Relieving pain: PT & Shockwave Therapy

Relieving pain: PT & Shockwave Therapy

Do you have pain? Most of us do. It is a pretty normal occurrence in our lives, often brought on by the daily rigors of our being. We sit too long. That’s bad. We stand too long. Also bad. Lay too long. Bad. Lift too much weight. Bad. Don’t lift enough weight. You guessed it, bad. Run too much or not enough. It’s all bad.

Now, this is not to say that we shouldn’t do these things. Frankly, we have to do most of them at some point in our lives, but all of our movements and positions come with consequences: some good, some, not so good.

This is why Physical Therapy exists. We are here to help. PTs help you discover why you are hurting, trying to get to the root of the problem, and find a solution that works for you. Customized treatment is the only way to be successful, because let’s face it, we are all different and what works for one person, may not work for another.

The first step in trying to get better is committing to do so. Getting better is not a once a day thing, it is an ALL day thing. Physical Therapy can put you on a plan that will help you discover the positives and negatives of what you are already doing and try, with as little interruption to your normal life as is possible, to make small adjustments to help you reduce your symptoms.

As a PT, we have limitations in what we are capable of, but research and technology keeps us moving in the right direction with the goals of helping people feeling better and restoring function.

I have recently had the opportunity to receive a treatment technique for my own pain that I have not encountered before. It is called EPAT or extracorporeal pulse activated therapy. You may have heard it referred to as “Shockwave therapy”. I was amazed after one treatment that my chronic shoulder pain, weakness and movement restriction had improved more than 50%. It was the best I have felt in over a year!

I started to do some research and found out that this can actually help to heal tears in the tissues. Here is an excerpt from the National Institute of Health (NIH), the National Library of Mecine (NLB) and the National Center for Biotechnology Information (NCBI) summarizing the effects:

“Many recent studies demonstrated the modulations of shockwave treatment including neovascularization, differentiation of mesenchymal stem cells and local release of angiogenetic factors. The experimental findings confirm that ESWT decrease the expression of high levels of inflammatory mediators (matrix metalloproteinases and inter-leukins). Therefore, ESWT produces a regenerative and tissue-repairing effect in musculoskeletal tissues, not merely a mechanical disintegrative effect as generally before assumed. Based on the encouraging results of clinical and experimental studies, the potential of ESWT appears to be emerging. The promising outcome after this non-invasive treatment option in tendinitis care justifies the indication of shockwave therapy… The success rate ranges from 60% to 80% in epicondylitis, plantar fasciitis, cuff tendinitis, trocanteritis, Achilles tendinitis or patellar tendinitis (jumper’s knee). ”

This means that shockwave therapy can help stimulate the growth of new blood cells (neovascularization), stimulate stem cell production (regrow your normal tissues), regenerate blood flow from capillaries that have been dormant (angiogenesis) and reduce inflammation, all of which help to improve tissue quality and reduce pain. It can immediately impact your motion and strength. While some changes are experienced immediately, others are often not noted until four weeks after your last treatment and the blood vessels and stem cells are repaired.

Some studies have shown under ultrasound that damage to tendons and muscle tissues can actually heal without the use of invasive procedures. It may help you avoid surgery!

Atlantic PT Center is lucky enough to have a Shockwave Therapy machine. Adding shockwave therapy to your normal physical therapy regimen has potential to lead to decreased healing times and faster restoration of function. It usually requires at least five sessions to achieve the best benefit, but some people do require more. Shockwave sessions are most effective when performed 5 to 7 days apart.

Shockwave therapy is not a replacement for PT, but used as an adjunct to your current PT treatment plan. The manual therapy and exercise programs in PT lay the groundwork for the shockwave to be more effective. And your home program is what will keep you better once you have reached your goals and been discharged from PT.

This treatment is not for everyone, as it can be uncomfortable due to the aggressiveness of the sound head as it vibrates at a very fast rate moving the sound waves deep into the tissues. Generally the treatment takes about 5 – 10 minutes.

If you are experiencing mild or chronic pain, schedule an appointment with your Physical Therapist and ask if EPAT / Shockwave is right for you.

Freehold NJ Physical Therapist, Jeremy Breden Jeremy Breden

Jeremy Breden is a PT at the Freehold location.

Call Us: 877-963-3378

Reiki Benefits for Multiple Sclerosis

Reiki Benefits for Multiple Sclerosis

Reiki can offer several benefits to those with Multiple Sclerosis including:

1. Better Immune Function

Multiple sclerosis is characterized by problems with immune function. By reducing stress and bringing feelings of calm and well being, Reiki sessions can help improve immune function.

2. Help with pain

Pain can be a daily problem for those with MS. A reduction in pain is often reported for those who undergo regular Reiki sessions. A literature review published in the Journal of Evidence-Based Complementary and Alternative Medicine found that Reiki is a potential treatment for patients experiencing pain.

3. Reduced Anxiety

Although anxiety can be an issue for lots of people, those with MS commonly have increased anxiety. Regular Reiki sessions have been shown to reduce anxiety, which may be helpful for those suffering with an increased anxiety. Multiple studies have shown that Reiki improves physical realxation at a greater rate than a placebo.

4. Fewer symptoms of depression

People who are diagnosed with diseases are prone to depression, especially those with MS due to the symptoms and progression of the illness. A study published in Research in Gerontological Nursing  supports the notion that regular Reiki sessions helps improve mood in people with MS.

5. No Risks or side effects!

Some treatments and medications come with the risk of side effects. Reiki is non-invasive, so there is no risk to giving it a try!

Katie Cummings is a PTA and founder of Positive Energy  – which offers Reiki inside the Lacey location of Atlantic Physical Therapy Center. 


5 Reasons Why a Postpartum Physical Therapy Evaluation Should Be Routine 

5 Reasons Why a Postpartum Physical Therapy Evaluation Should Be Routine 

It takes 40 weeks (almost 10 months) to grow a baby to full term.  During this time, your body under goes so many amazing changes to accommodate the growth of the uterus and baby.   The increase in the hormone Relaxin, allows for the hip and pelvic girdle to expand to hold the baby.  The pelvic floor muscles are under stretch tension, but also need to continue to be strong for support and stability.  As the baby grows, the hips shift anterior, increasing the curvature of the spine.  The breasts enlarge, and the shoulders begin to move forward.   All of these changes affect the surrounding muscles requiring them to rebalance, as well as posture and walking patterns.  And that’s not even including the muscle requirements for labor or childbirth, with more trauma occurring when a cesarean birth takes place.  The 6-8 week check up with the OB rarely includes muscles assessment of the pelvic floor.  And more often than not, women are cleared at this time to return to full activity.  Huh?  That hardly seems right after all the work, stress and changes the body has been through.  If you talk to any Pelvic Floor Physical Therapist, we will tell you that a postpartum evaluation should be offered, if not required, for every woman, and here is why. 

Reason 1: Posture Assessment

During pregnancy the shoulders round forward and there is an increase in the low back curvature.  Some of these postures progress while caring for a newborn, supporting the head and during feeding.  This posture puts excess stress through the shoulders, neck and low back, and can lead to pain.  A posture assessment identifies the limitations in normal spine movement and weaknesses throughout the trunk to re-align the spine.

Reason 2: Orthopedic Evaluation

This also includes a strength assessment of the hip girdle and shoulders, and flexibility assessment of the hips and spine.   This also includes the evaluation for a diastasis rectus (effecting 99.9% of women post-partum), and core activation/strength.  We evaluate movements patterns, transfers and lifting techniques (care for a newborn!). 

Reason 3: Breathing Assessment

Normal breathing patterns allow for the air to travel into the chest and then into the belly creating a soft rise.  During pregnancy, the growing baby takes up the belly room and shifts breathing patterns to become more chest dominant.  The pelvic floor and diaphragm need normal breathing patterns to work together.  

Reason 4: Pelvic Floor Muscles

These muscles play a huge role in stabilizing the hip girdle and supporting the baby and uterus during pregnancy.  During a natural childbirth, they undergo an incredible stretch allow for the baby to pass through.  Evaluation of these muscles includes assessment of strength and tension to resolve pain, incontinence and/or dyspareunia (pain with intercourse).   Scar tissue and healing of a perineal tear, cesarean scar mobility, and prolapse assessment is also performed. 

Reason 5: YOU

You are important.  Your body is important.  Taking the time now to heal and strengthen your body allows you to return to normal fitness routines, household chores, work and eventually chasing after a toddle.  It also sets your body up to be strong and ready for any additional pregnancies! 

Theresa Wilk-Feeley, PT, DPT, PRPC, NCMP, RYT is the Founder & Director of the Pelvic Health & Wellness Center. She is a Pelvic Rehabilitation Practitioner, NAMS Certified Menopause Practitioner and Registered Yoga Teacher who is passionate about helping her patients lead a more comfortable life. 


3 Tips For Tight Shoulders

Improving Mobility to Reach behind your Back


One of the most difficult motions to restore for the shoulder after injury or surgery is reaching behind your back. Whether you are recovering from impingement, rotator cuff repair or frozen shoulder, it is a tough movement for most. A few things I have found to be very helpful in restoring this motion, also known as Functional Internal Rotation (FIR), are below.


#1 Loosen up the back of your shoulder – your posterior capsule.

Pin a lacrosse or tennis ball up against the wall to loosen up this tissue. When the posterior capsule is tight it limits your internal range of motion.

posterior capsule loosen with tennis ball

#2 Stretch your posterior capsule with classic stretches.

The standard cross body post-cap stretch or sleeper stretch as seen below will help improve flexibility.

Posterior Capsule stretch Sleeper stretch

#3 Perform active motion behind the back.

Slow and controlled “subscap liftoffs” will help build up the muscles that help perform the behind the back motion. With your hand behind your back, try to keep your shoulder down while lifting your hand off your back.

Sub scapula liftoff exercise


Test yourself – if you have one shoulder that is more limited in motion than the other look at yourself in the mirror and see how high up your back your “good shoulder” is able to go and compare to how high the more limited shoulder can go before and after the above exercises.

See how high your hand gets behind back!


If things don’t feel right and you continue to have pain come in for an evaluation. Our team of therapists will help restore your mobility and get you back to doing everything you want to do.


Dave Garaffa, PT, DPT, is a Physical Therapist and Clinic Director of the Shrewsbury location of Atlantic Physical Therapy Center. He is also a Certified Strength and Conditioning Specialist and TPI Certified to help you improve your golf swing!

5 Concussion Myths Debunked

Did you know that 4 million sports concussions occur annually? Playing sports is not the only way a concussion can be sustained. Car accidents, work accidents, and other unlucky occurrences can result in a concussion and the symptoms can often times go undiagnosed. Concussion treatment has evolved as well! Below are a few of the outdated beliefs about concussions and how to treat them so those suffering from a concussion have a better chance of recovery.

Myth 1: You have to lose consciousness to sustain a concussion. False.

You don’t even need an impact to the head to have one. It is important to recognize the symptoms instead, such as:

  • headaches
  • blurred/double vision
  • fatigue
  • loss of concentration
  • sensitivity to light/noise
  • nausea/vomiting
  • ringing in the ears
  • slurred/slow speech
  • increased imbalance/clumsy

Myth 2: You need to stay in a dark, quiet place until you are better. False.

This is ok for the first 24 hours, but after that your brain needs to slowly get used to stimulus again. This is when it is best to contact a concussion specialist so that you can be evaluated and be guided on the proper protocol based on your symptoms.

Myth 3: You cannot go to sleep the night after a concussion. False.

Your brain needs rest, so as long as you’ve been checked by a medical professional, you can sleep as much as you need.

Myth 4: MRIs can show concussions. False.

They only make sure you haven’t done any other damage, like bleeding. You cannot see a concussion.

Myth 5: All concussions take months to heal. False.

75% of people have a recovery in 20-30 days. When it takes longer, it’s called post concussion syndrome, and physical therapy is recommended to treat it. It is best to consult with a concussion specialist such as the physical therapists in the Howell location of Atlantic Physical Therapy Center. No prescription is needed and appointments are readily available to get those suffering from post concussion syndrome the help they need as soon as possible.

Chris Beltran, PT, DPT is the Clinic Director of the Howell location as well as the Concussion Management Center. He is Certified in Concussion and Vestibular Therapy and is ImPACT® Credentialed. 


5 Tips for Running in cold weather

It’s December and winter is upon us! This means temperature drops that many of us runners love after a hot and humid summer or a milf fall, but it also means we need to be adapt and change so we can continue to enjoy our run. Here are few tips to help keep you feeling great running outside as the frost sets in:

Tip #1: Cover your ankles up in the cold weather to help prevent Achilles tendonitis. The cold can make your tendons tense or tighten, so keeping this critical area warm will help prevent injury while running.

Tip #2: Dress like how you will feel about 10 minutes into the run, you should be chilly starting off your run. This might seem self explanatory, but if you dress too warm and start getting hot and sweaty you are going to be uncomfortable during your run.

Tip #3: Wear reflective items/lights! If your running routine is early am or early evening you will find yourself out there in the dark in the fall and winter. It is imperative that drivers can see you so now is the time to make sure you have something reflective or bright on you for your safety.

Tip #4: Gradually build your pace up to help warm up your muscles and prevent injury. Being dressed for your fall / winter run means you might start off feeling a little cold. Do not go from 0-60 without giving yourself a little warm up! As stated before, the cold will make your tendons and muscles a little tight so they need to be warmed before you can expect them to perform. Give your body that grace of a warm up and you will be happy to avoid injuries.

Tip #5: Stretching at least one “tight” muscle after your run is better than no stretching. We all know we should stretch, but it feels like fall and winter days are shorter and who has the time? My advice is of course, take the time to stretch after your run! Since I know most people won’t, I highly recommend taking at least 1-2 minutes to at least stretch a muscle you know is tight for you. Remember stretching one is better than none.

Freehold NJ Physical Therapist, Andrew Goelz Runner's workshop

Andrew Goelz is the Clinic Director of the Freehold location of Atlantic Physical Therapy Center and an avid runner. He also is the Director of the Atlantic PT Center for Running Excellence leading Runner’s workshops for the community and managing the RunLab Gait Imaging Center also inside the Freehold location. For more information on RunLab:

Call Us: 877-963-3378