Balance problems is the leading cause of injury for senior citizens in the United States. This may stem from a majority of issues. It could be a specific cause such as issues with your sensory system leading to imbalances. Or, a new injury that limits movement and places you in unexpected positions. It could be you have issues from an old injury that has not been addressed and have slowly led to a point where you are constantly catching yourself from falls and may consider or are learning to ambulate with an assistive device.

There are several major components your body uses that assist with your balance. Your physical therapist will assess these components before creating a custom hands-on physical therapy approach.


Your vision helps your brain to organize where it is in space. Commonly where there are deficits in other areas that affect balance, individuals can become reliant on vision. It is not unusual to have a patient who can stand perfectly still on a single leg with their eyes open and quickly become a fall risk after they close their eyes.


Close your eyes and move your arm over your head. Knowing where your arm is without seeing it is proprioception. Issues with proprioception can range from decreased sensation, not uncommon in the lower extremities and a common factor with balance disturbances, to weakness that limit the patient’s ability to stabilize.

Vestibular system

Your vestibular system is responsible for letting your body know when you are accelerating. Patients may present with issues such as turning over in bed causing an uncontrolled spinning and a sense of vertigo. This can come from several causes including issues with the sensory organ itself to the nerves the conduct theses signal having issues.

Putting it all together

Multiple factors may be tied together leading to issues with balance. Your physical therapist may test for components individually or as a group. We run several tests to determine how unstable you are with dynamic movement and what components are the limiting factors.

For example, a patient can have issues with stability when reaching outside of their base support but have no limitations when they are on uneven ground.

What to Expect

Depending on your presentation, your physical therapist will work to create a hands-on plan to address your specific deficits to improve your balance and stability. Whether your limitations prevent you from performing a higher-level activity such as dancing or learning to use an assistive device to help with balance, we will be there to help get your move back.

Depending on your goals and limitations with balance problems, physical therapy has a place for you. Visit the location nearest you to get your balance back!

Shoulder surgery can be many things: removal of bone spurs, a labral tear, tendon repair, a fracture following a fall, a rotator cuff repair or a myriad of other issues. While your surgeon will dictate the specifics of what you can and can’t do based on your specific surgical procedure, you will likely see a therapist to aid in your recovery.

Here are some things you can expect from your time in therapy:

Types of Protocols

Depending on the extent and specific type of surgery, you may or may not be expected to avoid certain movements. This can range from no restrictions at all to no overhead movement and gentle stretching. Protocols can be a simple do’s and don’ts discussion with your surgeon. And sometimes they can be a more extensive plan that limits activity until certain milestones are reached. Expect your physical therapist to review these and discuss any limitations you may have. This may mean relying on family or friends to help with tasks like driving or modification of activities. For example, sticking with button-up shirts until you can raise your arms overhead.

The Range Before Strength

Typically you can expect a focus on the range of motion before you begin any significant strengthening at physical therapy. It would not do you any good to be able to carry a 50-pound load if you can’t run a comb through your hair or place a can on a shelf. Not to say strengthening would not be performed, typically while in physical therapy you will be strengthening the supporting tissues such as your grip, elbow strength, ability to position your shoulders or even neck strengthening while progressing your range of motion.

Strength To Function

As a patient’s protocol allows and functional range returns, strengthening will begin. Typically strengthening is a mix of resistance and stability training. This can mean general strengthening you see performed at a gym, such as pushing and pulling tasks. These tasks will eventually be converted into functional tasks such as changing a lightbulb and pushing yourself out of a chair.

Return To The Sport

The last stage of physical therapy is the return to the sport or activity. Dynamic shoulder tasks such as throwing, boxing, dealing with unexpected forces like walking your dog or catching a ball come last. As you work with your physical therapist they will keep your end of treatment goals in mind. Goals like returning to riding a motorcycle may be more important and different for you then returning to climbing for another patient. That is where patient-specific treatment comes in. Your therapist will work to return you to that final level you are reaching towards and progress you to that return. Every shoulder is different, every surgery is different, and every therapy treatment plan for your shoulder is different. It is our job as therapists to work toward your goals and get you back to what you enjoy.

Shoulder surgery can be many things and your surgeon will dictate the large strokes. A patient can have short bouts of care with minimal restriction to longer more intense therapy. It can range widely but I hope this helps to give you an idea of what therapy may entail.

For more information about shoulder surgery aftercare follow up with a Foothills Sports Medicine physical therapist near you!

While tossing a football you noticed a sharp pinch halfway through your throw that just does not seem to go away and has started to limit your tight spiral. Going for your morning jog, you step on a patch of soft soil, you notice your knee has felt a bit “off”. Picking up boxes while cleaning the garage is more challenging on the low back then you expected. Maybe you notice a sharp pain on the bottom of your feet in the morning as you walk to brush your teeth and it does not seem to be going away. You want to have everything checked out but are not sure where to go.

The licensed physical therapists at Foothills Sports Medicine are always looking for ways to help the community. We offer a Rapid Recovery® Injury Assessments for any person who may be concerned they have an injury and are curious if physical therapy should be used during treatment. An assessment consists of a short examination with a therapist where he or she will examine your particular limitation and determine if physical therapy may be the treatment option for you.

During the Rapid Recovery® Injury Assessment, the therapist will set aside time to sit and talk with you personally about your injury, condition, or functional limitation. He or she may take some preliminary measurements and perform several special tests to parse out information about your particular issue and tailor the appropriate answer for you. At the end of the assessment, the therapist may:

  1. recommend for you to begin physical therapy treatment,
  2. recommend for you to follow-up with your primary care physician if it is outside of our scope of practice
  3. prescribe some custom exercises for your particular issue
  4. recommend a mix of any of these.

The assessment allows you to receive a plan and approach for your limitation from a licensed physical therapist. It lets you meet the therapist and get a feel for the facility and staff and discuss how we can meet your needs. If it is determined that physical therapy may be the best option for you then it will permit the therapist to have a head start on your custom plan to improve your particular functional limitation and jump start your recovery.

Physical therapy helps to treat a wide array of injuries, limitations, pains, and soft tissue concerns. Given all this, sometimes it is hard to determine if physical therapy is the best choice for you. A Rapid Recovery® Injury Assessment allows both you and the therapist to have a quick meeting to work out any of these issues or concerns.

The licensed physical therapists at Foothills Sports Medicine are there to help make this decision a more informed one and help get you back to your everyday life, be that daily tasks, sports or work-related movement. Contact a location near you to schedule your free Rapid Recovery® Injury Assessment.

Myofascial cupping is an effective pain therapy. It helps reduce tension and adhesions in soft tissue to decrease pain and improve the mobility of tissue.

For a variety of reasons such as injury, overuse, or altered movement mechanics, areas of muscular tissue develop local areas of restriction or trigger points. This can cause pain or limit movement further compounding problems. With myofascial cupping, fluid is pulled into the target area to improve the body’s ability to heal itself. Broad, superficial muscles, in particular, are good targets for cupping therapy.

Cupping can take several different forms:

  • Static cupping is the use of a single cup to several cups placed — and left alone — upon trigger points to allow fluid to be drawn into these areas. This tends to be the least aggressive form of cupping.
  • Static cups on a dynamic patient is commonly used when movement causes restrictions in the tissue to present themselves. Cups are placed along trigger points and adhesions while the therapist directs the patient to move through dynamic, specific movements in order move the tissue through common multiplanar movements. This further increases the fluid that passes through the area in patterns that the tissue follows.
  • Dynamic cupping on a static patient allows the therapist to encourage fluid flow throughout the entire muscle or system of movement. This tends to be more aggressive than the prior two applications.
  • Dynamic cupping on a dynamic patient combines the movement of the cup with the movement of the muscular belly. This further increases fluid through the entire muscular belly while also moving the tissue through movements with restriction. This is one of the more aggressive forms of application of cupping therapy.

Whatever the application, cupping works as a pain therapy because it allows for the muscular fibers to repair and move with an improved efficiency. This, in turn, allows the patient relief from some of their pain as well as to increase their functional range and work to return to a higher level of function. If you have any questions consider asking a physical therapist at our various locations.