and become aware of this issue, you have the opportunity to resolve it!

But how do you do that?  First, you have to get specific. For example, if you want to address your back pain in the New Year, so that you can be more active and lose weight in 2019, it’s not enough to simply say “I have a problem with back pain.”  When we get specific, we are able to take what may seem like a big, overwhelming problem – and turn it into bit size actionable chunks….

Start with focusing on the what, when, where, and why of the problem.

“Back pain” in itself is a general term. It’s more likely that instead of your entire back hurting at the same level all the time, you have a specific area (or areas) that hurts during specific activities. For instance, your “what” (the specific problem at hand) could be low back pain. The “when” could be in the evening after a long day on your feet. “Where” could be your living room when you’re trying to get up off the couch, or the golf course after a swing. “Why” could be a combination of factors that are causing you to experience the pain. For example, your body mechanics might be off to the point where it’s causing degradation of your vertebrae. Learning to move properly (for instance, with a physical therapist) would be a logical way to address that “why.”

Next, write down your focused description of the problem.

The simple act of writing something down will clarify and solidify your intentions. In this example, we started with the general statement “I have a problem with back pain.” We broke that down into parts, so that now you might say:

“I am experiencing severe low back pain. It typically occurs in the evenings after I’ve spent a long day on my feet, particularly when I’m moving from sitting to standing. This is likely a result of poor body mechanics, as I have never been instructed in proper movement to relieve back pain. This is the issue I intend to resolve so that I can be more active in 2019 and lose 20 lbs.”

Our next blog post will consider this series and discuss how to set a specific long term goal.

Stay tuned for this post coming out on 11/20! In the meantime, you may want to consider how physical therapy could help you in improving your overall health this upcoming New Year. You may not have a specific physical complaint like the one we described in this post, but working with a physical therapist can actually help you PREVENT these issues from arising later on! As we continue to age, it becomes more likely that we will experience back pain and numerous other issues. The great thing about PT is that it strengthens your body in all the right ways to guard against joint degeneration, stiffness, achiness, muscular weakness, and loss of balance (just to name a few benefits).

If you want to know if one of our specialists can help you, apply for one of our FREE Discovery Visits right here in Portsmouth!