An anatomical foot and ankle model

Trail Running Injury Prevention in Northwest Arkansas: A Physical Therapist’s Guide

Prehab for Trail Running: How to Build Strength and Stability Before You Hit the Trails

Trail running offers unique rewards and challenges, and as a physical therapist and lover of our beautiful NWA trail system, I emphasize the importance of both prehab and rehab strategies to keep runners healthy.

Prehab (a proactive strategy with an emphasis on preparing for a specific activity) should focus on strengthening key muscle groups such as the glutes, quads, calves, and core to provide dynamic stability on uneven terrain.

Improving single-leg balance through proprioceptive exercises like single-leg stands and wobble boards helps enhance joint stability, while maintaining ankle, hip, and thoracic mobility allows runners to adapt efficiently to variable surfaces and reduces compensatory movement patterns.

Gradually introducing plyometric drills prepares muscles and tendons for the impact and agility demands of trail running. Footwear assessment is also crucial; runners should ensure they have proper shoe fit and consider trail-specific footwear for optimal support and traction. Additionally, transitioning slowly from road to trail running gives the body time to adapt to changes in surface and elevation. 

Common Trail Running Injuries in NWA

Common trail running injuries we see in our clinics include: 

Ankle Sprains

Ankle sprains are one of the most common trail running injuries due to the forces that uneven surfaces put on the ankle and foot joints. If you are new to trail running, it is important to work on ankle stabilization exercises to prevent ankle sprains from occurring.

IT band syndrome

The IT band is a sheath of connective tissue that runs from the outside of the hip to just below the knee on both sides. It helps to stabilize the hip and knee when walking or running. IT band irritation or injury is common among trail runners due to the uneven surfaces and repetitive forces placed on the hip and knee when trail running.

Patellofemoral Pain (Runner’s Knee)

Pain under or around the knee cap (the patella) is also very common in trail runners. Patellofemoral pain, or “Runner’s Knee” can occur when the tissues around the kneecap get irritated due to repetitive movements like running on uneven surfaces.

Achilles Tendinopathy

Tendinopathy refers to pain, swelling, and reduced function in a tendon. The Achilles tendon is very important for trail running because it helps to generate power from the ankle and foot. Achilles tendinopathy is an extremely common injury for trail runners due to the increased demands on the Achilles tendon during uphill climbs on unstable surfaces.

Plantar Fasciitis

Plantar fasciits refers to pain in the bottom of the foot, most often near the heel, that can occur when the plantar fascia, a band of connective tissue in the bottom of the foot, gets overstretched or overworked. This is a common issue among trail runners due to the demands of running on unstable ground.

 

How to Recover from a Trail Running Injury

When injuries do occur, early load management is essential—modifying activity to reduce pain while maintaining cardiovascular fitness through alternatives like cycling or pool running. Rehab should also focus on restoring range of motion with gentle stretching and mobility work, targeted strengthening of both affected and supporting muscle groups, and neuromuscular retraining to rebuild balance and confidence on uneven ground.

 

Returning to the Trails: A Stepwise Approach

A gradual, stepwise return to trail running—starting with less technical trails and shorter distances—is recommended, along with ongoing education about proper warm-ups, cool-downs, and recognizing early signs of overuse. 

Ultimately, a physical therapist’s approach to trail running injury prevention and recovery is highly individualized, taking into account each runner’s biomechanics, injury history, and personal goals. Consistency with prehab exercises and mindful training progression are key to preventing injuries and ensuring long-term enjoyment of trail running. 

 

Frequently Asked Questions About Trail Running and Physical Therapy

Should I stop running if I get injured?

The short answer is it depends. If you are able to run without any changes to your gait (the way you run) and without increased pain, then you can continue running through an injury. If the injury changes the way you run, causes you to limp, or the pain increases during or after running, these are signs that you need to temporarily scale back.

Our expert Doctors of Physical Therapy can perform an assessment to determine if your training plan needs to be scaled back due to injury.

How do I safely transition from road to trail running?

There is no specific formula for transitioning from road to trail running, but a good rule of thumb is to transition gradually. This could look like allocating 10% of your weekly mileage to trail running and then increasing gradually by no more than 10% per week. You may need to transition faster or slower based on how you feel after your first few trail runs.

How long does it take to recover from a trail running injury?

Recovery from a trail running injury looks a little different for everyone. If you are dealing with a soft tissue injury like a severe ankle sprain or Achilles tendinopathy, full recovery may take up to 3 months depending on the severity of the sprain or injury. Other injuries may recover faster if you can modify your activity and take care not to exacerbate them. A doctor of physical therapy can give you a realistic picture of how long it might take for you to recover from your injury.

Do I need a referral to see a physical therapist for a running injury?

Arkansas is a direct access state, which means you do not need a referral to see a physical therapist with most insurance plans. If you have a running or trail running injury, you can request an appointment with one of our expert Doctors of Physical Therapy directly – no referral required!

Written by Dr. Ryan Clark, PT, DPT

Ryan received his BS in Kinesiology from the University of Texas San Antonio, and Doctorate of Physical Therapy from the University of Texas Medical Branch in 2024. Ryan has interests in treating neuro-progressive patients, a wide-range of orthopedic cases, and has a strong passion for veteran mental health. Outside of the clinic, Ryan enjoys spending time with his wife, cooking exotic meals, and competing in various endurance sports.

shoulder range of motion

Shoulder Injury: What Your Physical Therapist Wants You to Know

A shoulder injury is a common cause of decreased function in daily life, affecting activities at home, work, and in the community. Proper diagnosis and management are essential to restore function and prevent further complications. Your physical therapist can use the following considerations to help diagnose, treat, and guide you through recovery.

 

Key Considerations in Diagnosing Shoulder Injuries

When evaluating your shoulder injury, your physical therapist will examine the following factors:

  • Onset and Duration: Is the injury acute, chronic, insidious, or traumatic?
  • Source of Pain: Is the source of the shoulder pain or dysfunction musculoskeletal in origin—such as from muscles, tendons, ligaments, or joints?
      • Or is it systemic, which could indicate a medical condition requiring attention from a physician?
  • Referred Pain: Not all pain felt in the shoulder originates from the shoulder itself. Pain may be referred from the neck, upper back, or even internal organs.  

While most shoulder injuries seen in outpatient physical therapy are musculoskeletal, it is important to remain vigilant for signs that may suggest a non-musculoskeletal cause. If your therapist determines that additional medical workup is required, they will assist you with the next steps.

 

Comprehensive Shoulder Assessment 

Once your therapist establishes that the pain is truly originating from the shoulder, a detailed assessment is necessary. This includes evaluation of: 

  • Global Shoulder Mobility: Assessing overall movement of the shoulder joint and scapula (shoulder blade).
  • Glenohumeral Mobility: Your therapist will check how well the ball and socket shoulder joint moves while checking for movement restrictions or excess movement.
  • Scapulothoracic Mobility: Your therapist will observe the movement of the shoulder blade on the rib cage, which is essential for full shoulder function.
  • Strength: Your therapist will test the strength of the rotator cuff, scapular stabilizers, and surrounding musculature. 
  • Tissue Tension and Tenderness: Your therapist will touch the soft tissues of your shoulder to identify areas of increased tension, trigger points, or tenderness in the muscles, tendons, or ligaments. 
  • Posture: Posture is an important factor that can affect shoulder positioning and function. Your therapist will examine posture to identify patterns that may contribute to shoulder dysfunction.

A thorough assessment to identify deficits in these areas helps pinpoint the source of pain and informs the most effective treatment plan. 

 

What Causes Shoulder Dysfunction and Injury?

Shoulder injuries can arise from a variety of sources, including: 

  • Muscle Imbalances and Weakness: Weakness in the rotator cuff or scapular (shoulder blade) stabilizers can lead to instability and compensatory overuse of larger muscles. 
  • Joint Instability or Stiffness: Limited mobility or excessive joint laxity can both contribute to pain and dysfunction. Manual therapy techniques may be used to improve joint mobility, while targeted strengthening exercises can enhance stability. 
  • Poor Movement Patterns: Faulty movement mechanics, often due to pain or previous injury, can perpetuate dysfunction and increase the risk of re-injury. 

 

The Role of Physical Therapy in Shoulder Injury Recovery 

Physical therapy offers a conservative (non-invasive), evidence-based (backed by research) approach to managing shoulder injuries. At Rise, our physical therapists are trained to identify the underlying causes of pain and dysfunction, and to develop a personalized plan of care to help eliminate pain and get you back to full activity. 

A comprehensive plan of care for shoulder pain or injury includes:

  • Manual therapy such as dry needling or joint mobilizations to address joint or soft tissue restrictions.
  • Therapeutic exercises to restore strength and mobility.
  • Education on posture and movement strategies to prevent recurrence.

 

How Long Does Physical Therapy for Shoulder Injuries Take?

It is important to recognize that conservative management through physical therapy services requires time and consistency. Recovery timelines can vary depending on factors such as tissue type, severity of injury, and whether the issue is acute or chronic. Adherence to your prescribed home exercise program is essential for optimal outcomes. While tissues have a natural capacity to heal, appropriate interventions during the healing process are critical to ensure efficient and effective recovery, and to reduce the risk of future injury. 

Shoulder Healing Timelines

  • Tendonitis/Tendinopathy: Between 2 weeks and 6 months depending on severity
    • Early treatment is key!
  • Post-operative shoulder conditions: 6-12 months for complete recovery
  • Muscle strain: 2-8 weeks if mild
  • Muscle tear or severe strain: 4 weeks-6+ months

 

Shoulder injuries can significantly impact your quality of life, but with a comprehensive assessment and a structured rehabilitation plan, recovery is achievable. If you are experiencing shoulder pain or dysfunction, consider consulting a physical therapist at Rise. Our team is dedicated to helping you identify the source of your pain and guiding you on the path to recovery. 

Dr. Matt Palmer

Matt Palmer joined Rise Physical Therapy in June of 2023. He is originally from St. Louis, MO. He received his undergraduate Bachelor of Science degree in Health Sciences with an emphasis in Physical Therapy at the University of Central Arkansas before receiving his Doctor of Physical Therapy (DPT) at Missouri State University. Matt enjoys working with patients who present with a variety of musculoskeletal conditions. He values every opportunity in the clinic and strives to create a safe and positive environment as he and the patient work together to achieve the patient’s goals. In his free time, Matt enjoys golfing, fishing, and attending Razorback games during basketball and football season. He and his fiancé also just welcomed their Bernese Mountain Dog, Reece, to their family!

Dr. Caroline Hardin explains the muscles of the pelvic floor

To Kegel or Not to Kegel?

Everyone recommends Kegels, but when are they actually appropriate?

Kegels, or pelvic floor muscle contractions, are often the go-to recommendation for pelvic floor dysfunction. But are they always appropriate? The answer is no!

Pelvic floor dysfunction is a broad term that can refer to the dysfunction of the pelvic floor muscles due to many different conditions.  

 

Examples of pelvic floor dysfunction:

  • Urinary incontinence 
  • Urinary urgency and/or frequency
  • Fecal incontinence
  • Constipation
  • Pelvic organ prolapse
  • Pain with penetrative activities
  • Pain in the pelvis, genitals, hips, low back, or abdomen

Having strong pelvic floor muscles can be helpful, but more specifically we want our pelvic floor muscles to be able to move throughout their full range of motion when needed.

Therefore, it is just as important for our pelvic floor muscles to be able to lengthen or relax when necessary. Sometimes pelvic floor dysfunction is not a result of a weak pelvic floor, but rather a pelvic floor that is tense.

Our pelvic floor relies heavily on surrounding areas such as our core, hips, spine, and diaphragm. We want all these areas to be well balanced and working together to support optimal pelvic floor function. 

How do I know if I have pelvic floor weakness or tightness?

The best way to determine if your pelvic floor issue is caused by pelvic floor muscle weakness or tightness is through an evaluation of these muscles by a Doctor of Physical Therapy.  

 

A tight pelvic floor can cause symptoms like:

        • Pain with intercourse
        • Difficulty starting to urinate and/or incomplete bladder emptying
        • Muscle spasms in the pelvic area
        • Pain that radiates to the tailbone or lower back
        • Bladder leakage with coughing/sneezing/exercising
        • Frequenturination
        • Chronic constipation
        • Secondary symptoms like hip or low back pain

A weak pelvic floor can cause symptoms such as:  

        • Incontinence or leakage (bowel or bladder)
        • A sensation of heaviness in the pelvic area
        • Prolapse
        • Decreased sensation during intercourse
        • Secondary symptoms like hip or low back pain

Some people may also experience symptoms of pelvic floor tightness and pelvic floor weakness simultaneously.

How do I know what kind of treatment is right for me? 

It can be hard to know where to start. Luckily, pelvic floor physical therapists are trained to evaluate and determine the most appropriate treatment approach. 

During your first pelvic floor therapy visit at Rise, your therapist will perform a thorough medical history review and physical examination to determine the root cause of your symptoms. An internal exam of the pelvic floor muscles can be helpful but is not necessary. Your therapist will ask for consent prior to each portion of the examination.  

Your therapist will recommend exercises and/or hands on techniques to address your specific type of pelvic floor dysfunction. While Kegels are a common exercise that can be effective for low level pelvic floor strengthening, your therapist will recommend a complete exercise program that may include strengthening or mobility work for the pelvic floor and other body areas, such as the hips and low back.  

Functional exercises and breathing drills are also important aspects of a treatment program for pelvic floor dysfunction. While Kegels can be a good starting point, your therapist will work with you to achieve pelvic floor activation or relaxation during functional movements such as squatting or lifting a heavy object from the floor. The goal is to improve your symptoms by addressing the pelvic floor while it works with other muscle groups for more effective targeting and symptom control.  

Ready to get started? Request an appointment with one of our skilled Doctors of Physical Therapy to chat more about how we can help! 

Check out this video for more information about your first pelvic therapy visit.

Dr. Katelyn Perez

Katelyn joined Rise Physical Therapy in June 2025. She is originally from Texas. She received her Bachelor of Science in Exercise and Sports Science from Texas State University and her Doctorate of Physical Therapy (DPT) from Harding University. Her special interests include working with the pelvic health population, including but not limited to, pregnancy and postpartum care, pelvic pain, pelvic organ prolapse, urinary incontinence, and pre- and post-prostatectomy care. Outside of the clinic, you can find Katelyn catching up on guilty pleasure TV shows, finding new restaurants in the area, or spending time with friends, family, and dog named Gunner.

Understand your insurance plan

Insurance Basics: Understand Your Insurance Plan

Understand Your Insurance Plan

Does navigating your insurance feel like learning a new language? You’re not alone! Insurance terms can be confusing, but we’re here to make them simple so you can focus on your health. In this article, we’ll explain insurance basics to define common terms and types of plans. We’re here to help you make an informed decision and understand your insurance plan.

 

Let’s start by defining some basic insurance terms to help you understand your insurance

  • Premium: The fixed amount you pay every month to maintain your insurance plan, even if you don’t use healthcare services that month.
  •  If the monthly premium is not paid, the insurance policy will be canceled. 
      • When shopping for your insurance plan, a lower monthly premium is not necessarily better in the long run. Some plans with a lower monthly premium may have a higher deductible that needs to be met before they will start covering the majority of services. 
  • Deductible: The total amount you pay out of pocket before your insurance starts covering services. For instance, if your deductible is $1,500, you’ll pay all costs up to that amount before your coverage kicks in.
      • https://www.healthcare.gov/glossary/deductible/
  • Copay: A copay is a flat rate that you might pay towards healthcare services (typically once your deductible is met.) This amount is set by the insurance company and may change year to year. For example, if you visit the doctor and your insurance company allows $150 to be billed for the services you receive, you would pay a copay that might be anywhere between $20 and $80. Then, your insurance plan would cover the rest of the cost. 
  • Coinsurance: A coinsurance is the percentage of a covered healthcare service you must pay after your deductible is met for the year. This amount is predetermined by your insurance plan. Your insurance plan will likely have a higher coinsurance amount if your deductible amount is lower. You will be responsible for paying the co-insurance amount once your deductible is met unless you reach your out of pocket maximum amount. 
      • In the previous example, the allowed amount billed by your doctor’s office for services is $150. If your deductible is met and you have a 20% coinsurance, you will pay $30 for the visit, and your insurance will pay $120. 
  • Out of pocket maximum: The out of pocket maximum is the total amount you are responsible for paying for healthcare services before your insurance plan will cover 100% of covered services. It differs from a deductible in that you must pay your deductible before your insurance will start paying for healthcare costs, whereas the out-of-pocket maximum is the highest amount you would be responsible for paying for healthcare services. It is important to note that each time you pay your copay or coinsurance, you are paying towards your out of pocket maximum. 
  • Billed amount: The billed amount is the amount of money your healthcare provider bills for services. 
  • Allowed amount: The allowed amount is the amount of money your insurance plan agrees to pay for covered healthcare services. The allowed amount is usually contractually predetermined between the provider and the insurance company. 
      • https://www.mdclarity.com/glossary/allowable-charge
  • Network: A network is a group of providers, doctors, and hospitals that are contracted with an insurance plan to provide care to its members. An insurance company may have different networks for different tiers of its insurance plans. 
  • In-network: Your insurance company has a contract with your provider to offer healthcare services at a pre-negotiated rate. 
  • Out of network: Your insurance company does not have a contract with your provider. Some insurance plans may still offer some coverage for services rendered by an out of network provider (out of network benefits). 

 

How does insurance work at Rise Physical Therapy?

When you make your first appointment with us, we will ask you for the name of your insurance plan and your member ID. Our dedicated insurance team will contact your insurance to check your benefits for physical therapy (how much coverage your plan offers for physical therapy services). 

We will then contact you prior to your first appointment to let you know about the cost of your physical therapy visits. Each insurance plan can vary in terms of how much coverage is offered for physical therapy services, so we make sure to contact your insurance directly in order to get the most accurate information. The cost of your physical therapy visits is determined by your insurance company based on the contracted rate. 

We are contracted (in-network) with most major insurance companies, but if we do not have a contract with your insurance company, we will work with you on a solution that works best for you. Our self-pay option is $130/visit. We can also provide a superbill for you to submit to your insurance company for reimbursement if we are not contracted with your specific insurance company. 

If your insurance requires any additional information or authorization forms prior to starting physical therapy, our insurance team will handle this process for you so you can start care with us without the hassle of extra paperwork. 

Confused about your insurance? Let us help! Schedule your first appointment today, and we’ll take care of the rest. You can also contact us at any time with questions about how to understand your insurance benefits. 

rise physical therapy

Written by Alyssa Dimitrov PT, DPT 

 

Photo by Scott Graham on Unsplash

Sources:

https://www.healthcare.gov/glossary/

A man with vertigo sitting on the edge of a bed looking ill.

Vertigo and dizziness treatment – how physical therapy can help

What is vertigo?

Vertigo is the false sensation of movement, often described as a feeling of spinning or swaying, that typically results from head movements such as rolling over in bed or getting out of bed. Unlike general dizziness, which can manifest as lightheadedness or unsteadiness, vertigo is characterized by a specific type of “false movement”.

One of the most prevalent causes of vertigo is Benign Paroxysmal Positional Vertigo (BPPV). Understanding BPPV and how physical therapists can help is essential for anyone suffering from dizziness or vertigo.

BPPV is the most common type of vertigo

Diagram showing anatomy of the inner ear

BPPV stands for Benign Paroxysmal Positional Vertigo. It occurs when tiny calcium carbonate crystals, known as otoconia, become dislodged from their usual position in the inner ear (in the utricle and saccule) and get trapped in the semicircular canals. To visualize this, imagine shaking a snow globe and watching the snowflakes get caught where they shouldn’t be.

These otoconia play a crucial role in maintaining balance by providing your brain with information about gravity and acceleration. The otoconia sit in a fibrous membrane above tiny hair cells contained within fluid. When your head moves, the increased weight of the fibrous membrane containing otoconia causes the membrane to move one way or another, which then displaces the hair cells and sends signals to your brain with information about head positioning and acceleration. When they become dislodged, the brain receives incorrect signals, leading to the false sensation of movement or spinning associated with vertigo.

There are three semicircular canals, and if otoconia get dislodged and make their way into one or more of the canals, vertigo follows. Nausea and vomiting may also occur. This can be very scary, especially if you have never had vertigo before. 

Dizziness and vertigo treatment

How can physical therapy help with BPPV?

Physical therapy is highly effective in eliminating BPPV. In fact, seeing a physical therapist is an excellent place to start if you have vertigo. Your therapist can confirm if your vertigo is caused by BPPV and can help eliminate it, or coordinate further medical workup. 

Here’s how the process typically works:

Assessment: Your physical therapist will conduct a thorough assessment to determine if BPPV is the cause of your dizziness. This involves a series of tests and questions about your symptoms and when they occur. If your therapist suspects BPPV, positional testing will be performed to determine the affected canal of the inner ear.

Corrective Exercises: Once BPPV is confirmed, your therapist will guide you through specific exercises designed to reposition the displaced crystals in your inner ear. These exercises, known as canalith repositioning maneuvers, are carefully tailored to move the otoconia back to their correct location, alleviating vertigo.

Additional Interventions: If there are residual symptoms or balance issues after the initial treatment, additional interventions may be required. These could include exercises to improve overall balance and reduce the risk of falls, as well as assessing your visual and postural reflexes. 

If your physical therapist determines that BPPV is not the cause of your dizziness, physical therapy may still be helpful. Your therapist can also help you determine if additional medical workup is needed. 

Comprehensive Balance Assessments

If balance or falling rather than dizziness is your primary concern, physical therapy can still help. A full balance assessment will be performed to identify any deficits or areas of weakness. Based on this assessment, your therapist will develop a customized program to improve your balance, enhance your strength, and prevent falls.

If you’re experiencing dizziness or balance issues, don’t wait to seek help. We have doctors of physical therapy who specialize in treatment of dizziness, vertigo and balance at all of our clinic locations. Our experienced therapists are here to help you feel better and stay safe in your day-to-day activities.

Give us a call or request an appointment today to get started on your dizziness and vertigo treatment. We offer comprehensive services at all our clinic locations and are committed to helping you achieve better balance and a higher quality of life.

You can also find more information about treatment of vertigo and dizziness on our Instagram and on our website.

rise physical therapy

Written by Alyssa Dimitrov PT, DPT 

 

 

Photo by Andrea Piacquadio: https://www.pexels.com/photo/young-man-in-sleepwear-suffering-from-headache-in-morning-3771115/
References:
Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. The Otolith Organs: The Utricle and Sacculus. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10792/
A woman lying on the couch holding her abdomen

Pelvic pain physical therapy – understanding causes and pelvic pain treatment

Pain is a normal and common human experience. Pain prompts us to pause, pay attention to our surroundings, and decide whether to stay still or move. However, living in pain isn’t normal. Each pain experience is unique and important, especially pelvic pain. But what exactly is pelvic pain? And where does it come from? 

 

Pelvic Floor Function

The pelvic floor muscles are the muscles in the bottom of the pelvis. They support the pelvic organs such as the bladder, urethra, uterus, prostate, and rectum. They also play an important role in controlling the bladder and bowels, regulating intra-abdominal pressure, and maintaining sexual function. Because the pelvic floor muscles impact so many systems, pelvic pain be present in any of the following areas: 

  • Lower abdomen 
  • Vulva / vagina 
  • Pubic symphysis joint 
  • Penis, scrotum, or testicles 
  • Perineum / perineal body 
  • Bladder
  • Anus / gluteal region 
  • Tailbone

Low back pain and/or hip pain are often present as well, due to the close relationship between the musculature of the low back, hip and pelvic floor region. It is important to determine the root cause of pelvic pain to determine the best pelvic pain treatment option. 

Pelvic anatomy - female

What causes pelvic pain?

Pelvic pain can have many causes, such as scar tissue, stress, hormonal dysfunction and changes, stiff muscles and joints, muscle weakness, bowel and bladder dysfunction, medications, a sensitive nervous system, lifestyle habits, and various conditions such as endometriosis, Ehlers Danlos Syndrome, interstitial cystitis, irritable bowel syndrome, and more.

While having names for conditions like interstitial cystitis and endometriosis can be helpful, pelvic pain presents very differently for each person. The brain produces pain when it perceives something as a threat. While guarding and protecting an area is helpful as a short-term solution, our “alarm system” can become so overly sensitive that any and all movements reproduce pain. This is why so many structures and systems could be involved depending on what the brain interprets as a threat, environmental factors, lifestyle habits, and body function. 

There are many pelvic pain treatments, but physical therapy is an excellent first line treatment option.

How can physical therapy help with pelvic pain?

The good news – pelvic therapists are trained to tackle these issues. There are many physical therapy intervention options for pelvic pain, such as mobility drills, hands on therapy for involved muscles and tissues, dry needling, strengthening exercises, and more. We will also work with your doctors on your medical team (such as urology, OB/GYN, gastroenterology, and primary care physician) if other interventions are needed. 

Check out our Rise Pelvic Therapy Instagram to learn more about pelvic conditions and how physical therapy can help. You can also go to our website for answers to commonly asked questions about pelvic physical therapy.

Unsure if pelvic physical therapy is right for you? Request an appointment with one of skilled Doctors of Physical Therapy, and we’ll chat and create a game plan to address your needs. We see patients one-on-one in a private room for all pelvic therapy appointments, ensuring your comfort and privacy. 

 

Gabi

Written by Gabi Back-Kremers PT, DPT 

 

 

Photo by Sora Shimazaki: https://www.pexels.com/photo/woman-suffering-from-a-stomach-pain-lying-down-on-couch-5938351/
Older woman washing produce in the sink

Become an athlete in the game of life – training for longevity

When you think of your life when you’re 80+ years old, what do you imagine? Hopefully, you think of spending time with your loved ones, attending family gatherings, and being able to do the things you enjoy, whether that is traveling, gardening or other hobbies. 

Athletes spend their lives training for a specific task, like running or playing football. Their whole day centers around that specific task. What if we could train our bodies to maximize function and quality of life over time? This is training for longevity. 

 

What is the the health span?

The idea of maximizing performance, well-being and physical functioning over time  is known as the health span. Most of us are familiar with the term “lifespan,” as it refers to how long we live. The health span is often overlooked in healthcare. Medical interventions can buy you time, but they can’t always guarantee physical functioning or quality of life. 

Peter Attia, MD, discusses this concept on his YouTube channel. He argues that health span is a “malleable metric,” meaning that you can alter your health span with the choices that you make throughout your life. 

This is where physical therapy can help; as physical therapists, we are highly concerned with your quality of life, ease of movement, pain levels, and physical functioning, AKA, your health span. 

If you look at improving your health span like an athletic event, then the goal of training is to improve your physical function, pain levels, safety, and overall quality of daily life. This can be accomplished through the four “pillars of exercise”, even if you are someone who has never exercised or followed a workout plan before. It doesn’t have to be complicated or time consuming. 

What are the pillars of exercise?

To maximize function and quality of life and training for longevity, there are four categories that are important to consider. 

The National Institute on Aging defines the four pillars of exercise as: 

  1. Cardiovascular endurance 
  2. Strength
  3. Balance
  4. Flexibility

The pillars of exercise defined

  1. Cardiovascular endurance 
    • Description: Cardiovascular endurance, also known as aerobic fitness, involves exercises that increase your heart rate and breathing, enhancing the efficiency of your heart, lungs, and circulatory system.
    • Examples: Running, cycling, swimming, walking, and dancing.
    • Benefits: Improved heart health, increased lung capacity, better circulation, and reduced risk of chronic diseases like heart disease and diabetes. Improved VO2 max for better endurance for tasks like prolonged walking. 
  2. Muscular strength/endurance
    • Description: Muscular strength refers to the amount of force a muscle or group of muscles can exert in a single effort. Muscular endurance is the ability of a muscle or group of muscles to sustain repeated contractions or continue applying force against a fixed resistance.
    • Examples: Weight lifting, resistance band exercises, bodyweight exercises like push-ups and squats. For endurance, planks, cycling, rowing, high-rep resistance training. 
    • Benefits: Enhanced muscle mass, improved bone density, better joint function, and increased metabolic rate. The benefits of improved muscular endurance are: greater stamina, improved posture, reduced fatigue, and better performance in daily activities and sports.
  3. Flexibility
    • Description: Flexibility involves the range of motion available at a joint or group of joints, facilitated by muscle elongation.
    • Examples: Stretching exercises, yoga, pilates, and dynamic stretching.
    • Benefits: Improved mobility, reduced risk of injuries, decreased muscle soreness, and enhanced overall movement efficiency.
  4. Balance
    • Description: Balance is the ability to maintain the body’s position, whether moving or stationary, by using various muscle groups effectively.
    • Examples: Balance exercises, tai chi, yoga, and stability ball exercises.
    • Benefits: Improved coordination, reduced risk of falls, better core strength, and enhanced athletic performance.

 

If this seems overwhelming, it doesn’t have to be! We are here to be your partner in improving your health span and overall quality of life. We can assist you with coming up with a program that matches your current ability level, addresses your long term goals, and progresses over time. 

The current CDC guidelines for physical activity for adults are at least 150 minutes of moderate intensity cardiovascular activity per week and at least 2 days of strength training per week. If you break that down into daily activity, that is just over 20 minutes of moderate aerobic activity per day. If you are not yet able to perform moderate aerobic activity for 20 minutes, that’s okay! Some activity is better than none, and we can assist you with creating a program to progress to the recommended daily activity level. 

 

Here is an example of the base level of a program to help you start improving your health span and training for longevity. 

Building the Foundation

Cardiovascular Fitness:

  • Frequency: 3 times per week
  • Activity: Brisk walking
  • Duration: 20 minutes per session 
  • Intensity: Moderate (able to talk but not sing)

Strength Training:

  • Frequency: 2 times per week
  • Exercises: Bodyweight exercises (e.g., squats, push-ups against a wall, lunges)
  • Duration: 15 minutes per session
  • Sets/Reps: 2-3 sets of 6-12 reps

Flexibility:

  • Frequency: Daily
  • Activity: Simple stretching routine covering major muscle groups (e.g., hamstring stretch, shoulder stretch)
  • Duration: 5-10 minutes

Balance:

  • Frequency: 2 times per week
  • Activity: Balance exercises (e.g., standing on one foot, heel-to-toe walk)
  • Duration: 5 minutes

 

From there, the next progression would be duration and intensity of exercise. The key is to choose activities you enjoy doing. They should be able to easily fit into your current lifestyle without having to make major changes. There is a reason why so many people sign up for gym memberships in January and stop going after a couple of months. If an activity takes too much time or there is a big barrier to getting it done (like getting dressed, getting in the car, driving to the gym, choosing what to do while you are there, etc.), then you are much less likely to consistently do the activity, especially over time. 

 

Tips for Success:

  • Listen to Your Body: Adjust intensity and duration based on how you feel.
  • Stay Hydrated: Drink plenty of water, especially before and after workouts.
  • Rest and Recovery: Ensure adequate rest days to prevent injury and promote recovery.
  • Consistency Over Intensity: Regular, moderate exercise is more beneficial and sustainable than sporadic intense workouts.
  • Enjoyment: Choose activities you enjoy to maintain motivation.

Another tip for success: consult a professional. At Rise Physical Therapy, we are fully staffed with only Doctors of Physical Therapy. We have the expertise and the time with you one-on-one to develop a full plan for you to improve or maintain your health span and to better understand the pillars of exercise. 

Are you ready to get started? Request an appointment today! 

Alyssa Lindau

Written by Alyssa Lindau, PT, DPT 

 

 

 

 

Photo by Jonathan Borba on Unsplash
Photo by Jenny Hill on Unsplash
Photo by Anupam Mahapatra on Unsplash
Photo by CDC on Unsplash
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. 

 

Diet

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. 

 

Exercise

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.

Gabi

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!

Gabi

Written by Gabi Back-Kremers, PT, DPT 

Featured image by JESHOOTS.COM on Unsplash.

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