Welcome to Advance Physical Therapy, Inc. Newsletter


Welcome to May! The gardening season is in full swing, and our minds turn to the tasks that need to be accomplished in the flower beds and vegetable patches before the hot days of summer. Or, you may have decided that this is the time to start training for that half marathon in the fall, or take the family for an active summer vacation. Whatever your plans for the warmer weather, we hope you enjoy this time with your family with good health and mobility!

The May newsletter completes our three-part series on low back pain. In March, we discussed the anatomy of the lumbar spine. In April, we described the most common low back conditions that people suffer from, and proper nutrition for recovery. This month, we discuss the type of evaluation and  treatment a person with low back pain can expect when they come to Advance Physical Therapy. We'll also introduce the 5 best foods for women and men to "supercharge" their brains.

To Your Health,

Advance Physical Therapy, Inc.

 Physical Therapy Treatment for Low Back Pain
Do You Know What to Expect?

When your doctor recommends physical therapy for your low back pain and or sciatica, you come with a referral that includes the medical diagnosis. In the March and February newsletter, we described several of the most common diagnoses, like disc herniation, degenerative disc disease, and spinal stenosis. The medical diagnosis is an important piece of information that helps your therapist identify the tissue problem(s) at fault. It is one factor that will be considered when developing your treatment plan. The plan of your care is decided after the subjective ("interview") and objective ("physical") examination - on the first day of physical therapy.

During the subjective exam, you will be asked to describe your symptoms, how the symptoms affect your life, common activities or movements that make it hurt, and provide more detail on how it started. This information sets the stage for the objective examination. The physical therapist will perform a movement analysis of muscle, joint, tendon, fascia, nerve and spinal structures, assess muscle strength around the hips, knees, trunk, and perform a detailed passive joint and soft tissue mobility examination. The passive joint and soft tissue work is often the most important part of the exam.   It identifies not only the vertebral levels that are affected by the problem,  but also the type of tissue at that level, whether it's a lumbar disc, vertebrae, nerve, or ligament that is generating the pain. The information gained from the subjective exam should corroborate with the movement exam. For example, if you tell us that you avoid bending over to pick up things from the floor, we expect that a forward bend test during the objective exam will be painful, limited in movement, done with hesitation, or all three.

Sometimes, people ask:  Why do I need an examination? Doesn't my X-ray or MRI show the problem?  It may or may not. A movement analysis cannot be performed by a static picture, no matter how detailed the picture is. An orthopedic manual physical therapist will be able to identify movement abnormalities at the problem area, as well as in the rest of the spine, the pelvis and the hips. All of these other areas may be contributing to the present pain which is generated by a structure in the lumbar spine.The physical therapists at Advance Physical Therapy are highly skilled in the use of manual therapy, and have gone through extensive residency training to become certified Orthopedic Manual Therapists (OMT) with specialized skills to resolve pain, increase range of motion, reduce soft tissue tension, eliminate joint inflammation, increase joint mobility, improve joint stability, restore normal movement patterns, improve general fitness, and return patients to work or a sport activity quickly.

Your specific treatment will follow up on results of this detailed examination, and may include:


This technique improves mobility to the muscles, tendons, ligaments, nerve and fascia as it relates to pain, posture, and joint dysfunction. It may include acupressure, myofascial release, strain-counterstrain, trigger point release and contract-relax techniques.


This technique is a continuum of skilled palpation and/or passive adjustments to the bone and joints or related soft tissue that are applied at varying speeds, oscillations and amplitudes to treat altered mechanics of the joint system.


This program involves a series of highly specific “dosed” exercises tailored to the your injury and/or movement dysfunction. The exercise program is designed to restore normal function and promote optimal tissue healing. Our advanced training of exercise progression and use of specialized gym equipment allows us to prescribe effective exercises necessary to restore pain free function. The movement analysis performed by your physical therapist will determine the type of exercises you will perform. The acuity of your pain, and how much or little it takes to "set off the pain" will determine the position, load, number of repetitions and sets performed. There is no "one size fits all" program. Two people with a disc herniation at L5 can have a completely different exercise prescription.


We will provide you with the knowledge on how to best manage your injury during and after your treatment sessions with us.  We will provide you the resources for preventative management, self-care strategies, prescribed home and/or gym exercises, ergonomics, postural adjustments and nutrition.  We will work with other health care practitioners that you may be consulting with (personal trainers, nutritionist or other specialists) regarding progression of your care. 
Based on your evaluation of your low back condition, your therapist will determine how much emphasis to place on each of these components of treatment.

If you have any questions about how we can help you with your low back pain, or movement problem of any type, give us a call.

Medical Exercise Therapy Improves Tissue Healing

Not all exercise prescriptions are created equal.  Our therapists implement a system of exercise training introduced by The Ola Grimsby Institute as Scientific-Therapeutic-Exercise-Progression or S.T.E.P.  This program involves a series of highly specific “dosed” exercises tailored to your injury and/or movement dysfunction.  More importantly, these "dosed" exercises specifically target the tissues (muscle, tendon, ligament, nerve, bone, fascia, etc.) that need repair and healing.  Our therapists understand that each type of injured tissue requires a specific method of exercise intensity and set up in order to achieve quicker healing.  Therefore, prescribing the correct "dosage" of exercise is essential since not all tissues in the body will respond to the same intensity, frequency and form of exercises.  There is no "one size fits all" program or "cookbook" protocol for any two individuals with an L5 disc herniation.  First, differentiating the specific tissue(s) that is causing pain and dysfunction and then creating the appropriate exercise set up to stimulate that tissue to heal are the key to restoring normal function and promoting optimal tissue healing. 
Supercharge Your Brain
4 Best Foods for Men and Women

Women and men require different foods because they have different brains.  Based on current medical research conducted by Daniel Amen, MD, a brain imaging specialist and author of more than 30 books including Unleash the Power of the Female Brain, 46,000 brain scans were studied involving 26,000 patients.  Using a brain-imaging test called SPECT (single photon emission computed tomography), they found clear differences between the male and female brains. 

In general, the female brain is more active than the male brain.  High concentration of activity is located in the prefrontal cortex which controls judgement, impulse control and organization.  Women produce less serotonin than men.  Serotonin is a neurotransmitter that makes an individual less worried and more relaxed; therefore women are more prone to anxiety and depression.  Men, on the other hand, produce less dopamine which is involved with focus and impulse control, so men are more apt to being impulsive and have difficulty concentrating.

Foods that increase serotonin are important for women because when serotonin levels increase, women naturally experience less anxiety and less likely to get upset.  The following are the best foods for women:

1) Chickpeas (Garbanzo beans)Chickpeas increase the brain's production of serotonin due to their high concentration in nutrients and fiber (12 grams of fiber per one cup serving).  Fiber slows the body's absorption of sugars, prevent spikes in insulin and helps the brain work at optimal levels.

2) BlueberriesAlso know as "brain berries," they are a concentrated source of flavanoids and antioxidants that decrease inflammation, increase good moods and memory and minimize the risks for dementia-related cognitive problems.

3) Dark ChocolateChocolate increases levels of nitric oxide, a molecule responsible to dilate arteries throughout the body, including the arteries in the brain.  It has been linked to improving verbal fluency, mental functions, moods and energy levels.  Because chocolate is high in antioxidants, it decreased the "oxidative stress" that can impair memory and brain functions.

4) Sweet PotatoesThey are high in vitamin C and fiber and do not raise blood sugar/insulin as quickly as white potatoes.  They're considered a "smart" carbohydrate which causes a gradual increase in serotonin.

Men naturally like high-protein foods.  The protein increases dopamine and provides fuel for increase in muscle mass.  The key for men is to choose healthier protein sources such as:

1) Salmon15-20% of the brain's cerebral cortex consists of docosahexaenoic acid (DHA).  DHA is one of the omega-3 fatty acids found in salmon, tuna, trout, herring and mackerel.  Men who don't eat fish may have a greater risk for brain inflammation that can impair transmission of nerve signals that affect learning and memory. 

2) EggsThey are an excellent source of protein that are high in vitamin B-12 and can reduce age-related brain shrinkage and improve cognitive function.  Eggs are not the dietary danger that people once thought.  Latest research shows that people who eat eggs once/day are no more likely to develop heart disease or have a stroke than people who don't eat eggs.

3) Sesame Seeds and 4) Brazil NutsThese nuts increase dopamine and contain antioxidants that protect the brain cells.  They are high in protein and monounsaturated fats that decrease LDL "bad" cholesterol.  They are just as good for the heart.  Research shows that people who ate nuts five or more times per week were only half as likely to have a heart attack as those who rarely ate them. 

If we can answer any questions or field any topics of interest regarding  physical therapy, health and wellness or about our programs, please contact us. We'd love to hear from you.
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Medical Exercise Therapy Continued...

So how do we repair these tissues and create a system in which they will respond effectively?  Our advanced training of exercise progression and use of specialized gym equipment and pulleys allow us to prescribe effective exercises necessary to restore pain free function. The movement analysis performed by us will determine the type of exercises you can perform safely and pain free. The degree of your pain and how much joint and muscle movement is necessary to create the desired motion will determine the position, load, number of repetitions and sets performed.  Our system of exercise training ensures that the injured tissue achieves the qualities of good vascularity (blood circulation), coordination, endurance, strength, agility, speed and power necessary for optimal repair and optimal tolerance for functional activities (work, sports, activities of daily living.)

Our approach to exercise prescription and S.T.E.P. has helped our patients not only recover more quickly from acute and chronic injuries, but also has given them a formula to prevent similar injuries from reoccurring.

Please feel free to contact us about how we can be a part of your healing process through movement and exercise!

2944 Broadway Street                         1208 E. Arques Avenue Suite #105
Redwood City, CA 94062                     Sunnyvale, CA 94085

(W) 650.261.0330                                 (W) 408.720.8225
(F) 650.261.0331                                   (F) 408.720.8755

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