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!

Conquering Carpal Tunnel: A Guide to Conservative Treatments

Carpal tunnel syndrome (CTS) is like an uninvited guest in your hand, but it doesn't have to stay forever. Several simple treatments can help manage CTS and make your hands feel better. Here’s how you can take control of your recovery.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome arises when the median nerve, responsible for sensation and movement in your thumb, index, middle, and half of your ring finger, gets compressed within the carpal tunnel in your wrist. This compression can lead to tingling, numbness, weakness, and pain in the hand and wrist.

What causes the compression?

It could be a combination of things: inflammation, awkward or sustained working positions, repetitive movements, operating heavy machinery, muscular strength, and mobility imbalances throughout the forearm, upper arm, and even the neck.

Combating CTS: A Multi-Pronged Approach

Conservative treatments aim to reduce pressure on the median nerve and alleviate CTS symptoms. Here's a look at some effective options:

1. Splinting: Wearing a wrist splint, particularly at night, immobilizes your wrist in a neutral position. This helps rest the median nerve and reduce pressure within the carpal tunnel.

2. Activity Modification: Mindfulness in daily activities can significantly improve CTS symptoms. Identify tasks that aggravate your symptoms and make adjustments. This may involve taking frequent breaks, using proper posture, and incorporating ergonomic tools into your workspace, keeping your wrist in neutral while you work, or changing your workspace to set yourself up for success.

3. Manual Therapy: Mobilization and manual therapy to the transverse carpal ligament and surrounding structures, trigger point dry needling to the flexor or extensor mass, depending on where the restrictions or limitations can be found, and nerve mobilizations/ gliding for the median nerve.

4. Therapeutic Exercises: Gentle hand and wrist exercises prescribed by a physical or occupational therapist can improve flexibility, nerve mobility, and overall hand function.

Wrist flexion stretching, wrist extension stretching, median nerve glides, grip strengthening, and upper extremity strengthening exercises may be appropriate depending on the severity (how intense they symptoms are and how they impact you), irritability (how much activity is required to provoke the symptoms) and nature (what other factors besides activity impact your experience) of your symptoms.

*Disclaimer: Exercises are for education only and should not be used in place of a PT or OT evaluation or free injury screen by one of our skilled PTs or OTs.

5. Functional Exercise: Using the fundamental strength and mobility built with therapeutic exercise to perform combined movements that mimic your job tasks, life outside of work, or hobbies that you may have.

The Takeaway: Early diagnosis and intervention are crucial for successful CTS management. By implementing conservative treatments at the first signs of CTS, you can prevent further nerve irritation and regain control of your hand function.

Consulting a physical or occupational therapist is vital for proper diagnosis and crafting a personalized treatment plan to conquer carpal tunnel and reclaim pain-free hand use.

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About the author: Ron Lawrence is a physical therapist and strength and conditioning specialist at our Shawano Clinic and with our Industrial Medicine Team. He holds advanced certifications in Dry Needling and Nutrition. He is an excellent resource for any work-related or non-work-related aches you may have!

3 Tips to Improve Your Desk Setup

As a physical therapist, I have had the opportunity to work with and support office workers in learning how to set up and use their workstations ergonomically for optimal support and comfort. I’d like to share some of the pearls I have learned.

We have all heard the saying, “Everything in moderation.” One may choose to start eating healthier and choose one less dessert at a party or cut back on the size of that favorite mocha latte. Someone with a love of shoes may decide to create a shoe budget to keep spending in moderation. In the same way, moderation also applies to physical activity and body posture. Runners prepare for a race by following a training plan that allows the body to have periods of rest to prevent repetitive injury. With stationary activities, it is just as important to have periods of movement. Designed to move, our bodies feel the impact of lack of movement. Sitting for prolonged periods can lead to reduced blood flow, stiffness, discomfort and fatigue (both mental and physical).

These simple tips will help you moderate stationary activity in order to work healthier and more efficiently in an office setting.

1. Sit Smart:

Seating Choice – office chairs with adjustable height, seat depth and lumbar support offer an individual fit to support the spine and legs.

Showing how to assess seat height, seat depth and lumbar support.

Key Seating Adjustments

Seat Height – choose a height that places the thighs parallel to the floor or slightly higher. This creates a stable base of support. If adjusted too low the hips can become stiff and if adjusted too high one may slide forward and slump.

Seat Depth – adjust to fully support the thighs, but still leave the width of a couple fingers between the front edge of the seat and the back of the knee. This is very important to distribute body weight evenly and not impede blood flow at the back of the knee.

Lumbar Support – adjust to support the curve of the lower back. This not only supports the back but also promotes healthier upper body and leg postures. In some cases, even with an adjustable lumbar support, individuals find they may need more. Rolling up a towel or purchasing an additional lumbar cushion is a simple fix.

2. Be Aligned (With Your Desk/Workstation)

Showing proper alignment with your desk

Desk Height – if able to adjust desk height, adjust so that while typing the forearms are parallel to the floor and wrists are at the same level or slightly lower than the elbows. This will keep the wrist in neutral postures and help reduce the risk for development of carpal tunnel. If the desk height cannot be adjusted, hopefully it is just a little high. To solve this problem, add a footrest and raise the chair. If too low, look for a different desk.

Keep It Close – to prevent leaning forward and slumping as well as unnecessary reaching, adjust the keyboard and mouse to be close to the edge of the desk; adjust monitor(s) to be centered in front of you, about an arm’s length away, and at a comfortable height to view the screen without needing to tip the head up or down.

3. Sit (or Stand) in Moderation

Schedule Movement Breaks – whether it is a sticky note or a phone or calendar reminder, plan to move every hour. A lap around the office, a water refill break, a longer walk during lunch break, a trip to the printer, and even 1-2 minutes of standing and shifting weight or marching in place help break the stationary cycle. If you have an adjustable desk and can stand while you work, remember it is just as important to move and avoid locking in a stationary standing posture for a long time.

Eye Breaks—Remember that our eyes need a break as well. Periodically look away from the computer screen and focus on something else in a different direction. This can reduce eyestrain and related tension headaches.

If our bodies are supported in healthy postures and given opportunities to move, we will reap the benefits of working comfortably with more energy and focus. If you haven’t already, take the time to adjust your office workstation and plan movement every day properly.

Remember to sit smart, be aligned, and of course, everything in moderation!

About the Author: Dr. Renee Anderson, PT, DPT, is heavily involved with our Industrial Medicine program and helps at our clinics in Shawano and Green Bay.

How to Decrease fatigue and reduce stiffness in 5 minutes.

Feeling sluggish or stiff at work?

Try these 5-minute breaktime exercises to boost circulation, reduce fatigue, and alleviate stress!

These short and simple exercises can be done during breaks to relax overworked muscles and activate those not used as often. This will improve your ability to perform your job with focus and reduce aches and pains. Dynamic stretches and postural reversals are critical to this process.

Dynamic stretches held for just 0-5 seconds increase blood flow and improve flexibility and strength.

Postural reversals, done throughout the day, counteract the effects of prolonged postures. Incorporate these exercises into your daily routine and feel the difference immediately! 

Dynamic Stretches:  

Dynamic stretches assist with restoring physical functioning & flexibility, elevating the core body temperature, increasing circulation, accelerating energy production, and improving speed & strength.

Increased blood flow to your tissues helps delay muscular fatigue. 

Perform each exercise until the muscles feel warmed up, avoiding any movements that cause pain.* Progress slowly and always move through a pain-free range. Stop when you feel a gentle pull. They are most effective if they are done a few times per day.

• Head Circles - Rotate the head to make circles. Complete in both directions.  

• Arm Circles - Lift arms away from the body. Move in a circle. Complete both directions.  

• Wrist Circles - Bend elbows. Move the wrist in a circular direction. Complete in both directions.  

• Squat-to-Fly: Stand with feet hip-width apart and push hips back as if sitting on a chair. Cross arms in front of your chest. Bend your knees to lower yourself into a squat. Stand up while uncrossing/opening your arms as wide as you can. Squeeze your shoulder blades together.  

• Toe-Touch to Side-Bend - Stand with feet hip-width apart. Try to touch your toes, and stop when you feel tension. Return to an upright position and lift one arm above your head. Reach to the opposite side. Re-center. Bend towards the toe and then reach towards the opposite side.  

• Butt Kickers - Stand with feet hip-width apart. Bend your right knee and lift your heel toward your butt. Lower your right leg and do the same on your left side.  

• Lunges: Stand with your right foot in front and your left foot in back. Move your hips forward while bending your front knee to tolerance. Repeat on the opposite side.  

• High-Knee with a Twist - Lift knee upwards towards the chest while rotating trunk. Bring opposite elbow to knee at the same time—alternate sides.   

This is an example of a program we use for our industrial clients; however, these are great for office workers too!

Postural Reversals:  

Postural Reversals involve placing your body in the opposite position or motion. They can be done throughout the day and only take a few seconds to accomplish. Postural reversals are more effective for combating muscular tension from prolonged postures than stretching alone.

• If you’re Standing, perform 5 squats every 30 minutes of continuous standing.  

• If you’re twisting your wrists a lot, draw circles with your wrist for 3-5 reps in each direction.  

• If you’re gripping a lot, Make a tight fist and then spread your fingers out as wide as possible, returning to the starting position with 3-5 reps total.   

• If you’re forward-bending a lot, Stand hip-width apart and reach up towards the sky for 5-10 seconds. Slightly bend or curve your spine backward, using your hands to support your lower back as needed.   

• If you’re Forward Reaching a lot, Stand hip width apart, arms out to the side, elbow bent at 90 degrees into a “Happy Cactus” position, perform 3-5 reps for every 15 minutes of work.  

• If you’re sitting a lot, stand and complete 25 high knees every 30 minutes of sitting. We can do this in place or march forward.  

• If you have low back discomfort while seated, arch your back and round your back for 5-10 reps as needed.  

You can perform these exercises wherever you have adequate space or surface support, as needed. 

Dynamic stretches and postural reversals boost circulation and reduce muscular fatigue. Incorporate these into your daily routine and feel the impact on your physical and mental health. 

*Disclaimer: Please note, these exercises are general recommendations. They should not take the place of advice from a medical professional. If you would like a program developed specifically for your or your workforce by one of our physical therapists, occupational therapists or athletic trainers or feel like you could benefit from manual therapy, dry needling or cupping to compliment these exercises, contact us today!

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About the author: Megan is a Physical Therapist Assistant at our Fond du Lac and Ripon Clinics. She is also heavily involved with our Industrial Team. She uses similar exercises to help workers thrive during their workday and prevent injuries for jobs requiring prolonged postures/positions and repetitive work.

Quenching the thirst for knowledge, one employee at a time

Advanced Physical Therapy’s Lynsey Hansen gives Wisconsin Rapids Officer Travis Plowman a gentle reminder about hydration: “Don't forget: Drink water and get some sunlight. We are basically houseplants with more complicated emotions.”

“Lots of people don’t like water,” she began.

Lynsey Hansen is one of Advanced Physical Therapy & Sports Medicine’s Industrial Athletic Trainers. It’s her job to care for employees of the companies, organizations and municipalities at which she works.

Hydration is one of her things. She brings it up a lot. But she tries not to hound.

“Being properly hydrated is super important, so I talk about it frequently,” said Hansen. “It can actually help improve your overall well-being.”

How that conversation starts is dependent on her audience—a police officer, a firefighter or someone in industry—but the questions that follow are the same:

“How have you been feeling lately?”

“How have you been sleeping?”

If the answer to either is “Not that great,” Hansen will touch on hydration in pretty short order.

If someone says they’re tired, she’ll ask how much water they’ve been drinking; Hansen uses the standard “drink half your weight in ounces per day” as the bare minimum, then adjusts that based on activity levels. If it’s about frequency and getting up at night, she’ll discuss front-loading the day with water intake. If it’s about simply increasing water consumption, she’ll provide tips to get reluctant water drinkers to move in the right direction (she sees sports drinks as a kind of compromise, which supplies some benefits but includes lots of additives).

Or, said Hansen, they might be complaining of being tired or in pain or struggling with some sort of issue that makes them reliant on eating sugary things or drinking caffeinated beverages.

“Many times in these moments when our body wants those things, we’re just dehydrated,” she said. “If you’re dragging or feeling like crap on a daily basis, you need to understand drinking more water can flip the script. Such knowledge can be a powerful motivator.”

Hansen acknowledges that getting people on board with better hydration (and better health and sleep as well) is not always an easy sell.

“If you don’t want to do it, you’re not going to do it, regardless of what I say.”

But the resolute athletic trainer carries on, undaunted, sprinkling her discussions with tips that might resonate with the unenthusiastic H2O consumer:

• “Add low-sugar Liquid IV to your water now and then. It tastes great, keeps you in the hydration habit, and trust me, it enhances the functioning of your cellular transport chain!”

• “Athletes prioritize hydration. You’re an industrial or tactical athlete, so you need to have that exact mindset. Now drop and give me twenty!”

• “Put 6 rubber bands around your 16 oz. water bottle because that’s how many bottles you should aim to drink daily. Every time you drink one, take one of the bands and put it on your wrist. By the end of the day, all 6 should be off the bottle and on your wrist! Easy way to keep track!”

At the mention of rubber bands, Hansen segues into another subject near and dear to every athletic trainer: injury prevention.

“Sorry, that just made my brain go this way. Your muscles are rubber band-like, so when you're hydrated, your muscles have that fluidity and pliability. When a force comes on, your muscles can take it and bounce back. If you’re dehydrated, your muscles will be super tight, and any force that comes along can create damage. Staying hydrated helps you prevent injuries. So rubber bands are very cool on many levels.”

Speaking of injuries, Hansen has a concussion tale, a fall of about three stories from a pyramid.

And there’s another about tearing her hamstring from the bone (it didn’t stop her from what she needed to do, however).

She’s a tenacious one, no doubt.

But those are stories for another time . . .

Providing Experiences for the Next Generation of Professionals

Getting people back to what they love is the job of an athletic trainer. Ensuring there are plenty of high-caliber graduates ready to serve active populations is the job of universities and colleges, whose programs provide interactive learning environments that will prepare students to enter the profession.

Advanced Physical Therapy & Sports Medicine (APTSM) plays a vital role in the process.

“It’s important we offer internships and job shadowing opportunities for those on the path to becoming athletic trainers,” said APTSM’s Traci Tauferner. “The field is projected to grow 25% by the end of the decade.”

While there is a broad range of settings for the athletic trainer—physician practices, professional sports, clinics specializing in sports medicine, occupational health, and performing arts, to name a few—the vast majority of graduates will enter the field’s most traditional setting: schools.

That’s where Tauferner started out after earning her athletic training degree at UW-Oshkosh. With a robust resume developed since her graduation—she’s the Director of Industrial & Tactical Medicine at Advanced—Tauferner now devotes time both to her administrative duties as well as to the onsite therapy services she delivers at multiple locations.

Tauferner is committed to bringing attention to industrial athletic training, especially as the need for athletic trainers to prevent, evaluate, manage, and rehabilitate conditions faced by workforces—directly at companies and municipalities—continues to grow.

“Achieving injury prevention and cost control in this day and age for the industries and tactical groups we serve is not just a desired outcome,” said Tauferner. “In many cases, it’s a matter of survival.”

More than 55 Wisconsin companies and organizations utilize Advanced PT’s hallmark program of onsite wellness solutions. APTSM’s dedication to workplace health and safety has contributed to recognition at local, state, and national levels.

That kind of focus includes providing learning opportunities for those interested in pursuing a career in the field, and Tauferner is passionate about students understanding the paths available to them.

“It’s important for us to provide these experiences for the next generation, especially so in the bourgeoning industrial and tactical realms, as fewer than 5% of graduates are going into those sectors,” she said.

The connection between APTSM and Tauferner’s alma mater remains strong, as evidenced by UW-Oshkosh student Cade Littleton’s recent experience.

Littleton, a senior in the Masters of Athletic Training Program, spent the summer working through four specific rotations: clinical, hospital, professional team, and industrial/tactical.

Littleton said a few football injuries (“some hip and shoulder pain, but nothing huge like a blown ACL”) led him to seek treatment. Though his high school didn’t have a traditional athletic trainer, a nearby orthopedic group supplied the small school with a physical therapist, and Littleton found himself fascinated by the PT’s skills.

“I was just very interested in what he did, so much so that I actually job shadowed him for one of my classes,” said Littleton. “That set me on the PT path, but once I got to school and got a little more experience with athletic training, I became drawn to that, to work with a younger and highly active population.”

To meet the requirements of the program, one of Littleton’s rotations had him paired with Tauferner.

“This was actually the third time I had met Traci,” said Littleton. “I met her following a presentation she did on mental health, then at the WATA (Wisconsin Athletic Trainers’ Association) conference this year.”

For two weeks Littleton followed Tauferner’s schedule (“yeah, she starts early”), which included stints with the tactical groups she services.

“It was cool to see the firefighters and police officers and how they handle things at their own facilities,” said Littleton. “It was a lot different than my traditional experiences.”

With those tactical groups, Tauferner gave Littleton the opportunity to do full evaluations; she provided guidance, talking Littleton through treatment options and giving him the chance to “do his own thing.”

“Traci allowed me to do a lot more hands-on than I expected, so that was really cool,” he said.

He also learned about Tauferner’s use of and advocacy for modern cupping techniques.

“Just how she used cupping and explained it so it made sense to the client was very interesting,” said Littleton. “That helped me a lot because I’m still a student trying to figure this stuff out.”

Asked about key takeaways following the rotation, Littleton doesn’t hesitate.

“The experience pushes me to continue to learn, to ask questions, and to demand respect as Traci does.”

Littleton admitted he’d like to replicate the demeanor Tauferner exhibited throughout their time together.

“Traci’s vibe is straight confidence,” said Littleton. “The setting doesn’t matter.”

Summer rotations are complete, Littleton is now working with UW-O’s athletic trainer for 2023 football season. Set to graduate next May, Littleton is currently leaning towards working in the high school or college setting, but he’s not ruling anything out.

“I’m not 100% sure yet,” said Littleton.

If uncertain about his job setting, Littleton expresses a clearer view in the geographic sense.

“I’m up to moving,” he said. “I’m not a huge fan of winter.”

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If you or a student you know is interested in experiencing what Advanced does every day, contact us today!.

The Journey of Anna Linstedt, LAT

As the chair of the Awards & Scholarships Committee for the Wisconsin Athletic Trainers’ Association (WATA), Anna Linstedt relied on input from the Board of Directors to identify a candidate for the organization’s Distinguished Service Award, given annually to a servant leader in recognition of their dedication to the advancement of the athletic training profession.

“We have a name,” said WATA President Keith Owsley.

Linstedt listened for it. There was a long pause.

“What are you waiting for?” she said.

“I really don’t know how to go about doing this,” he said.

“Just fill out the nomination form, send me a letter, get me their curriculum vitae,” said Linstedt. “It’s not that hard, Keith.”

“Well, we’re nominating the committee chair,” came the response.

The realization that Linstedt herself was the recipient of the award caught her off guard. A question immediately popped into her head; it came out of her mouth almost as readily.

“Don’t you have a better name?” Linstedt asked.

The President answered without hesitation.

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The path that led Linstedt to this moment can be traced back to her college days, as one of WATA’s founding fathers was her instructor. He impressed upon Linstedt the vital importance of participating in the association, and she’s been involved ever since, from member to committee leader to regional representative to President, leading the organization from 2020-2022.

The challenges would begin for Linstedt even before she took office, as three weeks prior to the beginning of her term the decision was made to cancel WATA’s annual meeting, the most important event on the calendar and the group’s main revenue generating source.

This would be the first of many disruptions during Linstedt’s unprecedented tenure, but such was the nature of first great pandemic of the 21st century.

Despite the inability to meet in person with lobbyists, state government officials, and even her own staff, Linstedt spearheaded WATA’s effort to achieve their goals, one of which was the streamlining of athletic trainer license requirements.

“That was a huge win for us,” said Linstedt.

Another effort was to gather and present data to lawmakers to ensure reimbursement rates for athletic trainers were equal to those of physical therapists. Working with insurance companies, WATA was able to provide the state legislature evidence from more than 90,000 episodes of care that demonstrated

rehabilitation processes followed by trainers and therapists were the same and should be compensated as such.

“A year later,” rued Linstedt, “this still hasn’t crossed the goal line.”

With the cancellation of the annual meeting and the concomitant reduction in capital, Linstedt and her team needed to go through the budget with a fine tooth comb, determining the absolute must-haves through a process of budgetary triage. Linstedt praised the work done by her predecessors for years of fiscally responsible choices that helped the association to weather the storm that was COVID and still come out in the green.

“The pandemic really forced us to think outside of the box,” said Linstedt.

When asked to reflect on her time at the helm, Linsted wistfully mentioned that a “do over” would be nice.

“There are so many more things we could have done for the association if not for COVID,” she said. “But our focus on advocating for all athletic trainers, in both traditional and non-traditional settings, never wavered.”

Her tenacity as a leader and her journey to athletic training is rooted in her experiences on the playing fields. As a high school freshman, Linstedt was a varsity starter for volleyball and basketball. She ran track as well. And it’s also when she tore her ACL. That very year was the first year Burlington High had an athletic trainer, and she worked diligently to get Linstedt back in the game.

When Linsted returned to her sports the following year, she found herself on the on the bench for JV squads.

“That’s not where I thought I belonged,” said Linstedt.

It was at this point when the school’s athletic trainer took Linsted under her wing, teaching her how to tape and rehab, as well as encouraging the fledgling trainer attend camps over the summers to hone her skills. Linstedt, the kind of athlete who took to sports and made them look easy, was now directing her focus to learning about injuries, keeping athletes healthy, and getting those sustaining injuries back to their sports quickly and safely.

She never went back to high sports as a player. But Linsted’s mentor took her to every football game, every basketball game, wrestling, baseball and track events too. You name it, she was there.

“I became involved in athletics in a different sense,” Linstedt said. “I wasn’t participating, but I was an integral part of our sports programs.”

Linstedt would later attend UW-Oshkosh and complete coursework that included experiences working with athletic trainers in a variety of environments. She also got back into sports as a participant. As testimony to her athleticism, Linstedt was seen “messing around” on a diving board when a lifeguard asked her to try out for the school’s diving team.

“I was never a diver,” said Linstedt.

Nevertheless, she became a collegiate diver.

And as a water skier, she traveled to China to represent the United States in competition.

After earning her degree in exercise fitness management, Linstedt gravitated to the most traditional of settings for the athletic trainer: the high school.

“Even early on, I knew that high school was the place for me,” said Linstedt. “I felt that's where my gifts were.”

She would spend the better part of two decades treating high school athletes. A chance encounter with Advanced Physical Therapy’s Traci Tauferner, Director of Industrial & Tactical Medicine for the Appleton-based group, led to a change in setting that once upon a time would have been unthinkable.

“While I cherish all my time at the high schools, it can be a tough gig for a mom,” said Linstedt.

Tauferner pitched the idea of having Linstedt join her industry team and bring her skill set to a completely different clientele, namely the employees of companies who contract with Advanced to supply onsite injury management services. Linstedt was receptive to the idea of a very different kind of work schedule.

“My kids grew up looking at my calendar,” said Linstedt. “They knew I was going to be missing their activities, that I wasn’t going to be home in time for dinner or to tuck them in at night. I was the only trainer at my school, so I missed a lot of my kids’ events because I couldn’t find anyone to work my time.”

Now a year into her job as industrial onsite provider for Advanced, Linstedt feels comfortable with the transition, using her strengths with the high school athlete and their acute injuries and applying them to a slightly older population who are more often than not dealing with chronic issues. She highlights one important similarity in the treatment of the two groups.

“This goes for everyone, be it a high school athlete or a 47 year old shift worker: each one has to come to the realization that they have to care more about their recovery than I do,” said Linstedt. “I can give you all the exercises in the world to make you better, but if you don’t do them, it’s going to inhibit your recovery. The high school athlete and the industrial athlete have different motivations, but they share same desire for the best outcome, the one that gets them back to the playing field or back to work.”

And Linstedt certainly has no problem relating to the injured workers she sees at multiple industrial sites. In addition to her ACL tear, she’s had multiple shoulder surgeries, ankle issues, and once tore her hamstring off the bone. She understands the sinking feeling that you’re just not going to get through an injury.

“I’m able to use my experiences. I let patients know I understand how they feel, like you’re never going to be able to walk again,” said Linstedt. “But three weeks down the road it’s ‘Look, you’re walking!’ There’s a light at the end of the tunnel. I know. I’ve been there.”

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Anna Linstedt received WATA’s Distinguished Service Award on April 23, 2023. A person who prefers not to be called into the light, Linstedt was nonetheless grateful for the award, and very humbled. In her acceptance address, she recognized her husband and family, and now, by removing both the schedule of a high school trainer and the responsibilities of President of her professional organization (oh, but she’s still involved!), she gets to see them with greater regularity.

Quick Access to Quality Care

The Zoom connection was spotty.

“So you said you’re from the Twin Cities? I love Minneapolis,” I stated.

“Not Minneapolis,” she said. “Leopolis!”

Wait, what?

“And now I live in Pella.”

After the reconnect, I had Sally Egan of Advanced Physical Therapy & Sports Medicine (APTSM) begin anew.

“As an onsite provider at three companies and a municipality in Northeastern Wisconsin, it’s my job to help create and maintain healthy environments for employees,” said Egan. “And the best way to do that is to provide quick access to quality care.”

Egan is a veteran of APTSM’s industrial rehabilitation team, a group of licensed athletic trainers and physical therapists dedicated to keeping employees healthy, safe, and on the job. Like many of her colleagues from the athletic training world, she began her career in the high school setting, as the athletic trainer at nearby Shawano High School (about 15 minutes away from what she refers to as the “Twin Cities”) for nearly a dozen years.

She stresses the similarities between the two environments.

“What we do as industrial athletic trainers is bring the sports medicine model of immediate, consistent care to the workplace,” said Egan. “And we do this at no cost to the employee.”

Which is so important to her clients, everyday people who are just trying to make a living and put food on the table.

Egan understands that concept well.

“I grew up in this area on a very small dairy farm. I know what it's like for a family to live paycheck to paycheck and not able to get healthcare when you really should, because you just can't afford it,” said Egan. “So being able to provide that service—literally in my hometown—is just an amazing opportunity for me.”

Interesting that she and her chiropractor brother (“two tiny farm kids”) both pursued careers in health care. It makes complete sense, though, as she describes it as a simple transition from fixing tractors or boards on a wall to fixing people.

The similarities don’t end there, as Egan quickly points out.

“You have to be adaptable and inventive because you don't usually have the resources. That's what onsite rehab is. You don't have a lot of equipment, so you have to work with what you have,” she said.

The companies and organizations she works with rely on Egan to deliver services known as “rapid response,” where direct access to care means employees will be seen in 24-48 hours for an evaluation. That kind of quick care creates the opportunity for an improved healing timeframe, as the onsite provider can swiftly address and manage issues that, if left untreated, could become a recordable injury.

“We can prevent that from occurring,” said Egan. “So you’re keeping the employee healthy and keeping them at their job, and you’re saving the employer money by reducing direct and indirect costs that result from such an injury.”

Again, she leans on her sports medicine background.

“One domain of athletic training is about reactive and emergency care, which in industry is rapid response and OSHA first aid. So we're there for that assessment, and occasionally wound care and emergency care,” said Egan. “For injuries, we’re able to assess and make appropriate decisions if this is something that you can rehab or treat, or make that decision for a proper referral and guide them to where they should go for the best quality and line of care.”

Developing a relationship and a rapport with her employees is crucial.

“Well, it’s on me to get out on the floor and make connections,” said Egan. “You need to show them that you're there to know them as a person, not just a patient.

Forming such bonds requires a level of trust, something Egan says comes naturally when employees get treated right away and feel better. Whether it’s Egan making the rounds on a factory floor or working with a patient who scheduled an appointment in a (usually) small treatment room, the brief interactions are the sources of the best kind of marketing there is word of mouth.

“One employee will say, ‘Sally has done great things for my shoulder. Go see if she can help you.’ And that keeps my days full,” said Egan.

Egan highlights additional services she can provide if companies so choose. One company, for instance, wanted to offer their office personnel some strategies to improve general wellness. So, every week at the scheduled time, staff members stop what they are doing, grab a chair, and join Egan at the center of the office, where she leads them in fifteen minutes of stretching and body mechanics.

“It’s just a special need that the company felt strongly about, and we can do those types of things,” said Egan. “We individualize services based on the company. I meet with HR every single week at my companies just to keep the lines of communication open. We’re there to prevent health issues as much as possible, so that kind of collaboration ensures their needs are being met.”

The stability of the Wi-Fi connection notwithstanding, someone needed to get going. Technically her “day off,” Egan was headed to a side gig, teaching chair yoga to retired adults. But she wanted me to know she hadn’t looked at list of questions I had sent her prior to the interview.

“I wasn’t going to prep for this. Because what works in this field is that we're ourselves. We're not scripted. You get the real me,” said Egan.

The small-town country girl paused, and before signing off acknowledged one final similarity between her job as an industrial rehabilitation specialist and her work with high school athletes in a previous life.

“We’re in healthcare for a reason, and that’s to help people. I get to make those personal connections with industry clients just like I did in sports medicine. And the best part is when I get somebody that comes in and says, ‘Thank you so much for helping me. I feel so much better, and I didn't know if I was ever going to feel better.’

“That’s the best part of my job.”

—

Click Here to learn more about our Industrial and Tactical Medicine and Wellness programs.

The impact of Athletic Trainers in Industrial Medicine

Heidi demonstrates a simulated pull during a post-offer test to assess the employees ability to perform their job duties.

Advanced PT’s Heidi Bohl had the opportunity recently to share her experiences as an industrial athletic trainer to college students on the AT track in South Carolina. The college seniors who comprised her audience have been the beneficiaries of a number of presenters who highlighted a variety of topics related to pursuing a career in athletic training, but this was their first exposure to industrial athletic training.

While there are many paths open to those earning an athletic training degree, the majority make their debut in organized athletics (secondary schools, colleges, etc.). Already employed at the YMCA when she joined Advanced Physical Therapy & Sports Medicine, Bohl was initially hired for on-call work, covering for full-time athletic trainers to provide care to high school and middle school athletes as well as to club team participants.

Bohl enjoyed the work but made clear to her audience the importance of considering options and thinking about what is most important to each individual as they continue their education and pursue their career goals

“The schedule of a high school athletic trainer isn’t necessarily conducive to raising a family,” Bohl said. “My husband and I knew we wanted kids, and I wanted to be home for them.”

Bohl continued with part-time efforts at both jobs until her position at the YMCA was eliminated due to COVID; to replace those missing hours, she looked to the bourgeoning field of industrial rehabilitation, where companies hire providers to deliver healthcare services onsite to their employees.

It just so happened her current employer was a leader in the delivery of industrial onsite services. And because of the growth in that area, Advanced was looking for additional providers.

“Rob Worth (President of Advanced PT) knew me through the PRN work I had done, and we discussed the kinds of services Advanced was performing at companies,” Bohl said. “We both thought it would be a great fit for me.”

Advanced PT works with over 60 industrial companies, who employ physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants, and, of course, athletic trainers from Advanced to deliver the services necessary to keep employees at their best. The idea driving the model is simple yet profound: reduce the time and money lost to a company by reducing employee injury.

“We look at the employees at our companies as industrial athletes,” said Bohl. “Our presence onsite allows them to work safely at their job and enjoy life outside of work.”

Bohl’s skill set is vast, and good thing, as there are a multitude of areas on which to focus, including early intervention services, job testing, injury prevention, ergonomics, and wellness initiatives, to name a few. Programs are customized by the employer; they choose what best fits their needs and objectives.

After three years in industry, Bohl now dedicates all her hours to a single employer. She’s available onsite, naturally, but she’s also available by phone, text and email when not onsite to discuss injuries and determine plans of care.

“We promise opportunities for access to care within 24 hours if we aren’t onsite, which includes access to orthopedic providers we partner with,” said Bohl. “That kind of rapid response is a win-win scenario for employees and the employer.” Typically, companies utilizing the onsite model will see a reduction in OSHA recordable injuries by at least 50%, along with significant reductions in healthcare costs from both work-related and non-work related injuries. Bohl covered a lot of information in her thirty-minute presentation, but she saved a few minutes at the end for questions.

“Can you discuss the importance of developing rapport with the employees and understanding the company culture?”

“It’s vital,” said Bohl. “You have to know your employees and know how to interact with them. I provide services at a concrete and construction company. My dad was a general contractor. My uncle does concrete for a living. This is just a natural fit for me.”

If students didn’t understand the concept of variety in the world of industrial athletic training at the beginning, they sure were on board at the end.

“You’ll be on the floor, moving from area to area, employee to employee, encouraging people to come talk to you if they have questions, then you’ll head back to meet with the employees who made appointments to see you. Afterwards, you’ll be at a safety meeting sharing data and ROI; following that, it’s time to perform a jobsite analysis and then an ergonomic evaluation,” said Bohl.

After a busy day that included many of the aforementioned tasks plus the Zoom presentation to prospective industrial athletic trainers located a thousand miles away, Bohl was back at her full-time job, the primary focus of which revolves around getting her children to and from a plethora of practices, games and competitions.

She has a vast mom skill set too.

“Police Support Staff Person of the Year.”

Traci Tauferner supplying rehab services at Wausau PD.

On January 7, 2023, the Wausau Police Department recognized Traci Tauferner as “Police Support Staff Person of the Year.” Tauferner, the Director of Industrial & Tactical Medicine at Advanced Physical Therapy & Sports Medicine, provides onsite preventative and reactive care for members of the Department and has been doing so since 2020.

Those who know Traci understand how squirmy this blog will make her, as she is the consummate team player who shuns any form of self-aggrandizement; however, the award is in her name, so we’re going to roll the dice and hope she’s too busy to notice we posted this.

And to put us in an even more precarious situation—because Traci flips really big tractor tires just for the fun of it—we’re going to use her own words to explain what she does and why:

“My passion to do my job to serve and protect others can be directly linked to the events of 9/11. The moment I saw TV news footage of departing soldiers leaving their families at airports across the country, I knew I was also going to help. I joined the Army soon after, and my 17 year old self went from "What have I gotten myself into?" to "I am capable of so much more than I have ever thought.

“I spent nine years in the National Guard, including a six-month deployment in Iraq providing security and surveillance support for tactical units. This training led me to where I am today. Helping others do what their job requires is what fuels and excites me, and a good deal of my energy now goes into developing programs and strategies that ensure essential job requirements can be performed safely.

“The day-to-day work with my tactical teams puts me in the unique position of understanding the physical and mental stressors they face; more importantly, it affords me the opportunity to do something about these circumstances. By providing the most advanced conditioning and rehabilitation resources available to the professionals tasked with keeping their communities safe, we can keep them performing at the highest levels while dramatically reducing the financial burdens placed on their departments.”

Congratulations, Traci!

Advanced Physical Therapy & Sports Medicine provides onsite therapy for Wisconsin companies, organizations and municipalities ranging from 50 to over 5,000 employees. To learn more about how we can customize an injury prevention and management program for your workforce, contact Traci Tauferner at 920-979-5597.