Overuse Injuries


Overuse injuries are one of the most common sources of pain for both competitive athletes and the general population. They are almost exclusively thought of in terms of soft tissue: a pitcher who strains an elbow ligament throwing too often, a runner who develops patellar tendinitis, or an office worker who gets carpal tunnel syndrome from using a computer everyday. However, “overuse” isn’t just a term that applies to tissues; our sensory receptors can also be overused, leading to pain and performance loss.

Today, we treated a client who has been complaining about head and neck pain. She is a musician who plays in a local symphony. Previously, she had noted that the symptoms were exacerbated when she played, so much so that she had demoted herself in order to avoid having to play the more challenging parts for her instrument. So we had her bring in her instrument for today’s session in order to determine if it was triggering problems.

Sure enough, we found three specific notes that, when played, triggered dysfunctions in the vibration sensors around the lips and mouth specific to those frequencies. Each “broken” vibration sensor was causing certain tissues in the head and neck to tighten as a compensatory measure, leading to tension and headaches. How did those sensors become a problem? Overuse. It wasn’t a single traumatic incident, but rather chronic stress on those sensors that caused them to eventually short circuit. Resetting those receptors with PDTR created an immediate softening of the tissues in her head and neck.

What sort of chronic stress are you placing on your body; not just on the tissues, but on the variety of sensors responsible for telling the brain about the world around it? Could even the seemingly innocuous small stressors of your favorite pastime be the unknown cause of your chronic pain? We can help you find the answer!

Emotions as a Source of Physical Pain



Pain is a decision made by the brain. This is a well-established but often difficult to comprehend fact. When we experience pain, we tend to think of the problem as there, in the location that is painful. But, for example, in a case of common pain like “runner’s knee,” there is often no problem in the knee itself. Let that sink in. The knee can be 100% healthy, undamaged, intact, yet scream at you so loudly that it keeps you from engaging in your favorite activity.

How can that be? Because pain occurs when the brain accumulates all the data coming from sensors throughout the body and decides, based on that data, to tell you it hurts. Sometimes this is the “right” decision; if the skin is penetrated and you’re bleeding profusely, then it makes sense for the brain to tell you about the injury by creating pain. But if the brain is getting bad data, then often pain and weakness will occur despite the fact that no physical problem actually exists.

This concept is important to understand when discussing the role of emotions in pain. It’s certainly not unusual for us to get odd looks when we trace problems through the nervous system and tell clients that the source is emotional. (This is not guesswork; we have definitive tools for coming to that conclusion.) When someone has been dealing with tangible, physical pain, it can be difficult to grasp that the pain is stemming from an emotional experience, not an actual physical problem. The inevitable response from clients is, “So I’m just imagining it?” Absolutely not.

The missing piece of the puzzle is understanding that emotions are data. And just as sensors in the knee can send bad information to the brain, emotions can also be data that results in the brain deciding to send a pain signal. The brain works like a computer. If you enter bad data (be it physical or emotional), you get bad output (pain). We all readily acknowledge that we can “hold stress” in our neck, or that in times of grief we can feel our guts clenching. Those are prime examples of how emotions can create real, potent physical changes in the body. We emphasize to clients that this is not something to just “get over” or address through talk therapy; these problems are hard wired into the nervous system and cannot be willed or talked away.

The emotional traumas we treat fall into several categories: past visual (e.g. the sight of a car speeding toward you prior to an accident), past auditory (e.g. the sound of a friend’s voice during an argument), internal dialogue (e.g. “I’m not good enough”), kinesthetic (e.g. the way you felt during a severe illness), future auditory (e.g. imagining your boss telling you that you’ve been laid off), and future visual (e.g. imagining the look on a loved one’s face when you report bad news).

If you’ve experienced an emotional trauma or stressor like the ones listed above, it’s likely that the effects are still trickling through your nervous system, even if you would swear that you’re “over it.” Again, the physical effects of an emotional experience become hard-wired into the nervous system. Sometimes the effects are small and of no real consequence. But there is not a person who has walked through our doors that doesn’t have a least one major emotional source of significant physical pain, weakness, or limitation.

If you’re ready to address the emotional sources of your pain and/or limited performance, or if you just want to “clean house” in an effort to optimize your health in the long term, we would love to help you accomplish that. As always, please feel free to call us if you have questions or would like a consultation.

***If you are struggling with emotional traumas causing severe depression and/or suicidal thoughts, please seek help here: http://www.metrocrisisservices.org/

DPPS vs. Traditional PT: Why Insurance Isn’t Always Saving You Money

Case of the Day – Oct. 24 2015

Today’s case is a great example of why clients often choose our integrated therapy sessions in lieu of traditional physical therapy. While physical therapy is a fantastic resource, and a good PT can be invaluable in many scenarios, it is often prescribed by doctors for the wrong reasons. (Remember, most doctors are not pain specialists. If you go to a general practitioner, orthopedist, etc., and they cannot find a problem that falls within their specialty, then they have no choice but to turn to generic answers, typically medication and/or standard physical therapy.)

At DPPS, our specialty is pain resolution. Yesterday, we saw a new client who was referred to us by a work colleague when her doctor told her she needed physical therapy for acute neck pain and stiffness. During our phone call, she was initially hesitant when I explained that we do not accept insurance. Understandably, most people want to take advantage of their health insurance because of the perception that it will save them money. Ultimately, this individual chose to see us anyway based on the strong recommendation from her colleague and because she could still use her flexible spending account with us.

As we see with most clients, the location of her pain and the source of her pain were not identical. In her case, most of her neck and shoulder pain was coming from neurological dysfunction in her pelvic ligaments and internal organs. (Yes, your organs communicate with your brain, and yes, we can identify and correct miscommunication when it occurs.)

When she walked in our door, her neck pain was an 8.5 out of 10, and she had perhaps 10 degrees of rotation in her neck. An hour later, her pain was 2.5 out of 10 and she had at least 60 degrees of rotation. From there, she probably could have chosen to recover completely with some additional rest, but she was adamant about returning for at least one more visit because of how powerful the work was.

As we explain to many clients in similar situations, when calculating costs, you have to consider the number of visits. Even paying out-of-pocket for two visits, this client will spend less than half of what she would have spent for her “prescribed” number of PT visits and the associated co-pays. And because traditional physical therapists cannot usually assess and treat the vast array of neurological issues we can, there is no guarantee they would have ever focused on the real causes of her pain. 

For reference, here are some common locations of organ referral pain. If any of these patterns seem familiar to you, consider scheduling an Integrated Therapy session with us.



Ligaments as a Source of Pain and Suppressed Performance

Case of the Day – July 28th, 2015

Denver Pain and Performance Solutions clients — as our name implies — are evenly split into two broad categories: those who are seeking to eliminate acute or chronic pain and those who are have noticed mysterious declines in athletic performance. (In reality, these two groups coexist the vast majority of the time.) In both cases, one of the first and most important things we do is assess the function of the pelvic ligaments.

All too often, even among well-educated healthcare professionals, ligaments are viewed as inert structures that passively hold the skeleton in place. Nothing could be further from the truth, and we prove it to clients on a daily basis. While ligaments certainly do play a critical role in maintaining skeletal alignment, they also function as a communication network of sorts that directly and actively affects muscle activity. The pelvic ligaments in particular are important to assess due to their “core” location and strong relationships with muscles from the ankle all the way to the neck. If the pelvic ligaments are dysfunctional, clients can present with symptoms ranging from a susceptibility to ankle sprains to thoracic outlet syndrome. Even if pain is not present, dysfunctional pelvic ligaments are a major player in performance losses due to their tendency to cause shut-down in muscles throughout the body.


How prevalent is this issue? We find dysfunction of the pelvic ligaments directly linked to pain and performance loss in 100% of our clients.

Most recently, we saw a young female athlete who had been suffering from chronic low back pain for 8 months. Our initial assessment showed an inability to fire the spinal erectors, glutes, hip adductors, hip abductors, hip rotators, hamstrings, and abdominals. Think that’s enough to cause a painful lower back and loss of performance? The protocol helped us identify the pelvic ligaments as a major culprit, so our corrections began there. After identifying and correcting dysfunctions in the inguinal, pubic symphysis, sacrotuberous, sacroiliac, and sacrospinous ligaments, the client was able to fire all previously weak muscles with very little effort. Her gait improved dramatically, and she reported feeling stronger and more stable than she had since her pain began.


If you have experienced pain or weakness in the same muscles for long periods of time, despite corrective work that seems to create temporary improvement, there is a strong possibility that the actual issue is poor communication between the pelvic ligaments and the brain, leading to motor control deficits. In other words, the muscle problems are just a symptom of a deeper problem, and no amount of treatment targeting only the muscles will solve the problem permanently.



Just Say No to Orthotics


The role of an orthotic is essentially to change the nature of the contact your foot has with the ground. When your foot has lost the ability to properly adapt to the landscape, an orthotic changes the landscape to accommodate your foot. I do tell my clients there is a time and place for orthotics: namely, when they provide a dramatic decrease in pain that allows a person to return to normal daily activity, eliminate pain medications, etc. Sadly, the vast majority of orthotics do not fall into that category.

Rather, orthotics tend to be blindly implemented as a panacea for a variety of symptoms, before even attempting to improve the function of the foot. Again, orthotics can alleviate pain. And when you sprain your ankle, you alleviate the pain by walking on crutches. But you don’t walk on crutches for the rest of your life. If you did, you’d be trading ankle pain for shoulder and neck pain, and you’d be sacrificing a lot on the performance front.  Instead, you work hard to rehabilitate your ankle, restoring it to full function and strength. So, if orthotics seem to provide some benefit, shouldn’t you consider that as an indication that your foot isn’t functioning properly and would benefit from rehabilitation?

Often, proper foot rehabilitation can take a lot of time and effort. But it’s always worth it. Not a day goes by when I fail to make a direct connection between a client’s pain pattern and some type of foot dysfunction. But just as often, dramatic improvements in foot function can come rapidly. The above client’s primary complaint was pain under the ball of the big toe that was progressively getting worse. In both photos, the hip and ankle are held in neutral to ensure the visual changes are in fact stemming from changes in the foot. In the first photo, you can see the base of the big toe is significantly lower than the rest of the foot. When that foot strikes the ground, which joint do you think is taking the brunt of the impact? In the second photo, you see a much more even forefoot, with the big toe and little toe at the same level. The best part? The below photos were taken 30 minutes apart, after therapy combining PDTR®, ART®, and AiM™.

The client’s pain disappeared, and she reported feeling like her foot was working properly for the first time in years.