News & Events

Shin Splits, How to Reduce Your Risk – 3 Strategies

I have two words for you.  Two words which give runners everywhere nightmares.  “Shin splints”. Most people are familiar with this diagnosis; and if you have had them before, you know that they are highly irritating!

In this blog, I want to talk about three strategies you can use to help reduce your risk of developing shin splints symptoms. 

1st: Buy a Good Pair of Running Shoes

Just like anything else shoes break down and need to be replaced. How often they need to be replaced depends on how far you are running in a week.

As a general rule of thumb, running shoes should be replaced every 300 to 500 miles, which means you can’t simply replace them once a year (if you are averaging 50 miles a week).

2nd: Slowly Ramp up Your Running Distance

Have a plan for building up your running distance. If you want to run a half-marathon this summer, but have not been putting in any miles during the winter, you should not start off running 30 miles a week.  You should instead begin by building up your walking tolerance, move to walk/run intervals, then build your running distance from there.

Going from spending most of your time sitting on the couch and binge-watching Netflix straight into hardcore run training is a sure fire way to end up with a case of shin splints.

3rd: Stretch Your Calf Muscles 

Finally, make sure you stretch out your calf muscles before and after your run. When stretching out your calves, it is important to ensure you stretch out both of the major muscles which reside there, your gastrocnemius and soleus muscles.

The gastrocnemius is stretched when your toes are pulled toward your head with your knee straight as this muscle spans across the knee. In order to stretch the soleus, you must have your knee bent as this muscle stops short of the knee.

soleus stretch

gastrocnemius stretch

 

Each of these three strategies can play an important roll in helping you to avoid shin splints and helping runners everywhere to get a better night’s sleep!

 

 

If you or someone you know is already dealing with this condition, then set up an appointment today to be seen by one of our physical therapists.  There are many strategies to help speed up recovery!

Written By: Josiah Parker, PT, DPT

Debunking 7 Common Concussion Myths

Hello, my name is Josiah Parker, PT, DPT, I am a physical therapist at Athletes’ Training Center. Although I treat a wide array of patients, concussions are one of my favorite areas to treat. I’ve attended courses at the University of Pittsburg and the American Academy of Neurology for specialized training in this area. 

We have learned so much about concussions over the last 10 years but there is so much left to be learned. This influx of information has been great for the rehabilitation of patients with concussions however, there is still a ton of misinformation out in the public. My goal with today’s blog is to shed some light on some of these common concussion myths.

Myth 1. Concussions only affect athletes and only on the field

False, I see many patients who get concussions from everyday activities such as work, driving, etc.

Myth 2. Concussions always come with a loss of consciousness

False, I would say from my experience less than 20 percent of the concussions I see experience a loss of consciousness. The biggest predictor of a longer recovery after a concussion is actually feeling dizzy after sustaining a concussion.

Myth 3. The person needs to just rest until all concussion symptoms are gone

False, rest is very important after a concussion but simply cocooning yourself after a concussion is detrimental if done for longer than 48 hours. After that 48 hours sleep continues to be very important and should be prioritized but along with this, a slow progression back into activities is very important for full recovery.

Myth 4. If I wear the right type of helmet, I will not get a concussion

False, helmets are very effective at preventing injuries such as skull fractures but concussions can be caused by the brain-twisting inside the skull or hitting the front and back of the skull. Both of these mechanisms of injury are not prevented through helmet use. Don’t get me wrong helmets are a good thing to wear but they are not a foolproof way to prevent a concussion.

Myth 5. My MRI/CT scan was clear so I don’t have a concussion

False, neither one of these scans are able to detect a concussion. They are able to rule out more serious conditions such as a brain bleed but concussion damage is on a more microscopic level which is not picked up on these scans.

Myth 6. People with concussions should wake up every 2-3 hours after a concussion

False, uninterrupted sleep is very important after a concussion, especially in that initial 48-hour window. There is not any research showing interrupting sleep is helpful even on the first night after a concussion.

Myth 7. Concussions are a minor injury

False, many concussions resolve quickly with little to no long-term effects. However, the more concussions someone gets the longer symptoms last and the more intense they are. There are some people who have lasting symptoms for months or even years after a concussion. Therefore though most concussions are not life-threatening, may be life-altering.

The effects of these concussions cause interruption in daily activities, making the return to work/school challenging and can be very frustrating. This is not an all-inclusive list but as you can see there are many wrong ideas about concussions.

If you or someone you know are suffering from post-concussion symptoms, know there is help available and many times rehabilitation can help to speed up the recovery process. Use the information below to get in contact with someone who can help guide this process for you!

Call us at 402.932.7111. or visit concussionfocus.org

Written By: Josiah Parker, DPT, PT


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


Tips for Managing Sleeping After A Concussion

Guest Blogger Introduction: Rebecca Lancaster, MD – Methodist Physicians Clinic

Rebecca is a graduate of Creighton University Medical School and Clarkson Family Medicine Residency.  She is a board certified Family Medicine Physician.  Rebecca began managing athlete concussions in 2010 when she became one of the first ImPACT certified physicians in Nebraska. 

She has continued to assist concussion patients in private practice and more recently at Methodist Physicians Clinic in Omaha, Nebraska. 

Her concussion patients now extend beyond athletes to include all age groups, as is consistent with family medicine, and varying degrees of head injury from acute concussions to post-concussion syndrome. Rebecca continues to be active in Concussion Focus and concussion education in the Omaha community.  Her goal in treating concussion patients is to understand where they are in their recovery,  help them through with the resources we have available and return them to their fullest quality of life after these most unfortunate head bumps.

Ah, sleep!  It is oh so important when you are recovering from a concussion, but what do you do when the injured brain does not want to sleep? 

Sleep habits become more essential post-concussion.  Scheduling regular sleep, wake times, and sticking to them helps. Here are a few tips you can implement to help manage sleep after a concussion. 

Managing a Concussion: Sleeping Tips

Aim for 7-9 hours of sleep per night. Minimize screen usage such as phones, computers, TVs, and reducing exposure to brighter lights before bed will help.

Try relaxing activities, meditation, stretching or reading if tolerated can be helpful before bed.  A short nap can be okay during the day, but if it starts to impair your ability to fall asleep, you may want to limit the duration of the daytime resting or eliminate it all together.  Physical activity is helpful during the day if you can tolerate some, but physical activity just before bedtime can make you more alert.  Decreasing or eliminating caffeine helps as well. 

And what if these tactics still do not work?

Sometimes an over the counter sleep aid like melatonin starting at a dose of 1 mg – 3 mg can be helpful to drift off to sleep easier. If headaches are a bother as well, Tylenol or Ibuprofen, at an appropriate dose for your age, prior to sleep may help.  You may also want to talk with your physician about medications that can diminish headaches as well as assist in sleep. 

Overall it is perfectly reasonable to start examining and modifying sleep habits. It may take some discipline and patience as you try a few nights with your new sleep routine. This course has no side effects and could lead to fewer concussion symptoms. If the concussion, however, has caused more difficult to manage sleep cycles, do not hesitate to seek help.

Sweet dreams!

Guest Blog Author: Rebecca Lancaster, MD


The care and treatment of concussions have become one of the fastest growing priorities in the medical community in the last several years and rightfully so.

An estimated 300,000 sport-related traumatic brain injuries, predominantly concussions, occur annually in the United States. In fact, for young people ages 15-24 years, sports are second only to motor vehicle crashes as the leading cause of this form of a traumatic brain injury. (Journal of Athletic Training)


Our Collaboration with Concussion Focus

What is ConcussionFocus? Concussion Focus is a collaborative group of healthcare professionals in the Omaha and surrounding area that decided to come together to provide a team approach to concussion management. 

Representing the areas of family medicine, pediatrics, neurology, athletic training, physical therapy, and other disciplines allow each professional to offer expertise in their field while communications with each other to best serve the patient’s needs.

Continue reading


What Everybody Ought to Know About: Concussion Protocol Evolution

Around 2004, while the head athletic trainer at a Class A high school in Lincoln, NE, I had the good fortune of being part of a research study that was looking at the use of a computerized tool for assessing concussion. The name of the program was ANAM and it assessed things similar to what we know today as ImPact.  In watching football players take this test after sustaining a concussion and comparing it to their baseline, I started to notice something that made me sick to my stomach.

Kids were not recovering in the 7 day window which we used at the time as the standard for clearing them to play again after concussion.

Especially freshmen and sophomores.

Concussions Early 2000’s.

Dr. Lori Terryberry-Spohr, a phenomenal practitioner and researcher at Madonna Rehabilitation Hospital, was instrumental in helping me understand what this program was finding and why it was starting to concern me.   I was noticing athletes were still symptomatic even after returning to play.  They were struggling with quick and accurate decisions – which is something essential to playing sports effectively and safely.  I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

I was starting to question how I was handling concussions and wondered if we needed to start doing things a little differently.  The other athletic trainers in my school district were wondering the same thing. 

 

At the same time, the national landscape was changing drastically in regards to managing concussions and in a very short amount of time we are where we are today.  No longer do we rate concussions in severity and no longer do we use a variety of grading scales that vary from liberal to conservative. You either have one or not.  Terms like bell rung, dingers, and stuns are not used any longer.

Concussions Today

All sorts of technology exists to aid athletic trainers and other sports medicine practitioners with concussion management.  There are state laws in place with the hope of protecting young athletes from continuing play after sustaining a concussion Nebraska LB 923.  Most importantly, we have much better approaches to return to play and now return to learn.

The more interesting point is all of this new information has streamed, really flooded, into mainstream media and the households of America.  Yet I still have to endure the verbal lashing from a parent when I explain why their athlete can’t finish the game and will probably be out for a minimum of 2 weeks. I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.  I still have to read doctor’s notes clearing kids a day later.  

Yes, I said doctor.

I still have to drum like the Energizer bunny advocating on behalf of the kid whose parents refuse to associate the decline in school with the concussion their athlete sustained months earlier.

 

The good news is the greater majority of athletes, parents, and practitioners get it now and this has led to some really great multidisciplinary approaches to helping athletes recover from concussion.  A great example is the team of providers in Omaha that participate in Concussion Focus.  My colleague Josiah Parker leads that team.  He has immersed himself in knowledge and practice techniques to provide post-concussion physical therapy and for the small percentage of cases that don’t resolve normally he can make all the difference in the world for their recovery.

Obviously I did the best I could back then based on the information we had at hand.  I also feel extremely grateful the kids I sent back out did okay.  Today, though, I know so much more and am appreciative for all of the resources that exist for kids in relation to concussions.

Written By: Danielle Kleber, ATC Director of Marketing & Operations

Question:  Do you know which sport has the second highest incidence of concussion (next to football)?

Save

How to Pick the Right Physical Therapist

Today’s blog post comes at the request of my father.  My answer to him was to simply call his son! Unfortunately this strategy will not work for most of you reading this post, and the decision may seem daunting. 

It seems over the last 10 years a physical therapy clinic has popped up on every corner in Omaha and the surrounding communities, which gives you a plethora of options. Going with the closest clinic may sound convenient but also may not deliver the results you are looking for. Today, I want to share my thoughts on how to narrow down your search!

IMG_9199_smallerjpg

First and foremost,

I would talk to former patients and see what their stories are along with asking several questions.

  1. Did they return to their desired activities?
  2. How long did it take?
  3. Did they get along well with their therapist?
  4. Did the therapist make adjustments if the initial plan was not quite meeting the patient’s needs?

Each of these questions can reveal important information about your potential therapist and what better person to ask than someone who has already worked with that person.

Next, see if you can get along with that potential therapist!

Therapy at times can be a long process. If you are recovering from a serious surgery you may work with your therapist for 6 months or longer. 

Stopping at the clinic and spending five minutes talking to your potential therapist can help you see if your personality meshes well with that person and if you can see yourself putting up with that person for the long haul.

Finally, set up an initial evaluation. 

During that evaluation the therapist should:

  • do a thorough history of your injury
  • take the needed measurements to show deficits and track progress
  • develop a plan of care

At some point during your first appointment the therapist should explain the “why” behind their plan of care.  If they don’t volunteer this information then feel free to ask them.

If the therapist cannot satisfactorily answer this question then I personally would find someone else to treat me. If you don’t understand why you are completing your exercises then it will be very difficult for you to buy in and give 100 percent effort.

Once a therapist has passed all these tests you should feel comfortable that you have a good person on your team to guide your road to recovery!

If you are reading this to start your selection process then I encourage you to give us a try! Stop in with any questions or use our website contact form to send an email.

Written By: Josiah Parker, PT

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

New physical therapist in West Omaha!

Say hello to Becca Buresh, the newest member of our physical therapy team! 

As a Lincoln native, Rebecca was involved in many youth sports, including soccer, basketball, softball, and volleyball.

She graduated from Lincoln Southwest High School in 2010 and was a part of the 2008 and 2009 state softball championship teams as a junior and senior.

She also excelled academically, graduating in the top 3% academically in her class. Rebecca continued her education at Creighton University, receiving her undergraduate degree in Chemistry while playing for the Creighton Bluejays softball team.

Read More of Becca’s story here!

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

The Football Helmet vs. Concussions

Who is excited for the Super Bowl this weekend? I know I am as football is definitely my favorite sport to enjoy as a spectator. Along with my role as a spectator though, I am also a provider who may treat those players who may sustain a concussion from participation in this sport. It is this role which led me to find research on the efficacy of helmets protecting against concussions.

Let’s dive into one of the questions that I receive pretty frequently. Do football helmets protect against concussions?

The head can sustain many types of trauma in the midst of a football game. This trauma can mostly be categorized into two different kinds of force, linear and rotational. Helmets do a great job of protecting against linear forces, or those which lead to skull fractures and focal bruising.

As stated in John Lloyd and Francis Conidi article entitled, “Comparison of Common Football Helmets in Preventing Concussion, Hemorrhage And Skull Fracture Using A Modified Drop Test” their study showed that skull fracture was reduced by 60-70 percent and focal bruising by 70-80 percent compared to not wearing a helmet.

On the other side of the spectrum there are traumatic brain injuries, which concussions are a mild form of. These injuries are often caused by rotational forces and are more diffused due to the bio-mechanics of the injury.

Their study also found that helmets, on average, only reduced the risk of concussion by 20 percent compared to not wearing a helmet.

At the end of the day, all sports involve some sort of risk but the more we know the better we can mitigate those risks.  Research continues to work towards finding a helmet that more effectively protects against brain injury.

In the meantime, safe tackling techniques and immediate removal from play should an injury occur are our best lines of defense.

The next line of defense is treatment starting after 2-3 days of rest.  If you find yourself or someone you know injured, find treatment as soon as possible from an athletic trainer or a physician trained in concussion management and if symptoms linger more than 2-3 weeks then contact us for further evaluation.

Source:

John Lloyd, Francis Conidi. “Comparison of Common Football Helmets in Preventing Concussion, Hemorrhage And Skull Fracture Using A Modified Drop Test. ” neurology.comNeurology April 8, 2014 vol. 82 no. 10 Supplement P5.320

 

What can a physical therapist do for a concussion?

What to learn more on the basics of concussion symptoms and how your physical therapists can help relieve these prolonging concussion symptoms? Then check out Josiah Parker’s blog, 3 Unexpected Treatments for Concussions – That Work! 

3 Unexpected Treatments for Concussions – That Work!

Written By: Josiah Parker, PT, DPT

Josiah Parker – My “Why”

I became a physical therapist really out of a desire to own my own business some day. My dad pushed me to find exactly what kind of business I would like to own and he saw that I am not the type of person who would be happy simply sitting behind a desk without people interaction all day long.

He brought up the occupation of physical therapy which I was familiar with due to all too many injuries through my sports career.

I initially was hesitant to the idea, but the idea caught on during my senior year of high school. I then got a scholarship which guaranteed me a spot at UNMC if I kept my grades during my undergraduate work. I haven’t looked back since receiving that scholarship!

My favorite part of my job at Athletes’ Training Center is seeing the difference that improved function makes in peoples lives. I love getting to know people and forging lifetime friendships.

Outside of work I am an assistant coach for grade school select basketball.

I coach an 8th grade basketball team called Elkhorn Attack. It was my first time coaching for a full season and I had a great time getting to know the kids on the team and helping them to improve their skills in the game that I have come to love.

Understanding Exertion Therapy

Concussion Treatment #1

The treatment of concussions has been widely debated over the past few years. What was previously known and proven with research about concussion treatment suggested that the patient must rest, both mentally and physically. This is indeed true for initial treatment of concussions. There has now been a shift with concussion treatment that suggests moderate amounts of exertion may be used to help treat those who suffer from lingering concussion symptoms.

If you read my earlier blog 3 Unexpected Treatments for Concussionsit may have stuck out to you that I used the term “exertion therapy.” You may have even thought to yourself, “is this guy insane?” People with concussions need rest. They don’t need to exert themselves!”  If this is what you thought, then you definitely aren’t alone.

As we all know, not all concussion injuries are the same. Sometimes people have symptoms months or years after sustaining an injury, this is called Post Concussion Syndrome (PCS). I will share a case study that comes to mind; he was a colleague of mine who played football and whom experienced long-term concussion symptoms.

football-official-standing

Case Study

He was a running back and had played football since he was eight years old. Throughout his career he suffered his fair share of hits and injuries and received two concussions before playing in college. On his last football game of his career he sustained his 3rd concussion, what a way to wrap up your collegiate career right?

This concussion was different than his previous injuries. He lost consciousness and had severe migraines for weeks, months and even years to follow. He had tried everything to relieve the pain. He had visited neurologists and multiple chiropractors. He had gotten mixed results and he never got rid of his migraines and overall neck stiffness. I reconnected with him years later and had heard his struggle. That was when I told him to come and get it checked out by a physical therapist. He was diagnosed with Post Concussion Syndrome.

Eighty percent of people who suffer a concussion are symptom free within 2-3 weeks of their injury. However, this means that 1 in 5 people make it past this 3-week time frame and continue to have symptoms.

 

Post Concussion Syndrome (PCS) Symptoms

  1. Elevated heart rate – Tends to be high even at rest for those with PCS.
  2. Depression – Many people with PCS begin to feel some level of depression due to their decreased tolerance to activity. This can be especially true in an athlete who is used to a regular high level of activity.

Thinking back to the case study that I shared above, there are a few techniques that can be used to help address symptoms of PCS that can speed up recovery time.

Exercise is a great start, and that’s the basis of exertion therapy. Of course I am not suggesting that three weeks after a concussion you should go out for a 10 mile run and then that evening suffer from a throbbing headache.What I am suggesting is that your daily exercise routines should be monitored by a professional.

This is crucial so that your exercise does not negatively affect your concussion recovery. Sometimes it is hard to know if your workout negatively affects you without having someone monitor you, so let me help clarify what I can do for PCS patients.

PCS patients who are seeing me are taken through a graded exercise test, which helps me to find how high they can get their heart rate prior to their symptoms getting worse. I then use this information to help them develop a program they can use to get moving again.

If this situation describes you or someone you know then contact us today to get a more comprehensive evaluation!

Written by, Josiah Parker – PT, DPT

Question: Do you have any questions about exertion therapy treatment for physical therapy?

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 www.concussionfocus.org.

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?

Understanding Cupping: Ancient Chinese Technique

Some of you may remember last year during the coverage of the Rio Olympics there was a lot of hype surrounding these strange circular shaped marks on the shoulders and back of the most decorated Olympian of all time, Michael Phelps.

These marks were made by a technique called cupping. It is an ancient form of Chinese medicine. This technique has again recently popped up in the news and today I thought it’d be a good time to answer some questions surrounding this technique.

Undeniably Phelps is a seemingly ageless beast in the pool, so why do he and many other professional athletes use the cupping technique and how does it work?  

Cupping is another tool in the toolbox that a physical therapist or a trained professional can use to help alleviate pain or speed up the recovery process. 

How does it work?

Cupping involves cups made of glass, bamboo, or plastic which are used to create suction over the skin. This suction draws up the skin, facia (connective tissue), blood vessels, etc in an attempt to mobilize the tissue, increase blood flow, stimulate the nervous system and decrease pain.  Cupping has been reported to help a plethora of conditions including pain, stroke and hypertension. 

In my review of the literature all of these uses have been poorly studied but the most well researched area was pain and there appears to be support to using cupping for treatment of musculoskeletal pain.

What to take away

At the end of the day, I think we all know that cupping is not what makes Phelps a great Olympian but clearly he believes cupping helps speed his muscle recovery between events. 

Personally I don’t believe the tool is the most important factor, it is the skill of the practitioner using the tool. Therefore my belief is that cupping is another tool in the toolbox for those looking for soft tissue mobilization and increasing blood flow to different areas. Other tools in this toolbox include instrument assisted soft tissue mobilization, dry needling, massage, and foam rolling.

If you have a condition you feel would benefit from some of the above tools, or if you have tried on your own and aren’t getting anywhere then set up an appointment today and add an expert to your team!

Written By: Josiah Parker, PT

Football Concussion Crisis: How to Respond

 – Advice from a Physical Therapist to a Concerned Mother

I absolutely love this time of year – temperatures are not quite so warm, the trees will soon start changing colors, and most importantly football is back! But my love for this sport has lead to many, serious conversations about football injuries. There is a common theme among these conversations, concern.

As you probably guessed, concussions are the prevailing topic of concern. The frequency of these conversations has led to writing this blog post. What should you do if your child sustains a concussion?at

As a parent your first line of defense is an athletic trainer, if the team has access to this person.  Athletic trainers are extremely adept at dealing with these injuries and will likely take point in your child receiving any medical attention that is needed.  But what if you don’t have access to an athletic trainer? My goal is to educate those of you who don’t have access to an athletic trainer on what to look for and what to do.

Concussions can be difficult to diagnose due to the subjective nature of the symptoms. Your child may be suffering from a concussion if they report:

– a persistent or worsening headache
– feeling dizzy/nauseous
– mental fogginess
– or a range of other similar symptoms

If these symptoms are reported after a blow to the head, medical attention should be sought out as soon as possible through the child’s pediatrician or an emergency room.

The initial goal is to rule out more serious, life threatening conditions such as a brain bleed or skull fracture which can be identified through imaging (unlike a concussion.) Once those are ruled out the initial recommendations will be rest from physical and mental activity.

“80 – 90% percent of concussions resolve within three weeks – but for those that don’t, further medical attention may be needed.”

If further medical attention is required, start with a doctor who has had further training on how to deal with concussions.  There is a list of suggestions available on www.concussionfocus.org.  This physician may suggest modifications to activity, medication, or rehabilitation to help return to normal function.

Concussions can be a scary ordeal, both for the affected individual and their family, but with the proper treatment most kids are able to get back to football, and other desired activities.  If you are in need of rehabilitation, or need help figuring out where to start, contact us today!  You can also visit the Concussion Focus website listed above for more details on concussions and for resources on how to treat them.

Written By: Josiah Parker, PT, DPT

Question: What questions do you have for a physical therapist about concussions?

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.