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3 Ways We are Hurting our Backs

Lower Back Pain? Don’t Drag Your Feet!

Okay, that sounds more like the start of the motivational speech my parents used to give me when I was younger. Many of you may be asking yourself what does shuffling my feet on the ground have to do with low back pain? Well, a lot more than you might think. 

When referencing lower back pain, this is the speech I find myself giving to more and more of my patients.

When we look down at the ground, we tend to bring our body into a position of trunk flexion. By this, I mean that your chest is coming forward over your toes. When this occurs, our center of mass starts to move forward and we create an anterior tilt through our pelvis.

When our center of mass comes forward we adjust our body position to maintain our balance by extending through our lower back and, on occasion, by going up onto our toes. The body corrects its position to maintain balance with changes being processed by the change in our visual field by looking down.

When we shuffle our feet, we typically create the habit of making our initial foot contact with the toes pointed down and then sliding the foot forward instead of actually rolling across the foot as one would walk with a normal gait.

A normal gait is to make initial contact with the heel and push off the toes. When I see people shuffle their feet, there is also a tendency toward reducing the amount of contact the heel makes with the ground. We refer to this as an ‘early heel rise gait’ and will often see this gait pattern in toe walkers. These individuals will hardly make contact with the ground through their heels. When we ambulate with this gait pattern, much like when we look down, we translate our center of mass forward. Again, to correct we typically go into back extension. 

These tendencies toward back extension are what lead to the long-term potential problems.

First, there are the anatomical stresses that long-term extension can create. These conditions are often seen in increased arthritic changes in the lower back due to the increased stress through the facet joints in the spine.

Next, there is the tendency toward using you back extensors to perform lifting activities. Since these muscles are already being engaged to help you maintain your balance they will often fire more when you are lifting something leading to the increased likelihood of a potential muscle strain.

The next time you are out for a run or a walk my advice is to look up and enjoy the scenery and think about that nice heel to toe gait pattern. Your back and the rest of your body will appreciate you for it in the long run!

Written By: Nick Wegener, Director of Physical Therapy – PT, ATC, OCS, CSCS

How to Self-Diagnose Your Athlete’s Arm Pain

Late spring into early summer is one of the most common times we see shoulder and elbow injuries.  A lot of parents often ask me what “warning signs” they should be looking for with their son or daughter’s arm pain. Most importantly they want to know if the pain is serious or not. 

To a certain extent, we come from a place where we believe the motto “no pain, no gain”, and in some cases, I fully agree with that mindset. But at other times, this mindset can be very detrimental. How do you determine which pain is okay to play through and which pain is not? Here are four common arm pain areas to evaluate and guidelines to help you decide if your athlete should get the area checked out.

Pain Area #1:
Front or the back of the shoulder

Back of Shoulder Pain 

Pain and soreness in the shoulder are not uncommon with athletes, but the key is where the pain is located. Pain and soreness in the back of the shoulder usually occur when athletes use their arm to throw or serve. The muscles in the back of the shoulder often get strained.  They are small muscles and take on a lot of force when the arm is stopping after a throw or a swing.  Typically, this soreness gets better by the next day and eventually the muscles get stronger so the pain does not return.  

Front of Shoulder Pain

Front shoulder pain is a whole different issue.  We consider this pain to be concerning, and it should be closely monitored. Structures like the front ligaments of the shoulder, the labrum (cartilage in the shoulder), and parts of the rotator cuff are all stressed during overhead movements.  If your athletes are complaining of pain here, this is NOT the pain they should try to play through.  The pain can go away on its own; however, if the pain persists for more than three days or if it occurs every time they try to play their sport, go have it furthered examined by a physical therapist or a licensed health care professional. 

Pain Area #2:
Outside of the upper arm

Pain and soreness aren’t commonly experienced on the outside of the upper arm as the deltiod muscle is just about the only muscle in that area. Pain here, especially in adolescent athletes, is usually a sign of an injury to the growth plate of the upper arm.  Have you ever heard the term “little leaguer’s shoulder”?

Little leaguer’s shoulder can have delayed healing and significant downtime if left unaddressed.  Again, like in the shoulder, this pain can go away fairly quickly.  However, if it becomes persistent or happens every time the athlete tries to use their arm for activity, it is time to have it checked out.

Pain Area #3:
Inner or outer elbow  

Inner elbow pain

Pain and soreness in the elbow are not as common as the shoulder and tends not to be bothersome – unless the athlete is throwing or serving. This infrequency is why I think people don’t have this area looked at as much or soon enough.  The inner elbow is home to some key structures that are stressed during overhead movements.  The ulnar collateral ligament (Tommy John ligament) and the inner elbow growth plate (little leaguer’s elbow) are the most significant.  Once these areas start developing pain, they are usually past the mild stage and are typically in the damage stage.  

Outer elbow pain

The outer elbow rarely develops pain and usually does not develop pain without previously having inner elbow pain.  Pain in the outer elbow can be significant such as a cartilage lesion on one of the forearm bones.  This damage happens from over-compression in the joint, commonly due to a loose ulnar collateral ligament.  Like the inner elbow, by the time this area becomes painful, the damage has already set in.  

Pain localized to the inner or outer elbow should not be dismissed as the consequences can be detrimental to the longer term health of the elbow.

Pain Area #4:
Biceps or triceps muscles

Pain and soreness in muscle tissue is rarely a “red flag” for us.  Injuries to muscles can definitely be painful but more times than not, they will resolve on their own in a reasonable amount of time.  The biceps and triceps are the muscles most susceptible to getting strained in sports like baseball, softball, and tennis.


A lot of the time the pain is located in the middle of the muscle or, for tricep pain, down by the elbow joint. Again, these pains usually go away quickly and usually respond well to light to medium massage.  If for some reason, the pain is not fully gone in a couple weeks, then I would recommend getting it checked out.


As your athlete participates in the common summer sports, pain and soreness can and will happen.  The key as parents is to continuously monitor the symptoms and use the guidelines above to help determine severity.  If the pain falls into one of the key areas, don’t be that parent that finally takes their kid in only to find out they fractured their growth plate.  On the flip side, if the pain isn’t too bad, “go rub some dirt on it” is sound advice!

When in doubt give us a call 402.932.7111 if you have any questions about your athletes’ arm pain.  We’d be happy to answer any questions you may have! 

Written By: Travis Manners, PT, SCS, CSCS

Your Most Popular Dry Needling Questions Answered

Dry needling is currently one of my favorite manual treatments and I am constantly discussing it in the clinic with my patients. Due to the mildly invasive nature of the treatment, and because many people have not heard of dry needling I end up fielding many questions.

I recently received an email from a patient with several good questions and decided it would make a good blog post! If you don’t know what dry needling is check out our past blog post, “Functional Dry Needling” before reading the rest of this article.

Question 1:
Why do you feel I would benefit from needling and how does it relate to the big picture?

Dry needling is only on piece of the puzzle but it is a powerful piece. I like to explain dry needling as the ability to press the reset button on a muscle. I give the muscle a stimulus through the needle and that stimulus can help to decease muscle tension, decrease pain, increase range of motion, improve muscle activation, and improve function.

Pressing that reset button provides a window that allows us to work on treating the root cause of the dysfunction. I may follow the needling with exercises, stretches, etc which will help to reinforce the treatment and allow those changes to become more permanent.

Dry needling is only one tool in the toolbox, but my experience so far says that it is a very strong tool and one that I will continue to use more and more.

Question 2:
Do you see this as a temporary solution?

No! Needling done only by itself would be a temporary solution, but as a physical therapist I always back up my needling with other treatment so that we address the root cause of the dysfunction and not just the symptoms. I feel like in many cases needling helps to deliver results faster but my goal is not a temporary solution.

Question 3:
I see a massage therapist to help with my tight muscles, would I get the same result from just getting a deep tissue massage?

Massage is another tool in the toolbox and one that I often use, sometimes even in conjunction with the dry needling. However, needling provides a different stimulus and sometimes people respond better and faster to needling than they would to deep tissue massage. I have seen patients who responded terribly to massage respond very well to needling and vice versa. Needling is not the answer for everyone but when it works well the results are undeniable.

Hopefully this answers some of your questions on dry needling! If this has sparked more questions for you then feel free to contact us or post them in the comments section below.

Likewise if you are interested in treatment call our office today 402.932.7111 and schedule an evaluation, we would love to see you! We offer cash based options for Functional Dry Needling, and the treatment may also be covered by your insurance. 

Written by, Josiah Parker – PT, DPT

Should You See A Foot Doctor, 4 Things to Consider First

What to Do When You Have Plantar Fasciitis 

So, has all that outdoor activity started to take a toll on your feet? Are you starting to experience some sharp pains in the heel of your foot? Well, in this case it might be time to consider addressing some of those concerns before your symptoms worsen.

Foot stepping on tack

Plantar Fasciitis is a condition in which the band of tissue (plantar fascia) that runs from your heel to your toes on the bottom side of your foot becomes inflamed.

This is a common condition that affects roughly 10% of the population and is typically seen in runners, individuals who spend prolonged periods of time on their feet, and those who are obese.

All of these factors can directly affect the positioning of your foot in standing (weight bearing) versus sitting (non-weight bearing) positions.

Other symptoms indicating you are experiencing this condition include significant pain in the morning when first getting out of bed and walking. This occurs because the fascial tissue has tightened in the evening when you were not weight bearing and then the excessive stretch upon standing causes increased discomfort.

Here are some things I have found the most helpful if you are suffering from these symptoms. 

1. Stretch

I really like two stretches in this instance, one for the plantar fascia and one for the Achilles/calf.

– Achilles/Calf stretch: Hang your heels off the edge of a step. You should feel a comfortable stretch through the calf area. Hold the stretch 20 seconds and repeat 5 times. Do this 5 times per day.

– Plantar fascia stretch: Standing facing a wall push your toes into the wall and let them extend backwards. Continue to press the toes into the wall until the stretch is felt through the bottom of the foot. Hold the stretch 20 seconds and repeat 5 times. Do this 5 times per day.

2. Strengthen

Stressing the tissue will help promote a healing response.

– Toe scrunches: Place a towel on a slick floor or on cookie sheet on the floor. Try to scrunch up the towel using your toes. Perform 10 minutes once per day.

3. Massage

This is another way to directly stress the tissue and will help promote tissue healing.

– Golf ball roll: Roll a golf ball under the arch of your foot for 10 minutes twice per day.

– Ice bottle: An alternative to the golf ball roll is to freeze a long, 10 oz. bottled water and roll that under your arch. This will provide you with the massage and some inflammation control at the same time.

4. Icing

Finally, I encourage icing for 10 minutes at the end of each day.

– This will help slow the inflammation process. You should also reduce stressful activities, which include running and jumping for 4-6 weeks.

If these few tips don’t help alleviate your symptoms over that period, you may be suffering from a more severe case or there are other factors contributing to your condition.

In those instances it is best to follow-up with a physician and/or physical therapist who can perform a thorough assessment and provide more thorough recommendations based on your presentation.

Written By: Nick Wegener, PT, ATC, OCS, CSCS. Director of Physical Therapy

Question: Which technique listed above has been the most beneficial to reduce your foot pain?

Do you Experience Back Pain After Working Out?

5 Things I Did to Reduce My Own Post-Exercise Back Pain

I don’t know about you but I love those workouts when you finish and you think to yourself, “Yep, I crushed it!” But for me, then the inevitable would happen. Later that night or the next morning I would feel my back start to tighten and before long that low-grade nagging pain would return in my lower back. 

When I was younger the pain would stick around for maybe a day. However, as I got older the pain would start to last for three or four days up to even a week.

The tipping point for me personally was about eight years ago when I herniated my L5/S1 disc. Once I recovered from that injury, I decided it was time to start being more proactive toward my nagging low back pain. Here are five things I began incorporating into my workouts on a regular basis.

I started incorporating these five things in my workouts on a regular basis and I am happy to say my back pain has significantly reduced and my recovery between workouts is back to where it was 15 years ago. 

My Top 5 Go-To’s:

1. Thoracic spine rotations

Why it works: Having a mobile and flexibile thoracic spine (upper back) is pivotal to low back health. If our upper back is tight, forces will transfer down into the low back which may overload the small joints of the back causing soreness and pain. 

Performing this exercise:

Lay on your side with your upper leg bent to 90 degrees at the hip and knee and propped up on a foam roller.  The hand of your down arm should rest across your top knee.

With your top arm, reach back toward the ground trying to get your shoulder blade to rest on the floor.  

Make sure your top knee does not lift off the roller.  Hold for 5 seconds and repeat 10 times each direction.

2. Hip figure 4 stretch

Why it works: Hip tightness, especially in the back of the hip, is without a doubt the most common restriction we see in people with low back pain. Like the upper back, if your hips are tight and don’t move well, the force from the lift gets moved up into your low back. This stretch is designed to target that specific area. 

Performing this exercise:

Starting on your hands and knees, bring one leg in front and across the other like you were folding your legs.

From there, sit back letting your other leg side straight which will stretch your other hip.  

Hold for 15 seconds and repeat 5 times.

3. Elevated toe touches

Why it works: For lifts like squats and deadlifts, you need an appropriate amount of calf and hamstring flexibility so that when you’re at the bottom of your lift your pelvis and spine can be positioned correctly. This exercise is one that I also like to use to determine if someone is ready to do those activities. If you cannot touch your toes in this position, we are not starting those lifts. 

Performing this exercise:

Start with placing the balls of your feet up on a couple inch block (25lb plates or books work well).  With your legs straight, slowly reach down and touch your toes.  

If you can not touch your toes, go as far as you can then slightly bend your knees to achieve the desired distance.  

Breathing out while reaching down can also give you a little more reach as well. Hold for 5 seconds and repeat 10 times.

4. Lateral band walks

Why it works: Unlike the first three exercises that were focusing mostly on flexibility and mobility, this exercise is specifically designed to get the most important muscle in your body prepared and ready for lifting. Your glutes are the cornerstone of having a solid foundation and platform to lift from. The more awake and ready they are for exercise, the less tension force will be taken through your low back muscles to lift yourself back into an upright position. 

Performing this exercise:

With a lateral band around your ankles, get into an athletic, ready position. Slowly step out to the side then slowly bring your trail leg back into the starting position.  

Do not let your trail foot drag on the ground. Repeat for 2 sets of 15 steps each direction. 

If you need a lateral band, click here:

5. Switch to front squat over back squat

Why it works: Squatting is an exercise that has huge benefits. Increasing your heart rate, elevating your muscle building hormones and developing strength in multiple muscle groups are all key benefits of squatting. However, the back squat is not for everyone’s body.

If you lack flexibility in certain areas or foundational strength, then loading a back squat will increase stress to the joints in your lower back. When the load is switched to the front, your body naturally becomes more upright and positions your spine in a way that does not excessively load your vertebral joints. 

Performing this exercise:

Begin standing tall with feet hip width, pointing forward and a barbell resting across the shoulders.  Hands can either hold the barbell in a cross face position or a clean grip position.  Squat down until the thighs are parallel with the floor, pause and then return to the original position.

Remember, your chest should maintain a relative tallness and your heels should remain in contact with the ground.

Nagging lower back pain after working out cannot just affect your ability to perform your next workout. If left unaddressed, that nagging pain could turn into something more severe.

If you are like I was, give these 5 things a try for a good month and see if you aren’t feeling better!

If after a month you are still having pain after your workouts, give us a call and let’s figure out what else needs to be done to get you feeling better!

Written By: Travis Manners, PT, SCS, CSCS, President and Founder 

Recharge Your Body – 3 Step-By-Step Exercises

Defeat the “mid-season slump” that plagues your young athlete.

The dreaded “mid-season slump.” You know, it is that period of time when your kid’s repetitions are high and their practices are sparsely scheduled between their competition dates. 

As a physical therapist, this is the time when we find that the body is over-stressed and not given enough time to recover which may lead to injuries. Today, we are going to cover 3 step-by-step exercises you can have your kid perform to decrease their chance of suffering from front knee pain.

Often, this is the time that coaches and athletes have their mind set on:

  • jumping higher
  • running faster
  • leaping bigger
  • landing stronger

With the athlete completing more repetitions and the motivation for new goals being set high, constant attention to proper jumping, landing, and running mechanics may be inconsistent. That can lead to fatigue, muscle weakness and even front knee pain. 

There are many injuries that can occur during this “mid-season slump.” But today we are going to focus on one common injury that we treat often at Athletes’ Training Center, it is called “Patellofemoral Pain Syndrome” (PFPS).

Understanding PFPS

PFPS describes pain in the front of the knee that occurs with sitting, squatting, going up/down stairs, running, and jumping. Believe it or not, researchers have found that PFPS may actually be coming from weakness in gluteal muscles and improper mechanics during sport-related activities.

Our skeletons are designed with three gluteal muscles; those gluteus muscles are called the maximus, medius, and minimus.

Research has concluded that weakness in the gluteus medius, in specific, may be the main contributor to PFPS. The gluteus medius muscle sits on the outside of the hip. This muscle helps to kick your leg out (as in a jumping jack) and rotate your knee outward.

Front knee pain caused by weakness in glutes? 

Now you may be asking, “how do I know if my child’s knee pain is due to weakness in their gluteal muscles?” First off, if they have knee pain, you may consider having them be evaluated by a physical therapist.

But a good at-home test would be to have them stand in front of a mirror. Have them stand on one foot and perform a single leg squat. If you notice that their opposite hip drops, their standing knee falls inside or they lose balance, they may have gluteal weakness.

Maintaining strength in their gluteal muscles may be an important and preventative measure you can have your son or daughter take during this “mid-season slump.” This will ensure that they can achieve all of goals they had set for the season.

Here are 3 exercises you can have your kid perform to decrease their chance of front knee pain. 

Lateral side-step with band


Place the resistance band above the knee. Begin with your feet together. Focus on having a slight bend in your knees and try to maintain a flat back. Step out to the side achieving resistance on the band. Slowly bring other foot to meet first foot. *Recommend doing 3 rounds of 10 reps

Hip Abduction


Lie on one side. Extend your legs out to make a straight line between your ear, hip, and ankle. Bend the knee that is in contact with the table to make a kick stand. Straighten top leg and lift directly up and back. Make sure to keep your hips forward. *Recommend doing 3 rounds of 10 reps 

Bridge with a band


Lie on your back with your knees bent. Place a resistance band above the knee. Make sure that your feet are hip-width distance. Squeeze your glutes and lift up to achieve a bridge position. Slowly lower back down.*Recommend doing 3 rounds of 10 reps

Helping your child stay focused on proper knee alignment while they perform in their sport will decrease their occurrence for PFPS knee pain. Ensuring strong knees may also help your athlete: jump higher, run faster, leap bigger, and land stronger. 

If you have questions about completing these exercises, or know of someone who is experiencing current issues with front knee pain then contact us today! We will get you connected with the right person for your needs.

Written By: Stephanie Wojton, PT, DPT

5 Tips for Avoiding Back Pain While Shoveling Snow

As we are well into the wonderful winter season, I want to take a moment to share some tips on snow shoveling that I hope will come in useful and maybe keep you from having to visit your favorite physical therapist. 

As anyone who has ever picked up a snow shovel knows, it is WORK.  In 1996, the Surgeon General noted that shoveling snow for 15 minutes was considered moderate physical activity equivalent to speed walking at 5 mph for 15 minutes on a treadmill.  As with any other physical activity, a warm up is always important. 

When completing a warm up, I encourage an active motion that is similar to the movement that you will be doing.  In this case I suggest a lunge with arm reach toward the opposite knee (see above picture). 

Perform 10 lunges on both sides.  This will help emphasize the need to bend with your legs, increase muscle activity, and provide a nice warm up before you ask your legs to lift a load.   

After the lunges, I also encourage some light stretching of the shoulders, neck and low back.  Good stretches to complete include pulling your arm across your chest, looking over your shoulder and seated rotational stretches for your low back.  Hold the stretch for 20 seconds and repeat 2-3 times.  Now let us get to the most important thing.  

5 Tips – how to position yourself when shoveling: shoveling

  • Bend your knees like you are going to lunge. 
  • DO NOT reach your arms forward when shoveling, LUNGE forward.  This reduces strain on your back. 
  • Move forward into the lunge as you lift the snow and bring your arms back in to your abdomen.  This will force you to use your legs more and reduce strain on your back bringing the weight shoveling_2
    closer to your body. 
  • When throwing the snow off to the side, move your feet and DO NOT simply twist at the waist.  Avoiding twisting will reduce the possibility of straining your back.
  • Push opposed to lifting: If you can push the snow forward opposed to lifting this will reduce the strain on your back.  

Other things to consider:  

  • Stay hydrated.  Just because it is winter doesn’t mean you don’t get dehydrated. 
  • Choose an appropriate shovel size and DO NOT overload it!  
  • Take a break when needed.  If we get 10 inches, shovel in sections and not all at once. 

If all else fails, my last recommendation is a good snow blower. Happy shoveling!

Written By: Nick Wegener, PT, ATC, OCS, CSCS

An Almost Foolproof Way to Relieve “Jumpers Knee” Pain

patellaBasketball season is upon us and with basketball comes the potential for knee aches and pains.  One of the more nagging and painful injuries basketball players can develop is patellar tendinitis, otherwise known as “jumper’s knee”.  I can always pick the players out on the floor who suffer from this injury because they all seem to wear the same brace. 

Though this brace can help certain people with the pain and keep them playing, in my experience other factors exist that continue to cause the symptoms.  In evaluating young basketball players, one of the common findings I have seen is poor flexibility in the quads, hip flexors, and IT band as well as poor mobility in the ankle.  Though other factors exist (including muscle weakness, foot posture, and poor mechanics), these problems can be easily remedied on your own with a couple of simple exercises. 

pretzel_stretchPretzel Stretch 

Step 1:  Lay on your non-injured side with your body in a perfectly straight line.   

Step 2:  Using your hand, pull your heel toward your rear end.   

Step 3:  Pull your thigh back so it is in a straight line with your torso.   

Step 4:  Put your bottom foot on the front, top aspect of your knee and push your top leg back and down toward the floor. 

*Hold for 20-30 seconds and repeat 3-5 times 


wall_quad_stretchWall Quad Stretch: 

Get into a half kneeling position and place the top of the foot of the down knee against the wall.  Make sure your torso is straight and tighten the butt cheek on the down leg.    

* Hold for 20-30 seconds and repeat 3-5 times 


wall_ankleWall Ankle Mobility Exercise: 

Standing with your feet staggered, place your lead foot roughly 4-6 inches from the wall.  Press the knee toward the wall, keeping your knee over your second toe.  The knee should just barely touch the wall without the heel lifting off the ground.  If your knee easily hits the wall, move your foot back and repeat.   

 *Once you have reached the optimal foot position, hold each for 5 seconds and repeat 10 times. 

Good luck and remember, if your symptoms do not improve it’s possible those previously mentioned factors could be coming into play.  If that happens, consult us for a more complete evaluation.

Written By: Travis Manners, PT, SCS, CSCS 

Life-Changing Advice for People Living with Osteoarthritis

Osteoarthritis (OA), Causes, Treatments and Diagnosis

We all have that one crazy relative. I know I’m not the only one that has heard “I can tell that it’s going to rain later on today because my knee, hip, and shoulder are getting achy.” Many individuals dealing with some form of arthritis experience this phenomenon. Although it is not a 100% proven theory, decreases in barometric pressure prior to rain are thought to cause tissue adaptations that decrease support and increase joint stress.

Arthritis! Such a commonly used term, but what is it? How do we get it? What can we do about it?

What is it?

When broken down, no pun intended, osteoarthritis (OA) is a loss of cartilage within a joint. Most often found among the knee, spine, hip and shoulder; all of these joints require vast amounts of movement.

Here’s a fun fact. Knee osteoarthritis is the leading cause of disability among older individuals.

How do we get it?

We can thank our own lifestyles for this one. OA can occur as a result of a specific injury or surgery, but in general it’s the result of daily wear and tear and muscle imbalances that lead to impaired movements. It begins as cartilage breakdown, and eventually results in two opposing bones coming in contact with one another if it is not detected early enough. 

Alnahdi et al. provides some great information through research. Read More

Those with OA are often linked to quadriceps weakness with deficits between 11-56%, and eccentric deficits up to 76%. Other areas of weakness include hamstrings, hip extensors, hip rotators, abduction, and adduction strength. These deficits make daily activities like ascending/descending stairs, getting in and out of chairs and just walking difficult. Just imagine the stress that occurs at your knee as a result of strength deficits at these levels.

What can we do about it?

Moving to warmer weather is not the answer. Just like a car, your body has impairments in alignment, muscle balance, and body mechanics. Therefore, a breakdown will occur naturally. You wouldn’t drive on a tire with 50% less air right? Then why move on a leg with 50% of the strength?

With the proper guidance through physical therapy, one can be educated in proper postures, movement patterns, strengthening of supportive tissues/structures, and exercise routines to prevent the continuum of osteoarthritis. 

If the condition becomes advanced, surgery for a joint replacement becomes an option. Knee replacements have become a common treatment in the senior population. With the right care following this procedure, individuals can return to a healthy and active lifestyle.

Take Away: Come in for education on proper movement techniques and exercise routines to maintain appropriate strength, then create an active and healthy lifestyle.

Written By: Eric Horstman DPT, PT

Question: Do you have any questions about our physical therapy techniques for arthritis pain?

3 Unexpected Treatments for Concussions – That Work!

I often get asked about what I do for a living and when I respond that I am a physical therapist many people ask me what kind of injuries I see. My response usually begins with the orthopedic injuries, which everyone kind of already expects, but one area in particular that almost always catches people off guard is when I tell them that I treat concussions.

What can a physical therapist do for a concussion?

That is a great question! Let me share with you the basics on what a concussion actually is.

Concussions: A mild form of traumatic brain injury, which is caused by a bump, blow, or jolt to the head. These injuries may be classified as mild but the symptoms they cause can be devastating to the people who are experiencing them.

Symptoms: Dizziness, headaches, poor balance, trouble concentrating, depression from lack of participation ability. Surprisingly, the symptom most correlated with a lengthened recovery is dizziness. For more information on the basics of concussions visit

Now that you understand the basics of a concussion, I promised that I would begin to reveal the three unexpected concussion treatments…and here they are!

  1. Exertion therapy is used to help get the body back to regulating its normal functions like heart rate, and also returning the patient back to sport or work.
  2. Finally, the musculoskeletal piece is used to help with neck or back pain, which often goes hand in hand with a concussion.
  3. Vestibular therapy is used to help address dizziness, headaches, and lack of balance.

In order to avoid getting too long winded, I will be breaking down each one of these three main areas in future blog posts. For now I know this is a very general overview so if you have any further questions feel free to contact me!

Written by, Josiah Parker – PT, DPT

Question:  What do you want to know about concussion therapy?

Deadlift may Prevent Future Back Injuries

Suffering from Back Pain?

Have any of you tweaked your lower back while picking up a heavy object? This is a common mechanism of injury, but we actually have a strength training exercise that mimics the act of lifting an object off the ground. It is called the deadlift and it is, without question, one of my favorite things to do in the gym.

Unfortunately, the deadlift often has a bad reputation for being associated with lower back injuries. There is no debating that poorly performed deadlifts will hurt your back. However, correct deadlifts are extremely beneficial! In fact, they build tremendous amounts of strength in your legs, hips, glutes, back, arms and hands. Let’s take a look at how you can safely perform the deadlift to ensure that you are reaping all of the benefits of this full-body movement.

3 Tips to Clean Up your Deadlift


deadlife_blog21. Perform a Proper Hip-Hinge

Getting in the proper starting position for a deadlift can be tricky. To get in the right setup, act as if you are going into a vertical jump. Boom! That’s a hip hinge. From here, reach down and grab the bar and then pull your chest up. Now you are in the proper starting position.

2. Pull Slack Out of the Bar

Now that you are properly set up, there is one more thing you must do before lifting off the floor. The last step is pulling the slack out of the bar. Doing this will tighten up your upper back and prep your body for the lift to ensure a smooth transition from the floor. If using a load that is close to your max, it is also beneficial to take a quick inhale prior to lifting. This will increase intra-abdominal pressure and will further increase the rigidity of your torso. Be sure to fully exhale once you finish the lift!

deadlift_blog3. Finish with your Hips, Not your Back

Push through your heels to lift the weight off the floor. Once the bar reaches your knees, forcefully extend your hips to finish the lift. You should be squeezing your glutes and your abs to complete the exercise. You should not extend your lower back by leaning back.

If you are new to the deadlift, I recommend starting with a kettlebell or by flipping a dumbbell upside-down. Once proficient, progress to a hex bar or straight bar. I encourage you to give these tips a try the next time you deadlift. Not only will you perform the lift safely, but you may be surprised at how much weight you can do!

Written By: Mike Servais, CSCS, USAW-L1SP, Head Performance Coach – Papillion

Question: If you have any further questions about your form or technique feel free to contact me or any other trainer here at Athletes’ Training Center!

Your Hips Don’t Lie

2 Reasons Hip Muscles are Vital For Runners

The sun is finally shinning and the temperature is rising, which means many of us are moving our workouts outdoors!  Some people are year-round runners, but if you’re anything like me then you only run on a beautiful day and as a last resort for a quick workout.

Athlete runner feet running in nature, closeup on shoe. Woman fitness jogging, active lifestyle concept

It never fails this time of year I see an uptick in the number of runners coming in with overuse injuries.  Many of these injuries could be minimized, or even prevented completely, with some proper maintenance of hip strength.

A runner’s hip muscles are important for many reasons.  Today I am going to focus on two reasons:

      1. The first is controlling knee position during the stance phase of running. Stance phase is defined as the time from when your foot initially contacts the ground until you push off for your next step. A runner’s knee should generally stay in line with their second toe while in stance phase and deviation inside of this point is called knee valgus. Excessive knee valgus consistently during the stance phase can lead to break down in a runner’s knee or foot.  The good news is the hip muscles can easily control this knee valgus.
      2. The second reason hip muscles are important for a runner is for pelvis control.  hipsphotoEvery time a runner is standing on one foot their hips should stay relatively level (see photo on the left).  If they drop while standing (photo on the right) on one foot then either the hip muscles are weak or are not being properly activated while running.

In my opinion the best way to avoid either of these problems is to make lower extremity strength training a part of your weekly training regimen at least 2 times a week. Your strength plan should consistently contain single leg strengthening exercises such as: single leg squats, lunge variations, and step up or down variations. While completing these exercises make sure and focus on your knee staying in line with your second toe and keeping your hip level each time.

If you have questions about completing these exercises for current issues with pain or just for injury prevention then contact us today! We will get you connected with the right person for your needs.

Written By: Josiah Parker, PT, DPT

Question: Do you have any questions about the strength of your hips and the exercises you should be implementing into your workout routine?

Jennie A., Collegiate Track & Field Athlete

Athletes’ Training Center has worked to specialize workouts to fit my athletic needs. The strength coaches have a one on one personal connection to fix minor details that have had a major impact on my athletic performance.