Where would you go? What would you do? A Physical Therapist’s journey through neck surgery.

As I enter my fifteenth year as a physical therapist I’m faced with a question many of my patients ask me…”What should I do? Where should I go?” I have decided to make lemonade out of lemons and let you in with pictures, videos, and interviews with my surgeon. This unique view of my recovery will give you a real world view of what happens from surgery through physical therapy and back to full activity.

To give you some background I’ve been involved with sports from seventh grade on and my two favorites were football and wrestling. In college I played football at Central and ironically never had a neck injury. As an offensive guard you tend to hit your head or take blows that affect your neck on every play, so I assumed at some point I’d have some neck issues. Around the age of thirty I started having right sided neck pain and some radiating pain down my right arm into my thumb and index finger. Since I’m a physical therapists I’d have colleages work on my neck and give me relief. I was able to continue this way for ten years, it is quite remarkable I was able to continue with only physical therapy when I saw how bad the xray and MRI was (thanks to everyone that worked on me!). This shows the power of physical therapy to keep people going.

During this fall football season while covering the Pella High Football sideline for injuries I began having more pain and symptoms with my right hand. I made the decision to move forward and seek treatment, this process started with choosing a surgeon, if you’ve talked with anyone you know that spine surgery can relieve symptoms but carries inherent risks so I needed to get this decision right. Over the years I’ve worked with many spine surgeons which helped make my decision, so I choose Dr. Lynn Nelson of Des Moines Orthopaedic Surgeons (DMOS). Dr. Nelson has an impecable reputation and also understands ex-athletes as he is one of the team physicians for the Des Moines Buccaneers.
On my first visit Dr. Nelson did xrays, and I can honestly say my jaw dropped when he showed them to me. Bonespurs, arthritis, decreased disc height…after we went through this we scheduled an MRI. The MRI confimed it, severe right sided herniated disc with bone spurs compressing on a nerve root at the C5-C6 level.
The next question I asked Dr. Nelson was, “What would you do if you were me?” He gave me a number of options but with my job and what I want to do physically the only option was surgery, a C5-C6 Anterior Cervical Discectomy Fusion.

I had the surgery in December, stay tuned for recovery pictures, videos and updates from Dr. Nelson!

Female Athlete Triad

There are many pressures in sports and particularly for the young female athlete. Those pressures can turn into real problems that affect their health and performance in sports. As the summer  continues many of our young female athletes will begin training for fall sports or may already be involved in camps or club sports.

This Female Athlete Triad, is a group of problems that can start as a small problem and snowball into more serious issues. When we see female athletes with repetative injuries we screen them for this problem.

The key signs of the triad are:

  • Irregular or absent menstral cycles.
  • Always feeling tired or fatigued.
  • Problems sleeping.
  • Stress fractures or recurring injuries.
  • Decreasing food intake/striving to be thin.
  • Cold hands and feet.

The best treatment is to prevent the problem which comes with education and early identification. Coaches can do a lot to educate their athletes.

  • Remind your athletes that eating is an important part of successful training and performance.
  • Focus on health and a positive body image, do NOT focus on body weight.
  • Support athletes throughout their training and competition, as well as during their everyday life.
  • Mobilize available resources – nutritionists, athletic trainers, physical therapists, counselors, and physicians.

If you are an athlete or parent and suspect a Triad problem seek out treatment before the problem becomes worse.  If you want further information go to here – .

Sterling Physical Therapy Fact #1

I have been a Physical Therapist since 1997. During my time working with patients we have identified common questions that most patients have. I have made these into a list of four facts as they pertain to Sterling Physical Therapy, in an effor to educate patients and the public.

Today I’ll discuss fact #1. “If your physician suggests physical therapy, you have the right to choose Sterling Physical Therapy.*”  This comes as a surprise to many people, they assume that they have no choice and need to do exactly what the physician says. We educate patients that they are the untimate consumer of health care for their body and they need to exercise this right. Many times when you are not given a choice for where to go for physical therapy or you are referred to a clinic where a physician holds a financial interest, a hidden reason exists….money. The evidence against physician self referral continues to build with a new study published in the Archives of Special Surgery showing that financial incentives linked to ownership of either specialty hospitals or ambulatory surgery centers influence the frequency of outpatient orthopedic surgical procedures.  A Washington Post article focused on the over-utilization of imaging tests and the problems this can cause for patients and the health care system in general. In 2010 a report by the Medicare Payment Advisory Commission (MedPAC) dealt a heavy blow to physicians who self refer patients to their own physical therapy services.

R. Scott Ward PT, PhD, President of the APTA, wrote “Although it was no surprise to those of us in the physical therapy profession, the MedPAC found that over the past 5 years certain services provided by physicians, including physical therapy, have experienced rapid volume growth. The report cites several studies that have found physicians with a financial interest in physical therapy initiate therapy for patients with musculoskeletal injuries more frequently than other physicians and that physician-owned physical therapy clinics provide more visits per patient than non-physician-owned clinics. Moreover, says the MedPAC report, there is evidence that some diagnostic imaging and physical therapy services ordered by physicians are not clinically appropriate.”

Some people will also submit that in hospitals where there is no financial stake by the physicians, an effort is made to refer patients “in their system” which in turn is a form of Referral for Profit. Finally in an era of increasing health insurance premiums this type of referral pattern drives up your premiums. We all want to save money and not be part of a pattern that costs us more every year in insurance premiums.

So remember the next time your at your physicians office and they tell you that you need Physical Therapy, tell them you want to go to Sterling Physical Therapy (Sterling PT fact #1). Sterling is locally owned and locally invested in our community. From our inception we have specialized in orthopaedic, sports, and workers compensation cases and choosing us will not make your health insurance premiums rise.  Our mission statement is “Personal Care. Proven Results” and we look forward to sharing this experience with you the next time you need physical therapy.

*Sterling will consult with your physician if appropriate.

Travis Sterling PT, OCS, CSCS

Clinic Owner

Board Certified Orthopaedic Clinical Specialist

Sterling is now an In-Network Provider for United Health Care and UMR.

Health insurance changes very fast and can be overwhelming to consumers and providers. With recent changes and the local health insurance enviroment Sterling is now an In-Network Provider for United Health Care (UHC) (Pella Community Schools Insurance) and United Medical Resources (UMR) (Pella Corporations Insurance). Many times people get confused with what “in-network” means. The best way to look at this is now when you want to access Sterling’s excellent orthopaedic and sports physical therapy, you will be able to per your insurance plan. For example now it will only cost you a co-pay to be treated at Sterling (per your specific plan).

Sterling Physical Therapy been providing excellent orthopaedic and sports physical therapy for the past four years, we are the only locally owned clinic with this specialization. It’s our goal to evolve as changes occur in health care and continue providing our unique, locally owned service, to our community. If you have any questions regarding this new option please contact us at 641.621.1401.

Winter Running


Winter Running

With the cold dark days of winter into full swing many runners have made the transition from hitting the road to striding out on a treadmill.  There will always be a handful of strong willed individuals that will run outside no matter the time of year, ignoring the bite of winter.  But for many of us we tend to migrate indoors.  I must say I do encourage all runners to take advantage of those “mild” winter days and absolutely get out into the fresh air for an invigorating run.  Personally I set specific criteria for determining if my long weekend run will be on the treadmill or outside.  I want the temperature to be at least 25 degrees with minimal wind.  YaktraxEven with my pair of Yaktrax I’m not a fan of running on slick, packed down snow or ice.  One slip and fall and running could be over for a very long time.  For many of us runners the thought of missing a run or multiple runs is more than our brains can handle.  So, I’d rather be safe than sorry.  If you do run outside this winter just make sure you have the appropriate gear from head to toe.

There are several things we can do to make treadmill running more enjoyable, or for some I should say less excruciating, monotonous and down right boring. 

-Take advantage of the various programs available on most treadmills.  These programs will automatically change the elevation at specific intervals during the run mimicking hills on the road.  Some programs allow you to incorporate a change of speed at set points as well without you having to push a single button.  Hit the 5K program from time to time and set a new indoor 5K PR.

-Watch a movie, television or listen to some music.  If you have a long run, throw in a favorite movie to watch.  On Thanksgiving morning I watched three hours of Diners, Drive-ins and Dives while on a long run.  Nothing like preparing my appetite for what was to come later that day.  Want to go extreme, try this.  Listen to some music while watching the television (closed caption) at the same time.  *You’ll have so much stimulation overload you won’t even know you’re on a treadmill.

*I want to conclude with the most important point.  No matter where you choose to run this winter, take time often to listen to your body without distractions.  Focus on your breathing, your foot strike, your arm action.  The television goes off, the music is left behind.  As coach Gerard (GP) Pearlberg told my wife and me at a running clinic one time, “To perform at your best you have to be a focused running assassin.”   

The winter can be a great time to focus on specifics within your training and preparation for the spring season and racing series.  As a side note to that if you are training for road races in 2011 make sure you are adhering to a proven training program or better yet work with a qualified running coach.