Foam Rolling – Mobility Work Or Masochism?

Foam Rollers
Foam Rollers

I find that many athletes think they need to use the foam roller as intensely as possible to produce the maximum amount of pain. After 30 seconds of pure agony, they put the foam roller back in the closet and consider themselves sufficiently “rolled” for the month. What a shame!

If this describes you, you need to read on.

Effective foam roller use can prevent injury, maximize performance, and improve your general well being. Episodic 30 second torture episodes will, well, only make you really hate foam rolling. Let’s create a healthy foam roller relationship full of mutual respect and understanding.

I think it helps to first understand WHY foam rolling is helpful. Consider this. A muscle is not a single rubber band that contracts uniformly. Rather, a muscle is a series of small units which can contract somewhat independently of each other. These units are called sarcomeres. Due to overuse, poor body mechanics, posture, etc. a cluster of sarcomeres can stay contracted forming a trigger point. Colloquially, most people call this a “knot”. A knot will shorten the length of the muscle as a whole, causing further deterioration of flexibility, joint mobility, and movement quality. A knot also has the potential to radiate pain to a different area of the body, similar to a nerve. A knot is NOT what you want! (you’re welcome, all you pun lovers out there)

Addressing these specific areas of muscle tightness with a foam roller can effectively prevent such symptoms. Furthermore, foam rolling BEFORE stretching may allow you to stretch further and more comfortably. Personally, after a 2 hour run or 5 hour bike ride the LAST thing I want to do is bend over and try to touch my toes. However, if I preface stretching with a gentle roll-session on my friendly foam roller? Heck yeah, that’s recovery at it’s finest, baby!

Now that you know why foam rolling is all the rage, you should familiarize yourself with The Foam Roller Kamasutra. There are multiple positions and techniques to address just about any muscle on your body. Know as many as possible! I’m a loud proponent of foam roller use and I’m constantly learning something new. If you are totally in the dark on how to use your cylindrical friend, consider making an appointment with your physical therapist for an educational visit that will benefit you for a long time to come.

So roll shamelessly in the middle of the gym floor! Embrace the weirdness of contorting yourself in your shortest running shorts! FOAM ROLL ALL THE MUSCLES!!!

Heal Your Body, Strengthen Your Life.
Your friends at Jackson County Physical Therapy

Creaky Knees Due to Osteoarthritis

To exercise or not?

If you clicked on this link you may be one of the millions of people in the United States that suffers from knee pain due to the development of osteoarthritis. Osteoarthritis is by far the most common type of arthritis and it is estimated to affect 302 million people worldwide with the most common region being the knee, hip, and hands. Now, you may have done some researching of your own to find out how to help your knee pain and gone down the rabbit hole on the internet to find some new creams or maybe YouTube stretches or exercises to help out. Unfortunately, most of these things probably didn’t have a positive long-term effect. Many people can relate and literally share the same aches or pains due to OA (osteoarthritis).

Knee osteoarthritis comes in various stages and different reasons. First, the most basic explanation of knee OA is the wearing away of the articular cartilage that lines the bones that make up your joint which are the femur and tibia. The degenerative process is progressive with resulting bone remodeling, synovial fluid inflammation (joint lubricant) and osteophyte (bone spur) formation but can be effectively managed without surgery if not already at a severe stage. You may have developed this arthritis over time without any injury or you had a prior accident causing trauma to the joint which set the stage for earlier formation of OA. Either way, Physical Therapy is an effective treatment approach to decrease pain and improve your ability to move.

Physical therapists are trained to be able to recognize and diagnosis knee osteoarthritis after an examination. We are able to individualize treatment plans that are unique to the presentation of the patient’s impairments and implement range of motion, strengthening, and flexibility exercises along with hands on therapy. Since OA is progressive it is important to establish an exercise program that prevents immobility without over stressing the joint. The most recent management guidelines for osteoarthritis of the knee, hip, and hand established by the American College of Rheumatology/Arthritis Foundation strongly recommended exercise for all patients.

Along with exercise, other categories that received a strong recommendation include weight loss, self-management programs, and Tai chi. Seeing your Physical Therapist will set you on your way to finding the right prescription of exercises so that you can effectively manage your condition and return to moving without knee pain. Summer is right around the corner and that means warmer days filled with hiking, biking, jogging, or whatever you enjoy. Schedule an examination with JCPT to give you the guiding force to set you on your way. Motion is lotion!

Heal Your Body, Strengthen Your Life
Your friends at Jackson County Physical Therapy

Reference
Kolasinki SL, Neogi T, Hochberg M, Oatis C, Guyatt G, Block J, Callahen L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey W, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello G, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner A, Reston J. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research Vol. 72 No. 2, February 2020, pp 149-162.

MY HIP IS KILLING ME

THE FIVE MOST COMMON CAUSES OF HIP PAIN AND WHAT TO DO ABOUT IT.

One of the most common areas that we treat as physical therapists is the hip. In fact, patients often complain of back or leg pain which is truly a result of hip dysfunction. It is easy to overlook how many structures cross the hip, how high our hip bones travel, and how intimately related the joint is to our pelvis and lumbar spine.

Hip pain can range from sharp and intense to dull, achy, and omnipresent. These symptoms can arise from a sudden injury or developed over years. Hip pain can even present as low back or groin pain. The .cause and thus symptoms of hip injury differ greatly from person to person, however, the common theme is that hip pain is one huge bummer.

Although each individual’s injury is truly unique, we tend to see some common themes in patients who suffer from hip pain. If these tips help you, GREAT! If they do not fully resolve your symptoms, do yourself a favor and schedule an individualized physical therapy assessment. Keep in mind that hip pain is NOT normal, and you don’t have to live with it!

The five most common causes of hip pain:

1. An unlevel pelvis

an unlevel hip

She’s an incredible endurance athlete, but those hips don’t lie.

Patients often tell me “oh, I have one leg that is longer than the other.” Are you sure? Although it is possible for someone to have one leg with a femur that is actually longer than the other, it is uncommon. More often, muscles are tighter on one side or an individual stands in an asymmetrical posture which makes one leg seem longer. Do you have one leg that you typically like to stand on, and it just feels uncomfortable to lean on the other? Look down and see what that does to your pelvis. One side is up and one leg looks shorter, right?

Over time, muscles on one side can become short and tight and the pelvis can begin to elevate, rotate and/or shift to one side. This puts the hip joint and the associated muscles in a different position compared to the opposite hip. I always like to make the point that there is a reason that one side begins to hurt versus the other…it’s not just a coin flip! Determining that reason and addressing it is an essential component to recovery.

2. A tight psoas, or hip flexor

Not to be dramatic or anything, but I believe that the psoas is the window to the soul. It is an epicenter for so many injuries that I have become somewhat obsessed with it, and it is one of my personal missions to teach others how to properly stretch the psoas.

Why does a tight hip flexor, or psoas, matter? The psoas is able to flex the hip (as in bring your knee closer to your chest) but it is also able to rotate, side bend, and extend the spine because it attaches to the front portion of multiple vertebra. How crazy is that? So a stiff psoas can compress your hip joint, decrease hip range of motion, cause an unlevel pelvis, contribute to back pain, decrease nerve space….the list goes on and on. Who knew one little muscle could cause so much mayhem?

3. Weak or inactive gluteal muscles

The hip is a ball-and-socket joint, meaning that the head of your femur (the ball) sits in a cup-shaped portion of the pelvis called the acetabulum (the socket). This configuration gives the hip a ton of mobility, but also a lot of complexity. If muscles aren’t working properly around the entire joint the ball can sit off-kilter in the socket and problems arise. One example of this would be a tight psoas, pulling the ball forward. Another would be tight, weak, or inactive gluteal muscles, pushing or allowing the ball to move forward inappropriately.

Although strengthening the glutes and learning how to fire them properly is a very generalized approach to treating hip pain, it often works! Check out this video from Garrett Mclaughlin for ideas on a basic hip strengthening program.

4. Tight or inhibited gluteal muscles

All of our muscles have a normal “resting length”, meaning the length the muscle prefers to exist at in order to contract strongly and perform optimally. Try jumping by just using your calf muscles. Keep your knees straight and hop up and down like you are jumping rope. Take note of how high you can bounce. Now try to do the same jumping exercise by starting on your tiptoes, which is a shortened position for the calf. Stay on your tip toes and don’t let your heel come down at all as you try to jump. Now how high can you go? Can you get off the ground at all without cheating?

Tight gluteal muscles will be similarly weak and dysfunctional. You may have proper strength, but if your butt is all knotted up then good luck getting it to properly stabilize your pelvis. (A trip to Cindy Duron, anyone?)

5. Poor movement patterns and habits

running terrible

Here is where I swallow my pride and post pictures of myself running terribly in order to prove a point. I’d love to pretend that because I am a physical therapist I magically move perfectly, never get injured, and have perfect biomechanics. Shockingly…not the case. I’ve had a longstanding left hamstring and hip injury for years. Why the left side and not the right? As I said before, there has to be a reason. Overuse injuries don’t land on one side like the flip of a coin.


both feet on the ground

Take a look at me when both feet are off of the ground. My hips are level left to right, which is the ideal position for running. When hips are level in this plane it minimizes the force that goes through our joints and soft tissues.


left leg stance

When I am in stance phase on my right leg, my hips remain fairly level. Not perfect, but not too bad. This indicates that my right gluteal muscles are strong-ish and function properly.

When I am in stance phase on my left leg however, my left glutes and stabilizers are a hot mess. Yikes, ouch, and yuck. My left glutes just didn’t want to get out of bed today. Can you see how this would stretch the outside of my left hip with every step? The inside of my left knee? Compress the outside of my left knee and stretch my IT band? Make my right leg have to bend further to swing through and not stub a toe? With EVERY. SINGLE. STEP?!? Bleh. Just gross.


Like I said, overuse injuries are never a coin flip; there is a reason and we are here to help you find that reason and treat the problem.

Have you struggled with hip pain, or just tried to live with it? Don’t. Ain’t nobody got time for that. Find out what’s going on and what you can do about it.

Heal Your Body, Strengthen Your Life.
Your friends at Jackson County Physical Therapy

The Importance of Exercise for a Healthy and Strong Immune System

During times of uncertainty when life is constantly evolving, it can be difficult to know what you can do to stay healthy. Although social distancing and staying at home are the best practices, it is just as important nowadays to find ways to move your body and exercise.

As long as you follow social distancing guidelines, going on walks, bike rides, hikes, and other outdoor activities are safe and recommended. As I will discuss, it will help you not only strengthen your muscles and bones but your immune system as well.

Exercise immunology is a relatively new area of research, with most of the studies coming out in the past 30 years; these studies have proven that the immune system is very responsive to exercise. The best kind? Moderate to vigorous exercise for a duration of 30-60 minutes. This stimulates the exchange of active immune cells between your blood and tissues, including immunoglobulins, anti-inflammatory cytokines, neutrophils, natural kill cells, T and B cells.

Doing this type of exercise regularly has a summation effect on your immune system, meaning that if you maintain a consistent workout schedule of 3-5 times per week, it will enhance your immune defense activity in the long run (no pun intended).

The proof? Randomized clinical trials have repeatedly demonstrated the relationship between consistent moderate exercise and decreased incidence of illness. Several studies also show that regular physical activity can decrease incidence rates of influenza and pneumonia 1.

However, keep in mind that moderation is key. Extreme exercise training programs have been correlated with decreased immune cell metabolic capacity, negatively affecting the immune system for a range of several hours up to several days. One study looked at 2,311 runners who competed in the LA marathon, and showed that 13% of the endurance athletes reported illness the week afterward. Other studies have shown athletes in heavy training are at increased risk of developing an upper respiratory tract infection. This just means that although you may have more time to work out, it’s not necessarily the time to go all in. Keeping exercise at a consistent and moderate is perfect for boosting your immune system along with a healthy diet and adequate sleep1.

This concept is especially important for those experiencing immunosenescence, which is the gradual decline of the immune system because of natural aging. Immunosenescence has been associated with infections, autoimmune diseases, and metabolic diseases. However, evidence has shown that regular exercise can thwart the onset of immunosenescence during the aging process. In fact, one study showed that women aged 70+ who were active in endurance events had significantly higher levels of immune system supporting cells compared with women of the same age who were sedentary1.

In summary, regular physical activity at a moderately challenging level of intensity and duration will help give your immune system a boost. If you’re already going on regular walks, hikes, or bike rides, keep it up! You can also find many exercise programs offered online or streaming through your local gym.

We at JCPT applaud your motivation and understanding of self-care especially during the current covid-19 pandemic. Do what you find the most rewarding and fun for your chosen activity. Just be safe, and avoid crowded trails or paths. If you feel confused about how to start or maintain an effective exercise regime during these trying times, feel free to reach out. We offer both in person and telehealth options for consultation and guidance.

Heal Your Body, Strengthen Your Life.
Your friends at Jackson County Physical Therapy

What is a physical therapist, and how can they help me?

physical therapist hands

Although I love my profession, I have to admit that physical therapists are terrible at educating the public on what we actually do. I’ve heard people refer to me as anything from a personal trainer to a personal torturer. Although I have to admit it’s a clever spin on the abbreviation “PT”, we are neither personal trainers nor personal torturers. In fact, I’m going to go out on a limb and say that most of us are in fact very, very nice people.

All jokes aside, what exactly is a physical therapist, or PT? And what do they do?

PTs are trained to evaluate, diagnose, and treat a variety of muscular and skeletal injuries, neurological disorders, or what I like to call Problems with a capital P. Ideally, we love to see people before something becomes a Problem. If our patients give us the opportunity, we are statistically very effective in preventing Problems. Problems can result in pain, immobility, unfavorable lifestyle modifications, loss of independence, surgery, medication, and avoidable healthcare costs… yuck! Let us save you a load of “yuck” and the healthcare system a load of money.

Speaking of the healthcare system…it’s a scary, uncertain time out there and here at Jackson County Physical Therapy we want to acknowledge that. It’s very understandable if you are nervous to schedule an in-person appointment with anyone at this time, PTs included. Although telehealth visits do not allow for hands on treatment they do allow for the safe transmission of information without transmission of less desirable, things like Covid-19.

Patients are often surprised at how a simple exercise or bit of professional advise can address a nagging Problem. We can demonstrate exercises and discuss strategies through video without the need for masks, hand sanitizers, and any of the other items that you inevitably cannot find in the grocery store right now. Even for a technology dunce like myself, these visits are easy to coordinate with your computer, smartphone, or tablet by simply clicking a link that we send to your email. Consider setting up a telehealth visit so that a physical therapist can point you in the right direction at a time where you may find yourself with a bit of extra time.

I will not list every single condition that we treat, as it will inevitably be incomplete. I will, however, say that if it aches, hurts, burns, tingles, feels numb, feels weak, feels uncoordinated, makes you dizzy, is swollen, doesn’t move enough, moves too much, pops, clicks, gives way…we can probably treat that. And if we can’t? We are educated, trained, and board certified in order to tell you where you need to go and who you need to see, in person or via screen, to be properly treated. That is why we earn a Doctorate in Physical Therapy and why you can, in the majority of all cases, come directly to see us without your physician’s referral. And yes, your insurance will pay for it.

Contact Jackson County Physical Therapy if it sounds like the education and training of our physical therapists may benefit you and your quality of life. In addition to treating Problems, we are also incredibly nerdy, passionate, and pumped to spread the word about WHAT WE DO.

Stay safe out there my friends,
The Jackson County Physical Therapy Crew

Molly Kujawa – PT, DPT

Molly Kujawa PT

Molly grew up in La Crescent, MN. She completed her undergraduate degree at the University of Wisconsin – Eau Claire, and received her Doctorate of Physical Therapy at the University of Wisconsin – La Crosse. Molly has been a patient herself, requiring physical therapy due to shoulder and running injuries, and is passionate about making sure her patients feel heard and well-cared for throughout the entire rehab process.

Molly has an eye for detail, ensuring that the most basic exercises are done correctly. She values a hands-on approach in order to help patients move forward with optimal movement patterns. Molly is excited to walk alongside patients to restore function and create strategies to maintain improvements made in physical therapy. Through education, exercise, and manual therapy, Molly aims to empower patients to overcome barriers in order to fully participate in everyday activities.

In her free time, Molly enjoys anything involving fresh air (hiking, running, biking, frisbee), spending time with her husband Bryce, reading, trying new recipes in the kitchen, discovering coffee shops, and occasionally picking up her trumpet.

Sarah Holst, PT, DPT

Sarah Holst, PT

Sarah grew up in the Rogue Valley and completed her undergraduate education in Portland before completing her Doctorate in physical therapy at Midwestern University in Illinois.

Before returning to the Rogue Valley, Sarah completed her clinical rotations in Illinois, Washington, and rural Oregon which helped to confirm her interest in treating orthopedic conditions. Sarah is motivated to help patients achieve their full potential through manual therapy combined with progressive exercises.

As a past fencing athlete, Sarah is also interested in working with athletes of every level to return to their sport after injury and decrease their risk of reinjury. In her free time, Sarah enjoys travelling throughout the Northwest and beyond, and is an outdoor enthusiast who enjoys spending time rafting, paddleboarding, playing sports and camping.

Bryant Brueckner, PT, DPT

Bryant Brueckner, PT

Bryant was born and raised in Charlotte, North Carolina. He graduated from the University of South Carolina with a major in Biological Sciences and minor in Psychology. He then went on to further pursue his education at Marshall University to become a Doctor of Physical Therapy, graduating in May of 2016.

Bryant has spent the past three years working as a traveling PT, which has provided him with experience in a multitude of different settings, including hospital, skilled nursing, and home health. However, his true passion is outpatient clinics such as Jackson County Physical Therapy. While traveling the country, he learned that he loved the people and beauty of Southern Oregon, having worked here in 2017. This realization led him to return to the region permanently in 2019.

Bryant enjoys working with people from all walks of life and tries to get to know each one individually to form a custom treatment plan. His professional areas of interest include the spine, shoulder, hip, knee, ankle, balance impairments, orthopedic and sport injuries.

When he is not working, Bryant likes to spend his time hiking, backpacking, stand-up paddle boarding, playing tennis and soccer, and seeking new destinations.

Kylie Padget, PT, DPT

Kylie Padget, PT, DPT

Kylie Padget is from the small farm town of Grass Valley, OR. She grew up working on her family’s wheat ranch, participating in 4H, and enjoying volleyball, basketball, water sports, and snow skiing.

Kylie graduated from Washington State University on the President’s Honor Roll with a BS in Kinesiology. She went on to complete her Doctor of Physical Therapy degree at University of St. Augustine in San Marcos, CA, where she graduated with honors. Kylie has specialized in outpatient orthopedic and neurological practice. Her treatment philosophy emphasizes functional evaluation and goals, with emphasis on whole-body integration. Kylie has taken advanced manual therapy courses for myofascial release and joint mobilization. She has been noted for her effectiveness utilizing hands-on manual assessment and treatment in conjunction with constructive communication with her patients.

Kylie has taken advantage of opportunities related to PT including membership in Pre-PT Club and Strength and Conditioning Club at WSU, as well as teaching undergrad anatomy courses. She also has experience volunteering at Rock Steady Boxing for athletes with Parkinson’s Disease and PATH hippotherapy riding program for kids with disabilities.

Kylie specializes in pelvic floor rehabilitation for both males and females. She is a trained and certified advocate for survivors of sexual and domestic violence and trauma.

Linda Muhlenkamp PT, MPT, CIMT

Stephanie Clark, PT, DPT, OCS

Linda Muhlenkamp PT, MPT, CIMT (Certified Integrated Manual Therapist) grew up in Ohio and attended Ohio Northern University where she graduated with a bachelor of science degree in biology. At Ohio Northern, she was a four sport collegiate athlete competing in volleyball, basketball, softball, and tennis. She then attended Northwestern University in Chicago where she earned a master’s degree in physical therapy. After graduation, she moved to Florida to enjoy some warm weather and sunshine while working for a rehabilitation hospital. In this setting, Linda got a lot of experience working with neurological patients especially strokes and traumatic brain injuries.

A few years later Linda wanted to explore the country so decided to work as a travelling physical therapist and got to experience many different places and work settings including acute care hospitals, skilled nursing facilities, outpatient private practices, acute rehabilitation, home health, and pediatrics – school and clinic based.

When she was ready to settle down, she chose Lodi, California and worked for Lodi Memorial Hospital for several years. She had many roles in that organization including lead outpatient therapist and rehabilitation supervisor. Also during that time, she worked toward getting a certification in manual therapy which is her passion. She completed that certification (Certified Integrated Manual Therapist) in 2018.

She enjoys treating a wide variety of patients including spine and all extremity joints, neurological diagnoses especially stroke, athletes, pediatrics and all age groups. She makes it a point to get to know what her patient’s thoughts and needs are when designing a treatment plan. Her goal is to find and correct the specific dysfunctions that are causing the problem and to empower the patient to maintain improved function and decreased pain.

In her spare time, she enjoys spending time with her family, doing anything outdoors – camping, hiking, backpacking, bicycling, tennis, yoga, photography – and learning new things.