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.

—

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

7 Tips and Tricks to prepare for surgery

Dr. Laura Johnson discusses how planning for your upcoming surgery can make the recovery process easier.

Whatever journey leads you to the need for orthopedic surgery, we want to make sure you are prepared for a successful recovery.

Most likely, you will have some difficulty moving around after surgery, so do as much as you can beforehand to prepare for post-surgery.   

We know you’ll be bombarded with information as you prepare for your orthopedic surgery, so we wanted to keep it simple: Prepare, Practice, Organize.

Here are some Tips and Tricks that we’ve found helpful for our patients:

• Arrange meals ahead of time.

  While you are recovering, you may not feel up to standing in the kitchen for long periods or going to the store to gather all the ingredients.

  This may involve buying frozen meals or preparing meals to freeze beforehand. 

  Whip up a batch of your favorite homemade soup for a quick warm-up meal after surgery. 

  Having the premade foods on hand will help provide your body with the nourishment it needs while it recovers.

• Get your ice packs lined up. 

  Swelling and pain are common after surgery. The general rule of thumb is to ice for 15-20 minutes, then remove it for 30-40 minutes, repeating as needed.

• Prepare to elevate. 

  Get extra pillows available to help elevate your limb.  Elevating a limb above the level of your heart allows the blood to circulate back to the heart without fighting gravity. The force of gravity will assist with moving the fluid.

  You can combine elevating and icing at the same time to especially help with your swelling.    

• Practice makes perfect part 1.

  If you must use an assistive device, such as crutches, a knee scooter, or a walker for mobility after your surgery, PLEASE PRACTICE transferring, walking, and navigating stairs with the assistive device before surgery. 

  Getting used to these assistive devices can be a balancing act, so practice, practice, practice! Manipulating around your home with an assistive device can also be a bit cumbersome, so practice this before surgery. 

  You may need to adjust furniture to provide larger pathways, remove throw rugs, add a chair cushion, etc.  

• Practice makes perfect part 2.

  Be aware of any weight-bearing and/or movement restrictions you may have to follow post-surgery.  Practice that weight-bearing restriction (i.e., non-weight bearing, partial weight bearing), as it may be more challenging than you imagine. 

  If there are movement restrictions (e.g., you must keep the knee fully extended and limit the amount of trunk flexion), practice following those restrictions prior to surgery and adjust your home setup as needed. 

  You may be in an arm sling, so your toilet paper roll needs to be switched to the opposite side.

  Little adjustments beforehand will make a huge difference after.  

• Start your exercises.

  If there are any prescribed pre-operative exercises to perform before surgery to help strengthen muscles and improve flexibility, jump on board!

  Get into the routine of sticking to an exercise program. 

  This can aid in post-surgery recovery.   

• Ask for Help.

  Inform your family and friends about your surgery and ask for help, especially during your initial recovery. 

  Also, ask for assistance with outdoor chores, household cleaning, meal prep, transportation, etc. 

  Individuals may be more willing to help than you expect, ask!  

  If you have questions or concerns about your surgery, get them answered beforehand. The more prepared you feel for surgery, the better your outcome may be!  

Working through these recommendations with a skilled physical therapist can be very helpful, especially when practicing your restrictions and guiding your exercises. If that interests you, contact us today, and we will help set you up for success.

If therapy is part of your recovery, please contact Advanced Physical Therapy and Sports Medicine. We will be happy to guide you back to an active lifestyle!  

Happy Recovery! 

Stay Safe While Water Skiing: 7 Tips from an Athletic Trainer and Physical Therapist

Water skiing is a super fun sport that exercises your whole body. Because skiing requires you to be solid and balanced, staying safe is essential to avoid getting hurt. Here are some simple tips to help you have a great time and stay injury-free: 

1. Get Ready Before You Ski 

Before you get in the water, you must prepare your body. 

• Strength Training: Build your muscles, especially in your core, legs, and arms. Do exercises like squats, lunges, planks, and rows. 

• Balance Training: Improve your balance by standing on one leg on even or soft surfaces like a pillow or grass. 

• Flexibility: Stretch your muscles, especially your hamstrings, quads, lower back, forearms, and shoulders. Yoga or a personal mobility program from a member of our team can help a lot! 

2. Warm-Up Before Skiing 

A good warm-up gets your muscles ready to work hard. 

• Dynamic Warm-Up: To get your blood flowing, do light exercises like leg swings, arm circles, cat-cows, high knees, lunges, or a light jog.

• Practice Movements: Try squats with various foot positions and rowing/pulling motions to get used to the required movements while skiing. 

3. Use the Right Technique 

Using the proper form helps prevent injuries. 

• Body Position: Keep your knees bent, back straight, and arms extended with a slight bend at the elbows (soft elbows). Balance your weight over the skis. 

• Grip: Hold the tow rope firmly, but don't squeeze too tight. A relaxed grip can help prevent hand, forearm, and elbow injuries.

• Falls: If you start to fall, immediately let go of the tow rope and fall into the water safely. 

4. Check Your Equipment 

Make sure all your gear is in good shape. 

• Life Jacket: Always wear a properly fitted life jacket approved by the U.S. Coast Guard. 

• Skis and Bindings: Check your skis and bindings for damage, and make sure the bindings fit your feet well. If you drop a ski or go barefoot, please check your feet before and after your session. Foot health is crucial for all aspects of life.

• Tow Rope: Look at the tow rope to ensure it's not worn out or frayed. 

5. Stay Hydrated, Eat Well and Protect Yourself 

Drinking water and eating the right foods help keep you strong. 

• Hydration: You sweat more than you think when you're out on the boat and skiing. Be sure to drink lots of water and a low-sugar electrolyte beverage before and after skiing. This will help you replace the fluid and electrolytes (sodium, chloride, potassium, magnesium, calcium).

• Nutrition: Eat healthy meals with good carbs and proteins to give your body energy. Don't eat heavy meals or drink alcohol before skiing. 

• Protection: Sunscreen or wearing sun-protective clothing with SPF is a great way to keep you cool, prevent sunburn, and reduce the risk of skin cancer. 

6. Rest and Recover 

Give your body time to recover so you don't get overuse injuries. 

• Cool down: After skiing, do light stretching to help your muscles relax. Stretching your forearms, quad, hamstring, and lower back for 20-30 seconds each can help decrease tone and facilitate recovery.

• Rest Days: Active recovery on days you are not skiing can help your muscles recover faster. Walking, jogging, biking, or lower-intensity weight training are great options.

7. Get Help if You Need It 

If something hurts, talk to a professional. 

• Early Help: Getting help early can prevent minor problems from becoming significant injuries. Often, a few sessions of manual therapy, trigger point dry needling, cupping therapy, and a targeted exercise and recovery program that matches your goals can keep you on the water without pain all summer long.

• Custom Plans: An athletic trainer or physical therapist can help you with exercises to strengthen weak areas and improve your skiing. 

By following these tips, you can have lots of fun water skiing and stay safe. Remember, getting ready and using good techniques are key to having a great time on the water. Stay active, stay safe, and enjoy water skiing! We’re here to support you in any way that we can. Contact us today if you need anything.

Should I be stretching or strengthening?

Dr. Chandler contemplating the deep questions of the PT world.

“Hey, Siri, I have had months of pain in my lower back, and every doctor has told me that I need to stretch my hamstrings because they are tight. Do I need to stretch, or should I go work out like my friend from the gym tells me?” 

Ah, to stretch or to strengthen, that is a great question. 

“When is it a good idea to stretch?” 

Let's look at what the research says: 

When and how you stretch is important and heavily depends on your goals! 

When added throughout the day, stretching has many benefits, including increased tolerance to muscle tension and improved flexibility. It is also suggested that it reduces soreness following activity.  

Prolonged stretching for 30 seconds or more before activity has been shown to reduce maximal strength. Therefore, prolonged stretching after activity is recommended. This includes your standard hamstring stretches, calf stretches, upper trap stretches, etc.

Dynamic stretching can improve motion for activity without impacting strength. That’s why dynamic stretching is recommended before an activity. Some examples of dynamic stretching include air squats, lunges, high knees, butt kicks, side shuffles, cross-over stepping, leg swings, arm circles, cat-cows, thoracic rotations, etc.

“I’ve been stretching for a while but still have pain and tightness...Why is that?” 

That's because muscle weakness can also disguise itself as tightness.  

Mind blown, right!? 

Don’t worry, ours was, too, when we first learned about it. 

If you’ve been stretching one area, such as your back, hamstring, upper traps, etc., and the tension keeps returning, it’s time to consider a progressive strengthening program and load those tissues. This helps build tissue resilience to your symptoms at bay.

A proper evaluation from a Physical Therapist is the best tool for determining the root cause of your muscular aches and pains and working with you to determine the best course of action. 

Life, including stretching and strengthening, is about balance. 

Let’s work together to rebalance your approach and abolish your aches and pains for good.

To schedule an appointment with Dr. Chandler at our Appleton North clinic, call 920-991-2561.

Or click here to find a location most convenient for you.

*Disclaimer: Stretching may not be the best option if you have an acute muscle sprain (e.g., you were sprinting, felt a pop or slipped on ice, did the splits, and felt your muscle pull with immediate pain after the incident). In these cases, follow up with a physical therapist ASAP to assess further and direct your journey. 

—

Not sure if PT is right for you?

We do offer Free Screens to assess further and determine the best course of action with you.

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 . . .

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.

Preventing Pickleball injuries

Hi everyone, my name is Melissa. I am a physical therapist and a pickleball enthusiast! 

Over the last 5 years, pickleball has become one of the fastest-growing sports in the United States. Today, over 5 million people play pickleball on a regular basis, many of whom have not participated in a sport in the previous years or ever!  

Pickleball is a great sport to get into if you have not participated in sports in the past and are looking to do so.  

Although pickleball can have less running and impact than other sports, it is still important to properly strengthen and condition yourself to participate in pickleball. 

Pickleball generally involves making a couple of quick steps forward, backward, and side to side. It also requires repetitive wrist movements to hit the ball. These movements can lead to acute or chronic injuries, most commonly knee pain, hip pain, back pain, Ahilles tendinopathy, and tennis elbow, which is now sometimes even called pickleball elbow!

Don’t let these injuries scare you; there are so many benefits to your health from being active! 

So, how can we prevent these injuries from happening and taking you off the court?  

I would recommend doing a good 5 to 10-minute active warm-up, as well as a good strengthening and 

stretching program for after your activity.

Here’s what I do for my warm-up and stretching/strengthening program: 

Warm-up: wall calf stretch, calf raises, side stepping, walking adductor stretch, wrist extensor 

stretch, hamstring scoops, walking butt kicks 

Stretching: seated hamstring stretch, standing adductor stretch, wall calf stretch, wrist extensor 

stretch 

Strengthening: calf raises (easy: double legs, hard: single leg), hip abduction (easy: standing, 

hard: side lying), hip extension (easy: standing, hard: bridge or on stomach leg lifts), hamstring 

(easy: standing hamstring curls, hard: bridge slow slides), balance (easy: tandem stance, hard: 

single leg stance - always have something nearby to grab onto for safety) 

 *Disclaimer: This is not medical advice but is only for educational/informational purposes. If you are having pain or health-related complaints, please seek out te and develop a plan that is specific to you and your needs. 

I hope to see you on the court… not in our clinic, but if an injury does happen, come see us so we can get you back on the court ASAP!

 —

You can Schedule an appointment with Melissa at our Appleton North Clinic by calling 920.991.2561

To find a clinic location that is most convenient for you, click here!

Fighting Osteoporosis one Exercise at a time

Patients with osteoporosis have similar questions and concerns, but a common theme exists when talking with them.

They all fear their diagnosis and its impact on their lives.

They fear that they are fragile.

I want you to know that even with this diagnosis, you are strong, and your body is still resilient.

So, let’s look at what osteoporosis is and what you can do about it.

What is osteoporosis? 

Osteoporosis is a bone disorder characterized by decreased bone mineral density and mass. This condition reduces overall bone strength and increases the risk of fracture.

Fractures related to osteoporosis often occur in the spine, hip, and wrist bones. The disease most commonly affects postmenopausal women and older men.  

How can I reduce my risk? 

Some known factors that can decrease the risk of developing osteoporosis are:

• exercising regularly

• reducing alcohol consumption 

• quitting or refraining from smoking 

• eating a well-balanced diet 

• limiting caffeine intake 

• discussing the use of certain medications with your primary care physician 

How is osteoporosis managed?  

Your primary care physician may discuss using medications or supplements (calcium and/or vitamin D) to manage osteoporosis.  

Physical therapy can be another essential component of managing osteoporosis. Here’s how a physical therapist helps with your bone health: 

• Help strengthen your muscles, bones, and ligaments to improve bone health and overall wellness

• Gradually increase your tolerance to impact to decrease the risk of fracture

• Provide education on body mechanics and postural training  to decrease the risk of fracture

• Assess your balance and fall risk 

• Provide safe exercises to improve balance and strength  

• Provide pain management strategies following a fracture related to osteoporosis  

It’s never too late to start. Even if you’ve been diagnosed with osteoporosis, there’s still time to make meaningful changes.

It’s also never too early to start. Participating in a strength, balance, and mobility program throughout your life is preventative when discussing osteoporosis.

Let’s continue the conversation!

Contact us for additional guidance on strengthening your bones safely and effectively.

Phone: 920-991-2561.

Thanks for taking the time to learn more about osteoporosis and what you can do about it! -Dr. Kaylie.

References: https://www.bonehealthandosteoporosis.org/ 

Let's talk about Urinary Incontinence

Since no one wants to talk about urinary incontinence, we will break the ice.

Yes, it can be an uncomfortable and personal topic, but we want you to know that you have options.

And we’re here to support you in any way that we can as you navigate your journey with leakage, urgency, or experience while you are going or attempting to go to the bathroom.

First, let’s learn about what urinary incontinence is.

What is Urinary Incontinence?  

Urinary incontinence refers to the inability to control the urine flow, which can cause slight to significant leakage.  

Many women and men mistakenly believe it's an inevitable part of aging, but it's not!  

With the help of a trained pelvic health physical therapist, you can gain the necessary strength and learn techniques to minimize or prevent urinary incontinence. 

There are 4 main types of Urinary incontinence: Stress, Urge, overflow, and functional.  

Stress Incontinence is classified by the inability to control the flow of urine with increased intraabdominal pressure or higher-impact activities. It occurs during activities like coughing, laughing, jumping, running, or lifting.  

Urge Incontinence is classified by a sudden, intense need to urinate, often leading to leakage on the way to the bathroom. This urgency can significantly affect confidence in public situations.  

Overflow Incontinence occurs when you leak urine because your bladder is too full. It may feel that you haven't completely emptied your bladder at the time of voiding. Overflow incontinence can be caused by a blockage in the urinary system, other medical conditions, or dysfunction of your pelvic floor muscles.   

Functional Incontinence involves the sensation of needing to urinate but being unable to get to the bathroom in a timely manner due to factors such as muscle weakness, poor balance and coordination, dysfunctional movement patterns, or even a cluttered household.  

Life’s too short; there’s no time to worry about leakage or urgency. 

So much can be done in pelvic health physical therapy to address these issues. 

Contact us to schedule an appointment with a trained pelvic health physical therapist!

To schedule an appointment with Dr. Madeline at our Neenah clinic, call (920) 215-6225.

We also have therapists specializing in pelvic health at your Appleton and Ripon clinics. 

Everything you need to know about concussions

Over the last 2 decades, there has been a lot of talk about the injury known as concussion. There has been a growing body of research about concussions—what they are, what causes them, and how we can better treat them. For this reason, the clinical management of concussion care has significantly changed in recent years; however, not all health care providers have been informed about these changes.  

My name is Logan Curry. I am a physical therapist at Advanced PT’s Appleton North location with advanced training in treating and managing concussions. I frequently get questions from patients or their parents about these injuries. Here are the answers to some common questions that I get about concussions. 

What is a concussion?

A concussion is a traumatic injury to the brain, which causes a cascade of events leading to inflammation, blood flow restriction, and a depletion of energy needed for normal neurological function. This is a functional injury to the brain without visible structural tissue damage to the brain. It causes signs and symptoms (such as dizziness, headache, fatigue, etc.) which can occur immediately or over time. Although these symptoms can be quite severe, typically we expect them to resolve in days or weeks following the injury.  

How do you diagnose a concussion?

A clinical assessment performed by a health care provider is necessary to formally diagnose a concussion. Assessment may include but is not limited to testing for cognition, eye control and vision, posture, gait, balance, and neck motion.  

Do you need to get imaging after a concussion?

No, it’s not necessary, but sometimes it may be appropriate. Currently, diagnostic imaging for clinical use cannot identify people who have sustained a concussion, so CT scans and MRIs will show no signs of tissue injury. If a person sustains significant head trauma and their symptoms progressively worsen or create an unstable condition, they should receive a CT scan to rule out something more serious. In other cases, a person may receive an MRI to assess for structural injury to the brain in cases where symptoms persist longer than expected.  

What do you do after a concussion to help recover?

Initially, a period of relative rest (reducing daily activities and limiting screen time) for the first 24-48 hours following injury is recommended. After this period of time, it’s important to gradually return to physical and cognitive activity with minimal increase in symptoms. Sometimes people want to avoid all stimulation that provokes symptoms following their injury. Unfortunately, this doesn’t help their brain adjust to the stimulation that comes with daily activities. After a concussion, the brain needs to be gradually exposed to normal stimuli as part of the recovery process.  

How does someone return to school, work, or sport?

Often after these injuries, people need to receive modifications or accommodations to their school or work day to allow them to return to those activities at a sub-symptom threshold level (with minimal increase in symptoms). This they can do with the assistance of a healthcare provider. Returning to sport should occur in a gradual manner under the direction of an athletic trainer or physical therapist. Returning to full participation in sport should occur after fully returning to school/work activities. 

How long does it take to recover?

The majority of concussions recover fully in a relatively short amount of time (14 days or less for adults and 30 days or less for children). Unfortunately, there are cases and situations where concussion symptoms can persist because the brain needs some additional help to get back to normal function. 

Should someone receive care or treatment after a concussion? I

t is important to have oversight by a medical provider to assist in helping a patient who has sustained a concussion return to normal activities. ER doctors, primary care physicians, and athletic trainers are often the first health care providers to see people following a head injury. In some cases, they may recommend that a patient receive care or treatment from other health care providers such as a physical therapist, occupational therapist, speech and language pathologist, neurologist, concussion doctor, neuro optometrist, and neuro psychologist. Their recommendation will be based upon the provider’s experience and the patient’s symptoms following an injury. Sometimes providers may not be aware of some options that may be available to help get their patient better faster. 

How does physical therapy help people who have concussions?

The main goal of physical therapy following a concussion is to help gradually retrain the brain to process information and return to normal activity and function. Every concussion is going to present differently, so treatment can vary from one injury to another. The physical therapist will perform a comprehensive assessment and determine the most appropriate treatment strategy to help each patient address their impairments and deficits as well as work towards achieving their specific goals. Physical therapy may include aerobic activity, treatment for the neck, exercises for the eyes, interventions for the inner ear, balance training, reaction training, and sports/job specific activities.  

Concussions are a very complex injury and not fully understood. Despite our limited knowledge on the subject, there are many great things that can be done to help people feel better faster and to assist in managing symptoms. If you have any additional questions about concussions or are curious about what physical therapy can do for treating concussions, feel free to contact me at lcurry@advancedptsm.com or 920-991-2561. 

Patricios JS, Schneider KJ, Dvorak J, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695-711. doi:10.1136/bjsports-2023-106898