Pursuit Physical Therapy is a sponsor for USA FIT Orlando now! Get back to pain free running today!

We are proud to be a new sponsor for USA FIT Orlando!

Dr. Ron Miller is the owner of a private physical therapy practice where they focus on better results in fewer visits, called Pursuit Physical Therapy.  Pursuit Physical Therapy is a new brand of therapy that is based on treatment outcomes and what is best for the patient.   Dr. Miller specializes in the treatment of heel pain and running injuries, and his main goal is to get you back to pain free running as soon as possible.  He designed the Running Injury Program specifically for runner's of all types and who want to get back to running quicker through a proven 4 step process that will guide your recovery.

As part of our sponsorship and their dedication to helping our local runner's, Pursuit Physical Therapy is offering FREE COMPLEMENTARY consultations to all of the USA FIT Orlando members!  If you have an injury or are experiencing pain with running with your USA FIT Orlando training, call us at 407-494-8835 for your FREE COMPLEMENTARY consultation or schedule at PursuitTherapy.com.  See what other runner's are saying about our programs here.  Can back to pain free running now!

Are you tired of having Foot Pain? We have the treatment for you! The Heel Pain and Running Injury program

Are you tired of having foot and heel pain?  Tired of running with pain?  Not interested in surgery or injections?  This is the answer for you!

Running Injury and Heel Pain 

Program

Want to get out of pain? This is the program you need to be on!

1.  Evaluation with accurate diagnosis and with prognosis

2.  4 Step Recovery Treatment Plan

3.  1 hour treatment sessions with One-on-One Patient Care with Board Certified Specialist

4.  Individualized Home Recovery Program

5.  Free pair of shoes or orthotics at your favorite running shoe store!

6.  Running Video Analysis 

7.  1 month consultation period after completion of program

8.  No surgery! No Injections!

9.  Pain free in fewer visits.  Get back to running sooner!

This is what are patient's are saying

"I suffered from achilles tendinitis after starting new training.  Luckily a friend introduced me to Dr. Ron Miller.   Dr. Miller was able to treat my achilles tendinitis without any drugs or injections and the best part was that I was back running pain free in just 2 weeks.  Not only did Dr. Miller help me recover faster but he also showed me how to prevent future flare-ups.  His treatment was able to save me time and money and I only needed 2 visits!  If you are currently suffering from any kind of physical pain trust me, Dr. Miller can help you."

Kathleen B.

This is the most comprehensive program to resolve your pain, make sure it doesn't come back and to get you back to the activities you love.  No surgery!  No injections!  Call us now at 407-494-8835 to schedule you evaluation today or visit us at www.PursuitTherapy.com for more information.

The 5 tips for pain free running series

Do you ever get pain when running?  Tired of having knee pain after a run when walking up stairs?   This is going to be the blog for you!

First, I would like to say thank you to Fleet Feet Orlando and I am very grateful to them for asking me to write as a guest blogger.  This series will be posted to their blog here as they start their No Boundaries Running Program.  I thoroughly enjoy treating runners and helping them get back to doing the activity they love....running.  Not just running , but pain free running!  Over the next several weeks, as the racing season starts, I will be posting  a 5 part series that will review 5 simple tips that can help prevent running injuries. Most running injuries occur due to 3 things: structural issues, training errors, and biomechanical errors, and simple changes can be made to correct any dysfunction that is present that may lead to injury.  We will be addressing the treatment, prevention, and certain strategies that me help with plantar fasciitis, runner's knee, IT Band syndrome, and more.  For more information about me, Pursuit Physical Therapy, the Running Injury Program, and about treatment of running injuries, visit www.PursuitTherapy.com.

Regards,

Ron Miller, DPT, OCS

Do you have pain when Running? Do you have a plan to treat your injury?

Do you experience pain from running?  Does your pain persist after you stop running?  The answer is to address the problem that caused your injury and get it treated!  Don't cover up your pain with medications and other "tricks" and run through you pain.  Definitely do not run while taking NSAID medications, as there can be many side effects and health concerns associated with this.

“There is no magical drug, machine, shoe, tape, or tip that will fix your injury”
-Bruce Wilk, The Runner’s High and author of The Running Injury Recovery Program 

At Pursuit Physical Therapy, we have created a Running Injury Program that is designed to specifically for runner's and to get them back to pain free running as soon as possible.  We have a 4 step process that will give you a guideline to return to running.  Feel free to visit our website for more information at www.PursuitTherapy.com and even sign up for our 5 Steps to Resolve your Heel Pain handout!   We want to get you back to pain free running and solve your problem now!

What is Plantar Fasciitis?

Have you ever experienced a sharp pain in the bottom of your heel when you step out of bed first thing in the morning?  Do you get heel pain when you run or from a long day standing at work?  Well, it is most likely a condition called plantar fasciitis and it is estimated over 2 million people experience plantar fasciitis each year.  The plantar fascia is a tight band of connective tissue that supports the arch of the foot.  Plantar fasciitis is thought to be caused by biomechanical overuse to the plantar fascia, thus creating microtears at its insertion of the heal.  Some experts have deemed this condition not an true tendinitis, implying that its etiology is a more chronic degenerative process versus acute inflammation.  Usually people will complain of a sharp pain on the bottom of their foot or pain closer towards their heel.

People state that walking, first stepping out of bed in the morning, walking after prolonged sitting, and running will cause their pain.   Usually people will report a decrease in pain after a warm-up or some stretching.   If you have a questions or concerns about plantar fasciitis feel free to visit www.PursuitTherapy.com or call 407-494-8835.  Stay tuned to see what are risk factors, diagnosis, and what is the best treatment!

Why Do I Have Low Back Pain When I Golf? Can Physical Therapy Help?

This is for all of the great fathers out there for Father's Day, who are probably on the golf course right now, and who will make it home in time to watch the end of the U.S. Open!  Are you noticing that your golf scores are higher lately?  Are you starting to get low back pain (LBP) when golfing?  Have trouble beating your friends on the gold course now because of LBP?  Well, this is the blog post for you regarding golf and low back pain!  Do you know that common site of injury among professional and amateur golfers is the low back. Low back pain (LBP) is the most common injury and makes up roughly 25-50% of golf injuries.

Many of you are probably on the golf course right now with your friends, but what do we know about golfers with low back pain? Research shows that golfers with LBP have poor neuromuscular control to rotate at increased speeds. This is essential to a complex and powerful movement such as the golf swing. This is why after experiencing LBP it is essential to start physical therapy to retrain this neuromuscular control associated with the golf swing and to make sure your LBP does not return.  Not only is it about the low back when talking about golf and LBP, but what occurs at the hips and pelvis is also relevant.  Research has shown the low handicap golfers have increased pelvis rotation speed, increased hip muscle strength than high handicap golfers!  Both of these factors can be addressed with physical therapy.

The modern swing (vs the classical golf swing) is more popular with most golfers due to its increased power and distance produced. Increasing the hip to shoulder ratio with the modern swing can be problematic due to the increased stress placed on the low back, which may also predispose you to LBP. Also, the increase lateral bending and "reverse C posture" with your follow-through, as shown in the picture below, may also cause you to have LBP. 

These are factors all can be identified, treated, and be prevented from causing you to have LBP when playing golf.  Golfers with LBP have been shown to have decreased trunk and hip range of motion (ROM). What do you think happens when you perform a golf swing but you don't have enough ROM? The body will compensate at another joint causing increased and unwanted stress/load to the adjacent joint, predisposing it to injury.  For example, look at the importance of lead hip internal rotation needed for your follow through in this picture below. This could be one of many factors that is causing your LBP.

Many golfers suffer from LBP and this is something that physical therapy can help with.  Doing something as simple as warming up for 10 minutes prior to golfing can decrease your chance of injury by 50%!  Don't settle for having LBP ruin for golfing scores and the time you should be enjoying.  Call Pursuit Physical Therapy today at 407-494-8835 and be seen by our Titleist Performance Institute Certified clinician now!  We can help treat your LBP, address any biomechanical impairments that are influencing your pain, and get you back to pain free golfing! 

Visit our website at www.PursuitTherapy.com and even see what our golf specialty program has to offer.

What does the evidence say is the best treatment (other than a total knee replacement) for knee osteoarthritis?

Dr. Harriet Hall just did an excellent review of The American Academy of Orthopaedic Surgeons (AAOS) new report evaluating the evidence on what is the best treatment for knee osteoarthritis (OA)!  You may be surprised at what has good and bad evidence to support its usage for the treatment of knee OA!  HINT:  you can do one of these at physical therapy!

What Kind of Running Shoe is Best for Me? Or Does it Really Matter?

Many runners ask what is the best shoe for me?  To date, many clinicians promote matching a certain shoe to a person's certain foot type.  Is this the best for my running patients and does this prevent injury?  I promote that there is a difference between poor shoes vs good shoes, but is there truly a difference between good running shoes?   A recent research article showed that matching a foot type to a specific shoe is not evidenced based and may not be needed.  Another study showed there was no difference in injury rates when shoes and foot types are matched vs randomly matching shoes to a foot type.  Another study showed no change in injury prevention and no decrease in injury rates when matching shoes.  So current reaserch does not support matching a specific shoe to a certain foot type in regards to injury prevention.    Ian Griffith wrote and excellent review regarding the evidence behind choosing the proper shoewear.  When dealing with a running injury there is a definite need for the proper shoe and/or shoe modification.  Chris Johnson shows an example of this here and also posts the importance of how to safely return from a running injury.  Good general shoewear is important, but it may not be as important as we think.  For example, I can run in a stability shoe or a cushioned shoe without any pain or symptoms.   The current research regarding matching shoes to a specific foot type is poor and this matching may not be a necessary.  Future research is needed to show optimal clinical outcomes with running shoewear.  Some general recommendations are: 1) choose a light shoe, 2)  make sure it is a good feel and comfortable 3) I still recommend a running store (in Central Florida, either Fleet Feet or Track Shack) 4) once you find a shoe that works for you, don't change it.   If you have a running injury or have any questions regarding the proper shoewear for you, contact Pursuit Physical Therapy at 407-494-8835 or visit www.pursuittherapy.com.

Tennis Elbow, Try Physical Therapy! No Need for an Injection

Tennis elbow (or lateral epicondylitis)  is a common elbow injury experienced by tennis players and other tasks that involve repetitive motions of the wrist and elbow. Typical signs and symptoms include pain and tenderness over the lateral epicondyle ( lateral elbow), worsened by resisted wrist extension and passive wrist flexion, and decreased grip strength.  Many people rush to the physician and get an injection for their first line of treatment and go on playing or doing their activity.  Current research actually showed worse long term outcomes with patients with chronic lateral epicondylitis who received corticosteroid injections.   A recent physical therapy study actually showed great outcomes with patients with  lateral epicondylitis within 5-10 visits.  What is even more amazing is when physical therapy included a cervical spine (neck) intervention that outcomes were reached in fewer visits!   Physical therapy is associated with short-term relief, the fewest recurrences, the best rate of full recovery at one year, and the lowest rate of nonsteroidal antiinflammatory drug use.   There is no need to be in pain or to play tennis with elbow pain.   Contact Pursuit Physical Therapy at 407-494-8835 or visit www.pursuittherapy.com for more information regarding your elbow pain.  Get pain free in fewer visits than the standard treatment!

Physical Therapy for Acute Low Back Pain? Can This Work?

Lets review this example of low back pain (LBP), that I happened to go through over the past 4 days.  So, for some reason, I decided to go to the gym on Tuesday and perform deadlifts as a part of my workout, which I haven't done since last year.

So later that day, after working at a skilled nursing facility and driving to my other job, I noticed an increase in LBP with strong muscle spasms.  Pain is a good thing (yes, it is very important!) and it tells you that something is wrong.  I always tell patients to "listen to your body", and if you are doing a certain task or position and you have increased pain try to avoid this, stop that activity, or attempt to complete it in a different position.  It is accepted in the research that acute LBP will spontaneously resolve in 4-6 weeks, but who wants to wait that long?   I know what caused my pain and that starting treatment with physical therapy with acute LBP as soon as possible will show better outcomes, decrease unnecessary testing, decrease the cost of healthcare, and I can start my treatment now!    So I was flexion sensitive, meaning I probably injured my low back during the deadlift during a flexion activity, driving also increased my pain (a flexion position again), and I know that prolonged sitting, bending forward, and any lifting would all increased my pain.

 I attempted to avoid these position as best I can, but as I was seeing patients, my work required me to be in some of these positions.  So I began treatment by myself throughout the day ... by doing prone press ups!

Since I was flexion sensitive, I would treat my LBP with repeated extension.  Many people with acute LBP fall into a directional preference and you can treat this with repeated motion with good research to support this.  I would perform at least 1 x 10 of prone press ups every hour to help me get through my day.  When I got home I usually sit in my chair, send some emails, and watch TV with my wife, but I knew that sitting would increase my pain, so I decided to do this.

I watched TV and checked my emails in this position, and by the time I was done I had no LBP!  This remained throughout the night and the next morning, and I was able to do a run/walk the next morning with only some muscle tightness.  I continued throughout my workday to perform at least 1 x 10 prone press ups every hour and was able to get through my day without exacerbating any symptoms.  On the 3rd day, I was able to return to the gym and perform basic strengthening during a light workout.  I could say that on the 3rd day I was pain free with no muscle spasm with no increased pain with flexion activities or prolonged sitting.  I know that this case will not work for every case of LBP, but this is a perfect example with acute LBP how early access and treatment with physical therapy can greatly help your pain and show a great outcome faster than the standard.  Physiopedia is a great online resource regarding physical therapy and LBP.  Pursuit Physical Therapy also has posted free information regarding LBP on their patient perspective page that reviews how LBP with effect their treatment and care.  Don't wait 4-6 months until your acute LBP to resolve, call Pursuit Physical Therapy at 407-494-8835 or visit us at www.pursuittherapy.com and start your treatment today!

What is Evidenced-Based Medicine and What Does it Mean to Me?

Evidenced-Based Medicine

Evidenced Based Practice has different meanings for medical clinicians vs for patients, that is probably beyond the scope of this blog post.   Regarding quality of healthcare, patients should be asking themselves "Am I receiving the best care, that is supported by evidence, that correctly diagnosed my symptoms and pain, that will lead me to the best outcome?"  For example, the treatment for low back pain (LBP) isn’t as easy as just being diagnosed as “low back pain”  Acute LBP has been shown to spontaneously resolve in 4-6 weeks, so if your treatment takes 4 weeks to get better, did the treatment really do anything?  So you can be treated with the standard care for your LBP with the normal 3x a week for 4 weeks with a (for example) $20 co-pay each visit, (and you may even better pay for the whole treatment if your insurance deductible is not met), receive exercise intervention only, slap on some E-stim that makes you feel good but does nothing to solve the problem, and at the end the treatment you received may not have even done anything. 

This is when evidence based practice comes in and can lead to a more accurate diagnosis, show better outcomes quicker, with less visits, and overall cost less money, getting you better in 4-6 visits instead of the standard 12.  Pursuit Physical Therapy offers one on one care, using evidenced based interventions, showing better outcomes than the standard.   Also Pursuit Physical Therapy is incentive based so if you only need a 30 minute treatment, that is what you get.  30-60 minute treatments for 4 visits and you are done.  The standard is insurance based and the longer you stay and the more times you are seen, the more productive they are.  The standard is usually 3 x a week for 4 weeks.   If a clinician has an intervention that can get you better quicker with better outcomes, don’t they owe it to you to provide this treatment? YES!   If you have pain that is stopping you from doing something you love to do, don’t wait for the pain to go away.  Call Pursuit Physical Therapy to see if physical therapy is appropriate for you, can get pain free sooner!

NSAIDS + runners = NO BUENO!

The New York Times wrote a great article and quoted good research regarding the use of NSAIDS (ibuprofen) in runners and cyclists.