Sports Injuries

Telehealth: Virtual PT

Telehealth: Virtual PT 389 129 Jennifer Lane

As we continue to navigate into uncharted waters, I have been looking for ways to stay connected with existing clients and future ones too. The virtual world is where many people are turning to stay in touch with friends, family and colleagues. Kids are taking classes on-line, work outs are being broadcast so you can stay at home, and happy hours are being conducted on sites like Zoom. Netflix even has created a way for you to watch your favorite show with a group of friends at the same time, which my daughter loves!

In the world of healthcare, there is a growing category called telehealth. “Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions (Wikipedia’s definition)”.

How does this work with Physical Therapy? Well, there is much that can be accomplished via conversation with an experienced clinician. This is where my 18+ years of experience pays off for you! When I question patients about their current issues, complaints, limitations, I can formulate a good working hypothesis on what is going on. From there, the physical exam is performed to corroborate the hypothesis created during the interview. For the PT with years of experience, can then set a plan of care based on the therapy goals set.

When utilizing Telehealth for PT, the same interview process is done, and copious notes are taken. This is followed by a visual objective exam using a secure video platform that is HIPAA compliant. Both the PT and the patient can see each other via webcam from a computer or smartphone. Movement, posture, gait can all be assessed by this method. Following the evaluation, an appropriate home exercise program, as well as extensive information on how to manage the existing issue will be developed for you.  As is typical with in-person sessions, at the subsequent visits, treatment is modified according to how you are responding to the initial suggestions.

The American Physical Therapy Association (APTA) is working diligently to get policies changed so that health insurances will reimburse for this. Colorado Medicaid has already authorized that telehealth can be used for its clients. The hope is that private insurance companies like Cigna, Anthem and United Healthcare will all follow suit and pay for these services. In the meantime, my cash pay rates apply. If you are a patient of mine that is currently receiving care, there will be discounted rates for follow-up visits. Please contact me directly via email, phone call or text if interested in seeing if a Telehealth visit would work for you.

What can be treated via Telehealth? Most everything that can be treated in person: Back pain, shoulder dysfunction, knee, hip or ankle issues, vertigo and pelvic floor therapy too. Contact me today to schedule an appointment.

Common Running Injuries

Common Running Injuries 1920 661 Jennifer Lane

Running is such an accessible way to get a great workout. You need a pair of sneakers, and some motivation and off you go! But as a physical therapist, I see a lot of injuries that arise from running or jogging and they all tend to be over-use injuries. Hamstring strains, groin pulls, knee, hip or back pain are the most common that I treat and can side-line the most committed of runners.

So, what do you do if you are dealing with pain and you can’t run anymore? Can PT help you recover? Yes! I will go over a couple of the most common injuries that I see and how PT can facilitate the healing process.

First, let’s look at the physical therapy evaluation. A Physical Therapist evaluates muscular balance surrounding ankles, knees, hips and the back. When muscles are healthy, they are both flexible and strong. When running there is a specific pattern of recruitment and timing of muscle activity that helps you be an efficient and strong athlete. If there is dysfunction in the firing of muscles or the timing of recruitment, it can lead to pain. Let’s look at 2 common complaints to better understand this…

A hamstring strain, which may present as pain in the back of the thigh or right under the buttock is a common running injury. It hurts when your first start running, may feel better after a mile but really gets flared up running hills or long distances. This is usually due to the hamstrings being over-utilized while the glutes (butt muscles) are not doing their job. The glutes are a powerhouse muscle that helps support your leg in single leg stance and they extend the leg (bring the leg behind your in your stride). The hamstring’s main job is to bend the knee but with dysfunctional patterning, it can also extend the hip. When it does this instead of the glutes, it gets strained, over-used and fatigued, leading to pain and possible tearing. PT addresses this problem through proper stretching, hands-on manual therapy to reduce pain and then specific exercises to re-balance muscle activity.

Knee pain is the single biggest complaint I hear from runners. There are many different reasons for it but I’m going to look at one. Patello-femoral syndrome or Chondromalacia Patella is a dysfunction that causes pain under and around the knee cap. Pain increases with prolonged running, running downhill or walking down stairs. It can be due to tight muscles on the outside or lateral aspect of the knee, and under-firing muscles on the medial (inside) aspect of the knee joint. There is also usually significant weakness in the lateral hip muscles, the gluteus medius and minimus, that creates poor alignment at the knee, especially in single leg stance. Treatment involves loosening tight muscles, re-activating the “lazy” ones, strengthening the hip musculature and mobilizing the knee caps.

Techniques I like to use and have found very effective in getting people back to running include manual therapy (hands-on techniques to muscles and joints), neuro-muscular re-education, functional dry needling and therapeutic exercise prescription. Homework includes dynamic and static stretching, balance work and running-specific exercise.

So, don’t give up on your running program if you have pain. See a PT to get properly evaluated and start your return to running ASAP!

For a list of Running Races in the Denver Area, Click Here.

To make an appointment at Holistic PT, Click Here.

Colorado is a Direct Access State

Colorado is a Direct Access State 1000 1000 Jennifer Lane

What does direct access mean? It means that you as a patient, can access PT without a referral. In other words, you do not need a prescription from your doctor to receive out-patient physical therapy. This is an important consumer right because it enables you to seek out the care you want to receive based on criteria important to you.

What should you be looking for in a PT? Well, some of the very basics (but still important factors) are location and cost. If you require therapy services, 1-3 times per week, having a conveniently located PT clinic near work or home removes a lot of the stress around getting there. And does that clinic accept your insurance? If not, you may be paying out of pocket more than you expected.

Keeping location and cost in mind, I think it is still most important to find a physical therapist that is skilled in the area in which you need help and has the training to help you get better faster. We don’t just take our cars to any old mechanic or garage, you ask for referrals and read reviews to make sure other people have had a good experience there. Why would you go just anywhere to take care of your health? There are good and bad PT’s out there and you don’t want to end up at the latter’s office.

Have you had a good experience at Holistic PT? Make sure to tell your friends and family so I can help them too!

Return to Running Protocol

Return to Running Protocol 1920 661 Jennifer Lane

It’s that season… weather is getting nicer, days are getting longer and you are motivated to get in shape, so you set a goal of doing a 1/2 marathon, marathon or triathlon. Training is off to a good start but then you develop knee pain. What now? You rest, it feels better and then you return to running again and the pain comes back. Going up and down stairs has also become painful. You don’t know what you should do because, well, you already paid the entry fee for the race and, in the past you have just been able to work through the pain. But what if something more is going on? Do you need to see an orthopedic specialist? Are you going to do permanent damage to your joints if you ignore the pain?

My suggestion is always… go see a Physical Therapist! No expensive MRI required. PT’s are able to use diagnostic testing to determine whether ligaments, meniscus, joint or soft tissue is the problem. Once the cause of the pain is determined, how fast can you get back to running, biking, training? Physical therapy is an excellent resource to help reduce pain, restore normal tissue function and help create better muscular balance. In addition to these hands-on techniques, I have used a Return to Running Protocol from Brigham and Women’s Hospital in Massachusetts for a number of years. This is for those people who are serious about resuming their running after knee pain has gotten in their way. Follow this link to see the whole protocol. Return to Running Protocol.

And call Holistic PT today to make an appointment!

New Year’s Resolutions: How to be successful!

New Year’s Resolutions: How to be successful! 619 330 Jennifer Lane

Happy 2019! If you are like most people, you are reflecting on 2018, successes and failures, things tried, goals that you accomplished and some that you fell short of meeting. You are also looking forward to 2019. What goals are you setting for this year? What resolutions do you have for yourself? Or have you decided to not set any goals or resolutions because you have never had any success meeting them? It’s not worth setting them, because by week 3 of January you’ve given up.

Here are some of the most common New Year’s Resolutions. They should sound familiar… Lose weight, exercise regularly, quit smoking-drinking-eating dessert. What about setting more realistic goals that are measurable and attainable and that you can get help achieving?

What usually gets in the way of you accomplishing your goals? What I hear frequently is “well, I started running to lose weight but then my knee started hurting again, so I quit“. Or, “I signed up for an monthly unlimited package of yoga classes but I tweaked my back again“. Or, “I was working out with a trainer and thought I could handle more weight but now my shoulder really hurts. I can’t even put my jacket on without pain!

Here is my challenge and offer to you. I want you to set the goal of getting rid of that nagging pain or chronic issue that always gets in the way of your wellness goals. And I want to help! As a physical therapist, I help people set goals and then work to meet them. Come in for an evaluation and treatment so you are set up for success in 2019. Using manual therapy skills, functional dry needling, therapeutic exercise prescription and much more, I can help you get pain-free and moving in a positive direction! Don’t put it off another day!

Once you have addressed the underlying issues, you can meet those other goals of losing weight, exercising much more easily. Don’t let your chronic ankle instability, nagging low back pain or recurring hip issues get in your way of success.

Start 2019 off taking care of yourself. Holistic PT can help you eliminate the obstacles that derail you from success.

Trigger Point Dry Needling

Trigger Point Dry Needling 575 383 Jennifer Lane

I will be certified in trigger point dry needling (TDN) as of December 9th. What is TDN and what does it treat? Dry Needling is a technique physical therapists use (where allowed by state law) for the treatment of pain and movement impairments.   The technique uses a “dry” needle, one without medication or injection, inserted through the skin into areas of the muscle. The needle acts as an extension of the finger, being able to access muscles much deeper.

Other terms commonly used to describe dry needling, include trigger point dry needling, and intramuscular manual therapy.

Dry needling is not acupuncture, a practice based on traditional Chinese medicine and performed by acupuncturists. Dry needling is a part of modern Western medicine principles and supported by research. Learn more about dry needling.

Can you get PT for free? Yes!

Can you get PT for free? Yes! 1200 800 Jennifer Lane

Have you Met Your Insurance Deductible this Year?

Do you have a family insurance plan? Have you had surgery this year? Have you used your insurance more than usual? If you answered yes, you are more likely to have a $0 balance remaining on your out-of-pocket expenses. This means the cost could be minimal or completely covered by your insurance plan.

Do you have unused money on your HSA account? Close to having met your insurance deductible for the year? Now is the time to come in for physical therapy! Are you feeling aches & pains? Need to work on your core? Les us help you get a head start going into 2019, before your deductible renews again.

See Jenn Lane, PT at Holistic PT for:

  • Pelvic Therapy
  • Vestibular Rehab
  • Manual Orthopedic Therapy
  • Post-op/Post-Injury Rehab
  • Wellness Consultation


Biking Should Be How You Get Around

Biking Should Be How You Get Around 2772 2661 Jennifer Lane

My family and I just returned from an amazing trip to Copenhagen and Amsterdam. In both cities, the majority of people get around by bike. For the most part, everyone is riding a one-speed or a three-speed junker of a bike with a basket in the front and saddlebags in the back. For people with kids to transport, they had kid seats on the handlebars or at the back of the bike or they rode a utility bike with a big wagon that sat over the front wheel. People wear normal clothes and shoes, not spandex and bike shoes and they pedal along at a nice pace but they are not racing. What makes it so easy for them to do this is that there is an amazing infrastructure to work with. On all streets, there is a sidewalk, a dedicated bike lane with curbs on either side and a traffic lane. Each lane has it’s own traffic lights so you know when its time to walk, pedal or step on the gas. There is an awareness of others as you navigate the streets and there didn’t seem to be any accidents (although I’m sure they happen). No one wears helmets, except we did see some cool blow up helmets that people were wearing. They looked like neck collars and when I asked someone what it was, they said that if you are in an accident, it will trigger the collar and an inflatable helmet with envelope your face and skull to protect you from damaging your teeth, skin and brain. Check out this video… it’s pretty cool!

My husband and I both commute by bike most of the time. And we had an on-going discussion of why can’t more Americans ride bikes to work and to run errands? To make it safe and accessible the infrastructure has to be there. A dedicated bike lane that is protected on both sides is a must. Currently in Denver they are adding new bike lanes in all the time. But some of them disappear into a turn lane or they are not protected from traffic at all. There have already been 7+ deaths this year which will not help to convince people to ride their bikes to work. Also, both Copenhagen and Amsterdam are pretty flat. I can’t imagine those same people we saw in Copenhagen wanting to ride up a hill from downtown Denver to the Highlands. E-bikes (electric-assisted bikes) may be a good solution for hillier terrain. And finally, there has to be a good option of transportation when the weather doesn’t permit riding. In both the cities we visited, there was an excellent public transportation system in place. It was affordable and time-efficient and got you everywhere you wanted to be.

So for the time being I will continue to ride my bike to work and to the market and around town. I hope you will give it a try too!

Tennis Elbow: not just for Tennis Players

Tennis Elbow: not just for Tennis Players 640 472 Jennifer Lane

Tennis Elbow, also called lateral epicondylitis, is inflammation of the wrist extensor tendons where it attaches at the elbow. More specifically, the tendons involved are the Extensor Carpi Radialis and Extensor Digitorum. For years, tennis elbow has been called tendonitis (which means acute inflammation), but upon examination, there is very little inflammation in the tendon due to the chronic nature of the disorder. A more accurate term is tendonopathy or tendonosis.

Tennis players are not the only ones who suffer from this. Anyone who performs repeated movements with their wrist (computer programmers, musicians, carpenters) can have tennis elbow. Traditionally, physical therapy treatment of tennis elbow has included cross friction massage to the tendon, modalities such as ultrasound or electrical stimulation, bracing and therapeutic exercise. More recently, research has shown that the prescription of therapeutic eccentric exercises is a very effective way in treating tendinopathies. Eccentric exercises effectively lengthen the muscle-tendon complex, remodeling the tendon and increasing the tensile strength of the painful tendon.

So, what does PT look like for my patients who have tennis elbow? First thing is to make corrections to posture and body mechanics to take undo stress off the wrist extensor tendons. Second, the use of ice or heat still is effective in reducing some of the pain and soreness that people experience. And finally the teaching people therapeutic eccentric exercises to do on a daily basis at home or at work will effectively help reduce pain and facilitate proper healing of the tendon.

Want more info on the research behind this? Keep reading…

Chronic Ankle Instability: Why does my ankle constantly give out on me?

Chronic Ankle Instability: Why does my ankle constantly give out on me? 635 405 Jennifer Lane

Ankle sprains are the most common musculoskeletal injury in physically active people. Chronic ankle instability can arise from repeated acute lateral ankle sprains. Lateral ankle sprains are incurred when your ankle rolls outward. The ligaments are strained or torn causing pain and instability. Research shows that individuals who sustain an ankle injury are more susceptible to re-injury which can result in a string of long-term issues. Chronic Ankle Instability, or CAI, is a term used to describe patients who have experienced prolonged functional deficits and report subjectively that their ankle is unstable. Over time, these people are less physically active, which can lead to decreased health-related quality of life and increased risk of developing ankle osteoarthritis as compared to healthy individuals.

What is the cause of this long-term ankle instability? Studies have shown that when given functional performance tests, individuals with a history of CAI tested as well as people without ankle pathology. But when asked how their ankle felt, the subjects who had CAI reported feelings of instability while performing the tests. So, what is the root of the issue? I would suggest that after suffering an ankle injury, proprioception is affected. Proprioception is the ability to know where your body or limbs are in space without consciously controlling it or looking at it. Proprioception helps you make minor adjustments in joints to stay balanced (piicture, standing on a moving train without falling). If you can’t sense properly where your ankle is, it is more likely that you will roll it again. For more info, read “Assessing Outcomes in People with Chronic Ankle Instability” in Journal of Orthopaedic & Sports Physical Therapy.

What should you do if you have rolled your ankle once or multiple times? See a PT who can prescribe appropriate balance and stability exercise, use Kinesiotape and who can check for proper ankle mobility, strength and flexibility.

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