Advanced Industrial & Tactical Presents at the 5th International Physical Employment Standards Conference

Advanced Industrial & Tactical Medicine will once again be well represented at one of the leading international gatherings dedicated to research and applied practice supporting performance standards in physically demanding occupations.

The 5th International Physical Employment Standards (IPES) Conference has accepted submissions for presentations from Advanced’s Traci Tauferner and Heidi Bohl. The two will travel to Oklahoma City to present case studies on February 21. Hosted by Oklahoma State University, the IPES 2025 conference addresses specific topics ranging from physical employment standards, physical conditioning, health and rehabilitation, and workplace diversity.

Tauferner, Director of Industrial & Tactical Medicine at Advanced Physical Therapy & Sports Medicine, will be presenting “Developing a Return to Work Test for an Injured Firefighter: A Case Report.” Bohl, Licensed Athletic Trainer with Advanced Industrial Medicine, will present “A Case Report: Adapting Return-to-Work Testing for Redi Mix Drivers in the Concrete Industry.”

The event, held previously in Australia, Canada and the UK, brings together an exceptional group of scientists and practitioners well versed in physical employment standards—considered the backbone of many industries—to support safety and performance in demanding tactical and industrial environments.

This is Tauferner’s second experience presenting at the prestigious conference. In 2023, Tauferner traveled to Australia to share “Developing a Return to Work Assessment for an Injured Police Officer: A Case Report” at Bond University. The university is home to the Tactical Research Unit, a network of multidisciplinary international experts who investigate ways to optimize the physical and cognitive capabilities of tactical personnel including military, law enforcement, firefighters, and first responders.

This year’s host university is home to the Tactical Fitness and Nutrition Lab, whose focus is providing evidence-based information to departments and agencies that support the overall health, wellness and occupational performance of tactical athletes.

“Heidi and I are honored to join with global colleagues to promote the best practices in the development and implementation of physical employment standards that improve worker health and well-being,” said Tauferner. “Engaging with each other at IPES ensures new research findings will have real-world outcomes.”

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Expert Tips to Prevent Slips and Falls

Winter brings beautiful snow-covered landscapes and plenty of outdoor fun, but it also has hidden dangers—icy sidewalks, slippery driveways, and an increased risk of falls.

This time a year, I see at least one person a week with a wrist, forearm or shoulder injury related to slipping and falling on ice.

How can I prevent slipping and falling on ice?

While some falls are unavoidable, these simple winter safety tips can help reduce your risk:
✔ Wear proper footwear with good traction— something like Yaktraxs is a great investment
✔ Walk like a Penguin—take small steps and walk cautiously on icy surfaces
✔ Use handrails when available
✔ Keep your hands free—avoid carrying too much in one hand

✔ Sprinkle sand or salt on walkways to improve traction
✔ Tuck and roll — we know it happens quickly, but if you start to slip, bring your hands to your chest, tuck your head, and let your momentum carry you through to a roll.

What should I do if I fall?

If you fall on an outstretched hand, watch for these symptoms:

-Pain, swelling, and bruising around the wrist, arm or shoulder
-Tenderness to the touch
-Difficulty moving or straightening your fingers or lifting your arm
-Numbness or tingling in the fingers
-If the wrist, arm or shoulder looks out of alignment

*It’s important to seek medical attention if you have a fall and experience the above symptoms.

A doctor may order X-rays to determine if there is a fracture and decide on the best course of treatment. Treatment options may include:
-Casting or splinting for less severe fractures
-Surgical realignment for more complex breaks

Rehabilitation & recovery:

After a distal radius fracture, proper rehabilitation is key to regaining wrist strength and mobility. At Advanced Physical Therapy & Sports Medicine, our hand therapy team works closely with doctors to guide patients through a safe and effective recovery process.

-Pain & Swelling Management – Techniques to minimize discomfort and promote healing
-Custom Orthosis or Splints – To support and protect the wrist as it heals
-Guided Exercises – To restore wrist, hand, and forearm movement
-Functional Training – Helping patients return to daily activities at home, work, or school

*A supervised therapy program leads to faster recovery and improved function compared to a home exercise program—especially in patients over 60. This means less pain, better wrist mobility, and a quicker return to daily life!

Need help after a wrist, forearm, or shoulder injury?

Our hand therapy experts at Advanced Physical Therapy & Sports Medicine are here to help! We have convenient locations in Appleton, WI (Appleton North, Champion Center), Green Bay, WI (Green Bay Hand Therapy), and Marinette, WI.

If you have questions or need an appointment, contact us today.

What is Pelvic Health Physical Therapy?

When most patients first walk into my office, they’re hesitant. They avoid eye contact, their voices soft. They wonder if it’s okay to talk about things like bladder leaks, painful periods, or even discomfort during intimacy. It’s not the kind of thing you casually chat about, right? But here’s the truth: these conversations are not just okay—they’re necessary.

What you’re experiencing may be common, but it’s not normal. You don’t have to accept discomfort, pain, or embarrassment as part of your everyday life. And you’re not alone. Physical Therapy can help—without the need for medication or surgery—so you can get back to what you love.

Once we break the ice, something beautiful happens. My patients start to open up. They share their frustrations, their struggles, and the toll it’s taken on their lives—whether it’s missing workouts, struggling to care for their families, or feeling disconnected from themselves. Sometimes, there are tears. But what follows is a sense of hope and determination. Together, we create a plan tailored to their goals and dreams.

What Is Pelvic Health Physical Therapy?

Your pelvic floor is more than just a group of muscles. It’s your foundation for stability, organ support, continence, and sexual function. When these muscles aren’t working as they should, it can impact your daily life in ways you never imagined.

Did you know? 1 in every 3 women will develop pelvic floor dysfunction in their lifetime.

While it is very common, it’s certainly not normal and not something that you have to live with.

Symptoms include:

• Leaking urine when you sneeze, cough, or laugh.

• Constantly feeling like you “have to go.”

• Pain during intercourse or tampon use.

• Pelvic or low back pain.

• A heavy or full feeling in your pelvis.

The good news? These issues are treatable, and you don’t have to live with them.

Pelvic Health Physical Therapy: Supporting You Before and After Pregnancy

Pregnancy and childbirth are transformative—beautiful, yes, but also physically demanding.

Prenatal Care: During pregnancy, your body undergoes incredible changes. Pelvic health physical therapy can help prepare you for these changes with exercises, hands-on techniques, and education. We can ease discomfort, improve muscle function, and set you up for a smoother labor and recovery.

Postpartum Recovery: After delivery, many women face challenges like incontinence, pelvic pain, or diastasis recti (abdominal separation). Physical therapy helps rebuild strength, promote healing, and restore confidence.

Why Choose Us for Pelvic Health?

Not every physical therapy clinic offers specialized pelvic health care—but we do. At Advanced Physical Therapy & Sports Medicine, our team is trained to provide compassionate, individualized care. We proudly serve Neenah, Appleton, and Ripon, WI, helping women reclaim their lives with confidence and strength.

Taking the First Step

We know it’s hard to make that first call. It can feel overwhelming to admit that you need help, let alone schedule an appointment. But we’re here to support you every step of the way. Your first visit is a chance to share your story and get your questions answered by a caring professional.

You are not alone. Taking that first step is the beginning of your journey toward healing and empowerment.

Call us at 920.991.2561 for Appleton locations, 920-251-6552 for Neenah and 920-896-0430 for Ripon to schedule your appointment today.

Dr. Madeline Kehler, PT, DPT, specializes in Pelvic Health at our Neenah clinic. Her passion is helping women of all ages navigate these challenges with expertise, compassion, and encouragement.

Save money with physical therapy.

Reference: Image and information used for this blog can be found here: https://www.valueofpt.com/ 

Looking for a way to save money?

Physical therapy can be a cost-effective way to manage a range of conditions, with proven results that include improving quality of life through patient education, hands-on care, and prescribed exercise.

Physical therapy is highly effective in treating musculoskeletal conditions, which impact over 127 million Americans and contribute to $213 billion in medical expenditures, lost wages, and decreased productivity annually.

In the report “The Economic Value of Physical Therapy in the United States,” the American Physical Therapy Association (APTA) investigated the application of physical therapy across several health conditions to assess the costs and benefits of physical therapist services compared with alternative courses of care.

The report examined the available scientific research on the care delivered for a range of conditions. An economic analysis was performed for each condition, comparing physical therapist services to an alternative treatment based on the costs associated with providing care and the benefits produced for the U.S. health care system.

Included in the report were the following musculoskeletal conditions commonly faced by industrial & tactical workforces:

Osteoarthritis of the Knee

Osteoarthritis is a degenerative and progressive joint disease affecting more than 32 million Americans. Knee osteoarthritis is the most common type of arthritis, and its prevalence has doubled in the last 70 years.

Using a scientific study that examined the cost-effectiveness of physical therapy compared with injections for knee osteoarthritis, the report demonstrates that choosing physical therapy over steroid injections to treat osteoarthritis of the knee saves $13,981, including the dollars paid for the services as well as hidden costs of the patient’s time, pain, and missed work and life events.

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) affects 50 out of every 1,000 individuals in the United States. CTS is commonly identified as an occupational hazard, as people at the highest risk have occupations that require forceful and often repetitive hand movements, such as office administrative staff and production workers.

Using a scientific study that examined the cost-effectiveness of physical therapy compared with surgery for patients with carpal tunnel syndrome, the report demonstrates that choosing physical therapy over surgery to treat carpal tunnel syndrome saves $39,533.

To learn more about how conservative treatments for CTS read: Conquering Carpal Tunnel Syndrome by Dr. Ron Lawrence at our Shawano clinic

Low Back Pain

Back pain is a leading musculoskeletal disorder with a high occurrence, costly treatment, and a significant effect on a person’s quality of life. Back pain is the leading cause of work-loss days and work limitations and can result in patients seeking emergency care.

Using a scientific study that examined the cost-effectiveness of physical therapy compared with the usual primary care management for acute low back pain, the report demonstrates that choosing physical therapy early, over typical management of acute low back pain, saves $4,160.

To learn more about how conservative treatments for Lower Back Pain read: Essentail Exercises to Prevent Low back Pain by Joe Hanel from our Industrial Medicine team.

Vascular Claudication

Claudication is a condition that causes pain in the thigh, calf, or buttocks when walking due to restricted blood flow. Vascular claudication is typically the result of peripheral arterial disease, or PAD, caused primarily by plaque build-up in the arteries that restrict proper blood flow to the lower limbs.

Using a scientific study that examined the cost-effectiveness of physical therapy-monitored exercise (walking and treadmill training) combined with “optimal medical care” (a risk factor management method as suggested by guidelines from the American College of Cardiology and American Heart Association) compared with “optimal medical care” alone, the report demonstrates that choosing physical therapy over alternatives to treat claudication saves $24,125.

Tennis Elbow

Lateral epicondylitis, also known as tennis elbow, is an overuse injury caused by an eccentric overload of a muscle in the forearm. Despite its name, tennis players make up only 10% of the tennis elbow patient population; as many as 15% of workers in highly repetitive jobs report having tennis elbow.

Using a scientific study that examined the cost-effectiveness of physical therapy and/or corticosteroid injection for tennis elbow compared with a placebo injection, the report demonstrates that choosing physical therapy over alternatives to treat tennis elbow saves $10,739.

To learn more about how conservative treatments for Tennis Elbow read: Tips and Tricks for preventing and Managing Elbow Tendonitis by Megan Werner from our Sports Medicine team.

Falls Prevention

Falls are a major injury risk and are closely associated with an increased incidence of fractures, such as hip and wrist fractures.

Using a scientific study that focused on the cost-effectiveness of physical therapy-based falls-prevention exercise versus no intervention to compare the isolated impact of exercise treatment on preventing falls and reducing future costs associated with common fractures, the report demonstrates that choosing physical therapy-based falls-prevention exercise saves $2,144 in future expenses related to common fractures due to falls.

Learn more about Advanced’s premier balance and fall’s prevention program.

You should consider attending physical therapy first when it comes to everyday aches, pains, sprains, and strains. Look at all the money you could save!

Ready to start?

Contact us to schedule your initial evaluation or free injury screen today!

Provider Spotlight: Bill Rein Helps the complex PT Patient

In order to know more about Bill Rein and one of his favorite topics, we needed to get past his least favorite.

“Yeah, I don’t really embrace talking about myself. So let’s get that out of the way,” Rein began.

Just did.

Once acknowledged, Rein spoke (quite willingly, by the way) about his passion for treating patients with chronic, persistent pain issues. He traced it back to the beginning.

“All of the professors and mentors I had were excellent working with their hands, but more than that they were great clinical decision-makers,” said Rein. “I wanted to model my career after those people.”

At Rein’s first job, he had the good fortune to work with a Fellow of the American Academy of Orthopedic Manual Therapists, a provider who completed stringent post-graduation specialization programs in the field of neuro-musculoskeletal disorders and the use of hands-on treatments of muscles, tendons, ligaments and joints.

“I worked with him for two years, and he kind of pushed me in a direction to treat spine conditions, neck, back, headaches, the sacroiliac region. I really took a liking to that,” said Rein.

That pushed Rein to earn his specialty certification as an Orthopedic Clinical Specialist (OCS). After 2,000 hours of direct patient care in orthopedics and a rigorous exam showing they have expertise in diagnosing, treating, and preventing orthopedic conditions, the OCS brings that additional level of understanding to their patients.

And that’s what Rein did. Still, there was some frustration.

“I felt I was getting four out of five patients to where they needed to be, but it was that fifth one that kept me up at night,” said Rein. “So I needed to keep searching for ways to help those I wasn’t able to treat effectively, patients with chronic issues who had been seen by multiple healthcare providers and still weren’t getting the relief they sought.”

So Rein kept at it.

Doing a lot of reading, engaging in a lot of research on his own, and teaching as part of his orthopedic residency, Rein’s work delivered him to the place he is now, where treating the most complicated patients has become his passion.

“There's something about the shared collaboration, trying to figure out with patients exactly what is going on and how we can help them, and where we, the medical establishment, may have missed the boat in treating their pain,” said Rein.

Rein feels he can take the vast majority of those challenging patients and find something that he can offer them that will help. That’s not 100%, though.

“There are still patients where physical therapy just isn’t going to work,” said Rein. “But I feel confident that I can offer things to them even if it’s just in the way of explaining what they are going through, to plant the seeds that might help them to not have to get an injection, or be on medication, or have a surgery later on, if I give them the tools they need now.”

And he strongly believes in a team approach.

“I feel very comfortable collaborating to get patients the help they need, facilitating connections with providers—a physiatrist, an orthopedic physician, a primary care specialist—who excel in these cases,” said Rein.

Rein estimates that about a quarter of his patients have chronic conditions.

“There's someone on my schedule pretty much every day that has a persistent pain condition,” he said.

Rein’s interviewer (me) admitted to having low back issues for much of his life. Is that considered chronic pain?

“I’m definitely not saying the low back issues you just described, which are fairly common, haven’t been debilitating and life-affecting for you,” said Rein. “But that's very different than the patient who's had fibromyalgia for 30 years, has severe headaches every day, and low back pain with pain radiating down the legs and is barely able to move. That’s a more challenging population.”

It’s a challenge Rein embraces.

“It’s about taking the emotion out of the pain experience, looking at it objectively, being a detective with you and trying to figure out how your body is working. When you connect the dots, it’s a very powerful thing.

Bill Rein serves patients at Advanced PT’s Appleton West location on Casaloma Drive.

He received his master's degree in Physical Therapy from the University of Wisconsin-Madison and subsequently earned his Board Certification in Orthopedic Physical Therapy. Additionally, Bill is certified in ASTYM (augmented soft tissue mobilization) and Trigger Point Dry Needling (Level 3).

His professional interests involve seeing patients who have shoulder, knee, and spinal issues.

Essential Exercises to Prevent Low Back Pain

By Joe Hanel, LAT

Back pain can be quite complex and a real hassle.

Whether you strained your back lifting something, sat for too long, or woke up with that all-too-familiar ache, back pain can really slow you down.

But here’s the good news—there are things you can do to help!

When back pain hits, it's important to take action.

Rest is a good starting point, but recovery requires more. You need to stay active and work on strengthening your back to help it heal and stay strong.

And remember, not all advice about back pain is accurate.

Let’s clear up some common myths:

• Myth 1: "If My Back Hurts, I Should Rest All Day."

  • Resting a little can indeed help when your back hurts. But too much rest can make your back worse. When you don’t move, your muscles can weaken, and stiff muscles can lead to more pain. Gentle exercises within pain limits can help reduce pain and keep your muscles strong.

• Myth 2: "Lifting Heavy Things Always Causes Back Pain."

  • Your back is strong and resilient. Lifting heavy objects can hurt your back if you do it the wrong way too many times in a row for an extended period, but learning the right technique can actually strengthen your back. The key is to lift with your legs, not your back. Keep your back flat, bend your knees, and use your leg muscles to lift. If you do find yourself out of position, it’s not the end of the world but you’ll want to focus on your form with each lift if your job requires repetitive lifting tasks.

• Myth 3: "Only Old People Get Back Pain."

  • Back pain can happen at any age. While it’s true that it becomes more common as we age, kids and teenagers can experience it, too, especially if they carry heavy backpacks, play sports, or spend too much time sitting. Everyone needs to care for their back, regardless of age.

  • It’s estimated that up to 80% of Americans will experience lower back pain at some point. Low back pain and disability impact up to 62% of our industrial workforce. Low back pain can also affect our police, firefighters, and emergency response at similar rates.

So, what can you do to prevent low back pain?

Over the years, I have treated LBP patients in many ways, trying lots of different approaches and hoping something provides them relief.

I have found that preventative exercise is the best way to prevent recurrence for many of those I have treated. Often, it may not be a lower back injury or tightness causing their discomfort, so it is important to address core strength and hip mobility while examining the lower back.

Check out this exercise progression, for example:

Start with a warm-up:

1. Single knee to chest stretch: Lay on your back with knees bent, draw in belly button to engage core. Birng one knee up to your chest and hold for up to 30 seconds; switch sides.

2. Rotation stretch/knee rock: Lay on your back with knees bent. Draw in belly button to engage core. Slowly rock knees to one side and hold for up to 30 seconds; switch sides.

3. Lumbar rotation stretch: Lie on your back, then bring one knee toward your face so that your hip is flexed to 90 degrees. With the opposite hand, pull it sideways toward the floor to feel a stretch in the lower back/buttock. Keep your shoulders flat on the ground during the stretch.

4. Back bridge: With head and shoulders relaxed tighten abs and glutes. Push through your heels to raise your hips, hold for 3 deep breaths and repeat.

Move to some strengthening Exercises:

5. Contralateral Extension: Activate your lower abdominals by bringing your belly button inward and by activating your pelvic floor muscles (inner thigh). Maintain steady abdominal breathing while you lift one arm and opposite leg up towards the ceiling keeping your chin tucked in. Return and repeat with the other arm and opposite leg.

6. Bird Dog (band optional): On all fours, draw in belly button then extend one arm then the other, then one leg then the other. Focus on keeping your back flat and staying balanced. Hold in extension for 1-3 sec. then switch sides.

If that’s too easy, try moving one arm up and the opposite leg up at the same time. Focus on keeping your back flat and staying balanced. Hold in extension for 1-3 sec. then switch sides. This movement should be slow and controlled.

By working up with core strength and hip and spine mobility, you'll keep ahead of lower back tightness and pain.

—

Disclaimer: As a reminder, these exercises are for educational purposes only and should not be taken as medical advice. If you have a complex history of lower back pain, are unsure if these exercises are right for you or have pain while doing an exercise, it is recommended that you connect with one of our skilled clinicians to assess further. It may be recommended that these exercises or a different series are accompanied by manual therapy, trigger point dry needling, and therapeutic cupping to ensure that you achieve your goals and eliminate your lower back pain for good.

CranioSacral Therapy: Understanding the body’s response to trauma

“It’s not something that’s considered mainstream,” he said. “But it can be very powerful.” 

So, the discussion about cranial sacral therapy begins with Dennis Kaster, a longtime physical therapist at Advanced PT. 

Kaster has as much experience as a PT practitioner as just about anyone on the Advanced team. He confirms what his online bio states, that he has a great deal of experience in the areas of the spine, chronic pain, hand injuries, sports medicine, industrial rehab, and various manual therapies. 

One of those manual therapies is cranial sacral therapy (CST). This alternative treatment releases tensions deep in the body to help reduce pain, relieve dysfunction, and improve whole-body health and performance. Dr. John Upledger pioneered and developed CST in the mid-seventies at Michigan State University. It’s a gentle technique Kaster has used with patients for decades.  

Describe gentle. 

“When I went through training,” Kaster said, “the instructors described CST this way: ‘You’re using the same amount of pressure you’d use to bend the Legs of a fly.’ It’s that subtle.” 

CST focuses on the connection between the cranium or skull and the sacrum or tailbone to relieve tension within the body’s connective tissue, called fascia. Kaster uses it frequently with his patients suffering from chronic pain. Many of those patients are women who have suffered physical or sexual abuse.  

“There’s a lot of trauma in their past, a lot of post-traumatic stress disorder,” said Kaster. “Probably half my caseload relates to migraines and headaches, and many of those patients have PTSD. 

Because CST isn’t mainstream, few people have been trained in the practice, and people looking for the relief it can offer can’t find clinicians to do it. Kaster says that he gets people all the time who come from a distance to see him. 

“I see patients in Stevens Point and other areas,” Kaster said. “One of my patients travels from Minneapolis to see me because she can’t find anyone there who does it.” 

So how is it done? 

For a typical PT visit (about 40 minutes), Kaster will use the technique when appropriate or combined with other approaches (such as manual therapy, functional exercise, and other interventions)

With the CST portion, Kaster is looking for a “rhythm or pulse,” feeling for the movement of the body’s connective tissues and any restrictions encountered.  

Cranial sacral therapy has differing results for patients. At times, the technique has little or no effect. With others, it’s life-changing.  

Kaster describes the technique as simply another tool in the toolbox.  

“I assess people to see if they have tightness and restrictions,” said Kaster. “For many people with headaches, any type of neck, low back, mid-back pain, tension, post concussions, chronic pain, CST can be a powerful tool.” 

By releasing the restrictions in the craniosacral system, Kaster says, you’re engaging the body’s innate healing processes, which has benefits for a wide range of physical challenges faced by his patients.

Kaster says another huge component of the technique is SomatoEmotional Release (SER), which expands on CST principles to help people rid their bodies of the residual effects of past injuries and negative experiences.  

Also a gentle process, SER facilitates the release of negative energy and allows the body to heal. Kaster describes it as working through layers of an onion. But the gentle process can bring forth some very emotional memories. 

“It’s important that the patient is working with a counselor before using SER techniques, as things can be brought to the surface that patients aren’t ready to deal with,” said Kaster. “But I’ve found it helps people to heal and get over deeply buried emotions, which is important because psychological trauma will manifest itself into physical conditions.” 

Kaster recognizes that some medical professionals will refer to CST and SER as “voodoo medicine.” That’s not his worry.   

“I’ve got 35 years of experience and a heck of a lot of training in it, and it’s helped so many of my patients,” said Kaster. “Like I said, perhaps not mainstream, but so very powerful.” 

If you have questions about Craniosacral Therapy or want to see if it’s a good fit for your treatment plan, please use our online submission form.

—

About the Author:

Dr. Dennis Kaster is a physical therapist at Advanced PT’s Stevens Point North clinic on Division St. He has been happily married to his wife Adrienne, who is also an extraordinarily talented physical therapist, for almost as long as they have been practicing. They love cycling, hiking, and traveling. They also love helping people feel better, which brings them joy.  

Recover Smarter with Blood Flow Restriction (BFR) Training

Can restricting blood flow really help you get stronger?

Well, sort of! Let us explain.

Blood Flow Restriction (BFR) training is a powerful tool athletes and individuals use to maintain strength and prevent muscle loss during rehab or recovery from surgery.

BFR involves applying a tourniquet-like system (similar to a strong blood pressure cuff) to the arm or upper thigh, reducing the flow of oxygenated blood to the muscles. When combined with low-intensity exercises, BFR tricks your body into working just as hard as you would during normal weightlifting or practice.

Benefits of BFR Training:

• Maintain muscle size and strength after surgery

• Reduce pain from muscle strains

• Safely build strength and endurance while recovering from an injury

• Achieve the same results as regular training with 20-30% less weight and effort

• Release endorphins and other natural healing substances, similar to regular exercise

Is BFR Safe?

Yes! BFR training has been proven safe and effective for most individuals cleared for exercise.

However, people with Factor V Leiden (a condition that increases clotting risk) should avoid BFR.

If you have cancer, a bone fracture, an infection, or are pregnant, consult with a healthcare provider before trying BFR.

In most cases, there is no increased risk of blood clots or deep vein thrombosis (DVT) associated with BFR.

What to Expect with BFR Training:

During a BFR session, as your muscles fatigue, you may feel a lactic acid burn, similar to what you'd experience during an intense workout.

Afterward, you might experience delayed onset muscle soreness (DOMS) for 24-48 hours, especially if you're new to exercise. This is normal and tends to decrease with repeated sessions.

When paired with a comprehensive treatment plan—including manual therapy and functional exercises designed with your physical therapist—BFR can be a valuable tool for recovery and strength building.

BFR training is available at our Appleton East, Appleton North, Champion Center, and Green Bay East locations.

Dr. Gerad Donahue and Dr. Blake Van Maanen, who contributed to this article, serve patients at our Clinic within the Champion Center on Champion Dr. in Grande Chute, WI.

Tendonitis 101: What Every Industrial Worker Should Know to Stay Pain-Free

Tendonitis is a prevalent condition characterized by inflammation of a tendon, the thick fibrous cord that connects muscle to bone.

It typically results from overuse or repetitive stress and can affect various tendons throughout the body, including those in the shoulders, elbows, wrists, knees, and ankles. In a previous blog post, we discussed some stretching and strengthening exercises and ergonomic concepts an industrial worker can utilize to help avoid tendonitis.

But what if you’ve already developed the condition?

This article explores the average recovery timeline and general treatment strategies for some of the most common cases of tendonitis industrial workers develop, helping you understand what to expect and how to manage this condition effectively.

Common Types of Tendonitis for Industrial Workers:

Click here to learn more about Tennis Elbow

1. Tennis Elbow (lateral epicondylitis): This condition involves the tendons on the outside of the elbow, usually caused by repetitive wrist and arm motions.

2. Golfer’s Elbow (medial epicondylitis): Affects the tendons inside the elbow, often from repetitive gripping or wrist flexion.

3. Rotator Cuff Tendonitis: This condition impacts the tendons in the shoulder, typically due to overhead activities or lifting.

4. Trigger Finger or Trigger Thumb (stenosing tenosynovitis): This condition occurs in the hand when the tendon sheath becomes irritated and swollen. It is often caused by repetitive use of the thumb or fingers, such as gripping or pinching.

5. Achilles Tendonitis: This condition affects the Achilles tendon, which connects the calf muscles to the heel bone. It is often caused by excessive running or jumping. Heavy, stiff work boots can also irritate the Achilles tendon.

Recovery Timelines

Recovery from tendonitis varies depending on the severity of the condition, the tendon affected, and the effectiveness of the treatment plan. However, general timelines can be outlined as follows:

1. Mild Tendonitis: For cases caught early and involving minimal damage, recovery can range from a few weeks to a couple of months. With proper rest and treatment, individuals often return to their normal activities within this timeframe.

2. Moderate Tendonitis: If the condition is more established and involves moderate inflammation and pain, recovery may take 2 to 6 months. This duration includes time for therapy and a gradual return to activities.

3. Severe Tendonitis: For severe cases beyond 6 months, it’s not uncommon for a tendinitis to transition to a tendinosis. This means there are actual physical changes and degradation within the cellular structure of the tendon. Depending on your symptoms, this may require intensive therapy or other medical intervention. Moral of the story here: if you’re having pain, don’t wait and see if it improves. Act ASAP!

General Treatment Strategies

Effective treatment for tendonitis involves a combination of self-care measures, medical interventions, and physical or occupational therapy. Check with your employer to see if they sponsor any on-site or near-site programs for seeing an athletic trainer, physical therapist, or occupational therapist.

Here’s a breakdown of common approaches:

1. Rest and Activity Modification:

o Rest: Avoid activities that exacerbate the pain. Giving the affected tendon time to heal is crucial.

o Activity Modification: Adjust your activities to reduce stress on the tendon. This might involve changing techniques or using different equipment. It’s essential to keep your body moving during this time, so find something that you like to do that doesn’t increase your pain.

2. Moist Heat:

o Apply moist heat: Apply moist heat (e.g., a moist heating pad) to the area for 5-10 minutes twice a day. The moist heat will promote soft tissue healing and increase the flexibility of the muscles surrounding the area.

3. Medication:

o Consult with your medical provider regarding medication usage. In general, nonsteroidal Anti-Inflammatory Drugs (NSAIDs) may be helpful; however, movement within pain-free limits may be equally as effective if done appropriately.

4. Physical Therapy or Occupational Therapy

o Stretching and Strengthening Exercises: An experienced physical therapist or occupational therapist can guide you through exercises to improve flexibility and strengthen the muscles around the affected tendon.

o Manual Therapy: Techniques such as massage, mobilization, therapeutic cupping, or trigger point dry needling may reduce pain and improve function.

5. Supportive Devices:

o Braces or Splints: These can help support the affected tendon and prevent further strain during the healing process. Consult your employer about which ones you may or may not be allowed to wear at your job.

6. Injections or Surgery:

o Things like corticosteroid injections, platelet-rich plasma and surgery may be an option if other interventions have not been helpful. When treating these conditions, seeing a PT or OT first has been proven to save you time and money.

Conclusion:

Understanding the recovery timeline and treatment options for tendonitis can help manage expectations and guide effective management of the condition.

Early intervention and adherence to a comprehensive treatment plan are essential for a successful recovery.

If you experience persistent or severe symptoms, let’s chat!

The best post-race recovery strategy

Dr. Rob Worth at the 2023 Fox Cities Marathon

Written by: Dr. Natalie Ullrich.

Happy race week to everyone participating in the Fox Cities full, half or 10k/5k races!

Congratulations, you have done the hardest part by just making it to race week.

You did your long runs in 90-degree weather, spent countless hours of your week training, and probably learned many lessons along the way.

On race day, remember all your hard work to be there, and have a great time! 

Here are some pieces of advice to make your post-race recovery more enjoyable.  

1.Don’t skip the post-race cool-down!

Even though you may be tempted to sit (or lie) down right after the finish to relieve your exhausted legs, an active cool-down is integral to the recovery process.

Walk for at least 10-15 minutes before resting. This will give your heart rate time to gradually lower and your blood flow time to normalize, which may help improve overall cardiovascular and respiratory recovery.

Unfortunately, research has found no link between an active cool-down and delayed-onset muscle soreness, but an active cool-down is still essential to improve acute post-race comfort. Walk a leisurely lap around Riverside Park before heading to the post-race snack tent! 

2.Fuel your run

Make sure you have a nutrition and hydration plan going into the race, and stick to it! Whether you like eating whole foods or prefer gels and chews, your body must replenish its energy stores and electrolytes. Fueling correctly during the race will help make your run more enjoyable help you feel better after the race, and speed up your recovery over the next several days.

(Pro tip: On hot days, don’t skip the pickles or bananas on the course; they can help you prevent cramping during and after your run.)

3.Prioritize post-race nutrition

Aim to eat something carbohydrate-heavy within 30 minutes of the race and prioritize carbohydrates and protein for the rest of the day. This is important to restore depleted muscle glycogen and repair damaged muscle tissue. It is common to lose your appetite for several hours after a hard effort, but try to eat small amounts often to refuel your body.  

(This is where we’re supposed to tell you that healthy food choices are the best, but we all know that all you want is a bag of chips…and in moderation, that’s okay, too.)

4.Keep moving a little bit and often for the rest of the day.

Whether you plan on heading to a brewery to celebrate or lying on the couch to binge-watch a new show, stand up and walk often throughout the day. I recommend that my patients get up at least every hour to walk and gently stretch. It is normal to feel progressively stiffer and more sore throughout the day, and you may notice a significant increase in soreness and stiffness when you get up the next morning. Do a similar amount of short and frequent movement throughout the day after your race.  

5.Take a gradual return to running and exercise.

This is very person-dependent on when it is appropriate to return to running. Still, as a general rule of thumb, you should no longer have any significant muscle soreness and should be able to jog without any pain.

Most people can do a recovery run within 3-7 days after the race, but some may need several weeks. If you cannot run, stay active by walking and doing low-impact cardiovascular exercises such as biking, swimming, or elliptical exercise.

Suppose running-related pain does not improve within a few weeks after the race. In that case, you may benefit from a physical therapy evaluation to address this and get you back to running ASAP! 

Good luck, everyone. Have fun, and remember that we’re here to support you in any way we can after the race!

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About the Author: Dr. Natalie Ullrich is a physical therapist at our Neenah clinic on Commercial St. She loves working with runners and helping them prepare for, perform during, and recover from their races.