Trigger Point Dry Needling.

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I just spent a weekend in sunny Arizona.  I was inside the whole weekend!  Some of you may think think that is horrible.  But I was learning!  I am now certified to perform Dry Needling.

What is Dry Needling?

Dry Needling is a physical therapy technique to help reduce pain and other symptoms.  In dry needling, a physical therapist uses acupuncture needles to stimulate an immune response in a certain area. We start by inserting an acupuncture needle or needles around the trigger point, and then along the myotomal (nerves responsible for muscle contraction) and/or dermatomal (nerves responsible for sensation of pain) pattern toward the spine.  Needles may also be inserted at the spine. The action of these needles creates a lesion in the surrounding tissues, stimulating the body’s own immune response.  An increase in blood flow to the area results from the needling!

It is important to note that acupuncture and dry needling are different. Acupuncture is based on Traditional Chinese Medicine and has a focus on correcting Xi.  Dry Needling is based on scientific neurological principles.

Joel with Dry Needles

Joel with Dry Needles

Be sure to call and set up an appointment in either Redmond (425-883-9630) or Mercer Island (425-883-9631).  For further information check out Advantage PT on the Web!



Aquatic Physical Therapy

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We are excited to announce that we are now offering Aquatic Physical Therapy at our Mercer Islappostcard Aquaticnd location!!

We have access to a pool at our Mercer Island facility and there are many benefits to using the water for physical therapy.  The bouyancy of water decreases the amount of weight one puts through joints and applies compression from the outside.  With just these two properties of water, one can begin to bear weight through injured joints, and decrease inflamation.

Aquatic Therapy has been used for arthritic conditions, joint replacement and other orthopedic rehabilitation, sports injury rehabilitation, and low back pain.  All of these, and more, can benefit from physical therapy in the water by decreasing the amount of stress through the joint.

Treatment in the water can include, but is not limited too:

  • Range of motion exercises
  • Core strengthening and stability
  • Strength training
  • Endurance training
  • Gait training

There are so many benefits to being in the water for therapy:

  • Increased temperature in therapy pools can help to decrease inflamation and increase circulation inside the body.
  • The resistance applied by the water can change depeding on the depth of the water, so a treatment can be constantly varied to meet individuals needs
  • Studies show that the copmbination of warm water and bouyancy can decrease sensitivity to pain

To experience the benefits of Aquatic Physical Therapy, please contact Advantage Physical Therapy at 425-883-9631.

Physical Therapy Patients Return to Competition

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In a physical therapy practice, we see many types of injuries.  Some people want to return to pain free living and working, but others want to return to competitive athletics and/or aggressive fitness styles.  From runners to basketball players; tennis players to swimmers; and many others, the goal of physical therapy is to return to the sport they love.  In the last couple of years, crossfit has become the new competitive sport that a lot of people are joining up and doing.

Crossfit is a very strenous workout that stresses “functional movement.” It is widely thought of as an intense workout, but not many people know that there are local competitions.  Advantage PT has 2 clinics (Mercer Island, WA and Redmond, WA).  Working at the Mercer Island clinic, I see many athletes from the local Crossfit gym Mercer Island Crossfit. Recently a husband and wife team of former patients competeted at a local event called the Resolution Revolution 2. Stone Way Crossfit hosted the event for “couples” (any male/female partner).


These 2 patients were exceptional athletes, had some injuries, and became better athletes after following a program of physical therapy.  They were seen for different body parts, but the activies they do require multiple body parts.  Here are a few pictures from the event!

jared press (2) meg clean (2)meg du (2)


Maintaining your balance

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English: Vrksasana, the tree position, a Yoga ...

English: Vrksasana, the tree position, a Yoga posture. (Photo credit: Wikipedia)

Is balance an issue for you? You are not alone!

I see many patients with balance problems, and not all of them are using canes, walkers, wheelchairs, crutches, or other aides to keep them upright.  Some of them feel they are moving and balance just fine on their own.  And maybe that’s true.  But I find it much more common that someone creates a way to balance so there is no need to realize that balance is poor.

The leading reasons for poor balance are; hip weakness, poor core stability, ankle instability, and joint hyper/hypomobility.

By keeping the muscles and joints of the low back and lower extremities in good condition with exercise and movement, we can prevent developing balance problems later in life.

Did you know that by moving, you innately need some balance?  Walking and running are basically just alternating balancing on one foot as well as moving forward at the same time.

In order to keep your balance long into life, you can try these exercises to keep you upright.

Here is an exercise to practice your balance:

You can make this harder by adding a pillow under your foot or closing your eyes, or both!!!

This second exercise will strengthen your hips to help your balance:


Spinal Mobility

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Most of us know that as we age, it is important to keep moving.  Whether that is full on, hardcore exercise, or gentle walking is not important.  What is important is to keep every joint in the body mobile.  This includes not only the joints of the extremities:

  • Toes
  • Ankles
  • Knees
  • Hips
  • Fingers
  • Wrists
  • Elbows
  • ShouldersThe lumbar region in regards to the rest of th...

But also the joints of the spine.  The spine consists of 7 cervical vertebrae each with 4 or more joints, 12 thoracic vertebrae with 6 or more joints and 5 lumbar vertebrae with 4 or more joints.  The spine has over 120 joints, which can tighten with bad posture, overuse, pregnancy, and/or poor technique with exercise.

We are trained as early as pre-school to sit still.  If you look at children today, most are hunched over a desk or table to learn (class), study (homework/library), eat, or play some sort of game.  This continues into adulthood as we tend to work at a desk or watch TV.  All of this time spent in one position can lead to degenerative changes in the joints of the spine.

We need to move.  Spinal mobility can be improved by standing up and moving around.  I recommend to my patients to get up at least once per hour and move around the office and do some back bends and neck rotation exercises to help keep the spine limber. (click here for some neck exercises)

When your spine is tight, it can lead to the muscles of the spine getting tight as well.  This muscle tightness can lead to back and/or neck pain, shoulder pain, and even headaches and TMJ (temporalmandibular joint) pain.

If you are concerned about back pain and joint mobility, your Physical Therapist can help design a program for you to stay mobile as well as provide manual therapy to increase joint mobility of the spine.


Prevent and Treat IT Band Symptoms

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Many people who are active feel sore knees either during or after participation in exercise and sports.  Unsure if they did anything to cause injury, most people just rest and then resume activity.  The IT (iliotibial) band can be a major culprit in some of these injuries.  The IT Band runs down the side of your leg from just above your hip all the way to your knee.  A tight IT band can pull the patella to the outside and cause some havoc with patellofemoral gliding.  At the same time, a tight IT Band can increase pressure over the greater trochanter and its bursa causing trochanteric bursitis.  Being able to keep the IT Band supple can help to stop both knee pain and some hip pain.

How do you keep the IT Band supple?  There are really two ways that work, and it is best if you perform both of them together. A strong hip will help create better alignment of the leg reducing the load on the ITB.  A majority of my patients demonstrate strength deficits in the gluteus medius muscle with is a strong supporter of pelvic alignment during ambulation.  Other hip dysfunctions due to weakness may result in walking or running with your leg rotated away from midline and the toes pointing more outward than forward.  Remember, strong and stable hips will help keep the IT Band from getting to tight.

Sometimes people are really tender along the IT band.  You can check yourself by applying gentle pressure along the side of your leg between your hip and knee.  If this is the case, the strengthening exercises below will help you out, but you will need to perform some “stretching” type of exercises as well.  I have found that even with a tight IT Band, it is a difficult muscle to perform a stretch to, but it is possible for some people.  What I find to be most effective to loosen the tissue is a self massage with a foam roller or a self roller.

Here are two exercises to help you on your way to stronger hips!

Side Lying Leg Raise



You can always use a foam roller to help massage out the ITB.  If this is not progressing the way you would like, please call us at Advantage Physical Therapy and schedule an appointment


Knee Pain

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Upon returning to exercise, it is common to feel pain in the front of the knee just below the knee cap (patella).  This is a very common complaint among my friends and in my practice.  In physical therapy and orthopedics, this type of pain is generally referred to as patellofemoral pain.  It is related to the way the patella tracks in the femoral groove.  There are many reasons for this to occur:

English: Right knee.

English: Right knee. (Photo credit: Wikipedia)

  • Weakness of the hip abductors
  • Tightness of the illiotibial band (IT Band)
  • Poor foot control
  • Tightness of the lower extremity musculature (hamstring, quadriceps, and gastroc-soleus complex)
  • Poor form in exercise

Because there are many causes for this anterior knee pain, it is important to get a proper and correct diagnosis from a physical therapist.  If you have pain in the front of your knee, your physical therapist can design a program to help you beat the pain and return to your exercise program.

This month’s Sports Health: A Multidisciplinary Approach has an article that talks about how exercise (done properly) is the best intervention for patellofemoral pain. (Read the Abstract here)

In my practice, I find that a majority of patients require training of the gluteus medius, which is the major hip abductor muscle.  This muscle can become weak due to positioning of the leg during exercise.  If you look at your feet when they move, are they turned outward?  If so, this is the body’s way of compensating for a weak gluteus medius, and forces the tensor fascia latae (TFL) and ITB to do a lot of the work, thus changing the position and angle of the knee bending during gait and squatting/lunging movements.

Here are a few exercises that can be performed to target and strengthen the gluteus medius:


Sidelying Hip Abduction:


Bridging with Band:


Single Leg Balance:


Wall Slides/Squats:


It is important to remember that, although these exercises may help your knee symptoms, a physical therapist can help treat the cause and individualize a program for you.  Please contact Advantage Physical Therapy to set up an appointment!!!


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