Category: Physical Therapy Tips

No Pills? No Surgery? No Problem.

Eliminate Pain Without MedicationPhysical therapists can help reduce and manage many types of pain, including low back pain, which affects up to 80 percent of Americans during their lifetime. Allowing a Physical Therapist to mobilizes the spine along with specifically prescribed exercises can help alleviate the pain and can have long-lasting effects.

1 If you are at risk of heart disease, the American Heart Association encourages seeing a physical therapist for the initial treatment of pain resulting from tendinitis/bursitis, degenerative joint problems (osteoarthritis), and inflammatory joint problems (rheumatoid arthritis), rather than prescription pain medication. 2 Our Physical Therapists are a great alternative to medication and surgery for musculoskeletal pain. Research shows individuals who receive active physical therapy experience greater improvement in function and decreased pain intensity. 3 No matter what part of your body hurts, our Physical Therapists at First Choice Physical Therapy can help you alleviate or manage pain without costly medication or other invasive methods, in many cases. 4 Speaking of pain-had any non painful surgeries lately? Physical therapists can help you avoid painful, invasive and expensive surgery, in many instances.

Research shows that Physical Therapists, combined with comprehensive medical management, are just as effective as surgery when it comes to relieving the pain and stiffness of moderate to severe osteoarthritis of the knee, low back pain and many other common areas of pain. 5 Pursuing an exercise program designed specifically by a Physical Therapist can be one of the best protections from injury and surgery. Explore the many ways in which our Physical Therapists at First Choice Physical Therapy can help you improve your mobility.

As always, First Choice Physical Therapy is here to help. Our desire is to get you better without pills and without painful surgeries. Over the past 12 years we have helped tens of thousands alleviate pain and avoid surgery. What are you waiting for? Call today to let one of our highly skilled, trained and caring Doctors of Physical Therapy evaluate you today. Two locations to PAGE 2serve you-Lynn Haven and our Newest Location on Panama City Beach in the Grand Panama Village.

To your Health,

Dr. Wade M. Rinehart

Doctor of Physical Therapy

First Choice Physical Therapy

“Our PhysicalTherapists are a great alternative to medication and surgery for musculoskeletal pain.”

Dr. Wade Rinehart

Excerpts of this article taken from the APTA website and the following Journals:

1 Spine, July 2008

2 Circulation, February 2007

3 Spine, July 2008

4 Spine, July 2008

5 New England Journal of Medicine September, 2008

Balance Is Best

It may be difficult to choose the right exercises to do based on an ailment or for a general exercise regimen. Many times individuals have the right intention of exercising and being healthier, but just need a little guidance in selecting the most appropriate activities to engage in. Just as it is important to eat a balanced diet with adequate micro and macro nutrients, it is just as important to maintain a balanced exercise regimen. Today the technology we have access to, such as instructional videos and images for a multitude of exercising strategies including CrossFit, yoga, HIIT, and many more. I get asked the question all the time by my patients, “ Doc, what is the best kind of exercise that I can do for myself?”. Obviously, Mrs. P my 87 y/o with osteoporosis will be given a different answer than my 17 y/o high school baseball player. However, in general I will tell both of them that variety is best. Our bodies adapt to stresses applied whether it be to bone, tendon, ligament, or our cardiovascular system all will become conditioned to whatever stress that is being applied. As a result these structures change to become more dense, improve tensile properties, become more pliable, or work more efficiently. These are usually good stresses that allow our bodies to become stronger and more resilient, however in excess some loads or stresses can cause damage. I like to use the example of the long time powerlifter who only strength trained for years with little variation in training, and now has an arthritic back and knees from chronic excessive loads and wearing down of his joint surfaces. In contrast the long time yoga instructor who can fold up like a pretzel but now has severe nerve pain in her leg due to spinal instability and neural involvement. As an example when you use the knee joint, it is just as important to have adequate strength of surrounding musculature in order to stabilize the knee during movement and activity, as it is to have flexibility in that musculature to allow for proper movements to occur. The point being made here is that with repetitive training regimens that lack a variety of movements and/or appropriate loading, you can become too strong and lack mobility or too flexible and lack stability. Either of these scenarios can place an individual at risk for injury or depending on the injury sustained could prolong the recovery. At First Choice Physical Therapy we specialize in analyzing and treating movement and strength dysfunction related to the musculoskeletal system. Come let us help you recover from your injuries and help you return to whatever activity it is that you are missing out on due to pain.

Arthritic Knees: Is Surgery Your Only Option?

Knee replacement surgery is becoming commonplace in our society. But is it always necessary? Knee replacement surgeries are a major and elective surgery. One should weigh their options and carefully consider   going “under the knife.” I’ve heard it time and time again from patients, “I never thought it would be this painful… I didn’t realize it would take this long to feel normal again… I thought everything would be better after surgery”. The reality is total knee replacements take an average of 6-12 weeks in physical therapy to return to a functional level of daily life. Stiffness, swelling, and overall discomfort can last upwards of one year. So is a knee replacement your only option when knee arthritis keeps you from enjoying your life? Research says no! 

High-level evidence shows that our weeks of physical therapy incorporating both exercise and manual treatment coupled with a consistent home exercise program can improve your function by 50-80% and decrease pain by the same amount. These effects have been shown to last for an entire year! If your knee arthritis keeps you from the life you want to live, let us be your First Choice for relief! You will never know until you try. In the worst-case scenario, you go into a total knee replacement surgery with the most optimal knee strength and flexibility, which will pay you dividends on your post-surgical rehab healing time. This is not just a logical approach, but it has the full scientific evidence to prove it. Come see us at First Choice Physical Therapy.  Call Today 850-248-1600.

What Causes Vertigo?

dizziness and hands holding head

Vertigo or a “spinning” sensation can be caused by different conditions, such as dislodged crystals in the inner ear (BPPV/positional vertigo), infections, or buildup of fluid in the inner ear (Meniere’s disease). One of the most common causes is when some of the crystals (bone-like material that is part of the balance system) get dislodged and end up in the semi-circular canals in the inner ear. These misplaced crystals send confusing information to the brain and cause your eyes to beat in a specific pattern (nystagmus). A series of maneuvers can help guide the crystals out of the canals and make the vertigo symptoms stop. We specialize in treating vertigo. So if you want the spinning to stop, call us today at 850-248-1600.

Get Your Mind Right


“Hey, how are you doing?” is probably the most commonly used phrase to start a conversation between yourself and another person. But are we really prepared for what the other person might say? Usually, the answer is “fine” or “okay.”  What happens if someone shares their anxiety or pain with you? How would you respond if they said, “I really need to share what’s going on in my life.”  

At First Choice Physical Therapy, we pride ourselves on our ability to examine, diagnose, and treat your orthopedic pain/dysfunction as well as get you back to a normal, pain-free life. But what happens when your physical pain turns to emotional or even psychological pain?  Unfortunately, physical pain can turn into emotional pain from feeling discouraged and anxious about your recovery, as well as psychological pain, thinking that you may never return to your normal life or that you will have pain the rest of your life. The worst thing you can do is stay silent about your worries and concerns. Sometimes just saying it out loud is therapeutic enough to know that you’re not alone and other people feel the same way you do.  

As I am writing this article, I am home with my wife and our new baby boy, who is nine days old. What an absolute gift from God and a life-changing blessing! I have felt anxiousness, worry, excitement, and sometimes fear of the unknown throughout this whole process. Fortunately, I have family and friends surrounding me who are there to listen, give advice, and most importantly, pray that God gives me strength and peace during this transition. However, I would have never benefited from their support if I had never spoken up about my emotions. The point is, if something is going on physically or emotionally, the best thing you can do is address the problem and find a support group. My love and trust in Jesus Christ are where I turn. 1 Peter 5:7 says, “Cast all your anxiety on Him because He cares for you.”  Psalm 55:22 reads, “Cast your cares on the LORD, and He will sustain you; He will never let the righteous be shaken.”  

Yes, at First Choice, we specialize in the physical aspect of the patient, and we never really have articles on this particular topic. Still, we also want you to know that we treat the entire patient as a patient at First Choice Physical Therapy. We are here to listen, counsel, and pray with you to get you better.  

To Your Health,

Dr. Brannon Chester, DPT

How To Have A Pain-Free New Year

It’s that time of the year again; the Holiday season is ending, and a New Year begins! Which means you may have traveled to see family, climbed up into the attic to put up the Christmas decorations, and inevitably lifted heavy luggage and presents. The latter may cause a great new year to become a nightmare with a terrible back injury. We often see patients with back pain from lifting luggage or boxes awkwardly and feeling immediate discomfort in their low back.

Maybe your back pain is not from lifting something awkwardly but from sleeping on a relative’s uncomfortable guest bed while visiting them for Christmas. Either way, chronic back pain is something that none of us want to deal with in the new year! Using proper body mechanics such as hinging at the hips and keeping your spine braced is a great trick to avoid back pain-You know, the whole lift with your legs thing! Another great piece of advice is to set aside the ego and get someone to help you with the lift.

Sleeping in an uncomfortable bed can also cause a lot of pain and discomfort, especially in the low back. One way to avoid awkward sleeping conditions is to sleep with a “neutral” spine. Make sure you are sleeping on your side or your back to help maintain a proper spinal alignment. Adding a pillion between your legs while on your side or sleeping with a pillow under your legs while lying on your back will also help take the pressure off of your spine. Try to avoid sleeping on your stomach, which can cause issues up and down your spine, specifically in your neck.

Our Doctors and staff at First Choice Physical Therapy want to wish you and your family a very Happy & Healthy New Year. We have two locations to serve you—one in town and the other on the beach. Keep an eye out for our third clinic coming in January of 2022.  If we can help you with any of the problems mentioned above just give us a call at 850-248-1600 today!

Fall Prevention and Decreasing Risk Factors

Five ways to prevent falls in your home:

Do you have someone living in your home at risk of falling? Here are some tips to prevent falls and secure your home for your loved ones!

  1. Remove loose carpeting or tack down with tape around all edges – this includes area rugs, entryway rugs, etc
  2. Run cords along walls. If cords must go along a walkway, tape to floor to prevent catching a foot or assistive device (walkers, canes…)
  3. Install railings at steps and stairs
  4. Keep clutter off of floors and walkways
  5. Be aware of pets when walking around, securing in another room if necessary

If you are concerned for yourself or a loved one who is at risk for falling, come see us for a fall risk assessment. We will provide you the tools to

increase your strength, balance, and confidence – all necessary to prevent falls and keep you healthy!

Dry Needling Can Help

Dry needling has been around for decades in the United States and used by various professionals, including physical therapists. Around the world, these techniques have been utilized for much longer and have scientific research to substantiate their effectiveness as a  treatment method for pain control and restoring muscle function. After a decade-long battle with the state of Florida by our founder Dr. Wade Rinehart and fellow colleague, Dr. Rob Stanborough, dry needling was approved in 2020 to be utilized by credentialed and trained Doctors of Physical Therapy.

Dry needling is the penetration of soft tissue trigger points with a thin needle that elicits a twitch response. Trigger points (TRPs) are caused by a cascade of things that ultimately causes pain by starving the muscle of oxygen and necessary nutrients. This leads to impaired muscle function, preventing it from contracting/relaxing properly, which in turn creates poor movement patterns, loss of motion, or even weakness. The presence of TRP’s can place more stress on other surrounding muscles as they pick up the slack of the impaired muscle, leading to TRPs becoming present in these muscles as well. Additionally, due to the poor muscle function, surrounding muscles working together to perform coupled movements fall short of stabilizing our joints throughout the activity, leading to joint pain.

Dry needling is also proven effective for treating chronic regional pain syndrome (CRPS) and fibromyalgia. These diseases are associated with chronic pain and are often unexplained. It is common to have multiple points of pain in many regions of the muscles and joints in these diseases. Our bodies detect taste, smell, hot, cold, and pain via the central nervous system (CNS) via the spinal cord. With fibromyalgia and CRPS, this pathway can become flooded with input from pain from various parts of the body. Normal signals like a sheet brushing up against your foot are perceived as pain. The cause of this pain is often associated with the presence of TRPs. Just as nerves can cause pain in other body regions, TRPs can have the same effect. For example, TRPs in the upper trapezius muscle can cause headaches and shoulder pain. TRPs in the cervical spine musculature can cause headaches and decreased range of motion in the neck.

At First Choice Physical Therapy, we have the ONLY expertly trained doctors of physical therapy in the Panhandle. These techniques have been vetted and proven repeatedly to be very effective and completely safe for treating the above conditions. If you suffer from CRPS, fibromyalgia, headaches, muscle aches/pains, or joint pain, let our doctors identify the root cause of your problem to help improve your quality of life. We now have three clinics to serve you- Lynn Haven/Panama City, Callaway, and Panama City Beach. Call now 850-248-1600 and let us help you today!

The “Core” of Your Back Pain

The phrase” you’ve gotta work your core” is frequently misinterpreted. We hear this from our doctors, our trainers, and sometimes our friends regarding treating or dealing with lower back pain. Let us first define core as the central, most important part of something. The misinterpreted portion of that phrase is the word core, as it is thought to be the anterior core musculature, particularly your abs. This is only partially true! Our core musculature fully wraps around our torso and forms a type of stability blanket around our internal organs and spine. It provides a central anchoring system for our limbs to move and manipulate objects in space. The deeper posterior and lateral core musculature is most responsible for stabilizing the spine and helps to prevent low back injuries from occurring in the first place.

Low back pain can have many origins, but disc injury is one of the most serious. In disc injuries, compression of the nerve roots can occur, resulting in localized inflammation and pain that can refer to the buttocks or the leg. Even the best-trained core can sustain a disc injury due to poor lifting mechanics or movement patterns. However, the chances of injury go down as your core function goes up. In sports such as soccer, volleyball, and baseball, the core is used to stabilize the body’s center, so kicking, serving, and throwing can occur. Without a sufficiently trained core, we can fall into poor movement patterns resulting in increased risk for knee, hip, elbow, and shoulder injuries. This causes us to use muscles improperly to make up the difference for force production, resulting in more injuries over time.

The take-home is that your core plays a vital role in injury prevention locally at the spine and globally with our extremities. At First Choice, we can help improve your resiliency to injury by providing you with the tools to achieve and maintain a stronger, more functional core. It is often the center from which we begin to rehabilitate our low back pain patients and is the focus of prevention for our athletic population. Give us a call to schedule an appointment with one of our Doctors of Physical Therapy 850-248-1600.

Conquer the Day

Matthew 6:25-34, Jesus teaches us about not worrying and to not be anxious about anything.  Scripture tells us to focus on today and today only, tomorrow will take care of itself. Controlling what we can control and making the best of today, will help with your overall health, mood, and protection from illness.  Yes, be informed. Yes, be careful and safe. Yes, take necessary precautions right now but we also must remember that our mind and emotional state both have a huge effect on how our physical body responds. Get out in the sunshine, play outside with your kids, exercise at home, stay hydrated with constant water intake and remember that this is only a season of our life.  There is a time coming when COVID-19 will be behind us and we will all be stronger.  

Exercise and proper nutrition are great ways to stay healthy and improve overall metabolic health.  Choose today to eat healthier, drink more water, get more exercise and practice positive things in our life that will help physically and emotionally.  All of us at First Choice Physical Therapy are here to help you. We are open and essential. If you need to make an appointment with us we are here to help.  We are also here if you have any questions regarding home exercise programs. If you had an upcoming surgery canceled, contact us if you have any questions on what to do to prepare for the surgery once that time comes.  These are not common times, but we are not common people. Stay strong, stay positive, stay in constant prayer with the Heavenly Father and know that we are all going to get through this.  

Brannon Chester, DPT
Doctor of Physical Therapy

Fixing Lower Crossed Syndrome

What is Lower Crossed Syndrome?

Lower crossed syndrome is a common abnormal posture associated with muscle imbalances in the lower body. This muscle imbalance consists of some weak/lengthened muscles (ie. the abdominals as well as the glutes) and some tight/over-developed muscles (ie. the lower back muscles and hip flexors).

What causes lower crossed syndrome?

There are several causes of lower crossed syndrome, including poor posture and suboptimal training that can lead to muscle imbalances. A sedentary lifestyle can cause the hip flexors to remain in a shortened position for long periods of time, which can lead to tightness. When you aren’t as active, your glutes and abdominal muscles also won’t be challenged, which may lead to weakness in these muscles. Even if you are active, overworking the hip flexor muscles or lower back muscles can also cause this imbalance.

How do you fix lower crossed syndrome?

In order to fix lower crossed syndrome, you have to address the muscle imbalance. To do this, you will need to strengthen the glutes, which pull the backside of the pelvis downwards. You’ll also want to strengthen the abdominals to help pull the frontside of the pelvis upwards. But that is just half of it. You’ll also want to stretch the tight muscles. This includes the lower back muscles and the hip flexors as mentioned above. Listed below are a few exercises that can help correct this poor posture. Come into First Choice Physical Therapy for proper instruction with each of these exercises!

  • Lower Trunk Rotations
  • Half-Kneeling Hip Flexor Stretch
  • Single Leg Bridges
  • Bird Dogs
  • Pallof Press

Dr. Ryan Bohn, PT, DPT

Bike Fitting to Prevent Injury

Being properly fitted to your road bike will not only make your ride more comfortable, but it will also help you maximize your efficiency, increase your speed, and most importantly prevent injury. Here are a few fundamental things to check out the next time you hop on the bike to make sure you have the best fit on your ride!

Frame Size: When standing over the bike, the top tube should be about one to two inches away from your crotch.

Seat Height: At the bottom of your pedal stroke there should just be a slight bend in your knee. There is some trial and error in finding the perfect seat height. If the seat is too high, you might feel your hips rocking while pedaling. If the seat is too low, you may start to feel some pain in your knees.

Seat Position: You will also want to check to make sure your seat isn’t too far forward or backward. To determine this, take a look at where your knee cap is when your cranks are parallel with the ground. The knee cap should be directly over the ball of your foot in this position.

Handlebar Position: The handlebars should be set to a position where your torso makes about a 45-degree angle and your arms form a 90-degree angle with your torso. However, some riders are all about maximizing speed and are willing to sacrifice a little discomfort to achieve this. Whereas other riders would rather be a little slower if it means they can be more comfortable on the bike. This can and definitely should be adjusted accordingly. The angle of the torse will be less if you are trying to be a little more aerodynamic and the opposite is true if you are looking for a more comfortable ride. Sometimes a different stem is necessary to achieve the perfect position for you.

Dr. Ryan Bohn, PT, DPT