Don’t wait to have that nagging pain looked at!

By: Dr Allison Hoestermann, PT, DPT


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WHY? More and more studies are showing that the longer you wait to address pain, the more difficult your condition will be to treat. The reason being: Once your body experiences pain, it will begin to compensate, thus creating further dysfunction and pain in other areas.


Musculoskeletal pain is pain that is felt on the skin or in the muscle, joints, bones, or ligaments. These structures are particularly sensitive to inflammation or swelling due their 1.) High blood flow and 2.) Relationship to movement.



A Doctor of Physical Therapy is an expert at treating musculoskeletal pain, second only to an orthopedic surgeon.1 You do NOT need a Physician Referral to see a Physical Therapist.



What to expect when you see a Physical Therapist for your pain:


  • A Physical Therapist will take a thorough medical history and ask several questions about your pain. Questions may include: Where is the pain? What is the quality of the pain? What aggravates the pain? What relieves the pain? When does the pain occur throughout the day? What impact does the pain have on your function and mood?


  • Next, the Physical Therapist will examine and evaluate the quantity and quality of movement. He/she will identify abnormalities with walking/running, assess posture, find areas of tenderness, assess joint mobility, nerve tension, motion, strength, flexibility, balance, check lifting, bending, and squat mechanics to figure out where the source of your pain may be originating.


  • They will be able to take those findings and identify where the muscles are not functioning properly and may be shut down, causing abnormal movement patterns.


  • Putting all of the pieces together, the PT will be able to make an individualized exercise plan, as well as perform manual techniques to improve movement quality and reduce dysfunction.



Research has shown that patients who went to physical therapy within 90 days of onset of low back pain avoided having an MRI, x-ray imaging, spinal injections, surgery, and prescription of opioids versus those patients who waited longer to attend PT.




  • A description of physical therapists’ knowledge in managing

musculoskeletal conditions. JD Childs, JM Whitman, PS Sizer, ML Pugia,

TW Flynn, A Delitto. BMC Musculoskeletal Disorders, 2005




Non-Operative Physical Therapy Treatment of Rotator Cuff Tears

By: Tina Memarzadeh, SPT




Rotator cuff tears affect at least 10% of individuals over the age of 60 in the United States, which accounts to roughly 5.7 million people.1, 2 An estimate of 75,000-250,000 rotator cuff surgeries are done per year, indicating that only 5% of patients with rotator cuff tears are being treated surgically.3 A number of recent studies suggest non-operative treatment of full thickness rotator cuff tears can be successful in some patients.4  Research shows that physical therapy alone can produce results equal to those produced by arthroscopic surgery and open surgical repair.



Many researchers have worked on creating an effective physical therapy protocol in treating rotator cuff tears non-operatively. Of note, is the Multicenter Orthopaedic Outcomes Network (MOON), a group of doctors from around the country focusing on research to enhance care of patients with shoulder problems. MOON shoulder group has developed a set of protocols to be used by physical therapists and at home by patients to treat non-traumatic rotator cuff tears. Study done by the MOON shoulder group demonstrated greater than 85% success rate using their physical therapy protocol, with the beneficial effects of this program lasting for a minimum of 2 years.5



The home therapy program created by MOON shoulder group is used to compliment a therapist directed program. Therapists will guide patients through a protocol which consists of three parts:

  1. Range of motion: done every day to get shoulder motion back
  2. Flexibility: done every day to stretch tight tissues
  3. Strengthening: done 3 times per week to regain strength



Example of range of motion exercises include pendulum exercises, posture exercises, active assisted range of motion exercises using unaffected shoulder, active training of the shoulder blade muscles, and active range of motion exercises. Flexibility exercises include door stretch, sleeper stretch, golfer stretch, and towel stretch. Lastly, examples of strengthening exercises are isometrically activating rotator cuff muscles against a wall, shoulder internal and external rotator strengthening using elastic bands or dumbbell, rowing using elastic bands, chair press ups, shoulder shrugs, shoulder blade push-ups, and Jackin’s exercises.




To learn more about physical therapy to treat rotator cuff motion and strength deficits, contact us at



  1. Dead men and radiologists don’t lie: a review of cadaveric and radiological studies of rotator cuff tear prevalence. Reilly P, Macleod I, Macfarlane R, Windley J, Emery RJ Ann R Coll Surg Engl. 2006 Mar; 88(2):116-21
  2. Werner CA. The older population: 2010, US Census Briefs, C201 OBR-09. US Department of Commerce, Economics and Statistics Administration, US Census Bureau. 2011 Nov; 1–19. (
  3. Rotator cuff repair: an analysis of utility scores and cost-effectiveness. Vitale MA, Vitale MG, Zivin JG, Braman JP, Bigliani LU, Flatow EL J Shoulder Elbow Surg. 2007 Mar-Apr; 16(2):181-7.
  4. Comparison between surgery and physiotherapy in the treatment of small and medium-sized tears of the rotator cuff: A randomised controlled study of 103 patients with one-year follow-up. Moosmayer S, Lund G, Seljom U, Svege I, Hennig T, Tariq R, Smith HJ J Bone Joint Surg Br. 2010 Jan; 92(1):83-91.
  5. Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elbow Surg. 2013; 22(10):1371-9.

‘Tis the Season on the Court: Overuse Injuries in Basketball

By: Dr. Trevor Stutz, PT, DPT




Basketball is a great game! The fast-paced, high scoring, team driven sport is one of the most popular games in America and the season is now in full swing for thousands of athletes across the country. Basketball requires a plethora of physical skills including strength, power, agility, speed, hand-eye coordination and endurance. I may be biased because I grew up in a house where basketball was a big deal, but I feel basketball requires the most well rounded athlete of any sport.


While it is such a great game, the stress playing basketball places on the body can cause injury. Consider that in 2009 an estimated 170,000 kids ages 5-14 were treated in emergency rooms following basketball injuries. While all sports carry some risk of injury, proper education and training can reduce the risk for injuries and missing game time due to injuries.


Many of the most common injuries related to basketball, such as patella tendinitis (jumper’s knee) are due to overuse and can be prevented with proper stretching, core strengthening, and monitoring intensity of playing time.


Other common injuries such as ankle sprains, ACL and MCL injuries (ligaments of the knee), and back strains can be also be reduced with proper core training and guidance to make sure muscles around these areas are strong and can handle the quick movement of basketball.


Whether it’s managing an existing injury, lowering the risk for a future problem, or maximizing performance,  a physical therapist can help you stay on the court and excel this season. Physical therapists are musculoskeletal experts who have extensive training in the treatment and prevention of injuries and are movement experts who can help determine the best way to keep you moving and get you back to the sports you love. If you are dealing with an injury now, or are more interested in finding out how to prevent a future injury and maximize your performance and time on the court, see a Sports PT physical therapist today.

Wrapping Presents can be a Pain in the Neck!

By: Alanna Pokorski, PT, DPT


As we wrap all of those perfectly selected gifts in their shiny wrapping paper, it can put a toll on our spine! We are being asked by our patients this holiday season… “what is the best way to wrap presents without getting sore?”


Here are five ways to reduce strain on your neck this holiday season:


  1. Choose a work station where your neck isn’t as flexed or looking directly down. Often, sitting is a better position because you often can wrap at eye level.
  2. Taking breaks after 20-30 minutes breaks of wrapping and stretching can offset the posture.
  3. Be sure that you aren’t slouching! Slouching creates stress on your shoulders and neck.
  4. Space your wrapping out rather than completing all of it in one day or evening.
  5. Relax your shoulders! During holiday stress, we can hike our shoulders up. Keep them down when wrapping.


Follow these tips and your neck will thank you! If your pain persists, please seek the advice of your PT.



What is the Recommended Amount of Exercise?

By:  Alex Moyer, BS, Exercise and Sports Studies




So your doctor says that you need to get more exercise…..Well how much exercise will make a difference? Should you be exercising everyday, every other day, once a week, for ten minutes, fifty minutes, or two hours?  


The American College of Sports Medicine recommends that the average American get 150 minutes of moderate activity total  (five days a week or more), or 75 minutes of vigorous activity per week (three days a week or more).  A combination of moderate and vigorous activity can also be used.  They also recommend that the duration of exercise be no less than ten minutes of continuous activity to gain maximum benefit from the activity.


How can I fit exercise in?


One of the easiest physical activities to begin is a walking program.  It only requires a supportive pair of shoes and a place to walk.  Walking at a moderate pace (about 3 mph) counts as moderate activity, while walking at a very fast pace (4.5 mph or greater) would count as vigorous activity.  Running is another exercise that can be done with little equipment, and counts as a vigorous activity.  You may even consider signing up for a race or walk to motivate yourself to get out and train (plus you usually get a shirt for signing up!)



Many sports can also be used to increase your minutes.  Golf (with no cart), ballroom dancing, shooting a basketball around, and doubles tennis can all be considered moderate activities.  While soccer, basketball (game), cross-country skiing, swimming and singles tennis can be considered vigorous activity.  The important things to remember are to stay safe, and find something that you enjoy.  If you enjoy doing your physical activity, you will be much more likely to stick with it in the long run, so get creative and find an activity that works for you.



Even small amounts of exercise can be beneficial even if it does not meet the recommended volume.  So even if you are not able to complete the recommended amount, just try to get moving and work your way up to the recommendations.  It is also important to consult your doctor before starting a new exercise routine, especially if you have any medical conditions.  




Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., … & Swain, D. P. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine & Science in Sports & Exercise43(7), 1334-1359.


Pescatello, L. S. (2014). ACSM’s guidelines for exercise testing and prescription. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health.

What Really Defines “Chronic” Low Back Pain?

By Amy Potter, SPT





Do you have low back pain that has lasted for a while? There may be some simple things you can do to help manage this! According to research, the best option in most cases is going to see a physical therapist. A Physical Therapist will evaluate and treat the source of your pain, thereby improving function.  


Chronic back pain is often defined as back pain that lasts longer than three months. There is a growing amount of scientific research that says that learning about the neuroscience behind your experience of pain can help you go through the day with less difficulty from your back pain. Practicing relaxation or diaphragmatic breathing, and beginning an aerobic exercise program (doing activities such as walking, jogging, and swimming) for 30 minutes per day, 5 days per week can also help your back pain.


The goal is to reduce back pain and improve function. When pain is chronic, the pain you experience is no longer indicating tissue damage, but rather your brain’s perception of a need to protect the tissue. This may be more easily understood using the analogy of a home alarm system. Initially when you injured your back, some tissue such as a ligament, tendon, nerve or muscle was hurt, and your nervous system acted as the alarm to let you know that something was wrong by making it feel painful. Over time, that tissue has healed, but your nervous system, or the body’s alarm system, has not calmed down and you still experience the same pain. This happens in about ¼ of people, and may be due to other factors such as stress, anxiety, failed treatments, lost hope, etc. This over-sensitive alarm system now has less tolerance for activities than it used to, and the alarm will go off (you will have pain) with even simple movements or activities that before your injury were not painful.


To help teach your “alarm system” or nervous system to become should consider an evaluation from a physical therapist to determine what type of corrective exercises should be performed. Hand –on treatment is also very important for, practice relaxation, and perform diaphragmatic breathing. Physical therapists can also help by creating a program of specific exercises and massage or other hands-on treatment techniques specific to your body and your experiences with back pain that may help you feel better, and get there more quickly than what you can do on your own.


Al Roker Of The Today Show Credits Physical Therapy For His Success After Total Knee Replacement

Written by Dr. Alex Barilla, PT, DPT and Michelle Denniger, PTA




As you may have seen, Al Roker, host on the Today Show, underwent a knee replacement surgery in June and has been giving viewers a look at his recovery process following this surgery. A knee replacement, or total knee arthroplasty, is one of the more common orthopedic surgical procedures performed and, with the Baby Boomer generation getting older and people staying active longer, more and more people will need this surgery to help them stay active as they age.


What is a knee replacement?


A knee replacement surgery is a procedure where the surgeon will remove damaged cartilage and old bone surfaces, and replacement them with a prosthesis. The prosthesis is typically made from metal and allows for more normal motion at the knee joint and less pain.


Who would get a knee replacement?


An individual would typically elect to undergo a knee replacement if they have damaged structures within the joint. The most common reason for having a knee replacement is a history of arthritis in the knee. As arthritis progresses the cartilage in the knee becomes thin and wears out altogether resulting in the bones that make up the knee joint painfully coming into contact with each other. Usually, this damage will be very painful, can lead to clicking and catching sensations in the knee and leads to significant limitation in daily function, making simple tasks like walking, standing, and going up stairs challenging.



What is the recovery process afterwards?


Physical therapy is a vital part of the total knee replacement process, both BEFORE surgery and AFTER. Before surgery, the goal is to achieve as much range of motion and strength to maximize the surgery.  After surgery, the initial focus of therapy is to decrease the swelling in the knee and increase the motion, specifically making sure the new knee bends and straightens like normal. Some individuals receive a continuous passive motion machine, which will constantly bend and straighten your leg without you doing anything! As motion improves, a physical therapist will guide an individual through the correct exercises to improve the strength in your knee, hip and surrounding musculature. A therapist will also help with strength and balance training, to assist with your walking, stair climbing and everyday activities. Once the basics are covered a good therapist will work with a patient to help them return to their favorite recreational activities and hobbies. There is nothing a therapist likes more than hearing about how a patient can return to all the activities they love without any pain.


What are the benefits?


Improved function, quality of life, and reduction in knee pain! The most common benefit is that patients who previously had excruciating pain with simple tasks such as walking, standing and using stairs are able to do these tasks without pain. Many people are able to resume very active lifestyles and a recent study showed that more than 3 out of 4 people who participated in exercise before having a knee replacement were able to return to sports after surgery.


A knee replacement is a major surgery, but the benefits can be life changing! Working with your Physical Therapist can help restore normal motion and strength to your knee and most importantly return to all the activities you love to do!

And thanks to Al Roker for supporting Physical Therapy!



Stress fractures need rest…even if you play for the Bills!

By Laura Brick, SPT


Stress fracture



Many football fans are aware that Buffalo Bills wide receiver Sammy Watkins suffered a foot injury, but don’t know the extent of the injury. Every week fans were wondering if he was going to play the entire season. On Sept 30th an official decision was finally made- Sammy was placed on the injury reserve list for 8 weeks. Certainly his skill and talent is a loss for the Buffalo Bills, but it was the best decision for Sammy’s injury.


Back in May, Sammy had surgery on his left foot to fix a 5th metatarsal stress fracture. The fifth metatarsal is the bone in your foot adjacent to your “baby” toe. A stress fracture means that there is a small crack in the bone from overuse/repeated movements like running when the muscles are not strong enough to handle shock absorption. So, for someone whose job it is to run, run, run and who is constantly hitting his feet on the ground, a stress fracture could occur.


According to the American Academy of Orthopedic Surgeons, the best form of treatment for a stress fracture is 6-8 weeks of rest so the bone can heal. Another treatment option is surgically placing a screw in the bone to help stabilize the foot. This is more commonly what professional athletes will do, and what Sammy had done in May. Unfortunately, Sammy started experiencing pain from the metal screw when he got back to full activity at training camp and earlier in the season. However, more complications can arise if he gets the screw surgically removed.


Sammy started training camp and the season playing through his pain tolerance, but for now the decision was made for him to rest. Although it is an option, there is no current plan for Sammy to have surgery. He needs time to rest and take stress off his foot to heal. Bones are still bones, even in professional football, so this short term rest will hopefully help Sammy to recover and prevent reoccurrence.  


As always, Go Bills!






WARNING: Prolonged sitting and physical inactivity causes chronic disease and premature death!



By: Alicia Lavelle, SPT, CWC (Student Physical therapist and Certified Wellness Coach)


You may recognize signs like this from public service announcements about the hazards of smoking. Physical inactivity is a risk factor for: heart disease, type 2 diabetes, breast and colon cancer, and many chronic (lasting greater than 6 months) conditions. Most Americans know they should, “exercise more and eat better”, but a good majority of Americans many not know what this means exactly.  Do you know the recommended amount of physical activity for improving overall health and quality of life? 


To gauge how you close you are to the guidelines you should ask yourself these 2 simple questions:


  1. “On average, how many days/week do you engage in moderate to vigorous physical activity (like brisk walking)?”  _________ days/week
  2. “On average, how many minutes do you engage in physical activity at this level?” ____________ minutes/day


Get your total activity by multiplying the responses = days/week x minutes/day = to get minutes per week. The recommended prescription is:


150 hours of moderate to vigorous physical activity per week (Example: 30 minute brisk walk 5 days of the week), in addition to strength training for major muscle groups 2 times per week.


In order to protect unnecessary stress to your heart and joints; if you are not currently engaged in regular physical activity you should:


  • Avoid unaccustomed, vigorous physical exertion and high risk activities (e.g. Racquet sports, water or cross-country skiing, highly competitive sports, deer hunting, snow shoveling).
  • Always start any moderate/vigorous activity with warm-up and follow-up with cool-down procedures. 
  • If experience chest pain or pressure, lightheadedness, or heart palpations/arrhythmias consider this a warning sign and stop exercise until cleared by your doctor. 
  • Exertion level should range “fairly light” to “somewhat hard” to know that you are at a training heart rate.
  • Reduce the intensity of exercise in hot weather or at altitudes of >1500m until acclimatized.



Other physical activity tips:


Children and adolescents should obtain up to 60 minutes per day of moderate to vigorous physical activity each day.


Regular exercise substantially reduces adverse health risks, even in the absence of weight loss.  If fact, it has been proven that obese/over-weight persons who are at least moderately fit, have death rate of approximately half those of people within a normal weight range who are not fit.


It is important to find a physical activity you enjoy and set realistic goals by exploring what you are willing and able to do to increase your physical activity levels. A great way to increase your daily activity is to keep track of it on a calendar or through a smart phone app.




  1. National Physical Activity Plan. Physical Activity Plan Web Site. Accessed September 17,2016
  2. Sallis, Robert E., Baggish, Aaron L., Franklin, Barry A., Whitehead, James R.,. The call for a physical activity vital sign in clinical practice. AJM the American Journal of Medicine 2016;129(9):903-5.
  3. Myers, Jonathan, McAuley, Paul, Lavie, Carl J., Despres, Jean-Pierre, Arena, Ross,Kokkinos, Peter,. Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: Their independent and interwoven importance to health status. YPCAD Progress in Cardiovascular Diseases 2015;57(4):306-14.










Falls Prevention and Physical Therapy: What You Need to Know


Written by:  Dr. Aimee Alexander, PT, DPT, OCS




Have you or someone you know have a fall that caused injury? Perhaps a loved one seems to be at a risk for falls…


The good news: Licensed physical therapists are the experts at identifying and helping to reduce the risk of falling in older adults by creating an individualized program for each person.


Did you know?

  • Falls are the #1 reason why older individuals lose their independence!
  • 1/3 of adults over the age of 65 fall each year – and less than half of these people tell anyone about it.
  • Over 2 million older adults
  • Every 29 minutes an older adult dies from a fall
  • 1 out of 5 falls causes serious injury (fracture/head trauma)
  • Direct medical costs for injuries related to falls is over $28 billion annually.



Falls Risk Factors:




Most falls occur due to a combination of risk factors, and a risk for falling increases with each fall. Fall risk can be reduced!  Falls risk factors are categorized as extrinsic (environmental factors) and intrinsic (those that relate specifically to the individual)


Intrinsic Risk Factors may include:


  • Advanced age
  • History of falls
  • Weakness in the lower body
  • Gait abnormalities/difficulties
  • Generalized muscle weakness
  • Vision deficits
  • Postural blood pressure changes with position changes (postural hypotension)
  • Balance deficits
  • Conditions such as: stroke, Parkinson’s disease, diabetes, arthritis, incontinence (in a hurry to get to the bathroom), dementia
  • A persons fear of falling actually increases the risk
  • Depression


Extrinsic risk factors may include:

  • Home environment: stairs, lack of grab bars in bathroom, throw rugs, pets, dim lighting
  • Slippery surfaces
  • Polypharmacy: the more medications you take daily, the more likely your risk of falling.
  • Certain types of medications create more risk than others (psychoactive meds-aka benzodiazepines, “sedatives” and sedating meds-tylenol PM, benadryl, and any medications having anticholinergic side effects-ex: blurred vision)
  • Improper use of assistive device or improper device for level of weakness/function.




What can you do to reduce your risk?

  1. Begin an individualized exercise program designed by a physical therapist to improve your strength and balance
  2. Review your entire medication list with your physician or pharmacist
  3. Annual eye examinations – update eyewear
  4. Reduce extrinsic risk factors at home: remove tripping hazards such as clutter/throw rugs, put railings or grab bars on all stairs and in bathrooms, improve lighting in all rooms


**Sports PT is committed to reducing Falls in the community and September 22rd is Falls Prevention Day. Each Sports PT location is serving their community with a Falls Risk Assessment that week. For more information on Falls Risk Assessment in your area, please contact us at .