Dedicating yourself to your health and rehabilitation takes a lot of time and effort. We want to help you achieve your goals to regain full function. Here are a few tips to help you benefit from your PT experience.

1. Consistency

When your physician refers you to physical therapy, they usually recommend a series of visits for your plan of care. It is crucial to stay as consistent with your frequency of visits. The visits work by building upon each other, and when patients are consistent, they will progress in their exercises, function, and goals quicker. Consistency leads to better results!

2. Goals

Before coming in for your initial evaluation with a therapist, be sure to jot down a couple of goals that you want to achieve during your rehabilitation. Sure, we all want less pain and more mobility and strength; if you can make your goals more specific and functional, the therapist will be able to more-clearly direct and progress your rehabilitation. Examples include, being able to pick up your grandson, to be able to train for a half marathon by October, and to be able to go up and down the stairs at your house.

3. Preparing for your Session

If you’ve never been to physical therapy before, then you will want to make sure that you dress in comfortable loose-fitting clothes for stretching. After all, we want to stretch your hamstrings, not your jeans. Sessions are usually performed out in the gym where you will be neighboring with many other patients. It creates a wonderful dynamic atmosphere, and I’ve even watched patients become friends over the years. Please remember to be mindful of others by silencing your phone and avoiding any perfumes or scents.

4. Home Exercise Program

When you hear the words “H-E-P”, you should start getting excited! This is your PT homework that will be provided to you by your physical therapist or tech at the very beginning of your sessions. I can’t stress enough that the patients who routinely do their exercises and integrate the corrections given to them far excel those who do them on occasion. If you’re not sure if you’re doing an exercise correctly, ask! We are here to answer any of your questions to help promote a regular exercise routine. That said, when you are discharged it is routine practice to keep up with your HEP as you will continue to see improvements well past your last visit.

5. Posture

Our posture is so important in daily function. Even if you are coming in for an ankle sprain and I pick up on bad postural habits, I will be the first to address it. I like to provide preventative care on posture. The bottom line is make your work or anything you’re working on come to you. For example, placing a pillow under your elbows while reading on the couch can help with your posture.

6. Integration

Although we mostly address your orthopedic concerns, I can’t stress enough how much I have to remind people to improve their overall health in terms of staying hydrated, making healthy choices for clean eating and incorporating appropriate stress management techniques. This is not limited to exercises, meditation, breathing techniques and yoga. When you treat the body as a whole you are a much more likely to advance your goals.

If you have any further questions about maximizing your visit, don’t hesitate to discuss them with a therapist. Find a Foothills Sports Medicine Physical Therapist location near you and Get Your Move Back!

“I have pain in my knee when I do yoga,” said my patient during a free consultation at our physical therapy clinic. “It hurts mostly when I do this pose and while transitioning into a balance pose,” the patient said as he demonstrated the warrior II pose. After obtaining a small glimpse of his alignment during this pose, I started to see compensations that were increasing torque to his knee and likely contributing his pain. We proceeded to do a full screening, which unmasked the underlying culprits. Within a few weeks of targeted exercise and skilled manual therapy, he was reporting no pain with yoga, or with running and hiking anymore.

Similarly, a yoga teacher approached me with concerns about insidious low-back spasms that would come and go throughout her yoga practice or gym workouts. Analyzing her posture in standing, otherwise known as mountain pose in yoga, and some of her painful yoga postures and gym exercises, it started to become clear to me about the inherent core instability this teacher was experiencing.

We used breath work, postural cueing, and a core stability program that started from the foundation to advanced activities in daily life. The patient had a couple more spasm episodes, but they were less frequent and the intensity had diminished greatly. Eventually, the patient was able to report months of relief and the ability to return to her workouts.

Yoga can help people improve their flexibility, strength, and balance and help to manage stress levels. It is a practice that works on mind, body, and spirit, and requires guidance from a certified yoga teacher or yoga therapist to optimize alignment and progression of practice.

If you are unsure about certain postures in the class, make sure that you ask your instructor to clarify or provide a modification that works for your body. If you feel you need a little more help, talk to your teacher after class to get a more in-depth explanation or instruction.

Some aches and pains may require further analysis, and that is where a physical therapist can be helpful. A physical therapist will screen the yoga poses and your unique body mechanics to help address the underlying contributors of your pain. It is worth your time to come in to have these problems addressed so that they do not hold back your practice and exercise routine.

Please schedule a free consultation at your local physical therapy clinic to help you get back on track with your yoga practice.

Juliana Kroese is a physical therapist as well as a certified yoga teacher and yoga therapist, whose unique combination of skills helps yoga practitioners get back on their mat.

The weather in Phoenix is absolutely beautiful right now, and what better way to enjoy the outdoors than with a round of golf or a trip to the driving range? As you are taking advantage of this phenomenal golf weather, you might be experiencing pain and tenderness on the inside of your elbow. That pain is most likely medial epicondylitis, commonly known as “Golfer’s Elbow.” When a golfer routinely flexes their wrist too much during the follow through of their swing, they can develop golfer’s elbow on their trailing arm and may require physical therapy (Prentice, 2011).

Medial epicondylitis is inflammation of the medial condyle—located on the inside of your arm. This inflammation can develop from overuse or repetitive movement of the wrist flexor and pronator muscles because they are attached to the same condyle (Walz et al, 2010).

Typical signs and symptoms of this condition are tenderness to touch, pain while gripping a club, pain traveling down the forearm, and/or pain with wrist flexion (Prentice, 2011). This pain can range from slightly annoying to debilitating. The key is to catch the condition early.

To help prevent medial epicondylitis from developing, you should follow these key steps:

  • Proper swing mechanics: Having the proper form will help prevent an improper load placed on your elbow.
  • Rest in between rounds: Do not play three rounds of golf back-to-back if you have not played in a while. Make sure to rest your body between rounds.
  • Stretching before and after: When you overuse your muscles they become tight, which adds stress. Two good stretches to relieve muscle tension are to extend your arm straight by your side, and bring your fingers toward your forearm. The second stretch is to extend your arm to about shoulder height, then bring your fingers towards your face with your opposite hand. Hold each stretch for about 20-30 seconds and do the stretches three times a day.
  • Ice sore areas: If you start to feel some irritation in your elbow, begin icing that area because ice helps decrease the inflammation by reducing the blood flow to the area. Only keep the ice on for 20 minutes.
  • Use of anti-inflammatories: Taking anti-inflammatories can help reduce developing inflammation.

If you follow those key steps you will greatly decrease your chances of developing golfer’s elbow (Prentice, 2011).

Unfortunately, there are some cases where the pain and inflammation can accumulate to the point where home treatment is not an option. A physical therapist at Foothills Sports Medicine Physical Therapy can provide comprehensive physical rehabilitation to treat your golfer’s elbow (or any other golf related injury). Our physical therapists have excellent expertise of human anatomy, body movements, and demands of the sport. They can give you customized treatment options such as:

  • Ultrasound: This promotes optimal healing and decreases inflammation.
  • Rehabilitation: To treat and prevent further injury through strength, endurance, and flexibility training.
  • Manual therapy: We give you a soft tissue massage and trigger point dry needling, which can reduce stress placed on the elbow.
  • Taping: This prevents overstressing the muscles, and activates underused ones.
  • Education: We will teach you proper mechanics and provide a home treatment plan for continuing care.

Before the pain becomes unbearable and you are unable to play your favorite sport, come see us at Foothills Sports Medicine Physical Therapy. We can help you get back to playing your favorite game this spring.



Prentice, W. E., & Arnheim, D. D. (2011). Arnheim’s Principles of Athletic Training: A Competency-Based Approach. New York: McGraw-Hill Higher Education.

Walz, Daniel M., MD, Joel S. Newman, MD, Gabrielle P. Konin, MD, and Glen Ross, MD. “Epicondylitis: Pathogenesis, Imaging, and Treatment.” RadioGraphics 30.1 (2010): 167-84. Web. 25 Mar. 2017.

Juliana Kroese is a certified Yoga Instructor and PT at our North Central Phoenix physical therapy location. She explains how injuries can occur in yoga, and describes modifications you can perform to avoid these injuries and get the most out of your yoga practice.

Yoga. We’ve all heard of it. When we think of yoga, flexibility, relaxation, healthy lifestyles, and comfy workout clothes usually come to mind. In recent years, yoga has quickly become an exercise staple of Western society. We regularly hear people talk about practicing yoga, we see yoga magazines at checkout lines, and we spot flyers for free yoga events all over town – no experience required!

The yoga industry is booming, and more classes are being held at studios, your local gym, or even at free sessions in the park. The business has expanded by offering retreats in exotic locations for people to immerse themselves in a week-long course. These trends have led to an increase in yoga teacher training courses as well. These courses teach individuals about the history of yoga, the various poses, and how to instruct classes. Upon completion, successful participants are able to become accredited with the yoga alliance and begin teaching classes.

Like any physical activity, yoga may lead to injury if performed incorrectly. While it is possible to receive an incorrect adjustment from an instructor, most people become injured on the mat by their own doing. We are all susceptible to this – we may get carried away trying to replicate the person next to us, or mimic the cover photo on a yoga magazine and push ourselves and our bodies over a threshold. When this happens, we overstretch, we strain, and injuries occur.

Any form of exercise should be approached with the same mindset adopted by the medical field. First, do no harm. When starting a yoga class, individuals are strongly advised to discuss any injuries or health concerns with the instructor. An experienced teacher is always recommended if you are currently experiencing complex health issues, in addition to checking with your physician to see if you are ready to do yoga.  It is wise for individuals to enter a yoga class with knowledge about their condition and possible aggravating motions they should avoid.

Often, low back pain can be exacerbated by bending forward or backward. Therefore, individuals suffering from degenerative disc disorder should avoid excessive forward bend poses, especially when accompanied with twisting, and individuals with spinal stenosis or facet arthritis should generally avoid excessive back bending. It is always important to exercise caution and perform modifications to avoid straining the body.

Similarly, individuals with poor hip mobility may find themselves experiencing knee pain if they force rotations, such as in pigeon pose. Most yoga classes also incorporate a significant amount of weight bearing through the upper extremities, which could result in shoulder injury if performed incorrectly.

The most important questions to ask yourself before starting any pose are “How is my body feeling today?” and “How can I get the most out of this pose for my body on this day?” Any yoga pose can be performed in a variety of ways through modifications. This does not necessarily mean the poses are made easier; in fact, if done correctly, you can actually harness the challenging action of the pose to improve your body.

An example of this is Trikonasana, a standing pose in which the legs are wide apart, arms are spread out, and the individual bends to the side towards one leg, forming a triangle. For some, this is an opportunity to enhance flexibility while placing the hand on the ankle or floor, while other may use this pose to work on spinal lengthening or core stability by keeping the hand from touching the floor and activating the core to maintain this posture. Depending on the individual, the emphasis you place on a pose can change, so you can get the most benefit from it.

If you find yourself struggling in a yoga class and would like to receive some personalized tips to strengthen your practice, I highly recommend speaking with your PT to help you find the correct modifications. Contact your local Foothills Sports Medicine Phoenix physical therapy clinic today with and questions!

Our therapists are committed to helping you achieve your goals and attain a healthy, active lifestyle. We offer a free, no obligation assessment of your needs, which can be scheduled online here. For more PT advice, visit our blog.

Juliana Kroese, PT, is a Phoenix physical therapy expert located at our Central Phoenix facility. She is here to explain posture and how we really should be sitting and standing:

“Stand up straight and pull your shoulders back.”

We’ve all heard adage in some shape or form in our lives, especially in our childhood. The truth is that even though their intent was good their direction was wrong.

Anyone who has tried standing straight and pulling their shoulders back, or walking around with a book on their head will notice they cannot hold it for long. In fact they may develop muscle strains in their upper back or neck while doing so. The reason we develop these problems is because humans are not designed to hold this posture for long. Our bodies are happier when we are in motion.

Unfortunately, many of our back problems stem from our posture. Pain and dysfunction of the neck, upper back and low back are deeply correlated to the way we move and maintain our spine. The way we align our body matters. If we optimize our movements for functional gains we can reduce back pain.

Overall, jobs and daily activities in society are geared forward bending and slumped posture. Once we maintain these positions we develop muscle imbalances. Certain muscles become short and tight while others are long and weak. None of our muscles actually gain strength when we succumb to gravity by standing or sitting in a chair.

So how should we sit or stand?

I give patients two simple poses that have helped them achieve better posture. One is called “Show your medal” and the other is “Give the chin a twin.” They might sound silly, but they have helped patients of mine learn how to properly align their bodies.

First, imagine you just won an Olympic medal. The medallion will rest on your chest bone, also known as your sternum. Now follow the simple instruction: “Show your medal,” meaning that you show your medal proud. By doing so you will lift your sternum up and out in front of you, while your upper back remains soft and relaxed. This is a small motion, but will be enough to lift you out of your slumped posture and into a correct spinal curve. You will feel your chest expand, making your breathing deeper, and you will feel your shoulders drop and relax ever so slightly away from your ears.

Second, I tell people to “Give the chin a twin.” Patients lightly tuck their chin down and lengthen the back of the neck while keeping their breathing soft. This will correct the forward positioning of the head, which can shortened the majority of the neck muscles and cause pain and dysfunction.

Before they know it, many of my patients say they find themselves practicing “Show your medal” and “Give the chin a twin” while brushing their teeth, waiting in line at the grocery store, talking on the phone, and working at their desk!

It is also important to realize changing your posture will take time. You are teaching your spine a new position that it has not been in for a long time, and it will tend to feel uncomfortable. My advice is to stick with it, but do so incrementally. Use small moments in time to work on your posture until it becomes a habit. By improving your posture you could significantly lessen your neck and back pain. Consult a physical therapist if you have questions about your posture and what you should be doing specifically to improve your back pain.

Our physical therapy experts like Juliana at Foothills Sports Medicine Physical Therapy know how to help all kinds of pain. If you have questions about chronic neck, upper back, or lower back pain and would like professional advice, make an appointment today! To learn more about Phoenix physical therapy at Foothills Sports Medicine Physical Therapy and what our certified therapists can do for you, check out the Foothills blog.