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Posts by Andrew Bartelt

Top 5 Reasons to go Direct Access for Physical Therapy.

Have you ever heard the term direct access for health care? How about direct access for Physical Therapy? I am guessing most people haven’t, and if you have, maybe you aren’t quite sure what it really means. In the “old days” patients had to rely on getting an order from their doctor to go to physical therapy and in most cases people would go reluctantly because “my doctor said I have to.”  Recently most states have passed laws that now allow anyone to see a Physical Therapist with direct access (check your local states laws).  This means that anyone can be seen directly by a physical therapist without seeing his or her doctor first.  In other words, a physical therapist can be your first access point for medical care when it comes to problems with movement. I know, this sounds kind of crazy and maybe even a little scary. Let me explain why this should not be scary and why it is actually a great option for people who are experiencing issues with movement, pain or performance.

Top 5 Reasons to go Direct Access to a Physical Therapist

1.     COST! When it comes to healthcare, there is no hiding that it can be very expensive.  However, you can be smart and savvy about how you choose to approach certain issues. One of those smart ways to keep cost down is by seeing your physical therapist first when it comes to muscle, joint and other movement related pain. It has been shown that treatment from a physical therapist can provide a significant cost savings when compared to the normal route of first seeing your primary care doctor.  By starting your journey at the therapist’s clinic you may avoid unnecessary doctors visits, costly medications, needless imaging and possibly avoid surgery!

2.     ACCESS: direct access to a physical therapist allows you the ability to get in and see a rehabilitation specialist quickly. For example, lets say you twist your knee while shooting hoops in the driveway or practicing at the gym. You may wait a day or two (or longer) to see if it gets better on its own. When it doesn’t, you probably end up calling your family doctor. In a lot of cases it may take up to a week or two to get in for your visit and when you finally get there they may do a quick evaluation of your knee and maybe even take an x-ray (maybe warranted, maybe not), which is another cost to account for. At that point, if it is serious enough they may even refer you to see an orthopedic specialist. Now you are looking at the hassle of setting up another appointment and again waiting weeks to get in. This hassle can all be decreased and possibly avoided by making your fist call to an orthopedic physical therapist. Physical therapists are specially trained, and according to studies, rank closely to orthopedic physicians in examining muscle and joint injuries. Following the evaluation with your therapist it can be determined if you really need to get in to see that specialist or if the best option is conservative rehab. In the long run, a therapist can help direct you in choosing the most effective treatment option while wasting the least amount of your time and money!

3.     RESULTS: Not only can you save money and time by seeing a therapist as your first line of care, you can get great results and possibly avoid those unwanted medications, injections or even avoid surgery! For example, recent studies have shown success with conservative therapy treatment and similar long-term outcomes in those who have underwent therapy versus those who have opted for surgery for meniscus tears of the knee. If you are looking for a way to avoid more serious treatment for your muscle, joint or movement issues check into setting up an evaluation with a physical therapist! Physical therapists use a combination of hands on techniques, specific exercise prescription, work on improving faulty movements and enhancement of already strong movement patterns on top of providing the client with the education on ways to help maintain and progress the improvements on their own!

4.     MOVEMENT HEALTH: Movement is something that a lot of people take for granted until it becomes compromised from an injury or overuse. Movement is obviously very important for day to day functioning but it is also a huge part of people’s enjoyment. Whether you are professional athlete, high school/collegiate athlete, recreational athlete, fitness enthusiast or a parent just wanting to play with your kids, being able to have pain free movement is huge! When it comes to the treatment of movement issues or pain with movement a great first place to start is a physical therapist. They are, after all, movement specialists who not only evaluate and develop treatments to get you moving better and with less pain, but help educate you so that you can take care your own movement issues with eventually less reliance on a healthcare provider. With that being said, take the first step in taking over your current and future movement health by calling a physical therapist first!

5.     RELATIONSHIP: How many times can you count that you spent an hour or more with your doctor? Let me re-phrase that, face-to-face time with your doctor? It doesn’t happen often does it? Imagine the relationship you could build with your provider if you were able to spend that amount of quality time trying to figure out and game plan your treatment. You are in luck, this isn’t a fantasy. Physical Therapists spend the quality time you need and deserve during hour long, and possibly longer, evaluations and treatment sessions to help determine what’s going on and how to best get you back to moving pain free and get back to doing the activities that you are missing out on or not performing to your highest level. The best results happen when the healthcare provider and the client are both on the same page and working towards the same goals. So, get out there and start building a relationship with your physical therapist!

Dr. Kyle Schwebke, PT, DPT

Board Certified Specialist in Orthopedic Physical Therapy

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Physical Therapy: Your Key to Surviving the Zombie Apocalypse!

Dear Breathers,

With The Walking Dead returning back this week, it’s best we have a little conversation about your Zombie Preparedness Plan, or ZPP.  I’m sure you’ve already thought about the essentials like food, water, shelter, gasoline, weaponry, etc. You’ve also probably thought about who you’re going to ask to join your Zombie Survival Team, or ZST. This list probably includes friends, family, and the neighbor up the street who is a little too into Bear Grylles. This is all well and good, but the best plan in the world means nothing if you don’t have the capacity to execute it. Do you have the strength, endurance, agility, and flexibility to carry equipment day after day while navigating through a post-apocalyptic landscape?

Let’s talk zombie facts for a second. Max Brooks’ Zombie Survival Guide1 is an excellent resource to gain insight about what you will be up against. Zombies aren’t fast. On average, they move at a speed of about one step per every 1.5 seconds, or about as fast as a turtle. Only 1 in 4 zombies can get upstairs, which gives you another health reason not to take the elevator. And, even if you can’t out run or out climb them, zombies are not very agile, so you can probably out maneuver them when they come stumbling at you. However, the zombie is an amazing endurance athlete. They move constantly and relentlessly. That’s a problem if you’re hindered by a sprained ankle, painful back, or injured knee. Even if you‘re in good shape now, have you made yourself injury-proof? You don’t want to be the slowest member of the herd; things don’t usually end well for those who lag behind.

Here’s a closer look at the physical requirements needed to stay alive during a zombie apocalypse.

Neck: While zombies aren’t fast, they are many, and being able to turn and look in all directions will be important as the undead are closing in. Decreased range of motion or pain when turning your neck could literally cost you your head.

Shoulders: Strength, stability, and endurance of your upper extremities are critical. You will have to be able to hold a gun, stab with a knife, and fend off any zombie that gets too close. However, more than self-defense, you need the strength to clear wreckage from the road, climb up to safety, and pull your friends and family up and out of harm’s way.

Back: We’ve already mentioned the importance of strength, and your back is no exception. But when society breaks down, you will no longer be dealing with an organized world. Your back will have to tolerate twisting, turning, bending, and extending over long periods of time. Not to mention, you won’t be able to recover at the end of the day on your memory foam mattress. You have to increase your functional capacity to perform even in sub-optimal conditions.

Hips and Legs: The most important function of your hips and legs will be to carry you for miles at a time. Your glutes, quads, hamstrings, and calves will all have to be well-conditioned to endure the micro-stresses of being on your feet all day. However, you will still need the unique blend of power and endurance when you find

yourself needing to leap to safety, kick open doors, or sprint away from a Biter.

Ankles/Feet: Have you ever been on vacation and noticed how tired and sore your ankles get after walking on a sandy beach? After the Walkers take over, you can forget about having nice, paved sidewalks. The muscles of your feet and ankles will have to react to unstable sand, mud, rocks, and tree roots. With our comfortable shoes and flat surfaces, these muscles don’t nearly receive enough attention in our modern world.

So, are you still feeling confident about your ability to face the Walkers and not go “Full Shane”?

If the answer is no, consider adding a visit to your Performance Physical Therapist to your ZPP. Your therapist can diagnose your areas of weakness and prescribe interventions to enhance your performance in difficult conditions. They can give you the tools you need to zombie-proof your body. They can take you from an average “Joe” and turn you into a “Daryl.”

And, if you’re currently building your ZST, I’m open to all offers. Remember, a Performance Physical Therapist could help keep you in peak condition when the “Stiffs” hit the fan.


Your ZST’s Physical Therapist?,

Dr. Bryan Schwebke, DPT

Brooks M. The Zombie Survival Guide: Complete Protection from the Living Dead. New York: Three Rivers Press; 2003.

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How to Pick the Right Strength and Conditioning Coach

Ever felt overwhelmed by the number of options you have when it comes to picking the right strength and conditioning coach? Hundreds of different facilities. Thousands of different trainers. All telling you that they are the best option for you. Well believe me, strength coaches are not all created equal. Here are some tips that will help you sift through the thousands of pieces of coal and help you find your diamond in the rough.

  • What do they call themselves? Do they refer to themselves as a “personal trainer”, “strength coach” or a “performance coach/specialist”? If they don’t take themselves seriously then you shouldn’t either.
  • What is their cliental? Look for a performance coach that works with athletes that are similar to you and with athletes that are better than you. If you are the best athlete working out with your trainer then you may have reached their ceiling.
  • Check their education. Where did they go to college? What certifications do they have. If you are an athlete I would highly recommend looking for someone that is a Certified Strength and Conditioning Specialist (CSCS). This is not the end all be all but is a good start.
  • Are they continuing their training? Do they go to conferences, read books and articles, etc. Ask them to explain some of the new stuff they have been learning about.
  • Are they educating YOU!? A good performance coach should be empowering you mentally as well as physically. Make sure they educate you on lifts, theory, strategy, etc. Knowledge is power!
  • Are they hands on? A good performance coach should be putting their hands on you and constantly correcting your technique and form. If you have worked out with a performance coach for 30 minutes and they have not physically touched you to cue you or fix something then you are likely with the wrong person.
  • Do they give you corrective exercises? No one is perfect and everyone has stuff that needs to be worked on outside of your time with your performance coach. Make sure they are giving you things to work on at home to help you correct these limitations.
  • Is your program cookie cutter or personalized? You should be looking for a performance coach that will design or modify the strength and conditioning program to fit your needs. You should not be doing all the same things as the other people in your group.
  • Do they make you do a screen prior to training? A good Performance Coach will want to have you screened by a Physical Therapist or other professional prior to working with you so they know what your needs are and how to build a program to fit it.
  • What types of lifts are you doing? Your workout should be mostly total body movements that work in a variety of planes and should be always changing. You should not be doing more than 1-2 single joint exercises (bicep curls, seated knee extension, calf raises) during a workout unless you are a body builder.
  • Is there progression? Lifting and conditioning programs should be changing as you grow and as the seasons change. Reps, sets, frequency and weights should all be changing throughout the year.
  • Do they communicate with other professionals? Your performance coach should be asking who your athletic trainer, physical therapist, or skills coach are so that they can communicate with them and modify your program as needed based on their feedback and input.
  • Do you like their personality? When it is all said and done, you will be spending a lot of time with your performance coach. Make sure it’s someone you can stand to be around.

Do not be afraid to ask any or all of these questions when you meet with a Performance Coach. You are paying good money with the anticipation that they will positively effect your life. Make sure they are the right fit for you.

For more information on how to select your ultimate performance team or for more information on how to safely and efficiently increase your performance please check out and follow us on facebook.

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