Making Excuses


Too often we make small excuses that can lead us down the road to frustration from unmet goals. We think that making a small excuse today for not moving our bodies, not strengthening our bodies or not eating well is okay and we justify by telling ourselves that our bodies need rest. While rest days are a major component in good health, they can sometimes lead to the lack of motivation to move at all. It is easy to put off our workouts, stretching or to ignore pain signals, but are you really helping yourself by making excuses? 


Our bodies need mobility, strength, sleep, nutrition and mindfulness to work the way we need them too. 


But our lives have become more fast paced. We place many demands on ourselves to be the people our minds say we should be. We cram our schedules with tasks and use business as an excuse to put off taking care of ourselves. These excuses prevent us from being truly authentic to ourselves and how our bodies need us to live. 


Take a look at your daily life…

Do you allow time for movement, flexibility, stress relief, good sleep and mindfulness daily? 


If not, take baby steps today to implement one of these into your daily life. Do a few stretches in the morning to help you wake up and loosen up any tightness before you start your day. Add in a simple 10 minute workout ( you have 10 minutes to spare)! Or, if you work at a desk, make a point to stand up, stretch, and walk around every 30 minutes to an hour during your work day.


Having a hard time keeping yourself accountable in these areas? 

Here are some courses that may help you:


Back Pain Relief Course

Knee Pain Relief Course

On demand Stretch and Mobility Class this Friday 2/12/21 at 11:00 LIVE  only $5.00

Upcoming Webinars and Events

Give yourself some grace today!


Shin Splints- What they are, how they develop and how to get rid of them

Have your shins been painful during and after running lately? You may be dealing with medial tibial stress syndrome, more commonly known as shin splints. Let’s discuss what shin splints are, how they develop, and how you can get over them so you can get back to your favorite activities pain-free!


What are shin splints?

Medial tibial stress syndrome or shin splints can be defined as pain or discomfort along the edge of your tibia (the bone that runs down the front of your lower leg) that primarily occurs during exercise. Shin splints are especially common with activities that require repetitive loading such as running, jumping, or dancing. Shin splints are one of the most common painful syndromes among athletes and are the most frequent injury among runners1.


How do shin splints develop? 

When you run or jump during athletic activity, your bones, joints, and muscles in your legs have to absorb the ground reactive force, which is the impact of your feet returning to the ground with each stride or jump. When the amount of impact that you’re absorbing during exercise OR the total amount of exercise is more than your legs can currently handle, you may begin to experience discomfort during the activity. One of the most common areas where this discomfort develops is in the shin bones and their surrounding muscles, because they help absorb a significant amount of the ground reactive force. Shin splints develop over time due to these excessive forces on your lower legs and can be classified as an overuse injury. This condition is one of the most common lower leg injuries among runners.


Overuse injury

Overuse injuries commonly occur when someone begins a new activity or are returning to an activity after a long break. Oftentimes, overuse injuries can be described as “too much, too soon, at too high of an intensity.” “Too much, too soon” refers to the volume (how much exercise you’re performing) and frequency (how often you’re exercising) of exercise. For example, if you are a beginning runner, doing too much too soon would be going from running 1 mile on 3 days one week (3 miles total) to 3 miles on 5 days the next week (15 miles total). This would be a 500% increase in running volume and a 67% increase in running frequency. Your body is likely going to have a hard time adjusting to the sharp increase in the amount of stress that you are placing on your legs.


“Too high of an intensity” refers to how fast you’re running, how high or far you’re jumping, or how difficult your dance moves are. Let’s go back to the running example. You recently ran a mile at max effort in 9 minutes. An abrupt increase in intensity would look like transitioning from running 1 mile each session at 11 minutes per mile to running 3 miles per session at 10 minutes per mile. The faster you run, the more force that your muscles and bones have to absorb. It’s important to make small changes to your exercise routine over time to progressively overload your body so that your performance improves.

How can I determine whether I have shin splints or some other issue?

When dealing with lower leg pain, one of the most important aspects is determining the difference between shin splints and a bone stress injury. A bone stress injury or stress fracture is a serious running injury that can have long term effects on your ability to exercise if it is not dealt with properly. I’m going to outline a couple of self-tests that you can perform to help determine whether your pain is coming from shin splints or something more serious.

  • Test 1: Find the bony border of your shin. Press on this bony border and on the area where your muscles and the bony border meets. Press along the whole length of your shins, starting at your knee and down to your ankle.
  • Test 2: Take a look at your shins – are there any areas where the color of your skin has changed, any redness or swelling?
  • Results of tests: For Test 1, if you had a painful area along your shin that was about 2 inches in length or more and this is the same area that hurts when you run, this indicates that you may have shin splints. However, if you pressed along your shin and had one very specific painful spot in the bone, this may indicate a bone stress injury.  If you have this specific painful spot and noticed a skin color change and/or swelling, this may further indicate a bone stress injury.


What should I do for my injury?

If after reading this article, you suspect that you have either shin splints or a bone stress injury, you should get evaluated by our physical therapists as soon as possible. If you suspect that you have a bone stress injury, you should immediately stop running, jumping, and dancing activities until you can confirm whether there is a true bone injury. Here at Stretch, we are happy to help you with any running-related information. Give us a call at 513-874-8800 to set up an appointment Today!



  1. Winters, M. The diagnosis and management of medial tibial stress syndrome. Unfallchirurg 123, 15–19 (2020).
  2. Burrus, M. Tyrrell & Werner, Brian & Starman, Jim & Gwathmey, F. & Carson, Eric & Wilder, Robert & Diduch, David. (2014). Chronic Leg Pain in Athletes. The American Journal of Sports Medicine. 10.1177/0363546514545859.


Rotator cuff impingement: Treat the cause not the symptoms

The use of posture management and scapula stabilization exercises to improve rotator cuff impingement outcomes.

Woman with shoulder pain is holding her aching arm – body pain concept

What is Rotator Cuff Impingement?

Impingement occurs when the rotator cuff tendons get pinched in the space between the arm bone (humerus) and the arch of the shoulder blade (acromion) in a region within the joint which is called the sub acromial space. Pain is felt at the front of the shoulder due to irritation and inflammation of the tendon at the point where it becomes trapped. This pain is usually aggravated by overhead or twisting movements of the shoulder. 

Causes of rotator cuff impingement

There are a number of reasons to which this problem can be attributed, these might include:

  • Wear and tear of the joint between the collar bone (clavicle) and the shoulder blade, 
  • Structural abnormalities of the acromion  
  • Weakness of the rotator cuff muscles 
  • Trauma or direct injury


However one very common reason relates to poor posture which affects the position of the shoulder and the body’s ability to maintain control through movement. The shoulder joint is a ball and socket joint and is the most mobile of any joint in the body. To achieve such large ranges of motion, the socket is quite shallow which means the joint itself is inherently unstable. Complex ligament, muscle and tendon structures (soft tissues) work together to provide the stability that would otherwise be lacking. The rotator cuff is extremely important in providing this balance between mobility and stability.


Postural abnormalities including forward head position, rounded shoulders, internal rotation of the shoulders and an increased curve in the middle back (kyphosis) are commonly seen in patients with rotator cuff impingement (1). The soft tissues at the front of the joint tighten and the soft tissues at the back of the joint lengthen. This adaptation may simply be as a result of prolonged poor posture or could have been caused by poor training methods which have created what is known as a muscle imbalance. 


Treatment of rotator cuff impingement

Pain is one of the major symptoms of rotator cuff impingement. It can be treated with a variety of modalities and by a range of clinicians and thus the irritation associated with impingement can be fixed with relative ease. However failure to address the cause of the problem i.e. the imbalance which has caused the impingement in the first place will only lead to a recurrence of the injury and persisting pain.

To achieve long term relief of rotator cuff impingement syndrome, posture management and scapular stabilization exercises must be implemented. 


Posture Management and Scapular Stability Exercises


The shoulder has a ‘neutral zone’ much like that commonly described in the lumbar spine. This is the point at which the shoulder joint complex is aligned in such a position that all the supporting structures (muscles, ligaments and tendons) are able to work together to maintain control of the joint throughout the required ranges of motion. The ability to maintain this ‘neutral zone’ is lacking in impingement cases. It can only be restored through correcting postural defects (stretching tight structures, strengthening weak muscles) and stabilizing the scapula to provide a strong base of support around which movement can occur. An exercise program can be implemented very early on the recovery phase. There is no need to wait for pain to settle, in actual fact working within a pain-free range at a load that does not provoke symptoms, will only serve to relieve pain (2).


Unfortunately, there is no universal blueprint of exercises that can be given to correct this problem. The imbalances that lead to the development of impingement are often complex and interlinked. The skill in prescribing the correct exercise program lies in the exercise professional’s ability to fully understand the issues which have led to the onset of the problem. Only through delivery of such an exercise program will long term relief from rotator cuff impingement be achieved.



  1. resting positin variables at the shoulder: evidence to support a posture-impairment association. Bostard, J D. 2006, Physical Therapy, Vol. 86, pp. 549-557.
  2. Dynamic evaluation and early management of altered motor control around the shoulder complex. Magarey, ME and Jones, MA. 4, 2003, Manual Therapy, Vol. 8, pp. 195-206.


Posture Correction Exercises to Treat Neck Pain

Neck pain affects many people; it can be the result of a range of conditions that affect the muscles, joints, ligaments, discs or nerves. Frequently poor posture contributes to this problem. Postural correction exercises are therefore used in the treatment of this problem.

There are a range of posture correction exercises but they can be broadly grouped into 4 areas:

  1. Chin Tucks
    These exercises aim to restore alignment of the head relative to the torso. It is common particularly in neck pain sufferers for the chin to poke forwards when standing or sitting.
  2. Breast Bone Lift
    Avoiding too large a curve in the middle back can be achieved through ‘opening the front of the chest’.
  3. Shoulder Blade Squeeze
    Retracting the shoulder blades prevents the shoulders from rounding.
  4. ‘Spine Neutral’
    Finding the middle range of pelvic tilt helps to activate the core muscles and ensures the spine is in its most efficient position.

The spine should naturally follow a shallow ‘S’ shaped curve. In this position the joints are stacked one on top of another. The muscles are orientated in their most mechanically advantageous position and there is minimal stress through the spine. Any abnormal curves will perpetuate neck pain through stress on muscles ligaments and joints.

Posture correction exercises aim to strengthen the muscles that support the spine and control the weight of the head so that normal spinal curves can be maintained.

Chin Tucks
It has been shown that neck pain sufferers demonstrate weakness and lack of endurance of the deep neck flexor muscles. Chin tuck exercises help to restore function of the deep neck flexors and even if used in isolation can be helpful in reducing neck pain.

Breast Bone Lift
This approach is also called thoracic extension or ‘opening through the front of the chest’. The thoracic spine (middle back) naturally has a slightly forward curve, however, where this curve is excessive it creates an imbalance between the muscles at the front of the chest which adaptively shorten and the muscles at the back which weaken.

Shoulder Blade Squeezes
Pulling the shoulder blades backwards is called retraction. Retraction exercises are used in conjunction with improving thoracic extension to reduce muscle imbalance. By strengthening the muscles which pull the shoulder blade onto the chest wall, one of which is the lower trapezius, it is possible to reduce stress on the upper trapezius. If the upper trapezius is overactive it can lead to the development of trigger points. Trigger points are tight bands or ‘knots’ within a muscle they cause pain in a particular distribution and are very often factors for consideration in neck pain of any source.

Spine Neutral
Spine neutral refers to the awareness of a mid range position between maximum tilt forwards at the pelvis and maximum tilt backwards. Where people exhibit poor posture often they have a tendency towards too far forwards which creates a big arch in the lower back or too far tilted backwards as is seen in slumped posture. The position of the pelvis is key to the alignment of the curves of the spine. Improving the strength of the ‘core’ muscles helps to maintain this position allowing the spine to follow the normal natural curves which are observed in good posture.

The use of posture correction exercises have been shown to improve neck pain (2). Not only will they reduce the stresses on ligaments, muscles and joints that may have caused the problem initially, they will also help to prevent further episodes of pain and movement restriction.


  1. The effeect of therapeutic exercise on the deep cervical flexor muscles in people with chronic neck pain. Jull, GA, Falla, D and Vicenzino, B. 2009, Manual Therapy, Vol. 14, pp. 696-701.
  2. Evidence for exercise therapy in mechanical neck disorders. Sarig-Bahat, H. 2003, Manual Therapy, Vol. 8, pp. 10-20.

How to keep from falling apart in your 50’s and beyond

You probably don’t think about your knees until you’re sitting in the doctor’s office staring down a diagnosis and a possible knee replacement surgery. How did you land here? You did your best to eat healthy and exercised when you could. Now you throw your back out by just looking at heavy objects, and the stairs feel like a marathon. It feels like your body betrayed you overnight and began falling apart at every seam.

This isn’t uncommon, because many people follow the same timeline. You go to high school, enroll in college, get married, and have children. The experiences, passions, and hobbies a person has make them different than someone else, but that’s a basic timeline everyone follows. Unfortunately, there is little time left for healthy living.

Beginning in your early 20s, your life will start to pick up. You’re making career choices, connecting with friends, starting a life with someone else, and possibly starting a family. There’s work, important deadlines, planning and cooking meals, bussing the children between activities, helping them with their homework, bills to pay, aging parents to care for, and by the end of the day, you’re just exhausted. How do you get time to yourself?

This is where we step in.

At Stretch Physical Therapy and Total Wellness, we’ve always been advocates for our patients, empowering them to lead happy, healthy lives. But starting in 2019, we’re making it a bigger part of our mission to prevent you from “falling apart” at age 60. We know life happens, and we know you have responsibilities, hobbies, or plans that may impede a regular wellness routine. Our goal is to help you find ways to introduce a healthy maintenance regimen into your life as early as possible to help you succeed at stay healthy.

Think about it: If a 28-year-old comes in to see us about their neck pain, we can help them find relief pretty quickly. We’ll work on a regular routine at their appointments and give them some basic at-home exercises to try. But if their diet is poor, they remain stationary at work, and they avoid regular exercise, their neck pain will come back. They’ll have to come back to see us for something that was completely preventative, all because they didn’t follow our plan.

This is also a common reason for surgery, but a large number of surgery procedures can be avoided through physical therapy. The concept is simple: Your body know how to heal themselves. For centuries, the human body has been relying on its natural expertise to help humans survive. But what you do aids in that healing. Your neck pain will return – or begin – if you don’t actively work to keep it and other conditions at bay.

The new year is a popular time to set resolutions and try to create a better “you.” Why not take this chance to create a better future for yourself and ultimately, your loved ones, too. There’s always going to be a reason to put off caring for yourself. Maybe you feel too bogged down at work, or your kid has so many weekend tournaments that finding a free minute is impossible. We know it’s hard, but we can help you find time for yourself – and your body needs you to do so.

Plantar Fasciitis Treatment in West Chester OH

Are you searching for plantar fasciitis treatment in West Chester OH?  There is a specific type of care for pain in the heel bone or calcaneus.  How do you know if you have this problem? If you lift your foot off of the ground and push your thumb into the heel area of your foot, you could be suffering from plantar fasciitis.

Most heel pain goes away in a short period of time, either on its own or after treatment. Without treatment the pain can become chronic which means lasting for more than 3 months.  Physical therapy care used to reduce heel pain are clinically proven to reduce pain as compared to no treatment at all. With time, most plantar fasciitis pain goes away but there’s no need to suffer for months when a little conservative, natural physical therapist directed care can help.

Conservative treatment of plantar heel pain – what’s involved

There are numerous over-the-counter remedies for plantar fasciitis but most fall short. First you need to make sure you have plantar fasciitis and your physical therapist can help confirm that you have the condition.

Other conditions that mimic plantar fasciitis.  According to Podiatry Today:

There are a variety of other etiologies (causes of pain) that are commonly associated with heel pain and are often misdiagnosed as plantar fasciitis. A short list of these etiologies includes:

  • plantar fascia tear
  • tarsal tunnel syndrome
  • Baxter’s nerve entrapment
  • calcaneal stress fracture
  • calcaneal cysts
  • soft tissue mass
  • short flexor tendon tear
  • gout
  • systemic arthritis (lupus, rheumatoid arthritis, psoriatic arthritis)

Click here for the reference

These conditions are rare compared to the common diagnosis of plantar fasciitis.

Plantar Fasciitis Treatment

All patients that see us first go through an initial evaluation. Once we find the root cause of the problem, rule out if it is plantar fasciitis or the other diagnosis but our treatment approach is:

  • Hands on manual Grade IV/V mobilizations in the Joints of the ankle,
  • Laser, to the entire foot ( based on the protocol).
  • Corrective inserts if necessary.
  • Our specialists will determine if those are needed during your Plan of Care.
  • Once the inflammation is down and pain is down we work to re educate the muscles in functional exercises.
  • We educate the customer on how to prevent reoccurrence and make sure they have a HEP that will help them return to the activities they were doing when the pain occurred.

Call Us if You Need Plantar Fasciitis Treatment Help

Physical therapy is all-natural, conservative, cost-effective, and is clinically proven to be effective.  Don’t let your heel pain linger for weeks or months. The sooner you address it the sooner you can get back to the things you enjoy.

Click here to visit our contact page or call us at (513) 874-8800.

Both our West Chester and Mason clinics have well-trained therapists that treat plantar fasciitis.


Lower Back Pain Treatment in West Chester Township

If you are looking for lower back pain treatment in West Chester Township, this post may help.

Understanding common causes of low back pain can help you make better treatment choices.  In most cases (>95% of the time), lower back pain can be successfully managed with conservative care like physical therapy.

Below is a list of three common causes of lower back pain.

Problem #1: Sacroiliac Dysfunction

Sacroiliac dysfunction (commonly called SI dysfunction), is common among pregnant women and patients that have sustained a fall onto their tailbone.  It is one of the tougher conditions to diagnose because it is often undetected on x-rays or MRIs.

Sacroiliac dysfunction is a problem with one or both of the joints between the sacrum and ilia (a region of the hip bones).

When you think about SI dysfunction, you should think about a stack of blocks.  The foundation of the stack of blocks (which is really your spine vertebrae), is called the sacrum.

But when the block at the bottom or foundation is out of line, the whole stack of blocks quickly has problems

Many people get injections, surgeries and medication for the L4, L5 vertebrae, when the hidden cause is actually the SI Joint (which can be found inside the pelvic bone).

Here are some indicators that you might have a sacroiliac joint dysfunction:

  • Pain during sitting and driving
  • Pain getting in and out of a car
  • Pain rolling over in bed
  • Common during childbirth when the body releases hormones to relax ligaments
  • Pain that is very broad, and hard to pin to any one area…With pain often wrapping around the outside of the leg

Since abnormalities are common on x-rays and MRI, SI joint dysfunction can go unnoticed.  However, a thorough evaluation that considers the entire kinetic chain, from the feet up through the spine, can help identify sacroiliac dysfunction.

Problem #2: Disc Issues

Disc pain is commonly felt in in the right or left-center of the lower back and often refers down the buttock into the thigh.  It’s characterized by sharp pain and is often made worse with sitting and forward bending.

With a disc problems, you will typically be able to point to the exact area the you are experiencing pain and run your finger down your buttock and thigh to precisely describe the discomfort.

Sciatica, or pain and paresthesia (numbness, and tingling), when caused by a herniated disc, can pinch a nerve in the lower back and cause decreased blood flow to the involved nerve root and cause radiating pain down into the leg and even the ankle and foot.

A herniated disc can happen to just about anyone.  It’s common in people in their 30’s, 40’s, and 50’s.  As we age, herniated discs are less common; however, with the aging process, it’s not uncommon to develop this next condition called degenerative disc disease.

Problem #3: Spondylosis, Stenosis, and DDD

The reason that we discuss these 3 conditions at the same time is that they often present concurrently.

When one hits 50 years-old, almost everyone has some sort of age-related change on x-ray or MRI.  Positive diagnostic tests at this age are commonplace. In fact, 95% of people over the age of 50 show at least one of these 3 things on an X-Ray.

But just because it is common doesn’t mean that it can’t be improved.

What happens is, as you age, your discs between vertebrae will start to shrink (which is why most people get slightly shorter as they age). It’s very easy to tell someone that is suffering from these conditions, because they will be leaning forward on their shopping cart (in an attempt to increase the space in between vertebrae), or will commonly be heard saying that they need to sit down for a minute (because their pain goes away when sitting down).

Someone with Spondylosis will feel a more general pain and tingling down the leg, will have the pain disappear when they sit down and will typically experience stiffness in the morning.

We Hope This Information Helps and Here’s Some Additional Research About Why You Should See a Physical Therapist First

There are numerous scientific studies that demonstrate the importance of seeing a physical therapist first for the treatment of lower back pain.  Consider this one:

Early physical therapy following a new primary care consultation was associated with reduced risk of subsequent health care compared with delayed physical therapy. Further research is needed to clarify exactly which patients with LBP should be referred to physical therapy; however, if referral is to be made, delaying the initiation of physical therapy may increase risk for additional health care consumption and costs. Reference:

Fact is, seeing a physical therapist first is not only safe (with little to no risks of side effects), in comparison to traditional medical care, it can save you a lot of money.

If you need help, have any questions, or would like to discuss your back pain, please don’t hesitate to give us a call.

If you are in severe pain, need immediate help, or have a referral from a physician, family member or friend, please click here to visit our contact page and we will get you scheduled as soon as possible.

I used to play sports, what happened to me?

I hear this a lot from older clients. Heck, I’ve heard it from myself when I went through ACL rehabilitation. Once a high level athlete, always a high level athlete. At least in our minds we are. The fact is that muscle takes 1-2 weeks to lose strength if it is not going through a workout program. Muscle responds very specifically to the strains that are placed upon it. Unfortunately as we get older, people do not exercise as often as they should. I’m guilty of this as well.

We tend to forget all the practices and conditioning that we did in order to be prepared to play in these events. We just remember the games themselves. Then we skip all the preparatory exercising that is needed in order to perform at that level. We go straight to playing pick up games.

Unfortunately, our bodies change as we age too. Without properly exercising, the muscle fibers actually change composition. The muscles become more use to long term activation. They get used to just holding us upright because standing and walking are the primary exercises we do. The muscles we use in sport require more faster activating muscle fibers. That means if we try to do fast acting movement with slow moving muscles, we’re going to have a bad time.

This is why it is important to see somebody educated in the performance of muscles to better prepare us for our activities.

Dr. Mark Geise, PT DPT

This is Hard

A lot of times we hear clients say that a seemingly easy exercise is surprisingly difficult. The most common time I hear this is when I ask somebody to hold their balance while they stand on one foot. Seems like an easy enough task right? Go on try it yourself.

Chances are that if you don’t actively practice this then it’s going to be pretty difficult. Wobbling back and forth are normal as long as you’re not at risk of falling over. There are several different reasons for why this easy exercise needs to be practiced. Every time you walk, you should be standing on one foot even if for a moment. If you can’t stand on one foot, you’re at risk for losing balance while you walk. If you’re not standing on one foot while you’re walking, then you’re not taking long enough strides. An important factor in determining if a person is at risk for a fall was the speed they were walking. Slower walking was actually predictive of falling.

Several reasons could be why this exercise is difficult. One is that practice makes perfect. Not trying it occasionally will make it difficult. Secondly, there are 3 systems in play when you’re trying to balance. The musculoskeletal system will try to keep your bones and muscles in position to stay upright. Your muscles need to be strong enough to keep you in a proper position. Your inner ear provides a lot of feedback to your brain which tries to determine how your head is positioned. Lastly, your joints have joint sensors that send feedback to your central nervous system. This keeps your brain informed of where your joints are.

So this is why we provide this exercise to patients. It challenges several systems at once. It helps determine if there are more than one system with problems. If standing on one leg is too easy, try doing it with your eyes closed!

Dr. Mark Geise, PT DPT

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