Orchestrating Care: Advanced PT at Lawrence University

The team behind the Lawrence University Conservatory

As the physical therapist serving music students at her alma mater, Amber Lisowe knew what question was coming first. She answered it before it was even asked.

“No, I don’t have any musical skills. None whatsoever.”

Her patients at Lawrence University don’t really care. They are less concerned with any musical predisposition she might share with them and more interested in the skills she brings diagnosing and treating their musculoskeletal issues.

And those issues can be considerable.

“These students are practicing and playing for hours, every day,” said Lisowe. “Imagine being in these athletic positions, using your arms and hands, your back, for that long.”

Her use of the term “athletic” is deliberate.

“There are a lot of similarities between collegiate musicians and their counterparts on the field,” Lisowe said. “Both are passionate, and both deal with injury.”

While Lisowe might deem her history of musical pursuits minimal, her athletic undertakings were anything but. A multisport athlete in high school, Lisowe went on to play basketball at Lawrence. As with many athletes who follow the path toward a career in the medical sciences, Lisowe was familiar with injury.

“At Lawrence, I tore my ACL,” said Lisowe. “Twice.”

The first happened early in her freshman season, a devastating blow but one she was determined to overcome. An ACL tear is a season-ending injury with a rehabilitation period of 9-12 months, but Lisowe was passionate about her sport and getting back to it as quickly as possible.

There’s a period of mourning, Lisowe says, that can last until you’re back on the hardwood. The rehab process means you don’t get back to practicing on the court for a full five months. By this time, any concerns of re-injury were the furthest thing from her mind.

“I’d already done running things in therapy, some jumping and cutting, so by the time you get a ball in your hands, your body just kind of takes over and falls into those routines,” Lisowe said. “When you’re back to playing competitively, your focus has shifted from thinking about the leg itself to the dynamics of the game.”

Lisowe would tear her other ACL in her senior year.

“With the first injury, I knew I could work hard and return for my sophomore season. This time there was no next season for me. Definitely a big thing,” she said.

Those serious injuries led to firsthand physical therapy experiences, which in turn kindled Lisowe’s burgeoning interest in the field. Following Lisowe’s time at Lawrence (she graduated with her Bachelor of Arts from Lawrence in 2014), she went on to earn her Doctor of Physical Therapy degree from Rosalind Franklin University of Medicine & Science. She joined Advanced Physical Therapy soon after to work in their Neenah clinic.

The opportunity for Lisowe to work with Lawrence University Conservatory of Music students happened when LU’s longtime physical therapist, Advanced PT’s Phil Sorensen, looked to cut down on his hours. Lisowe jumped at the chance to return to Lawrence.

“Coming from a smaller town, Lawrence was such a great place for me to find myself,” said Lisowe. “The growth and experiences I had there, the friendships I made, really helped shape who I am today. Athletics got me on campus, but the academics and everything Lawrence offers is what really drew me in.”

Lisowe now finds herself at Lawrence one hour a week, providing physical therapy sessions for her student-patients. She sees a range of musicians—freshmen to seniors, flute to clarinet, oboe to piano—with a variety of orthopedic issues.

“A lot of what I do is helping them to manage their pain, figure out what’s causing it, getting them stronger and finding the best positions to hold their instrument,” she said. “There’s not a certain group of people that appear to be more at risk. I enjoy training and teaching them all.”

Sorensen, who worked with LU’s music students for nearly a decade, describes the experience there as unique.

“There’s just such joy there. These students will walk out of a session and begin playing their horn, and stuff like that. It’s just a really cool atmosphere. It makes you young again.”

Lisowe too recognizes the special nature of the gig, one that gives as much as it gets.

“I just love being back here. I think it was meant to be,” she said. “I love being able to make a difference for such a diverse group of talented individuals.”

Mentioning the variety of students she helps, Lisowe notes the common trait all these musicians possess. And despite being “non-musical,” it’s a characteristic she shares with them, as demonstrated throughout her athletic career.

“They are all very motivated to get better so they can continue doing what they love,” said Lisowe.

Click here to learn more about Dr. Amber and Dr. Phil and the clinics they serve at our Neenah Clinic on Commercial St and Appleton East Clinic on Von Roy Rd in addition to their responsibilities at Lawrence.

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.

Clinician Spotlight- Ryan Bailey, PT, DPT.

Meet Ryan Bailey, PT, DPT.

I distinctly heard him say “Central Waters.”

And when a physical therapist gets invited to Amherst, WI to share his expertise, then we’re talking about more than just tapping into the body’s internal mechanisms to relieve pain.

Oooh. Tell me more.

“No, Central Woggers,” he said. “It’s a running group in Amherst. Think the name’s a play on words, a combination of walk and jog.”

Oh, gotcha. I’m guessing this will be more about pain relief than beer.

“Well, those topics aren’t mutually exclusive,” he said.

I like this guy already.

Meet Ryan Bailey, physical therapist at Advanced PT. Recently he was invited to share some of his knowledge with the Central Woggers before they took off for a run.

“So, what topic did they want you to focus on?” I asked.

“Oh, they let me choose,” said Bailey.

Golly, that narrows it down. Bailey’s experience and specialties include working with high-level athletes and orthopedic injuries, foot and ankle dysfunction, pre and post-operative joint replacement and general rehabilitation including ACL reconstruction, sports medicine and biomechanics, just to name a few.

“I decided to give a talk on exercise and pain relief, and why we feel good when we walk and run and exercise,” Bailey said. “More or less about the natural substances within our body to relieve pain that we can tap into instead of relying on medications. Then into anterior knee pain many runners can experience and what the research tells us about strengthening the knee.”

Bailey was under some pressure from the assembled group of several dozen runners to hit the presentation out of the park, as the week prior a nurse and wellness coach named Martha Bailey did just that.

“Yeah, Martha is my wife. She’s pretty good,” said Bailey. “I understand they are inviting her back.”

While he is a frequent runner, Bailey considers running more of a cross training component for some of the many other sports on which he focuses, one of which is surf ski racing. Designed for ocean paddling, surf skis are sit-on top kayaks that are sleek, fast and very tippy. Bailey competed in the sport, a popular pastime with lifeguards, while living in Hawaii and California. Even though it’s tough to find anywhere near the surf ski racing opportunities here in Wisconsin, Bailey still manages to keep his skills sharp.

“There’s actually a very good 17 mile race here called ‘Race the Fox,’ which goes from Berlin to Omro,” he said. “It’s something I’ve done since moving back to Wisconsin.”

Bailey met his Wisconsinite wife in California, where he lived for 30 years, when she went out west for a nursing job. They got married in San Diego and returned to Wisconsin to start their family. They and their three daughters now reside in the house Martha grew up in, located in Fremont. Not surprisingly, their children are into sports and activities just as mom and dad are, and the family takes full advantage of the gamut of outdoor activities Wisconsin has to offer.

And he insists he doesn’t miss the ocean and the beaches.

“I love it here in Wisconsin,” Bailey said. Bailey coaches a number of area teams and is committed to being a resource for youth sports and being there for families after an athlete’s injury. He’s also committed to helping community members stay active and healthy, hence his visit to the Central Woggers.

It seems as if the transplanted Californian has found the perfect place to be.

Learn more here: https://www.advancedptsm.com/ryan-bailey

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.”

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

Pelvic Health and You

May is Pelvic Health Month and here at Advanced, we are all about changing the narrative around symptoms/conditions that may be caused by pelvic floor dysfunction.

Did you know that 1 in every 3 women will develop a pelvic floor dysfunction in her lifetime and 1 in every 8 men* will develop a pelvic floor dysfunction in his lifetime?

While very common, it’s certainly not normal.

Pelvic floor issues may be embarrassing to admit to and even harder to talk about, but they affect the quality of your life. We understand that you may have questions; that’s why we are here.

Not all physical therapy practices have a therapist who specializes in pelvic pain/dysfunction, but Advanced PT’s Autumn Pawlowski is a physical therapist with training and experience in the management of a wide range of issues (for both women and men) that occur with compromised pelvic floor muscles.

When you are ready, please call the Appleton North clinic (920.991.2561) to request an appointment with Autumn.

In the meantime, here are a few facts that just might be the inspiration for you to take action and get back to living the life you want. 

What are pelvic floor muscles?

●     Group of muscles in your pelvis that is kind of like a hammock between your sit bones

●      Support pelvic organs

●       Maintain continence

●      Role in sexual function

What happens if there is dysfunction in the pelvic floor muscles?

●     Urinary incontinence

●     Urinary frequency and/or urgency

●     Pelvic pain

●     Heaviness/fullness feeling

●     Low back or hip pain

Are there other conditions that a pelvic health physical therapist could help out with?

●     After a prostatectomy

●     Prenatal and postpartum

●   Post-cesarean delivery care

What should I expect during my first pelvic health physical therapy visit?

Your pelvic health physical therapist has gone through extensive training in order to treat individuals who have pelvic floor dysfunction.

The first visit will allow you to discuss your concerns with the pelvic health physical therapist and they will ask you follow-up questions.

Then the provider will complete an assessment to help determine the root cause of your symptoms. The assessment may include an orthopedic screen (looking at your back/hips) to see if there are any significant findings that may be contributing to your symptoms.

If the pelvic health physical therapist feels like an internal pelvic floor assessment would be appropriate, they will explain what that would entail. The internal pelvic floor assessment would only be completed if you provide consent. Based on the findings, the pelvic health physical therapist will develop a treatment plan for you.

Treatment may include modifying bathroom habits, modifying diet/fluid intake, strengthening exercises, stretching exercises, breathing techniques, and discussing how the nervous system has a role in your symptoms.

How do I set up an appointment with a pelvic health physical therapist?

You are not alone with your symptoms.

We know how difficult it may be to pick up the phone and call to schedule an appointment, but we promise you you’ll be glad you did. The pelvic health physical therapist will be able to answer a lot of your questions during the first visit. 

Call our Appleton North clinic at 920.991.2561 to request an appointment with Autumn Pawlowski PT, DPT.

*Data is limited for our populations that do not align with the above genders; however, we recognize that every population has unique pelvic floor needs and implications.*

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References:

https://www.uclahealth.org/medical-services/womens-pelvic-health/patient-education/pelvic-floor-disorders#:~:text=One%20in%20three%20women%20will,problems%2C%20or%20bowel%20control%20problems.

https://theconversation.com/men-have-pelvic-floors-too-and-can-benefit-when-they-exercise-them-regularly-184451#:~:text=Though%20pelvic%20floor%20problems%20are,pelvic%20floor%2C%20bladder%20or%20bowel.

What is Modern Cupping Therapy?

Modern Cupping Therapy is a form of alternative therapy that has gained popularity in recent years. It involves the use of cups made of glass, silicone, or plastic that are placed on the skin to create suction. This suction is believed to increase blood flow to the area and promote healing.

Cupping therapy has been used for centuries in traditional Chinese medicine, and its modern iteration has evolved to become a non-invasive and safe therapy.

Here's what you need to know about this popular alternative therapy:

How does Modern Cupping Therapy work?

During a cupping session, a therapist places cups on the skin and creates suction. The suction is created using a handheld pump. Once the cups are in place, they are left on the skin for several minutes before being removed. Sometimes, they are moved in a very specific pattern or sequence depending on the desired effect.

The suction created by the cups is believed to stimulate blood flow to the area and promote healing. It can also help to relax the muscles, reduce pain, and improve overall circulation.

What conditions can Modern Cupping Therapy help with?

It can be used to help many different conditions including, but not limited to, those listed below:

• Back pain

• Neck pain

• Shoulder pain

• Knee pain

• Migraines

• Arthritis

• Fibromyalgia

• Lymphedema

Is Modern Cupping Therapy safe?

Yes! It is generally safe when performed by a qualified healthcare professional. Minor side effects may include mild discomfort, bruising, or skin irritation. It is important to seek the advice of a qualified healthcare professional before using cupping therapy.

Conclusion

Modern Cupping Therapy is a popular alternative therapy that has gained popularity in recent years. It involves the use of cups placed on the skin to create suction, which is believed to stimulate blood flow and promote healing. The therapy is generally safe when performed by a qualified healthcare professional and can help with a variety of conditions. However, it should not be used as a replacement for conventional medical treatment. If you are interested in trying Modern Cupping Therapy, call today and we can chat further to determine if cupping is right for you and how to work it into your treatment program.

References:

1. Wang, Sz., Lu, Yh., Wu, M. et al. Cupping Therapy for Diseases: An Overview of Scientific Evidence from 2009 to 2019. Chin. J. Integr. Med. 27, 394–400 (2021). https://doi.org/10.1007/s11655-020-3060-y

2. Mohamed, Ayman A., Zhang, Xueyan, and Jan, Yih-Kuen. ‘Evidence-based and Adverse-effects Analyses of Cupping Therapy in Musculoskeletal and Sports Rehabilitation: A Systematic and Evidence-based Review’. 1 Jan. 2023 : 3 – 19.

Dry Needling

Autumn Paul, PT, DPT

You may have heard about dry needling from one of your friends or family members and now you are thinking, “What is dry needling? Could I benefit from it?”

Dry needling involves the practitioner using a solid filiform needle or hollow-core hypodermic needle (similar to an acupuncture needle) to place it through the skin and enter the muscle. The goal is to place the needle specifically into a myofascial trigger point (hyperactive muscle fibers).

These trigger points can be located in a tense band of muscle. For example, many people have tightness or soreness in their shoulders or necks from the tension they carry throughout the day.

These hyperactive muscle fibers (tense bands of muscle) can send signals to other parts of your body which are considered “referred pain”.

The goal of dry needling is to pierce these trigger points in order to allow these muscle fibers to relax, which can help reduce your pain levels.

“So what conditions may dry needling help with?”

● Headaches

● Shoulder/neck pain/tightness

● Lower back pain/ tightness

● Tennis and golfer’s elbow

● Knee pain

● Shin splints

● TMJ/jaw pain

● Plantar fasciitis

● Hip Pain/ tightness

“Can any physical therapist perform dry needling?”

In order to be able to perform dry needling, the physical therapist is required to go through extensive training. This training includes studying human anatomy and hands-on practice. These training sessions are often a weekend course or even several weekend courses.

“Awesome, I want to see a physical therapist who can assess and see if I could potentially benefit from dry needling. How do I make an appointment?”

First, look online to see what location is closest to you. Then, you can request to schedule an appointment with a physical therapist who is certified to perform dry needling.

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References:

Firth C, Meon J, Price M, Taylor J, Grace S. Dry Needling: A literature Review. Journal of the Australian Traditional-Medicine Society . 2020;26(1):22-28. Accessed January 14, 2021.

http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143040461&site=eds-live

http://www.kinfolkwellness.com.au/dry-needling-adelaide

Baseline Concussion Testing

Ben Benesh, PT, SCS

What is a concussion?  The Center for Disease Control and Prevention (CDC) definition:

“A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells.”

According to a Pediatrics study from 2016, it was estimated that between 1.6 and 3.8 million sports concussions occur annually in the United States. Concussions can happen in sport during a violent head to head collision in football or taking a charge and hitting the back of your head in basketball. They can be sustained during a whiplash-type injury in a flyer during a competitive cheer stunt or when a young athlete takes a volleyball spike to the head or face. Besides the obvious appropriate post-concussion management for these athletes, a proper baseline concussion test is key in the successful return to school and sport.

High school-age athletes are baseline concussion tested as a Freshman and again as a Junior. They are usually tested in school by their athletic training team. The group that needs the most attention are the elementary and middle school-aged children, that do not have access to athletic training staff, and do not have school-based concussion baseline testing. These kids are still playing sports, including collision type sports that put them at risk for a concussion. Over the last 7 years of treating patients following a concussion, I have seen plenty of soccer and football athletes, but have also treated basketball players, volleyball players, wrestlers, competitive cheer athletes, and even swimmers! In order to treat these patients as effectively as possible following a concussion, baseline testing is crucial.

In healthy athletes, baseline concussion testing includes concussion education, past head injury medical history, baseline ImPACT neurocognitive computer testing, baseline vestibular/oculomotor screening and assessment, and baseline balance assessment. These objective measurements will be saved and used following a concussion to determine if your athlete is back to “normal” following injury and can safely return to their sport they love to do.

In this crazy time dealing with the COVID-19 pandemic, sporting events are delayed or canceled and then rescheduled without notice. The training schedule may not be as consistent or as intense as previous years as kids are quarantined or had exposure to COVID-19 or coaches are unable to secure facilities to practice. Parents are often not even able to watch their children play sports because of spectator restrictions in gyms. All of these reasons make this year unique. But the truth is, concussions still happen during a pandemic and we need to be best prepared to give our young athletes the best care possible if they sustain a concussion.

Please contact us for more information or to schedule your Baseline Concussion Test at our Appleton North or Community First Champion Center or online (ages 12+) clinics!

References

https://www.cdc.gov/headsup/basics/return_to_sports.html

McCrory et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. BJSM April, 2017

Elbin et al. Removal From Play After Concussion and Recovery Time. Pediatrics August, 2016

October is National Physical Therapy Month!

By Adam Wirtz, PT, DPT

In celebration of Physical Therapy month, I thought it would beneficial to share some facts about our profession:

Physical therapists (PTs) are movement experts who optimize the quality of life through prescribed exercise, hands-on care, and patient education.  PTs and the licensed physical therapist assistants (PTAs) may team up to provide care across the lifespan to anyone of any ability.

There are many benefits to physical therapy. Some of these include the following:

Ø It can maximize your movement. PTs can identify, diagnose, and treat movement problems.  Pain-free movement is essential for good quality of life, your ability to earn a living, and your ability to remain independent.

Ø Personalized care that meets your specific needs.  PTs design individualized treatment plans to address each patient’s needs, challenges, and goals.  PTs and PTAs improve patient mobility, manage/decrease pain and other chronic conditions, recovery from injury/surgery, and aim to prevent future injury and chronic disease.

Ø Accessibility.  PTs and PTAs provide care in a variety of settings, including hospitals, private practices, outpatient clinics, homes, schools, sports and fitness facilities, work settings, and nursing homes.  During these uncertain times during the pandemic, choosing to see a PT first can help to reduce patient traffic in physician offices.  This can allow physicians to focus more on caring for patients that are more critically ill or are at risk of becoming critically ill from COVID-19 or other illnesses such as influenza.  It also means that you do not have to risk being around patients at a hospital or clinic that may possibly be ill with a contagious pathogen.

Ø Active participation in care.  PTs and PTAs empower and motivate people to be active participants in their care.  They also work in collaboration with other medical professionals to make sure patients receive high-quality care.

Ø Reduces the use of opioids.  In certain situations, when dosed appropriately, prescription opioid medications can be an appropriate part of medical care.  However, current CDC guidelines are urging medical providers to consider safer alternatives to opioids like physical therapy for most long-term pain.  Opioids have several risks including depression, overdose, and addiction, plus withdrawal symptoms when stopping use.

Ø Avoid surgery.  Before undergoing expensive or invasive surgery, consider physical therapy first.  There is mounting evidence that physical therapy can be as effective or in some cases even better than surgery for conditions such as meniscal tears and knee osteoarthritis, rotator cuff tears, spinal stenosis, and degenerative disk disease.

Now that you are aware of some of the benefits of PT, let’s address the topic of direct access.

Did you know that you have the freedom to choose your own physical therapist?

Ø  Currently, you may be evaluated by a PT without a physician’s referral in all 50 states and the District of Columbia.  In addition, all 50 states and the District of Columbia allow some level of treatment by a PT without a physician’s referral.  This is referred to as “direct access” to physical therapy services.

Ø  Some insurance policies may require you to see a primary care provider or physician prior to seeing a physical therapist.  Also, some insurers may limit your access to preferred providers only.  Contact your insurance company to make sure you are aware of any of these policies.

Ø  If you have Medicare as your primary insurance, you are able to see a PT for an evaluation without a physician’s referral.  The PT would then send the plan of care to the patient’s physician for signature.  Once this is signed treatment can be continued.

Ø  Your physician may refer you for physical therapy that is provided in the physician’s office, or to a facility in which the physician has a financial interest.  However, you are not obligated to attend PT in any specific facility or location.  You can choose where you would prefer to attend physical therapy and which licensed physical therapist you would like to see if you have a preference.

Now that you know all about the benefits of PT and your ability to choose your physical therapist, the next time you have an aching knee, a bum shoulder, a sore heel, or an injured lower back, consider finding a physical therapist first to help you get back to moving well!

Our clinics are low traffic, safe environments that allow for continuity of care for those individuals that may not be able to get into their doctor’s office, especially during the COVID-19 pandemic.  We have implemented deep cleaning protocols and patient screening procedures to minimize the risk of infected individuals entering our clinics.

You can find a physical therapist by name or location.

Best Way To Get Rid Of Back And Neck Pain… Physical Therapy!

Written by: Dennis Kaster, PT-- Stevens Point North

Physical Therapy is one of the most effective and cheapest ways to treat back and neck pain, but few people know that. 

Most back and neck pain is caused by muscle weakness, tightness, poor posture, or poorly set-up workstations that put extra stress on the body. 

A Physical Therapist will assess which of these issues is causing the pain and help you get rid of it by doing specific stretches, strengthening, improving posture, performing treatment to decrease pain or swelling, using better lifting mechanics, or helping you set up your work or home workstations to put less stress on your body. 

The typical process in the past has been that when someone injures their back, they go to a medical doctor.  The doctor would decide what to do next, which many times included rest, medications, or expensive imaging. 

Several years ago a large medical organization, Virginia Mason, broke down the process of medical care for back injuries, looking for the quickest, most effective, and cheapest way to treat low back pain.  In the end, they found that people who saw a physical therapist first for lower back pain recovered much quicker, returned to work sooner, and experienced a much lower overall cost of care.  

This is because Physical Therapists specialize much more in the anatomy and mechanics of how the back works and how to stop and prevent pain.  Physical therapists also do not prescribe opioid pain medications.  Many times medical doctors prescribe opioid prescriptions, advise patients to rest until the pain goes away, or order expensive medical imaging, which many times is not necessary.  Many other research studies have found the same results.

As a result of the findings of multiple research studies, many insurance companies no longer require a physician referral to cover physical therapy, as they realize that people with mechanical low back pain respond much quicker and better if they see a Physical Therapist first.  Most people are not aware of this. 

Several studies have shown that as little as 7% of people with low back pain see a Physical Therapist.  This is crazy…..when Physical Therapy is one of the most effective ways to treat low back pain. 

Also, Physical Therapists have the expertise to recognize more serious medical issues that would require a referral to a medical doctor. 

So, if you see a Physical Therapist first and your pain is due to a medical issue, you can rest assured that the Physical Therapist will recognize it and direct you to the appropriate care. 

PLEASE HELP US TO GET THE WORD OUT!!  IF YOU HAVE BACK OR NECK PAIN, SEE A PHYSICAL THERAPIST FIRST.  IF YOU OR SOMEONE YOU KNOW HAS BACK OR ANY MUSCLE OR JOINT ISSUE, LET THEM KNOW THAT PHYSICAL THERAPY MAY BE THE BEST FORM OF TREATMENT FOR IT. 

If you have questions, please give us a call and we can answer them for you or check with your insurance to make sure our treatment is covered.

References

• Furhmans V. Withdrawal Treatment: a novel plan helps hospital wean itself off of pricey tests.  The Wall Street Journal. January 12, 2007

• Pendergast J, Kliethermes S, et al, A Comparison of Health Care Use for Physician-Referred and Self-Referred Episodes of Outpatient Physical Therapy. Health Research and Educational Trust DOI:10:1111/j.1475-6773.01324.x, Oct. 2011

• Mitchell JM, de Lissovoy G. A comparison of resource use and cost in direct access versus physician referral episodes of physical therapy. Phys Ther. 1997;77: 10-18

• Moore JH, McMillian DJ, et al. Risk determination for patients with direct access to physical therapy in military health care facilities. J Orthop Sports Phys Ther. 2005;35:674-678

• Leemrijse CJ, Swinkles I, Veenoff C. Direct access to physical therapy in the Netherlands: Results from the first year in community based physical Therapy. Phys Ther 88;8:936-946

• Kenney. Transforming Healthcare, Virginial Mason Medical Center’s Pursuit of the Perfect Experience.  CRC Press, 2011