A woman holding up a dumbbell in a bicep curl position

Strength Beyond Change: Empowerment in Menopause Management

As a society, we are under-educated about menopause management and how women's bodies change during menopause. If you’re menopausal, post-menopausal (after menopause), or even peri-menopausal (shortly before menopause), it can feel like you’re getting to know a new body. This can feel scary or daunting as we try to navigate these new changes! So, let’s navigate this journey together! 


Menopause and Common Symptoms 

Let’s quickly review what menopause is. Menopause is the time when a female does not have a period for at least 12 months. On average, this occurs at age 51. While there is a myriad of symptoms that can occur, common symptoms associated with menopause and after menopause can include: 

  • Brain fog, decreased concentration, and poor sleep quality 
  • Hot flashes and night sweats 
  • Joint pain and decreased bone health (including osteoporosis and osteopenia) 
  • Increased cardiovascular disease and metabolic changes 
  • Sexual dysfunction and pelvic floor disorders 

Of particular importance is bone health. Osteoporosis and osteopenia are metabolic bone diseases characterized by low bone mass, impaired bone quality, and increased likelihood of low-trauma fractures.  Low-trauma fractures are fractures that occur from a fall from standing height or lower, rather than a fall from a height or from an accident. 


Why is this a big deal?

Why does bone density matter? If we have low bone mass and we fall on our hands, hips, or knees, it can be challenging to recover if it results in a fracture. Studies have shown that hip fracture in adults over 65 is a risk factor for mortality vs. adults over 65 with no hip fracture. So, we want to make our bones as strong as possible! 


What can I do?

As you’re reading, you might be thinking, “What a depressing blog post. Where’s the good news?!” Or you might be thinking, “What if I’m already post-menopausal, is there anything I can do?” Fortunately, there are many things you can do to set yourself up for success no matter where you are in the lifespan! 

There are three major categories to consider when we think about either preventing menopausal system changes or improving existing conditions: 

  1. Medication and supplement management
  2. Diet
  3. Exercise


Medication/Supplement Management

A good place to start is by talking to your primary care physician about medications or supplements to manage your bone density, such as hormone replacement therapy and bone building medications. If you have not had a bone density scan (DEXA scan), your doctor will likely order one to determine your level of bone loss before ordering medications or supplements. 



It is also recommended to talk to your doctor or a nutritionist about a diet that can help with prevention of bone loss. You will need to make sure your diet contains an adequate amount of vitamins, minerals, and protein. This is especially important for rebuilding bone as a response to strength training exercises. 



When it comes to exercise, there are three primary types of movement to facilitate bone health: 

  1. Progressive resistance training 
  2. High-velocity power training 
  3. Weight-bearing impact training 


Progressive resistance training

For progressive resistance training, think “lift heavy and hard.” This could include weighted squats and deadlifts, pushups, weighted overhead presses, etc. All of these exercises can be modified to fit your current level of strength and fitness. For example, weighted squats could be performed as a sit to stand, and pushups could be performed against a wall or countertop. 


High-velocity power training

For high-velocity power training, think “quick and explosive,” such as jump squats and snatches. This kind of exercise can also be modified to fit your current level of fitness or mobility. For example, a jump squat could be performed as a "stomp" to a sit to stand. The specific exercise depends on which bones you are trying to strengthen!


Weight-bearing impact training

Weight bearing impact training is any activity where impact is placed on the bones, which stimulates growth of increased bone density. Walking, running, stair climbing and pickleball would be examples of weight bearing impact training.


Now what?

We're here to help! Our doctors of physical therapy are trained to assess joint limitations, joint pain and muscular strength to help you follow a program to minimize the effects of aging and maximize bone density. We can assist with coming up with a strengthening program that address all three categories of exercise that is tailored to your current ability level and your goal ability level.


Start feeling better today! Request an appointment with one of our skilled Doctors of Physical Therapy to get started with menopause management today.


More questions? Give us a call at (479) 442-7473. Check out our Instagram more more helpful tips!


Interested in learning more?

Check out this article for more tips on diet and exercise.


Written by Gabrielle Back-Kremers, PT, DPT and Leah Thompson, PT, DPT 




Photo by Limor Zellermayer on Unsplash
Leah Thompson
Physical therapist demonstrating shoulder anatomy

Cracking the Code: Understanding Noisy Shoulders

When crackles and pops come from your shoulder versus your bowl of cereal, it can be concerning. The good news is that shoulder cracking, snapping, or popping when moving your arm can be perfectly normal and does not always indicate a bigger issue. We aim to guide you in determining the next steps as we explore causes, treatments, and prevention options for noisy shoulder joints.


Shoulder Anatomy

First, let’s gather a brief understanding of the anatomy of your shoulder. The shoulder, also known as the glenohumeral joint, is a ball and socket joint capable of multidirectional movement. It’s composed of muscles, tendons, ligaments, bones, cartilage, and bursa. Any of these structures can be easily injured, over-used, or degraded with age or decreased use.

The shoulder is a ball and socket joint consisting of the humerus bone (upper arm bone) and the scapula bone (shoulder blade). The rotator cuff consists of four muscles that provide shoulder and scapula movement. Ligaments and tendons connect bone to bone and bone to muscle, respectively. Bursae are fluid-filled sacs that provide lubrication and cushioning to the joint, and cartilage (labrum) holds everything in place.


My shoulder pops but doesn’t hurt. Should I be concerned?

Crepitus is the popping, clicking, or crackling sound you hear when you move your shoulder, and it is usually harmless. Common reasons for experiencing shoulder popping when lifting, rotating, or performing other shoulder movements without pain include:

  • Aging
  • Posture
  • Long-term immobility
  • Old fracture or injuries
  • Idiopathic noise (shoulder popping without an explanation or injury) 
  • Cavitation*

* Cavitation happens when there is air in the joint, usually when some of the liquid lubricant turns into a gas. A quick shoulder movement then releases this air and creates a popping noise. This is similar in sound and sensation to cracking your knuckles. Often there is no pain or related illness


My shoulder pops and it hurts. What should I do?

There can be underlying pathological issues associated with noisy shoulders. Most of these disorders cause pain in and around the shoulder and often include weakness or loss of function. These are the most common medical conditions associated with shoulder pain and popping:

  • Bursitis: inflammation of the bursa, or bursae, in the shoulder and scapula areas
  • Labral Tears:  cartilage of your shoulder joint is torn by repetitive motions, injury, or age 
  • Osteoarthritis: OA is the most common form of arthritis and is the result of cartilage breaking down because of changes or damage to the tissue or structure of the joint.  
  • Rotator Cuff Injuries: damage to any of the four muscles of the shoulder joint and adjacent tendons. 


Start with physical therapy

The great news is that physical therapy can help the conditions listed above or be used as prevention for worsening of a noisy shoulder. Shoulder movement should not be painful and failure to treat a shoulder joint issue or injury can result in long term loss of function.  If your shoulder pop is accompanied by pain, warmth, decreased range of motion, decreased strength, request an appointment with your physical therapist for a shoulder evaluation. 

Physical therapist measuring shoulder ROM
Physical therapist testing shoulder ROM


Our doctors of physical therapy will assess your posture, muscle strength, and flexibility to pinpoint potential causes of the popping or cracking. You will be given a personalized treatment plan to address the underlying cause of your noisy, painful shoulder and to relieve pain. While shoulder sounds may not always be fully eliminated with physical therapy, shoulder pain is a highly treatable condition. 

Start feeling better today! Request an appointment with one of our skilled Doctors of Physical Therapy to start feeling better now.


More questions? Give us a call at (479) 442-7473. Check out our Instagram to find more examples of exercises and stretches for noisy shoulders!

Carrie Lynch

Written by Carrie Lynch, PT, DPT 

Physical therapy for gamers

Physical Therapy for Gamers

The Gamer's Guide to Physical Therapy

Scroll through social media and you’ll see endless posts targeted towards traditional athletes, like:

  • Strong Knees for Lifters
  • Core Training for Runners
  • Bulletproof Shoulder Exercises for Baseball Throwers

But when was the last time you saw a post about physical therapy for gamers? If your answer is “a long time ago in a galaxy far, far away,” then this post is for you!


How can physical therapy help gamers?

Whether you perform esports professionally or play tabletop role-playing games for fun, you’ve likely experienced body aches and pains at some point, especially if you’re gaming for long stretches of time. Due to sustained static postures and repetitive motions, many gamers suffer from neck pain or back pain, headaches, wrist pain, or carpal tunnel syndrome.

This can make it more difficult for gamers to play the games they enjoy, as well as affect concentration. No one wants to deal with pain when they’re trying to speedrun a dungeon without taking damage!

There are many factors that can help reduce or eliminate pain for gamers. One of the most important factors to take a closer look at is your gaming set-up. Many wrist, elbow, and neck issues can be helped quickly by just optimizing your gaming set-up for your height and ergonomics. Check out this YouTube video for helpful tips on desk ergonomics.

However, even with a 100% perfect gaming set-up, it is still possible to have pain due to the demanding nature of gaming for long periods of time. Due to the extreme concentration needed for most games, we don’t always think about our posture or positioning while gaming. That is why it is important to have a flexibility, mobility, and strengthening routine that you can turn to after your gaming session is complete.

Here are just a few examples of stretches and exercises that can help reduce pain related to gaming:

Chin Tucks:

chin tucks
Step 1
Step 2
Step 3

Upper Back Extension:

upper back extension
Step 1
Step 2

Tendon Glides:

Step 1
Step 2
Step 3
Step 4
Step 5

Nerve Glides:

Step 1
Step 2
Steps 3

Our doctors of physical therapy specialize in helping people improve their movement and performance as well as manage their pain. If you feel that you need more help with managing pain related to gaming, that’s where we come in!


What can I expect during my physical therapy visit?

The first session, what we call the initial evaluation, usually starts out with “What brings you to therapy,” where we then dive deeper into your symptoms. For example:

  • What are your symptoms and where?
  • What makes your symptoms better/worse?
  • What is your gaming setup like? (PC gamer vs. console gamer)
  • What type of gaming do you do (ie, tabletop board games vs. video games vs. card games)
  • How long and often do you play?
  • What have you tried to help the pain/symptoms?

Once these have been clarified, we follow it up with tests to look at muscle length and extensibility, joint range of motion, and muscle strength, endurance, and coordination, as well as tests to reproduce symptoms. It’s essential to assess muscle endurance as many gamers stay in one position for a long time and need the ability to maintain static positions comfortably. Based on these findings, your therapist will outline your diagnosis (the WHAT and the WHY) and a game plan for recovery (the HOW).

At Rise Physical Therapy, we assess each individual and their unique set of symptoms and goals. So if you’re having pain, neck stiffness, pins and needles, or XYZ, we can identify the WHAT, the WHY, and the HOW to get you on the road to recovery, fast!

Get back in the game today! Request an appointment with one of our skilled Doctors of Physical Therapy to start feeling better now.


More questions? Give us a call at (479) 442-7473. Check out our Instagram to find more examples of exercises for gamers!


Written by Gabi Back-Kremers, PT, DPT 

Featured image by JESHOOTS.COM on Unsplash.

Maintaining Balance as We Age

Balance is the ability to distribute weight in a way that will let us hold a steady position. Balance begins with a nonstop stream of information gathered by several systems in the body. The visual system (your eyes) helps you to orient yourself in space. The musculoskeletal system (muscles, joints, tendons) contains special sensors that provide you with awareness of your body and movements in space (proprioception or kinesthesia). The vestibular system (inner ear) provides information about head position, spatial orientation, and motion. All three of theses systems are continually sending their findings to the brain. This flood of data gets processed and the result is the ability to stand, move, perform tasks and remain balanced. Strength and flexibility are also other important components of balance. They are required to keep the body upright and under control. Good balance relies on the muscles of the feet, legs, buttocks, abdominals, and torso.

As we age, we lose the function to balance through loss of sensory elements, decreased ability to integrate information and issue motor commands, and loss of musculoskeletal function. What can you do to fight this loss? Resistance training and weightlifting will build strength and stamina. Yoga, tai chi, and Pilates will help with flexibility. Simple activities, such as standing on one foot while brushing your teeth or cooking, always rising from a chair without using your arms, practicing walking backwards or heel-to-toe in a straight line all directly target balance. Researchers have found that balance begins to decline in midlife, starting at about age 50. In one recent study, adults in their 30s and 40s could stand on one foot for a minute or more. At age 50, the time decreased to 45 seconds. At 70, study participants managed 28 seconds. By age 80 and older, they lasted less than 12 seconds standing on one foot.

Because the aging process can affect vision, strength and balance, adults 65 and older are at elevated risk for falls. However, falls are not a natural part of aging and can be prevented.

Balance and Fall Risk Assessment

Physical Therapists can examine you and assess your balance and risk of falling. Guidelines published by the American Geriatrics Society and British Geriatrics Society (AGS/BGS) recommend screening adults 65 and older for fall risk every year. A balance and fall screen may include questions about your history of falling in the past year, and if there was a need for medical attention. Even if you have not fallen, a comprehensive evaluation and balance training are key in preventing potential slips and trips, helping you live without the fear of an accidental fall. Physical therapists will use balance re-training exercises, gait training, safety training, and muscle strengthening to help those who are struggling with balance issues due to injury or aging.

Request an appointment to have one of our Doctors of Physical Therapy assess your balance and help prevent falls.

Written by: Carrie Lynch, PT, DPT
Fayetteville, AR

Photo by Raphael Renter on Unsplash