Physical TheraPT
Clinical Wisdom
Shannon Vigil
Superbill Best Practices
The Recovery Mindset
Nina Szemis, ATC
Can You Outrun Illness?

General common sense, as well as scientific research, tells us that lifelong physical activity acts as a protecting agent against chronic illness and disease. If you’re able to consistently rack up 300 minutes of moderate intensity activity per week, you’re at much lower risk for things like cancer, cardiovascular disease and other inflammatory disorders. Regular physical activity also increases your resilience against communicable diseases, like bacteria and viral infections. However, here’s where the research starts to diverge.

Planning ahead for holiday success

It’s that time of year again! Whether you’ll be shuttling between relatives’ homes, using the time away from work to check off some bucket list adventures, or hosting the chaos yourself, it’s safe to say your typical routine is going to be impacted.

We firmly believe that consistency and load management are two pillars of a successful plan- don’t let your goals get stuck on the sidelines this holiday season! Below, we’ve outlined how to approach the coming weeks to set yourself up for success:

 
 

1-2 Weeks Prior:

Check in with your clinician.

  • Plan to discuss your current presentation. Understanding the why behind your exercises helps to increase compliance.

  • Share details and goals of your travel- how long of a flight or drive do you have? What are your plans once you arrive? Your clinician can help identify strategies to decrease flare ups.

  • Update your circuit to reflect just the priorities. Be realistic about the amount of time you can dedicate while out of your normal routine, and highlight what exercises are critical to your continued progress.

  • If you won’t have consistent internet access, ask for a PDF copy of your circuit!

 
 

3-5 Days Prior:

Confirm what you’ll have access to.

  • Verify with your hotel if they have an on-site gym and what equipment they have.

  • Double check with family members or hosts if they have any home equipment.

  • Research local gyms. Consider purchasing a day pass if you need more robust equipment based on your plan.

  • Check the weather. If you typically run outdoors, does your temporary location allow for success?

  • Purchase travel equipment as needed. We’ve highlighted our go-to’s below:

 
 

On Location:

Make a plan.

  • Identify optimal times to fit in your exercises. Prioritize your circuit prior to any physical activity, completing a majority of the list at your accommodation, and a light warm up once you arrive at your activity.

  • Communicate with family and travel companions that this is important for your recovery. They’ll be more supportive of you taking 15-30 minutes away.

  • Split up high demand activities when possible to match your current tolerance. Try to plan lighter activity days between more physically demanding days.

Connect with your clinician sooner rather than later to schedule your pre-holiday appointment!

Therapeutic Applications of Heat vs Cold

If you've ever had an injury—whether it's a sprained ankle from running or joint stiffness after a long day—you've probably wondered: Should I grab an ice pack or reach for a heating pad? The truth is, both cold and heat therapies have their place in both recovery and injury rehabilitation. But knowing when to use each can make all the difference in your healing process.

Cold Therapy

Cold therapy, also known as cryotherapy, is the go-to for acute injuries. Think sudden sprains, strains, or any type of trauma where swelling is your body's immediate response. Ice helps to reduce swelling, numb the pain, and limit damage to the tissues.

How It Works:
When you apply cold, it causes blood vessels to constrict (Knight & Draper, 2013). This reduces blood flow, which means less swelling. It also numbs the area, providing almost instant pain relief—especially useful during the first 48 hours after injury. Research indicates that cryotherapy is particularly effective at reducing swelling and pain during the initial phase after an injury or surgery (Hubbard & Denegar, 2004). Some common methods include:

  • Ice packs or gel packs: Quick and easy for small areas like a sprained wrist or ankle.

  • Ice baths: Athletes swear by these for post-exercise recovery, especially after intense training.

  • Cryotherapy chambers: More intense, these are becoming popular for whole-body cold therapy.

When to Use It:
Cold therapy is most effective within 48 hours of injury and should be applied for no more than 20 minutes at a time. It’s is perfect for:

  • Acute injuries (sprains, strains, or fractures)

  • Reducing post-workout soreness

  • Controlling post-surgical swelling

What to Watch Out For:

  • Do not apply ice directly to your skin—it can cause frostbite. Always wrap it in a towel or cloth to protect yourself.

  • Cold therapy should also be avoided if you have poor circulation or conditions like Raynaud’s disease. 

Additionally, it's important to note that while ice can reduce pain and swelling in the short term, the long-term benefits of cryotherapy, particularly on tissue repair and recovery, remain unclear (Hubbard & Denegar, 2004).

Heat Therapy

Where cold therapy excels at calming inflammation, heat therapy is ideal for those days when your muscles are tight and your joints feel stiff. Heat is a great way to increase blood flow and relax the muscles. It’s perfect for anyone dealing with chronic pain or conditions like arthritis.

How It Works:
Applying heat causes blood vessels to dilate, allowing more oxygen and nutrients to reach sore areas. This helps relax tight muscles, soothe joint pain, and improve flexibility (Knight & Draper, 2013). There are two main types of heat therapy:

  • Dry heat: Heating pads or an infrared sauna.

  • Moist heat: Warm baths or steamed towels, which penetrate deeper into the muscles.

When to Use It:
Heat therapy can be beneficial before activities that require significant flexibility or range of motion. It’s recommended to apply heat for 20-30 minutes, and works best for:

  • Chronic neck or back pain

  • Joint stiffness from arthritis

  • Muscle tightness or spasms

What to Watch Out For:

  • Be careful not to use heat on new injuries or swollen areas. It can actually make swelling worse. 

  • Make sure the heat is comfortable, not too hot, to avoid burns.

Can You Combine Cold and Heat?

If you’re wondering whether you can use both, the answer is yes. This is known as contrast therapy, where you alternate between cold and heat. Cold reduces the swelling, and heat increases blood flow and mobility.

Contrast therapy is especially useful for:

  • Soft tissue injuries

  • Post-surgical recovery

  • Reducing muscle tension after exercise

 

Listen to Your Body

At the end of the day, both cold and heat therapies are powerful tools, but they aren’t one-size-fits-all. The right treatment depends on your specific condition and how your body responds. Always consult with a healthcare professional if you are unsure, especially if your symptoms persist or worsen.

Cold and heat therapies are simple but effective ways to manage pain, reduce inflammation, and promote recovery. Whether you’re dealing with a new injury or chronic stiffness, using these therapies correctly can help you get back to doing what you love—without unnecessary setbacks. 

To learn more, check out these resources:

Hubbard, T. J., & Denegar, C. R. (2004). Does cryotherapy improve outcomes with soft tissue injury? Journal of Athletic Training, 39(3), 278-279.

Knight, K. L., & Draper, D. O. (2013). Therapeutic modalities: The art and science. Lippincott Williams & Wilkins.

The Benefits of Kinesiology Taping

Kinesiology taping, sometimes called “KT” or “taping”, has emerged as a popular technique in sports medicine and rehabilitation, gaining recognition for its ability to support injury recovery and decrease pain. While the concept of elastic taping is not new, its application has evolved significantly. Let’s dive  into what therapeutic elastic taping is, how it works, and its benefits.

What is Kinesiology taping?

Kinesiology taping uses a flexible, stretchy tape designed to mimic the elasticity of skin. The tape is applied to the skin in various patterns and tensions, depending on the condition being treated. Unlike traditional athletic tape, which is often intentionally rigid and restrictive, kinesiology tape allows for a full range of motion, thereby supporting and stabilizing muscles and joints without restricting movement.

How Does It Work?

The primary theories behind the effectiveness of kinesiology taping involve its impact on the skin and underlying tissues. When applied correctly, the tape can lift the skin slightly, creating more space between the skin and the underlying tissues. This lifting effect is thought to improve lymphatic drainage, reduce pressure on pain receptors, and facilitate the body’s natural healing processes.

Additionally, kinesiology taping has been observed to provide proprioceptive feedback, which can help the body to correct movement patterns and improve posture. Applying portions of the tape with increased tension in specific patterns can gently influence the way a person stands or moves. This feedback may help athletes and individuals with musculoskeletal injuries to perform better and recover more effectively.

Benefits of Kinesiology taping

  1. Pain Relief: One of the most commonly reported benefits of kinesiology taping is pain relief. The lifting effect of the tape can help to alleviate pressure on pain receptors and reduce discomfort associated with various injuries and conditions.

  2. Improved Function: Kinesiology taping can enhance functional performance by supporting weak or injured muscles and joints. This support helps in maintaining proper alignment and reducing strain during physical activities.

  3. Enhanced Circulation: The tape’s effect on skin and underlying tissues is thought to improve blood flow and lymphatic drainage. This can contribute to reduced swelling and quicker recovery times.

  4. Injury Prevention: By stabilizing muscles and joints, kinesiology taping may help to prevent injuries during physical activities. It can also support rehabilitation by ensuring that muscles are properly engaged and protected.

Evidence and Efficacy

The scientific evidence supporting kinesiology taping is mixed. Some studies suggest that kinesiology taping can be beneficial for specific conditions such as musculoskeletal pain, joint instability, and post-surgical recovery. For instance, research published in the Orthopaedic Journal at Harvard Medical School (Bhashyam, et al 2018) found that kinesiology taping could reduce pain and improve function in individuals with shoulder impingement when used in conjunction with physical therapy. Another study in the Journal of Sports Rehabilitation (Kirmizigil, et al 2019)  indicated that it might aid in decreasing muscle soreness and improve post-exercise performance.

However, other studies question the clinical significance of these benefits. A review in the American Journal of Physical Medicine & Rehabilitation (Ye, et al 2020) concluded that while kinesiology taping might have some short-term benefits, its effectiveness compared to other treatment methods is still uncertain.

Application Techniques

Proper application of kinesiology tape is crucial for its effectiveness. The tape can be applied in various ways depending on the desired outcome. For instance, a "fan" technique might be used to address swelling, while a "strip" technique can target muscle support. It is advisable to seek guidance from a trained healthcare professional to ensure correct application and maximize benefits.


Kinesiology taping is a versatile tool in the field of rehabilitation and sports medicine, offering potential benefits for pain relief, functional improvement, and injury prevention. While the evidence supporting its efficacy is still evolving, many individuals report positive outcomes. Additionally, kinesiology tape is an inexpensive and low-risk modality. Exploring therapeutic elastic taping could be a valuable step in your injury recovery journey and may provide the support and relief you’re looking for in your journey towards becoming a more robust, durable athlete. 

Interested? All three of our clinicians are certified by Rocktape! Talk to your provider during your next appointment to see how kinesiology tape could supplement your recovery, or reach out to schedule a taping appointment.

What is an Athletic Trainer

While both are casually referred to as “trainers”, personal trainer and athletic trainers are two very different roles. Personal trainers generally work in gyms and health clubs, helping the general public improve their level of fitness; Athletic trainers are most often found at colleges, hospitals, clinics and with professional sporting or performance organizations, helping patients or athletes recuperate from injuries and safely continue to participate in sports and physically demanding professions. Below, we’ll dive into the two professions in greater detail:

Personal Trainers

Personal trainers evaluate a person’s fitness level and then design with an exercise program to improve the individual’s health, cardiovascular endurance and body composition. They teach clients how to perform exercises properly, while creating an atmosphere of accountability. Personal trainers with additional credentialing can also education clients on how to live a healthier lifestyle, coaching them on nutrition basics and recovery strategies.

While there is no governing body for personal training, it’s highly recommended to select a personal trainer who has completed a certification program; there are several institutions that offer certifications in personal training, including the American Council on Exercise (ACE) and the National Academy of Sports Medicine (NASM). However, some people may prefer to work with a coach who has learned personal experience in fitness such as a former athlete, rather than someone who has completed a certification program. In any arrangement, it is important to start smart-

  1. Check with your doctor before beginning a new fitness program

  2. Opt for simple movement patterns at low to moderate weights while you are still learning to limit your risk of injury

  3. Stay hydrated and take rest breaks as needed

  4. Stop exercising if you feel dizzy, lightheaded, nauseated, experience chest pain, or have an unexpectedly difficult time breathing

  5. Don’t do anything you’re not comfortable with

Athletic Trainers

Athletic trainers are clinicians who provide injury preventative services, emergency care, clinical diagnosis of injuries, therapeutic intervention and rehabilitation of both injuries and medical conditions. Athletic training is recognized by the American Medical Association (AMA), Health Resources Services Administration (HRSA) and the Department of Health and Human Services (HHS) as an allied health care profession. As a part of the healthcare system, athletic trainers work under the direction of a physician, and work collaboratively with physical therapists, massage therapists, and chiropractors. As part of an athletic department, they partner with the coaching and strength and conditioning staff, as well as nutrition and sport psychology teams to promote the overall health of the athlete.

Athletic trainers undergo rigorous academic and clinical training, supervised by the Commission on Accreditation of Athletic Training Education (CAATE). The current minimum entry point into the profession of athletic training is at the master’s level. Upon completion of a CAATE-accredited athletic training education program, students become eligible for national certification by successfully completing the Board of Certification, Inc. (BOC) examination. Once certified, athletic trainers are required to complete several hours of continuing education every year in an effort to ensure all professions remain current on the latest recommendations within sports medicine.

Comprehensive Care

There’s not a lot of crossover between the two occupations. This isn’t to say the roles can’t go hand in hand. After working with an athletic trainer to rehabilitate a sprained ankle, for example, an athlete may choose to enlist the help of a personal trainer to return his strength and endurance to the levels they were before the injury.

Physical TheraPT is a multi-faceted clinic, centered on patient success. By placing the individual at the hub of the system, instead of siloing by speciality, we’re able to streamline a truly comprehensive recovery. Our athletes are able to seamlessly work with the professionals they need- physical therapists, athletic trainers, massage therapists, and strength coaches- all in one place. Our athletic trainer offers:

  • Urgent Injury Assessment: Streamline your recovery by seeing an athletic trainer first. With extensive orthopedic education, athletic trainers are able to quickly determine the severity of an injury, determine next-steps and make referrals to local physicians, and provide you with home care instructions

  • Rehab: Apply the same proven approaches used with elite athletes to your unique situation and goals. Our expertise includes post-operative rehab, as well as rehab for both chronic and acute injuries and conditions.

  • Return-to-Play Training: We offer evidence-based programs, utilizing technology like force plates, dynamometer testing, blood flow restriction training (BFR), biofeedback and motion analysis to formulate your plan. Following a comprehensive evaluation, we can problem-solve with you to optimize your movement potential.

  • Injury Prevention: By using similar tools as detailed above, we are able to assess athletes and individuals before an injury occurs. Underlying movement compensations and imbalances are often evident even in healthy athletes. By prescribing corrective exercise strategies, and customized strength and conditioning programming, these vulernabilities can be targeted.

To learn more, check out these resources:

  1. American Counsel on Exercise

  2. National Athletic Trainers’ Association

  3. National Academy of Sports Medicine

  4. CT.gov

Image Credit

How intense does massage really need to be?

When it comes to massage therapy, many people wonder how intense the pressure needs to be to achieve the best results. There is a common misconception that the deeper and harder the pressure, the more effective the massage. However, the relationship between pressure and therapeutic outcome is more nuanced. Let’s explore the difference between deep pressure and deep tissue massage, why excessive pressure can be counterproductive, and how to find the optimal level of pressure for your needs.

Too Much Pressure?

One key aspect of effective massage therapy is understanding that getting muscles to release isn't about forcing them into submission. When a massage therapist applies pressure, sensory receptors in the skin and muscles send signals to the brain. These signals can help the brain to recognize tension, slowly convincing it to relax the muscles.

While other physiological effects also contribute to reduced tension in the body, putting the brain into a parasympathetic state is key to maximizing the benefits of massage. This means that excessive pressure is actually counterproductive, causing the body to go into a protective mode and tightening up the muscles even more in response to pain or perceived threat. Even worse, too much pressure can cause bruising, inflammation, or further injury.

Finding the Optimal Pressure

The goal of massage therapy is to promote relaxation and facilitate muscle release, not to cause pain. While a certain level of discomfort might be expected, particularly when working on tight or knotted areas, the sensation should be more of a "hurts so good" feeling rather than outright pain.

The optimal pressure during a massage varies from person to person and even from one area of the body to another. What feels good for one person might be too intense or too light for another. The "hurts so good" sensation is often an indicator that the right amount of pressure is being applied. This feeling suggests that the pressure is sufficient to address the muscle tension without causing excessive pain.

Take Control of Your Experience

To get the most out of your massage therapy session, there are several things you can do to help facilitate muscle release:

1. Stay in Communication

Always communicate with your massage therapist about the pressure being applied. No massage therapist, no matter how experienced, can know exactly what you are feeling. Your feedback is essential to ensure the pressure is just right.

2. Avoid Tensing Up

Try to keep your own muscles from tensing during the massage. Tension in the muscles can counteract the effects of the massage and make it harder for the therapist to work effectively.

3. Breathe Deeply

Make sure not to hold your breath. Deep, steady breathing can help to relax your muscles and enhance the therapeutic effects of the massage. When an especially tender or tight area is being worked on, focus on taking deep breaths to help the muscles release.

4. Relax Your Mind

Mental relaxation is just as important as physical relaxation. Try to let go of any stress or anxiety you may be holding onto. A calm mind can help facilitate muscle relaxation.


Effective muscle release involves communicating with the brain through slow and deliberate touch. The right amount of pressure to accomplish this is different from person to person and won’t even be consistent throughout your entire massage. Let go of any preconceived notions about how light or deep a massage needs to be. By finding a balance that promotes relaxation and healing without causing unnecessary pain, and by communicating with your massage therapist, you’ll be surprised at how much more benefit you can get out of each massage!

Dive Deeper on #fieldresearch
KT tape blog.png
Sports massage bay area
OverPage-0 44.png