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.

Provider Spotlight: Ben Benesh PT, DPT, SCS

Sometimes you have to push people to get out of them what is needed.

When you interview a physical therapist with numerous specialties, advanced certifications, and the broad range of experiences that 20+ years in the profession provides, you know you’re talking with someone who can treat just about anyone who walks into his clinic.

“I love working with all my patients and getting them back to full function,” said Advanced Physical Therapy’s Ben Benesh. “It’s very rewarding.”

Yes, I understand, but is there a type of patient that is your favorite to work with?

“Well, I do love working with athletes,” he said.

BAM

“Those are probably my favorite patients and it's a pretty wide variety and wide age variety of athletes. But I do love the high school athlete, and those are the patients that often stick out in my head over the last 20 years, those kids that had ACL injuries, a reconstruction, and then they come to me,” said Benesh. “And working with them, getting them to that sports performance phase over the last few months, moving them into a guarded progression and then getting them back to their sport.”

Here Benesh discusses a local high school athlete who suffered ACL tears in back to back years.

“About 18 months of rehab, a huge commitment,” Benesh said. “She was so strong, maybe the strongest patient in my 20 years.”

We discussed the high school athletes he’s treated and the emotional toll wrought by such devastating injuries. Those patients, said Benesh, are the ones who often end up becoming physical therapists.

So was that Benesh’s path?

“Well, I played sports and was injured a lot, but I didn’t receive a lot of PT for it.”

For Benesh, it was an opportunity as a college student to work with a physical therapist from his hometown that was the catalyst. This “one man show” of a physical therapy practice influenced Benesh in more ways than he could count.

“I loved his life, his family life, his demeanor with patients,” said Benesh. “The whole experience was fantastic. And he wrote me a really nice reference letter for my PT school application.”

Nearly a quarter century and a bachelor’s, master’s and doctoral degree later, Benesh’s special interest in sports continues unabated. He’s received additional sports medicine training in a number of areas including advanced treatment of the shoulder, concussion management, and performance running video analysis.

He’s also a Board Certified Clinical Specialist in Sports Physical Therapy (SCS), a certification that identifies those who are experts within their branch of PT. It also provides enhanced opportunities to use those skills working with local sports teams, high-level athletes, and youth feeder programs (Benesh provided on field coverage for UW-Oshkosh football as well as for the Oshkosh Flyers, a competitive youth football club for fourth through eight graders).

And it’s a commitment with rigorous requirements.

“It’s a beast of an exam,” said Benesh. “There aren’t that many of us in the state of Wisconsin with the SCS certification, but it’s worth it. Keeps you up to date on the latest on sports performance, nutrition, emergency medicine, coverage on the field, a wide range of specializations.”

Benesh is used to seeing highly motivated patients ready to take on the physical challenges of rehab, but mental and emotional components must be addressed. This is where Benesh the dad, the coach of his children’s sports teams, and the clinician all meet.

“I think that the honesty that I can have with these patients is important.” Said Benesh. “I feel like it's a positive thing for injured athletes to talk to somebody other than their coach or their mom or dad. It’s also good for the parents to have a sounding board to have a thought process. I try to keep it as objective as I can, but I have daughters and a son. I feel I'm in a good spot to understand and empathize in these situations.”

Benesh has three children, all involved in sports. And at one point he was coaching all three at the same time. That’s no longer the case, and you’d think that would result in a more stable work-life balance.

“Oh, no, it’s way easier to make schedules work for me when I’m coaching all of them,” said Benesh. “Otherwise, things conflict.”

Working at the Oshkosh YMCA location affords Benesh the opportunity to utilize facilities with his injured athletes. If he’s working with a swimmer, there’s the pool; a hockey player gets to use the ice; the soccer player is on the pitch; the hoops player is on the basketball court.

“It's really nice to have that ability to see them at this location,” said Benesh. “Usually, I'll see them weekly for three to five months, whatever it takes to get them back, and then I do a return-to-sport testing with them before I release them back to their sport.”

Sometimes you have to push people to get out of them what is needed.

That’s what physical therapists do.

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Dr. Ben works with patients and athletes at both YMCA locations in Oshkosh, WI (Downtown, 20th Ave). 920-305-7910

Provider Spotlight: Dr. Will Hartmann, PT at Lawrence University

Dr. Will Hartmann working with an athlete in the athletic training room at Lawrence University

When you work with competitive athletes to get them back to their sports following injury, does it help if you were a competitive athlete who suffered a few injuries and endured lots of rehab yourself?

Physical therapist Will Hartmann of Advanced Physical Therapy & Sports Medicine thinks it might.

To a certain extent.

“It helps athletes relate to me if they know it,” Hartmann said. “But I'm the washed-up version now.”

The former Division 1 athlete played five years of college football with the Wisconsin Badgers and had a litany of injuries (concussion, patellar tendinitis, lacerated kidney) connected to his days on the gridiron. Eschewing any details or elaboration, Hartmann recited his traumas like items in a bulleted list.

Just tell me a little about your most memorable, then.

“Yeah, the elbow injury in my first spring game at Camp Randall. I picked off a pass and dislocated it when I tried to score a touchdown. After the game, the coach saw me in the training room and said, ‘That’s why you take a knee.’ Thanks a lot, coach. Lesson learned.”

Now in his seventh year working with Lawrence University athletes, Hartmann’s approach is, in many respects, just that direct, albeit without the sarcasm.

“I tell injured athletes, if you want to do this, we can do this,” said Hartmann. “Or if you don't want to do that kind of work, we’ll just take it down a notch. It all depends on what the person wants to put in.”

Much like himself in days of yore, several of his Division 3 college athletes view their sport as their job, working out multiple times a day just about every day of the year. They bring that same focus to the rehab process when they get injured.

“I’m working with a girl who’s coming into the athletic training room twice daily to do rehab. That shows the level of commitment familiar to me,” said Hartmann. “I’ve been there; I’ve done it.”

His role at Lawrence is to help with the treatment of complex injuries. Hartmann’s sports medicine background and orthopedic training allow him to treat anyone who enters the door. Working with Advanced PT’s athletic trainers at LU, Hartmann is included when his expertise is needed, typically when an injury isn’t improving or rehabbing something more intricate, like an ACL reconstruction.

To further progress his manual skills and meet a wider variety of patient needs, Hartmann completed an Orthopedic Residency. An additional year of specialized training, the residency includes one-on-one mentorships with experts in the field to enhance clinical decision-making. Combined with his Strength & Conditioning Specialist certification, Hartmann is well-suited to communicate and collaborate with LU’s athletic trainers and strength coaches.

“We do a good job at Lawrence treating these athletes and getting good outcomes,” said Hartmann.

Advanced PT has deep roots at the collegiate level and has treated LU undergraduates—both athletes and students in the Conservatory of Music—for three decades.

At the time of this interview, Hartmann was preparing for spring sports at LU and the inevitable uptick of injuries by getting some care for himself: he had an arthroscopic knee procedure the following day.

And he answered the final question before it was asked.

“No, this isn’t related to football,” he said.

Physical Therapy Month Spotlight—Dr. PJ Christopherson, DPT

Dr. PJ and family: Sarah, Cooper, Declan & Micah

It would give us no greater pleasure than to shine the spotlight on EVERY one of our providers in October, otherwise known as National Physical Therapy Month, but that ain’t going to happen.

This is a blog, not a book.

So we are choosing to introduce you to PJ Christopherson, and not just because of what he brings to our practice.

He had us with the first sentence that came out of his mouth.

“Yeah, I really tried to talk myself out of going into the PT profession. Because of my mom.”

Wait, what?

A Shawano native, Christopherson grew up with physical therapy. No, this is not an injury story. His mother, physical therapist Jean Darling, has been a fixture in the community’s health and fitness scene for a lifetime. Suffice to say Christopherson had significant exposure to all things PT.

“My mom lived and breathed physical therapy, so I was around it a lot,” Christopherson said. “But for some reason—and I’m not sure what that reason was—I thought of doing something else. Maybe I just didn’t want to pick something because my mom did.”

Christopherson nevertheless found himself gravitating to the health field. His high school anatomy class was an early inspiration; later, an introductory course on health careers at UW-La Crosse revealed the variety of career opportunities beyond PT that were available to him.

Following completion of the course, a turning point.

“Not sure I’d call it closure, but I had this acceptance that PT could actually be something I could see myself doing,” Christopherson said. “Maybe it was on my radar all along.”

Fast forward, Christopherson would earn his bachelor’s degree in Exercise & Sports Science and then (of course!) his Doctorate of Physical Therapy, both at UW-La Crosse. Newly engaged, Christopherson and his wife Sarah moved to the Milwaukee area, where she attended graduate school and he began his career at a small private physical therapy practice.

Not that he didn’t consider other options, including one at Advanced PT, the very place where his mom practiced and thrived.

“Fresh out of school I actually interviewed with (Advanced PT president and co-founder) Rob Worth for a job,” Christopherson said. “At that point, I felt like branching out a bit, doing my own thing.”

A year later, the couple—he from Shawano and she from La Crescent, MN—had the desire to get back to a smaller community. A job at Advanced PT’s Ripon clinic became available, so the Christophersons found themselves headed right where they hoped they’d be.

Now Clinic Director, Christopherson divides his time serving patients in several capacities. He works with his patients at the clinic on Eureka Street, which also happens to be the near-site clinic for the Ripon Area School District (RASD). Advanced supplies PT services to all RASD employees and is part of the care team delivering high-quality, low-cost care to the district since they recently transitioned to a self-funded health care plan.

The relationship began when the district’s primary care physician needed space. His arrival at 402 Eureka Street resulted in conversations (Advanced PT assists several districts with their healthcare via direct contracts) that led to the establishment of the near-site clinic with a range of providers, part of the district’s overall strategy to reduce costs by offering health services to employees free of charge.

“Being part of this means we can really help people on a community-wide level,” Christopherson said.

Christopherson also finds himself as part of the industrial team at Advanced, providing onsite physical therapy, injury management and rehabilitation services to employees at a manufacturing company in a nearby community.

“With these relationships, we’re more than just a provider of services,” Christopherson said. “We’re part of these communities, growing with them and making them stronger.”

Speaking of growing, the Christophersons are the proud parents of three young children; recently they moved to a larger house to accommodate the needs of the family and the extra space they were looking for. They both love where they live (Sarah is a home health occupational therapist), a beautiful area of closely knit communities with small-town values, thriving and upbeat downtowns, a wide variety of recreational opportunities and the convenience of being close to larger metropolitan areas.

“My Milwaukee friends joke that I live in the middle of nowhere,” Christopherson said. “No way. I live in the middle of everywhere!”

Compared to his Milwaukee experience (he also completed a physical therapy internship with the Milwaukee Brewers, providing orthopedic evaluations for prospects at their spring training facility in Arizona), Christopherson finds his current schedule just as jam-packed, perhaps even more so.

He wouldn’t have it any other way.

“I’m in the clinic four days, then one day a week I’m onsite, so I see a little bit of everything, neck to jaws, knees to ankles to shoulders, vertigo patients,” he said. “If you walk in the door, I will see you for X, Y or Z.”

That ability to treat a wide variety of patients is perhaps a gift from his mother, whose resume is ridiculously robust. The fact that he chose to follow in her footsteps makes her very happy, which has upsides when you have a three, two and one-year-old.

“Mom comes down from Shawano every week to babysit,” he said. “That’s been a game-changer.”

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To learn more about Dr. PJ and/or the Ripon clinic, click here.