Head/Neck Pain

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Elbow Pain

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Foot/Ankle Pain

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Shoulder Pain

Experience a completely different approach to long-term shoulder pain-relief. Connect the dots from the deepest root & eliminate your pain from the source.

Hip Pain

Experience a completely different approach to long-term hip pain-relief. Connect the dots from the deepest root & eliminate your pain from the source.

Knee Pain

Experience a completely different approach to long-term knee pain-relief. Connect the dots from the deepest root & eliminate your pain from the source.

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

  • Arthritis & Joint Pain
  • Broken/Fractured Bone
  • Bursitis
  • Gluteal Muscle Strains
  • Hamstring Muscle Strains
  • Hip Flexor Pain
  • Hip Impingement (FAI)
  • Hip Instability
  • Ischial Tendinitis
  • Labral Tear
  • Misalignments & Postural Dysfunctions
  • Piriformis Syndrome
  • Post-Surgical Rehab
  • SI Joint Dysfunction
  • Sciatica
  • Snapping Hip Syndrome
  • Sports Hernia
  • Stress Fractures
  • TFL Syndrome
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Why is my hip in pain?

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Why Stretching Won’t Fix Your Tight Hips (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 one of the most frequently described problems that I hear from friends, family, and patients. Stretching is also what most of these people describing their hip muscle tightness tell me that they need to do more of.  At first glance it seems like stretching makes sense to do. Something feels tight, getting a good stretch seems to scratch the itch of that tight sensation, I need to do more of it!  But what if that’s an incomplete view of what is happening? All these statements and questions have something in common: the methods being used aren’t addressing what is driving the issue.  To begin to understand what better strategies are for addressing this, it’s important to appreciate how muscles do their jobs to create movement.  Kinesiology 101 – What’s the Job of Our Muscles?  Muscles are attached to tendons, which are then attached to our bones. Muscles are simple – when they contract, they squeeze and change their shape to shorten, flatten, and compress.  When they are not contracted, they are relatively more lengthened, and expanded than their compressed state.  It’s important to note what terms are missing there – tightness. Muscles can’t be tight – they can be relatively more compressed or expanded, squeezing or not, changing their behavior in part by the positions that their attachments are in.  [caption id="" align="aligncenter" width="718"] Source: https://dannyomokha.blog/tag/hip-complex/[/caption] Let’s use an example of this to help build some clarity on how the positions of the bones that muscles are attached to can drive muscle behavior. In the diagram above, you’ll see the large muscle Psoas Major. This is your largest hip flexor, and what’s called a “biarticulate muscle” because it runs from your lower back, across the pelvis, down to your femur. That is relevant because, if we are thinking about bony positions that can affect muscular behavior, we now must consider the position of the spine, pelvis, and hip bone itself.  Now, let’s consider a position that would drive psoas major to be more shortened, or compressed. If you glance down at figure 2, a lower back and pelvis that is oriented towards the front side of your body like this would absolutely bring the two attachments of psoas major closer together, making it have more leverage to be shortened, or to contract.  [caption id="attachment_1669" align="aligncenter" width="408"] Figure 2: An Anteriorly Oriented Lower Back and Pelvis[/caption] One of the most common ways I see people attempt to reduce their front of the hip or hip flexor tension is by performing a movement that looks like the following:  [caption id="" align="alignnone" width="1200"] Source: https://evofitness.ch/hip-flexor-stretch/[/caption] The additions of my masterful neon yellow editing to this picture illustrate that this individual didn’t address the position of the lower back and pelvis in a way that would give their hip flexors a reason to be able to get into a more lengthened position. This actually reinforces the issue because it magnifies the lower back strategy moving the spinal attachment of psoas major closer to the femur attachment, simulating that muscle contracting.  While you might feel a stretching sensation in the front of your hip, what’s happening is the front of your hip joint is being pushed against the front most part of the hip capsule. Not getting your hip flexors into a lengthened or expanded position, just loading the front of your hip.  Clinically, we can usually skip these more stationary stretching movements all together, and use an activity like the Hooklying Two Arm Reach to address the position of all three of the regions that the psoas influences. I love this activity because it takes the spine away from traditional extension into a relatively flexed position, puts the pelvis into a relative posterior orientation to the spine, and starts to extend the hip. Hitting every aspect of joint position that influences the muscles we are trying to influence!  [embed]https://www.youtube.com/watch?v=C7hLRzrWF_4&t=3s[/embed] We can use the same principles in an activity like this Half Kneeling Cable Press  to get the pelvis and hip into a position that would drive length in the bottom leg’s hip flexors, and use the pressing action to reinforce a lower and middle back position that will influence the upper parts of the psoas as well. While at the same time building fitness qualities and not spending extra time outside of your training to improve your mobility. [embed]https://youtu.be/DJJI28xT5og[/embed] The takeaway is simple: muscles don’t get tight; tightness is a sensation. Muscles exist on a behavioral spectrum of relatively compressed to expanded based on the position of the bones that they are attached to. Want to more meaningfully get muscle behavior to change? Start respecting position and watch your efforts start to return major results. 
How To Improve Hip Mobility Without Static Stretching
Hips are not born to be “tight”, but with the amount of frequency that people lambast about feeling like their hips have more in common with rusty gears than Stretch Armstrong I can see how you think they might.  I’m here to tell you that, for the most part, your hip mobility woes can be a thing of the past with some different perspective on identifying what might be contributing to your outcome of perceived or restricted motion.  Let’s look first at the anatomy of the hips and then break down how we can identify different areas to focus our efforts at making change here.   Anatomy Think of the pelvis as the house around your hip. It’s two wing-like structures called “innominates” connected by a bone called the sacrum. Not shown in Figure 1 is how your lower back is continuous with the topmost aspect of the sacrum, to form a complex between your spine, pelvis, and hip bones.  [caption id="" align="aligncenter" width="877"] Figure 1: Bony Anatomy of the Pelvis[/caption] 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 are attached to tendons, which then attach to bones. If we just chase a feeling of a stretch in areas that we perceive to have tightness, we might not meaningfully be addressing an issue that could be driving that perception. So first, let’s start to make some buckets for figuring out what could be going on.  Bucket 1: What Does my Total Hip Rotation Look Like?  An easy way to figure out if you’ve got a loss of motion in your hips is to examine your total range of motion between Hip External (Hip ER) 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 good benchmark to shoot for in most individuals is to have around 100 total degrees between the two measurements. This means that you most likely have good freedom for your innominate bones to move relative to your sacrum, and that you have the potential to get into a lot of different positions. Nice!  If you’re missing quite a bit of total hip rotation in this range, one of the easiest places that we start clients is with learning to move with less tension, and to start to recapture some of the relative motion between their innominates and sacrum, is with some simple rolling.  This Sidelying Rolling with Lateral Compression exercise is a simple and effective way for clients to begin to recapture some of their hip rotation and decrease their muscular effort used to move. It’s also a phenomenal move to start to build some sense of self around how your hips are able to move, to leverage that kinesthetic awareness to be successful in more challenging exercises!  [embed]https://youtu.be/oeLwLrrsSI4[/embed] Figure 3: Sidelying Rolling with Lateral Pelvic Compression Two other popular activities we might use to help clients and patients restore their total hip rotation that also revolve around improving your ability for your hips and pelvis to move relative to each other are the 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  Like mentioned in the previous Stretching (feel free to adjust whatever the abbreviation for my previous article is, Mike) article, both of these activities do a good job of helping to re-orient the pelvis as a unit and give it the potential to start to recapture a TON of hip rotation quickly!  Bucket 2: What are my Tissues “Calibrated” to Do?  Guitar strings get the tension on them adjusted through use and playing. Each guitarist has their preference for the tension on their strings. Our body is more than just bones and tendons and muscles, it is a network of different connective tissues that are adaptive to the demands put upon our body. Our connective tissues are a significant player in helping our bodies absorb and transmit the forces involved with movement!  Were you just in the camp of missing a lot of total hip motion, but now your hips are incapable of lying after working on the above activities? It’s time to tune your connective tissue tension to facilitate your desired motion.  Try an activity like the Goblet Squat to a Rockback first. It’s an activity where you’re doing the same thing on both sides of the body, so it’s easy to perform, and the relaxation and hold back on the box forces your connective tissues to have to absorb more energy and reduce their stiffness to accomplish that.  [embed]https://youtu.be/R26W48oflok[/embed] Figure 6: Goblet Box Squat with Rockback After working on that, activities like the Lateral Lunge with Hold force the same kind of stiffness reduction, but with an emphasis on side-to-side motion.  [embed]https://youtu.be/wXljK0b7vhM[/embed] Figure 7: Lateral Lunge with Static Hold If you’re missing a bunch of your total hip rotation, work on helping your pelvis get into the shapes it needs to for you to be able to express that first. This helps to restore your potential to be able to move in many directions freely!  Once you’ve got more potential to move, it’s time to start to tune your body’s proverbial springs to get better at what you want it to do: absorbing force and creating more motion or putting on the brakes and stopping motion from happening. I’ll give you a hint: we need to be able to do both to crush all of our active pursuits.  Give these activities a shot to have more success with improving your hip motion without just hanging out and catching a stretch! 
Why Stretching Isn’t Working: Hamstring Edition
Stretching is something a lot of us do, but have we ever thought about why? Of course we have. The muscle is tight, so to fix it we stretch it. That makes sense, if the only reason why a muscle is “tight” or “restricted” is because it was shortened and we have to stretch it to elongate it. What happens if the reason why it’s “tight” is not because the muscle is actually shortened. If that’s the case what good is stretching it. Hear me out. To help illustrate this and help this make more sense, let’s use the hamstrings as an example.  And don’t worry at the end of this I will show you my Top 3 Exercises To Fix “Tight” Hamstrings.  Almost everyone has tight hamstrings and stretches their hamstrings. Common tests we use to assess the hamstrings are the active straight leg raise or the toe touch. We all probably remember the sit and reach test in physical education class as kids too. Do they still do that?    Anyways, if you couldn’t lift your leg straight, touch your toes or reach far down the ruler, you were told you have tight hamstrings and you had to stretch them.  Just because it’s tight doesn’t mean the solution is stretching!  How many of you have stretched and stretched, but never saw much change or any real lasting change? If stretching doesn’t change it, maybe the muscle isn’t shortened and stretching isn’t the answer. What is it then? “Because I really do feel tension and tightness in the back of my leg when I try to touch my toes or when someone lifts my leg up”. I believe the tension and tightness individuals feel are real, I’m not saying it isn’t, but the reason is not because the muscle is shortened.  One thing we need to look at and appreciate is POSITION. To understand this, it comes back down to anatomy and neuro, like most things do. Let’s take a look at the hamstrings... The hamstrings originate on the ischial tuberosity of the pelvis, or the “sit bone”. They insert across the knee joint at the tibia or fibula, the lower leg bones.   Think of the hamstrings as a rubber band that extends from the butt down to the back of the lower leg.  When you bring the leg up, like in the straight leg raise, we can see how you put tension on, stretch, or elongate the hamstring. Remember though, while it inserts into the lower leg, it originates at the pelvis, so the position and orientation of the pelvis will have an effect on tensioning the hamstrings as well. Pelvis Position: Let’s say someone starts in an anterior pelvic tilt. That means the pelvis is tipped and rolled forward. If the pelvis is rolled forward and anteriorly tilted, that will put the hamstrings on tension. If an individual naturally stands, sits, or lays down with an anterior pelvic tilt, that means their hamstrings are already on tension, and the rubber band is stretched. So when you go and try to reach for your toes or you go and lift the leg up, you feel a pull before you’re able to touch your fingers to the floor or straighten your leg out. This is because your brain and your body is stopping to protect you!  Figure 5: The picture above illustrates the influence of pelvis position on hamstrings. On the left, the pelvis is neutral and balanced. On the right the pelvis is anteriorly tilted and tipped forward. Observe how the black line (hamstrings), is longer. Again, based on your pelvis’s position (anteriorly tilted), your hamstrings are already on a tension and “stretched”, so when you try and ask your body for more and more, eventually it will stop and not let you. If you haven’t found success with stretching, before you stretch and stretch, or have someone jump on your back and push your down, please take a look at and appreciate position.  Get your body into a better position and then check and see if you still have the problem. If this is you, correcting something like an anterior pelvic tilt or getting out of an over extended posture, will not only help your mobility, but probably your pain if you’re experiencing any, and your risk of injury.  Disclaimer: I’m not saying stretching is bad. There are many benefits to and it is necessary to have good tissue quality, elasticity, and durability, but if you aren’t having success with improving your mobility by stretching, you may be attacking your issue wrong. Click here to learn my Top 3 Exercises To Fix “Tight Hamstrings”
Why Bands Aren’t Helping Weak Hips
Many people are told that their knee pain, hip pain, or low back pain is due to weakness in their hips. This is often determined after strength tests show weakness in the ability to use muscles like your glutes, which are important for hip and pelvis stability. The fix is often doing banded hip strengthening exercises, such as putting the band around your legs and doing sideways steps, or exercises such as clamshells. However, these exercises often fall short and don’t actually help reduce pain. Let’s dig into why that might be, and what would be a more appropriate and successful approach.  The first thing to understand is that all muscles have what’s referred to as a “Length-Tension Relationship”. What this means is that the amount of tension that a muscle is able to produce (aka force or strength) is dependent on its length. An easy way to think about this is to imagine you’re doing a pull up. If you start from a dead hang at the very bottom, it is difficult to initiate the force required to start your pullup. However, if you “cheat” and start with your arms already bent, you’ll notice it’s much easier. At the top of the pullup, you will also notice the last 10% tends to be the hardest, when you are fighting to get your chin over the bar. Here it is clear to see that the range in the middle of the movement is the easiest, and you feel the strongest. The reason for this is when you’re at the bottom of the pullup hanging, your muscles are fully stretched and in as long of a position as possible. At the top, they are fully contracted and shortened. Neither fully stretched or fully contracted are ideal positions to generate force from. Just like goldilocks – something right in the middle is ideal to produce as much force as possible.  The science behind this is simple if you understand how a muscle contracts. Within muscle fibers, there are tiny filaments called actin and myosin. These filaments lie parallel to each other, creating the “fiber” of your muscle. Small arms called “myosin heads” reach forward from the myosin and attach to the actin, then pull the actin together to cause the muscle to shorten and squeeze. The picture below will help demonstrate this.  If a muscle is stretched out there will be less overlap between the actin and myosin, and therefore there cannot be as many cross bridge connections and it is harder to contract the muscle. Likewise, if a muscle is fully shortened or squeezing, there is not much more room for the myosin to pull the actin together, as it is nearly all the way together. In either case, this results in lower force production even with higher efforts. The chart below demonstrates the highest force production happens around the middle point of a muscle length.  Now let’s go back to looking at your “weak” hips. While sometimes there are true weaknesses in the hips, this can easily be exacerbated by the position of your hips. If your glutes for instance are extremely tight and rest in more of a contracted position, it will be hard for them to squeeze any further, and will present as “weak”. Likewise, if your glutes are in a more stretched position there won’t be enough overlap to create a strong contraction. These resting positions are influenced not by “tight” or “loose” muscles, but rather tight or loose muscles are a result of the underlying position that they are held in based on the position of your pelvis. This is something that can be easily assessed and screened for in a discovery session at Next Level.  If we do find that the position of your hips is contributing to your “weakness”, the solution is not to just add a band around your knees and try to strengthen your glutes. If anything, this may even contribute further, especially if you are someone who is already in an over contracted state; this old-school strengthening approach may actually be further exacerbating your inability to create force from your hips.  Instead, the first priority should be getting your hips in that nice middle ground, like the goldilocks example, so that your hips will feel like you’re at that mid range of a pullup – strong, healthy, and supported. The right exercises to do this will require a deeper assessment to determine the position of your hips, where we can determine if the muscles are starting in a contracted or relaxed position, from which we can determine the best next steps to get you back to neutral. After that, then we can reinforce this position with strengthening exercises that will help not hurt you, and get you back to 100%. Whether you have knee, hip, or back pain, or are just feeling like you aren’t able to perform at your highest level, addressing these restrictions can help unlock your ability to finally progress. 


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Dan S.
“Understanding capability, but also understanding that to unlock that capability I've got to be able to make some adjustments…that mindset shift coupled with some real inspiration…that was the biggest thing I learned about my body.”
Michelle A.
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John F.
Active Adult

I am a fit 50-year old who has had tight hip flexors, hamstrings and hips for my whole adult life. I have been to many other healthcare professionals who gave me different stretches etc… Maybe minor improvements but still tight. In my first session with Dr Wehrhahn in April 2016, he discovered the root of my long-term tightness and provided me several exercises to work into my workout routine. The results have been outstanding. A five-star rating is not enough. I want a 6-star rating!!!! Thanks Dr W!!!!!

Justin B.
Active Adult / Hockey Player

I have been putting off Physical Therapy on my hips for years now. All my previous experiences have been very poor. You show up, the PT has 40 other clients at the same time, they throw a band at you and tell you to do a few reps and then they don’t come back for 10 minutes. That was my impression of all PT until I saw an ad for Next Level PT on google.

I called and spoke with someone who seemed interested in my injuries and my plan to get better.

I showed up and met Dr. Elyse. She walked me through the whole process and set goals and expectations for me before we got to work.

Once we got to work, it was an experience UNLIKE any other program I had gone through. It was 1:1, it was personal and Dr. Elyse took her time with me and pushed me at the times when I needed it.

I have just wrapped up my 10 weeks. When I started, there were nights when I couldn’t walk up the steps without tears in my eyes. Those nights are gone. I am much stronger than I was when I started.

I will always have to work at this to keep the pain under control and fight off hip replacements, but Dr. Elyse gave me the tools and the confidence to be able to live a more active life and I am truly grateful for that.

I will recommend Next Level Physical Therapy to anyone looking for PT.

Also, Nicki, the client care Specialist, is an absolute delight to see before every session and always made the effort to find times for appointments that fit my schedule.

Dan B.
Volleyball Player

As a high-level beach volleyball player who suffered a torn hip flexor in September 2019, learning the root cause of the injury and fixing it so it could be prevented in the future was paramount. My trainer, Kevin Wagner, recommended Dr. Ben Fan at Next Level Physical Therapy because of his personal experience as a beach volleyball player as well as his deep understanding of human movement. Within an hour, Dr. Ben was able to diagnose my issue and its root cause (misaligned hips), recommend a treatment plan, and give me a timeline to fully recover. However, he reinforced the idea that in order to stay healthy, the program I was about to begin would need to become a part of my athletic routine. Dr. Ben put me through rigorous workouts, combining body positioning with breathwork to help my body open up and correct its positioning. Every day he was attentive, receptive, and patient working with me, fielding dozens of questions in order to explain his recommendations and their benefits. His easy-going demeanor and high levels of professionalism are a reflection of the expectation of service that Next Level Physical Therapy offers. I could not be more grateful I went to Next Level – I am a better patient and athlete as a result.