Human Performance and Rehabilitation Centers, Inc.

A Patient’s Letter To Congress

On March 12, 2020 I suffered a fall that resulted in several injuries. The most important injury was a torn rotator cuff. Secondary injuries were to my elbow, wrist, and finger.

Due to the growing pandemic surgery for my elbow, wrist, and finger was postponed until May 29th. In the mean time my doctor ordered a physical therapy routine beginning on March 26th. I continued a weekly regimen of physical therapy until my surgery at the end of May and resumed therapy in again early June. My rotator cuff surgery was done on July 31st.

The success of my surgeries and my rehabilitation can be attributed to my physical therapist. He created a rehabilitative plan that would result in my hand and arm being in the best possible condition prior to each surgery and followed by physical therapy after the surgeries. I believe that the tremendous benefit of my physical therapy cannot be overstated. I would ask Congress to continue to fund Medicare Part B services at the current levels rather than the slated cuts.

Please consider how important Medicare funding is to people like me who need physical therapy and will be adversely affected by funding cuts.

If you would like to be a part of the conversation, visit the American Physical Therapy Association’s Action Page.

A Testimony of Care | HPRC Physical Therapy Columbia, SC

Since the Pandemic of 2020 began in early March 2020, Lester Holt has ended his popular newscast with the phrase, “Please take care of yourselves and each other.” This phrase prompted me to take action and provide a message of hope to others like me who have lived with chronic pain.

An injury to my back six years ago changed my way of life without physical limitations to one with many challenges. I know firsthand that pain will wear you down, depression creeps in over the loss of enjoying activities you used to not even think about, and you question whether you will have quality of life restored. After many prayers, doctors’ visits, x-rays, tests, physical therapy, aqua therapy, pain management, not to mention searching the internet in desperation and buying anything and everything I thought might make me feel better, a solution landed right in my lap.

I joined MUV Fitness Gym where I saw fliers for HPRC Physical Therapy (Human Performance and Rehabilitation Centers, Inc.) but didn’t give them a second thought. I had already been to several different physical therapy groups only to feel just a little better. It wasn’t until my sister who suffers from back issues expressed that she really wanted me to try her therapist, because she was convinced he could help me. As it turned out, he was the Director of HPRC Physical Therapy for Columbia and Lexington, practicing right in the gym I had been attending each week. Although I didn’t want to feel disappointment again, something was telling me to try her therapist, Roy (Dunny) Dunlap, Jr.

What I discovered was a concept in physical therapy I had not encountered. Previously, I would go to a physical therapist, receive an evaluation, and over the six to eight weeks course I would work mostly with PT assistants. I was amazed that week after week for each hourly visit at HPRC, I was receiving professional care – not from an assistant but from a highly experienced, knowledgeable physical therapist. No, the facilities are not over the top (more minimal), but the care is 100% patient focused.

I realized that the concept was not about numbers or volume but more about restoring patients to good health. Dunny listened keenly to everything I said about how I felt. He drew on years of education, experience and expertise to customize a plan not just to help me in the short term but one for long-lasting health. He even sent me to one of his colleagues, Tim Sutton, for a few visits, because he felt that Tim had specialized experience with my type of injury. There was no competition for control of care, only teamwork for optimum results for me. Speaking of teamwork, Nicole, the Patient Service Representative, was always friendly and helpful in arranging appointments convenient for me. That type of partnership and teamwork totally focused on helping the patient was impressive, especially in today’s health markets where the three to five minute per patient rule is evident at some providers.

I learned how to strengthen my back through an understanding of muscle groups and proper exercises, but most importantly, how I could be the best manager of my pain. Through the sessions, I came away with a renewed sense of hope that I could lessen the pain that had stripped me of joy and enthusiasm for my life. I may never be completely void of pain in my back, but HPRC Physical Therapy restored my hope in actually feeling good and living my best life. I am currently back in physical therapy for a condition with my foot called plantar fasciitis. But this time, I am confident that I will receive the same professional, patient-focused care and will soon be free of pain.

In watching an interview with George M. McCluskey, Jr., owner and founder of HPRC 65 years ago, I think he said it best with “We are not trying to see how big we can get, we are trying to see how good we can get.” His mission for the company is to provide the best care possible and improve lives one patient at a time.

Don’t waste another day of life living with pain. Invest in yourself and see for yourself how the professionals at HPRC Physical Therapy, especially Dunny, can help you! And when I watch the evening news with Lester Holt, I will know that I have done my part in some small way to take care of myself and others! Thank you Dunny and HPRC Physical Therapy!

Connie Frith

Prevent Weightlifting Injuries In Young Athletes With Proper Form

As strength and conditioning continues to be a priority in youth sports, it’s more important than ever that young athletes and their parents understand the importance of proper form. Young athletes often aren’t experienced in correct strength training techniques, nor do they understand what amount of weight is appropriate for their developing bodies. Not surprisingly, many feel the pressure to work out with more weight than they should in an attempt to get stronger faster.

Competitive fire is great, but it shouldn’t come at the expense of injuries that will keep an athlete on the bench and out of the game.

We see a lot of young athletes from middle school to early high school who are eager to get more playing time by getting as strong as they can as quickly as they can. They have access to their school’s weight training program, but they may not have consistent, hand-on training from a coach while doing so. Perhaps a coach or trainer has written a workout on the board, demonstrated the exercises quickly and then left the athletes to lift on their own. While older athletes may be developed and experienced enough to complete the routine safely, younger athletes are more vulnerable to injury.

This is especially true in kids who are still developing. Since everyone grows and develops differently, it’s important for athletes and parents to pay close attention to this issue. Kids who have yet to hit their growth spurt, or who have not fully completed it, have natural inconsistencies in the development of their bones and muscles. Attempting to lift too much weight when the muscle development hasn’t caught up to the bone development can cause failures in the back, knees or hips.

Prevent these kinds of injuries from happening by making sure your athlete is aware of proper technique and appropriate weight. If he or she is not getting an adequate amount of training in a school or club program, consider scheduling a few sessions with a personal trainer with experience in strength and conditioning.

If a young athlete experiences an injury or regular pain resulting from a strength program, physical therapy will help. Caught early, these issues are generally easy to correct.

Our first step is pain control. We find out exactly what’s hurting, and reduce the level of pain through manual therapy, isometrics and other modalities. Then we examine how the athlete has been performing their weight training exercises by having them safely simulate what they do in the gym. We watch how they move and hold their bodies through common exercises like dead lifts, squats and clean pulls. Sometimes we’ll video the session and slow it down to take a hard look at form and function. Then we correct their technique and give them guidelines for the right amount of weight and repetition to accomplish their goals safely.

As a former athlete, one of my biggest passions is helping young people master their training techniques and help them understand that it’s not about how heavy the weights are, but how much weight they can lift while also being technically sound in their form.

Brittany West, DPT is a licensed physical therapist with HPRC’s St. Francis Rehab River Road location. Brittany earned her DPT degree from the Medical College of Georgia and is a member of the American Physical Therapy Association. Her practice areas include orthopedics and sports injuries.

ASTYM and Tennis Elbow

Astym therapy is a very specialized type of treatment therapists use to address soft tissue dysfunction in their patients. This treatment was developed by a group of multi-disciplinary medical specialists that wanted to use an external, non-invasive treatment to address issues their patients were experiencing, specifically with muscles, tendons, nerves, and other soft tissues. This group of specialists developed specific protocols that use the body’s own response to stimulate the growth of new, healthy tissue and facilitate the resorption of inappropriate scar tissue and fibrosis, which can play a leading role in pain in certain areas of the body.

Tennis Elbow, or lateral epicondylitis, is inflammation of the tendons that originate at the outside of the elbow. When a patient is diagnosed with lateral epicondylitis it is typically because of overuse or a specific injury that has damaged the soft tissue. These muscles are used often as they are the muscles that allow for extension of the wrist. Over time, development of “microtears” in these tendons cause the body to lay down scar tissue, which is made of collagen fibers. When the body lays down those collagen fibers, they are laid down in an unorganized manner…think cooked pot of spaghetti noodles. Astym treatment stimulates the body’s own healing mechanisms to realign the scar tissue (uncooked box of spaghetti noodles) and resorb inappropriate tissue, helping reduce pain while increasing motion and functional ability.

Using Astym specific instruments, the entire arm is treated with a very specific series of strokes that follow the direction of muscle, ligament, and tendon. During the treatment, which usually lasts about 20 minutes, you may feel smooth areas and you will feel more gritty areas. The gritty areas are the areas of dysfunction and as treatment progresses, those gritty areas will be less noticeable, indicating healing.

In conjunction with Astym treatment, stretches are essential to the healing process. The stretches provided by your therapist will tell the new fibers to line up properly (uncooked box of spaghetti noodles, again). And when your pain has been significantly reduced or alleviated, a strengthening program will be started to help the pain from returning once you get back to your daily routine.

A typical course of treatment utilizing Astym therapy lasts 4-6 weeks and can only be offered by certified Astym therapists. Many patients opt for this treatment instead of surgery and/or injections. Talk to your physician to see if you would be a candidate for Astym therapy.


Learn more about Katherine Branch, OTR-L. Learn more about ASTYM.

5 Ways to Use Bubbles to Promote Motor Development

Whether you’re blowing them, popping them, seeing who can blow the most, or simply watching them blow away with the wind, bubbles are a fan favorite for outside playtime with kiddos of all ages. Not only are bubbles fun, but they can also be great motivation for exercises to promote motor skill development in children. Do you have bubbles waiting outside to be played with? Go outside and grab them – let’s exercise and play!

Sitting Balance

Using bubbles is a great way to have a child sit still and practice their sitting balance. You can have them sit on the grass or challenge their balance more by having them sit on a pillow, bosu ball, or any surface that is wobbly, but safe. Challenge your child’s balance reactions by having them reach up, down, forward, and backward to pop the bubbles.

All Fours

Positioning your child on all-fours (quadruped) is an excellent exercise for strengthening their core, shoulder stability, back, and hips. Think of it as a mini plank for your kiddo! Use cues such as pretending to be a dog or cat and tell them they have to pop the bubbles with one hand at a time. If your child is a little older, challenge them mentally with you calling out right hand or left hand to pop the bubbles with.


Having kids stomp on bubbles is a great challenge for working their balance on one foot. You can blow the bubbles low to the ground and have them stomp multiple bubbles, or you can catch the bubble on the wand, hold it low, and have them slowly raise one foot to stomp the bubble.

Tip Toes

Many kids have trouble raising on to their tip toes and keeping their balance while doing it. Sometimes, if you place something (like bubbles!) just out of reach for your child will cue them to raise to their tip-toes. Make it a challenge and see how many they can pop while on their tip-toes before coming back down on their heels!


Jumping is a great task for your child to practice! Jumping helps strengthen all of your child’s lower body, and is also a developmental motor skill that physical therapy helps children achieve. You can cue your child to “bend your knees, and jump up high!”. Challenge them to pop at least 10 bubbles while jumping.

Meet the author of this post, Shelbi Moxley, PT! Shelbi is a licensed Physical Therapist at Pediatric Rehab at Easter Seals in Columbus, GA. She has been employed with HPRC since March 2020. Shelbi received her Doctorate of Physical Therapy from the University of St. Augustine in 2019, as well as her Bachelor of Exercise Science in 2015 from Columbus State University. Her primary practice interests include pediatrics and neuro rehabilitation. Shelbi is a member of the American Physical Therapy Association (APTA). She resides in Columbus, GA where her hobbies include exercise and enjoying all the live music Columbus has to offer.

Shin Splints: How to treat and prevent this common runner’s condition

Running is a popular pastime in the South, where the weather makes it possible to pursue the activity year round. But runners often face shin splints, the more familiar term for medial tibial stress syndrome, a common overuse injury. It refers to the pain experienced along, or on either side of, the shin bone (tibia). It can also be felt on the back of the leg between the bone and calf muscle. The pain is due to inflammation of the connective tissues that attach the muscles to your tibia. Several factors can trigger this inflammation, including improper body mechanics, a change in your routine of exercise regimen, lack of support in your footwear or weak or tight musculature.

The good news is that shin splints can improve with the right steps, especially when the condition is caught early. If the pain persists, it can also be addressed with a variety of therapeutic techniques under the direction of a physical therapist, including targeted exercises and “directed” dry needling. As shin splints improve, it’s important to also integrate consistent stretching/strengthening exercises and other prevention strategies into your routine in order to keep them from returning. Shin splints that get progressively worse can lead to other injuries.

What triggers shin splints?

Several factors can cause shin splints. Some of the most common include:

Improper body mechanics

Body mechanics, or the way your body moves as you walk or run, are an important factor in preventing or causing injury. Often, tightness in the hip flexors or weakness in the glutes can cause one side of the body to be off balance as you strike the ground, execute forward motion and then brake. Exercises that stretch and strengthen the hips, quads, calves and glutes can help to bring the body into better balance and prevent stress to the muscles around the tibia.

Change in routine

Most runners have a regular workout routine, but when you make a sudden change to your regimen, particularly when you haven’t stretched and strengthened key muscles, you open yourself up to inflammation. A change in routine could mean an abrupt increase in mileage or in speed. It’s better to make gradual changes, even when you’re in great shape. Another change that could trigger inflammation is a sudden change in terrain. For example, if you’re used to running on turf, dirt or a synthetic rubber track, and you start to primarily run on concrete, you could experience inflammation.

Running on an uneven surface

One of the causes for tightness on one side of the body is running on an uneven surface, especially if you run in the same direction each time you exercise. While most surfaces we might run on are, by nature, uneven, you can avoid tightness in your hips and quads by running your regular course in reverse on alternating days of the week.

How to treat shin splints

Rest and ice

The first step in treating shin splint pain is rest and ice, and if needed, an over-the-counter anti-inflammatory pain reliever like ibuprofen. While heat may feel good, it doesn’t actually do anything to reduce the inflammation.

Assess your footwear

Make sure you’re running in a supportive shoe that provides plenty of cushion and shock absorption, and that addresses any other foot issues you may have, like pronating. When you’re not wearing running shoes, be sure to wear shoes that provide good support, and aren’t too flat, or too high.

Stretch and strengthen

Stretching and strengthening your calves, quads, hips and glutes will go a long way in improving shin splints and ensuring they don’t return. Good exercises to do regularly are calf raises, toe taps, squats, hip abduction strengthening (side lying, or standing, with a resistance band) and glute bridges.

Remember, shin splints are treatable with the right steps. It’s important to catch them early to make sure they don’t turn into something worse.

Sachiko Garner, PT, is a licensed Physical Therapist. Employed with HPRC since 2005, she received her MSPT degree in 2004 at The University of Alabama at Birmingham and her BS degree in Exercise Science/Athletic Training at Columbus State University in 2001. She is credentialed as a Clinical Instructor and certified in the treatment of myofascial pain and dysfunction with dry needling and ASTYM. Her specialties and interests include shoulder rehabilitation, post-breast cancer rehabilitation including lymphedema and running biomechanics. She is a member of the American Physical Therapy Association (APTA) and Orthopedic Section of the APTA.



HPRC Announces Partnership with Confluent Health

Legacy private practice group, HPRC, announces partnership with Louisville-based Confluent Health

Human Performance and Rehabilitation Centers, Inc. (HPRC) is proud to announce plans to partner with Confluent Health, a Louisville, Kentucky-based private equity holding company focused on creating a healthcare system that combines best-in-class clinical care in the rehabilitation industry with proven management services.  The partnership is expected to be effective in 4th quarter 2020, and will maintain HPRC’s brand, management/leadership and namesake while allowing them access to Confluent Health’s shared management services, including accounting and finance, talent acquisition, marketing, and staff development opportunities.

HPRC was founded in Columbus, Georgia in 1955 by George M. McCluskey Jr, PT.  What began as one-man practice has grown into a business with locations across Georgia, Alabama, and South Carolina.   McCluskey founded HPRC with one idea in mind:  to rebuild the body’s functional capability and to improve life, one patient at a time.  “Our culture and values are the only things that haven’t changed since my father founded our company 60+ years ago.  Our task is to grow our business while understanding the realities of the present and the challenges of the future, and yet remain faithful to our heritage,” said Brian McCluskey, Ph.D., Chairman/CEO of HPRC.  “Change is the only constant we know,” he added.  “We believe that partnering with Confluent Health is our best chance to continue to grow and remain a viable and relevant healthcare company in the future.”

“We are enthusiastic to venture in this partnership with Confluent Health; this will enable us to continue to invest in our communities by improving patient’s lives, and increase professional growth opportunities for our staff,” stated Patrick Graham, PT, MBA, HPRC’s President/COO and son-in-law of founder George McCluskey.

Confluent Health has a simple strategy – to partner with legacy practices in the therapy industry, align their clinical focus with Confluent’s business resources and proven systems, and grow business.  “We offer our warmest welcome to Brian and Patrick and the team at HPRC.  They have a rich history of best-in-class clinical care and uphold a steadfast commitment to their patients, which are exactly the practices we love to join in partnership,” said Confluent Health CEO, Dr. Larry Benz DPT, OCS, MBA, MAPP.

To learn more about Confluent Health, visits


About Confluent Health:

Confluent Health is a Louisville, Kentucky-based private equity holding company focused on creating a healthcare system that recognizes physical and occupational therapy providers as the Best First Choice for preventing and managing musculoskeletal and movement disorders. Confluent Health offers the following management services: evidence-based practice, patient loyalty, regulatory assurance, marketing and branding, clinic operations, hiring and retention, strategy, accounting and finance, and customer service to Baton Rouge Physical Therapy – Lake, BreakThrough Physical Therapy, Capitol Physical Therapy, El Paso Physical Therapy Specialists, the Evidence In Motion family of companies, Fit For Work, Orthopedic & Sports Physical Therapy, Pappas Physical Therapy, Physical Therapy Central, ProActive Physical Therapy Specialists, ProRehab Physical Therapy, Redbud Physical Therapy, RET Physical Therapy Group, Rehab Therapy Works, Lake Center for Rehab, SporTherapy, and Texas Physical Therapy Specialists, and Tallahassee Orthopedic & Sports Physical Therapy.  Together, these companies share a common ownership team and are committed to developing a learning, purpose, and coaching culture.

About Human Performance and Rehabilitation Centers, INC.

Established in 1955, HPRC was founded with one idea in mind: to rebuild and enhance the body’s functional capability – to improve life, one patient at a time. Sixty-five years later, HPRC offers a broad service line including physical therapy, occupational therapy, speech therapy, orthotics, prosthetics, and electrodiagnostic testing to pediatric, adult, and geriatric populations in 9 locations across Georgia, Alabama, and South Carolina.




Preparing for Pregnancy

How can you prepare your body for the exciting nine month marathon of pregnancy?  Take stock in a healthy attitude and practice.  Your body will go through miraculous changes in a  short nine month period to bring your newborn to you. Learn how you can help. 

The most ideal situation is visiting your OB-GYN before you become pregnant.  Your MD  will perform blood work that reviews your current vaccination/ antibody status,and screen for viral infections, as well as advise about appropriate medications. He/she will review your/your family’s medical history, and make appropriate recommendations.


Eat a healthy diet. A balanced diet will assist in proper nutrients for your growing baby and your energy level.  Recommended weight gain through pregnancy depends on your pre pregnancy weight

 Pre pregnancy—-   normal weight—weight gain 25-35 pounds   

 Pre pregnancy—    underweight—   weight gain  28-40 pounds

 Pre Pregnancy—– overweight —  – weight  gain 15-25 pounds

 Keep in mind, the range of appropriate weight gain changes when you learn you are carrying multiple births. Your pregnancy weight includes your fetus, placenta,  amniotic and maternal fluids, breasts and maternal fat stores.

 This is a great time to learn to eat clean.Your diet should include whole grains, fruits, vegetables, lean protein and low fat dairy . 1,000 mg of calcium per day, which is about 3 8 ounces glasses of skim milk is recommended while trying to become pregnant, but you can substitute with low fat yogurt and pasteurized cheeses. Limit your sugars and high fat foods.  During your first trimester you do NOT need extra calories.  Take heart,  for those that want to eat for two, extra calorie consumption comes in the second and third trimester with the growing demands of the baby. A healthy weight gain limits the possibility of complications such as gestational diabetes, and or high blood pressure.  

Folic acid is most important in the earliest stage of your pregnancy.  It  is a B vitamin that supports the development of a healthy spine and brain, and is often prescribed by your MD before conception or at your first prenatal visit. It can be found in nuts, green leafy vegetables, fortified breakfast cereals, vitamin supplements beans and citrus fruits so if you’re eating a healthy diet prior to conception you are on the right track.


If you are an avid exerciser stick with it, and monitor its effects on your body.  Staying active throughout your pregnancy is highly recommended. 30 minutes of moderate exercise per day, repeated 5 days per week, is the general recommendation of ACOG, The American College of Obstetricians and Gynecologists.  If you are not, the athletic runner or yoga  pilates guru, consider starting a gentle aerobic exercise routine…slowly…  that can be as simple as taking a 5-10 minute walk and building your exercise time over a matter of weeks.  Of course this all depends on your health status at the start.  If you have pre-existing conditions such as diabetes thyroid disease or heart lung issues you should rely more heavily  on your MD’s advice 

ACOG  recommends 150 minutes of “MODERATE” intensity exercise per week for generally healthy individuals…..

Moderate exercise activity can be assessed by utilizing the simple talk test, the exertion rating scale or target heart rate monitoring. 

 The talk test is a valid, reliable yet informal way to estimate the intensity of your exercise.  Generally if your ability to talk is a little challenged then you are in the right range.  In other words,  being able to talk with light effort but not sing are good indications you are in the right zone for moderate activity. Check out:                                                                                 

The Perceived Rate of Exertion Scale/                                                                          Is another way to measure your exercise intensity.  Moderate exercise would indicate an 11-14 on the Borg scale of perceived exertion.

Monitoring your target heart rate is one more way to measure that moderate level of activity.

Include a warm up period with your exercise routine which can be as simple as the exercise  activity at a slower pace.  Warm ups are important in pregnancy due to the extra demand on your body with pregnancy.

  • Safe Aerobic exercise in pregnancy
  • Walking at a brisk pace
  • Stationary bicycle riding
  • Swimming and water exercise
  • Modified Yoga
  • Modified Pilates
  • Running/ if you were running before pregnancy/ consider modifying intensity and frequency/ clear with MD
  • Weight training 
  • Generally avoid contact sports,hot yoga, hot pilates, scuba diving and of course skydiving and surfing.  We want to keep your fall risk at a minimum.  


If you are a big abdominal class proponent, you should know that crunches and exercises that shorten the abdominal muscles and increase intra abdominal pressure are not advocated during your prenatal period. Your abdominal muscles need to stretch to accomodate your baby’s growth.  There are acceptable ways to exercise the abdominals during this time and a physical therapist can help you coordinate your inner core, abdominals, breath, and pelvic floor, so you feel supported  as your abdominal muscles stretch.

Exercise with awareness  and mindfulness of your body. Exercise will give you more energy, support healthy joints and spine, reduce your chances of constipation, may decrease your risk of gestational diabetes, preeclampsia and C- section delivery.  It can improve your mood, enhance your sleep, and make it easier to lose pregnancy weight.  

Please, don’t forget to include a cool down period in your exercise routine, that should consist of gentle stretches of the hips spine and chest musculature, and general relaxation exercise for the pelvic floor in the later stages of pregnancy.  Make sure your water intake  keeps you hydrated through your exercise.  Be aware of the signs of over exerting yourself. Learn to listen to your body.  Consult here for more info on precautions  and warning signs to stop exercise .

Kegel or not

“Kegels” are strengthening exercises for the muscles that sit at the base of the pelvis.  These exercises are generally considered an important aspect of pregnancy.  They are a group of muscles that never stop working, they keep us dry/continent, and  lengthen and relax to allow the bladder and bowel to empty and to deliver your baby. Their ability to support the organs within the pelvis are taxed with the weight of the growing baby which makes them more vulnerable to weakness in some but not all women.  Some women exhibit tightness of the pelvic floor muscle and do not need to perform Kegel exercises. It may be best to consult with a pelvic physical therapist to help you decide if Kegels are needed during your pregnancy. Every woman should know how to coordinate her pelvic floor muscles with a regular exercise regime and be able to demonstrate lengthening and relaxation of these same muscles .  It is the reverse Kegel taught towards the end of your 9 months that will assist with your  vaginal delivery.  

 Follow these recommendations and treat yourself to your best possible pregnancy.  Happy Baby!


Joanne O’Connor, PT, PRPC


Joint Pain? Physical Therapy Can Help Osteoarthritis

Osteoarthritis is a common condition that impacts about 27 million Americans a year, and is experienced among many men and women as they age. Targeted physical therapy, along with appropriate physical activity and a healthy lifestyle can help slow the onset of osteoarthritis and reduce the pain and stiffness associated with this condition.

What is osteoarthritis?

Osteoarthritis is what we think of when we say “arthritis.” It’s the inflammation of the joint caused by deterioration of cartilage and protective tissue. Osteoarthritis is common in weight bearing joints, such as hips and knees. The pain stems from bone-on-bone friction during movement, caused by cartilage and tissue wearing away. Osteoarthritis is different from rheumatoid arthritis, which is a chronic condition in which the immune system attacks the joints.

What causes osteoarthritis?

A number of factors can contribute to osteoarthritis, including age, past injuries, overuse injuries from athletics, occupations that require repetitive weight-bearing activities, genetics and obesity.

How can physical therapy help?

Physical therapy is a noninvasive way to minimize the progression of osteoarthritis, lessen the pain caused by it and improve strength and flexibility. PT for osteoarthritis is widely seen as an alternative to surgery and prescription pain killers. A physical therapist will begin by assessing the extent of the joint inflammation, how it impacts your body mechanics and how to strengthen and or stretch the muscles surrounding and supporting the joint. This assessment will be used to create an individualized treatment plan aimed at reducing pain and inflammation and maximizing pain free movement.

What kind of treatment can I expect?

A physical therapist will perform a number of different modalities, including ice and manual therapy with soft tissue work to help reduce pain. He or she will prescribe exercises that improve range of motion, muscle strength and balance. The therapist will also have the patient perform low impact stretches and exercises that help build strength in the muscles surrounding joints. For example, patients with osteoarthritis of the knee will perform exercises that help strengthen the quadriceps, helping to relieve pressure on the joint. Finally, the physical therapist will help the patient establish a lifelong maintenance plan for joint health.

Is physical activity important?

Light to moderate physical activity can make a big difference in the quality of life of osteoarthritis patients. Swimming, walking and bike riding are all activities that can help build strength without introducing unnecessary load on the joints. These exercises, along with a healthy diet and plenty of water, can help overweight patients lose weight, an important step in reducing extra joint pain and pressure.

It’s important to remember that your therapist will also advise an at home plan to complement the work accomplished in the clinic for lifelong self-management of osteoarthritis symptoms.

Sachiko Garner, PT, is a licensed Physical Therapist. Employed with HPRC since 2005, she received her MSPT degree in 2004 at The University of Alabama at Birmingham and her BS degree in Exercise Science/Athletic Training at Columbus State University in 2001. She is credentialed as a Clinical Instructor and certified in the treatment of myofascial pain and dysfunction with dry needling and ASTYM. Her specialties and interests include shoulder rehabilitation, post-breast cancer rehabilitation including lymphedema and running biomechanics. She is a member of the American Physical Therapy Association (APTA) and Orthopedic Section of the APTA.


hip scope

Physical Therapy after a Hip Labral Repair by Scope

Hip arthroscopy, otherwise known as a “hip scope,” is a common, minimally invasive procedure used to address common conditions in the hip, such as a labral repair (a repair of the cartilage that lines the hip socket), to help reduce hip pain, improve stability and restore movement. This type of procedure is used to treat younger athletes who have suffered hip injuries as well as older patients who are experiencing normal degeneration.

Protocols may vary by physician, but usually a patient should avoid bearing weight on the hip scoped immediately after surgery. The patient can also expect to use crutches for the first week or two. Physical therapy generally starts within a few days after surgery. Depending on the patient and protocol, it takes about six weeks of physical therapy, once or twice a week, before the initial range of motion is restored and a patient can safely embark on more rigorous therapy. It may take another six weeks of targeted exercises to restore full range of motion and athletic function.

What to expect from physical therapy

The goal of physical therapy is to restore the patient’s functionality, whether they’re a younger athlete or an older adult. A physical therapist will start with isometric therapy, in which the patient squeezes and holds the quads and glutes to encourage these muscles to “fire” and regain strength. Manual therapy is also an important part of this first phase. The therapist will carefully move the hip joint to encourage soft tissue and joint mobilization.

Restoring hip mobility

As the patient is able to bear more weight, the therapist guides them through exercises in both standing and sitting positions. The therapist will use a variety of exercises to help rotate and stretch the hip to restore hip flexion.

Regaining stability and strength

After about four weeks, the therapist helps the patient regain function hip strength and stability. Exercises are usually focused on specific hip muscles such as glutes and hip rotators to improve stability of the hip during functional activities. Exercises tend to start with standing on both legs and will progress to single leg activities. Progressive activities tend to challenge the stability of the leg as a whole, including both hip and ankle stability. Depending on the patient’s goals, exercises are tailored to aim for a full return to specific activities.

In addition to regular therapy with a clinician, patients should follow an at-home therapy plan. At home exercises extend the work accomplished in the clinic and a good way to speed along positive results.


Brittany West, DPT is a licensed physical therapist with HPRC’s St. Francis Rehab River Road location. Brittany earned her DPT degree from the Medical College of Georgia and is a member of the American Physical Therapy Association. Her practice areas include orthopedics and sports injuries.