Our clinics are CLEAN. Our environment is SAFE. And we are READY to get out of pain and back to doing the things you love

At Foothills Sports Medicine and Physical Therapy, there is nothing more important to us than your health and well-being and we are open to serve you. The coronavirus (COVID-19) is an emerging, rapidly evolving situation, and we are working diligently to keep patients, customers, staff, and referral partners updated on our policies and prevention preparedness.

We have been working closely with the Center for Disease Control (CDC) and state and local health officials to ensure our centers and clinical teams are taking the proper action to keep everyone safe and healthy.

In addition, we offer virtual visits for patients that are unable to come to the clinic for their treatment. 

As an essential health care provider, it is our goal to ensure you can continue receiving care in our centers with the confidence that we have taken every precaution necessary regarding your safety.

Current COVID-19 Policies

  • All patients, employees, and vendors inside Foothills facilities must wear a mask covering their nose and mouth. If you do not have a mask, one will be provided for you by our front office staff.
  • Body temperature screenings will be performed daily for all staff, patients and vendors.
  • Per the CDC guidelines, frequent hand washing is safer than wearing gloves; therefore, gloves will not be worn unless requested. When requested, gloves will be single use only.
  • We will continue to uphold our standard of excellence on cleaning and sanitation between patients.
  • Any patients or staff experiencing Covid-related symptoms (cough, sore throat, fever, shortness of breath, or other symptoms listed by the CDC known to be Covid related) will be sent home and asked to return when they have 3 continuous days, symptom free, and without medication. Confirmed positive Covid patients must self-quarantine for 10 days and be symptom and medication free the last 3 continuous days before we will schedule an appointment.

Outside the Clinic

To ensure the health and safety of everyone in the clinic, we ask that patients and staff follow the following guidelines outside of Foothills, as well:

  • Wash your hands often with soap and water for at least 20 seconds.
  • Avoid close contact with people who are sick.
  • Avoid touching your eyes, nose and mouth.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue and throw the tissue in the trash.
  • Clean/disinfect frequently touched objects and surfaces

We thank you for your patience as we navigate updates and changes so that we are able to continue to provide you excellent care and a safe environment.

Ready to get your move back? In the clinic, or at home – choose what feels right for you!

In popular culture, the word “access” implies exclusivity—like a backstage pass to a rock concert or high-level clearance to government files. When it comes to direct access to physical therapy, however, the opposite is true. Direct access allows a patient to go to a physical therapist to receive an evaluation and treatment without a physician’s prescription or referral. That’s right; direct access essentially cuts out the middleman—no backstage passes, security authorizations, or physician prescriptions necessary.

Sometimes, when you’re suffering from an ache, pain, or injury, you have a pretty good idea of what you’re dealing with and might be able to pinpoint the cause of it. When that is the case, wouldn’t you prefer to get right to your physical therapist to begin treatment?

Direct access is governed on a state-by-state basis. All 50 states provide some form of direct access to PT, but there are restrictions and limitations depending on which state you live in. Arizona is one of 20 states where patients have unrestricted direct access to physical therapy, with no provisions or limitations for those who seek therapy without a referral. Before we get too deep into the thick of things, here’s a quick disclaimer: We’re not compliance or legal experts. The following data was sourced from the American Physical Therapy Association.

Which states offer limited patient direct access, which states offer direct access with provisions, and which states have unlimited patient direct access?

Limited Patient Access States
Alabama, Missouri, and Mississippi have limited direct access to PT. Meaning, they have access to evaluation and limited treatment. In most cases, this treatment is restricted to patients with qualifying medical conditions.

Patient Access with Provisions States
There are 27 states who have direct access to PT with provisions.

– Arkansas
– California
– Connecticut
– Delaware
– Florida
– Georgia
– Indiana
– Illinois
– Kansas
– Louisiana
– Maine
– Michigan
– Minnesota
– New Hampshire
– New Jersey
– New Mexico
– New York
– Ohio
– Oklahoma
– Pennsylvania
– Rhode Island
– South Carolina
– Tennessee
– Texas
– U.S. Virgin Islands
– Virginia
– Washington
– Washington, D.C.
– Wisconsin

Find provisions for each state detailed here.

Unrestricted Patient Access States
There are 20 states with unrestricted patient access. This means there are no limitations or provisions for patients who seek therapy without a referral.
– Alaska
– Arizona
– Colorado
– Hawaii
– Idaho
– Iowa
– Kentucky
– Maryland
– Massachusetts
– Montana
– Nebraska
– Nevada
– North Carolina
– North Dakota
– Oregon
– South Dakota
– Utah
– Vermont
– West Virginia
– Wyoming

The Many Advantages of Using Direct Access: 

1. It saves time, money, and stress with no need for a time-consuming trip to a doctor’s office.

Going straight to a physical therapist will allow you to get help, lower your costs, eliminate expensive diagnostic testing, and it will decrease wait times at doctor’s offices.

2. It helps patients become more actively engaged in their healthcare decision-making.

The physical therapist is recognized as a licensed professional of choice to manage musculoskeletal and movement disorders in patients.

3. It improves patient access to care.

Can become a part of a patient’s routine for injury prevention, fitness, and health

4. Physical therapy improves conditions that impact the ability to move and perform functional activities, thus improving outcomes and providing increased strength and mobility to help prevent future injury.

Physical therapists can now work as an integral member of the health care team and provide a cost-effective access point for patients with a wide variety of musculoskeletal conditions that impact their ability to move and perform functional activities.

No Referral Needed

At Foothills, we believe that rapid access to our services is an essential factor in efficient healthcare delivery. With direct access in Arizona, you can seek physical therapy services without a prescription from your physician or healthcare professional. Physical therapists have become part of the front-line management for patients’ suffering from musculoskeletal pain or injury. As physical therapists, we’re experts in movement and movement dysfunction, evaluating not only the injury/pain but the underlying conditions and contributing factors. Many needs can be addressed, assessed, and quickly treated without expensive on-going testing or surgery. However, should your injury or condition be outside of our scope of practice, we can refer you for further evaluation with one of the many physicians and medical providers we’re connected with.

Don’t let your health benefits go unused. 

In January, most health plans reset, allowing individuals to continue preventive or elective medical treatment. With your Full Recovery Focus in mind come to Foothills to get a hands-on, individualized approach to your evaluation and treatment. With your specific needs in mind, we can restore movement, improve function, and get you pain-free and feeling better than ever so you can start enjoying life again. Most think of physical therapy as a post-surgery requirement, but in reality, Foothills physical therapists are experts in restoring movement and function without surgical intervention!

If you’ve recently been injured or are suffering from a nagging ache or pain that won’t go away, contact us today so you can meet one-on-one with one of our physical therapists.

Schedule your free assessment here.

When inflammation occurs in the body, especially in your joints it can cause irritation, wearing down of cartilage, and may even lead to arthritis. Chronic inflammation if left unchecked can have damaging consequences over the long term. But did you know that the foods you eat, the quality of sleep you get, and how much you exercise can all play a role in reducing inflammation? In order to be more dedicated to our wellness goals, we must feed our bodies with the proper nutrients, rest, and exercise in order to fight off the harmful effects inflammation can have on our bodies.

What is inflammation?

The immune system is our body’s main defense system again foreign invaders. It recognizes these invaders and battles to keep all our systems as close to 100% as it can. This is done using the inflammatory process as a defense mechanism. But, just like any fighting soldier needs recovery from the constant attack, so does the immune system. It needs a break from inflammation. Otherwise, it loses the ability to resist and build back immunity.

Chronic (long-lasting) inflammation can rear its ugly head in the form of symptoms that can be all too familiar to many of us: unexplained lingering body pain, sleep disturbances, constant fatigue, weight gain, frequent sickness, and gastrointestinal issues which all can lead to an increase in negative thoughts and feelings diminishing our mental health and leading to depression and/or anxiety.

How to fight against inflammation.

What we nourish our body with has an effect on the inflammation in our bodies. So, what you eat is a good place to start in preventing and/or resetting that chronic inflammation. A good tool to use is called the dietary inflammatory index, or DII. It is an evidence-based index developed by researchers who have tested over 1,900 foods and their components by tracking markers on cells (our building blocks) in the body and overall effect on systemic inflammation.

You can start by going all in and following a strict elimination diet which basically allows you to eat only anti-inflammatory foods for 3+ weeks. Then, slowly adding in food groups that contain inflammatory properties in moderation to analyze the effects you feel.

Anti-inflammatory foods.

Anti-inflammatory foods include: vitamin C such as citrus fruits, strawberries, colored peppers, and potatoes; omega-3 fatty acids such as salmon, albacore tuna, and lake trout; flavonols such as apples, berries, onions, kale broccoli; beta-carotene found in orange vegetables; flavones such as eggplants and tomatoes; and isoflavones which are found in soy. There can be some controversy over specific anti-inflammatory foods. Just make sure you listen to how your body feels and responds!

Foods to stay away from.

Inflammatory foods that should be avoided or eaten in moderation include: sugar and high fructose corn syrup, artificial trans fat such as fried foods, margarine, processed baked goods; refined carbohydrates such as any processed food that includes added sugar and flour, bread, pasta, candy; processed meat such as hot dogs, sausage, bacon; and excessive alcohol which is no more than 1-2 standard drinks per day.

It’s more than just anti-inflammatory foods.

Although your dietary intake is a very important factor in reducing inflammation, you can’t rely on this to do all the work. Help that soldier out and add to your army with regular exercise and stress management from a mental aspect. Find something you enjoy such as yoga with meditation, reading outside in fresh air and Vitamin D, or listening to a positive podcast while at the gym.

Just like that and your habits are changing from the inside to out. You’re on your way to meeting your goals with hopefully some extra benefits of better sleep, more energy, and a body feeling 10 years younger!

If your inflammation is slowing you down, contact your nearest Foothills Sports Medicine Physical Therapy to get your move back!

Telehealth physical therapy is a great option to get the care you need, virtually. Licensed physical therapists go digital to accommodate patients with different needs and comfort levels. Discover whether virtual physical therapy is the right fit for you.

At the beginning of the pandemic, we were asked the question “Is physical therapy essential?” The medical community responded with a resounding “Yes!”

We’ve continued to stay open, safely, and adjust to the times, continuing to help as many patients as possible.

However, we acknowledge the need for more options, particularly for high-risk patients. And, this is a request we’ve heard from patients with limited time for many years.

Well, here it is: a virtual solution that is quick, inexpensive, and effective!

Many patients have questions about what to expect with virtual care and if it will work for them. I spoke with DPT and clinic director of our Metro Center location, Susie Williams, who has been performing virtual care, to answer our most commonly asked questions and concerns when it comes to virtual care.

Let me tell you, Susie is a gem! Opening her clinic early for at-risk patients, working through her lunch, and always adapting to the latest technology to provide the highest level of care to all of her patients.

It was inspiring to speak with a healthcare provider so passionate about helping her patients. I’m so excited to share with you the details from this amazing conversation. And if you’re in the Metro Center area and looking for care? I cannot recommend Susie enough!


The Best Care Plan for Telehealth Patients

We’ll get into the ins and outs of virtual care, but let’s get right to the point, shall we? Does virtual physical therapy even work?

The answer may surprise you, but we really believe it does! However, we also believe that the best treatment plan includes a blended approach.

To get the most out of your treatment, we prefer to do an in-person initial evaluation to make sure we can accurately diagnose your injury or condition from the get go. After one-two visits, most patients are able to transition to virtual care moving forward.

We understand that some patients feel less comfortable coming into the clinic. In speaking to Susie and other therapists, I learned that many clinics provide accommodations for high-risk patients, bringing them into the clinic before opening, during lunch, or after closing to mitigate their risk and provide the fewest in-person interactions.

Additionally, clients can also request a private treatment room to avoid sharing the space with other patients.

Patient safety is our #1 concern, and we believe this blended approach offers an innovative solution for patients to begin and continue treatment.

What is Telehealth Physical Therapy?

woman sitting at her desk on a telehealth physical therapy appointment holding her foot

In telehealth physical therapy, you will work with a licensed physical therapist to address your injury and create a rehabilitation plan, just like in-person visits. 

The difference? It happens virtually. 

In your space. Where you feel comfortable. On your time.

Many patients don’t realize that physical therapy professionals also offer virtual options. While it is newer in practice, as the world changes, we all have to adapt. We’re so proud of the way our therapists have researched, learned, and grown to adapt to a new climate and offer care in a way that’s convenient, effective, and safe.*

*Note: We take the highest precautions to ensure our clinics are safe for the public, including masks, distancing, and all of the sanitizing. We feel strongly that our clinics are safe. However, we respect that physical therapy is not a one-size-fits-all treatment, and we are passionate about providing treatment options for all patients.

Related content >> Foothills At Home

Pros of Telehealth Physical Therapy

There are many reasons virtual physical therapy can be a great choice, pandemic or no pandemic! Let’s take a look at a few of the top reasons patients decide to go virtual.

  • Peace of mind for high-risk patients. While we take every precaution inside our clinics to keep patients safe, the risk at home is always the smallest. Staying home helps our high-risk patients continue to receive the care they need without the added stress of leaving home.
  • Less expensive. Insurance copays are typically significantly less for virtual care and, sometimes, non-existent! If cost is a concern for your care, virtual PT can be a great solution.
  • Shorter appointments. Much of virtual physical therapy is dependent on you completing your home exercise program outside of your appointment time. This means your appointment times are shorter and easier to squeeze in during the workday.

Cons of Telehealth Physical Therapy

While virtual physical therapy is a great solution, there are a few cons compared to in-person therapy.

  • Difficult diagnosis. While there is a lot we can do virtually, Susie shares that an initial diagnosis is the most difficult thing to achieve virtually. There is something to be said for being able to feel the way your body works in person.
  • Fewer treatment options. While the method of physical therapy is based in strengthening and improving mobility to treat and prevent injuries, there are a lot of great additions to your exercises, such as manual therapy, trigger point dry needling, cupping, and scraping, that you can’t do virtually. 
  • More time working solo. Virtual PT eliminates the in-clinic time spent doing your exercises with a technician or assistant. Instead, you spend more time completing exercises on your own and checking in with your therapist to make sure your form is correct. It doesn’t offer the same in-the-moment corrections that you receive in the clinic.

Will Telehealth Physical Therapy Work for Me?

screen shot from telehealth physical therapy appointment for sprained ankle

Well, it depends.

We wouldn’t offer virtual visits if we didn’t believe in our ability to help patients in this non-traditional format. However, we’re realistic, and we realize virtual sessions are not a fit for every person or every type of session.

Ideal Candidates for Telehealth Physical Therapy

To help you determine whether telehealth is a viable option for your care, Susie helped break it down by who is most likely to see results that are comparable with in-person treatment.

  • Athletes. Not just the pros! When we say athlete, we mean any active individual with heightened body awareness. The more in-tune you are with your body, the more likely you will be to achieve a full recovery, virtually.
  • Passionate & determined patients. We’ve always seen that patients who take an active role in their recovery have the best outcomes. That becomes even more important when your recovery is reliant on your dedication to your home exercise program and following the recommendations of your therapist without the benefit of manual therapy.
  • Technologically-savvy patients. Listen, you don’t need to be a tech wizard to succeed here! What Susie is saying is that patients who are used to Zoom, FaceTime, and other video-related web services typically have an easier time adapting to the technology component. 
  • Existing patients. If you’ve already been working with a physical therapist, in most cases, it’s really easy and effective to transfer your sessions to virtual care.
  • Returning patients. If we’ve already worked with you and know your body, it can also help ease the transition to virtual care. 

Related content >> 10 Things I Wish My Patients Knew and Practiced

Ideal Conditions for Telehealth Physical Therapy

Additionally, some injuries and conditions are easier to treat in a virtual setting. Here are the recommendations Susie typically sees success with in a virtual setting:

  • New injuries. Meaning, you haven’t been dealing with this pain untreated for years.
  • Common athletic injuries. Our therapists are pros at treating things like IT band syndrome, Achilles’ tendonitis, plantar fasciitis, and other common athletic injuries that they see daily. The treatment for these is dialed in and easy to adapt. 

Less-Than-Ideal Candidates for Telehealth Physical Therapy

Virtual care isn’t appropriate for every patient. The following patients typically do better with a blended (in-person and virtual) approach or strictly in-person care.

  • Brand new patients. If you’ve never been to physical therapy in person before, it will be more difficult to start out virtually. Ideally, we recommend coming in for one or two in-person visits before transitioning to virtual care.*
  • Lower-activity patients. If you’re not used to daily activity, the learning curve can be a little bit steeper for a home exercise program. It’s always helpful if we can see you once or twice to make sure you feel comfortable before transitioning to virtual care.
  • Less motivated patients. We get it; not everyone loves doing their PT exercises. Coming into the clinic can help motivate patients less inclined to do the work on their own. At the end of the day, it’s your recovery, and you have to take ownership and do the work if you want it to be successful.
  • Anyone unable to use a computer, smart phone, or tablet. We know that the technology gap makes this treatment inaccessible to some patients, and we fully acknowledge that it is unfair to lower-income households. Unfortunately, we do not have the ability to loan out technology to complete these visits at this time. Additionally, if you don’t feel confident using a device, virtual care can be stressful and challenging.

*Don’t stress! If you don’t feel comfortable coming into the clinic at all, we can and will still work with you. If you’re dedicated to your results, there is nothing we can’t fix together!

Less-Than-Ideal Conditions for Telehealth Physical Therapy

Some conditions require more manual therapy or are more difficult to diagnose virtually. The following conditions don’t typically resolve without in-person care.

  • Untreated long-term conditions: For example, if you’ve been experiencing back pain for five years and never sought help for it, it will be difficult to diagnose virtually. This is a time where it’s best to see the patient in person first, then transition to virtual care once we have a clear diagnosis.
  • Post-op. Post-op physical therapy is very specific and requires a lot of manual mobility work. This work is often uncomfortable, making it difficult for patients to do the work on their own. We recommend in-person visits immediately following surgery. You can then discuss transitioning to virtual visits with your therapist when they feel you’re ready.
  • Headaches & migraines. For work on headaches and migraines, we typically provide fewer exercises and more manual therapy. Because we can’t do manual therapy virtually, it’s difficult to truly help patients without working on them in person.

Related content >> Can Trigger Point Dry Needling Relieve Tension Headaches?

The Virtual Physical Therapy Process: Step by Step

screen shot from telehealth physical therapy visit for sprained ankle

Now that you know a little more about whether you might be a good candidate for virtual physical therapy, let’s talk about the process from start to finish, from preparing for your first appointment through discharge.

How to Prepare for Your Virtual Visit

Preparing for your virtual visit is not unlike preparing for an in-person visit. Just follow these five simple steps, and you’ll be good to go!

  1. Remember to fill your paperwork out ahead of time.
  2. Check your internet connection to make sure you don’t have any connectivity problems.
  3. Dress in comfortable clothing that’s comfortable for exercise and stretching.
  4. Find a quiet, open space with good lighting. You want your therapist to be able to see you well, and you want to make sure you have room to move comfortably.
  5. If this is not your first visit, make sure to have your questions and concerns ready. Even better, write them down so you don’t forget!

What to Expect from Your First Virtual Visit

Your virtual physical therapy visit will be very similar to coming into the clinic. If it’s your first visit, your therapist will perform an injury assessment.

In many cases, therapists can diagnose virtually. However, depending on your injury, your therapist may request that you come in for a quick assessment during a slow time or during off hours in the clinic.

Your therapist will then take you through a series of exercises and make recommendations for which activities are appropriate in your current condition.

If this is a follow-up visit, you will check in with your therapist, discuss how your home exercise program has been going, and ask any questions you have related to your treatment. Your therapist may have you demonstrate some of your exercises to ensure proper form.

The main difference is that your visit will be much shorter since you won’t be working with any technicians or assistants. You can expect initial assessments to take anywhere from 30-60 minutes and follow-up visits to take approximately 15-20 minutes.

Related content >> For the First-Timer: What to Expect at Your First Visit

How Frequent are Virtual Visits?

When you first begin your treatment, it’s likely your therapist will want to see you twice a week to make sure everything is going okay and that your recovery is heading in the right direction.

Once we know things are going well, we typically space out visits to every other week.

Of course, if something changes and you need to be seen sooner, we encourage patients to call and make an appointment. We are diligent about making room for same day or next day visits to ensure our patients are receiving the best care possible.

Expected Outcome of Virtual Physical Therapy

Every physical therapist will tell you something a little different here, as some rely more on manual therapy and some are more strength based.

For ideal candidates and conditions, you can expect to see a full recovery from virtual visits. It may take a little longer, as treatments like manual therapy and dry needling can speed up recovery, but the overall outcomes are comparable with in-person treatment.

For patients whose conditions don’t lend themselves to virtual care, we can still see comparable results using a blended approach of very few in-person visits (remember, we will accommodate you during slower times or even off hours!) combined with virtual care.

However, for post-op patients, the outcomes just aren’t as good. We really need to work hands-on with patients immediately following surgery. Still, we’re happy to work to find your comfort zone during slow or off hours or in a private treatment room.

How to Make Your Virtual Care a Success

woman running outside after success with her telehealth physical therapy

Just like in-person visits, and really, with most things in life, the most important thing you can do to make your virtual care successful is take ownership in your recovery!

Similar to online education, you get out of virtual care what you put in. Here are a few tips to guarantee successful treatment:

  • Do your homework. Seriously. If you don’t do your home exercise program, you won’t get better doing virtual care.
  • Listen to your therapist. If they tell you to stay off your sprained ankle, going for a run the next day is not advised. 
  • Bring your questions. With biweekly visits, it’s important to maximize your time with your therapist. Between visits, write down your questions so you remember them and have them ready for your appointment.

Telehealth Physical Therapy FAQs

Will I be able to keep seeing my current therapist?

Yes! Continuity of care is extremely important to us, and we take every measure to ensure you are not passed off between therapists.

How long will my virtual session take?

Initial assessments take 30-60 minutes. Follow-up visits take 15-20 minutes.

How much will I be charged for my virtual visit?

Telehealth copays are typically lower than in-person visits. Many insurance companies don’t require a copay at all, and Susie said that she hasn’t seen a copay from any insurance company go over $30. 

With fewer sessions and lower copays, virtual care is a great option for patients who find care to be cost prohibitive.

If you don’t use insurance, our cash pay fee for virtual care is $35 for sessions under 30 minutes and $70 for sessions 30-60 minutes.

Will I need any special equipment?

Nope! It’s our therapists’ job to make sure you can do everything you need with whatever you have.

Susie will occasionally suggest exercises that require bands. In that case, she will have bands cut, ready, and waiting at the front desk for clients to pick up during slow hours to limit exposure.

Will I get better?

We hope so! 

Unfortunately, it’s impossible to answer that without evaluating your individual condition. However, yes, we do see great outcomes using virtual care!

How do I schedule a virtual appointment?

Glad you asked! 

You can go directly to our “request a referral” page and select “video conference”. Alternatively, you can call in and request to make a virtual appointment with your therapist.

request appointment form used to schedule in-person and virtual telehealth physical therapy visits

Ready to get started? Schedule your visit (virtual or in-person) today!


older woman with her laptop completing telehealth physical therapy exercises with her physical therapist virtually

Source: Susie Williams, DPT

Avid gamers can tell you that the world of esports isn’t always easy and pain free. Learn the 3 most common video game injuries and how to treat, and more importantly, prevent, these injuries to keep your game hands strong.

Although we don’t talk about them as frequently, injuries in esports are fairly common. I spoke with certified hand therapist Doug Rich at our Red Mountain Clinic who has seen and treated the gamut of video game injuries.

Doug boasts an impressive resume with 25 years’ experience as a physical therapist, 15 years as a certified hand therapist, and a certification in trigger point dry needling that makes him one of only a handful of hand therapists in the valley that can perform dry needling. 

I asked Doug about the most common gaming injuries, causes, symptoms, prevention, and treatment.

What are the Most Common Video Game Injuries?

The most common video game injuries we see are gamer’s thumb, carpal tunnel syndrome, and tennis elbow. However, the world of video games is more expansive than just console games. Doug breaks common video game injuries into 4 main categories:

  • Console video game injuries. These are the most common injuries that bring gamers into the clinic. Most common injuries include gamer’s thumb and tennis elbow.
  • Computer video game injuries. These injuries are consistent with desk-job injuries, with carpal tunnel syndrome being the most common.
  • Wii Sports & active video game injuries. It’s true; you can develop the same injuries as tennis, soccer, bowling, etc. by playing the esport equivalent. We encourage active game players to follow the same prevention techniques as athletes playing that sport. Make sure to warm up properly, keep good form (yes, really!), and keep up strength and mobility work. And remember to take a break since you won’t get as winded or play as long as if you were really playing the sport.
  • Virtual reality video game injuries. Virtual reality has opened up a whole new world of video game experience where players are fully immersed in the game. While doing this, faces and eyes are covered, and players are unable to see what’s around them. There has since been a surge in falls and acute injuries in virtual reality players that we’ve seen in our clinics.

Since gamer’s thumb, carpal tunnel syndrome, and tennis elbow are the most common game-related injuries, we’ll dive a little deeper into those to teach you what you can do to relieve some of your pain without giving up your hobby (or career – Twitch and YouTube have really changed the game here, turning video games from a personal hobby into social media platforms, and sometimes, careers).

Gamer’s Thumb

Diagram of the tendons in the hand affected by the video game injury gamer's thumb

The most common and widely known video game injury gamers experience is gamer’s thumb. Like runner’s knee, it’s one of those pesky overuse injuries that comes with the territory when learning your body’s limits in a new activity. 

What is Gamer’s Thumb?

Tenosynovitis of the first compartment of the wrist, more commonly known as gamer’s thumb or de Quervain’s syndrome,Gamer’s thumb  is characterized by inflammation of the tendons in the wrist and thumb, typically presenting as a sore thumb or wrist pain

This is caused by repetitive use, and in this case, repetitive video game play. It’s also especially common for new mothers due to the repetitive action of lifting their new baby.

Alternative Names for Gamer’s Thumb

You may hear this common injury referred to by many names. The technical diagnosis is tenosynovitis of the first compartment of the wrist. Yeah, it’s a mouthful! That’s why gamer’s thumb has lots of nicknames, including:

  • de Quervain’s syndrome
  • de Quervain’s tenosynovitis
  • Gamer’s wrist
  • de Quervain’s disease
  • de Quervain’s tendonitis

What Causes Gamer’s Thumb?

Specifically for video game use, the most common cause is the repetitive motion of consol or keyboard play. Engaging in these repetitive motions for a prolonged period of time with little to no real breaks is the most common cause we see.

According to Mayo Clinic, there are a few risk factors and groups of people more prone to gamer’s thumb. Risk factors include:

  • Age. Most commonly 30-50 years old.
  • Sex. Women are more likely to suffer de Quervain’s syndrome. However, it is unclear whether that is a genetic predisposition or due to the repetitive motion of picking up a new baby being a primary cause. There is no evidence that suggests women are more likely than men to get this injury from video games.
  • Pregnancy. Some evidence suggests a correlation between pregnancy and de Quervain’s syndrome.

Symptoms of Gamer’s Thumb

If you’re big into esports, it’s pretty easy to tell when you’ve developed gamer’s thumb. Look out for these 3 symptoms:

  • Pain in thumb, especially during / after gaming
  • Wrist pain, especially during / after gaming
  • Pain specifically when rotating thumb and wrist down away from your forearm

If you’ve been experiencing any of these symptoms, you can do this quick at-home test to see if you could be suffering from gamer’s thumb:

If you experience pain completing the test above, we recommend making an appointment to get checked out by a certified hand therapist*.

*Note: Did you know that in many states, Arizona included, you don’t need a referral to see a physical therapist? In a direct access state, you can skip the general and move right toward physical therapy treatment.


Treatment & Recovery for Gamer’s Thumb

Good news! Gamers typically don’t require a lot of time off for gamer’s thumb. Only in severe cases where pain becomes unreasonable and you can no longer maintain your daily activities does Doug recommend a prolonged break from gaming.

Physical therapy has proven to be extremely successful in treating gamer’s thumb and other game-related injuries. 

Typically your treatment will begin with an assessment of the injury. Your therapist will work with you on some stretching and strengthening exercises. They may also include ice and electronic stim in your treatment plan.

Below, you’ll see some hand exercises for gamers, hand and thumb stretches, and more treatments we do with our patients suffering from gamer’s thumb.

Additionally, Doug mentioned that he has seen an up to 50% increase in recovery with patients by incorporating trigger point dry needling into their therapy. Dry needling uses a tiny needling to quickly release muscle tension; Doug refers to it as “30 massages in 30 seconds”. 

Very few hand therapists are also certified in this technique. Doug is one of only a handful in the Phoenix area that is able to incorporate dry needling into his hand therapy treatments.

Related content >> Hand Therapy: Thumb Arthritis and Trigger Point Dry Needling

Carpal Tunnel Syndrome from Gaming

Diagram of the tendons in the hand affected by carpal tunnel syndrome

Carpal tunnel syndrome is most well known as the desk-job injury. There’s been a lot of research and literature about setting your desk up properly and using the right keyboard setup to avoid this injury.

However, there’s less information out there regarding carpal tunnel from gaming. Carpal tunnel syndrome is one of the most prominent esport injuries, and it can affect all types of gamers.

What is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow pathway that runs from your wrist to your hand. There is a nerve called the median nerve that runs through it. The median nerve can become compressed from overuse and/or a poor set-up, causing numbness, tingling, and weakness in your hand.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel in gamers is caused by repetitive gripping with an extended wrist. This is common in both console and computer video games, as well as traditional daily computer use.

According to Mayo Clinic, there are a few risk factors and groups of people more prone to carpal tunnel syndrome. Risk factors include:

  • Sex. Women are more likely to suffer from carpal tunnel syndrome. This is likely due to the fact that the carpal tunnel passage is more narrow in women than men, making compression on the median nerve more likely.
  • Anatomy. Although women are typically more likely to have a more narrow carpal tunnel, this can be a risk factor for both men and women. Additionally, acute injuries and arthritis can alter the carpal tunnel, making it more narrow and more likely to compress the median nerve.
  • Medical conditions. Diabetes, rheumatoid arthritis, menopause, thyroid disorders, kidney failure, and lymphedema are known to be risk factors.
  • Pregnancy / fluid retention. Fluid retention can cause pressure within your body that can irritate or initiate compression on your median nerve, causing or worsening carpal tunnel syndrome.
  • Obesity. Obesity is also linked to increased risk of carpal tunnel syndrome.

Symptoms of Carpal Tunnel Syndrome

If you believe you may be suffering from carpal tunnel syndrome from gaming or otherwise, there are a few tell-tale symptoms to look out for: 

  • Hand numbness, particularly in your thumb and first 2 fingers
  • Thumb numbness while playing video games
  • Tingling or pins-and-needles feeling in your hands, particularly in your thumb and first 2 fingers
  • Hand weakness causing you to drop things or lose your grip

If you’re experiencing the above symptoms, we recommend seeking medical attention.

Treatment & Recovery for Carpal Tunnel Syndrome

Here’s the real deal: as a physical therapy company, we feel extremely confident in the benefits and positive outcomes associated with physical therapy. We’ve found that in most cases, physical therapy can eliminate the need for invasive surgeries and excessive medications.

That’s why I was surprised to hear Doug tell me that, while physical therapy can certainly assist carpal tunnel patients with increasing strength and eliminating symptoms, it is a long, drawn-out road with inconsistent levels of success. 

Prevention is a better goal. You can decrease the pressure on your median nerve that causes carpal tunnel syndrome by correcting your head and shoulder position. This eliminates the need to bend your wrist excessively while squeezing your remote.

Simply sitting up tall will usually correct poor head and shoulder positioning.  If the front of your shoulders are too tight, try this pec corner stretch to loosen those muscles and improve your posture.

According to Doug, the surgery for carpal tunnel syndrome is relatively quick and easy, and patients typically see immediate success. In fact, it’s common for surgical patients to make a full recovery.

However, physical therapy and adjustments to your set-up for your esports and/or other activities are always a great place to start to determine the extent of damage and whether that can be reversed with manual therapy and splinting.

Related content >> How Better Posture Could Improve Carpal Tunnel Syndrome

Tennis Elbow from Gaming

Diagram of the tendons in the arm affected by tennis elbow

Don’t let this name fool you; gamers suffer from tennis elbow fairly frequently, and not just as a result of too much time playing Wii Tennis.

In fact, tennis elbow is a common injury resulting from any repetitive wrist and arm movement, as well as activities that engage your grip, like weightlifting, gymnastics, and you guessed it, esports.

What is Tennis Elbow?

Tennis elbow, technically referred to as lateral epicondylitis, is a type of tendonitis where the tendons that run from your elbow down through your forearm become inflamed, typically due to overuse.

What Causes Tennis Elbow?

Aside from traditional repetitive use, prolonged grip on a gaming console without proper posture, and particularly, without regulated breaks can cause these tendons to become inflamed, causing elbow pain. This is the most typical cause we see in esports enthusiasts.

While we learned that there are several risk factors for other video-game-related injuries, tennis elbow doesn’t typically involve any specific risk factors beyond activities or careers that involve repetitive arm movements.

It typically comes down to repetitive gripping and bending the wrist up or down. This is exacerbated if shoulders are not retracting (drawing back) and moving to help assist this movement. 

To decrease the stress on your elbow, avoid moving just your wrist; instead, retract your shoulders to help take some of the pressure off your elbow.  

According to Mayo Clinic, most cases are seen in adults ages 30-50.

Related content >> What to Do About Tennis Elbow

Symptoms of Tennis Elbow

If you’ve been experiencing pain in your elbow and forearms due to prolonged video game use or any other repetitive motion, it’s possible you’re suffering from tennis elbow. Tennis elbow typically causes pain and weakness during your preferred activity as well as the following everyday tasks:

  • Shaking hands
  • Turning a door knob
  • Holding a coffee cup

Doug shows a quick assessment he does to determine if a patient is suffering from tennis elbow:

If you’re experiencing any of these symptoms, we recommend making an appointment with a certified physical therapist (for elbow issues, you don’t need to specifically go to a hand therapist) to assess your injury.

Treatment & Recovery for Tennis Elbow

When symptoms are acute, Doug recommends taking a short break from your gaming activities to allow the inflamed tissue to heal. Only in severe cases where pain becomes unreasonable and you can no longer maintain your daily activities does Doug recommend a prolonged break from gaming.

Physical therapy has proven to be extremely successful in treating tennis elbow from gaming. 

Typically your treatment will begin with an assessment of the injury. Your therapist will work with you first to improve your posture and stretch out the front of your chest, allowing you to play with less pressure coming down your arms.

Your therapist will also work with you to stretch the area around the tendons that come down through the elbow and become inflamed with tennis elbow. Additionally, they will provide eccentric exercises to strengthen the arm and thicken those tendons to avoid repeat injury. They may also include ice and electronic stim in your treatment plan.

Like gamer’s thumb, Doug mentioned that he has seen big improvements in patients by incorporating trigger point dry needling into their tennis elbow therapy. We recommend looking for a physical therapist certified in dry needling when you’re assessing your treatment options. 

Related content >> Tennis Elbow: Not Just for Tennis Players

How to Prevent Gamer’s Thumb & Other Video Game Injuries

The two best ways to prevent video game injuries are built in breaks and creating a proper set-up that allows you to play with good form and posture.

Related content >> Tips To Prevent Injuries At Your Desk Job

Take a Break to Prevent Video Game Injuries

The best way to prevent gamer’s thumb and other video-game-related injuries is to take a break every hour. Get up and walk around for just a few minutes. It helps to set a timer or alert on your phone to make sure you don’t get distracted and remain stationary for too long.

The biggest thing I heard Doug say in our interview was the importance of breaks during marathon gaming sessions. In fact, when I asked Doug, “What would you like avid gamers to know?”, he only had one statement: Take. A. Break.

We all know that prolonged periods of sitting and repetitive motions can have a negative impact on our health. That’s why those smart watches yell at you every hour to get up, even if you already ran a marathon that day.

It’s easy (or at least easier) to make yourself get up in the middle of the work day. I mean, who doesn’t enjoy getting away from their desk for a few minutes? But, gamers are passionate about their game play. It can be difficult to want to step away, even for a few minutes.

Many gamers will take ~30 seconds, shake their hands out, and return to playing. Doug warns this is not enough. The prolonged sitting position causes stress on your tendons running all the way down to your hands. The only way to properly care for your body and prevent these injuries is to stand up, put the console down, and walk around for a couple of minutes before returning to play.

These few minutes can prevent painful injuries down the road. It’s always better to sacrifice a few minutes up front so that you don’t have to sacrifice a few weeks off later on due to an injury.

Set Yourself up for Success

Additionally, maintaining a good set-up with your computer or gaming system is very important

If you’re using a keyboard, invest in one that is ideal for long periods of use. Also, make sure your wrists are elevated above your fingers. Consider a standing set-up with your gaming console, and make sure you’re using controls designed for long periods of use. 

Have you been experiencing pain playing during or after gaming? Schedule a free 15-minute injury assessment to determine if you might be suffering from gamer’s thumb, carpal tunnel syndrome, or tennis elbow.


Video game injuries collage graphic

Sources: Doug Rich; PT, OCS, CHT | Mayo Clinic 


Foothills Sports Medicine Physical Therapy is celebrating 20 years in business! Foothills’ CEO, Mike Basten, PT, DPT, first opened the doors to the Ahwatukee clinic in fall of 2000. And now, 20 years later, we have 35 clinics between Phoenix and Tucson and have helped over 500,000 patients #GetTheirMoveBack!

As providers of physical therapy in Arizona for 20 years, our reputation hasn’t been built on luck. It’s been built on our daily commitment to the needs of our patients and clients. Our growth from 1 clinic to 35 speaks to the loyalty of our referral sources, our patients, our clients, and the positive outcomes they’ve experienced through Foothills.

Being good isn’t good enough at Foothills. We strive to improve each and every day. This means that we are always pushing the envelope to improve our services, and exceed our customers’ expectations. We aren’t just a place for physical therapy, we strive to be the place for physical therapy.

We’re grateful for the support we’ve earned over the years, and look forward to serving the physical therapy needs of the community for years to come.


It is the middle of November and you are at your son’s club baseball or daughter’s club softball game and you have been informed your child’s teammate is having to sit out this tournament because their arm hurts.  Or even worse, this may be your son or daughter who is needing to sit out. As a father to 3 baseball players who all play club/travel baseball, I have seen this firsthand.  It is stressful for the player, the family, and the team. It happens more often than one would think. In the blog below, we will talk about overuse arm injuries in throwing athletes. As well as some of the reasons for them and what to do about them.

Early specialization and the rise of club/travel teams

Youth sports are competitive, there is no doubt about it, and today’s parents (and kids) have the stress that their kids have to play club sports in order to stay competitive. Club or travel ball teams now dominant youth sports and have become a lucrative business model for coaches. With this development, we have also seen the rise of kids playing one sport year-round or one-sport specialization.

Here is a list of some of the reasons for specialization:

  • The more my child plays, the better they will be.
    • This statement is true, the more you practice a specific skill you will get better at it. But, being good at a sport is multi-faceted and so many things go into being “good”. The repetition of the sport is only one piece.
  • If they don’t continue to play, then they will lose their spot on the team.
    • This is the stress that all parents deal with being part of the travel team sports (including myself!). But we need to understand that this is just not true, it will not be the end of the world if your child takes a season off. It may actually be a good thing!
  • The coach of the team makes his living running travel teams.
    • As adults, we need to make a living and provide for ourselves and our families. If someone can make a living coaching the game they love then more power to them. We as parents need to remember that the coaches and organizations need to keep their teams full and playing year-round to ensure their businesses are successful. For this reason, we must be our children’s loudest and best advocate.

Individualized coaching versus a general strength and conditioning base:

This follows with early specialization and the stress placed on parents for their children being the starting shortstop on their team (or fill in the blank). If you are looking to get individual coaching lessons, there is no short supply of coaches offering these services.  The same travel ball coaches are probably offering lessons or there are numerous facilities/coaches that offer coaching lessons.  This is definitely a great resource to improve your skill set and I have used them for my kids. They need to be spending time working on strength, flexibility, balance/coordination, speed, and agility.

Our bodies need and crave variability which we can get playing more than one sport but if they only play one sport then it is even more important that we supplement activities like:

  • Strength and Conditioning Activities
    • The number one thing coaches look for at the higher levels of sports (high school and above) is the player’s physical attributes – strength, speed, and quickness. Of course, athletic ability is very important but that can be worked on; they want to see that athletes are athletic.
  • Playing Outside
    • When kids go outside and play, they run, jump, skip and perform activities that translate to them being more coordinated, agile, and not mention happier.
  • Play other sports for fun…
    • Who said that every game played has to be serious and played to win? Grab a basketball, go to the park and shoot some hoops.  Have fun!

So what do I do to keep my child from hurting his arm?

Research has shown the #1 reason for youth arm injuries is lack of rest. Kids are simply playing too much and not getting enough rest and recovery time in between playing. Here are a few tips to help keep your child’s arm healthy throughout the travel ball season:

  1. Keep an eye on their pitch count and recovery
    • There are great resources to help guide you in understanding how much rest your child should get based on how many pitches they have thrown. I recommend Pitch Smart by Major League Baseball (mlb.com/pitch-smart).
  2. Develop a Routine to Take Care of their arm

    • All ballplayers need to be doing a strengthening program to address all the muscles of the shoulder to ensure they have the strength and endurance needed to handle the stresses placed on it with throwing. We at Foothills Sports Medicine are a great local resource when looking to develop an Arm Care Program (foothillsrehab.com).
  3. Work on strengthening your legs and core.
    • The force to throw a baseball fast does not come from your arm but actually comes from your legs and core. So if you want to throw the ball harder and take the stress off your arm then get your legs stronger!! Our FAST trainers are a great resource to help build bigger legs (fast-training.com).

 What do I do if my child’s arm is hurting?

As a physical therapist and a father of baseball players, I get asked this question both in the clinic and at the ballpark. Here are my suggestions if your child’s arm has been hurting from playing baseball or softball.

Stop Playing and Take a Break

Seems pretty obvious but as I said earlier there can be a lot of stress involved in playing on a team from not wanting to let the team down to your child not wanting to stop playing. But if he or she has been having some complaints from some time then the first thing is to stop playing to allow the injured area (shoulder, elbow, etc.) to rest and allow the things to calm down. If things do not get better then see a physical therapist.

Go See a Physical Therapist to Assess your Child

Once you have shutdown your child from playing and they are still having pain, then the next step is to have them assessed by a medical professional as you want to rule out anything serious and then get a good plan to get them healed and back playing.

One Tip, see a professional that has experience working with throwing injuries as it does make a difference!! It is important to get the correct diagnosis and plan set up. Arizona is a Direct Access state, so that means you do not need a referral from a doctor to see a physical therapist. PTs are a great first provider to see these types of injuries as they can assess the athlete and deem if a referral to a physician is warranted.

Not All Rehab Programs are the Same…

Physical therapy is normally the first thing recommended for arm injuries in overhead athletes. Seeing a physical therapist will help ensure your child is on the correct program and will recover as quickly as possible. The other piece of the rehab program in the throwing program. It is imperative that a throwing program is implemented prior to being released to their sport to ensure their arm has been conditioned to handle the stresses. This is biggest thing that I see missed when a patient comes to see me with a recurring arm injury.

We at Foothills Sports Medicine Physical Therapy/FAST have the knowledge, skill, and compassion to help keep your baseball/softball player’s healthy and on the field. Contact a clinic near you for further information and questions.


Imagine that while waiting at a stop light in your car you look into the rearview mirror only to see a car barreling at you without any indication that it’s going to stop. You instantly tense up as it impacts the back of your car and your head moves forward and backward possibly hitting the steering wheel or headrest with the force that is transferred through the car to your body. A couple of days later, you start to feel a persistent pain in your neck, shoulders and back. This pain is associated with a condition commonly called whiplash.

Fortunately for us, whiplash is a treatable condition. It is recommended that you be evaluated by a physical therapist as soon as possible following a motor vehicle accident to rule out more serious injuries. If left untreated, whiplash can lead to more chronic pain, muscle changes and even changes to your sensory systems.

Physical therapy for treating whiplash would involve decreasing pain, increasing neck mobility, increasing muscle strength and increasing overall endurance for functional activities. Specifically, treatment may include:

  • electrical stimulation (TENS)
  • cupping
  • intramuscular dry needling
  • manual soft tissue work
  • manual joint movements
  • postural exercises
  • strengthening exercises
  • vestibular exercises
  • re-training of the sensory systems
  • breathing exercises
  • training in work positions

Recovery time from whiplash can vary from as little as a few days and as long as a few months. It is important that you give your body some time to recover. Once your body is fully recovered you will be able to return to your prior level of activity safely.

If you ever experience neck, shoulder or back pain schedule an appointment at Foothills Sports Medicine Physical Therapy to Get Your Move Back!

Have you ever been stuck thinking who do I call? Where should I go? What’s the best option to get my injury assessed? Am I going to the doctor just to get referred somewhere else? These are all valid questions that you deserve to know today!

Get PT 1st is the movement that you do not have to take time off work to go to a doctor, get assessed, get a referral elsewhere, take more time off work, schedule another appointment and then arrive at your physical therapy appointment. That is too many steps that are time and money consuming. We want you to get the care you need the fastest and most efficient way possible. This starts with direct access.

What is Direct Access?

Direct access allows a patient to directly go to a physical therapist without the prescription or referral of a physician.

Benefits of Direct Access?

  • Saves Money
  • Saves Time
  • Gets Better Faster

Did you Know?

Physical therapy is not just for sports and orthopedics but can also treat patients in need of help with disorders such as Parkinson’s and Alzheimer’s Disease. Dizziness, headaches, stroke rehab, cardiac rehab, fractures are just a few of the many services a physical therapist can help you to get better too.

Physical therapists are also trained to screen for serious medical conditions including and are not limited to cancer. You will be in good hands and if any red flags do pop up at your appointment then your physical therapist will get you the care you need!

Physical therapists can do things that your doctor may not be capable of:

  • Assess your injury risk with a movement screen to better assess a patient’s weaknesses
  • Find the workout/plan that best fits your needs
  • Speed up your recovery faster
  • Correct your alignment and postural issues

Why not take the step to Get PT 1st? Take action with direct access, save money, and see improvement! Schedule an appointment with Foothills Sports Medicine Physical Therapy Clinic near you! We want to help you Get Your Move Back!

Soccer players, in particular, are susceptible to lower body injuries and often require physical therapy for their ankle and knee injury treatments.

Due to the nature of the game, soccer players are at risk for a different scope of sports injuries. A seemingly minor hit early in the season can knock any player out of the line-up for the rest of the year.

This is something Phoenix Rising fans know all too well. For many, the concern over the safety of their favorite player is just as important as the final score (if not more).

As the 2019 season kicks off, players are preparing to take to the field in the safest way possible.

Both professional and minor league soccer players are at high risk for lower body injuries like these:

  1. Ankle Sprains

Ankle sprains can happen in a multitude of ways. Switching directions while running, turning on the spot, impact (kicking a ball), tripping over another player, and getting kicked are all common causes.

When the RICE method isn’t enough, players seek physical therapy for their ankle. A licensed physical therapist works with the player to strengthen and heal the injury through regular sessions.

  1. ACL Tears

The anterior cruciate ligament(ACL) is a ligament that provides stability to the knee joint.

While an ACL tear is much different than a sprain, the injuries occur in the same manner. It’s easy to tell the injuries apart. ACL tears are often accompanied by pop felt in the knee. (Ouch!)

Surgery is required for a tear to properly heal. The recovery period for an ACL tear can last two to six months — however, it may take nine months for you to return to your pre-injury condition.

  1. Cartilage Damage

Aside from ACL tears and sprains, there is another reason why knee injury treatments are common for soccer players: cartilage wears down over time.

Eventually, joints become stiff and painful. Of course, when you move differently because of pain, you stand a greater chance of injury. Physical therapy and continuous monitoring can reduce the pain associated.

  1. Stress Fractures

Shin splints and Jones fractures (where the bones running along the small toe is injured) are the most common stress fractures.

The stress placed on the skeletal structure through repeated impacts (running, kicking, crashing into other players) can lead to chronic pain. Most of these injuries are treated with therapy, but, in certain cases, surgery is required for the break to fully heal.

  1. Pulled Muscles

All of the injuries listed above are painful and take weeks, if not months, to heal. But just because the pain from pulled muscles eases within a few hours, it’s not an injury to shrug off.

If a player is experiencing repetitive pulled muscle pain, there may be an underlying issue at hand.

A licensed physical therapist would be able to access the problem and come up with a treatment plan that could prevent future, serious damage.

Soccer is a high-impact sport, but that doesn’t mean players should throw in the towel. Safety precautions such as proper running shoes, hydration, and preparation can reduce the likelihood of needing emergency knee injury treatment or surgery.

Has a soccer injury put you in need of physical therapy for your ankle? Schedule an appointment at one of our Valley-wide locations. We’re ready to get you back on the field and show you how to avoid any future missteps.