Tag Archive for: knee pain

Is running bad for your knees?

Turns out – Running isn’t Bad for your Knees

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].

pain

Your Pains Location May Not be it’s Source

Pain is both a confusing and scary topic.

There’s lots of advice out there on what to do when you experience pain and it’s hard to know who to listen to. Should you rest – exercise – apply heat – apply ice – see a doctor – get an MRI – or just wait it out to see if it goes away on its own? Any or all of this advice could be right – but it’s irrelevant until you accurately determine where your pain is coming from.

For example, if you have pain in your knee, and it’s coming from your back, the best knee treatment in the world isn’t going to fix it. Inaccurate diagnosis of pain is one of the most common reasons why so many people suffer longer than they need to, and it’s one of the biggest contributors to unnecessary procedures and surgery. You must accurately determine the source of your pain for treatment to be effective. And the location of your pain, alone, is not a reliable way to figure that out.

Let me explain.

I’ve met people who’ve suffered from unrelenting tennis elbow for years – despite treatment protocol after treatment protocol – only to find out it was coming from their neck. I’ve met people who’ve undergone major knee surgery and it failed – only to find out later they never actually had a knee problem. Isolated extremity pain (knees, elbows, shoulders) is one of the most mis-diagnosed problems in the musculoskeletal world. In a study published in the Journal of Manipulative Therapy, they found that over 40% of people suffering from isolated extremity pain had a spinal source responsible for their symptoms, even when there wasn’t any spine pain. In other words, the pain they were feeling in their knee, elbow, or shoulder was actually coming from their back or neck (respectively).

Confused? I don’t blame you.

But more importantly, how do you reliably figure out the source of your pain when it’s not always where you’re feeling it?

As already mentioned, the most common place for this to happen is with extremities. If you’ve got shoulder, elbow, or knee pain, and you don’t recall having a specific injury to it, you must consider that it could be coming from your spine. There’s a 40% chance that it is. Where this gets really confusing is that typically, when you’ve got isolated knee or shoulder pain that won’t go away, your doctor will order an MRI. And if you’re over 40 years old, the MRI will almost always show “something”. It could be a torn rotator cuff, torn meniscus, arthritis, or wear and tear. But what most people don’t realize is that these findings are quite normal and happen naturally as you age.

Just because they show up in your MRI – doesn’t mean they are responsible for your pain. Despite the science proving this over and over – doctors continue to order these tests and rely on them to make important decisions about treatment. It’s how people end up undergoing unnecessary procedures or surgery – they let images and an inaccurate diagnosis lead the way.

Whenever I meet someone with isolated extremity pain, especially if it came on suddenly and out of nowhere, I always consider that it could be coming from their spine.

How can you figure this out?

Well, it’s challenging to figure it out on your own. But if you work with a movement specialist who understands this concept – you’ll be able to figure this out accurately. The basic premise is that if you can move your spine in specific directions – repeatedly – and influence the symptoms you feel in your extremity – then there is a very good chance your problem is coming from your spine. Or at the very least, your spine is involved. And whenever your spine is responsible solely or partially for pain elsewhere – and it’s ignored – your problem will persist and likely get worse over time if it’s not addressed.

Moral of this story… If you’ve had pain in one of your extremities for a while now, and it’s not going away, it’s possible you’ve missed the source, and that where your pain is may not be where your problem is. And if you’re considering some kind of surgery or procedure, you definitely want to rule out that the problem could be elsewhere.

Specialized movement exams are one of the most reliable ways to figure this out – studies have proven it. If you’ve had unexplained pain in your elbow, knee or shoulder that isn’t going away, look for someone who understands this and can give you a proper movement exam to accurately identify the source of your pain.

Looking for help and local to Portsmouth, NH? Click here to speak with a specialist.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, or get one of her free guides to knee and back pain, visit www.cjphysicaltherapy.com or email [email protected].

Pain when gardening

Six Ways to Protect your Knees and Back when Gardening

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

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

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

1. Warm up first

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

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

2. Avoid bending from the waist

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

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

3. Take frequent breaks

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

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

4. Pivot instead of twist

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

What does this look like?

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

5. Use ergonomic gardening tools

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

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

6. Use beds to raise your gardens

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

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

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

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

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

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

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

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

Click here to speak with a specialist.

golf injuries

Five Common Golf Injuries and How to Avoid Them

Golf is a beloved passion enjoyed by millions around the world, and the season has officially begun here in New England. Let’s talk about golf injuries. Most golfers won’t let anything get in the way of tee time – but when you’re dealing with back, knee, elbow, or shoulder pain – playing 18-holes is just not as fun.

An injury of any kind during golf season not only impacts your performance – but it keeps you from enjoying the game to the fullest.

Your buddies are walking the course while you have to drive the cart… Instead of focusing on your swing, you’re thinking about your pain and whether or not you should push through it…

The good news is that with the right knowledge and preparation, you can avoid some of the most common injuries impacting golfers.

Here are five of the most common golf injuries and what you can do to avoid them:

1. Back Pain

Back pain is the most common injury to plague golfers. Repetitive bending and twisting is a well-known source of back problems – and that’s literally all you’re doing when you play golf. While practicing proper swing mechanics can help, it might not be enough.

If you lack adequate mobility in your spine, for example, the best swing in the world won’t compete. It’s important that you take time to optimize and maintain good spinal mobility during golf season.

Stretching backwards regularly, and avoiding excessive sitting during the day, are two things alone that could make a huge difference in your back mobility – and pain – and help you to get through golf season injury-free.

2. Elbow Tendonitis (Golfer’s Elbow)

Golfer’s elbow occurs when the tendons on the inside of your elbow become inflamed from the repetitive swinging motion of the golf club. Once again, good swing mechanics can go a long way in preventing this from happening. But it’s also important to consider what’s happening above and below your elbow joint.

If you’ve got a weak rotator cuff, or weak and stiff wrists for example, your elbows will experience added and unwanted strain when trying to do something like swing a golf club. It’s important that you perform regular conditioning of these areas (both mobility and strength) during golf season to keep your elbows from suffering the consequences.

3. Knee pain

Between walking 18 holes, and the repetitive twisting that happens at your knee when you swing a golf club, there’s the potential for lots of stress (and injury) through your knee joints.

If you lack adequate mobility or stability in and around your knees, you could develop pain as the season goes on. The power in your golf swing should come from your hips and core, not from your knees (or back). If they aren’t very strong, your knees could take the brunt and eventually suffer.

Much like the elbow, the most common source of knee pain comes from the joints above and below, and not necessarily from the knee itself. To keep your knees mobile and healthy, and prevent them from getting overstressed during golf season, it’s important that you take measures to optimize the strength in your core and hips, as well as the stability in your feet and ankles.

4. Rotator cuff (shoulder) Injuries

Another common injury for golfers is strain, tendinitis, or impingement of the rotator cuff. Your shoulder is the most mobile joint in your body, and the rotator cuff’s job is to provide strength and stability to your shoulder joint. If it’s weak, or compromised in any way, you could eventually see problems during golf season.

There’s quite a bit of stability required from your shoulder joint to withstand the acceleration and deceleration forces that come with a golf swing. The repetitive swinging of a golf club could take a rotator cuff on its last leg and push it over the edge.

As mentioned several times already, work on your golf swing. But given you don’t want your shoulder girdle or rotator cuff bearing all the strain, you have to make sure your core is strong, as well as your mid back muscles and upper thighs and hips.

This group of “powerhouse” muscles will give you a stable foundation so the more distal areas of your body (knees, elbows, and even shoulders) don’t get injured from having to work so hard.

5. Wrist and Hand injuries

Wrist and hand injuries – such as sprains, strains, and even fractures – are also quite common in golf due to the gripping and twisting of the club.

Using proper grip technique when holding your club is paramount, but you’ll also want to make sure the club you’re using isn’t too heavy or long. And as mentioned previously, make certain you’ve got a strong and stable shoulder girdle, because much like the elbow, your wrists can compensate for weakness above the chain.

But one overlooked area when it comes to wrist and hand problems is your neck.

Did you know that 47% of upper extremity pain (including wrists and hands) can come from a source in your neck?

An underlying neck problem could be the cause of your weak hands and wrists, if this is the case, working on grip strength will not make a difference. You must first resolve what’s going on in your neck.

Hopefully these tips help you to understand why golf injuries happen and most importantly, how to prevent them.

If you try these tips and are unsuccessful, then it might be time to talk to an expert who can help you work through these aches and pains so you can be back on the course in no time.

Are you dealing with pain now and local to Portsmouth, NH?

Consider talking to one of my specialists for free. Tell us everything that’s been going on with you, and determine for yourself if we’re the best people to help you. CLICK HERE to speak with a specialist.

tendinosis

Why the Difference between Tendinitis and Tendinosis Matters

Tendinitis and Tendinosis: Why the Difference between them Matters.

Many patients at our specialized physical therapy practice in Portsmouth, NH, suffer from either Tendinitis or Tendinosis. Tendinitis and Tendinosis sound very similar, and are often used interchangeably but they couldn’t be more different. And neither should their treatment regimen.

Tendonitis is an acute, short-term, inflammatory condition typically caused by repetitive overuse of your tendon.

Tendinosis, on the other hand, is a chronic, degenerative condition of your tendon that involves deterioration of collagen, a structural protein in your tendon.

Tendons are tight, yet flexible bands of fibrous tissue that connect your muscle to bone. Without tendons, your muscles would be useless. Tendons are extremely organized, and the fibers are designed in a way to withstand and transmit high forces of tension so your muscle can function properly.

With tendinitis, your tendon becomes inflamed and irritated, typically due to repetitive overuse, and it will hurt when you try to move. The most common areas for tendinitis to occur are your elbows, rotator cuff (shoulder), patella (knee), and Achilles tendon (ankle).

Tendonitis is an acute condition, and the best treatment is to rest, apply ice, and sometimes take anti-inflammatories to control pain. But this should only be for a short period of time. From there, you want to figure out what caused the tendinitis to occur in the first place and address that.

Typically, it’s due to some sort of mismatch between muscle strength and the activity you need to perform, leading your body to compensate and put unwanted stress on your tendon. Once you figure out and correct this pattern, it’s very easy to get rid of your tendinitis.

When you don’t manage tendinitis properly, and it goes on longer than a few months, it can result in tendinosis.

Tendinosis is a very different condition where the fibers in your tendon actually start to break down. An important thing to note is that tendinosis no longer involves inflammation of your tendon. So using ice every day, resting it, and taking anti-inflammatories will not help you, and could even worsen the condition.

Second, since tendinosis involves disorganization and degeneration of the fibers that make up your tendon, you have to “re-organize” those fibers and get blood flowing to the tissue (actually create some inflammation). Unresolved tendinosis leads to progressive weakening of your tendon over time – making it easily susceptible to full blown tears. This is how so many folks tear their Achilles or rotator cuff, for example, “out of nowhere”.

So how do you treat tendinosis and prevent more serious problems from happening down the line?

You have to get blood flow to the area and re-organize those fibers so your tendon can work properly again. Passive treatments like ice, rest, and medicine will not help tendinosis.

The only exception is shockwave therapy (also known as Extracorporeal Pulse Activation Technology).

With shockwave therapy, high-energy sound waves stimulate the body’s natural healing mechanisms by increasing blood flow to the injured, affected area. The increased blood flow delivers oxygen and nutrients to the damaged tissue to help accelerate healing and reduce inflammation.

With pain reduced and the healing process promoted, your tendon is now primed for physical rehabilitation and re-organization of the tendons, the next most essential part of getting rid of your tendinosis.

The only way to truly re-organize tendons is to put stress on them so they can “remodel”. To do this, you have to put just the right amount of stress to cause a little bit of pain (inflammation) – but not so much that your tendon gets inflamed again.

This is literally one of the few times where “no pain no gain” actually holds true. A properly trained physical therapist who is well-versed in tendinosis rehabilitation will know how to do this and can guide you through it.

You have to retrain the fibers in your tendon to withstand normal forces again – and this process takes both time and careful loading strategies.

The good news, however, is that if you rehab your tendinosis properly, you can get back to all the activities you love again as if nothing ever happened. You don’t have to accept this as a chronic condition.

If you’re confused on tendinosis and tendinitis after reading this don’t worry – so is half the medical community.

The take home points to remember are that tendinitis involves pain and inflammation. There is no damage to your tendon, and it only lasts about 4-6 weeks.

Treatment for tendinits should involve passive modalities like ice and rest. The focus should be on what caused your tendon to get irritated in the first place. Then, you can get rid of it before it turns into tendinosis.

If the problem in your tendon has gone on longer than 3 months, you must suspect tendinosis. This no longer involves inflammation but instead, a breakdown of your tendon. Passive treatments (with the exception of shockwave therapy) will not work. They could actually prolong your problem – so stop icing and resting.

To get rid of tendinosis, it requires carefully prescribed loading strategies, aka strengthening. That will properly re-organize your tendon so that it can be strong and functional again. This is extremely challenging to do on your own.

So it’s a good idea to talk to an expert about this. If you are local to and looking for physical therapy in Portsmouth, NH, reach out to schedule a FREE 30 minute discovery session.

knee pain source

When Knee Pain Doesn’t Go Away – Consider your lower back.

One of the most important things to get right when it comes to successfully resolving knee pain is to correctly identify the knee pain source.

Is your knee pain actually due to a problem in your knee? Or is the root cause of your knee pain coming from somewhere else in your body?

Rosedale, et al published a study in 2020 that revealed 43% of all isolated extremity pain was coming from the spine. What that means is that you could have nagging knee pain, and no back pain at all, and your knee pain is the result of a lower back problem. I’m not going to get into the technicalities of how this happens. Generally speaking, it’s a mechanical problem in your lower back that causes irritation to nerves or structures that impact your knee – and only your knee.

But how do you know for sure?

One of the biggest clues you’ve missed the root source of your knee pain is that it doesn’t go away after trying everything that “should” help it. Perhaps you’ve tried ice, heat, pain medication, foam rolling, strengthening, and stretching. Even physical therapy – but no matter what – your knee pain just won’t go away. It might get better for a short period, but it always comes back. If the lower back is not considered at this point, then it’s typically when knee doctors get involved. This is great if you’ve actually got a knee problem.

Knee pain that doesn’t respond to conservative treatment should be looked at further. But if your knee pain is a symptom of a problem in your lower back, and it’s missed, you risk having an unnecessary knee procedure or surgery that will only cause you more problems later.

Here’s a quick story about someone this happened to…

I spoke to a client the other day – we’ll call him “David”. He had surgery on his knee to clean out some cartilage and wear and tear from arthritis. They recommended this surgery because he had “failed” regular physical therapy treatment. Nothing else seemed to be resolving his knee pain. It was supposed to be a “quick recovery” and take his pain away because they assumed all his problems were due to arthritis. Well, three months later, Davids knee felt (and functioned) worse than pre-surgery. Now he had back pain to go along with it. To fix the new pain he was having they were recommending even more knee surgery. And now they wanted to do an MRI of his back.

How does something like this happen?

The biggest culprit is over-reliance on imaging to form a diagnosis and treatment plan. Leading you to have the wrong idea of your knee pain source.

If you’re over 50, and you get an X-ray or MRI taken of your knees, there is a 60 to 80% chance they’ll find arthritis and/or meniscus (cartilage) tears. And this will be whether you have knee pain or not. That’s because these are normal changes that occur as you age.

So if you’ve got knee pain, and your doctor wants to do some imaging, there is a very good chance they’ll find one or more of these changes in your knee. They might just blame your knee pain on it without looking at anything else. That’s exactly what happened to David. They blamed knee arthritis for his knee problem when it was actually coming from his lower back.

How do I know?

Luckily for David, he refused the second knee surgery. He went to a mechanical pain expert for diagnosis and treatment, and in 2 months both his knee and back pain were gone.

Do you have knee pain that won’t resolve with typical knee pain treatment? You must consider that it could be coming from your lower back before you undergo any kind of surgery or procedure.

If your knee pain seems to come on slowly or out of nowhere, if you have trouble pinpointing exactly where the pain is, if it moves around and changes from day to day, or if it runs up or down your leg – there is a good chance your knee pain is a symptom of a mechanical problem in your lower back and you should get it looked at.

Knee Pain

Knee Pain? Top 3 Causes and What You Can Do.

Knee pain impacts one-third of all Americans, and annoyingly interferes with activities of daily life. Such activities could be as simple as walking, squatting, going up and down stairs, and getting in and out of the car. This is in addition to the multitude of recreational activities knee pain can impact.

It’s the second most common complaint behind back pain when it comes to musculoskeletal problems. It’s one of the most common complaints I still hear about that started or worsened during the pandemic.

But what if there was a way to address some of the most common causes of knee pain on your own – without procedures or surgery?

Here are three of the most common causes of knee pain I see and what you can do to resolve it – naturally:

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 this is just below or behind your knee cap. With PFS, the source of the pain typically comes from unwanted pressure around your knee cap. This will eventually results in inflammation and pain.

It’s very tempting to just get a cortisone shot or take pain pills to quickly reduce the inflammation and relieve your pain. But the problem with this approach is that you’re only putting a bandaid on symptoms. Inflammation is the result of an angry kneecap – not the cause. What you need to figure out is what is causing your knee cap to get angry in the first place.

Typically, PFS is the result of an imbalance somewhere in your body, typically from poor form and movement habits. Over time, this ultimately causes more pressure at your knee cap. If your hips, quads (front of the thigh), and hamstrings (back of the thigh) aren’t balanced and working together, for example, you could end up with problems with the way your knee cap tracks and functions. This will make your knee cap angry and inflamed over time.

When you figure out the true culprit behind the pressure and inflammation at your knee cap, you’ll not only be able to resolve and manage PFS naturally and for the long-term, but you can avoid temporary band-aid treatments.

2. Iliotibial band syndrome

The causes of iliotibial band syndrome are very similar to that of PFS. Except that your pain and symptoms will be experienced on the side of your knee instead of the front. Your iliotibial band (ITB) is a large 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 the tensor fascia latae (TFL). When your TFL gets overworked, your ITB suffers. It 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. While these are great modalities to relieve your symptoms, they don’t 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

This is a very hot topic and everyone wants to know if they have it. (Spoiler alert – if you’re over the age of 50 – you already do.) Osteoarthritis happens naturally over time and is a normal part of aging. The problem with arthritis is that it only gets paid attention to when you’ve got pain. Then it gets blamed for all your problems. Arthritis certainly plays a role in your mobility and quality of movement. But it’s not the “death sentence” that many make it out to be. Many people find out they have osteoarthritis in their knees and think they have to just “live with it” or get a total knee replacement.

Remember, arthritis is normal and it happens to everyone as they age. What is not normal is for you to think you’re helpless or have to avoid your favorite activities because of it.

Arthritis occurs when the protective cartilage that cushions the ends of your bones wears down over time. There isn’t anything you can do to reverse this process. But, 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 and hip strength. As well as good flexibility in your hips and ankles. If anything is off in these areas, your knees will want to compensate. This could result in compression at your knee joint and aggravation of your arthritic symptoms.

There is no need to rely on pain pills, or believe that procedures and surgery are your only options when it comes to knee pain.

As you can see, three of the most common causes of knee pain are due to – or influenced – by movement problems. Therefore, movement should be your go-to solution – not something you avoid.

If you’re having difficulty using movement as your solution and you want to contact a movement expert who understands mechanical knee pain and can diagnose the root cause of your knee problem – consider speaking to one of my specialists!

In your free Discovery Session we will ask you all about what’s been going on & see if we would be a good fit to help you. Book your free discovery session HERE.

tendinitis and tendinosis

Why Cortisone Shots Often Fail in the Knee

When you’ve got nagging, persistent knee pain, it’s common for doctors to recommend a cortisone shot in the knee.

A cortisone shot in the knee, also known as corticosteroid injections, or “steroid shots”, works by reducing inflammation in your knee joint in an effort to alleviate pain. Sounds pretty straightforward, right?  Well… not so fast.

Assuming your knee pain is truly due to inflammation, then yes, a cortisone shot can be a successful treatment option. For example, it’s often used as a pain management strategy when you’re awaiting a major joint replacement surgery.

Advanced osteoarthritis is a common cause of knee inflammation.  The only real “cure” for this is joint replacement. Periodic cortisone shots may help give you the pain relief you need to pass the time until surgery. But this is a very specific and not common circumstance.

What we see more often than not is cortisone shots either working temporarily, or not working at all in your knee joint.

Patients are often told they need up to three cortisone shots to see results. There’s a problem with this approach. Every time you get a cortisone shot, you risk damaging the cartilage and tissue in your knee joint. This not only leads to irreversible joint damage, but more persistent pain in your joint that gets harder and harder to fix.

So when it comes to whether or not you should get a cortisone shot in your knee – you really want to make sure that the root source of your problem is inflammation.

The reason why so many cortisone injections “fail” is because quite often – they weren’t needed in the first place. Even though the knee pain you are experiencing might be due to inflammation, the underlying cause leading to that inflammation could be something else entirely. Eight percent of the time the knee pain you’re experiencing is due to a mechanical or movement problem.

So while the symptoms you’re experiencing could be inflammatory in nature, the root cause of your issue is not. A cortisone shot is not going to help your knee in this case. Or worse, you’ll get temporary relief that fools you into thinking it worked. This only delays treatment that will give you the long-lasting relief you’re looking for.

So how do you know if you have a true inflammatory problem in your knee?

Let me explain.

Let’s say you have some arthritis and general wear and tear in your knee joint. You have good days and bad days. The pain comes and goes. Certain movements and exercises make your knee feel better while others seem to really aggravate it.

This is a pretty classic presentation of a mechanical knee problem. The mechanical issue (aka movement problem) in your knee can irritate certain structures within your knee joint (like a meniscus or ligament) and cause it to be inflamed.

If you go ahead and just inject cortisone into this knee, it might relieve the inflammation for a short time. It won’t help the underlying movement problem. It’s only a matter of time before the cortisone wears off and the structures in your knee feel irritated again. Not only have you masked the problem, but now you risk creating actual damage to those structures from the cortisone. Studies have shown that repeatedly injecting cortisone into your knee (or any joint) can advance the formation of osteoarthritis.

Another interesting statistic is that 41% of knee pain has been shown to be coming from your spine – even when there is no back pain present.

In this case, your knee could really hurt and appear to be inflamed. If a doctor can’t find any real explanation for this from an X-ray or an MRI (because the real problem is coming from your spine), he or she may assume it’s just inflammation from wear and tear and suggest a cortisone shot. This is not going to help your knee. Once again you risk causing real damage to an otherwise healthy knee joint.

These are just a few examples of where cortisone shots are unnecessary and can go wrong when incorrectly prescribed.

Have you recently had a cortisone shot in your knee and it didn’t work? It could  be that you never actually needed it. Or that the symptoms (inflammation) was being addressed instead of the underlying cause.

If you are considering a cortisone shot in your knee, it’s always a good idea to get a second opinion to make certain you really need it. A mechanical pain expert can tell you whether or not your knee pain is truly due to inflammation. If your knee pain is due to a movement problem (80% of time it is) then a proper movement prescription is your answer.

Are you local to Portsmouth, NH and looking for help with your knee pain NOW?

Consider speaking to one of my specialists.

Tell them about your knee pain and they’ll see if we would be a good 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 request a free copy of her Knee Pain Free Report CLICK HERE  or to get in touch, email her at [email protected].

skiing

Four tips to Protect your Knees and Avoid Injury when Skiing

Skiing can put a lot of stress on your knee joints and if you’re not careful – lead to pain and injury.

Your knee joint requires both mobility and stability to function well. It’s important for your knee joint to be mobile enough to allow for a full range of motion. But, it also needs to be stable enough to support your body weight and absorb the forces that come with everyday activities. When it comes to skiing, mobility is going to protect your knees when you fall, and stability is going to keep your knees feeling strong as you twist and turn down the slopes. Maintaining a balance between mobility and stability is crucial for knee joint health in general. It certainly is crucial when it comes to skiing.

Here are four tips to help protect your knees and avoid injury when skiing:

1. Warm up before hitting the slopes.

When you take the time to stretch and warm-up your muscles before skiing your knee is not only going to feel better, but be better equipped to handle the stress of the day. Warming up helps to increase blood flow to your muscles and improve your strength, endurance and agility on the slopes.

When warming up, choose exercises that take your knee, hips and ankles through full range of motion. Plus – if skiing is a day trip for you, you’ve likely just sat in the car for an hour or more. Prolonged sitting puts extra stress and compression on your knee joint, especially in the front of your knees. Warming up your knees can help relieve this added stress on your joints before you hit the slopes.

2. Strengthen your upper leg muscles and core

Having good strength of your upper legs and core can help improve both the stability and alignment of your knee joint – which is important during skiing.

Your knee joint is surrounded by a complex network of muscles, ligaments, and tendons. When the muscles around your knee joint are weak, imbalanced, or simply not functioning well – this will cause your knee to move in ways that add extra stress to your joint. Given the stress skiing already adds, you don’t want to make your knee work any harder.

Strengthening your core and upper leg muscles will improve the alignment of your knee during activity, reduce the risk of injury, and improve the overall function of your knee – which can only help you when skiing.

3. Keep your Knees Mobile

Full and free mobility of your knee joint is important. It helps maintain the health of your joint and surrounding tissues.

When your knee (or any) joint doesn’t move well, you will get added stress on your ligaments, cartilage, and tendons. Your knees need to bend all the way so you can squat and pick things up.  They need to straighten all the way to give you stability when needed. When either of these motions are lacking – your knee joint suffers.

When it comes to skiing, if your ligaments and surrounding tissues are already stressed due to lack of mobility in everyday movement – they will certainly not be happy when you add the stress of skiing. Having a good mobility routine for your knees as a preventative activity is important. It’s going to really pay off when you go to hit the slopes each ski season.

4. Talk to a mechanical pain expert

70% of all knee pain is going to be mechanical in nature. Everything I’ve already described above is going to help you deal with mechanical movement faults that might be happening in your knee joint. But occasionally, despite all your best efforts, you need help from someone who specializes in mechanical joint pain.

Mechanical joint pain responds very well to what we call “corrective movements”. When you know what specific movement your joint needs to feel better, it literally acts like a prescription medication. You can use that movement any time you want to help relieve knee pain on your own. This is particularly advantageous when you’ve gone a little overboard on the slopes. You can “fix” your knee and be ready for the next day.

If you’ve already tried many of the strategies I mentioned, and continue to have knee pain when you ski, it might be worth visiting a mechanical pain expert to help set you on a customized path to preventing knee pain and avoiding an injury that requires more invasive intervention down the line.

It’s more fun to focus on the ski day ahead than worry about whether or not your knee joints can handle it.

I hope these tips help you to not only enjoy what’s left of ski season – but help you have healthier knees in general to keep enjoying all of the activities you love.

Local to Portsmouth, NH and need help with your knee pain NOW?

CLICK HERE to request a Free Discovery Session with one of my Specialists. They’ll ask you all about what’s been going on – and figure out if we would be a good fit to help.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth. To get a FREE copy of her guide to knee pain – CLICK HERE

Failed Knee Surgery

Knee Surgery Gone Wrong? It’s More Common Than You Think.

Arthroscopic knee surgery is 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.

Science tells us that people who do undergo arthroscopic knee surgery are likely to have knee arthritis that advances rapidly. This results in a total knee replacement that you could avoid.

Arthroscopic knee surgery is a minimally invasive procedure that’s commonly done to help “clean out” your knee joint. It’s done 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?

Well… it is until it isn’t.

The big problem is that arthroscopic knee surgery is not necessary for most cases of knee pain.

If there is a complication – which there are many even with “minimally invasive” procedures – you could end up being worse off than when you went in.

Plus – if you never even needed the surgery to begin with – you just put your knee through unnecessary trauma that you’ve got to now heal from. This further delays you from addressing the root cause of your knee pain.

The truth is that most people can get full relief of their knee pain as well as full restoration of knee function without any type of surgery or procedure. This is true for 70% of all knee pain cases.

An early research study from 2002 by JB Moseley and colleagues, and published in the New England Journal of Medicine, revealed that placebo surgery for advanced knee arthritis was just as effective as actual arthroscopic surgery.

Since then, numerous studies have proven similar results. This means that even if you have a torn meniscus or degenerative arthritis in your knee – you can still get better naturally and with conservative treatment.

So why then – despite all this research – are surgeons still performing arthroscopic knee surgery 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 of knee pain. If you’ve gotten physical therapy and it wasn’t effective, people believe that the physical therapy “didn’t work”.

But more often than not, you just haven’t found the right physical therapist yet – someone who understands how to diagnose knee pain properly and get you the customized approach that is required to avoid surgery.

And then there’s the elephant in the room…

It’s very common for knee pain to be coming from somewhere other than your knee. Knee pain can come from your ankle, hip, or back. One study showed that 40% of the time – knee pain is caused by your back – even when you don’t have any back pain.

MRI’s add even more confusion to this. It’s entirely possible to have degenerative changes, a torn meniscus, or advanced arthritis in your knee – and still have your knee pain stemming from a source other than your knee.

Over the course of my 20 year career, I’ve seen many knee surgeries go wrong.

Most of the time, it has nothing to do with the procedure itself. It has everything to do with an incorrect diagnosis going in. Say your knee pain can be resolved conservatively. Then you put it through unnecessary trauma (surgery). There’s a good chance you’re going to have more problems afterwards. You get knee surgery when your knee problem isn’t even coming from your knee. Then you’re definitely going to have problems afterwards.

The moral of this story is to make absolutely certain that:

1) Your knee problem is really a knee problem and

2) You’ve fully exhausted all (quality) conservative therapy options before going under the knife.

Remember that 70% of all knee pain cases do not need surgery.

Science has proven this. Don’t resort to knee surgery unless you’re 100% sure you really need it. Because it can go wrong and when it does – it’s much harder to come back from then if you had avoided it to begin with.

Want help with your pain now? CLICK HERE to talk to one of my specialists for free – you can tell them all about your knee pain and we’ll let you know if we can help. 🙂

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].