On Track Physical Therapy

Stop Daily Annoying Knee Pain Without Taking Painkillers Or Having Surgery

Knee pain is one of the most commonly treated and surgically operated injuries in the world. It impacts you daily by making stairs or frequent lifting a nightmare. It might be stopping you from playing a sport with your child or going for a round of golf with your buddies.  Maybe you have had an x-ray performed, and been told you have degeneration or arthritis in your joint? While x-rays certainly do not lie, they also do not tell the entire story.

In fact, one study by Katz and fellow researchers showed that getting physical therapy first helped 60%-70% of knee osteoarthritis patients avoid surgery.  

Another study of 180 patients with osteoarthritis were separated into three groups: two different types of arthroscopic surgery, and a placebo (fake) arthroscopic surgery. Interestingly, the two arthroscopic surgeries were no more effective than the placebo (fake) surgery.

Staggering information isn’t it? That’s a lot of money to throw at a surgery with questionable outcomes. Not to mention you probably will have to go to therapy after surgery anyways. Fortunately to both you and me “arthritis” is a normal change in the body that happens over years of accumulated stress and as a result can often be improved through conservative measures.

Why Does My Knee Still Hurt?

The knee often takes the brunt of the force for lack of mobility or control in the hip or ankle. The degrees of freedom in the knee are much less than the ankle or the hip. If motion limitations exist in the hip or ankle, the knee will start creating wear patterns as a result. This wear pattern typically presents itself in some form of faulty orientation of the knee. The body will always take the path of least resistance. So if the hip and ankle orientation are not optimal due to restrictions, this creates a twisting mechanism at the knee as it tries to adapt and accommodate for other structures that are not functioning at optimal capacity.

As you can imagine, this makes the knee much less adaptable and resilient.

Maybe you have had a previous injury to the knee? If optimal function and adaptability was never restored in the knee afterwards, then the overall level of resiliency to injury of the knee will remain low as well.

So how do we reduce pain in the knee so you can squat, go up and down stairs, and walk without that annoying pain?

1) Perform exercises that will get the muscles around the hip strong. This program is often much trickier than going to the gym and working out. Remember we have adaptive changes to deal with that have occurred in the body as a result of dysfunctional or overused movement patterns (most likely both).

Because the body currently has a very low level of resiliency we need to be careful of the amount of load applied to the knee. This is one reason why a low impact endurance program can be very beneficial such as riding a bike 10-30 minutes a couple times per week at about 75% effort. In fact, a lot of research has actually shown that endurance training can increase pain tolerance.

But ultimately, we need to gradually start to load the knee again in a functional way to improve tolerance to activity. We can do this by improving hip function, this will help take some of the stress off of the knee. Here are a couple options that may be helpful. 

As part of a physical therapy treatment, we can perform different manual techniques such as dry needling that can help modulate pain. However, if we never address other limitations above and below the knee joint, the pain may remain or linger much longer than necessary. This is why a detailed assessment is required, so specific interventions can be given to restore optimal function and abolish pain.

Looking at the way you move through different ranges of motion and see where limitations might exist in both the hip and ankle. This will often direct which set of particular exercises and manual therapy techniques would be most important for your particular set of limitations. This is why we at On Track Physical Therapy will take you through a movement assessment every visit and multiple times per visit. It allows us to be very targeted in what we do as opposed to throwing things out and hoping something sticks, which unfortunately is what many other providers do. This allows us to help you get off painkillers, get some sleep, and keep an active lifestyle. If that sounds like something you’d enjoy, then schedule an appointment or a FREE discovery session to take things for a test drive.  

References

Katz, Jeffrey N., et al. "Surgery versus physical therapy for a meniscal tear and osteoarthritis." New England Journal of Medicine 368.18 (2013): 1675-1684.

Moseley, J. Bruce, et al. "A controlled trial of arthroscopic surgery for osteoarthritis of the knee." New England Journal of Medicine 347.2 (2002): 81-88.

Jones, Matthew D., et al. "Aerobic training increases pain tolerance in healthy individuals." Med Sci Sports Exerc 46.8 (2014): 1640-7.

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Does Gaining Range of Motion Really have to Hurt?

Not all physical therapists are created equal. Nor does gaining range of motion have to be extremely painful! Unfortunately there is this idea among the public that physical therapy has to hurt to be effective. In most cases, nothing could be further from the truth. Sadly enough there are plenty of physical therapists out there who also believe "no pain, no gain" to be true.

Before we go any further, I need to clarify that pain is very different then a "stretch", "pull", "pressure" or "fatigue/workout soreness". Just because I don't believe in "no pain, no gain" doesn't mean I'll vouch for laziness or sub-par effort.

So here is why gaining range of motion does not have to hurt:

–  When the brain starts feeling ‘stress’ it goes into protection mode.  A pain response results in signals sent to muscles, fascia, and joint capsule to literally tighten down to protect the painful structure.  So the entire time your PT is cranking on your new rotator cuff repair, knee replacement, or you are cranking on it at home per their instructions. Your brain is busy fighting back.  The result is lots of pain and minimal progress.

– Pain fires up your sympathetic nervous system, the part of the system that handles ‘fight or flight’ situations.  To complicate matters, research has found that a lot of people are already in this sympathetic state even at rest. These individuals tend to exhibit increased stress hormone levels that result in poor sleep patterns and poor recovery from workouts and games (If you are coming off of surgery, I would argue that you are already in this state to some capacity anyway).  This elevated level of stress over the long term can have some serious effects and implications on rehabilitation.

Balance is good!

The moral of the story here is that increased pain levels correlate with increased stress levels which can delay healing and recovery.  Some pain is going to be present when you’re dealing with an injury or surgery, but your therapy should not be making you consistently feel worse! Increased pain is not an ideal situation for someone trying to gain range of motion, strength, and returning to work or athletics.

So how do we avoid the "no pain, no gain" philosophy! For starters, you still need to put forth maximal effort. Laziness will not get you out of pain. If you are post surgery then you should expect some type of "stretching" or "pulling". It is very important to distinguish between this and actual pain. The surgical limb has to move (when appropriate) and move frequently in order to start improving and building back up normal tissue resiliency. However, you want to avoid jamming your limb through further ranges of motion putting yourself into a further stressful (sympathetic) state then you already are post surgery.

Taking this a step further, in both surgical and non surgical folk we want to consider other areas which could be contributing to your overall dysfunction and pain on movement. This means looking at the joints above and below the injured area to make sure they are functioning optimally. Assessing the difference between active and passive movements also plays a role on distinguishing between actual soft tissue restriction or just lack of motor control or coordination in those end ranges of motion.  Muscle strength, endurance, work capacity, and timing are all important factors as well.

Next time you go through a physical therapy treatment, or any treatment for that matter, ask yourself if all these things are being assessed? If your program feels like a cookie cutter program then it probably is! Find a provider that understands pain and will take the time to assess/reassess movement. In most cases, there are better ways to gain range of motion and strength than trying to push through restrictions and pain.

Plank Exercise Progressions

A lot of people will perform planks as part of their exercise routine.  The front and side plank get a lot of love, and for good reason! For a lot of people these exercises are challenging enough. However, once you've mastered the basics, you may need to step it up a notch. Here are some challenging progressions that I feel really carry over to athletics and can get you closer to your training goals. Each of the following plank progressions add hip motion to the equation so you will be supported on one limb for a period of time.  It’s the support leg that is most important for stability and will be working the hardest.  With all of these exercises, you must maintain a stable core.  So in other words, when you lift a leg your trunk should remain motionless.  If you have to lift your butt up or it sags down then either it is too much for you or you are getting fatigued and need a break.  Perfect reps, nothing less.

The other great thing about these exercises is that they give you a chance to look at symmetry.  By this I mean how does your right leg compare to your left leg when doing a front plank, or how about right and left sides when performing a side plank?  It should be just as easy or difficult on both sides.  Right-Left asymmetries are a huge predictor of injury so work to limit these.  Typically I will have patients or athletes perform an extra set on the weaker side to bring that side up to par.

Alright, done with the lecture.  Check out the plank progressions below.

Prone Plank with Hip Extension -alternate lifting legs about 4-6 inches off the floor.  Nothing moves but the hips.  Shoot for 10 solid reps each leg without losing form.  And if you’ve been paying attention in previous posts, hold the leg up long enough to cycle a breath, then set it back down.  That will be the true test of your inner and outer core working together.

Side Plank with Hip Abduction – I really like the side planks as they test your entire lateral kinetic chain for stability.  Post up through the forearm by pressing it ‘through the floor’.  Now lift the top leg keeping the hips high.  Shoot for 10 quality reps with proper diaphragmatic (belly) breathing throughout.  When you can achieve that, now hold the leg at the top and cycle a breath before bringing it back down. 

Side Plank with Hip Adduction –this is another great variation that I think gets overlooked.  The bottom leg will be off the ground in this case so the adductors (inner thigh muscles) of the top leg will be carrying more of the load.  Breathing is crucial again so get it right.  Start with 10 second intervals if necessary shooting for 30 second holds ultimately.  If you’ve achieved that, then progress the exercise by moving that bottom leg back and forth.  It should look like a running stride – flex the hip up and then extend it back.  Adding the front to back movement will make your core have to work that much harder to remain stable.  I’ll shoot for 10 reps here again as well.

Three great ways to challenge yourself!  Remember to play close attention to those side-to-side differences.  Cleaning those up will bring the greatest benefits.

Physical Therapy - Ann Arbor, Mi

So what should Physical Therapy look and feel like? There are many things to consider when choosing which physical therapy clinic is right for you.  Over the next few weeks I’m going to offer a few suggestions for things to think about, or even ask other therapists about, prior to beginning a course of physical therapy.

Some things should be fairly obvious such as will you see the same therapist each visit? How much time each visit will I spend DIRECTLY with my therapist (not supportive personal)? How many visits per week? and so forth.

What I want to discuss are the things most people would not normally consider (in fact, most therapists and physicians aren’t thinking this way either!)

1) Movement Based Approach:  my previous blog entries Don’t Put Fitness on Dysfunction and Movement Proficiency and the Ankle describe how looking at patterns of movement are critical to narrowing down where the cause of the pain is coming from.  Just because your back hurts doesn’t mean it’s the back’s fault.  Your back may just be the victim of poor hip mobility below and poor Thoracic and ribcage mobility above just to name a couple.

A simple model I discuss in those previous posts is the Joint-by-Joint model of alternating mobility and stability requirements.

Following the traditional physical therapy model, you’re probably not going to find the connection (Instead the pain in the low back is generally the only focus). Don't get the wrong impression. It's not that the low back does not deserve to be treated to reduce pain and inflammation.  That absolutely must be done! But if that is all that is addressed, then chances are your low back symptoms will be back sooner than later.

The Selective Functional Movement Assessment is a quick and effective way to determine the person’s most dysfunctional movement pattern.

The object is to determine which pattern is the most dysfunction, and then break that pattern down into it’s component parts to find the impairment.  So for example, if someone cannot touch their toes, it could be a lack of mobility in the spine, hips, hamstring, or even a lack of core stability and poor breathing mechanics.  Your therapist must have a way to find that answer!

If you’ve ever been to physical therapy for your back, I can almost guarantee you were told you must stretch your hamstrings. Am I right?

Well if you can’t touch your toes, of course your hamstrings will feel tight.  Lacking mobility in your spine or hips will limit your toe touch and make it seem like your hamstrings are tight.  It’s probably only the hamstrings 25% of the time at the most.

Unfortunately many people are spinning their wheels in physical therapy because they are not working in the right place at the right time. I can’t tell you how many people have told me that they have failed a trial or two of traditional PT, injections, massage, etc.

2)  A Soft Tissue System:  at On Track Physical Therapy I use the IASTM because of the great results I’ve had treating all types of soft tissue injuries from tendinopathies. From plantarfasciitis, to contusions, scar management, and more.  I also utilize Dry Needling to address soft tissue dysfunctions. Granted this treatment is not for everyone, but it defiantly could be a viable option.

Some sort of soft tissue release may be needed to allow for a window of opportunity to access greater movement. It is the exercises job to then lock the new movement into place. Very often even above and below the site of pain there will be significant soft tissue restrictions that should be addressed.  As I mentioned earlier, using a movement based approach will allow a physical therapist to pin point restrictions. This way time is not wasted treating irrelevant areas.

For example, we know from the literature that very often trigger points in the gastroc/soleus complex (calf) will contribute to plantarfasciitis and even radiate pain to the bottom of the foot.  Limitations in hip extension and glute strength will also contribute to the condition.  Is your therapist looking that far up the body?

So what difference does all this make?  Ultimately it can be the difference between actually ‘fixing’ the problem or just addressing symptoms.  When we can ‘fix’ the problem (the ultimate cause of your pain), we may never see you again and that’s a good thing.  When only the site of pain is addressed, very often you will find yourself back in the Dr. office and back for another bout of physical therapy a few months down the road.

At On Track Physical Therapyour goal is to ‘fix’ the problem, and to give the patient the tools necessary to prevent a recurrence.  Contact us anytime with questions about our methods, and how we can help you if you’ve been unsuccessful with other methods of treatment in the past. This is why we offer a Free 15 minute consultation to address any of your concerns!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.

Learning The Value Of Physical Therapy – A Patient’s Perspective (Part 2)

To Recap: Last week I covered why I wanted to write about the value of physical therapy, and how my flawed mentality got me into hot water. You can read part 1 HERE. This week, I get down and dirty about my ride on the “healthcare merry-go-round”, the people who joined me, and the making of my mess.  Again, I want to reiterate that these were just interactions I had with healthcare professionals along the way. I’m sure their intentions probably were to help me, even though it may not have seemed that way at the time. Their specialties all have a place in healthcare, but they aren’t going to be the first place I stop at in the future!

merry_go_round.jpg

Just a little snippet on my HMO insurance…..I’m not going to say much on this subject, as HMO pretty much speaks for itself. It’s a revolving door of referrals, authorizations, and denials. It’s like walking around with a pebble in your shoe or a thorn in your side, making everything just a little more difficult than it really needs to be. Everyone should try an HMO once in their life…. just for the experience! Moving on to the Primary Care Doctor.…

Two years prior to my injury, I had started having consistent pain in my neck, head, and back area. I was on a steady diet of Motrin for this. I work a desk job, and eventually it was just too hard to sit and work.  My “quick fix” medication wasn’t cutting it. Over the next year, I went to my primary care doctor three times. She diagnosed me with head, neck, and back pain…. and for some reason a urinary tract infection?  I got antibiotics, muscle relaxers, and was told to keep taking Motrin. No mention of what might be causing the issue, or any other possible solutions. Why she ever thought I had a urinary tract infection, I will never know ha ha. This interaction wasn’t really good or bad. It just wasn’t “anything”, and produced no results. She was satisfied with the status quo. The only thing I got out of this was a “referral” to the chiropractor, which was my idea. I’m on the merry-go-round now, but really bored because it’s going slow and nobody is on it with me.  Moving on to the Chiropractor….

One year prior to my injury, and after obtaining the coveted “referral” required by my HMO, I started seeing a chiropractor. I got x-rays and was told I was in “bad shape”. I was subluxed and degenerated, and needed to start treatment ASAP. I jumped on board with this, went three times a week over the next year, and it did provide some relief! This treatment still kept me in that “quick fix” mindset. Each visit was only a few minutes, got adjusted, and back to my day.  I was now dependent on this for relief, just as I had been on Motrin. Hey, at least I had someone on the merry-go-round with me now, and we were having a pretty good time….. at least for a while!

The day of my acute injury, I had gone in for a regular adjustment, but this time I didn’t get relief and it caused me pain. It was a severe “pinched nerve” feeling in my neck and back. I was told not to worry, and that they could fix this.  I was still “all in” at that point, and wanted to see if they could help me, but this would be the beginning of my mess.

One week into my mess, I had went every single day for adjustments, but the pain was getting much worse. I couldn’t sit, couldn’t sleep, couldn’t work, and was losing strength in my right hand. Taking 800 mg of Motrin barely made a dent.  He took another set of x-rays, and seemed very concerned. He stated my x-rays looked much worse than at my initial evaluation one year prior. My heart dropped into my stomach, he got nervous, and I got scared. Was it the adjustments that caused the problem or was it a coincidence? I didn’t really know, it didn’t really matter, and I just needed help. I told him I thought I should seek other medical care since things were getting worse. He then became somewhat defensive. Maybe he was offended that I wanted to get another opinion, or thought I was accusing him of something.  I expected him to offer some suggestions, but that didn’t happen. This interaction became all about him, and not about helping the patient anymore, so that relationship was over! I was on the ride alone again, and it was spinning faster.  Moving on to the ONLY place that my HMO doesn’t require a “referral”…. the Emergency Room…

Two weeks into my mess, I still have severe pain in my neck/back/arm, numbness and tingling, and the right hand was much weaker…. off to the ER! This ER doctor examined me, and sent me for an MRI. A few hours later, he briskly informed me I had a herniated disc in my cervical spine (neck) that was pressing on some nerves, which was the reason for my intense pain and weakness. He gave me a script for pain medications and steroids. He also handed me a card for a neurosurgeon, and stated I needed to see him ASAP. I spent the next week popping pills, flipping out, and of course searching on Google for all the horrible things that could happen. This interaction provided me six things… a diagnosis, three medications, a business card, and a lot of anxiety!  That doctor could work on his “diagnosis delivery” skills, but he did his job that day, and I can’t fault him for that. I’m freaking out now, and my ride has really picked up speed!

Moving on to the Neurosurgeon and the PM&R doctor…..

Three weeks into my mess, I have worked myself into an anxious frenzy, have my “referral”, and now I’m seeing the neurosurgeon. This was my least favorite interaction. He examined me and reviewed the MRI. After just a few minutes, he very bluntly said he could “fix” all my problems by drilling a hole through the front of my throat and shaving off the disc that was pressing on the nerve. I almost passed out, and then started to cry. I told him I didn’t want this and asked what else could be done. His demeanor quickly changed to irritated and angry. He spent the next 10 minutes reprimanding me and talking down to me like I was an idiot for asking questions. He said he was busy, had other patients to see, and flippantly commented, “You can TRY physical therapy, but it probably won’t work,and might make it worse.”  He then said he would have his PM&R doctor see me. I didn’t know what a “PM&R” doctor was, or why I needed to see one. I’m still crying, had failed to wear my waterproof mascara, and now looked like a complete disaster!

This new doctor walked in with a consent form for an epidural injection in my neck, and a “referral” for physical therapy.  Nobody asked me if I wanted an injection, or told me what it was really for, and I was having NONE of it that day! They spent about 15 minutes with me, treated me like an idiot, and then expected me to just blindly agree to their interventions. My thinking was this….

If you can’t treat me with common respect, then why would in the world would I trust you to cut into me with a sharp instrument or stick a large needle into my neck?

I left that appointment upset, exasperated, still in pain, confused.... and crying all the way home ha ha ha. If I wouldn’t have been in so much pain, I would have tried throwing both of them off the merry-go-round! This interaction, while extremely negative, was probably the best thing that could have happened to me at this point, but I wouldn’t realize this just quite yet……..

Wait… hang on a second……Everyone was offering me “quick fix” solutions for my problem, so why am I so upset!  Adjustments, surgery, injections, medications…… so what’s the problem here?  The problem was that nobody was really explaining my condition to me, what was causing it, what the interventions were all about, and what the consequences may be. They didn’t spend enough time with me or give me enough information. This was my spine, there were nerves involved, and I couldn’t afford to make a wrong decision based on limited information.  Was there something else I could be doing to help myself?  Were these my only options?  I had lasted three weeks with this pain, and figured I could go a little longer if it meant finding answers to my questions. I needed to stop just going along for the ride, and take some control of my own situation. I closed my eyes and jumped off that spinning merry-go-round. I ended up landing in a ditch, but made sure to keep a tight grip on that interesting piece of paper the doctor had given me that day……… the “referral” to PHYSICAL THERAPY.

Fun Term Of The Week - Merry-Go-Round: A continuous cycle of activities or events, especially when perceived as having no purpose or producing no result.

UP NEXT WEEK:   PT Tow Truck, Skeptical Train Wreck Patient, and the Weirdest Exercises I Have Ever Seen…….Stay Tuned for Part 3!

Patellar Tendinitis (a.k.a. Jumper’s Knee) – Ann Arbor, Mi

Ann Arbor, Mi - Maybe you have heard of Osgood Schlatter Disease, Patellofemoral Pain Syndrome, Patellar Tendinitis or “Jumper’s Knee” before? These diagnoses are very similar, and are common diagnoses given to athletes or active individuals of all ages. Osgood Schlatter’s Disease is a diagnosis commonly given to children, to boys between the ages of 12-15 and girls between the ages of 8-12.  This is generally due to the rapid changes in body composition these adolescent children are experiencing in conjunction with increased participation in sports1.

Patellofemoral Pain Syndrome is a fancy way of saying that the kneecap (patella) is having issues tracking properly across the knee joint, thus causing your pain. More on this a little later.

Patellar Tendinitis or “Jumper’s Knee” explains everything you need to know in the title about one of the possible causation factors. Sports involving dynamic activity such as jumping, bounding, plyometrics, and change of direction inherently places you at a higher risk for developing this type of painful experience. However, it is also very possible to manifest itself in the general population as well, with frequent bouts of activities such as squatting, lifting, or carrying objects up and down stairs.

Related Article: Is Plyometric Training Causing Knee Injuries?

All these types of diagnoses tend to have very similar limitations and symptoms, and error on the side of overuse injuries. No matter your age or activity level, a painful experience can generally be explained by a sudden increase in activity that your body was not prepared to handle, or an accumulation of repetitive physical stress without ample rest.

With that being said, there are usually very predictable limitations that occur in the body which predispose an individual to any of the previously mentioned injuries. In most cases, when these limitations are addressed and external causation factors are managed properly, the outcomes tend to be very positive.

Maybe you have noticed that most of these diagnoses make mention of the patella. In fact, one of them actually has a syndrome named after it (Patellofemoral Pain Syndrome and Patellar Tendinitis). Unfortunately for the patella, it is the most prominent and superficial part of the knee. As such, it usually takes the brunt of the criticism for causing knee related pain. However, if we take a deeper look into how the body operates, we understand that the patella really is just the result of an underlying positional problem. Understand that the patella is just a sesamoid bone (free floating), that rides on the groove of the femur as it connects to the tibia to create leverage in the quad muscle.

The common analogy used for the patella is that it acts like a “train” that rides on the “tracks” of the femur. If the femur or “track” is in a poor position, then the patella cannot run properly across its groove. This analogy holds true not just for Patellofemoral Pain Syndrome, but rather every one of the diagnoses mentioned (Osgood Schlatter’s Disease, Patellar Tendinitis/Jumper’s Knee). If a person is unable to maintain proper position with various demands the body may encounter, then a lot of torque is placed on the knee and patellar tendon, which may result in a painful experience over time.

We all know the function of the knee is to bend because it’s a hinge joint.  However, it also has rotational capabilities because of the hip and the ankle. This rotational component from the hip and ankle when functioning on all cylinders is how the knee absorbs forces. Without it, the adaptability of the knee is minimal. Think about hitting a pothole with your car. Without shocks, chances are your car goes out of commission pretty quick.

As part of a physical therapy treatment, we can perform different manual techniques such as taping, active release, IASTM or dry needling that can help modulate pain. However, if we never address other limitations above and below the knee joint, then pain may remain or linger much longer than necessary. This is why a detailed assessment is required, so specific interventions can be given to restore optimal function and abolish pain.

At On Track Physical Therapy, we provide a one-on-one treatment approach unlike any other. Full one-on-one, uninterrupted hour long treatment sessions with a Doctor of Physical Therapy at every appointment. This allows for detailed assessments and frequent reassessments during the treatment session, to ensure we address the issue appropriately.

Click the image below for your FREE sports injury report and discover how pro athletes recover from injury FAST!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist and strength coach specializing in athletic performance. He attended The University of Findlay as a student athlete. As an athlete he competed in both Indoor and Outdoor Track & Field where he earned honors as a 5x Division II All-American and 6x Division II Academic All-American. In 2013 he completed Graduate School earning his Doctorate of Physical Therapy (DPT). Greg is the owner of On Track Physical Therapy in Ann Arbor, Mi. Follow On Track PT and Performance on Facebook.