If you’ve ever gone through traditional physical therapy and were left feeling like just another name on a chart, you’re not alone.  So many active adults and athletes don’t realize there’s a better way. One on one physical therapy. It’s personal, focused, and results-driven. At Next Level Physical Therapy, we believe individualized care isn’t just a luxury…it’s essential. In this post, we’ll break down what makes one on one PT different, how it can speed up recovery, why it leads to better long-term results, and share a real-life case study that shows the power of this approach. What Is One on One Physical Therapy? Personalized Care in Every Session 1. Attention and Balance: In a one on one setting, every session is just you and your physical therapist. No juggling multiple patients, no handing you off to an aide. This undivided attention means we’re fully focused on your unique movement patterns, goals, and progress. That way, we can get to the root cause of your pain that much faster.  A Deeper Understanding of Your Needs 2. Understanding: With traditional PT, therapists often see 2-4 patients at a time. That limits how much time they can spend truly understanding your condition. One on one care allows for deeper assessment and the ability to pivot your treatment plan in real-time, based on how your body responds. Better Connection with Your Physical Therapist 3. Trust and Connection: Engaging in one on one physical therapy vs traditional physical therapy allows you to build trust with your therapist. This is essential to following through with your plan of care with the confidence and determination you need to get pain-free and make it last.  Why Traditional PT Falls Short Divided Attention Equals Slower Progress In many clinics, you’ll see your PT for 10-15 minutes, then spend the rest of the session doing exercises on your own, or worse, being supervised by someone unfamiliar with your injury. It’s like trying to get personal training in a crowded gym class. You end up doing stale exercises and boring stretches by yourself, which can affect your whole mindset on recovery in the long run. And that can be as harmful as the injury itself.  One Size Doesn’t Fit All Cookie-cutter programs are common in traditional PT settings. But what works for a 70-year-old recovering from surgery probably won’t work for a 30-year-old CrossFitter dealing with chronic knee pain. Your body and your goals deserve a customized approach. Compared to traditional PT, one on one physical therapy allows for your physical therapist to zero in on your exact pain points and plan to help fix it. It’s the only way to be sure you’re getting the quality of care you deserve. Drawn Out Recovery Process The less time and attention your physical therapist has for you per session, the more drawn out your recovery will take in the long run. Which can end up costing you more money and valuable time.  Traditional physical therapy tends to rely on more passive treatments instead of really getting to the root cause of your pain. Which hinders their scope of understanding and can lead to a longer recovery process. When our clients come to us, one of the biggest things that have affected their lives surrounding their injury is the time they feel they wasted at other clinics or offices. Don’t fall into the trap of thinking there is a quick fix in traditional PT. The quality of your physical therapy can save you more time than you thought possible.  How One on One Physical Therapy Speeds Up Recovery Early Wins Build Momentum When we’re working with you one on one, we can make precise adjustments from day one. That means fewer flare-ups, less wasted time, and faster improvements. You’re not spending weeks doing exercises that aren’t right for you, we’re constantly refining your plan to move you forward. And that touches back on the idea of mindset. Pain lives in your brain. Your outlook on your recovery process can be the deciding factor on how fast the process actually is. Being able to refine your therapy early on can be the change you need to get pain-free. Real-Time Feedback Improves Movement Quality Form matters…a lot. In traditional PT, they aren’t overseeing every exercise, every stretch, every movement. Which can lead to improper form and prolonged injury! In a personalized session, we’re there to watch every rep, correct every subtle mistake, and help you develop better movement habits that protect your joints and prevent setbacks. One on One Care Sets You Up for Long-Term Success Addressing the Root Cause At Next Level, we don’t just chase pain. We dig deep to understand why you’re hurting. That might mean evaluating your gait, your lifting technique, or even your breathing mechanics. When we find and fix the root issue, results stick. Empowering You to Stay Pain-Free Education is a huge part of what we do. You’ll learn how to manage your condition, avoid future injuries, and keep moving well. That kind of knowledge pays dividends long after your last session. Our goal isn’t just getting you pain-free, it’s keeping you pain-free. And that’s the difference between one on one physical therapy like us and traditional PT. When you focus on the long-term, you can prevent the injury from coming back, and get even stronger in the process.  Case Study: From Chronic Shoulder Pain to Personal Bests Meet Jake, 35, Competitive Powerlifter Jake came to us after months of nagging shoulder pain that no one could figure out. He’d seen other PTs but felt like he was going through the motions without getting real answers. The Turning Point In our first one on one session, we noticed that Jake’s shoulder issue was actually coming from poor thoracic mobility and a weak core, not the shoulder joint itself. That insight changed everything. A Custom Plan That Delivered We built a plan around mobility drills, core control, and shoulder stability, progressively loading Jake back into his lifts. After 6 weeks, he was pain-free. After 10 weeks, he hit a personal record on his overhead press. “I didn’t realize how important personalized care was until I experienced it. The results speak for themselves.” – Jake Is One on One Physical Therapy Right for You? If you’re an active adult or athlete who: Feels like PT hasn’t worked for you in the past Wants faster, longer-lasting results Values individualized attention Is motivated to get back to your sport or training safely… …then one on one PT is a no-brainer. Ready to Take Your Recovery to the Next Level? Whether you’re recovering from an injury, managing chronic pain, or just trying to move and perform better, you deserve more than a generic treatment plan. At Next Level Physical Therapy, we help athletes and active adults get back to doing what they love, stronger, smarter, and pain-free. Get in touch today to start your personalized one on one physical therapy journey. Let’s find and fix the root of your pain, together. FAQ 1. What types of conditions or injuries are best treated with one on one physical therapy? One on one PT is ideal for a wide range of issues, from sports injuries, post-surgical rehab, and chronic pain to mobility limitations, strength deficits, and performance plateaus. Whether you’re dealing with runner’s knee, shoulder impingement, low back pain, or just want to move better and train smarter, individualized care ensures you get the most effective treatment for your body and goals. 2. How long does a typical one on one session last? At Next Level Physical Therapy, our one on one sessions typically last 60 minutes, depending on your needs. During that time, your therapist is 100% focused on you, evaluating, coaching, adjusting, and progressing your plan in real-time. 3. Do I need a referral from my doctor to get started? In most cases, no referral is needed to begin physical therapy in New Jersey. You can reach out to us directly, and we’ll guide you through the process. If we believe you need to consult with another healthcare provider first, we’ll let you know, your safety and success come first!

If you’ve ever had an injury, surgery, or condition that affected how you move or perform daily tasks, you’ve probably heard the terms occupational therapy (OT) and physical therapy (PT). But let’s be honest, unless you're in the healthcare world, these two can be really easy to mix up. Both OT and PT are essential rehabilitation services that help people regain function and independence, but they have distinct focuses and approaches.  Whether you're recovering from surgery, helping a child with developmental delays, or dealing with chronic pain, understanding the difference can help you choose the right path for your health journey. Let’s break it all down. Key Differences: Occupational Therapy vs Physical Therapy While OT and PT share some similarities, the biggest difference lies in what they focus on helping you to do: Occupational therapy focuses on helping you perform the activities or "occupations" that matter most in your daily life. Physical therapy focuses on improving your physical movement, strength, and mobility to help you function better. Let’s dig a little deeper into each to really understand the distinctions. Occupational Therapy 1. Focus: Function in Daily Life Occupational therapy is all about functional independence. It helps people of all ages participate in the activities (aka "occupations") that they need or want to do in their daily lives. Whether that’s brushing your teeth, cooking dinner, typing at work, or even playing a musical instrument. If something, be it an injury, illness, or disability, is getting in the way of those everyday tasks, an occupational therapist helps you work around it or through it. 2. Scope: Mind, Body, and Environment OT takes a holistic approach. It considers not just the physical limitations a person may face, but also cognitive, emotional, and environmental factors that may affect function. For example, someone with a traumatic brain injury might need OT to relearn how to manage time, use tools, or navigate social situations. A child with sensory processing issues might work with an OT to regulate sensory input during school tasks. 3. Example: Helping After a Stroke Let’s say someone has a stroke and loses partial use of their right arm. An occupational therapist might work with them to: Relearn how to dress using one arm Use adaptive equipment to cook safely Modify their home or workspace to reduce fall risk or fatigue 4. Goal: Independence and Meaningful Participation The ultimate goal of OT is to help you live your life with as much independence and meaning as possible. It’s not just about surviving, it’s about thriving in the roles and routines that matter most to you. Physical Therapy 1. Focus: Movement and Physical Function Physical therapy, on the other hand, zeroes in on restoring movement, strength, flexibility, and balance. PT is especially common after surgeries, injuries, or any condition that limits how your body moves. Physical therapists work to reduce pain, improve mobility, and help you avoid future injury or disability. Want to learn more? Speak with one of our Client Specialists to find out how you can avoid future injury with Next Level Physical Therapy! 2. Scope: Musculoskeletal and Neuromuscular Systems PTs focus primarily on your muscles, bones, joints, ligaments, tendons, and nerves. While they may consider emotional or lifestyle factors, the approach is typically more biomechanical. Whether it's post-op rehab for a torn ACL or strengthening muscles around an arthritic joint, PT is about helping your body move better. 3. Example: Recovering After Knee Surgery After ACL reconstruction, a physical therapist will help a patient: Regain range of motion in the knee Rebuild strength in the leg muscles Learn how to walk properly again Progress to running, jumping, or playing sports if applicable 4. Goal: Restore Physical Capacity and Prevent Re-injury The goal of PT is to get your body moving at its optimal level so you can live, work, and play without pain or limitations. It’s about performance, recovery, and prevention. Similarities: Occupational Therapy vs Physical Therapy Even though OT and PT focus on different things, they do have some key similarities: Both Aim to Improve Quality of Life Whether you're seeing an OT or a PT, the ultimate goal is the same: to help you function better and live a fuller, more independent life. Both Can Be Used Together In many cases, OT and PT work hand-in-hand. For example, a person recovering from a spinal cord injury might see a PT to work on core strength and leg mobility, and an OT to learn how to adapt to tasks like getting dressed or cooking. Both Require Personalized Treatment Plans No cookie-cutter plans here. Both therapies involve individualized assessment and goal-setting to meet the specific needs of the patient. Both Are Evidence-Based Both professions rely on research and clinical evidence to guide treatment decisions. Whether you're working on movement patterns or task modifications, the approach is grounded in science. How to Know Whether You Need Occupational Therapy vs Physical Therapy If you're wondering whether you or someone you love should see an occupational therapist or a physical therapist, here are some tips to help you decide: When to Consider Occupational Therapy: You’re having trouble with daily tasks like dressing, cooking, writing, or bathing You’re recovering from a stroke or brain injury You or your child has sensory processing difficulties or developmental delays You need help with adaptive strategies or equipment to stay independent You're experiencing challenges with cognitive function that affect daily life When to Consider Physical Therapy: You’re recovering from an orthopedic injury or surgery You’re experiencing chronic pain, limited mobility, or balance problems You’ve been diagnosed with a neurological or musculoskeletal condition You want to improve your strength, posture, or athletic performance You're at risk of falls or have mobility limitations When You Might Need Both: Sometimes, the line between OT and PT blurs. For example: A child with cerebral palsy might need PT to build strength and OT to learn to use a spoon or get dressed. An older adult recovering from hip surgery might need PT for walking and balance and OT to safely bathe or cook at home. The good news? You don’t have to figure it out alone. A medical provider, or even the therapists themselves, can help guide you to the right combination of care. Let’s Review: Occupational Therapy vs Physical Therapy Occupational therapy and physical therapy are both powerful tools for regaining independence, improving function, and living your best life. While they serve different roles, they’re often complementary, and in many cases, working with both types of therapists offers the best outcomes. Still unsure what you need? That’s totally normal. Your first step is talking to a healthcare provider or reaching out to a rehab clinic that offers both services. Your recovery isn’t one-size-fits-all… and your therapy shouldn’t be either. FAQ 1. Can occupational therapists and physical therapists treat the same conditions? Yes, sometimes. But they approach the condition from different angles. For example, someone recovering from a car accident may have both a PT and an OT on their care team. The PT might focus on restoring strength and range of motion, while the OT helps with daily tasks like getting dressed or using utensils again. It’s like two sides of the same coin: same condition, different goals. 2. Do I need a referral to start OT or PT? That depends on your state laws and insurance. Some states allow direct access, which means you can see a physical therapist without a referral. Occupational therapy often requires a referral, especially if it’s being billed through insurance. That said, even if you’re not sure, it’s always okay to reach out to a clinic. They can guide you through the referral or insurance process. 3. Is occupational therapy only for kids or people with disabilities? Not at all! While OT is well-known for helping kids with developmental challenges or adults with disabilities, it’s also incredibly useful for anyone who’s having trouble doing the things they need or love to do. That includes older adults recovering from injury, people with arthritis, stroke survivors, or even someone dealing with burnout or cognitive changes. If an activity is important to you and you’re struggling with it, OT might be able to help.

Do you ever feel a tingling sensation that starts at the base of your spine and goes down the backs of your legs? It can also get pretty painful, right?  This is sciatica.  Sciatica is a common yet debilitating condition that affects millions of people worldwide. Up to 40% of people deal with sciatica pain at some point in their lives. Usually characterized by pain that radiates along the sciatic nerve, it can significantly impact daily activities and overall quality of life. If you're struggling with sciatica pain, understanding its causes and learning some effective home exercises can help you find relief quicker than you may think. What is Sciatica? Sciatica is a condition that occurs when the sciatic nerve is irritated, compressed, or inflamed. It typically manifests as pain that travels from the lower back down through the buttocks and into one or both legs. This pain can vary in intensity, ranging from mild discomfort to severe, debilitating pain that makes walking or even sitting difficult. Possible Causes of Sciatica: Herniated Disc: One of the most common causes of sciatica is a herniated or bulging disc in the lower spine, which can press against the sciatic nerve. Spinal Stenosis: Narrowing of the spinal canal can put pressure on the sciatic nerve, leading to pain and discomfort. According to the National Institute of Health (NIH), spinal stenosis affects an estimated 10-15% of the population over the age of 50. Piriformis Syndrome: A tight or inflamed piriformis muscle can irritate the sciatic nerve as it passes underneath. Degenerative Disc Disease: Age-related wear and tear on the spine can lead to disc degeneration, which may contribute to sciatica. Muscle Imbalances: Weak core muscles and tight hamstrings or hip flexors can place undue stress on the lower back and sciatic nerve. *Looking for a physical therapist to help you with your sciatica pain? Speak with one of our client specialists today and learn how Next Level Physical Therapy can help YOU get pain-free! What’s the Deal with the Sciatic Nerve? The sciatic nerve is the longest and thickest nerve in the human body. It starts at the lower lumbar spine (L4-S3) and travels down through the buttocks and into each leg. This nerve plays a crucial role in movement and sensation in the lower extremities. Functions of the Sciatic Nerve: Provides motor function to the muscles of the lower leg, including the hamstrings, calves, and foot muscles. Enables sensation in the lower back, buttocks, legs, and feet. Helps with reflex actions like knee-jerk and ankle reflexes. Since the sciatic nerve runs through several different parts of your body, any compression or irritation can result in severe pain and functional limitations. 12 Home Exercises for Sciatica Pain Relief Doing targeted exercises at home can alleviate sciatica pain by improving mobility, reducing nerve tension, and strengthening supportive muscles. Here are 12 effective home exercises that can help with sciatica pain relief: 1. Sciatic Nerve Flossing Sciatic nerve flossing helps to improve the mobility of the sciatic nerve by gently gliding it through the surrounding structures. Sit upright on a chair with both feet flat on the floor. Extend the affected leg straight and point your toes upward while tilting your head back. Slowly lower your leg and flex your head forward. Repeat 10 times on each side. 2. Seated Sciatic Nerve Flossing Sit at the edge of a chair with one foot on the ground and the other extended straight. Flex and extend your foot while tilting your head forward and backward. Repeat 10 times per leg. 3. Prone Elbow Rested Position Lie face down and rest on your elbows, keeping your hips in contact with the floor. Hold this position for 30 seconds to 1 minute. This helps to reduce pressure on the lower spine and sciatic nerve. 4. Prone Press-Up Lie face down and place your hands under your shoulders. Press your upper body up while keeping your hips on the ground. Hold for 10 seconds and return to the starting position. Perform 10 repetitions. 5. Frog Leg Press-Up Start in the prone position on your belly. Place your hands under your shoulders and press up while slightly spreading your knees apart. Hold for 10 seconds and repeat 10 times. 6. Press-Ups with Hip Shift Perform a standard press-up but shift your hips slightly to one side. Hold for 5 seconds, then switch sides. Do 10 repetitions per side. 7. Lumbar Side Glide Stand with your affected side next to a wall. Place your elbow against the wall and gently press your hips away. Hold for 5-10 seconds and repeat 10 times. 8. Side-Lying Hip Lazy Roll Lie on your side with your knees slightly bent. Roll your top hip slightly forward, then return to the starting position. Perform 10 repetitions per side. 9. Single Leg Bridge Lie on your back with one foot flat on the floor and the other leg extended. Push through your grounded foot and lift your hips. Hold for 5 seconds and repeat 10 times per leg. 10. Glute Foam Rolling Sit on a foam roller with one ankle crossed over the opposite knee. Roll gently back and forth for 30 seconds. Switch sides and repeat. 11. Piriformis Foam Rolling Sit on a foam roller and position it under one glute. Roll back and forth to release tension in the piriformis muscle. Spend 30 seconds per side. 12. Kickstand Romanian Deadlift (RDL) Stand with one foot slightly behind the other for balance. Hinge at the hips while keeping a neutral spine. Lower until you feel a stretch in the hamstrings, then return to standing. Perform 10 repetitions per leg. Join our Facebook page to watch our Physical Therapist, Dr. Rich, explain these exercises in detail! Don’t Let Sciatica Pain Hold You Back Sciatica pain can be frustrating, but incorporating targeted exercises such as sciatic nerve flossing, foam rolling, and glute strengthening can significantly alleviate symptoms. If your pain persists or worsens, don’t hesitate to seek professional medical advice. By staying active and maintaining proper spinal health, you can keep sciatica pain at bay and enjoy a pain-free lifestyle. FAQ How is sciatica pain treated? Sciatica pain is usually treated by a combination of approaches, including physical therapy, medications, and in some cases, injections or surgery, with the goal of reducing pain and improving mobility. Speak with your doctor to determine the best course of action for you. Will sciatica pain go away? For many people, sciatica pain improves within a few weeks with proper care, including rest, stretching, and strengthening exercises. However, if left untreated or caused by more serious conditions like a herniated disc or spinal stenosis, it can persist for months or even become chronic. Does Next Level Physical Therapy treat sciatica pain? Yes! We help you get to the root cause of your pain so you can begin your journey to recovery while also giving you the tools to avoid future sciatica pain, setting you up for success in your active lifestyle. Speak with one of our Client Specialists today to begin your pain-free journey.

Let’s Talk Knee Pain! So, you’ve been dealing with knee pain for a while? The first step to recovery is understanding what is causing the pain in the first place.  Knee pain is a common complaint that affects people of all ages and activity levels. Knee pain affects approximately 25% of adults and causing millions of primary care visits annually. It can stem from injuries, mechanical problems, or other underlying chronic conditions. Some people experience pain behind the knee, while others feel discomfort on the inner side of the knee. But no matter the source, knee pain can be extremely frustrating and hold you back from performing even the simplest everyday activities. Understanding the causes and treatment options is key to keeping your knees strong and pain-free. Types of Knee Pain Pain behind the knee can be a result of issues like a Baker’s cyst, hamstring injuries, or even a blood clot known as deep vein thrombosis. This type of pain can make it difficult to fully straighten your leg or put weight on it. On the other hand, pain on the inner side of the knee is frequently caused by medial meniscus tears, MCL injuries, or osteoarthritis. Individuals with this pain often feel discomfort when climbing stairs, squatting, or after prolonged sitting. For some, knee pain is more generalized, meaning it could be due to overuse, improper joint alignment, or underlying conditions like arthritis. Identifying the type of knee pain you experience is the first step toward effective treatment.  So ask yourself specific questions about your knee pain: Does it hurt to stand up and sit down?  Does it hurt to walk, jog, or run?  Are you doing repetitive movements like squats or lunges with improper form?  Understand what triggers the pain, and you’ll be on the path to figuring out what the root cause of the pain actually is. What Are Some Common Knee Injuries? Knee injuries can range from minor sprains to severe ligament damage that may require surgery. These injuries often result from sports, accidents, or even everyday movements that put prolonged stress on the knee joint. Ligament Injuries The knee is supported by four major ligaments: Anterior Cruciate Ligament (ACL): In the center of the knee, the ACL prevents excessive forward movement of the shinbone and is commonly injured in sudden stops, twists, or impacts. Medial Collateral Ligament (MCL): The MCL supports the inner knee and is often damaged by excessive force pushing the knee inward. Posterior Cruciate Ligament (PCL): Also in the center of the knee, the PCL prevents the shinbone from moving too far backward. Lateral Collateral Ligament (LCL): Located on the outer side of the knee, the LCL is less commonly injured but can be strained by excessive force pushing the knee outward. Damage to any of these ligaments can cause significant pain and instability. The anterior cruciate ligament (ACL) is one of the most commonly injured, often torn due to sudden stops, twisting, or direct trauma. This injury is especially common in athletes who play sports like basketball, soccer, football, and BJJ. ACL injuries often require surgery for a full recovery. Meniscus Tears The meniscus is a piece of cartilage that cushions and stabilizes the knee joint. Acute meniscus tears are common among athletes and often occur during twisting movements. When torn, the knee may feel like it locks or catches during movement. Degenerative meniscus tears occur over time due to wear and tear. Older adults are more prone to these injuries, often experiencing pain and stiffness that gradually worsens over time. Tendon Injuries The patellar tendon, which connects the kneecap to the shinbone, can become inflamed due to repetitive stress. This condition, known as patellar tendinitis or Jumper’s Knee, is often seen in athletes who perform frequent jumping movements. Some More Insight on the Causes of Knee Pain There are many reasons why knee pain may develop, ranging from direct injuries to chronic health conditions and mechanical problems in the body. Injuries Traumatic knee injuries, such as fractures, ligament tears, or dislocations, often occur from falls, accidents, or sports-related incidents. Overuse injuries are another common cause, developing gradually due to repetitive motion, such as running or jumping. Chronic Conditions Conditions like osteoarthritis, rheumatoid arthritis, and gout can contribute to chronic knee pain. Osteoarthritis is one of the most prevalent causes, wearing down the protective cartilage in the knee over time. Rheumatoid arthritis, an autoimmune disease, leads to inflammation and joint damage, while gout results from uric acid buildup in the knee joint, causing sudden and severe pain. Mechanical Issues Poor alignment, muscle weakness, and tightness can also contribute to knee pain. When muscles surrounding the knee, such as the quadriceps and hamstrings, are weak or tight, they place unnecessary stress on the joint. Similarly, improper foot posture, such as flat feet, can alter walking mechanics, increasing strain on the knees.  This is where proper physical therapy comes into play. Sometimes, the pain itself is not a direct indication of the root cause of the pain. Identifying an underlying mechanical issue in the knee could be the key to fixing the issue itself (and prevent further injury while avoiding surgery). The PT’s at Next Level Physical Therapy are trained to find these root causes and not only get you back to pain-free movement, but improve the quality of that movement going forward. Want to know more? Fill out this form and one of our Client Specialists will be in touch! The Key to Knee Pain Management While knee pain can be frustrating, various treatment methods can help relieve discomfort and promote healing. A combination of home remedies, physical therapy, and medical treatments is often the most effective approach. Home Remedies One of the simplest ways to manage knee pain is through rest and ice therapy. Resting the knee allows tissues to heal, while applying ice helps reduce swelling and inflammation. Using compression with a knee brace or bandage can provide additional support, while elevating the leg helps minimize swelling. Apply ice packs for 15-20 minutes several times a day. Use compression sleeves or braces for additional support. Keep the leg elevated to reduce swelling. Physical Therapy Physical therapy plays a crucial role in knee pain recovery by strengthening the surrounding muscles, improving flexibility, and enhancing joint stability. Strengthening exercises focus on key muscle groups like the quadriceps, hamstrings, and glutes, which provide essential support for the knee. Flexibility training, including gentle stretching, can relieve muscle tension and improve movement, while balance and stability drills help prevent future injuries. Working with a physical therapist ensures that exercises are performed correctly and tailored to individual needs. 3 Low-Impact Stretches for Knee Pain Relief Stretching and exercise are the best ways to maintain knee health and reduce pain. By strengthening muscles and improving flexibility, you can reduce strain on the knee joint. Strengthening Exercises Strong muscles help absorb impact and support knee function. Quad sets, where you sit with your leg straight and tighten the thigh muscles, are great for engaging the quadriceps. Straight leg raises and step-ups also build leg strength while minimizing knee strain. Stretching Exercises Stretching is essential for maintaining flexibility and reducing tension. Here are a few to relieve knee pain: Hamstring stretch: to relieve tightness behind the knee Quadriceps stretch: improves front-thigh flexibility Calf stretch: to help with lower leg tightness that affects knee function Incorporating these stretches into a daily routine can improve movement and decrease stiffness. Low-Impact Activities For those looking for exercise alternatives that don’t place excessive stress on the knee, low-impact activities like swimming, cycling, and yoga are excellent options. Swimming provides resistance training without impact, cycling strengthens the legs while keeping the motion smooth, and yoga enhances flexibility and balance. Time to Take Control of Your Knee Pain Recovery Knee pain can interfere with daily life, but the right approach can help manage discomfort and restore mobility. Whether you’re dealing with pain behind the knee, pain on the inner side of the knee, or looking for knee pain exercises, taking proactive steps can improve knee health. By understanding the causes, recognizing symptoms early, and following a well-rounded treatment plan, you can maintain strong, pain-free knees for years to come. Join our Facebook group to watch Dr. Saige talk more about knee pain! FAQ Does Next Level treat knee pain? Yes! We treat all levels of knee pain from injury due to overuse to ACL post-op recovery. Let Next Level help you find the root cause of your pain so you can get back to your active and healthy lifestyle! What Causes Knee Pain? Knee pain can stem from a variety of factors, including injuries, chronic conditions, and mechanical issues. Injuries such as ligament tears, meniscus damage, and tendon inflammation are common causes, often resulting from sports, accidents, or overuse. Chronic conditions like osteoarthritis, rheumatoid arthritis, and gout can also lead to persistent knee pain by causing inflammation, cartilage breakdown, or joint damage. Additionally, mechanical problems such as poor posture, muscle imbalances, and improper movement patterns can contribute to knee discomfort over time. Understanding the root cause of knee pain is essential for effective treatment and long-term relief. How Do You Treat Knee Pain? Treating knee pain depends on the cause and severity of the discomfort. For minor pain, simple home remedies like rest, ice, compression, and elevation (RICE) can help reduce swelling and promote healing. Over-the-counter pain relievers, such as ibuprofen, can also provide temporary relief. If knee pain persists, physical therapy is often recommended to strengthen the surrounding muscles and improve joint stability. In cases of chronic knee pain caused by arthritis or long-term wear and tear, treatments like corticosteroid injections, bracing, or even lifestyle adjustments—such as weight management and low-impact exercises—can be effective. For severe injuries, including ligament tears or cartilage damage, surgical options like arthroscopic surgery or knee replacement may be necessary.

Hips are not born to be “tight,” but with how often people describe their hips as feeling more like rusty gears than Stretch Armstrong, it is easy to believe they are. The good news is that, for most people, hip mobility issues can be significantly improved by shifting how you think about what is actually limiting your motion. Before we talk about solutions, let’s look at the anatomy of the hips and then break down how to identify what deserves your attention. Anatomy Think of the pelvis as the house that your hips live in. It is made up of two wing-like structures called innominates, which are connected by the sacrum. Your lower back connects directly into the top of the sacrum, forming a complex relationship between the spine, pelvis, and hip joints. In a previous post, I talked about why “stretching” a muscle that has the perception of tension, or that might be a contributor to a reduction of joint motion might be a simplistic, reductionist way of viewing how the body creates movement. Muscles attach to tendons, which attach to bones. If we only pursue the feeling of a stretch in an area that feels restricted, we may miss the underlying factor that is actually driving that sensation. To make this more actionable, let’s break hip mobility into a few buckets. Bucket 1: What Does My Total Hip Rotation Look Like? One of the easiest ways to assess hip mobility is to look at total hip rotation. This means adding together your hip external rotation and hip internal rotation. (Figure 2).  [caption id="" align="aligncenter" width="882"] Figure 2: Hip ER and IR measured on an examination table.[/caption] A general benchmark for most people is around 100 degrees of total rotation between these two movements. When this is present, it suggests that the innominates can move well relative to the sacrum and that the hips have access to a wide range of positions. If you are missing a significant amount of total hip rotation, a good starting point is learning to move with less muscular tension and restoring relative motion between the pelvis and sacrum. A simple and effective option is sidelying rolling with lateral pelvic compression. This exercise helps reduce unnecessary muscular effort, restore rotation, and build awareness of how your hips actually move. That awareness becomes incredibly valuable as exercises become more challenging. [embed]https://youtu.be/oeLwLrrsSI4[/embed] Figure 3: Sidelying Rolling with Lateral Pelvic Compression Other commonly used movements that serve a similar purpose include the supine cross connect and the hooklying two arm reach. [embed]https://www.youtube.com/watch?v=TcsiqnDrd0g[/embed] Figure 4: Supine Cross Connect [embed]https://youtu.be/C7hLRzrWF_4[/embed] Figure 5: Hooklying Two Arm Reach  Both of these exercises help reorient the pelvis as a unit and can rapidly restore access to hip rotation when position is the primary limitation. If you are missing total hip rotation, start here. Restoring potential movement comes first. Bucket 2: What Are My Tissues Calibrated To Do? Think about guitar strings. Their tension changes depending on how they are used and how the guitarist prefers them tuned. Your body works in a similar way. Beyond muscles and bones, connective tissues play a huge role in absorbing and transmitting force. These tissues adapt to the demands placed on them. If you recently restored hip rotation but still feel stiff or restricted, it may be time to recalibrate how your connective tissues handle force. A great starting point is a goblet box squat with a rockback. This symmetrical movement encourages the body to absorb force and reduce stiffness by relaxing into the bottom position. [embed]https://youtu.be/R26W48oflok[/embed] Figure 6: Goblet Box Squat with Rockback Once that feels comfortable, a lateral lunge with a static hold introduces similar demands but emphasizes side-to-side motion. This helps the body learn to manage force in frontal plane positions that are often undertrained. [embed]https://youtu.be/wXljK0b7vhM[/embed] Figure 7: Lateral Lunge with Static Hold Putting It All Together If you are missing a large amount of hip rotation, focus first on getting the pelvis into positions that allow that motion to exist. This restores your potential to move freely in multiple directions. Once that potential is there, the next step is tuning your body’s connective tissues to do what you actually need them to do. That means being able to absorb force when necessary and create force when needed. Both qualities matter. Mastering them is what allows you to move well, train hard, and stay active without constantly feeling stiff. Give these strategies a try and see how your hip mobility changes when you stop chasing stretches and start respecting position and force instead.

(The #1 Most Overlooked Aspect Of Hip Mobility) “My hip flexors are always so tight.” “I always stretch but my hips just feel stiff again later.” “My foam roller is my best friend, why aren’t my hips more flexible?” Stiffness or feelings of tightness around the hips are some of the most common complaints I hear from friends, family, and patients. Stretching is also the most common solution people believe they need more of. At first glance, this makes sense. Something feels tight, stretching gives temporary relief, so doing more stretching should fix it. But what if that view is incomplete. All of these statements have something in common. The strategies being used are not addressing what is actually driving the issue. To understand what more effective strategies look like, we need to first understand how muscles actually work. Kinesiology 101: What Is the Job of Our Muscles? Muscles attach to tendons, and tendons attach to bones. Muscles are simple. When they contract, they shorten, flatten, and compress to create movement. When they are not contracted, they exist in a more lengthened and expanded state. Notice what term is missing here. Tightness. Muscles themselves are not tight. They exist on a spectrum from relatively compressed to relatively expanded. Their behavior is largely dictated by the position of the bones they attach to. [caption id="" align="aligncenter" width="718"] Source: https://dannyomokha.blog/tag/hip-complex/[/caption] Muscles of the Hip Complex Let’s use a specific example to make this clearer. One of the most important muscles in hip mobility is the psoas major. This is your primary hip flexor and it is considered a biarticular muscle because it crosses multiple joints. It runs from the lumbar spine, across the pelvis, and attaches to the femur. Because of this, the behavior of the psoas is influenced by the position of the spine, pelvis, and hip. If we are trying to change how this muscle behaves, we must consider all three of those regions. How Position Drives Hip Flexor “Tightness” Now let’s look at a position that would cause the psoas to be more shortened or compressed. When the lower back and pelvis are oriented forward into an anterior position, the attachments of the psoas are brought closer together. This places the muscle in a position where it is already shortened and primed to contract. This is one of the most common postures seen in people who complain of tight hip flexors. [caption id="attachment_1669" align="aligncenter" width="408"] Figure 2: An Anteriorly Oriented Lower Back and Pelvis[/caption] Now consider one of the most common hip flexor stretches people perform. The individual lunges forward and arches through the lower back while trying to stretch the front of the hip. While a stretch sensation is often felt, the position of the pelvis and spine has not changed in a way that would allow the hip flexors to truly lengthen. In fact, this position often reinforces the same forward orientation of the pelvis and spine that created the issue in the first place. What is frequently happening is not a stretch of the hip flexors, but increased pressure at the front of the hip joint and capsule. The muscle behavior has not changed. Only the sensation has. A More Effective Approach to Hip Mobility Rather than forcing static stretches, a more effective strategy is to first address joint position. An exercise like the hooklying two arm reach is often far more effective. This position places the spine into relative flexion, brings the pelvis into a more posterior orientation, and allows the hip to extend. All of the regions that influence the psoas are addressed at the same time. [embed]https://www.youtube.com/watch?v=C7hLRzrWF_4&t=3s[/embed] This creates a genuine opportunity for the hip flexors to move into a more lengthened and expanded state. The same principles can be applied in movements like a half kneeling cable press. This positions the pelvis and hip to encourage length through the hip flexors of the down leg, while the pressing action reinforces a spine position that influences the upper portion of the psoas. [embed]https://youtu.be/DJJI28xT5og[/embed] An added benefit is that these movements improve mobility while also building strength and coordination, instead of requiring separate time dedicated solely to stretching. The Takeaway Muscles do not get tight. Tightness is a sensation. Muscle behavior exists on a spectrum from relatively compressed to relatively expanded, based on the position of the bones they attach to. If stretching has not improved your hip mobility, it is likely because position has not been addressed. When you start respecting joint position first, changes in muscle behavior follow, and results tend to come much faster and last much longer.

Many people are told that their knee pain, hip pain, or low back pain is caused by weak hips. This conclusion is often made after strength testing shows difficulty activating muscles like the glutes, which play a major role in hip and pelvis stability. The most common solution is banded hip strengthening. This usually looks like placing a resistance band around the knees for side steps, monster walks, or clamshells. While these exercises are popular, they often fall short and do not lead to meaningful pain relief or long term improvement. Let’s look at why that might be, and what a more effective approach actually looks like. Understanding the Length Tension Relationship All muscles operate under what is known as the length tension relationship. This means the amount of force a muscle can produce depends on the length it starts at. A simple way to understand this is by thinking about a pull up. Starting from a dead hang at the bottom is very difficult. If you start with your elbows already bent, the movement feels much easier. At the very top of the pull up, the last portion is also challenging. The strongest point is somewhere in the middle of the movement. This happens because muscles produce the most force when they are neither fully stretched nor fully shortened. Much like the Goldilocks principle, the middle range is just right. What Is Happening Inside the Muscle Muscle fibers contain tiny structures called actin and myosin. These filaments overlap and interact to create contraction. Myosin heads attach to actin and pull, shortening the muscle. When a muscle is overly stretched, there is less overlap between actin and myosin, making it harder to generate force. When a muscle is fully shortened, there is very little room left for further contraction. In both cases, force production is reduced. Maximum strength occurs when the muscle starts in the middle of its available range, where overlap is optimal. Why Your Hips May Appear Weak Now let’s apply this to the hips. Sometimes hip weakness is real. However, very often the issue is not true weakness but the position the hips are resting in. If the glutes are already held in a shortened or contracted position, they will struggle to squeeze any further. This presents as weakness during testing. On the other hand, if the glutes are excessively lengthened, they may not be able to generate enough force either. These resting positions are influenced by pelvic position. Tight or loose muscles are often the result of the position they are held in, not the original cause of the problem. This is something that can be identified with a proper movement assessment. Why Bands Often Miss the Mark If hip position is the underlying issue, adding a resistance band and doing more strengthening does not solve the problem. In fact, if someone is already in an over contracted state, banded exercises can make things worse by reinforcing poor starting positions. This can further limit force production and continue to feed pain patterns. This is why many people perform band exercises consistently and never feel stronger or more stable. A Better Approach The first priority should be restoring the hips to a more neutral position so they can operate in that strong middle range. Once the hips are in a better position, strengthening exercises become far more effective. At that point, resistance training reinforces good mechanics instead of fighting against them. The exact exercises needed depend on how the hips and pelvis are positioned at baseline. This requires an individualized assessment to determine whether muscles are starting in a contracted or lengthened state and what needs to change to restore balance. After that, strength training can be layered on safely and productively. Whether you are dealing with knee pain, hip pain, low back pain, or simply feel like your performance has plateaued, addressing hip position is often the missing piece. When that foundation is restored, strength gains come more easily and pain is far more likely to resolve.

Stretching is something most of us do, but have we ever stopped to think about why. Usually the logic is simple. The muscle feels tight, so we stretch it. If a muscle is tight because it is shortened, stretching it to make it longer makes sense. But what if the reason a muscle feels tight has nothing to do with it actually being shortened. If that is the case, how effective is stretching really. Let’s use the hamstrings as an example to explain this idea more clearly. And do not worry. At the end of this article, I will still show you my top three exercises to fix “tight” hamstrings.   Why Everyone Thinks Their Hamstrings Are Tight Almost everyone believes they have tight hamstrings, and almost everyone stretches them. Common ways hamstrings are assessed include the active straight leg raise and the toe touch. Many of us also remember the sit and reach test from physical education class growing up. If you could not lift your leg high enough, touch your toes, or reach far down the ruler, you were told you had tight hamstrings and needed to stretch them. But just because something feels tight does not mean stretching is the solution. How many people have stretched their hamstrings consistently and seen little to no lasting change. If stretching does not change anything long term, maybe the hamstrings are not actually shortened and stretching is not the answer. A common response is, “But I really feel tension in the back of my leg when I try to touch my toes or when my leg is lifted.” That feeling is real. The tension is real. The reason for it is just often misunderstood. To understand why, we need to talk about position. Understanding Hamstring Anatomy The hamstrings originate at the ischial tuberosity of the pelvis, often referred to as the sit bone. They cross the knee joint and attach to the tibia and fibula in the lower leg. An easy way to visualize the hamstrings is to think of them like a rubber band running from the pelvis down to the back of the lower leg. When you lift your leg during a straight leg raise, the hamstrings are lengthened and tension increases. However, because the hamstrings attach to the pelvis, the position of the pelvis plays a major role in how much tension is already present. Pelvis Position Changes Everything Now let’s talk about pelvic position. If someone stands, sits, or lies down in an anterior pelvic tilt, the pelvis is tipped forward. When the pelvis is tipped forward, the hamstrings are already placed under tension. In other words, the rubber band is already stretched before you even move. So when you go to touch your toes or lift your leg, you feel tension much earlier. Your nervous system interprets this as approaching a limit and creates a protective response by stopping the movement. This is not because the hamstrings are short. It is because they are already lengthened due to pelvic position. Figure 5 illustrates this clearly. With a neutral pelvis, the hamstrings sit at a more optimal resting length. With an anteriorly tilted pelvis, the hamstrings are visibly longer and already under tension. When you then try to stretch further, your body says no. Why Stretching Often Fails If your hamstrings already feel stretched due to pelvic position, stretching them more does not solve the problem. In many cases, it simply reinforces the same limitation. This is why some people can stretch daily and never see meaningful changes in flexibility. Before forcing more stretching or having someone push you deeper into a toe touch, it is worth looking at position first. If you improve pelvic alignment or get out of an overly extended posture, you may find that hamstring mobility improves without stretching at all. This often leads to better movement, less pain if pain is present, and reduced injury risk. A Quick Disclaimer This is not an argument that stretching is bad. Stretching can improve tissue quality, elasticity, and durability. It absolutely has a place. However, if stretching has not improved your hamstring mobility, there is a good chance you are addressing the wrong problem. Sometimes the solution is not to stretch harder, but to change position first. If you want to learn how to do that, click below to see my top three exercises to fix “tight” hamstrings.

If you are here to read about your knee, you have come to the wrong place. We are not here to talk about your hips and ankles either. Well, not entirely true. We are really here to talk about your diagnosis: patellofemoral pain syndrome, or PFPS, which typically describes pain in the front of the knee. Unfortunately, PFPS is more of a description than a true diagnosis. Before diving deeper, let’s briefly review the relevant anatomy. A joint exists anywhere two bones meet, and the knee is no exception. The knee joint is formed by the femur, or thigh bone, and the tibia, or shin bone. While it may look like the knee moves like a simple hinge, it does not. Like every joint in the body, the knee relies on rotation. As you straighten your knee, the femur rotates inward while the tibia rotates outward. When you bend your knee, the opposite occurs. The top of the tibia is relatively flat, while the bottom of the femur resembles two rounded surfaces resting on it. Ligaments and muscles work together to keep the joint stable. Although many muscles influence knee position, the quadriceps are often the main focus in PFPS discussions because the patella, or kneecap, sits within the quadriceps tendon itself. Now that we understand the anatomy, here is the part that matters most. Why Force Management Matters More Than Anatomy What truly matters in PFPS is not the knee structure itself, but how forces move through your body. Every time your foot contacts the ground, force travels up the leg and through the body. To move forward, you must then push force back into the ground. This is walking. When done at higher speeds, it becomes running. The same principles apply to strength training, even when your feet stay planted. How efficiently your body absorbs and redistributes force determines how much stress is placed on the knee, muscles, ligaments, and surrounding tissues. There is no need to fear normal tissue stress. Strain is a natural and necessary part of being human. It is how tissues adapt and become stronger. The issue arises when the amount of stress exceeds your ability to recover from it. You can think of this like a budget. Small withdrawals are normal and manageable. Over time, if withdrawals exceed deposits, you slowly go into debt. That accumulated debt is what often shows up as pain. Why PFPS Does Not Explain the Real Problem PFPS tells you where your pain is located, not why it exists. Because of this, the label itself offers very little guidance on how to actually resolve it. The most common advice given for PFPS is to strengthen the quadriceps, hamstrings, calves, and glutes. The reasoning is that stronger muscles will better tolerate force and reduce strain on the knee. Strength training absolutely matters, but this approach is often incomplete. Strong muscles are only useful if they activate at the right time, in the right sequence, and in coordination with the rest of the body. Strength alone does not guarantee proper force distribution. Many people do find relief through strengthening programs. However, if you have already gone down that path and are still dealing with pain, something important was missed. Even the presence of old injuries such as meniscus tears, arthritis, or ligament damage may not be the main driver of your symptoms. Improving how your body manages and distributes force through the knee can lead to meaningful improvements, even when structural issues exist. The Takeaway If you have persistent pain in the front of your knee, PFPS does not mean you are stuck with it forever. Mechanical pain always has a source. When the focus shifts away from isolated structures and toward improving how forces move through your body, real change becomes possible. With the right approach, anterior knee pain can absolutely be resolved.