Pumpkin Spice Physical Therapy

All this fall weather and pumpkin spice latte talk has me thinking about Starbucks.

In the first blog post earlier this month, I discussed direct access – an import pillar in the physical therapy profession. To expand, today’s blog post will include a great example of how beneficial direct access can truly be.

In the early 2000’s, a physician named Dr. Robert Mecklenburg, chief of medicine @ Virginia Mason Medical Center, sat down to determine how his hospital could lower its healthcare costs; a major insurance company (Aetna) was threatening to remove them from their network due to high cost for care.

Since Starbucks was represented by Aetna @ this time, Dr. Mecklenburg reached out to the benefits manager @ Starbucks to determine how he could make their health care more financially efficient. Starbucks determined the most common healthcare costs for their companies were low back pain and headaches, and therefore Dr. Mecklenburg analyzed the entire process of how back pain patients passed through the healthcare system. He determined the following:

“90 percent of what we did was no help at all,” says Mecklenburg. “Does an appointment with an orthopedic surgeon, a neurologist, a neurosurgeon help for uncomplicated back pain? The evidence says no. Does an MRI help? No. As far as we could tell, the only thing the evidence showed [that] was worth anything was physical therapy.”

Naturally, Virginia Mason Medical Center changed their health care process so individuals with low back pain were seen first by a PT (a great example of direct access). This resulted in same-day treatments, reduced healthcare costs, and patient satisfaction through the roof!

In summary, go see your local ATPSM physical therapist, grab a pumpkin spice latte, and pray the Packers get it together!


PS: Below is a great visual of how direct access works can save resources!




Given October is National Physical Therapy Month, I wanted to take the time to discuss an important PT topic – a “pillar” in our profession that many people are not familiar with: direct access; hence our push for more education on the topic.

Many of my patients have grown accustom to hearing the phrases “don’t put your pain off” or “make your pain a priority”. The rationale behind these statements, and/or other similar ones, stems from one simple fact: it makes our job easier!

Why might you ask? It makes our job easier because your body heals faster when we correct problems before they progress. Just think - if you took the time to pull that one dandelion out of your garden each week, you likely wouldn’t end up with a garden full of weeds, since the spread of their seeds results in rapid multiplication. Similarly, if you paid the interest off your student loans, the interest wouldn’t compound and you wouldn’t have insurmountable debt (I promise I am not speaking from experience). There are countless examples in everyday life that mimic our bodies and reiterate the same concept: the sooner we address issues in life, the better off we are.

An article recently published by the Clinical Journal of Sports Medicine confirms this belief. The article looked at 200 athletes who had sustained a stress fracture in their low back. Patients who initiated physical therapy within the first 10 weeks returned to full activity an average of 25 days quicker than their counterparts who waited until after the 10-week mark (Selhorst et al., 2016). That’s an entire month people!!

Luckily, in Wisconsin, our mission of addressing pain ASAP is very feasible with direct access, which allows patients to be treated by a physical therapist without a physician’s referral.  "This allows us to streamline patients’ treatment, which results in a quicker recovery; not to mention a reduced expense. So, call your local ATPSM today, and let us help correct that small ache or pain before it becomes a field full of dandelions!"



Selhorst et al. (June, 2016).  Timing of physical therapy referral in adolescent athletes with acute spondylolysis: A Retrospective Chart Review.

Clinical Journal of Sports Medicine.

PT vs. Opioids. The Why. #ChoosePT

Recapping blog episode number one this month: opioids are a growing and significant problem and physical therapy is the proper solution.

Today’s agenda: Why? Prove it!

As most people can probably guess, a recent study reported that individuals’ (people currently seeking treatment for opioid addiction) primary goal for initially taking opioids was pain relief (Weiss et al., 2014). However, the majority of these same individuals then reported their main rationale for continuing opioid treatment was avoidance of withdrawal symptoms (Weiss et al., 2014); pain was no longer the culprit. To me, this situation has addiction written all over it.

As physical therapists, reducing pain/discomfort is the root of virtually all our interventions. If we can reduce patient pain ASAP (Science, 2017), therefore reducing the need for patient opioid dependency early, we can be the barrier that prevents the continuation of this addiction cycle. As the research article stated, people’s main reason they continue to take prescription pain medication is to prevent withdrawal symptoms; PT = less pain = less opioids = less withdrawal(s) = less people continuing opioids = less addiction. I wasn’t a math major, but that equation makes sense to me!


1. Weiss, R. D., Potter, J. S., Griffin, M. L., McHugh, R. K., Haller, D., Jacobs, P., … Rosen, K. D. (2014). Reasons for opioid use among patients with dependence on prescription opioids: The role of chronic pain. Journal of Substance Abuse Treatment47(2), 140–145.

Opioids versus Physical Therapy

Prescription medication abuse, specifically relating to “opioids” (the medical word for pain medication), has been well documented. It seems this issue is gaining increased mainstream attention in the media, however, one problem remains: what is the solution?

Although many solutions have been proposed, one has consistently remained atop the lists of many of these solution-seekers: physical therapy. In fact, the U.S. Surgeon General recently penned a letter, which was sent to physicians across the country, addressing this fast-growing issue. In addition to educating people about negative side effects of opioid abuse, related resources specifically listed physical therapy as primary alternative to treatment of chronic pain (APTA, 2016).

At Advanced Physical Therapy & Sports Medicine, we acknowledge the growing opioid epidemic and utilize many treatment interventions specifically aimed at reducing your pain. If reducing pain is your goal, APTSM is your solution!

For more constructive information on the overuse of opioids, please visit http://turnthetiderx.org.


APTA. (November, 2016).  Surgeon General Letter Urges Action on Opioids Recommends Treatment Guideline That Includes Physical Therapy.PT in Motion, 8(10), 46.

Diaphragmatic Breathing

To Breathe, Or Not To Breathe…That Is The Question!

“Just take a few deep breaths and everything will be ok”. Sound familiar? In many instances throughout our lives we are told this, or even reiterate this common practice subconsciously to ourselves during stressful times. So what is the method to this madness?

Believe it or not, there is actually a “correct” way to breathe that can provide optimal benefit both during times of high stress and absence of stress (if there is such a thing). Diaphragmatic breathing is a breathing technique that involves emphasizing using your diaphragm, a large breathing muscle below your lungs. Via many complex methods in our body that are initiated when participating in this form of breathing, this technique results in better breathing efficiency, lowering cortisol (stress hormone) levels in our body, improving our mood and attention, and many more positive health benefits. See below for a step-by-step tutorial in this technique.

For more questions about diaphragmatic breathing, regarding the technique or the benefits it can have for you, please reach out to your physical therapist or occupational therapist at your local Advanced Physical Therapy and Sports Medicine!

Breath in through your nose so your stomach elevates while your chest remains still

Breath in through your nose so your stomach elevates while your chest remains still

Figure 2. Exhale through your mouth, allowing your stomach muscles relax; again your chest should remain still

Figure 2. Exhale through your mouth, allowing your stomach muscles relax; again your chest should remain still


1)      Cleveland Clinic. (2016). Diaphragmatic Breathing. Retrieved from https://my.clevelandclinic.org/health/articles/diaphragmatic-breathing

2)      Ma, X., Yue, Z.-Q., Gong, Z.-Q., Zhang, H., Duan, N.-Y., Shi, Y.-T., … Li, Y.-F. (2017). The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Frontiers in Psychology8, 874.