Clinical Conversations

Flying through the seasons

I hope that you stayed well and active during this beautiful warm October. It is hard to believe that we already flew through the beginning of the new school year and Halloween activities!

The leaves have turned colors and it is likely that many of you are starting to look into getting early bird deals on ski tickets and planning winter getaways. With that in mind, I wish to remind you to use this time to prepare your body for winter sports.

As you switch from your gardening and harvest collecting “exercises” to cardio and weights, make sure you have the proper knowledge and tools to keep your body healthy. If you need advice Nick Rinard Physical Therapy is here to help you make this transition! This way you are likely to avoid injuries and that disappointing muscle fatigue that causes you to stop too soon, while the snow on the slopes is just about to fall.

If the summer and beginning fall season vacations have not healed your injuries, now might be a good time to take care of them, before your insurance plan changes with the new calendar year.

               ~ All the best,   Krissy Brown-Marshall

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Do you know someone in pain?

Nick Rinard Physical Therapy WANTS to help!

Send your friends, family and coworkers to Nick Rinard Physical Therapy for a free screen or full evaluation.

They will thank you for helping them find relief.

We will thank you for letting us help them be free of pain in just 6-8 visits before their deductible renews and they the New Year begins.

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Just a friendly reminder…

NOW is  the BEST time to get the treatment you need for your aches and pains and…

…get better before your insurance deductible or health savings account renews.

Get the most out of your dollars.

The end of the year is FAST approaching.

More quickly than we expect.

With an average number of visits of just 6-8, you can complete treatment before the end of the year  and make the most of your health care benefits.

Don’t hesitate– call 503-244-6232

Schedule your evaluation today!

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Thank you Miranda for sharing your Nick Rinard Physical Therapy story!!

“Several years ago I saw Nick on a whim after battling daily migraines for over a year. I had seen countless doctors and specialists, had cat scans, tried everything I was told to try and didn’t get any relief. I was a stay at home mom to two kids under 4 at the time and the immense pressure and stress this was putting on me was nearly debilitating. I found this clinic when I had nearly lost hope.


At my consultation, Nick was able to positively identify the issue at its core (sub occipital muscle spasms) and put me on a physical therapy treatment plan to begin my healing. Something no doctor had been able to do in the years prior. I now have been migraine free for over 2 years. Since curing my migraines I have also seen Nick for other issues, which he usually is able to clear up for me in a matter of 1-2 weeks.
You’ll notice a difference immediately with Nicks way of diagnosing- he doesn’t just guess and begin treatment. He identifies the root cause through process of elimination.


Nick’s understanding of the dynamics of the human body is absolutely incredible, and his way of dealing with patients is both comforting and straightforward. I’ve recommended Nick to several people including 3 family members who have seen him and had results far beyond expectation. This is not your average physical therapy clinic. This is next level healing for even the most stubborn issues. I can’t thank Nick Rinard and his team enough for giving me my health back.”

Mirand

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Fall is just a day away…

It has been a busy and wonderful summer at Nick Rinard Physical Therapy!

We are excited about getting you pain free from summer injuries so that you can slide into your favorite fall activities!

While a lot of injuries can occur during activities, it’s just as common to injure yourself slouching on the couch with your feet up.

Of course the chill of fall can cause you to start to creak like the brittle leaves that fall, it is best not to ignore these symptoms just because they happen every year.

Your seasonal pains could point to a chronic condition that could easily be treated.

With winter just around the corner take care of your aches and pains now before they get worse.

Nick Rinard Physical Therapy is ALWAYS here to help!

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Pseudo Tennis Elbow: A Commonly Misdiagnosed Mechanical Problem

Lateral epicondylitis, more commonly known as “tennis elbow,” is a pathology that is familiar to physical therapists and the general public.  What is lesser known is “pseudo tennis elbow,” a mechanical problem with a very simple solution!  Unfortunately, therapists whom are not familiar with the utilization of mechanical diagnosis may unknowingly miss this common elbow derangement.  As a therapist practicing the McKenzie method of mechanical diagnosis, Nick Rinard Physical Therapy has diagnosed elbow pain patients as derangements (or pseudo tennis elbow).

Symptoms

Our patient, “Jane” presented to therapy with intermittent right elbow pain, worsening over the last 3 months. Jane reported difficulty with gripping, lifting, carrying and global limited function of the right arm.  Jane described symptoms as “variable” meaning she could perform a task that produced his elbow pain. Then, perform the same task or movement again without experiencing any pain at all!  This variability of pain is the hallmark of a derangement and should not be misdiagnosed as a tendonitis, which would indicate inflammation (in which case pain would be constant).  Jane rated worst elbow pain as a 6/10.

Physical Therapist Evaluation & Findings

Objective findings included pain with passive elbow flexion and extension as well as pain with active wrist extension and with gripping a tennis ball.  Because of my experience as a mechanical therapist, I am familiar with a technique called a mobilization with movement (MWM), developed by Brian Mulligan (a colleague of Robin McKenzie).  The mobilization provides a lateral force over the ulna at the elbow joint. While the patient applied this force, she was able to grip the tennis ball PAIN FREE!  This same technique was applied for other painful baselines and achieved the same results of ABOLITION OF ALL PAIN!  This ability to turn symptoms off with a mobilization indicates an elbow derangement and the MWM is used as the treatment strategy.

Patient Homework and Outcomes

Jane was asked to perform the MWM utilizing the lateral glide while gripping a tennis ball to be performed 10-20 times every hour.  The theory is that this mobilization is repositioning the joint in order for it to articulate correctly, resulting in improved range of motion and strength after.  Jane returned to the clinic the next day with reports of at least 25% improvement! Objective findings were retested and nearly all baselines had improved in less than 24 hours!  Jane returned 1 week later and reported an 85% overall improvement with symptoms.

Get Your Own Mechanical Assessment

Don’t be misdiagnosed! Straightforward pathologies which require one exercise to treat are commonly missed with standard treatment.  This results in extra therapy visits, and more of your time and money.  It is worth your time to see if your pain has a MECHANICAL component.  A simple solution may otherwise be missed.

Get your pain correctly diagnosed at Nick Rinard Physical Therapy.

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