All Posts tagged Nick Rinard

Mechanical or Medical? How Targeted Assessment Helped Differentiate the Source of Rib Pain

Written by: Danya Sadler, SPT

When Rib Pain Isn’t What It Seems

We had a patient this past week with a unique challenge. This patient had been fighting with a serious medical condition for the past couple months and had, a week before seeing us, started experiencing pain on their left lower ribs. This patient had great difficulty sleeping, rolling over, and generally moving around and wanted to see if this new symptom was related to the illness or if it had a mechanical component.

This visit was conducted via telehealth which is a great way for patients to be seen who either are living or travelling far away or people, like our patient in this article, who are homebound due to their illness or injury. This patient was told at the start of the visit that we were going to use this first visit to determine if there was a mechanical component to their rib pain and if there wasn’t, that we were going to help guide them to appropriate medical providers for further evaluation.

Using Movement to Find Answers

During this visit, it was difficult to conclude whether the rib pain was mechanical or visceral. The patient had tenderness around their left lower ribs, but also had right sided tenderness right underneath the ribs dealing more with internal structures. One notable finding was the patient experienced some pain relief when side-gliding to the right and side-bending to the right. Based on this response, we decided to have the patient perform these consistently over the next few days to see if this would relieve symptoms and help us conclude if this rib pain was indeed mechanically based.

An Unexpected Setback—and a Breakthrough

When we followed up with the patient a few days later, they reported an eventful week. Shortly after our initial evaluation, they went to the emergency room with severe rib pain and did not do their PT exercises at all. After testing negative for any illness related cause of her rib pain, she went home and then began performing the assigned movements consistently. They worked! The patient was happy to report that their pain had almost completely gone away! They were very grateful that we were able to provide the tools to reduce their pain and gave them hope even in these really difficult times that they were facing with their illness.

The Power of a Thorough Assessment

This case highlights the value of a thorough physical therapy evaluation, even when symptoms occur alongside a significant medical condition. Rather than making assumptions about the source of the patient’s pain, we used movement testing and symptom response to guide our clinical decision-making and determine the most appropriate next steps. By the patient’s second visit, their rib pain had improved dramatically, allowing them to move, sleep, and function more comfortably. Just as importantly, the patient gained confidence and clarity during a challenging time in their health journey.

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Our best referral source is YOU!

We want to share your great experience at Nick Rinard Physical Therapy with the world! We take great pride in what we do for our patients and are always looking to improve our care and services. Your feedback helps us with our online exposure in reaching new patients so that they too can get back to pain-free living! Here are some options as to how you can leave your feedback to share with the world!

These reviews should only take a few minutes to complete and go a long way in helping us reach patients we would not have previously!

Please feel free to contact us if you have any questions.

Thank you in advance and as always, we are here for YOU!

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Happy Thanksgiving from Nick Rinard Physical Therapy

Happy Thanksgiving from everyone at Nick Rinard Physical Therapy.

We are so very Thankful to have a strong community that support small business. We couldn’t do it without you, our patients, friends and family!

Nick Rinard Physical Therapy will be CLOSED for Thanksgiving on Thursday, November 27th 2025, Friday November 28th, 2025, Monday December 1st 2025 and Tuesday December 2nd 2025.

Regular office hours will resume Wednesday December 4rd 2025.

If you are in need before then please do not hesitate to call
503-244-6232 or email help@rinardpt.com and we will get back to you as soon as possible.

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Insurance keeping you in the dark?

Do you have the feeling or expect that Physical Therapy should be covered by your insurance?

Physical therapy providers are starting to identify some very good reasons why involving your insurance may NOT be in your best interest!

Just like filing an auto insurance claim for damage that doesn’t meet your deductible – it is often best to forego involving your insurance and just pay out of pocket. There is no need to inform your car insurance that there was any damage and risk them increasing your premiums the next time your policy renews. It is the same with filing a health insurance claim. Filing a small claim for physical therapy can have negative complications and unintended consequences. Especially when you can get diagnosed in 2-4 visit at Nick Rinard Physical Therapy, and get good results soon after that, it is better to not have your insurance medaling in your physical therapy affairs by questioning whether you “deserve” physical therapy or not.

Health insurance companies are demanding more and more that patients meet certain criteria, through one-size-fits-none measurements to either deny you care, or begrudgingly agree to authorize just a limited number of visits. This is insulting to your legitimate pain, and disrespectful of your medical providers who should be the only ones deciding if you need care or not.  Also, your insurance reserves the right to determine – even after the fact – that your care is/was not “medically necessary” and deny your claims leaving you with an unforeseeable bill. This really is unethical and undermines your relationship with your provider.  Also, insurance companies are increasing your cost of care to save themselves money with patient portions closer and closer to the total bill. You, the patient, are better off just paying at time of service at our clinic and not bothering with the extra headache, expense, and disrespectful treatment associated with filing insurance claims – even though you are totally legitimate!

Nick Rinard Physical Therapy’ wants to save you money. Our pay at time of service rate eliminates billing uncertainties from insurance companies. We are making visits more affordable and getting better health outcomes for patients. Advantages to paying at time of service include that patients get uninterrupted service, higher quality care they can trust, hassle-free billing, and no surprise bills at the end. It really is a win – win for both providers and patients for those with high deductibles, who want care out-of-network, who are self-employed, self-insured, expired PIPs and for people who have health savings accounts.

Now is the time to stop insurance companies from unethically pretending to be medical providers and payment specialists that do not have the patients’ best interest at heart. We are your providers working for you! It is our oath to get you results, free of pain and back to living life… We know health insurance companies cannot promise the same.

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Are you still in pain from a car accident?

Nick Rinard Physical Therapy can get you back to living “a life free of pain.”

“I came in with major chronic pain and injuries from a car accident.

With care, patience, and always a great sense of humor – Nick Rinard Physical Therapy help me back to a life free of pain.

Through every twist and turn on my road to recovery, Nick help me stay informed, comfortable with the treatment, and motivated to keep going.

Thank you so much!”

Autumn

 

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***** 5-Star google reviews!

Have you read our google reviews lately??

If you trying to find the best physical therapy clinic in the Portland Oregon area, look no further!

Nick Rinard Physical therapy is here to help!

 

But you don’t have to take our word for it….

“I can’t say enough on how pleased I am working with Nick as my Physical Therapist. His approach to PT gets results and his thoroughness with educating his patients on how to get better and stay better is second to none. If I ever run into physical pain/issues again, he’ll be my first stop.” Andy

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Thoracic Outlet Syndrome

If you are experiencing pain in your neck, shoulders, arms and sensitivity in your fingers it may be thoracic outlet syndrome (TOS).

Get your accurate diagnosis today at Nick Rinard Physical Therapy.

“I experienced numbness in my pinkie and ring finger on both hands.

I had shoulder pain, especially when doing chest exercises.

Thoracic Outlet Syndrome.

The numbness in my finger has gotten better.

My shoulder pain is gone.

I can do chest exercises now without pain.”

Gordon

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Happy Thanksgiving

Happy Thanksgiving from Nick Rinard Physical Therapy in Portland Oregon 2024

Happy Thanksgiving from everyone at Nick Rinard Physical Therapy.

Nick Rinard Physical Therapy is very Thankful to have you in our lives! We couldn’t do it without you!

Nick Rinard Physical Therapy will be CLOSED for Thanksgiving on Thursday, November 28th 2024, Friday November 29th, 2024, Monday December 2nd 2024 and Tuesday December 3rd 2024.

Regular office hours will resume Wednesday December 3rd 2024.

If you are in need before then please do not hesitate to call
503-244-6232 or email help@rinardpt.com and we will get back to you as soon as possible.

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Nick Rinard Physical Therapy helps get our firefighters back in the line of duty.

A Nick Rinard Physical Therapy patient emphasizes the importance of health and fitness in the the demanding role of a firefighter.

His home exercise plan is so convenient he can do it while he works!

Thank you for your service and courage you give to the community.

Thank you for sharing your Nick Rinard Physical Therapy story!

 

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Happy 4th of July

Red, white and blue flowers to celebrate the 4th of July.

Happy 4th of July

May all of us at Nick Rinard Physical Therapy wish you, your family and all friends a very safe and happy 4th of July.

The office will be closed on Thursday, the 4th, and Friday the 5th to celebrate. We will reopen Monday the 8th.

Please don’t hesitate to leave a voice message at 503-244-6232 or send an email to help@rinardPT.com and we will respond to you as quickly as we are able.

We are always here for you.

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