Physical Therapy vs Imaging Study Hits the Washington Post
On March 27, The Washington Post published an article summarizing the findings of research that compared health costs for patients with uncomplicated low back pain (LBP) who were referred to physical therapy with patients referred for advanced imaging. As reported in PT in Motion News, the results showed that physical therapy typically resulted in dramatically lower subsequent costs than a first referral for imaging. The original research article was published in the journal Health Services Research (abstract only available for free).
The Post article characterized the reasons for the differences as being “more likely found in the heads of patients and doctors than in anyone’s back.” Post reporter Lenny Bernstein writes that patients with uncomplicated first-time LBP can “pressure” physicians for a referral, and physicians may comply—sometimes with a referral for advanced imaging, sometimes for a referral to physical therapy.
The lower health care costs associated with physical therapy have a connection with how patients respond to physical therapy’s more proactive, patient-focused approach, according to the Post.
In summarizing comments from Julie M. Fritz, PT, PhD, FAPTA, the study’s lead author, the Post describes physical therapy as an approach that “focuses on educating patients about what might be causing their back pain, assuring them that most problems subside in time, and engaging them in their therapy.”
The study theorizes that as opposed to physical therapy, a referral for imaging early on can lead to a different patient attitude, one that often results in more testing, more physician visits, and greater use of medication. After 1 year, the imaging-first approach can result in average costs over 3 times higher than a physical therapy-first approach, according to the study.
Fritz is quoted in the article saying that “We think this is an area where our profession has something to offer, especially when it’s timed correctly,” adding that advanced imaging can be appropriate thing to do, but “just not early in the course of care for most patients.”
Available at the APTA Learning Center: pre-recorded CE on manipulation for LBP presented by study author Julie M. Fritz, PT, PhD, FAPTA; also “Manual therapy management of the lumbopelvic spine” presented by Josh Cleland, PT, DPT, PhD, OCS, and Shane Koppenhaver, PT, PhD, OCS, FAAOMPT.
Myofascial Release
There is a growing trend among health care professionals and patients of physical therapy clinics that recognizes the effectiveness of manual therapy in treating variety of neuro-musculoskeletal conditions. Joint manipulation and soft tissue mobilization, hands- on or instrument assisted, form the backbone of majority of treatment plans in our clinic. One of the most utilized therapeutic modalities integrated into physical therapy treatment is myofascial release.To understand the term “myofascial release”, it is crucial to explain, what the myofascia is. Prefix “myo” means muscle in Greek language, “fascia”, on the other hand, comes from Latin and it means a flat band or bandage . Fascia is the dense connective tissue composed of elastin and collagen fibers that surrounds and covers every muscle, nerve, blood vessel and organ in our body. Similar to yarn in a sweater, pull and damage in one area will strain distant areas and cause tension throughout fascial network. Healthy myofascial tissue has the ability to stretch and move without restriction. Due to poor posture, sedentary life style, emotional stress, inflammation, repetitive motions, surgical procedures, or traumas such as a fall or car accident, fascia scars and hardens. It loses its pliability, adheres to muscle, which leads to restricted range of motion of the neighboring joints and abnormal biomechanical functioning.
Myofascial release is an effective hands-on or instrument assisted technique that involves applying sustained pressure directly on the myofascial tissue. Initially, a therapist seeks autonomic or reflexive effects and gently stimulates sensory receptors in the skin and at the level of the subcutaneous fascia. This way a therapist desensitizes affected area and gains entry level to deeper structures with less potential for tissue microtrauma and exacerbation of pain. The next step of the intervention is mechanical change such as a stretch of the contracted muscle or superficial tissue rolling to mobilize adhesions. After freeing up the superficial restrictions, stronger pressure is applied to go through the “layers” until the deeper tissues are accessed. At times, forceful technique is required to free up longstanding restrictions. When optimal length and mobility of the soft tissue are established, therapy focuses on changing abnormal joint alignment and normalizing patient’s movement patterns.
The purpose of myofascial release is to break down scar tissue, loosen tightened fascia, reduce hypertonicity of the contracted muscle and decompress lesions such as nerve impingement. It is also intended to increase blood circulation, lymphatic drainage and facilitate tissue repair capacity. Although fascia and its corresponding muscle are the prime targets of the myofascial release, other structures, such as Achilles tendon or forearm common extensor tendon, are frequently treated with this technique.
Myofascial release therapy has been effectively utilized for relief from common problems such as neck and low back pain, headaches, plantar fasciitis, lateral epicondilitis (tennis elbow) to name just a few. It shortens and optimizes recovery from traumatic injury or surgery and improves performance in high level athletes. By targeting specific areas of restrictions, myofascial release therapy reduces pain, restores normal mobility and allows the patients to return to their normal functional capacity.
Maggie Garbiec, PTA
“My Back Hurts” — Really??

Do you have lower back pain that came out of nowhere? Can you not remember how it got there? You’ve been through X-Rays and MRIs and nothing shows up. You start to think you’re going crazy, right? Don’t worry, you’re not crazy. It could be a pelvic asymmetry. Pelvic asymmetries occur frequently and often mimic lower back pain. Often times, there are no real tender points. Usually, just aching and pain with certain activities. Your SI joints become maligned and cause aching in the muscles attached to the pelvis and even into the legs. Women are more likely to have SI problems than men due to the ability of the pelvis to move for childbirth. If you’re having persistent low back pain or pain into your hips, give First Choice a call to get it checked out.
Dr. Stephen Peaden, DPT
Doctor of Physical Therapy
Do the research
Life is full of choices. Marriage School CareerHealth. So how do you make a great decision? You do the research. You will find that Frist Choice Physical Therapy is the best choice for all your physical therapy needs.
- We hire the most Doctors of Physical Therapy.
- We have two convenient locations to serve you.
- Our award winning service and care is second to none.
- And with our expanded clinical hours we can conveniently see you when you need us.
Remember. It’s your choice. Make it count.
First Choice Physical Therapy
2015 Annual Yard Sale
Happy New Year!
Thank you Bay County for making First Choice Physical Therapy your “First Choice” in Physical Therapy. We had a blessed 2014 and are looking forward to serving you again in 2015. We want to help you bring in the New Year with better health! If you have pain in any joint or muscle, then your body may be trying to tell you something. Our Doctors of Physical Therapy can evaluate your condition, diagnose the problem and explain the best way to relieve your pain. Call us today!Have a Healthy and Happy New Year!
To Your Health,
Dr. Wade M. Rinehart
Doctor of Physical Therapy
Stuff The Bus Toy Drive 2014
REVOLT Ministries Stuff The Bus Toy Drive 2014
December 07 – 15, 2014
Recurring daily
Auto Brokers of America 512 W 23rd Street Panama City, Fl 32405
512 W 23rd Street, Panama City, FL 32405
Ph: 850-358-9152
Times: All Day
Admission: New Unwrapped ToySpreading the love of Christ, and Partnering with Island 106 Revolt Ministries is planning on collecting toys for the Marine Corps Toys for Tots foundation. Going bigger than we ever have before this year’s event will not only include camping on top of the Big Yellow School Bus 4 Jesus, but free nightly concerts. Each person/group that brings a new unwrapped toy will be entered into the nightly drawing and will receive a picture with Santa. Again the concerts are free, and you are welcome to come nightly to enjoy the music without bringing a toy. So, come on out, bring a toy, and enjoy the free concert. Concerts start at 6:00 nightly, but you can come out any time to see us!
Christmas funny
Merry Christmas
Patriotic Christmas Show on PCB
We are proud to be a sponsor for Todd Allen Herendeen’s Patriotic Christmas Show to be held at the Panama City Beach Senior Center on December 19, 2014. Todd performed for us at the Grand Opening of the First Choice Physical Therapy clinic at the Village of Grand Panama. It was a great show. Todd is best known for his incredible Elvis tributes, but the show featured songs from many different artists.Todd has written several patriotic songs about America, including “My Name is America” which was a huge hit across the nation. You can read more about Todd and the events he has at http://tentrevivalofamerica.org/. We highly recommend the show and hope you will be able to attend!


