Aquatic Physical Therapy: The Science Behind the Water

Aquatic physical therapy involves performing exercises and activities in water, usually a heated
pool. Aquatic physical therapy can have lots of benefits for people with conditions like arthritis,
back pain, fibromyalgia, osteoporosis, neurological disorders, sports injuries, and more. Let’s
DIVE IN and explore some of the advantages of aquatic physical therapy.

Reduced Weight Bearing

One of the main benefits of aquatic physical therapy is that it reduces the impact and stress on
the joints and muscles, thanks to the buoyancy of water. When submerged, you feel lighter and
more supported, which allows you to move more easily and comfortably. Your therapist can use
different depths of water to change how much force you experience. For example, when the
water is up to your neck, you only bear about 10% of your body weight. This can be especially
helpful for people who have difficulty walking, standing, or exercising on land due to pain,
stiffness, or weakness.

Built-In Resistance

Another benefit of aquatic physical therapy is that water provides natural resistance. You’ve felt
this if you’ve ever tried to move your arm or leg quickly underwater, or run in a pool. Water
resistance can be adjusted by changing the speed, direction, or surface area of the movement.
There is also equipment like hand webs, water weights, and kickboards that can make
movements more challenging. Resistance training can help increase muscle strength and
endurance, as well as improve blood circulation and heart health.


A third benefit of aquatic therapy is the hydrostatic pressure. This is the force that water exerts
on an object, which increases with depth. If you’ve ever dove to the bottom of a deep pool and
felt pressure on your body or in your ears, this is what caused it. The pressure of the water can
be used to help reduce swelling in joints or tissues. The pressure of the water also gives your
brain more input about the position your body and limbs are in. This can help improve
proprioception, or the sense of where your body parts are in space. Improving proprioception
can help enhance balance, coordination, and stability.


Our last benefit of aquatic physical therapy is that it takes advantage of the warmth of the water,
which can help relax the muscles and relieve pain. Warm water stimulates nerve endings in
your skin, which can help block pain signals. It also dilates the blood vessels, which can
increase blood flow and oxygen delivery to the injured or affected areas. Lastly, warm water can
also have a calming effect on the mind and body, which can help you feel better.
Aquatic PT can reduce the impact and stress on the joints and muscles, provide resistance and
hydrostatic pressure, and use the warmth of the water to reduce pain while improving strength,
endurance, proprioception and function. Aquatic physical therapy can also be fun and
enjoyable. If you are interested in aquatic physical therapy, talk to your doctor or physical
therapist to see if it is suitable for you.


• Research (peer-reviewed)
o Efficacy of aquatics for LBP –
o Aquatics for people with MS –
o Aquatics for people with stroke –
o Aquatics for Knee OA –
• Articles and Content
o Benefits of Aquatic Therapy –
o Who is a good candidate for aquatic PT –
o Aquatic exercises – Mayo Clinic

No Bones About It: Physical Therapy Helps Dogs Too

Physical therapy for dogs, also known as canine or veterinary rehabilitation, is a growing field of
treatment that can help dogs with various conditions. Whether your dog has suffered an injury,
undergone surgery, or has a chronic condition like arthritis, physical therapy can help!

What is physical therapy for dogs?

Physical therapy for dogs is similar to physical therapy for humans, just with more treats! It uses
techniques like exercise, massage, heat and cold therapy, hydrotherapy, laser, ultrasound, and
even treadmill therapy to improve your dog’s range of motion, strength, flexibility, and
endurance. Just like in humans, the goal is to decrease pain, speed up recovery, and improve
your dog’s quality of life.

Physical therapy for dogs is usually performed by a certified canine rehabilitation therapist.
These are veterinarians and physical therapists who have undergone extensive training and
certification. They will assess your dog’s condition, medical history, and goals, and design a
customized treatment plan for your dog.

What do dogs need physical therapy for?

Physical therapy for dogs can treat lots of conditions, including:

• Arthritis: Physical therapy can help reduce inflammation, stiffness, and pain in your
dog’s joints. It can also improve your dog’s mobility and prevent further deterioration of
the cartilage.
• Hip dysplasia: Physical therapy can help strengthen the muscles around your dog’s hip
joint and improve its stability. It can also reduce the risk of developing osteoarthritis in
the future.
• Torn cruciate ligament: Physical therapy can help your dog recover from surgery or
avoid surgery altogether. It can help restore your dog’s normal function and prevent
muscle atrophy and joint instability.
• Neurological conditions: Physical therapy can help your dog with conditions that affect
the nervous system, such as intervertebral disc disease (IVDD), degenerative
myelopathy (DM), or stroke. It can help stimulate nerve function, improve balance and
coordination, and prevent muscle wasting.
• Obesity: Physical therapy can help your dog lose weight and improve its overall health.
It can help your dog burn calories, increase metabolism, and reduce the strain on the
joints and organs.
• Sports injuries: Physical therapy can help your dog heal from injuries sustained during
activities like agility or flyball. It can help prevent scar tissue formation, enhance
performance, and increase body awareness.

Physical therapy for dogs is a great way to help your best friend heal from injuries, improve their
mobility and fitness, and enhance their quality of life. If you think your dog could benefit from
physical therapy, consult with your veterinarian first. They can refer you to a certified canine
rehabilitation therapist who can evaluate your dog and create a suitable treatment plan. With
physical therapy, you can help your dog live a happier and healthier life.


(1) The Power of Canine Rehabilitation Therapy – American Kennel Club.
(2) Physical Therapy For Dogs: How Can Canine Rehabilitation Benefit Your ….
(3) Dog Rehabilitation – A Detailed Physiotherapy Guide.
(4) Dog Physical Therapy: Exercises, Modalities, Techniques – TopDog Health.
(5) A Complete Guide to Physical Therapy for Dogs – RocketDog.
(6) Canine Pelvic Osteotomies Outcomes –
(7) Canine hip dysplasia study –
(8) Canine Rehabilitation Institute –
(9) Dog physical therapy exercises –
(10) What can be included in rehab –
(11) Evidence for canine PT –
(12) Select Technique for PT for dogs –
(13) Dogs Physical Therapy Exercises | LakeCross Veterinary Hospital.
(14) Overview of the role of rehabilitation for arthritis.
(15) Pet Rehab.
(16) Advanced Canine Rehab Center – Home.

How Does Physical Therapy Benefit Children With Autism?

What Is Autism?

Autism, or autism spectrum disorder (ASD) describes a range of developmental conditions that
affect how a person communicates, interacts, and behaves. ASD is called a spectrum disorder
because the symptoms and severity can vary widely from one person to another.

Typical signs and symptoms of autism include:

• Having difficulty with communication and social interaction
• Restricted or repetitive patterns of behavior such as repeating words or phrases, lining
up objects, or having intense and narrow interests
• Sensory issues, such as being over- or under-sensitive to sounds, lights, or textures

How Can PT Help?

Children with autism also often have difficulties with motor skills, which affect their daily
functioning and quality of life. For example, they may have trouble with balance, coordination,
motor planning, and body control. They may also have low muscle tone, which can make them
appear floppy or weak. These challenges make it hard for them to participate in physical
activities like playing games or on playgrounds with peers, which are important for both their
physical and mental health.

Physical therapy can help children with autism overcome these difficulties and improve their
motor skills. Using individualized and structured interventions, pediatric physical therapists help
children with autism learn new skills and practice them in a fun and motivating way. Physical
therapy can also help children with autism develop a positive attitude toward physical activity
and enjoy the benefits of exercise, such as improved mood, energy, and sleep.

Improved gross motor skills and increased physical activity can also support the development of
other areas that are affected by autism, like social and emotional skills. Physical activities can
provide opportunities for children with autism to interact with their peers and family, express
their feelings, and follow rules and directions. Physical therapy can also help children with
autism cope with sensory issues, such as hypersensitivity or hyposensitivity to touch, sound, or
movement, by exposing them to different stimuli and helping them regulate their responses.

How Do I Find A Qualified PT For My child?

If you think your child with autism may benefit from physical therapy, you should consult with
your child’s pediatrician, who can refer you to a physical therapist who specializes in working
with children with autism. You can also search for a physical therapist near you using the
American Physical Therapy Association website.

• Research (peer-reviewed)
o Physical Activities for Children with Autism –
o Exercise for children with autism –
o Physical activity effects on sleep and executive function –
• Articles and Content
o Recognizing Autism in Healthcare –
o Autism – diagnosis and management –
Supporting people with autism 19 or under –

Dry Needling Explained

What is dry needling?

Dry needling is a procedure where a physical therapist inserts a fine needle into what is known as a trigger point. A trigger point is a tender palpable nodule in muscle that can cause pain locally or referred to other parts of the body. The term dry is used to describe the insertion of a needle without any medication.

What causes trigger points?
There are many potential causes but commonly trigger points are caused by overload of a weak muscle or prolonged muscle contraction such as with maintaining posture. These causes can turn into a self-sustaining cycle if not addressed.

How does dry needling help?

  • Creation of a Local Twitch Response which is a spinal cord reflex in response to the insertion of the dry needle
  • Decrease in inflammatory and pain causing chemicals
  • Improvement in circulation
  • Activation of pain relieving processes in the central nervous system

What areas of the body can dry needling be performed?

Dry needling can be performed throughout most of the body with our most commonly treated areas including the shoulder, neck, low back, and hip/glutes. Our therapists have extensive training in dry needling and are able to competently and safely perform dry needling on your area of pain or dysfunction.

How often is dry needling performed?

The typical trajectory is to dry needle more often early on with visits becoming spaced out over time as self-care techniques and exercise are implemented to create lasting changes. 

Call us today to find out more information or to schedule an initial evaluation!


Physical Activity: How much? How often?

The American College of sports medicine (ACSM) recommends that,

“All healthy adults aged 18–65 years should participate in moderate intensity aerobic physical activity for a minimum of 30 minutes on five days per week, or vigorous intensity aerobic activity for a minimum of 20 minutes on three days per week.”


Examples of moderate intensity activities include:

  • Riding a bicycle 
  • Walking a dog/Brisk walking
  • Mopping
  • Vacuuming
  • Weeding
  • Bowling
  • Golf

Examples of vigorous activities include:

  • Shoveling snow
  • Mountain biking
  • Stationary bike at moderate to vigorous effort
  • Running
  • Racquetball
  • Tennis 
  • Soccer


There are more heart healthy activities than just walking and running for distance. Many activities that people already do during their day can add up to meeting activity requirements. Physical therapy exercises, most chores, and hobbies such as tennis or golf are great paths to meeting the minimum activity requirements to see increased health benefits.

Why is reaching 75 to 150 minutes of physical activity a week so important?

  • Exercise reduces blood pressure in adults with high blood pressure. More exercise leads to larger reductions in blood pressure reducing the progression of cardiovascular disease.
  • Men and women that are less active are more likely to die or become injured from heart attacks, strokes, and chronic medical conditions such as diabetes. Increased physical activity decreases the risk from these medical conditions with more activity showing even higher benefits.
  • Regular physical activity reduces the risk of fall-related injuries by over 30%.


If you have pain or difficulty leading an active lifestyle, give us a call to see how we can help.

Bad MRI report? Think again…physical therapy can help.

Two very common scenarios are seen every day at Gold Medal Physical Therapy and other clinics across America:

You bend over one day to tie your shoes before work and feel a jolt shoot from your back all the way down your right leg.
You recently retired and want to take control of your back or neck pain that you have been dealing with for decades so that you can enjoy time with your grandchildren or traveling the world.

When this happens, it is common for people to seek out an MRI to try to determine what is truly going on.

After an MRI, you receive a report detailing the findings. The report will include many words such as degenerative, desiccation, osteophyte, bone spur, spondylosis, herniation, or bulge.

So would mine, and I am completely pain-free!

A 2014 study by Brinjiikji et al. reviewed MRIs of over 3,000 people grouped by decade from people in their 20s to people in their 80s. Everyone in the study had no history of back pain and had full pain-free function.

Thirty percent of participants in their 20s had lumbar (low back) disc bulges and seventy-three percent of participants in their 70s had lumbar disc bulges – without even knowing!

A similar 2015 study by Nakashima et al. showed that eighty-seven percent of the over 1,100 study participants had a disc bulge in the cervical spine (neck) without any pain, history of pain, or other symptoms.

Just because there are findings on an MRI report does not mean that your pain will be forever, unchangeable, or that you will require surgery to fix it. Every day in our clinics we help people regain function, decrease pain, and avoid surgery.

Often, findings on an MRI report can be viewed as simply a natural process of life, just as one’s hair turning gray. We observe what is on the report, but then treat the deficits we can change as physical therapists: muscular weakness, flexibility, mobility, etc.

There are times when an MRI report or a patient’s current symptoms and presentation will mean they need further medical intervention such as consultation with an orthopedic surgeon or neurosurgeon. We as physical therapists are well versed in noticing the signs and symptoms of a patient that needs to seek out further consultation, and we will refer out for anything that we believe will not respond to conservative care or is an emergency.

Vertigo and Physical Therapy

What is Vertigo?

There are several types of vertigo that can be treated in physical therapy. The most common type of vertigo is known as benign paroxysmal positional vertigo commonly referred to as BPPV. BPPV is twice as common in women than men and also more common in individuals greater than 60 years old. This type of vertigo is due to crystals known as otoconia in the inner ear that become dislodged and are now free floating in the semicircular canals in the inner ear. These crystals are gravity sensitive and there is a feedback loop that works with the vestibular nerve to send signals for posture, balance, eye and head position. When there is dysfunction present patients often report dizziness and nausea, and present with nystagmus which is involuntary eye movements.


How can Physical Therapy help?

Physical therapy uses head movement techniques known as the modified Epley maneuver and the barbeque roll maneuver to help the crystals move back to their original resting position. This decreases the dizziness and nausea that are often the main symptoms of BPPV. Symptoms can resolve quickly within the first few treatment sessions. Exercises are then implemented to improve the vestibular system to prevent reoccurrence. These exercises include balance, eye and head movements, and also strengthening of the head, neck, and shoulder for improved proprioception and optimal positioning of the head and neck.


What can I do for prevention? 


There has been some recent research to figure out some of the causes of BPPV. Some research suggests a link with BPPV diagnosis and low vitamin D and calcium levels. Vitamin D helps with the absorption of calcium and phosphorus from the food you eat. The otoconia are calcium crystals and with low calcium the crystals become less dense and easier to become dislodged. There is also a link between BPPV and osteoporosis for the same reasons for low vitamins D and calcium. It is theorized that BPPV is more common in the older population due to nerve atrophy and the loss of the nerve cells and the nerves pass the messages along more slowly. No matter the cause, BPPV is treatable and responds very well to physical therapy and often patients find that they are able to return to their previous level of function.

Call us today to see if you could benefit from physical therapy.

Insurance…..oh no! Breaking down the barriers to care.

Insurance – oh what horrifying word. The truth is insurance can be scary if you do not know what it is exactly you are reading. It sounds like a bunch of mumbo jumbo. Deductible, co-insurance, co-pay, in-network, out of network, and let’s not forget to mention all the little codes they put on your Explanation of Benefits and expect you to know what they mean by them. Sure they give you explanations of everything but if you truly do not understand the wording you will be confused.

Does anyone ever really understand the language of insurance companies? The answer is no. No one really truly understands their insurance benefits and knows exactly what their insurance company is talking about when it comes to your benefits and when they send your explanation of benefits. Well that’s what we are here for!

When you go see your physician and they prescribe you physical therapy, I bet a thought you might have is – does my insurance cover it? Yes, 90% of insurance plans cover physical therapy. There is that small 10% of plans that do not cover it.

While your insurance may cover it there may be an out of pocket cost to you! So how do we determine what your out of pocket cost will be? Normally, we will verify eligibility online or with a phone call. When we verify your insurance we obtain your benefits for physical therapy – we will find out if you have a deductible and if it applies to physical therapy, if you have a copay or if you have a co-insurance, how many visits you are allowed, if you need a script or referral from a visit.

What does deductible, co-pay, co-insurance and out of pocket mean?


What is a deductible? A deductible is a specified amount of money that the insured must pay before an insurance company will pay a claim: You will be responsible for your entire deductible before your insurance will pay for anything.


Do I have a copay? A copay is a fixed amount you pay for a health care service, usually when you receive the service. The amount can vary by the type of service. How it works: Your plan determines what your copay is for different types of services, and when you have one.


What does coinsurance mean? Coinsurance is the percentage of costs you pay after you’ve met your deductible. You will never have a copay and a coinsurance. There may be these slight procedures that require a copay and coinsurance but that is very rare.

Out of Pocket 

The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits. The out-of-pocket limit doesn’t include: monthly premiums.

If you have any further questions or would like to set up an appointment please feel free to reach out to one of our Patient Care Coordinators at either office or request an appointment above.


Tips to improve your home office situation

One of the major challenges that many people have had to deal with since 2020 is working from home. Whether it was having to create a make-shift desk and workspace in a pinch, or if you already had a home office set up, many Americans have had to face these challenges.

Here we will briefly discuss some modifications that you can make in the home to help with your seated posture, and ultimately reduce the risk of postural related pains.

What Chair should I use?

A chair that is adjustable will be your best bet. As easy (and cheaper $$) as it is to use a dining room table chair, this may be a major culprit to your posture. Ideally, a chair that has adjustable height setting is key, which will allow you to sit comfortably with a few easy steps:

– Feet flat on the floor
– Hips and Knees at 90* angles
– Wrists straight with the elbows rested at an angle

What kind of table should I use?

As long as you have an adjustable chair, and your table height allows you to be seated comfortably and correctly, then any table will do fine. Just remember:
– Wrists slightly below your elbows
– Keep your arms close to your sides
– Keep you monitor at arms length away
– The top of your monitor should be at your eye height

What happens if I sit in bad posture for too long?

One of the most common issues that can develop is what is called Upper Crossed Syndrome (UCS). UCS will present with a forward head, rounding of the thoracic (upper back) spine, shoulders up and forward. This can lead to decreased mobility in the upper back, tightness in the pec muscles (Chest) , the Upper Trapezius (Neck) and your sub occipitals (Attaching to your skull).

Is Upper Crossed Syndrome bad?

If left uncorrected it can lead to aches and pains as well as longer term postural issues. However, there are a few things that can be done to prevent the occurrence.
– Change the way that you are sitting
– Stretch the muscles that are tight
– Strengthen the muscles that are weak

What exercises are best for me to start NOW?

– Seated Thoracic Extensions with a Foam Roller
– Is Ys and Ts with a Foam roller
– Upper trapezius and Levator scapulae stretches
– Pec stretches
– Theraband Rows
– Theraband Pulldowns

Examples for some of these exercises can be found in the home exercise tab at the top right hand side of the page.

Disclaimer: As always, these are examples of exercises/ stretches that your physical therapist can discuss/ provide to you. If you attempt any of these exercises and develop additional pains, please contact your M.D or seek counsel from a Physical Therapist. Thank you.


Prehabilitation for success after surgery

Pre-operative Physical Therapy, also known as ‘Prehabilitation’, has shown to have positive outcomes on the recovery process of postoperative rehabilitation for individuals undergoing orthopedic surgery. Undergoing surgery with a poor preoperative functional status can increase the chance of complications postoperatively.

Here are some common questions asked about pre-habilitation, also known as prehab:

What can I expect from my prehab care?

Your therapist and clinical team will prescribe you targeted exercises to improve your overall strength and range of motion (ROM). The more ROM and strength you have prior to surgery, the easier it will be to reach these milestones after. Nutrition is vital before and after surgery. Your Doctor may recommend you meet with a nutritionist. This will ensure that you have a balanced diet needed for recovery.

Surgery is not only taxing on the body, but also on the mind. Working with a Physical Therapist who has helped individuals like yourself, may give you a better understanding of what to expect during the recovery process. You may be discouraged at first, feeling as though you are not progressing as quickly as you’d like. This is okay, recognizing that everyone progresses at different rates is part of the healing process.

Rehab is hard and should be challenging.  Prehab with a Physical Therapist will help to place you in the right mind set to succeed.  Exercise is going to be crucial in your recovery.  Learning discipline and holding yourself accountable will help you recover more quickly.

Which population will find prehab most effective?

Typically, we have found that the elderly population benefits the most from Pre-hab. However, all ages typically do well and we have found that individuals who have sustained ACL tears do particularly well with prehab therapy.

What are the benefits of prehab?

Range of motion and strength appear to improve/ progress faster in individuals who utilize prehab as opposed to those who do not. Patients report reduced post surgical pain levels after working in a course of rehab prior to surgery. Your Physical Therapist can give you an accurate idea of what you need to do for a quicker recovery. Most importantly, having therapy prior to surgery helps you, the patient, set expectations following your procedure.

How long should I undergo prehab?

This will be up to your Surgeon and Physical Therapist. It will likely depend on the severity of the injury and what goals you would like to accomplish prior to your procedure.

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