Author: Apex Physical Therapy

June Covid-19 Updates

APEX PT remains OPEN and ready to serve youWe wanted to remind everyone that all 5 of our Apex locations are open and treating all current and new patients. We are offering both in person and telehealth appointments depending on what is best for you! 

 We first want thank all of our patients that have endured the unknown over these last couple of months and your unwavering flexibility with a changing world. We understand that this has been a trying time that we have all had to learn to be adaptable and understanding that we are all experiencing different levels of impact. As we embark on new phases and reduced restrictions, our number one goal is to continue to provide the best care to our past, current, and future patients.  

 As we transition back to full operations and our new “normal”, you may notice a few changes around the Apex clinics. We have implemented various policies and procedures to keep both our staff and patients safe. We continue to promise to serve our community to the best of our abilities as well as provide the safest possible environment. We will be following all guidelines set forth by the CDC, Washington DOH, and the American Physical Therapy Association/Physical Therapy Association of Washington. 

 So, what does this all mean? Here is just a few of the things that we are doing.  


  • Temperature Screens 
  • All persons that enter the building has their temperature taken prior to further interactions with any other person 
  • Request for any persons being sick or experiencing any COVID 19 related symptoms to cancel appointments or call in sick 
  • If having symptoms, we have particular guidelines for return to work or appointments pending the type of symptoms; as well as requirements for follow up with their PCP and testing as necessary 


Face Coverings 

  • All staff is required to wear a face covering and we are requesting patients to do the same due to not being able to maintain social distances during appointments   


  • We have changed our appointment schedule to spread our patients out and allowing a staggered start time for appointments to reduce patient interactions 
  • Allowed for more time between patients to provide proper cleaning and sanitizing in shared work spaces 
  • Offering in person as well as telehealth appointments pending needs and preference 

Waiting Rooms 

  • Limited time in waiting rooms, patients will be escorted to their treatment rooms quickly to reduce their exposure to other patients and staff 

Hand washing and Hand Sanitizers 

  • Employees are required to wash their hands before and after all patient interactions for the required minimum of 20 seconds 
  • We have various hand sanitizer stations available for all patrons to use throughout the clinics 


  • All surfaces that have been touched during a patient appointment are disinfected immediately following the conclusion of an appointment 
  • High touch surfaces are cleaned often throughout the day 

We are honored to continue serving our community however we are able.  We look forward to helping you return to the activities that you love and being able to reach your maximal potential.  

If you are in need of resuming or beginning physical therapy treatment please call any of our locations to help you figure out the best treatment options for yourself.  

 All our Best, 

Apex Physical Therapy 

Coronavirus Disease 2019 (COVID-19)

At Apex Physical Therapy, the health and safety of our patients and staff is always our top priority. As such, we are diligently monitoring updates to the Coronavirus or COVID-19. We understand this is a challenging time for all of us, but we want to reassure you that we are committed to using preventive measures such as disinfecting our equipment and countertops, washing our hands frequently, and using alcohol-based sanitizer to prevent the spread of Coronavirus, as well as cold and flu.

We kindly ask that if you are experiencing any cold or flu-like symptoms, that you allow our patient care coordinators to reschedule your appointment when you are feeling better. We will continue to monitor the latest Coronavirus updates and will make all changes necessary to help keep our patients and staff healthy.

Attached you will find the link for the CDC for the most up to date and correct information.


WA State DOH:  Potential Exposure

WA State DOH:  COVID-Symptoms

COVID-19 What you need to know!

What can I do to Stop the spread of germs







Pelvic floor health and exciting new product!


In all the years I have worked as a physical therapist, specializing in pelvic floor conditions, I have not been this excited about a new product as I am now. Many of my past and current patients have heard me talking about ways to keep their pelvic tissue healthy, especially during and post-menopause. Females rely heavily on estrogen to keep our tissue healthy, including muscle tone and vaginal suppleness. This, in turn, allows our pelvic floor to maintain its ability for bladder and bowel function and reduce the risk of incontinence. I have also explained to all of my patients that pelvic floor exercises are important for any female over the age of 25 so that this tissue can remain healthy during and after pregnancy, pre, and post-menopause. However, exercises may not be the only thing females need. Several people may require estrogen supplements during and post-menopause, and often this supplement comes in the form of a vaginal suppository. This is because the collagen in the vaginal tissue can respond to estrogen and plumb up with this supplement.  

Now a new product is available to help with this very condition, and it does not require a physician’s prescription! Introducing the vFit Plus. This new product is FDA approved as a general wellness device and is designed for females to help improve intimate wellness and sexual function. It is non-hormonal and non-invasive and allows the collagen to respond similarly as with a hormonal supplement. vFit Plus is used in the privacy of your own home and a session only takes up to 12 minutes. It is intended to be used every other day for the initial 6 weeks, and maintenance is generally 1 to 2 times per week. I began using mine 4 weeks ago and was amazed at the difference I noticed within 3 sessions.  I cannot say enough about the ease of use and the physical response I’ve noticed.  

If this at all piques your interest, you may contact me at our Cheney office and I can meet with you to review your needs. If you are wanting to read more about this, please feel free to check out the website: 

Apex Physical Therapy Store

We are excited to be able to share our Apex PT store with you. The Apex PT logo items will be available for purchase until February 1st, 2020. Ordered items will be available for pick-up in Mid-February from a convenient Apex location.  There are no returns or exchanges and size charts can be found within the order site.


Nine Mile Falls Office Coming Nov. 2019

Coming soon to the Nine Mile Falls area. Apex Physical Therapy will be opening their 5th location conveniently located at the intersection of Highway 291 and Swenson Rd. Andy Hamilton, Doctor of Physical Therapy, Orthopedic Clinical Specialist, and long-time resident of the Nine Mile Falls Area will be managing the location.

Andy plans to bring an upbeat motivating treatment style with a focus on manual therapy combines with individual functional exercise prescribed specifically for each patient. Andy brings nearly 10 years of experience in treating all musculoskeletal conditions. He specializes in post-surgery rehabilitation, return to sport/recreation therapy, and low back pain management.

The clinic is currently under construction and plans to be open starting this November.  To schedule an appointment you can call any of our other locations and let them know you would like to be seen at the Nine Mile Falls location. Come see the Apex difference and get back to doing what you love without pain.

Shoulder Health In The Overhead Athlete

This blog will focus on shoulder health in the overhead athlete, specifically baseball players. We will review all pertinent shoulder anatomy that contributes to the throwing motion in this first post.  Nick Motsinger, DPT, CSCS, will be demonstrating some very effective strengthening exercises and total body drills for these muscle groups. These exercises and drills can be incorporated into any warm-up routine or maintenance program to help reduce the risk of shoulder injuries and improve your performance this season.

The overhead throwing motion is an extremely skillful and complicated movement. When throwing a baseball, the overhead athlete places enormous demands on the shoulder complex due to the considerable forces that are generated with such a movement. In this first part of the video, all pertinent shoulder anatomy that contributes to the throwing motion will be reviewed. It is imperative that the majority of the muscles highlighted in this post be strong in order to decrease arm fatigue, and thus the risk of injury, in the overhead athlete.

The Thrower’s Ten

The Thrower’s Ten Program was developed by Kevin Wilk, DPT, and Dr. James Andrews in conjunction with a group of experts with over 100 years of combined baseball sports medicine experience. The Program highlights the best rehabilitation exercises and movements to isolate and strengthen the muscle groups that contribute to the throwing motion. The Thrower’s Ten Program has been shown to address the three most significant causes of shoulder and elbow problems in throwing:
1) decreased arm strength, 2) increased fatigue, and 3) lack of flexibility.

The Thrower’s Ten Program consists of 21 exercises in total. I will demonstrate 8 of these exercises in the first portion of the video and 9 more in the second section (I will not be demonstrating the four wrist strengthening exercises included in the Program). The Program has been designed so that it does not require a lot of equipment or even dumbbells to successfully complete. It can even be properly performed using just resistance tubing or bands. Start with 1 set of 10 reps for each exercise and go from there!
-Diagonal pattern D2 extension & Diagonal pattern D2 flexion
-External rotation at 0 deg. abduction & Internal rotation at 0 deg. abduction
-External rotation at 90 deg. abduction & Internal rotation 90 deg. abduction
-Shoulder abduction to 90 deg. & Scaption, external rotation

This second part of the video is a continuation of the first portion of the video which highlighted the first 8 exercises of the Thrower’s Ten Program. Exercises 9-17 will be demonstrated in this portion (again, I will not be demonstrating the four wrist strengthening exercises included in the Program). Like I mentioned before, start with 1 set of 10 reps for each exercise and go from there! The Thrower’s Ten Program is a safe, simple, and effective way to help reduce the risk of shoulder injuries and improve your performance this season.
1. Sidelying external rotation
2. Prone horizontal abduction (neutral) & Prone horizontal abduction (full external rotation, 100 deg. abduction)
3. Prone rowing & Prone rowing into external rotation
4. Press-ups & Push-ups
5. Elbow flexion & Elbow extension (abduction)

This last portion in our Shoulder Health in the Overhead Athlete series will address mobility and stability concerns of the lower half and core that may prevent a consistent release point. This portion is for all you baseball pitchers out there!

Mike Reinold, DPT does a great job of highlighting some of these issues in his article, “5 Mobility Issues That May Prevent a Consistent Release Point.” If you have mobility or stability concerns in your lower half and core, your body is going to make necessary adjustments with your arm in an effort to throw a strike. This can lead to shoulder and elbow injuries that would otherwise be avoidable. In this portion, I will be demonstrating 8 exercises designed to combat five common mobility and stability faults found in the overhead athlete, specifically pitchers. These common faults are:
1. Inconsistent lead knee and trunk flexion
2. Restricted lead hip mobility
3. Restricted rear hip mobility
4. Poor rear leg stability
5. Poor core control

As with the previous exercises highlighted in this series, start with 1 set of 10 reps for each exercise and increase as tolerated.
1. Lunge onto an unstable surface (BOSU) & Trunk core control drill
2. Get into your hip drill & Posterior hip mobilization
3. Adductor foam rolling & Adductor mobilization
4. Wind-up stability at a balance point
5. Anti-extension core control drill

For questions or for more information please feel free to contact Nick Motsinger at

Strength and Mobility For a Pain Free Golf Season

It’s that time of year again golfers!

The snow is finally melting in town and we’re all thinking about shaking the winter rust off of our game. Several local driving ranges have opened and soon the courses will too. I’d like to offer some food for thought as we get this season going (albeit a little later than we all had hoped). Most of us here in Spokane spend five months or more without touching a club. That’s an awfully long time for our flexibility and conditioning of golf specific muscles to suffer. A recent study suggests that up to 41% of amateur golfers will experience some type of golf related injury annually. More than 1/3rd of these injuries are to the lower back, with the remainder involving primarily the upper extremity. The overwhelming majority of these injuries can be blamed on overuse, lack of flexibility and swing faults. These statistics should be a little frightening to all of us that love the game, but there is good news! Studies report that a simple warm-up done consistently can reduce injury rates by 50% or more. I’ll address 3 topics that I believe can really help reduce injuries amongst amateur golfers. We’ll discuss the importance of hip strength and mobility, thoracic spine mobility and proper warm up.

Hip Strength and Mobility:

Our hips play a critical role in the golf swing. Not only are they a huge source of our power, but dysfunction in the hips during the golf swing really increases the potential for injury to the low back. A quick overview of the hips during the golf swing: At the top of the backswing the right hip is maximally internally rotated and the left hip is externally rotated (for the right-handed player). This process reverses on the downswing where the left hip is maximally internally rotated while the right hip externally rotates. Deficits in hip mobility while shortening our turn, decrease power, increase the likelihood of swing faults and increase the potential for injury to the low back. Here’s a simple test to find out how your hip rotation measures up!…/screening/the_lower_quarter_rotation_test

If you’ve tested yourself and are concerned with the results, here are some good stretches to help address both internal and external rotation of the hip:…/dr-greg-rose-90-90-hip-stretc…

Strength in our hip stabilizers and gluts are critical. A recent study shows that low handicap players have more than 10% greater gluteal strength relative to bodyweight compared with high handicap counterparts. If your hip muscles have been neglected this offseason, here are some ideas to get you going:

Forward T/single leg RDL
Goblet squat
Monster walk
Side plank

Thoracic Spine Mobility:

Another stubborn spot – the thoracic spine (our mid back). This area of the spine is capable of tremendous mobility and can contribute to a nice full turn in the golf swing. However, it’ also tends to become very stiff and can then be a source of limitation in our swing, creating a lot of extra stress of the low back and even the shoulders. Through a proper mobility program for the thoracic spine, we can improve our turn and decrease injury risk. Here’s a quick test you can do at home to check your thoracic rotation:…/screening/the_seated_trunk_rotation_test

Here are some simple exercises to help with motion in the thoracic spine:
Thoracic Rotation Quadruped
Foam Roller
Open Books

Proper Warm-Up:

In the last two sections, we’ve talked about the importance of the hips and thoracic spine in the golf swing. The final topic for the month of April will involve how to execute a proper warm up. Unfortunately, too many of us arrive at the course in a rush with just a few minutes before we head to the first tee. Often this leaves only enough time to hurry through a few shoddy swings and a minute or two on the practice green. Its been shown that an adequate warm-up has several benefits. First, we can decrease our injury potential by half! Second, we have the ability to create additional distance – and who doesn’t want that? A recent study shows a 2 mph bump in clubhead speed and 6-yard boost in distance off the tee just by warming up properly! Here are some ideas for a good warm up.

Try to arrive 45 minutes (at least) before your tee time. This allows you 10-15 minutes to warm up properly before hitting range balls or putting

5-minute brisk walk to increase cardiovascular output and warm up important lower body muscles. Often this could be accomplished walking from parking lot to the driving range

New data suggests dynamic stretching is more applicable for golfers so we can move away from those traditional static stretches held for 30 seconds each

Example of a dynamic warm-up:

Trunk rotations from set up position – start slow and gradually increase speed continuing for 30 seconds

Counterbalance squat – 12 reps

Side lunge – 12 reps each side

Shoulder blade retractions – pull the band apart for 30 seconds

Lunge and rotate – 6 reps each

Now would be the time to hit a few balls. Start with a dozen or so soft wedge shots progressing through short, mid and long irons finishing with just a few balls with hybrids, fairway woods, and the driver.

Most importantly – go enjoy your round!




Is your child’s backpack making the grade?

What you need to know about Backpacks


Backpacks are often a “school supply” that we either buy yearly or try and squeak out a few years of use. We tend to make this purchase based on a few things such as style, longevity, and price. It’s just a convenient way to carry their books and supplies, right? WRONG! Did you know that backpacks worn improperly, a poor fit, or overloaded can lead to spinal injury?? SAY WHAT??

Postural dysfunctions; primarily forward head, rounded shoulders, arching back, and leaning forward or to one side can cause poor spinal alignment leading to poor function of the spine (see picture on the far left and far right).

Want some tips on backpack safety?

  • Wear BOTH straps! This is a big one. One strap places more weight on one side of the body leading to increased weight bearing through one side and a postural shift (see picture on the left). Wearing BOTH straps distributes load EVENLY and symmetry for postural alignment achieved (see center picture).
  • Wear the backpack over mid-back muscles…why? Because they are the STRONGEST! You want the backpack resting on mid back and NOT over the buttocks and arms should be able to move FREELY.
  • Lighten the LOAD! Keep the total weight between 10-15% of student’s body weight. Place heaviest items closer to the back to promote correct postural alignment.

Overloaded backpack WARNING signs:

  • Student’s posture CHANGES when wearing the backpack
  • Struggling with putting on and taking backpack off
  • Student complaining of pain when wearing backpack or at the end of the school day
  • Tingling in arms (or legs) but mostly arms
  • Red marks on the shoulders after wearing backpack for ANY amount of time

What should we look for when purchasing a backpack?

  • Wide straps
  • Padded Back
  • Hip and chest clips
  • Multiple compartments
  • Reflective material

If in doubt a Physical Therapist can evaluate the backpacks fit for each student individually. Physical Therapists can also evaluate and treat pain, muscle strain/fatigue, and postural alignment concerns with poor backpack use/fit. Apex Physical Therapy has YOUR BACK!


Here is a helpful video from the Move Forward/APTA website on Backpack Safety for Kids

Basketball Wars: Spokane Hoopfest

Hoopfest: Spokane, WA. The best basketball weekend on earth. The event spans 45 city blocks, includes 450+ courts, 3,000+ volunteers, 6,000+ teams, and 225,000+ fans. Hoopfest holds a special place in the heart for many in Spokane and many outsiders. There are so many factors that go into the preparation for volunteers, athletes, fans, and the community. Apex Physical Therapy loves to give back to the community and doing so be a part of this amazing event. Most years, we have volunteers from Apex assist at the first aid booths. We also try to bring some awareness to the community about how to prepare for this mind-blowing event.

Injury prevention is a phrase we use to place emphasis on athletes preparing their bodies for the rigors of sport play. Although some injuries happen due to the nature of the sport on the streets, intense physical play, and unlucky circumstances injuries can be prevented! For those athletes that play basketball regularly throughout the year, they stay conditioned with sport specific play. It is recommended that participants in Hoopfest use the coming weeks to improve muscle memory, strength, agility, running, stretching, balance, jumping, and sport specific training towards basketball as injury prevention. In most instances, there is no better way to prepare the body for a weekend like Hoopfest than playing the game of basketball with the idea of simulating game play. Organizing multiple indoor or outdoor 2 on 2, or 3 on 3, pick-up games with similar rules to Hoopfest is an outstanding way to allow the body to develop similar movement patterns you will encounter at Hoopfest. Regardless, if you are a recreational or a competitive basketball player it is best to get comfortable moving side to side, jumping, and simulating basketball movements in your basketball shoes with moderate to high intensity.

Beneficial exercises like cardiovascular endurance, strengthening, mobility exercises, and balance training are all usual components of an athlete’s rehabilitation program to prepare for sporting events. The key to preparation is through dynamic warm ups, stretching, and active cool downs, as well as finding ways to consistently challenge yourself. Some ways of challenging yourself are to add resistance, time, repetitions, and frequency of exercising. The most important part is being consistent so the body has time to adapt to the stress you are applying to it. Hoopfest has outstanding volunteers during the event if you happen to encounter injuries prior, during, or after games. Please make sure you are seeking help from medical professionals at their designated stations before attempting to play through injury. Ankles, knees, wrists, and other joints can be assessed, taped, and prepared for play.

Athletes and competitors are recommended to not only physically prepare their bodies for injury prevention, but to control the importance of nutrition, hydration, and adequate sleep leading up to the big weekend. Again, the key with preparation in these areas is consistency. Apex supports community health and wellness, and we recommend practicing good habits year around. We also recommend spending the crucial month of June to prepare the body to its best ability. Above all remember to have fun, practice good sportsmanship, and enjoy a truly unique basketball experience in our wonderful city.

How’s your running form treating you?

Poor running mechanics can lead to a domino effect of pain and injury which can sideline a runner. Here in the Inland Northwest we have many running clinics, groups, and scheduled runs/races in the near future and Apex Physical Therapy wants you to be in your tip-top running shape and decrease your risk of injury this running season.

Physical Therapists can advise runners on proper form, strategies for preventing injuries, proper shoe selection, as well as proper training methods to help decrease risk of injuries and have a successful running season.

All Apex Physical Therapists treat and manage conditions often associated with running such as, but not limited to:

  • Achilles tendon injuries
  • Groin strain
  • Hamstring strain
  • Iliotibial Band Syndrome
  • Knee pain
  • Patellofemoral Pain
  • Plantar Fasciitis
  • “Sleeping” glutes
  • Female athlete triad
  • Stress Induced Urinary Incontinence (We have specialists for this condition)

Apex PT in Cheney specifically has Physical Therapists trained in a program called Dartfish. Dartfish is a computer program that allows us to take digital video and slow it down to analyze small aspects of an individual’s unique run pattern. It can identify areas of weakness, imbalance, or dysfunction that can either be the cause of pain or can be used to identify issues BEFORE pain/injury occurs.

A running gait analysis is a scientifically based, individualized evaluation of the running form. It includes an evaluation of the whole body to identify areas of poor movement patterns and their underlying causes. These areas can lead to an inefficient running form, and if left uncorrected/untreated can often lead to a high risk of injury.

A licensed Physical Therapist is uniquely qualified to perform a gait analysis due to their extensive education in biomechanics as well as their knowledge in identifying, correcting, and preventing a wide range of musculoskeletal injuries.

The human eye simply cannot catch everything that happens in the few milliseconds of time the foot is in contact with the ground during the running cycle, therefore we use video analysis downloaded onto a computer using the same Dartfish software used by many Olympic training programs. This allows us to view the running form in super slow motion or even frame by frame speed, thus catching problems that otherwise would easily be missed.

A Dartfish Gait and Running Analysis can be scheduled at our Cheney office location. The Analysis is generally a self-payed visit however; it may also be used in conjunction with physical therapy as the patient returns to running after injury or surgery.

Give Apex a call today to get you to your full running potential as soon as possible!