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Performance

The World Class Pain Solution for Athletes and Active Adults.
Revolutionizing Physical Therapy, one success story at a time.

Online Program

The Most Innovative Online Pain Solution for Active Adults and Athletes. Eliminate pain from the deepest root, no matter where you are in the world.

Post-Surgical
Rehabilitation

You took a big step. Let’s cross that finish line with confidence. Undivided attention and care to guarantee your surgery is a success.

Sports
Rehabilitation

No one understands the athlete like Next Level. Experience the only pain solution trusted by the world’s top athletes.

Physical Therapy

The World Class Pain Solution for Athletes and Active Adults.
Revolutionizing Physical Therapy, one success story at a time.

Yes, It’s possible. Get to the deepest root of your pain. Online.

The Next Level Online Program is what happens when innovation meets the World-Class Pain Solution.

This isn’t your ordinary “online consultation” where you talk to a PT and get advice with some basic exercises.

No. It’s the same exact treatment you get in our clinics. How is it possible? Because knowledge is power.

Getting to the deepest root of your pain is not about massages and stretches. It’s about having a deep understanding of how the body works. How the patterns of movement, posture, control, and breathing integrate together. A true expert can see the symptoms and make sense of it from a whole.

It can be hard to grasp because it’s a completely different approach.

But the results speak for themselves!

See below what people have said about the online program. If you’re interested, start with our free assessment. You’ll know exactly how and why it works.

 

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FOUNDATION

Pain is the result of a weakness in your foundation.

Regardless of location, severity, and age, recovery relies on 4 key foundations.

This is our “4 Pillars of Recovery.”

Failure to address each pillar leads to pain and poor results. Long-term pain relief happens only when each pillar is strengthened at the right time.

PILLAR 1:
STRUCTURE
Structural damages must be addressed first. Any internal processes that have potential to limit your physical ability to recover must be identified.
PILLAR 2:
MINDSET
There must be clarity around what you actually think about your pain. Your thoughts and beliefs are a major indicator of your body’s ability to recover. We must ensure that they are healthy, empowering, and most importantly, accurate.
PILLAR 3:
MOVEMENT
You must possess a level of mobility and stability in your functional movement patterns. How you move at the most basic level is the building block of everything. In order to load your body with advanced movements, you must possess strength and control in your basic functional movement patterns.
PILLAR 4:
CAPACITY
Solid movement with strength and control is what leads to long-term pain relief. You need to understand the specific movements you are trying to do in your activity, and load the body with a sound strategy. As your body builds capacity, you’ll feel stronger and more confident to get back to doing what you love.

STRATEGY

We start with the end in mind so that your treatment has intent and purpose.

We get clear on your goals and what you want to achieve from the start.

We implement our 7 Level System to identify the root cause of your pain and develop a personalized treatment plan that is solely focused on your goals.

The system has transformed lives from professional and Olympic level athletes, to the everyday fitness enthusiast.

It is the perfect bridge that will get you from being limited in pain, to doing what you love again.

  • 07:
    Physical Mastery
  • 06:
    Transformation
  • 05:
    Power & Capacity
  • 04:
    Integration
  • 03:
    Control
  • 02:
    Position & Range
  • 01:
    Understanding
  • 00:
    Acute Management

Execution

Sound strategy with precise execution results in lasting transformation.

We have tested the most effective treatments and combined the most proven methods.

What we’ve created is a world-class treatment system where you’ll feel a difference at each session, one where you’ll have deep-rooted pain-relief at the end.

Video Testimonials

Eric O.
“I’ve seen the benefits of having expertise…in many ways I feel like I got my life back”
Deanna P.
“I would say it was definitely worth it for me…I had some basic equipment but that is all I needed…I can do everyday life functioning things now”
Lacouir Y.
“It helped me to beat down fear…it felt uplifting, it felt inspiring.”
Robyn M.
“I was able to workout without my back spasming…I feel more motivated to workout.”
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Your Scapula Is NOT Dysfunctional
I think we can all agree that shoulder pain sucks. Personally, I use my arms all of the time. To put on clothes, shower, feed myself, drive, lift weights, do pushups, write this article, and a whole lot more. If you’re anything like me, you do too. There are a lot of possible causes of shoulder pain, but if you’re in a group of people diagnosed with scapular dyskinesis, scapular instability, or scapular dysfunction, which are essentially the same thing, I have something to tell you. It’s the truth, but I don’t know if you’re ready for it. Are you sure? Really really sure? Alright, you asked for it... There is no such thing as a dysfunctional scapula 😱 I know, you must be shook, but allow me to climb onto my soap box for a minute. I believe that the word “dysfunctional” has no place in a discussion about how bodies move. It reinforces unhelpful narratives around our bodies being fragile or broken, which can lead to hesitation, fear avoidance, and increased risk of repeat injuries. How? Our good friend Dumbledore said it best: (his beard is filled with wisdom) Using the word dysfunctional implies that there is a functional, normal, and/or correct way for a shoulder to move. Those who are dysfunctional are therefore abnormal, incorrect, and at risk for harming themselves. The terms dyskinesia, abnormal mechanics, and instability have similar issues. They’re binary. You’re either normal or abnormal with no room in the middle. It’s unintentional mental framing that leads to a self-limiting belief. People with these diagnoses commonly avoid activities out of a fear of making things worse, which in the end actually makes things worse! Just because your shoulder doesn’t work as well as you want doesn’t mean there’s something wrong with it. You just need to figure a few things out. The anatomy is important here. There are three main structures to consider when thinking about the shoulder: the ribcage, the scapula, and the humerus. The scapulo-thoracic joint is between the ribcage and scapula while the glenohumeral joint is between the scapula and the humerus. The scapula is responsible for about 30% of your total shoulder motion, and the scapulo-thoracic joint operates as a “floating” joint with no direct bone-to-bone attachment to the body. Your upper arm bone, the humerus, connects into a socket on the outside edge of the scapula. Your shoulder blade floats because as it moves so does the socket. It can therefore orient and position itself in a wide variety of ways, allowing you to get your hand into a lot of different positions. The shoulder has more range-of-motion than any other joint in the body. The more motion you have available the more complex movement becomes, and the harder it is to control. This is where the conversation of stability comes in. For the sake of this discussion I’m going to define stability as the ability to resist unwanted motion and/or to return to a desired state after being moved. This is why the common treatments for an “unstable” shoulder include activities like bosu planks, having your therapist slap your arm around while you hold it in one place, lifting and carrying weights hanging from bands, etc. The intent is good but the application is often poor, leading to inconsistent and incomplete results. These activities are complex, with a lot of variables to control. For someone who is already having issues, it’s a lot to ask. A better approach would be to start with development of passive motion, allowing access to the arm positions needed. Next step would be active motion within this newly acquired motion. From there we need to start producing force in all of these positions and developing both strength and consistency in the desired motor patterns. If the issue still exists at this point then, and only then, do we get into the fancy stuff. For example, I wouldn’t have a client do any form of an “unstable surface” pushup until they can clearly demonstrate 20 crisp and consistent repetitions of the strict pushup first. While complex, highly variable, dynamic activities might look sexy they are the top of the pyramid, not the bottom. You need to properly build the foundations before you get there. If you’ve been struggling to get your shoulders back to where you want them to be, and you feel like you’ve tried everything, I highly encourage you to go back and master your basics using the progression above. If you can’t figure it out, hire a skilled professional who truly understands the process. There’s nothing wrong with your shoulder, it’s just struggling to manage complexity.
Hand Going Numb? Check Your Thumb – How the Relationship Between Your Hand and Wrist Movement Can Affect Your Carpal Tunnel Syndrome Symptoms (Part 1/2)
Carpal tunnel syndrome is a collection of symptoms that most commonly appear in the thumb, index and middle fingers on the palm side of the hand.  The hallmark symptom of this is aching or a loss of sensation in those three fingers specifically.  Typically, these symptoms are arising because the median nerve is experiencing a prolonged compression where it crosses into the hand at the “carpal tunnel” – or a small loop of tendon overlapping several muscles that run into the hand and the median nerve at a very small space near the bones of your wrist. (Figure 1).  [caption id="" align="aligncenter" width="600"] Figure 1: Anatomy of the carpal tunnel region and the median nerve. The nerve in the middle that runs to the thumb and middle finger is the median nerve. Source: https://qph.fs.quoracdn.net/main-qimg-2effc0be8c4ff02f065339aebda08596-c[/caption] The most common courses of treatment that I see recommended are prolonged static stretches of the muscles on the front of the wrist and forearm, active range of motion exercises for the wrist and hand in all motions, stretching of the thumb muscles, and tendon and nerve glide activities.  What all these activities have in common is that they are being prescribed with the goal of reducing the compression on the median nerve. Nerves love movement, blood flow, and space around them. The intent of what needs to happen during treatment is spot on – it’s why the surgical option to try to alleviate the symptoms is to cut that white-colored tendon you see running between the thumb and pinky muscles, to make more space over the median nerve.  While there is nothing wrong with these activities, not all interventions have the same effect. If we are trying to create room around the carpal tunnel, we need to appreciate the position of the hand versus the wrist, because many of the muscles that cross the carpal tunnel cross or directly attach to these bones.  Stretching muscles statically mostly just increases the tolerance of a muscle to being lengthened, and does not do much to address the qualities or behavior of muscles or tendons from what the latest research on stretching tells us (PubMed ID# 28801950). Plus, prolonged tension put onto a nerve that is already compressed can be like stretching an already taut rubber band more – it’s not going to help to reduce the tension in that structure. So, instead of just focusing on a muscle or muscles that are “tight”, let’s instead focus on helping the bones of the hand and wrist be able to get into a position to “unstretch” the rubber band and help give that nerve more space around it to help it be able to move more freely.  The picture below shows an example of a thumb that is internally rotated (the yellow area) relative to the position of the wrist. The blue arrow shows a thumb that is better able to externally rotate relative to the wrist than the yellow arrow. (Figure 2) [caption id="" align="aligncenter" width="960"] Figure 2: An example of differing thumb and wrist orientations. Source: https://i2.wp.com/plasticsurgerykey.com/wp-content/uploads/2020/06/10-1055-b-002-98003_c049_f001.jpg?w=960[/caption] Can you see how stretching the muscles of the yellow hand might have a completely different result than the blue hand?  The same solution applied to these two different hands does not yield the same outcome.  In the next part of this discussion, we’re going to talk about how to tackle getting a more effective solution to create space and movement around the median nerve and possibly eliminate symptoms in the carpal tunnel that are tailored to the specific presentation of the yellow hand. 
The #1 Missing Piece In Resolving Shoulder Pain
Are you Treating the Problem or The Result?  Shoulder “problems” are incredibly common amongst the athlete and active adult population that we see. As therapists, we see traditional diagnoses such as shoulder impingement, tendonitis, and rotator cuff injuries daily. Traditionally, these common issues are blamed on weak rotator cuff muscles, scapular winging, imbalance of muscle activity, etc. One major thing to understand about these diagnoses is that they are not the actual problem…they are a result. A result of deeper-rooted movement habits and mechanics that usually go unaddressed in the traditional rehab process. Typical solutions for these “results” are equally short- sighted. Frequently these solutions, which include stretching, rotator cuff strengthening, and general strength training, miss the mark as far as resolving pain. Why? Because they are addressing symptoms and not the thing that has caused the faulty mechanics, the need to over- use certain musculature or orient musculature in a disadvantageous position. To truly understand what the biggest missing piece is in resolving these common shoulder issues we first need to understand how the shoulder behaves.  A Quick Anatomy Lesson of the Shoulder Complex  The shoulder complex is made up of 4 major components: The glenohumeral joint (ball and socket), the scapula (shoulder blade), the sternum and clavicle, and the rib cage. Shoulder movement in any direction requires rotation of the humeral head (ball) within the glenoid (socket).  Because the shoulder has so much freedom of movement, stability of the joint needs to be ensured. That is why every shoulder movement is accompanied by scapular movement. Since the actual socket of the shoulder joint is on the scapula, its movement is vital in maintaining the humeral head centered within the glenoid during shoulder movement. When the humeral head doesn’t stay centered within the socket is when things like shoulder impingement occur, proximal biceps tendonitis rotator cuff injuries occur For a shoulder joint to move well, you need a scapula that can move in congruence with the humerus. What allows the scapula to move? The scapula has a slight curvature to its shape. The scapula sits on a rib cage that has a roundness to it due to normal thoracic kyphosis or curvature of the upper back. The roundness of the upper rib cage and the curvature of the scapula allow the two to maintain congruency with each and allows the scapula to rotate about its normal motion in support of the humeral head. The position of the rib cage and its ability to expand appropriately to support the scapula is essential for normal scapular movement that allows for normal shoulder movement without compensation.  Rib Cage Position and Expansion  The rib cage, under normal circumstances should be able to expand circumferentially (360 degrees) during normal breathing. During every inhale, the lower ribs should move outward in what’s called bucket handle movement while the upper ribs and sternum move up and out in a pump handle movement. The backside of the rib cage should reflect a similar movement, especially in the upper rib cage. It is when the rib cage lacks these normal, requite movements that things like scapular position and as a direct result, shoulder mobility, are negatively affected.  For example, when the back side of the upper rib cage becomes too restricted in its movement or flattened due to chronic muscular tension in the upper back you will see a limitation in scapular movement. A curved scapula on a flat surface does not achieve the same movement and rotational capabilities as one that is on rounded, congruent surface. Remember, without scapular movement the shoulder joint either cannot access normal movement or will have to move through compensatory mechanics to get there. Chronically moving in to ranges that you don’t have access to or compensating for movement limitations is exactly what leads to frequent pressure and tension in the same area i.e., shoulder impingement, biceps tendonitis, wear and tear of rotator cuff tendons, etc. How does one lose normal rib cage mechanics? This is easiest to see in an activity like resistance training. Most movements in the gym emphasize “shoulder blades back and down” for “stability.” No matter whether you’re pushing or pulling, back squatting or deadlifting, the rib cage and scapular position are relatively the same. A similar effect occurs from the ill-fitted advice to pull your shoulder blades back and down for “good posture.” Chronically spending time in a scapular retracted position will both prevent normal scapular movement and flatten the upper rib cage resulting in the need to compensate to achieve the desired shoulder movements.  The Solution To truly resolve shoulder pain, you must start at the source. Yes, there are many other factors involved in shoulder pain; rotator cuff strength, dynamic stability, local tissue inflammation, etc. Regardless of these issues you must understand and resolve what lead to these issues in the first place, otherwise you are just treating a symptom. If your goal is to improve the mechanics and motion at the shoulder joint, you need to ensure proper scapular movement. To have normal scapular movement requires a rib cage that is positioned properly and can expand in all directions to provide a foundation and support for the scapula. Once you have established a proper foundation, all factors mentioned before can be addressed with much greater success.  Below are 2 examples of drills to implement into your program to improve ribcage expansion: Seated Zercher Breathing Video [embed]https://www.youtube.com/watch?v=3CtDqIZnC_U[/embed] Seated Back Expansion Video  [embed]https://www.youtube.com/watch?v=24K6f7OMDXE[/embed]
Ditch The Theraband To Build A Confident Shoulder
The foremost principle that guides rehabilitation is the SAID Principle – or “Specific Adaptations to Imposed Demands”.  Simply put, this principle of physiology tells us that our body adapts to the specific demands that are placed upon it.  Perform enough aerobic exercise and your heart adapts by increasing the size of the muscles in your left ventricle. This increases the amount of blood your heart can pump with every contraction, and your resting heart rate drops. The same adaptations effect the hormonal function of the nervous system and tend to decrease your resting blood pressure as well.1 The tendons of sprinters become increasingly stiffer as they train to be faster and faster. This is a positive adaptation – think of the last time you struggled to change the roll of bathroom tissue because the spring was stiff and kept snapping back quickly. A stiffer spring (tendon) releases more energy when it is deformed (stretched) and makes the sprinter more likely to win his race.  When an injury is present, either to a muscle, or a tendon, or another part of the structure of the joint, this has happened because that area was applied a stress, or repeatedly more stress, than it could positively adapt to.  When you trip over something and roll your ankle in the classic position shown below in Image 1, you sprain the ligaments and strain the muscles on the outside of your ankle because you loaded them at a speed and magnitude in which they were not adapted for. Meanwhile, in the Far East, there are historical truths about mixed martial artist practitioners being able to break stone with their shins without hurting themselves, because they have repeatedly exposed their shins to those compressive forces by kicking trees and harder objects for years.  [caption id="" align="aligncenter" width="652"] Image 1: Despite this being Klay Thompson of the Golden State Warriors, my left ankle was in this same exact situation about a year ago. Source: https://i2.wp.com/b-reddy.org/wp-content/uploads/2016/07/klay-thompson-right-ankle-sprain.jpg?ssl=1[/caption] How does this relate to a shoulder injury though?  If we want to restore the function of someone’s shoulder to being able to tolerate more and more physical stress and use without a negative adaptation like injury, we must now follow the Goldilocks Principle of rehabilitation (image 2) and find a dose of stress that is “just right”: not so much to drive a negative adaptation, but enough of a stress to start to drive a positive adaptation.  When it comes to our ability to produce force or restore freedom of motion in a joint following injury, this chart below is a useful illustration of that Goldilocks principle.  Image 2:  Volume vs intensity threshold for gaining an adaptation. (Joel Jamieson’s “Ultimate MMA Conditioning”)  Resistance tubing, often used by the commercial brand name of “Theraband”, is one of the most common images conjured up when folks are asked what they think of physical therapy.  And despite the title of the article, I am not against the use of Theraband or tubing.  For people in the early stages of rehabilitation from a shoulder injury, resistance tubing can be a very useful tool for giving a low dose of resistance that may be enough of a challenge to recapture strength, or to give enough resistance through a range of motion to help someone improve their ability to control their arm in challenging positions.  Tubing can also be very useful for helping to give you external resistance so you can feel your body and shoulder getting into different positions to help you restore range of motion (link to an article about “position restoring range of motion”).  If our goal is to build a shoulder capable of producing and absorbing significant forces, we need more force than just the band can provide, so that we can find the right dose of “volume and intensity” to help us get stronger.    Sidelying Kettlebell Arm Bar Activities like the kettlebell or dumbbell arm bar, shown above, are a great entrance point to retraining rotation at the shoulder with greater loads. They are also effective at retraining the ability for the shoulder blade to turn to accommodate improving smooth total movement of the arm.  Hooklying Dumbbell Pullover The hooklying dumbbell pullover is another way to improve range of motion, and strength across a whole range of motion. This is a way that I commonly help clients improve their ability to go overhead without using a substitution from their lower back, and to get them confident in keeping heavier objects overhead.  Staggered Stance Landmine Press Landmine pressing, shown above, is a great way to load all the muscles that work around the shoulder, and eventually with a substantial amount of load. Landmine pressing is easy to modify to train the timing of rotation of the ribcage with rotation of the shoulder and shoulder blade to improve different aspects of upper body performance.  If you’re returning from a shoulder injury, make sure that you’re aware of what you’re trying to accomplish with the exercises that you choose to do. Not all rehab has to look like bands and two-pound weights. It should be intense enough to prepare you above and beyond what you need your shoulder to do. Make sure you’re getting the adaptations your shoulder needs with the time you are investing in your rehab. References Farrell C, Turgeon DR. Normal Versus Chronic Adaptations To Aerobic Exercise. [Updated 2021 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK572066/

Reviews

Carson L.
Physical Therapist

I was extremely fortunate to find Next Level PT in my quest for better movement, decreased pain and better training. I myself am a sports medicine PT, was a college athlete, have strength trained for many years and have (for the most part) successfully rehabbed my own injuries and surgeries, but for the last several years have been unable to really reverse the trend of tightness in my R shoulder that was reducing my training quality and, honestly, my desire to even train, since I would train and be in pain for 2-3 days after. Sometimes a problem needs a new perspective….

A PT friend of mine happen to send me a link for Next Level and after doing some research and taking advantage of a free phone screen, I signed up and am glad I did! The intake process was very thorough and pertinent, asking not only health but training questions and the most important piece for any patient – what are my goals? I was subsequently matched with Artem and he proved to be an excellent fit!

It’s important to note that I live in Chicago and can fully endorse telemedicine as a viable treatment option. In the hands of an expert clinician such as Artem, this treatment format worked wonderfully!

Artem did an extremely thorough movement assessment to identify the origins of my deficits and systematically built a custom-tailored program that took me from very basic, isolated movement and breathing patterns to much more complex movements. Artem structured and progressed my program in a very collaborative manner, constantly soliciting feedback and adapting to any particular areas where I was struggling. Now that I’ve completed the program I feel empowered with a rock-solid program of corrective and mobility exercises that feed into an overall training regimen that really works and feels good. I feel like I’m finally moving forward, gaining strength and not getting hung up with small nicks that turn into larger injuries down the line.

So as both a PT and a patient, I recommend Artem and everyone at Next Level PT with the utmost confidence. Not only is Next Level a strong group of solid clinicians, but they are a credit to the PT profession as a whole – the type of practice that every PT should aspire to!

Kiley S.
Active Adult

I am an (getting back to being) active 47 year old and have had low back pain for 5 years. There was no known cause or injury at the time and I had never had back issues before. For all of those years, my back hurt almost all of the time, to varying degrees, depending upon the day.
I have done yoga for years – sometimes that helped. I ran – that did not help but I didn’t want to give it up. I tried a couple of back pain programs I found online – no luck. I have seen chiropractors (“Sounds like degenerative disk disease? Well, you’re over 40, so ….” Shoulder shrug.), my MD (“Take ibuprofen and Tylenol.” For 40 more years? Ummmm….No. Plus meds only took the edge off.), and a local physical therapist (who really, really tried), all with no relief.
Last spring, at the end of about 6 months of PT, I knew I wasn’t really getting anywhere. I saw a Facebook ad for Next Level PT, and half-heartedly asked for more information. (Seriously? Facebook? Yup.) I talked to Dr Ben on the phone who discussed my issues and previous treatments. He actually screened me to see if I was someone they could help. It was with nothing more than a hope and a prayer that I jumped in to yet another program. But this one was different. Enter Dr Artem into my living room (via laptop).
The program is, and must be, individualized. It involves getting into SPECIFIC positions that are awkward and, oftentimes, difficult at first. And then you breathe. It works. Over time, things shift, exercises advance, and you work on getting stable and then stronger. I couldn’t do some of the exercises at first and many had to be broken down or modified. It was difficult for me to determine if I was doing them properly because my body was so used to being out of alignment and had weak areas. But, always, Dr Artem had a patience, and a plan with clear direction, and encouragement. No lie, it takes time and effort. There have been some not-so-great weeks. There were a couple SOS calls to Dr Artem between appointments for adjustments. It’s not magic. (Except for one foam roller release that resolved over 10 years of worsening side pain within a few sessions. That was beyond.) These guys are knowledgeable and organized. There are videos on each and every prescribed exercise.
I now have had days without ANY pain. Sometimes, I do something new or stupid and I hurt again. BUT, not anywhere to the degree that I used to. Plus, it resolves very quickly now. I stand differently. I move differently. I have a solid base to build the rest of my body on now.
I live in Wisconsin. This PT group is in Pennsylvania. ALL appointments have been via telehealth appointments, in my home, with a minimal amount of equipment. (chairs, doors, tables, walls, pillows or towels, a couple of weights, foam roller, resistance bands) They are remarkably good at telehealth consults and direction/explanations. The cost is very comparable to my out-of-pocket cost for local PT.
I have things I need to do – vacuum the house, mow the lawn, pick up a cat or a kid, sleep all night. I have things I want to do – a full Tough Mudder and hiking Half-Dome in Yosemite. To do the most basic activities of daily living without pain is such a relief. It makes me a much better person with so much more patience and energy, and subsequently, a bigger and more enjoyable life. I mean, that’s the goal, right?
LADIES: This was an unexpected bonus: I don’t pee when I run anymore. The realignment of my pelvis and the strengthening of all of those pelvic muscles (through exercises for my back) have made a tremendous difference. I haven’t completely mastered sneezing with a full bladder yet, but this is pretty fantastic!

Ben R.
Active Adult

This has been truly life changing. I started the online program after having tried all sorts of options in the past – physical therapists, chiropractors, even sports medicine professionals. Within a few short weeks, I was already seeing progress in my range of motion, and now a few months later I feel like a new person. The online program I did was tailored exactly to my needs, and I always felt like they were listening to me when anything new came up. I can’t recommend Next Level highly enough!

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