Clinical Conversations

Anterior derangement are treated at Nick Rinard Physical Therapy.

This is an abbreviated, trimmed case study of a fit, active middle-aged man, Ian, who has an unbroken history of over 10…

Posted by Dr Mark Laslett on Tuesday, November 20, 2018


Nick Rianrd Physical Therapy and the MDT method know the importance of pain.

A great read! Exercise & Education: The hallmarks of MDT: "Central pain processes, the immune system and affective…

Posted by McKenzie Institute USA on Saturday, November 24, 2018


Nick Rinard Physical Therapy treats non-specific low back pain

“When you recognize that pain is often structurally non specific it allows you to treat ALL of the factors that…

Posted by McKenzie Institute USA on Wednesday, November 21, 2018


Nick Rinard Physical Therapy treats persistent disc derangement very well!

This is an abbreviated, trimmed case study of a fit, active middle-aged man, Ian, who has an unbroken history of over 10…

Posted by Dr Mark Laslett on Tuesday, November 20, 2018


Nick Rinard Physical Therapist has been involved in mountain rescue

Remembering the Mount Hood tragedy and all the people lost in 1986. Nick climbed Mount Hood on the 1 year anniversary, and was involved in mountain rescue for several years. Thought you might find it interesting how the school is keeping memory of the diseased students alive.


Mount Hood’s Deadliest Disaster | Outside Online…/mount-hood-disaster-1986 Nov 1, 2018 – The Oregon Episcopal School Mount Hood climb remains, to this day, the second-deadliest alpine accident in North American history, ….. The historical record—which includes dozens of news articles from 1986 and the years …


Get Moving at Nick Rinard Physical Therapy

Get Moving!

Check out this article from the American Physical Therapy Association which discusses new changes to activity guidelines from The US Department of Health and Human Services:

To summarize the article in a paragraph: any movement is better than none.  Inactivity and prolonged sedentary periods due to the conveniences of modern life are taking a toll on our health.  People of all ages should get a minimum of 150 minutes per week of moderate intensity exercise.

So what is moderate intensity exercise? Moderate intensity exercise will noticeably elevated your heart and breathing rate but you should still be able to carry on a conversation. “You should be able to talk but not sing.” (ttps://  Here are some great examples of exercises that fit this category:  brisk walking, easy jogging, elliptical trainer, leisurely swimming, water aerobics, biking without steep hills, doubles tennis, gardening, and line dancing.

So let’s get moving!

-Margo Burette, PT, DPT


Nick Rinard Physical Therapy can help you rapidly reverse your low back pain “No area of clinical over-treatment is as egregious as musculoskeletal care. Mis-diagnoses…

Posted by McKenzie Institute International on Saturday, November 10, 2018


Nick Rinard Physical Therapy cert MDT: Staying up to date

Just published. Yet more evidence about directional preference: "The most prevalent Directional Preference (DP)…

Posted by McKenzie Institute USA on Monday, November 12, 2018


Knee pain: The complete question and answer by Nick Rinard Physical Therapy

1). What is a surprising fact about knees that most people don’t know?


The most relevant misinformation about knees for patients is that radiologic findings (either x-ray or MRI) are what’s responsible for their pain.  On the contrary – something ‘wrong’ found in imaging is most likely NOT associated with pain!  In one study of 24 elite athletes NOT complaining of knee pain, “EVERY knee imaged had at least one structural anomaly” (  The rate of “false positives’ (what researchers call it when a positive test for a disease is incorrect because the patient does not actually have the disease) varied from around 50% to 80% in this study.  So, if your knee hurts, and you get a radiological diagnosis, you have a high chance of getting misdiagnosed.  Better to get a full examination to get a better clue as to the source of pain.


2.) How do your knees affect your stride?


Technically speaking your knees (the joint parts) do not affect stride since running is a “mid-range” motion.  Walking, on the other hand, does involve end range extension, so limited extension could have an effect – but not in running.  Pain in the knee is likely to affect your ability to tolerate a running stride, and your body will find ways to avoid pain – thus affecting your stride in varying ways.  There is no typical way this happens, so if you have knee pain, you need to have a good mechanical examination to find out how to best treat or manage it.


3).  Is ‘runner’s knee’ a real problem (and is it as big a one as people think?)


‘Runner’s Knee’ could be any one of many diagnoses, so, as a term, it is not really a diagnosis – it is a symptom.  Consider this:  Meriam Webster’s “Medical Definition of ‘Runner’s Knee: pain in the region of the knee especially when related to running that may have a simple anatomical basis (as tightness of a muscle) or may be a symptom of iliotibial band syndrome or chondromalacia patellae.”  It can be a real problem, and it can be a big one if not well understood by the patient or treating healthcare provider, like a physical therapist.  If your pain does not subside quickly after running, or is so bad that you cannot increase your running distance due to pain, then it is best to get a full mechanical evaluation from a trained provider (and given the answer to question 1 above, imaging should not be necessary first.)


4).  What are the most important things a runner can do to keep their knees injury free?


The body is amazing and can be trained to do almost anything.  Injury creeps in when your training load exceeds your body’s ability to adapt.  Progress your training in small increments and don’t underestimate the power of a rest day to give your tissues a chance to heal and catch up.


5).  Anything specific we didn’t talk about that you think I should mention?


Yes, over the years I have seen a high incidence of spinal problems being either the sole source, or contributing to, knee pain.  This rate is up to 40% or higher based on my anecdotal experience and confirmed by research in progress (presented at the 2017 McKenzie Institute International Conference in San Francisco).  Many runners have consulted with me right in the middle of training for an event (like a marathon, mostly), desperate to not interrupt their training due to knee pain.  I have helped them stay in training and complete the event by effectively screening for spinal issues that are masquerading as knee pain.  Often the patient dismisses this since they “always have a sore back, but the knee pain is new”.  Given the important role the spine plays in controlling everything in the extremities, it should not be surprising how relevant it can be in knee pain – and how important it is that your properly trained specialist can identify and treat it effectively!




Nick Rinard MPT, Cert MDT


Nick Rinard Physical Therapy is the best at getting you out of a lateral shift

This is an unpublished report of a study carried out between 1989 and 1991 in collaboration with clinicians at the…

Posted by Dr Mark Laslett on Monday, October 29, 2018