Massage Therapist Certification

December 16, 2008 by admin  
Filed under Physical Therapy

Often I see some massage therapist’s with a nationally certified credential behind their name. What does this mean and is it important to look for when searching for a therapist?

Nationally Certified in Therapeutic Massage and Bodywork, NCTMB as seen written behind a massage therapist name, sets high standards for massage and bodywork practitioners. It protects consumers and employers by ensuring that certified practitioners have the necessary skills and knowledge to perform their job – and that they are committed to upholding NCBTMB’s Standards of Practice and Code of Ethics. NCMTMB is an independent, private, organization established to set high standards of ethical and professional practice through a recognized credible credentialing program.

A nationally certified massage therapist represents the highest professional credential in the field. This therapist has completed a minimum of 500 hours of instruction, demonstrates mastery of core skills, abilities and knowledge, and has passed a standardized exam. This credential will help gain the therapists’ recognition and visibility, and will also increase employment opportunities.

So, is it important when searching for a good massage? Yes, I feel that it is a good thing when doing research for a therapist, yet it’s completely up to that individual. I personally have received great treatments from non-nationally certified therapists. Yet, it does show continued advancement in the profession.

-Brian A. Hrindo, LMT, NCTMB

Getting in Shape for Skiing

November 19, 2008 by admin  
Filed under Personal Training

What are the most important elements to getting in shape for ski season?

The first thing that comes to mind for getting in “ski shape” is strengthening. I believe everyone would agree that strengthening of the lower extremity or leg muscles is top on the list. The legs are doing most of the work during a ski or snowboard run, so, focus strength training here. The muscles to emphasize are the quads (front of the thighs) the hamstrings (back of the thighs), the calf muscles, and the glutes. It is very important for one to gain strength of the proximal leg muscles, those closest to the trunk, typically called the hips. The stronger one is in the hip region, the less strain will occur across the knee joint.
A great exercise for the whole lower extremity is the squat. This uses the buttocks, the quads, the calves and the hamstrings. Also great are lunges and leg presses. These exercises directly correlate to the motions used in telemark skiing and downhill skiing. Bicycling is a wonderful outdoor activity for lower extremities. Lastly, calf raises (going up and down on tip toes) is great for balance and calf strength.

Besides strength, flexibility is highly important for all activities. A tight muscle is more likely to tear or be strained because there is no slack in the system. Stretches create length in the muscle and allow for freedom of motion.

While everyone agrees that training the lower extremity muscles is highly important, I also want to emphasize the importance of training the trunk or core muscles. The trunk is the “power center” of the body. These muscles include, among others, the abdominals, the iliopsoas, the glutes, hamstrings, and the spinal extensors. A strong core helps with speed, balance, strength, and power, quickly changing directions, improvement of skill level and prevention of injury. A training program needs to consist of trunk flexibility and strength conditioning. Having a strong and flexible core allows one to twist, turn and stabilize the body during the downhill journey. According to Douglas Brooks, MS, who wrote Effective Strength Training, the trunk is the base or foundation of the body. A body is only as strong as its weakest link. A body needs a strong base from which to direct its energy. If the core is weak, it leads to poor performance or worse, injury.

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Massage and Chronic Pain

October 20, 2008 by admin  
Filed under Massage & Wellness, Personal Training

Can massage help me with chronic pain that I have had for years?

Therapeutic and deep tissue massage and bodywork can not only relieve acute symptoms but can also affect a change in chronic pain that you may have been experiencing on and off for years. In some cases, massage is the most beneficial tool used to deal with these ongoing discomforts.As with anything, it may take several sessions to relieve symptoms of chronic pain. You didn’t develop these pains overnight, so they may take more than one session to relieve. As you begin to treat your condition, it may be important to be treated several times before you can transition to a less frequent schedule for health maintenance.

Please be sure to share specifics with your massage therapist to develop the best plan for you.Massage therapy is particularly effective in treating the chronic pains experienced as a result of exercise, fibromyalgia, and job related discomforts (i.e. working at a computer, sitting or standing for long periods of time). I have the experience and training to facilitate your bodies healing process and look forward to ridding your body of the pain and discomfort that keep you from enjoying a healthy lifestyle in Lake Tahoe. Massage should not only be looked upon as a commodity, but as preventative maintenance on your body’s tissues and subsequent organs which is one of the best ways to stay out of your doctors’ waiting rooms.

-By: Brian Hrindo, LMT

Hip Replacement Care

September 14, 2008 by admin  
Filed under Physical Therapy

My relative is getting ready to come home from the hospital after a total hip replacement surgery. What do I need to know to set up my home and make them most comfortable during their recovery?

After a standard posterior approach total hip replacement, most surgeons instruct the patient (and all involved caregivers) in three major hip precautions. Familiarizing yourself with these three rules will allow you to promote a speedy and safe recovery for your family member:

1. Avoid hip flexion more than 90°- Lifting the leg out in front beyond 90° puts excessive stress on the posterior joint capsule of the hip as it attempts to heal. Exercises that require excessive hip flexion such as marching and straight leg kicks are not recommended after a total hip replacement surgery until the medical professional instructs the patient in the proper form.

2. Avoid hip adduction- If a line were drawn down the middle of your body from head to toe, the affected hip cannot cross over this midline. This rule is particularly difficult to abide by when rolling over in bed. Using a pillow between the patient’s knees can prevent them from crossing the midline.

3. Avoid internal rotation- Do not allow the patient to turn the toes on their affected leg inward. Again, placing a pillow between their feet can prevent the patient from being able to internally rotate their hip.

Depending on the surgeon, physical therapy can begin soon after the patient awakes from the surgery. Specific questions should be directed to the doctor or physical therapist directing the patient care. As the caregiver, remember you are an important part of the rehab team and helping to communicate with the medical professionals can best promote a safe and speedy recovery for your loved one.

-Rebecca L. Deal, MSPT

Orthopedic Massage

May 28, 2008 by admin  
Filed under Massage & Wellness, Physical Therapy

Orthopedic Rehabilitative Massage is an advanced form of bodywork in the current mainstream health care community. This type of massage is indicated for post-surgery, chronic pain, overuse, and repetitive stress injuries. It is indicated for people of all ages and body types. This deeper (more pressure, deeper layers) type of massage is very useful when patients/clients are in some sort of discomfort or pain and is useful (and in some cases more results with) as preventative medicine, which seems more important in this day and age. It compliments treatments by physical therapists, chiropractors, acupuncturists, osteopaths, and medical doctors.

This advanced style of bodywork requires more training from therapists specifically in the areas of anatomy, physiology, and pathology of injury. This work can be applies to any body part ranging from the neck all the way down to the feet. You will find practitioners of this work in multiple work settings, whether it is in a physical therapy or chiropractic clinic or day or resort spa. But if you decide to receive this type of therapy, please do your research. Not every massage therapist is qualified or for that matter good. So do your homework, find out the massage therapist’s history, education, and experience in body work. At North Tahoe Physical Therapy we are constantly increasing our understanding of how to address pathology, as continuing education is required for all licensed therapists.

Orthopedic Massage is a form of manual therapy that specializes in the treatment of musculoskeletal pain and dysfunction. In addition to the benefits of traditional massage such as relaxation and increased circulation, orthopedic massage has several other treatment goals. These include increasing the range of motion, decreasing and managing pain, and normalizing musculoskeletal function. The therapist works to dissolve adhesions in muscle and connective tissue, lengthen connective tissue, balance muscle function by strengthening weak muscles and releasing tight ones, as well as normalize the position of soft tissue, restore joint function, release entrapped nerves, and facilitate normal neurological function.

What to expect from Orthopedic Massage

You may ask, why a deeper more rehabilitative massage as opposed to your traditional Swedish massage? I prefer to label what I do as body work as opposed to massage. For a few reasons; when people think of massage they tend to correspond it to your every day Swedish massage, “which is nice to get”. Yes, I am doing tough “massage strokes”, but I am providing the body the therapy is desperately needs to return it to normal working order. I provide this type of work when everything else fails with traditional massage therapy and the pain and dysfunction persists. Also, I will incorporate other therapies such as Myofascial Release, myofascial stretches, manual traction, muscle energy techniques, and craniosacral therapy. So it is not necessarily massage strokes.

A session typically lasts from ½ hour to 1 hour. The work will be both gentle and deep. For lasting results, the therapist will want to see the patient 2-3 times a week initially, as frequency is the key. During the course of a session, the therapist will evaluate the entire body and address the body as a whole, to see how is responding to the injury. The therapist will then specifically address the area of trauma to increase the fluidity in the tissue and range of motion in the effected joints. This can be done by a postural evaluation, checking passive range of motion, or movement analysis.

-Brian Hrindo, MT

Stay Physical, With Therapy

May 23, 2008 by admin  
Filed under Physical Therapy

Ask five people what physical therapy is and I’ll bet you a Spring Pass you get five different answers. The beauty is that physical therapy is very different depending on what the individual requires to optimize health and quality of life. A good therapist customizes treatment to reach a patient’s goals and improve quality of life. This means that the process should be very different for a competitive skier and a deconditioned elder, even if both have knee injuries. Physical therapists are trained to identify limitations or dysfunction on many levels and problem solve in a way that best serves the patient.

Many don’t realize that for those entering the field today, a Master’s of Science or Clinical Doctorate (DPT) is necessary to qualify for the licensing exam. In addition, the American Physical Therapy Association is advocating for all educational programs to be DPT accreditated by 2020, generally 6-7 years of college education. All this training is geared toward evaluation and treatment sensitive to each individual’s needs. This includes integration of a variety of body systems affecting one’s health. Musculoskeletal, neurological, cardiovascular, respiratory, integumentary, digestive/urinary, and emotional health are all part of this assessment process.

The advantage to this background is that a physical therapist can gear treatment toward the larger picture of health. An injured shoulder is not a separate entity, but a piece of the puzzle affecting daily activity, mental health, recreation, occupation, and social life. It is most therapists’ intention to see this spectrum and work toward improvement through treatment, lifestyle changes, patient education, and home exercise. For the patient with pain, the treatment approach should include identifying the problem, working toward relief, and then preventing future pain. The injured athlete may need guidance in pacing his/her progression for optimal recovery. The client with neurological dysfunction and balance deficits should be instructed on home environment modifications to prevent falls. These are very different situations with different needs. Also, taken into account are individual characteristics. Factors including fear, attitude, motivation and bodily awareness must be recognized. Responsibility also lies on the therapist to educate the patient so they understand their body and can help prevent future impairments. To work with the patient and understand this broad approach will create the best outcomes.

What many don’t realize is that one doesn’t have to be suffering to benefit from therapy. Wellness promotion can be the sole purpose with prevention of future ailments being the primary goal. For someone that has had a heart attack and isn’t quite sure just how to improve their fitness, physical therapy can be a great place to start. For the office worker with slight aches and pains, education in ergonomics and stretching to prevent carpul tunnel or thoracic outlet syndrome may be indicated. Unfortunately, our society has valued reaction instead of prevention in healthcare for much too long. Most problems are more successfully treated early in their course than later when dysfunction has escalated and negatively impacted physical activity or movement patterns.
Furthermore, every patient has the right to choose the physical therapist they utilize. As with any profession, some people work well together and some don’t.

Communication is the key to successful treatment to ensure that both understand the plan of care and how the patient is reacting physically and emotionally. Specialists in physical therapy may also better serve you. Training and expertise in many fields are part of physical therapy and can be overlooked. Physical therapists who are specialists in Women’s Health, pediatrics and geriatrics, wheelchair evaluation, orthotics and brace fitting, Myofascial Release, and other manual therapies can help manage specific problems or pain. This can supplement or prevent a need for medication or more invasive medical options. If it’s important to you, a bit of research may give you other alternatives.

To those young people looking for direction and wondering what occupation to pursue, I encourage an investigation of the field of physical therapy. Options are numerous with this degree. Sports physical therapy or rehabilitation from athletic injury is often the only mental picture people get when they think of this field. In actuality, one can work in hospitals, schools, with animals, in education, in research, or as specialist, among other options. It’s an exciting time in our history to be involved with healthcare as technology changes, research diversifies, and health trends evolve. If working with a broad range of people and studying the human body and its condition interest you, physical therapy may be a good fit. With permission, shadowing a physical therapist for a day can be a good opportunity to learn more.

For more information, visit the APTA website,, or, contact a clinic with your questions. Be well and enjoy the day.

-Andrew Emery, PT at North Tahoe Physical Therapy

Myofascial Release Therapy - Breakthrough in Pain Relief

February 5, 2008 by admin  
Filed under Myofascial Release, Services

An Amazing Breakthrough in Pain Relief

Myofascial Release is a relatively new addition to the techniques of the physical therapist. Because it is somewhat different from traditional physical therapy, many people are unaware of what it is and how it works.

Myofascial Release (MFR) works on releasing the restrictions in the connective tissue called fascia. Fascia runs head to toe in a continuous sheath and surrounds every muscle, organ, nerve, cell, and blood vessel of our body. Restrictions can occur in the fascial system from trauma, surgery, poor posture and stress. When these restrictions occur, they can pull with forces of greater than 2000 pounds per square inch. Such tension acts like a “straight Jacket” and can lead to decreased range of motion, pain, headaches, poor posture and lack of mobility.

For many years, therapists have ignored the importance of the fascial system. This omission is now being recognized as the missing link to effective and lasting results in physical therapy.   The effects are profound throughout the body because the fascial system is ingrained in all of our bodily tissues.

When fascia scars and hardens in one area (following injury, inflammation, disease, surgery, etc.), it may create tension on adjacent pain-sensitive structures as well as on structures in far-away areas.  Often, medical professionals find that their clients have bizarre pain symptoms that appear to be unrelated to their original injury or to their primary complaint.  For, many, these symptoms can now often be understood as arising in the fascial system. Because this fascia of the body is all interconnected, a restriction in one region can theoretically put a “drag” on the fascia in any other direction.

During MFR treatments, a client may be treated in areas unrelated to their condition.  The physical therapist has a thorough understanding of the fascial system and will release the fascia in areas that she knows have a strong “drag” on the area of injury.  This is, therefore, a whole body approach to treatment.  For example, the chronic low back pain patient: although the low back is primarily involved, the patient may also have a significant discomfort in the neck.  This is due to the gradual tightening of the muscles and especially of the fascia, as this tightness has crept its way up the back, eventually creating neck and head pain.  Experience shows that optimal resolution of the low back pain requires release of the fascia of both the head and neck; if the neck tightness is not also released it will continue to apply a “drag” in the downward direction until fascial restriction and pain has again returned to the low back.

Often remarkable improvement is noted immediately during or after a treatment.  Sometimes new pains in new areas will be experienced.  At times, there’s a feeling of light-headedness or nausea, and at times a patient experiences a temporary emotional change.  Occasionally, a client may report a temporary increase in their discomfort followed by tremendous relief.  All of these are normal reactions of the body to the profound, but positive, changes that have occurred by releasing fascial restrictions. In general, acute cases will resolve with a few treatments.  The longer the problem has been present, generally the longer it will take to resolve the problem.

It is felt that release of tight tissue is accompanied by release of trapped metabolic waste products in the surrounding tissue and blood stream.  It is highly recommend that clients “flush their system” by drinking a lot of fluid during the course of their treatments, so that reactions like nausea and light-headedness will remain minimal.

Myofascial release can greatly help reduce headaches, neck and back pain, shoulder pain, pelvic and hip pain. Besides pain, MFR can help lengthen muscles to gain increased power. It is useful for restoring poor range of motion. Clients with poor posture can also gain amazing results from this technique. Lastly, MFR feels great and leaves a client with restored energy. It is a wonderful form of body work to receive instead of a traditional massage due to the lasting effects which are created. Many clients have regular Myofascial sessions to prevent dysfunctions. Info on minor Therapeutic Tune-ups.

Massage & Wellness

February 1, 2008 by admin  
Filed under Massage & Wellness, Services

Therapeutic Massage

Wellness Center, Therapeutic Tune-ups and Massage

More than just Physical Therapy

You do not need to be injured to enjoy our Wellness services. We offer programs to help you stay well.

Our services include:

• Post-Surgical Recovery and Rehabilitation
• Myofascial Release
• Pilates-Based Movement Therapies
• Massage
• Personal Training
• Cardiovascular conditioning
• Sports-specific training
• Weight control and management
• Classes and workshops

Therapeutic Tune-ups (Save Time and Money)

Get 15 minutes of treatment and pay a small fee without worrying about doctor’s prescriptions or insurance issues.

These are minor treatments for pains, strains, and sprains. Have you ever awoken with a kink in your neck and wished someone could treat your discomfort for just 15 minutes that day? Or perhaps you twisted your ankle or flared up your knee during a hike and wished you could get some minor attention to prevent this from getting worse. Then you realize that a massage is costly and takes time. In general, to see a Physical Therapist, you would need to see your doctor first, get a prescription, then call the PT office and schedule. Perhaps your insurance does not cover Physical Therapy.

What if you could just walk into the PT’s office, get 15 minutes of treatment and pay a small fee without worrying about doctor’s prescriptions or insurance issues. Well, that is exactly why we created Therapeutic Tune ups. Now, you can walk into North Tahoe Physical Therapy, talk to the therapist about your issue, and receive a 15 minute treatment for only $35. Treatment may consist of massage, Myofascial Release, craniosacral therapy, ultrasound, electrical stimulation, stretches or spinal mobilizations. It just depends on what your body needs.


1) Direct Access to a therapist. No need to see an MD first
2) Less waiting time between injury and treatment
3) The sooner treatment occurs means quicker recovery time.
4) No insurance issues
5) Low cost
6) Brief appointment times

Orthopedic Massage

Orthopedic Massage is a form of manual therapy that specializes in the treatment of musculoskeletal pain and dysfunction.  In addition to the benefits of traditional massage such as relaxation and increased circulation, orthopedic massage has several other treatment goals.  These include increasing the range of motion, decreasing and managing pain, and normalizing musculoskeletal function.  The therapist works to dissolve adhesions in muscle and connective tissue, lengthen connective tissue, balance muscle function by strengthening weak muscles and releasing tight ones, as well as normalize the position of soft tissue, restore joint function, release entrapped nerves, and facilitate normal neurological function.

A session typically lasts from ½ hour to 1 hour.  The work will be both gentle and deep.  For lasting results, the therapist will want to see the patient 2-3 times a week initially, as frequency is the key.  During the course of a session, the therapist will evaluate the entire body and address the body as a whole, to see how is responding to the injury.  The therapist will then specifically address the area of trauma to increase the fluidity in the tissue and range of motion in the effected joints.   This can be done by a postural evaluation, checking passive range of motion, or movement analysis.

Simply call 775-831-6600 and schedule your appointment
Walk-ins welcome

Personalized Hands-On Physical Therapy

January 29, 2008 by admin  
Filed under Physical Therapy, Services

More than just Physical Therapy

At North Tahoe Physical Therapy, we offer a unique combination of Myofascial Release, Hands-on soft tissue mobilization, skeletal mobilizations, Pilates- based exercises, Education and Self Management.
Our therapists are highly trained, experienced professionals. We provide a strong interaction between you, your doctor and your physical therapist.  North Tahoe Physical Therapy uses a 1-on-1 approach to Physical therapy with exceptional customer service. We treat you as a whole person, not just your injury.

Each client obtains a thorough explanation of their condition. Your physician receives timely reports regarding your progress. We empower you to become active partners in your recovery and health maintenance. Our personalized approach results in your wellness and satisfaction. Click here for client testimonials.

The cornerstone of our approach is Myofascial Release.

Our Treatment Philosophy

At North Tahoe Physical Therapy, our treatment philosophy is based on the pelvis, the base of the spine.  We believe the pelvis is the foundation of the body.  This foundation must be level for the head and neck to sit properly and for the legs to hit the ground evenly.  When a client comes to us with “low back pain”, we begin by assessing the pelvis for symmetry.  If the pelvis is rotated or if the trunk is shortened on one side, the surrounding soft tissues will attempt to stabilize the system.  This may lead to muscle spasms, pain, or tension of the nerves and the discs which sit atop the pelvis. Additionally, the spine may rotate and side bend in response to the un-level base below.  Consequently, the head which sits atop the spine will be un-level.

Our bodies are smart.  If our spine is rotated, we naturally adjust our head to have our eyes level. This may lead to issues of muscle spasms, muscle tension, TMJ/jaw disorders and headaches. So, for a person who comes to NTPT complaining of TMJ, headache or neck pain, our treatment starts at the pelvis.

Like a house if the foundation is not level, the roof will crack and the windows won’t easily slide open or close. Therefore, it only makes sense to balance the pelvis, which is the foundation of the body.

Self empowerment
You may spend 1-3 hours a week with our team of therapists at North Tahoe Physical Therapy. There are 168 hours in a week. What are you doing the other 165 hours? A maintenance program of Home exercises, education about how to avoid aggravating your condition, and awareness of how you can help yourself are important components of your care. North Tahoe Physical therapy, we empower you to be an active participant in your health and wellness.

Get well
• Orthopedics
• Sports Injury Care
• Back and Neck care
• Incontinence/Pelvic Floor Dysfunction
• TMJ/Migraines/Headaches

Stay Well
• Myofascial Release therapy
• Massage
• Personal training
• Medically Supervised gym
• Classes and workshops

Address the Symptoms, look elsewhere for the Cause
At North Tahoe Physical Therapy, we treat the cause of your problems. Our evaluation is a full body assessment. We look for Pelvic imbalances, fascial pulls, and postural abnormalities. We then determine how these deficits may have created your symptoms. For example, neck or jaw problems may arise from an unlevel pelvis. Knee issues may be due to a pelvis imbalance. If we only treated the symptomatic jaw without leveling the pelvis, the issues will return because the problem has not been corrected. By treating the cause, we are able to address and decrease the symptoms.

Women’s Health and Wellness

January 26, 2008 by admin  
Filed under Services, Women's Health

Our Women’s Health Program offers assistance to clients within a caring and private setting. Jane K. O’Brien, MSPT, member of the American Physical Therapy Association, Section on Women’s Health, will create a treatment program tailored specifically for the individual needs of the client.

  • Pelvic Floor Dysfunction (PFD)
  • Overactive Bladder ( OAB)
  • post Breast Surgery Care
  • Fibromyalgia
  • Osteoporosis
  • Pre and Post partum Care
  • Lymph edema/breast cancer
  • Pre natal Fitness
  • Abdominal Rehab ( post surgical/ diastasis)

Pelvic Floor Dysfunction

PFD includes a myriad of diagnoses which affect both men and women. Symptoms may limit a person’s ability to perform daily activities, cause one to change exercise habits and create embarrassment.

Pelvic Floor Muscle Weakness

  • Urinary and fecal incontinence
  • Pelvic organ prolapse
  • Post prostatectomy

Pelvic Pain

  • Levator Ani Syndrome
  • Penetration Pain
  • Hips, Abdomen, Low Back, buttocks
  • Sacroiliac ( SIJ) pain
  • Painful intercourse
  • Dysmenorrhea ( painful periods)
  • Vulvodynia
  • Endometriosis, Abdominal Adhesions

Both men and women can benefit from our services for PFD. We have answers and solutions. PFD is common but not normal. You can take control of your symptoms and often relieve them completely.

Incontinence Helpful Hints

  1. Allow no more than 2-4 hours between voiding.
  2. Avoid bladder irritant of tea, fruit juices, acids
  3. Consume adequate water and fiber
  4. Squeeze before you sneeze
  5. Avoid liquids 2-3 hours before bedtime
  6. Avoid tendency to go “Just In Case” ( JIC pees)
  7. Do your Kegels 10 seconds each 30-80 times per day.