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. 



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


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


  • 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. 



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.

PT Treatment of Cervicogenic Headaches

Navigating the Path to Relief: Physical Therapy for Cervicogenic Headache Treatment

Cervicogenic Headaches- Causes and treatments 


What is a cervicogenic headache? 

A cervicogenic headache is a headache that originates from structures in the neck. It is known as a secondary headache because it is a symptom of an underlying problem such as a neck issue or injury.  These headaches usually accompany a reduced range of motion (ROM) of the neck and may be confused with a migraine, tension headache, or other primary headache syndromes.  

Diagnostic criteria must include all of the following points: 

  1. The source of the pain must be in the neck and perceived in the head or face.
  2. Evidence that the pain can be attributed to the neck.
    • It must have one of the following: demonstration of clinical signs that implicate a source of pain in the neck or abolition of a headache following diagnostic blockade of a cervical structure or its nerve supply using a placebo or other adequate controls.
  3. Pain resolves within three months after successful treatment of the causative disorder or lesion. 


What causes a cervicogenic headache? 

A cervicogenic headache is caused by referred pain arising from irritation of cervical (neck) structures innervated by spinal nerves C1, C2, and C3. Therefore, any structure innervated by the C1–C3 spinal nerves could be the source of a cervicogenic headache. These nerves can radiate pain to the back of the head, behind the ear, and the upper shoulder. 


Nerves of the neck






Image illustrating nerves of the neck and shoulder.


Because cervicogenic headaches arise from problems in the neck, different conditions can trigger this type of pain. These include degenerative conditions like osteoarthritis,  disc issues in the neck, or a whiplash injury. An injury to the neck from falling or playing sports can also trigger these headaches. They may also occur due to your posture while sitting or standing.  Falling asleep in an awkward position can also cause these types of headaches.  A compressed or pinched nerve in or near the neck is another cause of cervicogenic headaches. 


Cervicogenic headache treatment

Physical therapy is considered the first line of treatment.  Your doctor of physical therapy will ask questions about your symptoms, assess your range of motion, joint mobility, posture, and strength. They will then come up with a treatment plan that will help eliminate the underlying cause of the headache. Our doctors of physical therapy provide evidence-based treatments that are backed by science. 


Physical therapy treatment for cervicogenic headaches may include: 

  • Massage
  • Dry needling 
  • Joint mobilizations of the neck and upper back
  • Posture education and retraining
  • Strengthening exercises


Most cervicogenic headaches respond very well to physical therapy treatments. In more severe cases, further medical management may be needed. 

Other treatment options include: interventional therapy (injections, ablations, nerve blocks, etc.) which will differ depending on the cause of the headache. 


Do I need imaging (x-ray or MRI?)

Imaging of the cervical spine is not sensitive enough for diagnosing a cervicogenic headache. Recent studies show no specific radiologic abnormalities associated with cervicogenic headaches, meaning that your imaging may be normal even if you have headaches. MRIs or CTs can be ordered to help rule out some possible causes such as Chiari malformations, nerve root pathology, or identify spinal cord pathology (e.g., asymmetric facet arthropathy or rheumatoid changes around the atlantoaxial joint) but cannot point directly to a cervicogenic headache.  Surgery is performed only as a last resort


If left untreated, cervicogenic headaches can become severe and debilitating. If you have a recurrent headache that doesn’t respond to medication, see a doctor. The outlook for cervicogenic headaches varies and depends on the underlying neck condition. However, it is possible to alleviate pain and resume an active lifestyle with physical therapy treatment. 


Our doctors of physical therapy can help screen for the cause of your headache and help you determine if further medical intervention is needed. 


Take charge of your health 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.


Carrie Lynch









Written by Carrie Lynch, PT, DPT



Image source:



jaw pain treatment

Taking a Bite Out of TMD: Physical Therapy Treatment of Jaw Pain

Physical Therapy for TMD

Have you ever seen someone on TV clutching their jaw in pain and exclaiming, “I have TMJ!”? Well, the truth is, they’re not wrong–we all have TMJ, two of them to be exact. The TMJ, or temporomandibular joint, refers to the joint between the jaw bone and the temporal bone of the skull. What people are actually referring to when they have pain in these joints (there is one on each side), is TMD, or temporomandibular dysfunction.


What is the TMJ?

The TMJ is responsible for opening and closing the jaw, as well as assisting with speech. The TMJ consists of the two joint surfaces that contact a cartilaginous disc in the center, which provides cushioning and stability to the joint. Pain associated with TMD may be felt in the jaw, face, ear, neck or head. Associated symptoms may also include ear fullness, ear pain, tinnitus, headaches, clicking, popping, grinding, or getting stuck with your mouth open or closed.


What is TMD?

TMD refers to dysfunction of the TMJ and associated structures. There are several categories of TMD that are culprits for causing pain in the jaw and surrounding areas. 

Muscle Disorders

  • Tightness in the muscles responsible for moving the jaw (primarily closing) can cause pain that may be felt in the temple, cheek, face, jaw, or head.

Disc Displacement

  • Disc displacement is generally characterized by abnormal movement (too much or too early) of the internal disc during opening and closing of the jaw. Normally the disc should slide forward during jaw opening, but sometimes this occurs too early or the disc can remain stuck in a forward position, causing increased pain with jaw opening or closing. Sometimes the jaw can even get stuck in an open or closed position. 


  • Just like any other joint that moves, there can be arthritis in the TMJ. This occurs due to normal wear and tear over time, but it can cause pain and what is known as “crepitus,” or abnormal joint sounds that may sound like crunching or grinding. However, disc issues can also cause noise when opening or closing the jaw. 


What to do if you think you have TMD

  • The good news—Physical Therapy is an excellent, though often underutilized first-line treatment for TMD.
  • Your PT will assess your jaw and neck movement and check for any tightness in the muscles and joints.
  • There are many treatment options for TMD. They might consist of stretching, range of motion exercises, stretches for posture, and hands on therapy on your jaw, muscles of mastication (eating) and neck and jaw joints. Dry needling is also well supported by current research as a treatment for TMD.
  • Your PT will also work with your dentist or orthodontist if they think that any mouth guards or other dental intervention is needed. 


Take charge of your jaw health 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. You can also check out additional TMD resources here.


rise physical therapy









Written by Alyssa Lindau, PT, DPT



Front desk checking your deductible

Fiscal Fitness: Leveraging Your Deductible and HSA/FSA for Year-End Physical Therapy Benefits

As the year draws to a close, it's essential to take advantage of the health benefits you've earned through your insurance plan. Insurance can be confusing, and it’s essential to understand your benefits and how your deductible can be used to your advantage at the end of the year. 


What Is A Deductible?

A health insurance deductible is the amount you must pay out of pocket for covered healthcare services before your insurance plan starts to contribute. In simpler terms, it's your initial financial responsibility for medical expenses. Once you meet your deductible, your insurance coverage typically kicks in, and you'll only be responsible for co-payments or co-insurance for the remainder of the year.


Why Meeting Your Deductible Matters

For many patients, meeting their deductible means they've reached the maximum amount they need to pay for covered services in a given year. This presents a unique opportunity, especially if you've been considering physical therapy.


If you've met your deductible, scheduling a physical therapy evaluation before the end of the year can be a smart financial move. Since you've already fulfilled your deductible, you can take advantage of your insurance coverage without worrying about additional out-of-pocket expenses. This allows you to receive the care you need while maximizing the benefits you've paid for throughout the year.


Benefits of Scheduling Physical Therapy Before Year-End

  • Cost Savings: With your deductible met, you can potentially receive physical therapy services at a lower cost or even at no additional expense.
  • Optimal Health: Addressing physical issues promptly can prevent them from becoming more severe, leading to better long-term health outcomes. Addressing your pain now can get you feeling better before your deductible resets at the start of the new year!
  • Maximize Insurance Benefits: By scheduling before the end of the year, you ensure that you make the most of the insurance benefits you've worked hard for throughout the year.


Utilizing Your HSA or FSA Before Year’s End

Health Savings Accounts (HSAs) and Flexible Spending Accounts (FSAs) are financial tools that enable individuals to set aside pre-tax dollars for qualified medical expenses. Some plans have a "use-it-or-lose-it" feature, where any remaining funds at the end of the year may be forfeited. Scheduling a physical therapy appointment before the year's end can be advantageous for those with HSA or FSA balances to spare. By utilizing these funds for physical therapy sessions, patients can optimize their health benefits and prevent potential forfeiture of unused dollars. This proactive approach not only promotes well-being but also maximizes the financial benefits associated with these accounts, contributing to a healthier and fiscally responsible start to the new year.


Are you ready to take advantage of your year-end health insurance benefits? Request an appointment now and start feeling better before the New Year!


rise physical therapy









Written by Alyssa Lindau, PT, DPT



apple health app

Unlocking Your Balance: How Smart Devices Can Help Assess and Improve Your Gait

In this era of smart technology, our gadgets are not just for convenience but are becoming indispensable tools for our health. There is an increasing interest in using sensor systems embedded in smartwatches/smartphones for health care purposes. The Apple Health app can now assess your gait and balance and let you know if your gait has changed. 

Gait (walking) performance is an important marker of functional ability, independent living, and survival. Studies show that a smartphone can be used as an assessment tool to quantify ambulatory tasks while navigating both unobstructed and obstructed surfaces. Smartphone-based assessment using the Apple Health app, regardless of phone placement, is shown to be reliable and valid for all gait parameters across obstructed and unobstructed conditions, both indoors and outdoors. 

How Does the Apple Health App Assess Your Balance?

When you carry your iPhone in a pocket or holster near your waist, the Apple Health app uses custom algorithms that assess your balance, strength, and gait. You can receive a notificationif your walking steadiness becomes low or stays low, and you can automatically share the notification with friends or family. According to Apple, walking steadiness is calculated using factors like walking speed, step length, double support time, and walking asymmetry data that is stored in the Health app. This provides a sense of the way you walk and is also related to your fall risk. As steadiness goes down, your risk of falling goes up. Walking steadiness is not an indication of how likely you are to fall in any given moment but an overall sense of fall risk in the next 12 months. 


According to the National Institute of Health (NIH), falls in older adults are an indicator of “frailty, immobility, and acute and chronic health impairment." They can lead to serious health complications and injuries such as fractures and head injuries. However, even if you or a loved one are at risk for falls, a physical therapist can assess your balance and strength and provide interventions to significantly reduce risk of falls.


How Can I Assess My Fall Risk?

To assess your fall risk yourself using your Apple Health app:  

  • Open the Health app on iOS. It looks like a small red heart in a white square.  
  • Then tap "Show All Health Data" and scroll down. 

Android also has a version of this feature. 


While your device might spot the poor stability in your stride, this is just the first step. Don't wait until an accident happens – take action now! Request an appointment with our expert physical therapists to have your balance and fall risk assessed. Your journey to improved stability begins with a single step.



Carrie Lynch









Written by Carrie Lynch, PT, DPT

Photo by Oliur on Unsplash


References: https://www.ncbi.nlm.nih.gov/books/NBK235613/
shoulder anatomy tendonitis treatment

What Is Tendonitis/Tendinopathy?

Tendonitis Treatment

Before we discuss tendonitis treatment, let's first consider the anatomy! Tendons connect our muscles to bones, and therefore are the main way that we produce force.1  Before the 90s, it was thought that inflammation was the primary cause of tendon pain, so people used to call these issues “tendonitis”. As more research came out focusing on the damage in the tendon (primarily due to degenerative changes) being the main driver for both pain and decreases in function, this terminology shifted to “tendinopathy” (largely based on the work of Mafulli et al.). 2, 3  


Stages of Tendinopathy


So, there has been damage to a tendon, and the most prominent model currently followed is Jill Cook’s three-stage model (reactive, disrepair, degenerative).4  The first stage, reactive tendinopathy, has also been called the “injury” stage, and is typically an acute response.5 Another way of putting this is you may have jumped into something too rapidly or advanced load or volume too quickly.  An example of this could be starting a new workout routine or doing a lot of repetitive movements. Another potential mechanism is direct trauma – let’s say that you fell directly on your knee or shoulder. This could trigger the reactive stage as well. 


The second stage of tendon disrepair has also been called the “failed healing” stage, where changes in the extracellular matrix become more pronounced, and the tendon is thus more susceptible to the damage. Typically, this occurs when that initial stage continues to be handled poorly and advances to this stage. An example of this would be continuing to work out or perform the same repetitive motions once you already have tendon pain. 


The final stage is the degenerative stage, also labeled the “clinical presentation,” as this is typically when patients seek medical attention. This is when tendons are most susceptible to ruptures, and also where we start to see large scale degenerative changes in both the extracellular matrix and within the tissue cells (which is what may lead to those ruptures). 


Symptoms of tendonitis include difficulty and pain with movement, joint stiffness, swelling, and a “crackling” or grinding sensation.



I think I have tendonitis/tendinopathy. What do I do now?

Seeing a physical therapist is a great place to start for tendonitis treatment. Our skilled doctors of physical therapy will identify contributing factors such as muscle imbalances or improper biomechanics (movement of joints and muscles). Based on this evaluation, a personalized exercise program is developed, incorporating targeted stretches and strengthening exercises to gradually restore the affected tendon's integrity and flexibility. Manual therapies, such as soft tissue and joint mobilization, can further aid in reducing pain and promoting blood flow. Additionally, our doctors of physical therapy will educate you on proper body mechanics and ergonomic practices to prevent future recurrence.


I shouldn't start physical therapy for tendonitis treatment unless I have imaging first, right?

Medical imaging, such as ultrasound or MRI, is not always necessary to diagnose tendonitis. In many cases, a skilled healthcare professional, such as a physician or physical therapist, can diagnose tendonitis based on a thorough clinical examination, medical history, and a discussion of symptoms. Our highly trained doctors of physical therapy will assess your pain, range of motion, strength and functional movements in addition to your symptoms and medical history.


Tendonitis can often be effectively managed and even resolved with physical therapy alone, especially in mild to moderate cases. Physical therapy plays a significant role in promoting healing, reducing pain, and restoring normal function to the affected tendon and surrounding tissues.

If you think you are dealing with tendonitis/tendinopathy, request an appointment so we can help get you back to the activities you enjoy!



Matt Harper

Written by Matt Harper, PT, DPT, CSCS



1. Canosa-Carro, Lorena, et al. "Current understanding of the diagnosis and management of the tendinopathy: An update from the lab to the clinical practice." Disease-a-Month 68.10 (2022): 101314. 
2. Khan, Karim M., et al. "Time to abandon the “tendinitis” myth: painful, overuse tendon conditions have a non-inflammatory pathology." Bmj 324.7338 (2002): 626-627. 
3. Maffulli, Nicola. "Overuse tendon conditions: time to change a confusing terminology." Arthroscopy: The Journal of Arthroscopic & Related Surgery 14.8 (1998): 840-843. 
4. Cook, J. L., and Craig R. Purdam. "Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy." British journal of sports medicine 43.6 (2009): 409-416. 
5. Fu, Sai-Chuen, et al. "Deciphering the pathogenesis of tendinopathy: a three-stages process." BMC Sports Science, Medicine and Rehabilitation 2 (2010): 1-12. 



Photo by Alan Calvert on Unsplash