The Clinical Truth About Accelerated Healing:
As a Doctor of Physical Therapy with over 27 years of outpatient clinical experience, I have dedicated my career to evaluating medical technologies through a strict dual lens: uncompromising clinical efficacy and optimal patient experience. We do not adopt technology because it is a trendy marketing buzzword; we invest in systems that possess a superior solid-state engineering design, maximize cellular physiology, and respect patient comfort.
Recently, local competitors have begun promoting Shockwave Therapy (Extracorporeal Shockwave Therapy or ESWT) as the newest premium add-on. To help our patients make fully informed, evidence-based decisions for their recovery, this document breaks down the mechanical, electrical, and biological realities of our advanced Class IV Therapeutic Laser compared to Shockwave Therapy.
1. The Core Scientific and Engineering Disconnect
To understand why these modalities yield vastly different patient experiences, we must look at the underlying physics and engineering principles of how energy is generated and transferred into human tissue.
| Engineering Feature | Class IV Laser Therapy (Our Standard) | Shockwave Therapy (ESWT) |
|---|---|---|
| How it Feels | This modality operates on a principle of deep cellular soothing. Patients perceive zero pain during treatment, instead reporting a deeply relaxing, comfortable, and gentle thermal sensation as the continuous infrared photons actively sedate overactive nociceptors (A\delta and C pain fibers). | Because this modality relies on raw mechanotransduction to intentionally induce microtrauma, patients perceive it as highly painful, jarring, and uncomfortable. The rapid, non-coherent acoustic spikes physically hammer the tissue, frequently triggering defensive muscle guarding, high patient anxiety, and localized post-treatment bruising. |
| Energy Generation Source | Solid-state Gallium-Aluminum-Arsenide (GaAlAs) semiconductor diode arrays. | Mechanical ballistic compressor or electromagnetic coils driving a physical projectile launcher. |
| Primary Mechanism | Photobiomodulation (PBM): Photonic light energy absorption by intracellular chromophores. | Mechanotransduction: High-amplitude, acoustic sound waves creating mechanical microtrauma. |
| Waveform Type | Continuous wave or synchronized super-pulsed coherent electromagnetic waves. | Non-coherent, divergent, rapid-rise radial or focused acoustic pressure waves. |
| Consumable Hardware Breakdown and wear | Zero moving parts. Minimal degradation over tens of thousands of operating hours. *Class IV Laser Handpiece Lifecycle: ~50,000 Hours usage | High mechanical friction. Requires mechanical rebuilds (“bullet and barrel” replacement) every 1–2 million shocks. *Shockwave Handpiece Lifecycle: ~35 Hours usage |
2. Biological Mechanisms: Healing with Light vs. Repairing via Trauma
Class IV Laser & Photobiomodulation (PBM)
Our premium multi-wavelength Class IV Laser utilizes specific infrared spectrum wavelengths (typically 810nm, 905nm, 980nm, and 1064nm) delivering high-density photon streams deep into compromised musculotendinous and joint structures.
- Mitochondrial Activation: Photons directly target Cytochrome C Oxidase within the cellular mitochondria. This accelerates the electron transport chain, forcing a massive up-regulation in Adenosine Triphosphate (ATP) production. Your cells instantly gain the localized energy needed to repair themselves at an accelerated velocity.
- Immediate Vasodilation: The laser stimulates the localized release of Nitric Oxide (NO), a potent natural vasodilator. This opens up microcirculation, immediately flooding the injured area with oxygenated blood, nutrients, and growth factors while rapidly flushing out metabolic waste.
- Systemic Anti-Inflammation: Laser light suppresses pro-inflammatory cytokines (such as TNF-alpha and IL-1beta) while stimulating anti-inflammatory mediators, safely down-regulating swelling and acute pain from the very first minute of exposure.
Shockwave Therapy (ESWT)
Shockwave relies on acoustic pressure waves generated by a miniature internal “bullet” repeatedly striking an applicator tip against your skin.
- Induced Microtrauma: Shockwave does not add energy directly to cellular metabolism. Instead, it uses mechanical force to intentionally tear old, poorly healed scar tissue and break down calcifications.
- Pro-Inflammatory Triggers: By creating controlled micro-damage, shockwave forces a dormant, chronic injury back into an acute, highly inflamed state. The body is effectively forced to restart its natural inflammatory healing cycle from scratch.
- Tissue Cavitation: The rapid pressure changes create micro-bubbles in the tissue that burst, causing further mechanical stress to the localized extracellular matrix.
3. The Patient Experience: Comfort, Compliance, and Recovery Pathways
From an operational standpoint and a patient-centric perspective, a treatment is only as effective as a patient’s ability to tolerate it. If a modality causes defensive guarding, muscle bracing, or severe anxiety, it actively works against the neurological goals of modern physical therapy.
- The Sensation of Laser Therapy: Because our Class IV Laser delivers high power smoothly, patients experience a deep, soothing, relaxing warmth. There is absolutely no pain, no skin irritation, and no mechanical bruising. It is frequently described as feeling like an deep thermal massage. It actively sedates overactive pain receptors (C-fibers and A-delta fibers), providing immediate analgesic relief.
- The Sensation of Shockwave Therapy: Shockwave is loud, disruptive, and can be intensely uncomfortable. The mechanical pounding feels like a miniature jackhammer striking bone or tendon. Patients routinely report sharp pain during the session, and it frequently leaves behind significant skin redness, localized swelling, and deep bruising for 24 to 48 hours afterward.
4. Clinical Versatility: Why the Laser Dominates Our Comprehensive Tech Stack
As a modalities specialist, I look at how technologies integrate with our core clinical strengths—specifically our region-leading team of Dry Needling certified specialists.
Shockwave is highly limited in its clinical applications. Because it relies on brute force mechanical trauma, it cannot be safely used over acute muscle sprains, fresh surgical incisions, active nerve pathways, arthritic joints, or hypersensitive tissues. It is restricted almost exclusively to dense, chronic tendinopathies like plantar fasciitis or calcific tendinitis.
Our Class IV Laser holds unparalleled biological versatility, proving highly effective across the entire spectrum of neuro-musculoskeletal pathology:
- Acute Injuries & Post-Surgical Care: Can be applied safely directly over fresh surgical incisions, acute ankle sprains, or acute muscle tears to clear swelling and halt pain without disturbing fragile tissue.
- Chronic Degeneration & Arthritis: Deeply penetrates large joints (knees, hips, lumbar spine) to soothe chronic osteoarthritic inflammation and protect cartilage health.
- Neuropathy & Radiculopathy: Safely accelerates peripheral nerve regeneration, down-regulating severe sciatic or cervical nerve root pain.
- Synergistic Integration: When paired with our advanced Dry Needling protocols, the laser can be used immediately afterward to instantly soothe the neuromuscular junctions, eliminating post-needle soreness and maximizing tissue remodeling.
5. Summary: Choosing Evidence-Based, High-Comfort Recovery
While competitors with limited resources or fewer locations rely on aggressive mechanical trauma to shock the body into healing, we choose a more precise, scientifically elegant path. Our Class IV Therapeutic Laser respects your body’s biology—delivering the pure cellular energy required to erase inflammation and rebuild tissue without forcing you to endure extra pain.
Experience the definitive difference of elite clinical engineering, world-class expertise, and compassionate care across Bay County.
Visit us online at www.readytogetbetter.com to book your comprehensive evaluation today.
New Years Help-Increasing your metabolism
I hope everyone had a very Merry Christmas and enjoyed time with loved ones and some much needed rest and relaxation! If you are like my family and I, you spent a lot of time eating, fellowship with one another, napping, and more eating over the Christmas break. Now as the New Year approaches I wanted to give you a few easy steps on how to increase your metabolism and help with all of the holiday festivities (over-eating). Below is a link that will give you a number of easy and simple steps to speed up your metabolism. As always, if you are experiencing any musculoskeletal pain or joint pain, come see one of our Doctors of Physical Therapy for an evaluation and treatment. God Bless and Happy New Year!!
http://www.active.com/fitness/articles/15-easy-ways-to-speed-up-your-metabolism
Write Your Own Script
In Florida and 47 other states you do not have to have a script from your primary physician to see a Doctor of Physical Therapy. That is the point of this ad we ran in the Lynn Haven Ledger in March of 2015. This is one of a string of ads that we designed in-house.
That was the beginning of our series of ads with full color backgrounds and busier than most of the ads you saw in the Ledger. Ok, we admit they were the busiest ads. They looked good in the large newspaper format though and we decided to put together a few ads of that style. We hope you liked them for their difference!
Regardless of the style of the ad, our main thought was always to make sure that we educated the reader that they have the final say in where they go for physical therapy. That is why we include the tag of “It’s Your Choice – Make It Count” in most of our ads.
Free School Physicals Was A Big Success!
Over 200 middle and high schools students took advantage of the free school physical offer that happened at the two First Choice Physical Therapy locations in Bay County. The plan is to do this again next year on the first Saturday in August. Whether you were able to take advantage of this program this year or if you will be joining us for the first time next year, put it on your calendar now! This offer was made possible through the combined efforts and help from the following:
Runner’s World article worth reading
I know we’ve given this to some runners that have come through our office, but if you haven’t seen it yet, here’s some light reading for you. Enjoy!!
http://www.runnersworld.com/injury-prevention-recovery/the-whole-body-fix
Free Athletic School Physical Evaluations – Again…
What: Free Athletic School Physicals (Girls & Boys)
When: Saturday July 25th, 2015
Where:
First Choice Physical Therapy in Town:
2300 Jenks Ave Ste C
Lynn Haven, FL 32444
850-248-1600
Time: 8:00 to 10:00 am. No appointment needed, but if you are not in line by 10:00 am you will not be seen.
What to Bring: Download the physical form here, fill out sections 1 and 2, and then bring it with you to the clinic. It can also be found at your school guidance office, your coaches or online at the Bay County School Board Website.
Cost: FREE, No Charge, Nada, Zilch, Zero, Nothing.
Why: Because we love you.
Thanks to the Following businesses-
The importance of running shoes…
Published June 17, 2015 |
With running as a hobby you do not need much equipment and do not need to spend a lot of money, but it is important to get a good running shoe. To determine what type of shoe you need, you will need to know the characteristics of your running gait. For example, when I run, I slightly pronate so I need a shoe with medial support. Check with us at First Choice about what kind of running gait you have so that you can lace up and get on the road.
Simon Haussmann, PTA
Physical Therapy vs Imaging Study Hits the Washington Post
Research on the cost-savings of physical therapy vs advanced imaging has been making news in professional circles, and now it’s making an even more public splash.
On March 27, The Washington Post published an article summarizing the findings of research that compared health costs for patients with uncomplicated low back pain (LBP) who were referred to physical therapy with patients referred for advanced imaging. As reported in PT in Motion News, the results showed that physical therapy typically resulted in dramatically lower subsequent costs than a first referral for imaging. The original research article was published in the journal Health Services Research (abstract only available for free).
The Post article characterized the reasons for the differences as being “more likely found in the heads of patients and doctors than in anyone’s back.” Post reporter Lenny Bernstein writes that patients with uncomplicated first-time LBP can “pressure” physicians for a referral, and physicians may comply—sometimes with a referral for advanced imaging, sometimes for a referral to physical therapy.
The lower health care costs associated with physical therapy have a connection with how patients respond to physical therapy’s more proactive, patient-focused approach, according to the Post.
In summarizing comments from Julie M. Fritz, PT, PhD, FAPTA, the study’s lead author, the Post describes physical therapy as an approach that “focuses on educating patients about what might be causing their back pain, assuring them that most problems subside in time, and engaging them in their therapy.”
The study theorizes that as opposed to physical therapy, a referral for imaging early on can lead to a different patient attitude, one that often results in more testing, more physician visits, and greater use of medication. After 1 year, the imaging-first approach can result in average costs over 3 times higher than a physical therapy-first approach, according to the study.
Fritz is quoted in the article saying that “We think this is an area where our profession has something to offer, especially when it’s timed correctly,” adding that advanced imaging can be appropriate thing to do, but “just not early in the course of care for most patients.”
Available at the APTA Learning Center: pre-recorded CE on manipulation for LBP presented by study author Julie M. Fritz, PT, PhD, FAPTA; also “Manual therapy management of the lumbopelvic spine” presented by Josh Cleland, PT, DPT, PhD, OCS, and Shane Koppenhaver, PT, PhD, OCS, FAAOMPT.
12 Years and Still Going!!
It has now been 12 years since First Choice Physical Therapy opened it’s doors. Dr. Wade Rinehart started his own clinic because of his personal drive and high standards. Over the years the company has grown. We have two clinics in Bay County and have added more therapists and office staff to help us continue the mission. Our motto is, “Excellence Drives Us-Compassion Guides Us.” You can count on us to do our best for you. Your well being and health are first in our minds as we use the skills we have learned while earning our degrees and most importantly while treating of thousands of patients.
Thank you for making First Choice Physical Therapy your first choice for your physical therapy needs.
To Your Health.
October is National Physical Therapy Month
Benefits of Physical Therapy
Doctors of Physical Therapy are experts in improving mobility and motion, and pain-free movement is crucial to your quality of daily life, your ability to earn a living, your ability to pursue your favorite leisure activities, and so much more.
Improve Mobility & Motion
Movement can help you prevent obesity, which may be responsible for at least 18% of US adult deaths. Meanwhile, recent studies suggest that prolonged sitting can be unhealthy, and that walking just a little bit more each day can help reduce the risk of heart attack and stroke. Consistent movement is also vital to maintaining a healthy balance system, and that’s important because falls often lead to significant, costly injuries.
Doctors of Physical Therapy work with their patients and clients of all ages and abilities to expand, restore, and maintain motion.
Avoid Surgery and Prescription Drugs
Many people are referred to a Doctor of Physical Therapy in order to rehabilitate from a major medical trauma or surgery, but increasing research suggests that treatment by a physical therapist is often an equally effective – and cheaper – alternative to surgery and prescription drugs for numerous conditions ranging from back pain and degenerative disk disease to meniscal tears and knee osteoarthritis.
Although direct access laws vary by state and insurance plans differ, anyone in the United States can arrange a screening by a physical therapist without a physician’s referral. Florida is a direct access state which means you can walk right into a Physical Therapist office to get the treatment you deserve fast. Through individualized treatment plans designed by physical therapists, patients can sometimes achieve the same results without the expense and side effects of surgery and prescription medication.
Participate In Your Recovery
Doctors of Physical Therapy routinely work collaboratively with their patients. Treatment plans can be designed for the patient’s individual goals, challenges, and needs. Receiving treatment by a physical therapist is rarely a passive activity, and participating in your own recovery can be empowering. In many cases, patients develop an ongoing relationship with their physical therapist to maintain optimum health and movement abilities across the lifespan.
(The Above Excerpt Was Modified and Taken From Move Forward by APAT http://www.moveforwardpt.com/Benefits)
To your Health,Dr. Wade Rinehart, PT, DPT
Doctor of Physical Therapy
First Choice Physical Therapy
Free School Physicals in Lynn Haven and Panama City Beach
What: Free Athletic School Physicals (Girls & Boys)
When: Saturday August 2nd, 2014
Where:
First Choice Physical Therapy in Town:
2300 Jenks Ave Ste C
Lynn Haven, FL 32444
850-248-1600
&
First Choice Physical Therapy on the Beach:
The Village at Grand Panama
11501 Hutchison Blvd
PCB, FL 32407
850-249-1603
Time: 8:00 to 10:00 am. No appointment needed, but if you are not in line by 10:00 am you will not be seen.
What to Bring: Download the physical form here, fill out sections 1 and 2, and then bring it with you to the clinic. It can also be found at your school guidance office, your coaches or online at the Bay County School Board Website.
Cost: FREE, No Charge, Nada, Zilch, Zero, Nothing.
Why: Because we love you.
Thanks to the Following businesses-
No referral needed…
In our wonderful State of Florida, you can choose where you receive Physical Therapy services and do not need a referral from your physician? The Florida State Physical Therapy Practice Act allows patients to be seen by the Physical Therapist of their choice without the need of an order from any physician. There are some exceptions that are mandated by certain insurance carriers requiring a referral from a Primary Care Physician. This makes Physical Therapy easily accessible, efficient and affordable.
In a recent study, “Physical therapy for acute low back pain: associations with subsequent healthcare costs”, it was concluded that “Adherence to the recommendation for active care was associated with better clinical outcomes and decreased subsequent use of prescription medication, MRI, and injections. Improving adherence to this recommendation may present an opportunity to improve the cost effectiveness of care for acute low back pain.” There are many other studies that show the effectiveness of Physical Therapy interventions, but not all therapy clinics are created equal or employ the qualified individuals needed to get the quality outcomes. Bottom line…be a consumer of your own health care.
Dr. Wade Rinehart, PT, DPT