Latest Physical Therapy News

How Does CranioSacral Physical Therapy (CST) Help with Chronic and Acute Pain?

July 4, 2018

If you've never heard of craniosacral therapy, you're not alone. John Upledger was the first person to bring Craniosacral therapy to the forefront in the 1970's. The term marries both "cranium" and the pelvic bone connected to a spine. As an alternative therapy in the medical world, Craniosacral therapy employs a gentle method aimed at strenghtening the physiological system. This system is comprised of the membranes and cerebrospinal fluid that surround and protect the brain and spinal cord. These intricate systems work together to play a central role in the overall controlling functions of the body. As a result, when something goes wrong with this system, it can cause issues throughout the entire body such as lower back pain and knee pain.

Using very little pressure, practitioners give relief to the central nervous system by manipulating the blocked pathways. This is aimed at re-balancing these structures and is  necessary even decades after injuries have occurred throughout the body. Many injuries can continue to persist for years beacuse the trauma was never fully addressed.
How does Craniosacral Therapy help with chronic and acute pain? Let’s take an in-depth look at what is chronic pain and acute pain?

What is Chronic Pain?

Pain that is considered chronic lasts more than three months. This type of pain is different than cutting your finger or injuring your knee while running. Chronic pain is usually more of a constant dull pain that never seems to heal, but can also commonly be experienced as pain that is throbbing, burning, shooting or stiffness.
Many people experience chronic pain after an injury that hasn’t been taken care of properly. When an injury is suffered, surrounding pain sensors send a signal from nerves to your brain. As an injury heals, the strength and existence of these pain signals dissipate until they are no longer felt. However, in the case of chronic pain, the nerves do not stop transmitting these signals to the brain after the body has recovered.
Many times, however, it is a puzzle when it comes at identifying the pain points where the chronic pain starts to originate and beacsue of this, practitioners use trial and error. When left untreated or ineffectively treated, this ongoing discomfort can make it difficult for a person to function on a daily basis. This interference with the performance of routine activities can often lead to mental health issues as pain is intertwined with emotions such as anger, depression, fear, etc.
While finding the right treatment might be difficult to find, it is not possible. The following are regularly causes of chronic pain, though there are many others. If any of these issues are present, consider using CST to address pain:
  • Back problems
  • Neck problems
  • Past, untreated injuries
  • Arthritis
  • Fibromyalgia
  • Migraines
  • Infections
  • Nerve Damage

Acute Pain

Acute pain is classified differently than chronic pain because of the duration. Acute pain typically lasts less than three to six months and is related to soft tissue damage such as scrape or a sprain. Chronic pain differs from acute pain in that acute pain will cause discomfort until the injury heals and is always easier to eradicate. The pain can easily be assigned to an existing trauma and more easily addressed.

How Craniosacral Therapy Helps
The membranes and fluids that surround the central nervous system are subjected to strains throughout daily activities. Overtime, this can cause the craniosacral system to develop tensions that restrict the body’s ability to function naturally. Craniosacral therapy aims to remedy the pain processing and the brain and spinal cord and release the tension that has become present and causes ongoing problems.

As a tool that encourages the body's natural healing processes, CST is used as a preventive measur and helps at curbing disease as well as a multitude of medical problems.
  • Migraines/Headaches
  • Chronic Neck and Back Pain
  • Motor-Coordination Impairments
  • Central Nervous System Disorders
  • Concussions
  • Traumatic Brain and Spinal Cord Injuries
  • Chronic Fatigue
  • Stress/ Tension-Related Issues
  • Fibromyalgia
  • Temporomandibular Joint Syndrome (TMJ)
  • Neurovascular Disorders
  • Post-Traumatic Stress Disorder
  • Pelvic Pain
Craniosacral therapists use the rhythm of your body to create a healing blood flow. Often times their work releases trapped traumas from physical injuries, emotional and psychological stresses throughout the individual's life. There are many individuals who have been told that their condition is genetic or caused by stress, and if no effective treatment has been found for them, they may have to learn to live with it. Craniosacral work offers lots of hope in taregting specific issues and is goes strigh to the source--n the cental nervous system.                                                                                                                                                        
This is a specialized type of treatment, and Body Image Physical Therapy has several practitioners who have used this as part of their normal physical therapy practice for over 25 years. Many patients have dramatically improved their pain after starting to implement   craniosacral therapy. A craniosacral session goes for about 45-60 minutes and may be covrered by insurance.

Contact Body Image Physical Therapy today at 720-870-8900 or fill out our contact form on the website to get help living the life you love, pain free. We are the experts in this field and are excited to help you with Craniosacral therapy in Aurora. We offer a wide range of both traditional and alternative treatments aimed at serving the community with the highest standards of care. We can help with neck pain treatment, lower back, chronic back pain and more.  No matter what you are experiencing, we are here to help you recover. We look forward to working with you soon!

Stop Relying on Your Old Supports/Braces!

June 6, 2018

One of the most common comments we hear in physical therapy and in the fitness center is…

”You know….I do have a few knee braces in my closet….maybe I should wear those again” (Or back brace, ankle brace, elbow brace, etc.). 

Unfortunately, many people believe that once an injured joint, muscle, tendon or ligament, always an injured body part. That is not always the case! This kind of thinking causes people to keep their braces safely tucked away, just in case they might need them in the future. Although we do have some people that might need to go back to their old supports for specific activities, it should really be limited. The goal is to heal completely and properly and retire your support/brace. But when do we know when the time is right?
Here are some general guidelines for when it comes to using support devices:

Post Surgery

If you had a surgery to correct a mechanical problem and that surgery really did correct that issue, like an ACL reconstruction, or a spine fusion, you will usually graduate to the next phase of healing. The next chapter is usually the use of a support/brace for a specified period of time. Following that you will start retraining the muscles to support that area correctly. Once that has occurred, it would be no longer be necessary to use that support or brace. The retraining of the muscles supporting the area is as important as the surgery in making sure that you get long-term relief and you cannot properly do that if you are consistently relying on a brace. If you are still experiencing trouble with the affected area, you should contact your medical professional or physical therapist to understand more clearly why your body is failing to fully recover properly. Relying on a brace can cause long-term problems if your muscles are not retrained.

Post Therapy

There are many kinds of injuries that might require a support or brace for recovery and can be common, especially for high impact careers and athletes. This can include but is not limited to a blown out knee, ligament damage, fractures, and torn muscles. If you had a non-surgical injury, then the same pathway is generally followed as with a postoperative status. There may be some kind of brace or support, followed by rehab to help the body recover strength, balance, and endurance. At this point in your recovery process, it is vital to use the brace prescribed so you can retrain your muscles affected. But be sure to only rely on the brace for as long as prescribed by your If the area of concern is deemed to be permanently unstable, then a brace may be appropriate at certain times. Your rehab specialist will help you make this determination and will instruct you on how and when to rely on the brace.

On-going Pain

Do you suffer from on-going pain after a surgery or injury? If you are reaching for your braces and supports anytime you even consider activity or feel pain, perhaps the issue was never fully resolved. Have you seen a professional about it lately? There have been significant advances in surgery and physical therapy and your issue may be one that can now be addressed more easily than it once might have been. Remember that oftentimes, chronic issues can cause secondary concerns or overcompensation that can actually be worse than the original injury. This can happen because the patient may have chosen to just deal with the injury or suffer through it instead of fixing it properly by engaging the help of a medical professional. Once the mechanical fault has been addressed (and this does not always involve surgery), rehab or physical therapy will help ensure a complete return to a normal lifestyle. 

Here are three things you should remember when recovering from an injury:

  1. Be careful to not have too much impact on your injury. If you have on-going knee pain, it might benefit for you to alternate exercise to something that has less impact on your knee. Talk to your rehab specialist to discuss equivalent activities that you can participate in. Instead of running, you might switch to something that isn’t as hard on your knees, such as swimming.
  1. Don’t rest too much. Although your doctor might recommend down time, you will also need to restore and rehabilitate the injured muscles eventually. A lack of activity can cause weight gain, stiffness, or a lack of adequate healing. This can cause your recovery time to increase even more. It is important to follow directions provided by your  physical therapist as they might provide you with specific stretches that are directly associated to your injury. Make sure to talk to your doctor about which activities you can start out with that are low impact before you graduate to your regular exercise regimen. Another issue that is commonly related is weight gain associated with down time. Weight gain can affect your injury too and it is vital that you get back to your regular exercise schedule as quickly as possible to minimize that happening.
  1. Wear the right shoes. Be sure to understand what shoes and inserts are the best option for you based on your injury, body type, and shape of foot. If you have high arches, you need a shoe with stronger support. There are a multitude of options available for you to choose from when it comes to shoes. You can even consider getting custom inserts made that are perfectly formed to your feet for the ultimate support.
Give those braces away, and make more room in that closet for hiking boots, skis and biking shoes. Life is short…and time is precious.  Worry about whether or not you still fit into your uniform, and not whether or not you still fit into your brace.

If you have any questions about whether or not you should be using an old brace, please contact Body Image Physical Therapy & Fitness Center to schedule an appointment or get more information at 720-870-8900! We are more than happy to help you be on your way to a full recovery.

It's April in the Rockies and Time to Work Out the Winter Kinks!

April 11, 2018

Springtime: April showers, digging in the yard, hiking, biking, climbing, running, skateboarding, soccer, baseball, park days…..that time of sliding out from under the winter blahs and back into all those outdoor activities. It’s that time for those activities that Colorado affords us the opportunity to do 6 months out of the year by providing us clear skies and the perfect temperature. Of course, if you are a true Coloradan, you have already had the shorts, t shirts and sandals out for months.

Whether you are an extreme outdoor enthusiast or a casual admirer of CO’s beautiful weather, there are steps you should take to shake off the winter cobwebs. Jumping head first into your favorite spring activities can lead to soreness or even muscle and joint injuries. It’s a story we hear all the time here at Body Image Physical Therapy and Fitness. Here are a few exercises that can help with full return to activity and which can also lessen the possibility of needing to see your orthopedist or PT anytime soon:

Back bends:

Back injuries are both common and can be very serious. Dealing with pain from a back injury can take you out of commission for a significant period of time. It is important to take the necessary preventive steps to make sure you aren’t wasting any of your spring days stuck laying down on the couch. Back bends are especially important after bending over in the garden or spending an extended time in a forward bent posture, come back up to erect position slowly, while squeezing the butt muscles isometrically, and then gently bending slightly backwards a few times. This helps with realignment of the spinal segments and encourages the muscles to pull you back into a fully erect position more comfortably.

Pectoral stretches and scapular squeezes: 

We also spend so much time with our arms in front of us (think driving, computer work, knitting, holding a book, holding any electronic device, etc) that our chest muscles tend to get short and the postural muscles get too long and ineffective. Spend at least 60 seconds a couple times per day, putting your hands on your doorframe about eye level and leaning your body gently through the doorway to stretch the chest muscles. Then drop your arms at your sides and pull the shoulder blades gently down and together to help activate the postural muscles. This is a subtle motion and the arms should not move when you do this; just pull from the blades.

Quad and Hamstring stretching:

Another 60 seconds on each leg for the quads and the hamstrings will go a long way in loosening up the rest of the body. To stretch your quads, stand erect and bend a knee, bringing your heel to your butt. Keep the knees in line with each other and hold your foot with the hand on the same side as the bent knee. Place your other hand on a stable object in order to brace yourself for balance if you are struggling to hold the position. Next you will want to work on loosening the hamstrings. Simply begin by facing a chair (or any flat surface of a similar height), stepping back away from the chair, keeping all toes pointing forward, and placing one heel on the chair with the knee straight. Keep your body upright, and lean forward but all the way not down (like trying to keep your nose above water).

Calf Stretches: 

Calf stretches can be especially important for hiking. Calf cramps are zero fun and can happen easily if you don’t take the time to loosen them up. To stretch your calf you will want to find a wall or some other stable upright structure of some sort. Face the wall and step backward with your right foot, bringing your right heel all the way to the ground. Be sure you are keeping the toes of both feet pointing forward toward the wall. Your right foot should be stepped back far enough to where your left knee bends. Place your hands on the wall for balance. You want to be in a comfortable position, yet still feeling the stretch in your right calf. Hold this stretch for 30-60 seconds. After, switch the position of your feet to stretch your left calf.

Groin Stretches: 

When you have tightness in your groin and inner thighs, you may experience pain in both your hips and lower back. The following simple stretch is another great warm up for nearly any outdoor activity. The first step is to stand upright with your feet spread apart and toes pointed slightly outward. You will want to slowly lunge or bend your knee to one side until your knee is roughly over your foot. After holding the position for 30-60 seconds, stand back upright, and repeat the move to the other side.

Taking a few minutes to stretch is a much better option than taking a few days, weeks, or months to heal after damaging your body. Remember to stretch about a minute (watch the clock, please) as your muscles need time to understand they are being required to lengthen. Do not only stretch before engaging in physical activities. Also be sure to stretch after activities to re-lengthen the muscles and do dynamic warm up before activities to get the blood circulating for action.

When you incorporate a routine of pre and post stretches surrounding physical activity, you are doing more than helping to prevent injuries. Increasing blood circulation to muscles, improving your posture, acquiring a greater range of flexibility,  reducing overall soreness resulting after strenuous activity are all health benefits of stretching. However, there is no foolproof protection against sustaining an injury. If you do get hurt during your spring adventures, contact Body Image Physical Therapy & Fitness to help get you back in action in the shortest amount of time possible.

Spring Cleaning - Advice on How to Properly Maintain Your Sports Equipment

March 14, 2018

With the first day of Spring quickly approaching, many people are dusting off their athletic equipment to use in the warmer weather. But what many don’t realize is that a simple spot shine won’t do the job of properly maintaining their gear. As with our bodies, proper maintenance of our athletic equipment can go a long way towards ensuring that you are getting the maximum benefit and investment from your bikes, skates, skateboards, snowboards, skis, rackets, running shoes and those ever so expensive orthotics.

Body Image PT, would like to remind you about the need to clean and maintain the many tools you may choose to use to keep yourselves active and healthy. Here are a few tips for you to follow as you start to take your equipment out of storage, and get them back into fighting shape.


It may seem like a daunting task, but if you maintain all the parts of a bike you can rest assured that it will operate smoothly and efficiently for years to come. Before every ride it is important to inspect your bike. A good rule of thumb is to remember you ABCs! A for air, B for Brakes, and C is for chain.

When checking the tire pressure, it is important to the know the psi (pounds per square inch) for your tires. Narrow bike tires need more pressure than wider ones. Road bike tires require anywhere from 80 to 130 psi, hybrid tires need 50 to 70 psi, and mountain bike tires from 25 to 35 psi. When out for a ride it is important that you have a patch kit and a air pump with you incase you lose air or get a flat.

For brake inspections, make sure that they engage when you squeeze both the front and back levers. As for the chain, ensure that it is well lubricated and everything is clean. This will ensure that the gears shift easier and will help the parts last longer.  

Snowboards and Skis

Winter weather sports is slowly winding down but it is still important to keep your equipment in good condition for next season.

To start with, it is important that your skis or snowboard have a protective layer of wax, to keep them from drying out and to provide you with a smoother ride. While new equipment may come with “factory wax” already applied, many riders agree that giving them a hot wax treatment will go a long way in extending the life of your gear. Tools of the trade include wax, an iron and a scraper. While they sell designated irons for this purpose, any iron will suffice: but never use the iron on clothing afterwards as it would ruin your garments. It’s important to note that waxing isn’t a one-and-done step, but will need to be conducted from time to time.

When dealing with gashes caused by exposed rocks or other abrasive materials on the slopes, deal with them sooner rather than later. If it’s just a small nick, you can apply hot wax to the area, but if it is much deeper you’ll need to take it to a shop or you can repair it yourself with a P-Tex candle.

After each and every ride, remember to dry your equipment thoroughly as any moisture left on your board could rust the metal components. If you’re ready to hang up our skis or snowboard for good this season, give it a good wipe down and thick layer of wax that you can scrape off next year; and store it in a cool, dry place where it is not at risk of getting knocked around.

Skates and Skateboards

While skates and skateboards differ in their specific maintenance, the overall theme towards maintaining them is to tighten their components, keep them out of temperature extremes, and make sure that the wheels are well oiled to provide for a smoother ride.

Having the tools available can help you check the wheels, trucks, bearings and more without having to take your gear to the shop each time.  

Skates, skateboards, snowboards and skis all need upkeep as well.  Replacing worn parts (do the wheels roll smoothly and do your bindings release properly?)  will go a long way toward making your upcoming season a smooth, active, injury free one. There are many resources online that provide exceptional details towards skate and skateboard maintenance, so be sure to conduct your research when taking your things out of storage.

Tennis and Racquetball Rackets

Have you had your tennis /racquetball rackets restrung in the last decade?  Do the handles fit your hands properly? Or are you just itching to come to physical therapy with tendinitis created by an ill- fitting racket? Chances are, if you play hard with your rackets, they might need to be replaced or repaired.  

Running and Walking Shoes

Running and walking shoes are an item that some people are meticulous about replacing properly, and many more are not so good about replacing.  You know which one you are. If you fall into the second category, you are not doing your feet, knees, hips or back any favors by trying to slide through one more year in a pair of worn shoes.  A shoe is support for your feet so that they hit the ground properly, and propel you forward with ease and proper body mechanics. An orthotic being used in worn shoes will not substitute for having a proper shoe in which to put the orthotic.  

So let’s talk about orthotics.

Due to the expense of a molded orthotic, we tend to think they should last forever.  As our feet change shape pretty much constantly throughout our lives, this theory can be lacking in truth.  Your feet may no longer work with the orthotic you bought even 3-5 years ago. That ache you have been developing in your back could be related to the old orthotics in your shoes.  Start with a good shoe that supports your feet properly, then determine if you need an orthotic to assist you further.

Do some Spring cleaning to start your year off right.  It will help you play better and feel better.

Dry Needling in Denver: What is Trigger Point Dry Needling, also known as TPDN, TDN, or IMS (Intra Muscle Stimulation)?

February 14, 2018

Have you ever wondered what those nasty little knots are that appear in your muscles and cause you pain?  They may be active trigger points in your muscle or connective tissue. Physical therapist that are trained in treatment of trigger points through trigger point dry needling. Trigger point dry needling can treat these points to provide relief of even chronic pain symptoms. The term ‘dry needling’ was coined to differentiate it from ‘injection needling’ where a substance (medication or otherwise) is injected into tissue with a hypodermic syringe.

Trigger points occur when there is too much electricity trapped in the muscle fibers.  This can happen through injury, misuse or overuse of a muscle. Trigger point dry needling is a technique where acupuncture needles are inserted into a myofascial trigger point, muscles or connective tissues to help release trapped electricity and, essentially, deflate the trigger to relieve pain.  It is known that the use of trigger point dry needling activates a ‘local trigger response’, an involuntary spinal cord reflex, although some of its biochemical and neurophysiological effects are still being studied.

While trigger point dry needling utilizes the same solid filiform needles, typically .16-.31 mm in thickness, that the Traditional Chinese Medicine of acupuncture utilizes, its science and research is based off western medicine principles and large body of research of the human muscular system.  The effects and mechanisms of dry needling are complex though research suggests that the local twitch response elicits a response from the brain in the area of pain or discomfort. There is a growing body of scientific evidence that supports the positive effect inserting a needle has on the electrical and chemical communications that take place in our nervous system, including the natural release pain relieving chemicals as well as the transmission of pain signals in our spinal cord. 

Trigger point dry needling can also be utilized as a diagnostic tool for physical therapists as the local twitch response would not be stimulated within healthy muscle tissue.  Trigger point dry needling may be heavily utilized near the beginning of a treatment plan as a means to break the cycle of pain.  After the technique is applied to a particular area, the muscle then needs to undergo re-education through exercise to help it learn how to work normally again.  This will help reduce recurrence of these trigger points, and help provide long term relief from pain.

Why does trigger point needling work?

The most widely accepted theory as to the reason trigger point dry needling works to help treat muscle spasms and reduce further muscle damage is that a muscle spasm creates a cycle of pain which further inhibits blood flow, oxygen and nutrients to the muscle tissue.  By introducing a needle and disrupting this cycle, the muscle is allowed to relax and repair itself while allowing further treatment using standard physical therapy practices.

This is a technique that should only be performed by someone who has been trained, and your physical therapist may be that person.  Physical therapists will typically utilize trigger point dry needling as a single tool within its larger treatment plan for any given condition.  Release of trigger points may provide relief from pain that has been present for short or long periods of time.  Some patients may feel soreness immediately following and even a few days after in the area of treatment and some may even see signs of bruising.  Most of the symptoms of trigger point dry needling are mild and will only last a few days, depending on the patient and in comparison to the pain usually experienced caused by the condition, the pain will be much less.

What can be treated by trigger point dry needling?

Trigger point dry needling can help with a variety of common conditions including headaches, shoulder pain, neck pain, back pain, knee pain, sciatica, Achilles tendonitis, plantar fasciitis, tennis elbow, golfers elbow, hip pain, gluteal pain, muscle strains, ligament strains, muscle spasms, jaw pain, sore muscles, tight muscles and more.

How is trigger point dry needling different from acupuncture?

As mentioned above there are some similarities between the Ancient Chinese Medicine of acupuncture and trigger point dry needling including the disposable, sterile needles used in each, however acupuncture largely is used as a method to treat ailments internally such as stress, insomnia and digestive problems.

With a session of acupuncture the needles inserted into a patient are done so along meridian lines and often left in for around 30 minutes.  The meridians lines represent the body’s organ systems.  By inserting needles along the meridian lines, acupuncturists attempt to rebalance and restore energy flow throughout the body.

In comparison, trigger point dry needling can oftentimes be finished in a few minutes depending on the condition, size of area and complexity of the problem.

Example of trigger point dry needling successes

Recent patient experiences include individuals suffering from muscles spasms in a patient’s back caused from a strain in one of the major shoulder muscle groups.  The strain of this muscle cause the body to use muscles which were much weaker causing them to contract beyond a point of function.  In order to restore function to the area, trigger point dry needling was done to these muscles.  Once the patient had relief from the pain, additional strengthening therapy was prescribed in order to teach the muscles how to properly function.

Who licenses and regulates dry needling in Colorado?

In Colorado, the Department of Regulatory Agencies and State Physical Therapy Board has regulated the use of trigger point dry needling in 4 CCR 732-1.  In the United States, Medical Doctors, Osteopaths, Physical Therapists, Chiropractors, Naturopaths and Acupuncturists are utilizing Dry Needling.

If stretching, massage, or just plain ignoring the pain has not worked for you, consider trying trigger point dry needling. Consult Body Image Physical Therapy to understand and discuss if trigger point dry needling may be a good option for you and your condition.