Head/Neck Pain

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Elbow Pain

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Foot/Ankle Pain

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Shoulder Pain

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Hip Pain

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Knee Pain

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Back Pain

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The Only Way to
Long-Term Pain Relief

You’ve tried everything, but why hasn’t it worked? 

You may have experienced 1 or all of the following:

  • They told you to stretch because you had “tight muscles”
  • They gave you exercises because you had “weak muscles” 
  • You went and got adjusted because there was some “misalignment”
  • You received surgery because they found a “tear” 

These methods only give temporary relief because they are just fighting the symptoms and not connecting the dots from the deepest root. The body is too complex for such a basic approach. 

You need a specialized solution that will treat the body as a whole and get to the root cause of your pain. 

Conditions Treated

  • Achilles Tendinitis
  • Ankle Impingement
  • Ankle Instability
  • Broken/Fractured Bone
  • Bursitis
  • Flat Feet
  • Heel Pain
  • Lisfranc Injury
  • Muscle Pain & Tightness
  • Muscle Pulls & Strains
  • Plantar Fasciitis
  • Posterior Tibialis Tendinitis
  • Post-Surgical Rehab
  • Shin Splints
  • Sprained Ankle
  • Stress Fractures
  • Turf Toe
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The 3 Things Your Doctor Didn’t Tell You About Plantar Fasiitis
You’re reading this because either you, or someone you care about, has been complaining about a persistent burning, aching, painful feeling under the bottom of their feet. Maybe it only hurts when they’re walking, maybe it hurts all of the time. Maybe it hurts in the middle of the arch or back more by their heel. Either way, they’ve probably been told by a podiatrist or orthopedist that they have plantar fasciitis (PF). Here are 3 things they probably DIDN’T tell you:  There is typically nothing wrong with the foot itself Typical solutions don’t address the root of the problem Exercise is the only way to truly eliminate it Let’s get into it... There is Typically Nothing Wrong With the Foot Itself PF is an inflammatory condition, but inflammation isn’t the problem. Inflammation gets a bad rep in the media and most medical offices but it’s actually, in many ways, a very good thing. When tissue damage occurs, even very mild stuff, inflammation happens. It is the first step of our healing process.  Imagine a car accident on the highway where a guardrail got damaged. The police show up to cordon off the area, tow trucks arrive to haul away the cars, street cleaners come to sweep away the debris, then new materials and construction crews follow to repair the rail. This is basically what inflammation is in the body. It’s the cleanup crew rolling in to eliminate debris and deliver raw materials for tissue rebuilding.  Inflammation only truly becomes a problem when it’s there all of the time. If inflammation is the first step in our healing process that means you’re constantly in debt, trying to heal from something but falling behind. This is the core definition of an overuse issue. Unfortunately, like many diagnoses for pain caused by overuse the diagnosis tells us little about how to treat the issue. Thinking about PF specifically, the pain in your foot is usually the outcome of a problem and not the problem itself. Whether you have flat feet, high arches, or a family history of foot pain typically doesn’t matter. If the shape or structure of your foot was a problem you would have hurt way before now.  Typical Solutions Don’t Address the Root of the Problem Typical solutions include rest, wearing a boot, stretching, massage, cortisone injections, and/or orthotics. All of these solutions miss the bigger picture and, when not combined with a more comprehensive approach, often leave people wanting more.  The intent of the initial phase of therapy is to decrease the stress placed through the plantar fascia and allow the tissues to heal. Maybe your doctor told you to take it easy and rest, put you in a night splint, or is having you wear a boot for a few weeks. Your pain is going to come down as the body does its thing and you heal. The boot comes off and you start living your life like you did before but a few weeks later the pain starts to creep back in.  What. The. Heck. The problem is that plantar fascia strain didn’t happen by magic. You felt better because you had the extra support of the boot and changed the amount and type of activity you were doing. This offloaded a LOT of stress, but once you go back to living your life you’re right back to where you started.  Alright, maybe stretching and massage are what you really need so you start rolling your foot on a frozen water bottle and doing calf stretches. Ahhhhh, sweet relief...or so you think. You feel great for an hour but then the discomfort starts to creep back in, so you do it again. Next thing you know you’re a frozen water bottle addict and spend half your day rubbing your feet. You keep a stash in the freezer at work just to save your coworkers from hearing you complain all day. Damn, back to the drawing board.  You find yourself back in your doc’s office, shoulders shrugged. Since nothing else worked they offer to give you a shot of cortisone and you go for it. Wow! It worked like a dream and suddenly you feel like you’re 20 all over again. Unfortunately, this too is temporary. Cortisone is a steroid and works by eliminating the inflammation, but that’s just a band aid. While sometimes we all wish this weren’t the case, our problems don’t go away just because we can’t see or feel them.  When you really take a close look, all of these solutions treat the symptoms of a problem and not the actual problem itself. They can give you a lot of relief, which will give you the opportunity to do the real work, but on their own will not get you back to where you want to be.  Exercise is the Only Way to Truly Eliminate It We’ve established that most treatments for PF aim to address the symptoms of the problem, namely pain, rather than the problem itself. To address the actual problem we need to strengthen the bottom of the foot, take away unnecessary stress through more efficient movement, or both.  Strengthening is pretty straightforward. Strong things can handle more stress before they begin to break down, meaning you can do more with your body without going into that overuse debt. Unfortunately, seated calf raises and toe curls only strengthen so much. If that’s the extent of your exercise, you won’t get far. Walking, farmers carries, step ups and step downs, split squats, lunges, and light plyometrics must be included as well.  The other thing that needs to be addressed is your motor variance. For the sake of this article we’ll define motor variance as your total movement options. How many different positions of the foot, ankle, shin, etc can you access and control? Having many options means less wear on any one particular tissue. Imagine if you only had one pair of shoes, they’d get beat up much quicker than if you had 7 and cycled through them each week.  We already discussed how stretching and massage can take away your pain by improving range of motion, but it’s temporary. Since range of motion is muscle driven, you need to figure out why those muscles keep turning on. What is the job that they’re doing? If you can figure that out and eliminate the source, the muscles will be less stiff and motor variance returns. This typically means looking above the foot, which means that basically any part of your body could be the culprit.  What if I told you that your PF could be caused by your upper back? The position of your center of mass, where the middle of your weight is, has an enormous influence on your feet. If you have stiff muscles in your upper back, lower back, or hips those muscles are pushing you forward. As your weight shifts forward your feet and calves will have to work double time to keep you from falling. You’ll push your toes down harder into the floor to slow the forward lean, putting tons of stress through the bottom of your foot, your calf, and everything in between. Your muscles will stiffen to prevent you from leaning. With this understanding it might be possible that the solution to your foot pain lies in improving your shoulder flexibility. Completely wild, I know.  I strongly believe that any approach to managing PF that does not address COM is grossly incomplete. If you’ve been dealing with pain in the bottom of your foot for a long time and nothing takes it away, widen your lens. Don’t look so closely at one tree that you forget to see the forest.
Why Your Big Toe Matters & What Your Bunion Is Actually Telling You
For something as small as a toe, it can be shocking to realize how large of an impact your big toe can have on the rest of your body. Every step we take, our big toe helps us sense and feel the ground under us, and plays a critical role in how we push off one foot and onto the next. If we have limitations in how well our big toe can extend, as it does when we come up onto our tip toes, it can significantly alter how we walk. This can then cascade into a series of compensations that can impact knees, hips, low back, and even further up the body into your upper back, shoulders, and neck.  Basics of Walking:  To understand the importance of the big toe, we have to first understand some basic anatomy, as well as the gait cycle – aka how we walk. Our big toe is meant to extend backwards about 70 degrees, to almost become a right angle from the bottom of our foot. This motion can become limited in a number of ways, but the two major contributing factors for decreased big toe extension would be a poor joint position which reduces this motion, or tightness in the flexor muscles which curl the toe down into the ground.  Changes in joint position that could reduce toe extension can occur in a number of ways and for a number of reasons, but would be best identified in a full assessment with a physical therapist who would be able to properly evaluate you. The big takeaway here should be that changes in your foot, such as a high or low arch, excessive pronation or supination, or changed mechanics such as pushing off the outside of your foot rather than the big toe, can contribute to changes in how the bones line up at the big toe. This can then reduce how much your big toe can move. These are things we can improve if appropriate interventions and exercises are used to address the root cause of this position.  The second contributing factor would be tightness in the muscles that hold the toe in a flexed or curled down position. The important thing to understand however is that this muscle would be tight as a reaction to whatever position your foot is being held in, or the demands that are placed on the foot. This is to say it’s very uncommon that people are born with muscles that are just “too tight”, but rather, it’s much more likely that the muscles become “tight” as a reaction to the environment they are in. Therefore, just as above, it is critical to find the root cause that is leading to this tightness to be able to resolve it and find long term solutions.  Gait Cycle: Push Off To understand the importance of the big toe, we will be looking at the terminal stance to toe-off phases of gait outlined below. In this phase, our heel leaves the ground and we rock forward over the big toe. To be able to do this, as mentioned before, the big toe needs to be able to extend backwards. This is critical in allowing us to have normal mechanics and the ability to push ourselves forward. We take thousands of steps every day, so if these mechanics are impaired, it can have big impacts over time.  Without appropriate toe extension, people will often roll to the pinky side of their foot to push off, or they will develop a bunion where they have rolled off the inside edge of their toe rather than it extending backwards at the joint itself. Either of these can lead to pain within the toe and foot itself, and can also increase stress and strain at the knees, hips, low back, and other body parts as they compensate to allow for smooth walking around this limitation.  Regardless of if you are having specific foot pain, have pain elsewhere, or are concerned you may be developing a bunion, this small joint is an important piece of the puzzle for many who are struggling to get out of pain. If you have been focused on just the location of your pain and not having success, it may be time to look head to toe  – quite literally – to see what other factors may be at play. A thorough assessment from a physical therapist will take this into account to help build a clear picture of your body’s limitations, compensations, and how they are keeping you in pain. 
Wobble No More: What Unstable Surface Training Misses For Ankle Sprain Rehab
Wobble No More: What Unstable Surface Training Misses for Ankle Sprain Rehab  The inversion ankle sprain is the most common injury in the entire world. Walking down the stairs, then missing a step, then… wham. Getting bumped in the air when going up for a lay-up, then landing on the outside of your foot… wham. Like we can see in Image 1 below, this injury that everyone has seen happens when a force is applied through the outside of the foot and ankle at a rate that the ligaments and soft tissues in the region can’t elastically rebound back from. [caption id="" align="aligncenter" width="894"] Image 1: An inversion ankle sprain in the NBA.[/caption] Like most new traumatic injuries, the damage to the bones, muscles, ligaments and tendons in the area draws in inflammation to start carting away the damaged anatomical materials and to start the healing process. Swelling comes along as a byproduct, and then slowly goes away as the acute phase of injury ends.  Once you get your full range of motion back in your ankle and foot, one of the most frequently used interventions is unstable surface training for the ankle. This involves standing on a surface that isn’t solid ground, like a foam pad, or a bosu ball, and maintaining your body’s orientation and foot contact on the surface.  The thinking is that the changing surface that you are standing upon will change the orientation of your ankle and center of gravity less predictably, forcing you to adjust and keep your foot on the surface and re-train your body awareness of not producing force on the outside of your foot and spraining your ankle again (Figure 2).  [caption id="" align="aligncenter" width="929"] Figure 2: Single Leg Stance Balance Retraining on a Bosu Ball[/caption] There’s nothing wrong with this method and thought process. It is important, especially if you are involved in competitive or recreational sports or athletics, to be able to quickly control perturbations of your body and be able to bring yourself back to a position where you can safely move from again.  The only issue here is transfer of training to the tasks you perform, and what you are trying to get out of doing the activity.  Nearly all sporting events are performed on solid surfaces (wooden basketball courts, artificial turf or grass fields, asphalt, or concrete) which do not yield in the same way that unstable surfaces do.  The yielding and “unstable” nature of unstable surfaces make it hard for you to get your ankle and the rest of your body into positions that are better at producing forces to slow yourself down faster and then change direction safely.  Clinically, I frequently find that individuals with recurrent ankle sprains struggle to be able to control the ability to get their ankle, foot, and hip in a position to produce internal rotation, which is a force down and into the ground. To be able to slow yourself down and control yourself when landing, you have to exert a force down into the ground over a longer period of time. To propel yourself in another direction to keep running or jumping, you need to produce another downward force (internal rotation) quickly to push away from the surface you are on.  If you continue trying to produce that downward force, but your foot and what’s above it are still positioned towards external rotation, the end result is that the direction of where your force to control yourself or push yourself away is still more towards the outside of your foot instead of right beneath it and that you’re not maximizing your training for reducing the likelihood of spraining your ankle. In this case, see how although this patient’s foot is on the ball, her shin is still oriented towards the outside of her body?  A good question is: how can we start retraining your ability to produce force right beneath your body instead of outside of it?  Our first step: getting good at the supine cross connect (video 1). [embed]https://youtu.be/TcsiqnDrd0g[/embed]  Video 1: Supine Cross Connect  In this activity, you start building the coordination to get your foot, knee, hip and ribcage lined up as you’re learning to press into the wall to retrain where and how you’re producing force. In this case, the wall simulates you pressing into the ground or the floor, you’re just laying on your back so it’s easier to do.  Once you can ace that, now we need to start retraining it standing up. A low step up cable chop is a great way to work on this.  [embed]https://youtu.be/mGzNekn1g3o[/embed] Video 2: Low Step Up Cable Chop  In this exercise, your left leg is right beneath your body, and the chop of the cable or band is helping you to direct force right into the inside aspect of your left foot.  These exercises are just a couple examples of methods to retrain you being able to absorb and produce force without your bodyweight being oriented towards the outside of your body.  To really be prepared for sport, you need to continue training these principles at higher speeds, with greater amounts of force, and repeatedly without fatigue kicking in.  If you’ve tried unstable surface training and still feel like your ankle isn’t functioning as well as you’d like after an injury, give this kind of training a shot and let us know if you have any questions. 
You See Me Rolling…My Ankle. Make It Stop! (Part 1/2)
I used to train in martial arts pretty extensively, I even competed for both glory and tiny trophies. I studied a lot of different styles but I went the furthest in Judo. There’s something deeply satisfying about getting into your opponent's head, navigating every move and counter move. It was like chess, but with actual fighting and no getting punched in the face. This article isn’t about my love for throwing people though, it’s about how I used to sprain my ankle every few months. One wrong step, one moment of lost focus and I was off of the mat and out of the gym for 2-4 weeks. This obnoxious cycle kept me from getting as strong and as skilled as I wanted. It left me feeling fragile. What was the point of training so hard, of honing my body, if I could be taken out so easily, and so often, by the simplest thing. I no longer have these issues, but if this sounds anything like you I’d keep reading. There are many kinds of ankle sprains, but we’re going to focus primarily on inversion sprains as they’re more common. An inversion sprain is where your heel rolls inward and the outside of your foot falls into the ground. This happens for a whole slew of different reasons, but the two most common are when your center of mass (COM) shifts outside of your base of support (BOS) or when the peroneal muscles, the muscles on the outside edge of your lower leg, don’t turn on quickly enough as the ankle rolls. Your peroneal muscles primarily evert the foot and ankle complex, essentially opposing the mechanism of an inversion sprain. You want them on your team. For the sake of this article we’re going to focus primarily on the latter cause. The term “sprain” means you’ve caused damage to a ligament, one of the connective tissue structures that connect one bone to another bone. You have hundreds of ligaments in your body, but when it comes to an inversion ankle sprain the most likely to be injured are the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL). Ligaments, unlike muscles, are non-contractile and don’t have their own blood flow. This means they both heal slower and can’t change their length once healed. Fun fact: the number one predictor of a future ankle sprain is a previous ankle sprain That’s an interesting statistic, don’t you think? Let’s investigate why. People are taught that our ligaments hold our bodies together. This is not completely true. Ligaments are not that strong, only muscles have the power to truly hold us together and move us through the world. Your ligaments are full of mechanoreceptors, little organs that help you to sense where your body is in space. As you move your bones shift and tug on your ligaments, sending hundreds of signals into the brain which, once interpreted, let you know where every bone is in relation to each other. This phenomenon is called proprioception and without it you’d basically walk around like you were drunk all of the time. When you sprain a ligament you legitimately cause damage to it in the form of forced stretching and partial tearing. As the ligament heals, it does so at this new length. If you remember from about 12 seconds ago, ligaments can’t change their length, so your ligaments post-sprain are a bit longer than they were before. If ligaments are how your brain knows the position of all of your bones, and your ankle ligaments are now longer, this means that the signals they send to your brain will be a bit delayed compared to before your injury. It might only be microseconds, but with high intensity activity microseconds matter. Wanna know something cool? Your muscles have mechanoreceptors too. Retraining the muscles of your lower leg and foot to pick up this slack (see what I did there?) is a critical part of rehab and returning to sport following an ankle sprain. It can’t ONLY be strength. Now you know why you keep spraining your ankle, but what should you do about it? Stay tuned to catch my next article where I’ll go over a few starter exercises that we believe are mandatory as part of any complete ankle rehab program.


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Lisa T.
“At Next Level I feel like they don’t just treat your symptoms, they figure out what is the root of the problem…they start from the ground up, and they rebuild you.”
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“My number one objective when I first walked in was to complete a marathon, which I thought I was going to have to abandon…they definitely helped me achieve that, I did complete it.”


Michelle A.
Active Adult

July 31/2018 fell down the stairs and ended up with a bimalleolar fracture. Off to the hospital I went and a week later on August 9 I was having surgery. 9 pins and a rod later, i was in a cast for 6 weeks. Cast came off and my surgeon sent me home in a air CAM boot for 4 weeks and told me to start weight bearing 25%, then increase to 50% and so on. I was still using crutches. This was it! This was all the guidance I received. Needless to say I was so scared and anxious as to how I was going to learn how to walk on my own with this air boot that weighed a ton! I thought I was making good progress on my own until my follow up visit a month later with my surgeon who looked at me and said “you’re still using the crutches and can’t walk on your own yet? You’re very behind on your progress!” Handed me a script for physical therapy and I was on my own again.
I called every single therapy place in my area. Couldn’t find anyone in network with my insurance. I was in tears and very overwhelmed.
I said to myself if I have to pay out of pocket then I might as well go to the best! I googled “best physiotherapy in Mercer county” and voila NEXT LEVEL PT appeared!!
I called, practically sobbing and Katie answered. Katie was so kind, listened to my story and told me everything would be ok. She was right. I called on a Friday and I was in the following Tuesday to see Dr Ben.
I was so scared because everyone I spoke with that had a prior injury and physical therapy told me it would be painful. Friends and family warned me that physical therapy would be very painful.
I met Dr Ben on Tuesday October 21/2018. I was immediately at ease and knew that Katie had done a great job in choosing Dr Ben as my physiotherapist.
I walked in using two crutches. Dr Ben told me that same day I’d be walking out with only one crutch and sure enough, I did!!!
The confidence that Dr Ben gave me in one hour in one day was enough for me to know that I was at the right place.
Two weeks later, I took my first steps without crutches and I never looked back.
Dr. Ben is phenomenal. He’s patient, kind and compassionate. By Christmas 2018 i was walking with a cane, walking up and down the stairs and doing things I never thought I could ever do again.
I returned to work February 2019, used the cane for 2 weeks and then i was walking without it!!!
All this took a lot of work and patience from Dr Ben but he never gave up on my recovery. Dr Ben always pushed me to do things I thought I couldn’t and for this I will forever be grateful.
Next Level Physical Therapy not only targets your injury but it heals your mind, body and soul.
Thank you, Dr Ben and everyone at Next Level!!
I am back to running again and I owe this to you.

Jeff L.
Ironman Triathlete

Dr. Mike and the staff at Next Level are top notch. They take time to work with each patient and prescribe specific exercises that get you back on track quickly! Their approach to physical therapy was exactly what I was looking for and that approach helped me recover from nagging plantar fasciitis.

Vanessa P.

Dr. Mike is AMAZING, hands down! I went to him with a nagging calf injury that I couldn’t shake for months, and he has been working magic on it. He uses new and exciting treatment like dry needling, after one session, my calf, which has been bothering me for about 4 months felt significantly better. I keep coming back for more! His clinical expertise and credentials are stellar: DPT, CSCS, Sports PT internship etc. You’ll be impressed with how thorough his assessments are and he really gives each patient the time needed to complete each treatment. So smart, and an all around great guy! Anyone that is an athlete / needs rehab, go to him, you won’t be let down. Prices are great, and worth it! Nice job and THANK YOU Dr. Mike!! My calf thanks you too