Physical Therapy

Hiking in Arizona? Here's How To Prevent Injury

One of the best things about living in Arizona is the abundance of hiking trails. With sunny skies the majority of the year, Arizonans are able to enjoy the outdoors virtually year round.

On many occasions, I have seen patients with either a new injury from hiking, or from a previously resolved injury that got exacerbated by hiking. Due to the physical demand of even the smallest and easiest hiking trails, it is not uncommon to develop some aches and pains resulting from a hike. Over the years, I have offered advice to minimize risk of injury.

Bring Water
This one is, or at least should be, obvious. Often people underestimate the dehydrating effect of a hike. Also, don’t think this only applies to the summers. Cooler weather days in Arizona are often very dry as well. In addition, excessive sweating, no matter what the ambient temperature is, can lead to dehydration. Dehydration can lead to headaches, muscle cramping, dizziness, confusion and fainting. So, bring water with you on your hike and drink before, during, and after your hike.

Flexibility is key to prevent injury in any type of exercise. Flexibility of the joints that are involved in hiking (specifically hips, knees, ankles) allows for full range of motion. Lack of flexibility in joints can lead to injury when the joints are forced to move out of their normal range of motion. This can lead to sprain/strains or even worse, tears.

Taking breaks when hiking will allow for muscles to recover. When muscles are too fatigued, this makes them vulnerable, and can ultimately, lead to injury.

Dress right
Focus on utilitarian and function rather than fashion (sorry Lululemon). Wear good supportive shoes, proper clothing, a hat and sunscreen.

Know your limits
It’s ok to challenge yourself, but pushing yourself when hiking on Arizona trails, especially when you’re deconditioned, not prepared, or have a medical condition, can lead to injury.

So, next time you decide to take advantage of one of Arizona’s beautiful hiking trails, be smart and follow the pointers provided above. Also, ask the advice of your Physical Therapist at ReThrive to determine whether you are physically capable.

Bad Headache? Your Posture Might Be To Blame

What is a cervicogenic headache?

A cervicogenic headache is head and/or neck pain that is referred from the bony structures or soft tissues of the neck including the muscles or joints. Referred pain is pain that is felt at a site other than where the cause is located. These kinds of headaches can present on their own, or in conjunction with other types of headaches, such as migraines.

While these headaches can be seen after a traumatic event such as a motor vehicle accident or assault, these headaches are often seen without a precursor of trauma or specific injury. In fact, many people with cervicogenic headaches have sedentary jobs that often include sitting at a desk or computer for most of the day.

Cervicogenic headaches often appear in conjunction with other types of headaches. Some experts say there are as many as 150 different types of headaches. Also, a person can experience more than one type of headaches and many are hard to tell apart. The different headaches can affect each other as well (ie: cervicogenic headaches can be worsened by migraines and vice versa).

Symptoms Physical Therapists can Help

-Pain localized to the base, side or front of the skull
-Pain localized above or behind the eye, jaw/ear area
-Pain into the head or neck that is intermittent and lasts hours to days
-Pain that worsens with head/neck movement, or sustained or awkward positions - range of motion is often limited
-Can have any of these symptoms with nausea and visual disturbances as well

How to prevent or minimize cervicogenic headaches

Often, people who suffer from cervicogenic headaches, sit at desks for the majority of the day. This contributes to a forward head and rounded shoulders posture. As a result, this can lead to shortening and weakening of the muscles around the neck and shoulder blades. Below are ways to prevent/minimize headaches.


Sit up tall
Pull back shoulder blades Stand up every 30 minutes


Massage from neck to mid back


Chin tucks- hold 5 sec, repeat 5x (insert chin tuck pic)
Neck stretches- pull ear to shoulder & chin to shoulder, do 2x, 30 sec holds (insert neck stretch pic)
Rows: pull shoulder blades back, do 2 sets of 10 (insert row pic)

When evaluating a patient with cervicogenic headaches, a Physical Therapist performs an assessment of the following:
-Posture of head, neck, shoulder blades, and mid back
-Range of motion of neck, mid back, and shoulder

-Flexibility of soft tissues surrounding the neck, shoulders, shoulder blades, and spine -Strength of muscles around neck, shoulders, and shoulder blades
-Joint mobility of the neck, mid back, ribs, and shoulders

After assessing the patient, the Physical Therapist will treat the patient. When treating my patients, I utilize 5 methods:

  1. Modalities such as ultrasound or electric stimulation to promote blood flow and healing and decrease inflammation

  2. Exercises to strengthen/stretch muscles in the neck, rotator cuff, also postural exercises.

  3. Education- instructions on body mechanics when sitting (in car or at desk), standing, bending/lifting, sleeping (proper use of pillow)

  4. Manual Therapy- joint mobilization and muscle stretching to improve joint and muscle flexibility

  5. Home exercises to reinforce program

Physical Therapy can be a very effective means in the reduction and often complete resolution of cervicogenic headaches. If you are unsure as to whether you’re a candidate for physical therapy, ReThrive can help determine the best course of action. If you’re interested, contact ReThrive, and schedule an evaluation.

Think You Have Whiplash? Read On.

Whiplash is an injury to the neck region caused by a sudden forward and backward force of the head and neck. Most often, this is from a motor vehicle accident.

Cause of whiplash
Most of the time, whiplash is caused by a motor vehicle accident where someone is rear ended. This force pushes the car seat the person’s torso forward which causes a relative backward motion of the head. Following this, the head and neck are forced forward. This forced, unexpected motion can lead to stress/strain to the soft tissues surrounding the neck region.

How long does whiplash pain last?
Whiplash pain can last from a couple days to several years depending on the severity of the injury and also the condition of the individual prior to the injury.

Symptoms of whiplash
There are a variety of whiplash symptoms. Some symptoms that might be experienced include: neck pain, arm pain, shoulder pain, back pain, headaches, dizziness, nausea, blurred vision, or numbness or tingling into the arm/hand.

What to do if you think you have whiplash
Go to your doctor or Physical Therapist. An x-ray might be recommended to rule out a more severe injury such as a fracture. Sometimes, other diagnostic tests may be recommended to rule out other issues such as a tear, disc herniation, etc. Often, after a motor vehicle accident, the individual is taken directly to the hospital where the above tests are performed immediately.

Treatment for whiplash
Physical Therapy is often recommended for whiplash. The physical therapist has the skills and knowledge to effectively diagnose and treat whiplash. Physical Therapists can expedite the healing process and provide for the best possible outcome by addressing the problems and building up strength and flexibility, which, in turn, can prevent/minimize the chance of future injury.

How Physical Therapists treat whiplash
The physical therapist’s goal is to get the patient back to their prior level of function. Often, patients finish their physical therapy course of treatments feeling better than they did prior to the whiplash injury.

After completing a full, comprehensive evaluation, treatment for whiplash has a four step process.

  1. Patient education - teaching the patient body positions to avoid which can impede healing. Also, will teach good body positions to utilize while active during the day, when at work, or when lying in bed. This will allow for optimal healing by minimizing irritation and providing an adequate healing environment.

  2. Manual therapy - manual therapy is physical therapist’s use of their hands to address flexibility and joint mobility. This is done by stretching muscles and fascia and by mobilizing joints of the neck and mid back. There are many different manual therapy techniques, including use of dry needling, that can be utilized and significantly improve the patient’s pain and improve function.

  3. Exercise: exercises will emphasize the upper body to improve strength and stamina. This can improve function and reduce pain by providing adequate support to the upper body specifically around the shoulder blades and neck.

  4. Modalities - various modalities such as electric stimulation or ultrasound can help in the reduction of inflammation, reduction of pain, and increase of blood flow to promote the healing process.

Contact ReThrive if you have any questions and/or need treatment for whiplash. It’s never too early to consult with a PT.

After Spine Surgery, Physical Therapy is Key

There are many reasons people undergo spinal surgery. Whether spine surgery was due to an acute injury, a structural anomaly, or a chronic issue, physical therapy is an integral component of the rehabilitation process. Often physical therapy begins immediately after the surgical procedure. Other times, physical therapy isn’t started until several days or weeks following the surgery. When exactly physical therapy begins is determined by the spine surgeon and is based on numerous factors including: time needed for healing, physical condition prior to surgery and the type of spinal surgery performed. Physical therapy plays a crucial role in the process of getting you back to doing your daily routine, including completing activities of daily living, and work related tasks.

Initially, the physical therapist will focus on pain control and patient education. The goal is to educate the patient on spinal care including positions to avoid. Also, will focus on teaching proper, more efficient ways to transfer in and out of a bed, chair, and car. Education on proper posture and movement patterns is crucial to minimize harmful positions. It’s important to incorporate positions that minimize spinal compression and allow for adequate healing. Various means of pain control that are utilized in physical therapy include: ice and different modalities such as electric stimulation. This can help with healing, improving tissue mobility, and the reduction of inflammation and pain.

Next, the physical therapist will work on exercises focusing on improving flexibility, proper body mechanics, and building up strength, power, endurance and stability in and around the spinal region. Various exercises will be instructed. The physical therapist has knowledge and skills to know what muscles need to be addressed. Also, the patient will be provided a customized home exercise program that reinforces the physical therapy provided.

As the patient continues physical therapy, exercise intensity will be increased with a goal of functional independence. Eventually, the patient will be discharged from physical therapy and advised to continue performing the home exercise program to further improve.

While the spinal surgery addresses the structural damage done, the goal in physical therapy is to learn or relearn how to move in order to prevent further injury to the area involved, or other areas of the spine.