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Balance is something I work on with many of my physical therapy patients. Whether you want to feel steadier on your feet, return to your favorite activities or reduce your risk of falling, choosing the right exercises matters. Balance isn’t just one skill. Standing still without wobbling is different from catching yourself when you trip or step around an obstacle. A 2026 study published in Ageing Research Reviews examined which types of exercise best improve balance in adults over 60. Researchers reviewed 423 clinical trials involving nearly 34,000 participants. They found that most exercise types improved balance, but some appeared more effective for specific skills. What types of exercise help balance? Perturbation training: Safely practicing how to recover when you lose your balance, such as responding to a gentle push. Sensory training: Challenging the balance signals your brain receives from your eyes, inner ears and feet. This might involve standing on different surfaces or changing what you can see. Tai Chi: Using slow, controlled movements and weight shifts to improve body control. Pilates: Practicing controlled movements, core strength and coordination to help you stay steady while moving. Agility and stepping exercises: Practicing quick steps, changing directions and stepping over obstacles to prepare for everyday challenges. Dance: Combining rhythm, stepping and changes in direction to challenge balance in an enjoyable way. Aquatic exercise: Moving in water to practice balance and movement with less impact on your joints. Strength training: Strengthening your legs and hips with exercises like sit-to-stands and step-ups to help with everyday movements. Which exercises work best? The study found that different exercises showed promising results for different balance skills. Perturbation training, sensory training, dance and agility stepping ranked highly for overall balance. Pilates showed strong results for balance while moving, while agility stepping helped with preparing for movements and obstacles. These rankings are estimates, and no single exercise is best for everyone. How can physical therapy help? This is where working with a Physical Therapist can make a difference. I look at your goals and identify which balance skills need the most attention. For one person, that might mean strengthening the legs to make getting out of a chair easier. For someone else, it might mean practicing quick steps or recovering from a stumble. The goal is to help you feel more confident doing the things you want and need to do every day. You don’t have to wait until you’ve had a fall to start working on your balance. Physical therapy can help you find the right exercises for your needs. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Junyu Wang, Shenghui Guo, Yong Yang, Yixin Liang, Chaoyu Guo, Yuge Cheng, Yiqi Li, Bopeng Qiu, Shaoxing Ma, Peijie Chen, Jie Zhuang. Exercise modalities for overall and domain-specific balance performance in older adults: A systematic review and Bayesian network meta-analysis, Ageing Research Reviews, Volume 121, 2026, 103303, ISSN 1568-1637.

As a new mom, sleep deprivation is in full force. Now that I’ve returned to work and started working out again, I find myself having the same internal debate: Do I work out… or do I take a nap? So, naturally, I turned to the research. A recent study published in Proceedings of the National Academy of Sciences looked at whether exercise or a nap could help protect memory after sleep loss. Researchers found that both a short bout of exercise and a nap improved memory performance compared with doing neither. Interestingly, they appeared to help the brain in different ways. Exercise supported brain activity involved in processing and forming memories, while napping helped reduce some of the effects of sleep pressure and fatigue. Now, before you decide that a workout can replace sleep, there’s an important caveat: it can’t. This study looked at healthy young adults after 30 hours of sleep deprivation, which is very different from the interrupted sleep many new parents experience. But I think there’s a helpful takeaway: When sleep isn’t perfect, movement can still be valuable. If you’re tired but feel good enough to move, a short workout, walk or some gentle movement may be just what you need. And if your body is telling you that you desperately need rest? Take the nap. There’s no prize for pushing through exhaustion. For me, the research doesn’t completely settle the daily “workout or nap?” debate. But it does remind me that both movement and rest are forms of taking care of yourself. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Lotlikar, Madhura S., et al. "Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions." Proceedings of the National Academy of Sciences 123.32 (2026).

If you’ve had a total knee replacement—or are considering one—you may wonder what recovery should actually look like. A new 2026 clinical practice guideline for Physical Therapists provides some helpful answers. The big takeaway? Exercise matters and progressive exercise should be a key part of recovery after knee replacement. You don’t have to “baby” your new knee After surgery, it’s normal to have pain, swelling, stiffness, and weakness. But that doesn’t mean you should avoid using your leg. The new guidelines strongly recommend starting a progressive strengthening and exercise program early in recovery. Research shows that exercise can improve: ● Leg strength ● Knee range of motion ● Walking speed ● Balance ● Everyday activities and overall function And progressive exercise doesn’t mean pushing through severe pain. Your Physical Therapist can gradually increase the challenge based on how your knee responds. Interestingly, research found benefits from many different types of strengthening, including resistance bands, machines and exercises that work the muscles as they lengthen and shorten. Both lower- and higher-intensity programs can be effective when appropriately prescribed. More isn’t always better One important point from the research is that progression needs to be individualized. Your therapist should consider things like pain, swelling, soreness, range of motion, and how you’re functioning when deciding when and how much to progress your exercises. Trying to advance too quickly can actually increase pain and swelling and potentially slow your recovery. The goal isn’t to see how much you can tolerate. The goal is to give your body the right amount of challenge to keep getting stronger. Recovery is about more than strength Another strong recommendation from the guidelines is motor function training. In everyday language, this means practicing how to actually use your new knee. That can include: ● Balance exercises ● Sit-to-stand practice ● Stair training ● Walking and gait training ● Changing directions ● Practicing movements that are important to your daily life This is an important distinction. Being stronger doesn’t automatically mean you’ll feel confident getting out of a chair, walking through a grocery store, or going up and down stairs. Your rehabilitation should help you build strength AND teach you how to use that strength. What does this mean for you? Whether you’re a few weeks or several months out from a knee replacement, your rehabilitation should be based on where you are now and what you want to get back to doing. There isn’t one perfect exercise program for everyone. The research supports a variety of approaches, which means your physical therapist can tailor your program to your goals, abilities, and response to exercise. As a Physical Therapist, this is one of the reasons I focus on more than simply treating pain. We want to build capacity, improve how you move, and help you get back to the activities that matter to you. A knee replacement is the beginning of your recovery—not the end of it. The right rehabilitation can help you make the most of your new knee. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Allyn M Bove, Lindsay A Carroll, Sean Cone, Pamela Dibblee, Craig P Hensley, Kimberly Lenington, Paul A Manner, David A Scalzitti, James Tompkins, Michael J Bade, Clinical practice guideline for physical therapist management of total knee arthroplasty: revision 2026, Physical Therapy, Volume 106, Issue 7, July 2026.

Spring is here which means more sun and more time outside! I love when the temps warm up and I can get back to hiking the trails at Percy Warner Park or going for walks in the neighborhood. While I am always in support of increased activity, more time on your feet can put added stress on your plantar fascia. The plantar fascia is a thick band of connective tissue that stabilizes the arch of the foot. Repetitive stress to this area can cause pain in the inside heel that can extend into the arch. To maintain healthy plantar fascia you need mobility in the ankle, calf muscle flexibility and adequate strength. The video below shows 2 exercises that address all three! Heel raise with toes on folded towel, 3 x 12 reps Dynamic calf stretch alternating between knee straight and knee bent, 30 sec x 2 reps each side Add these in before a hike or walk so that you can stay active and pain free. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT

After a tough workout, what’s the best way to recover? Should you stretch, ice, get a massage or simply rest? A large systematic review published in Frontiers in Physiology analyzed nearly 100 studies to determine which recovery techniques actually reduce muscle soreness, fatigue, inflammation and muscle damage. What the Research Found The clear winner was massage. Massage was the most effective recovery technique for reducing muscle soreness and fatigue after exercise. It also helped decrease inflammation, making it one of the best-supported recovery strategies available. Other techniques, such as compression garments, cold water immersion (ice baths), and light active recovery (like an easy walk or bike ride), also showed benefits. Interestingly, stretching after exercise did not significantly reduce next-day muscle soreness. Massage vs. Soft Tissue Work The studies in this review focused on massage, which generally involves hands-on pressure to muscles and other soft tissues to promote recovery. In Physical Therapy, I use soft tissue techniques, which include massage but also more targeted treatments such as myofascial release, trigger point work and instrument-assisted soft tissue mobilization. The goal isn’t just to help you feel better temporarily—it’s to improve tissue mobility, reduce pain and help you move more efficiently. What This Means for You As a Physical Therapist, I use soft tissue techniques to help reduce pain and get you back to doing what you love. Just as importantly, I teach my patients how to perform self-massage and other recovery techniques at home. You don’t need to rely on clinic visits alone—having the right tools and knowing when to use them can help you recover more effectively between workouts. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Dupuy O, Douzi W, Theurot D, Bosquet L, Dugué B. An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis. Front Physiol. 2018 Apr 26;9:403.

As a Physical Therapist, I get asked about kinesio tape all the time. You’ve probably seen the colorful tape on athletes, runners, CrossFitters or maybe even walking around Target. But what does the research actually say? Before becoming a PT, I worked in sports medicine as an Athletic Trainer at the University of Wisconsin-Madison. We used tape constantly — ankles, shoulders, knees, anything that needed support before practice or games. Athletes loved it, coaches expected it and honestly sometimes it felt like half the athletic training room was held together with tape. A new large review published in BMJ Evidence-Based Medicine looked at 128 systematic reviews involving over 15,000 participants with musculoskeletal pain and injuries. The results were interesting. Kinesio tape may help decrease pain and improve movement in the short term — especially right after it’s applied or over the next few days. But the research found little evidence that it creates meaningful long-term improvements in pain, strength or function. So does that mean kinesio tape is useless? Not necessarily. Tape can still be helpful as a temporary tool. Sometimes reducing pain even a little allows people to move better, exercise more confidently and stay active during recovery. It may also improve body awareness and provide a sense of support. But tape alone does not fix the underlying problem. This is an important reminder that there is rarely one “magic” treatment in rehab. Long-term results usually come from the basics done consistently: strength training, mobility work, sleep, stress management, recovery and a personalized treatment plan. And yes… sometimes the colorful tape still makes people feel more athletic. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Mo Q, Deng Z, Zheng J, et al. Effectiveness and clinical relevance of kinesio taping in musculoskeletal disorders: an overview of systematic reviews and evidence mapping. BMJ Evidence-Based Medicine. 2026.

If you’ve been told you have a “large” disc herniation in your neck, it sounds alarming—but size isn’t everything. A recent study found that the size of a cervical disc herniation does NOT strongly relate to pain, disability or symptoms in people with cervical radiculopathy. In other words: Bigger doesn’t mean worse. Your symptoms are influenced more by nerve sensitivity, inflammation and movement—not just what shows up on an MRI. Takeaway: Don’t let imaging define your recovery. We treat people, not pictures. If you’re dealing with neck or arm pain, there are ways to improve how you feel and function—and I’m here to help. Lauren DeYoe Doctor of Physical Therapy Reiki Master Owner Reiki PT Gül A, Yang X, Goedmakers CMW, Vleggeert-Lankamp C. Does the Size of Cervical Disc Herniation Affect Clinical Parameters in Cervical Radiculopathy? J Clin Med. 2025 Dec 16;14(24):8900.

When you live with chronic pain, negative thoughts can show up quickly and often. Thoughts like “This is never going to get better” or “My body is broken” are common—and completely human. But research shows that when negative thinking becomes repetitive, it can affect more than just your mood.   A 2025 study published in BMC Psychiatry  found that repetitive negative thinking was linked to faster cognitive decline in older adults. People who tended to dwell on worries or replay negative thoughts performed worse on memory and thinking tests. Another study published in Alzheimer’s & Dementia  found that ongoing negative thinking was associated with higher levels of amyloid and tau—proteins in the brain connected to Alzheimer’s disease—as well as greater cognitive decline over time.   In simple terms: repeatedly thinking negative thoughts may affect how the brain functions and ages. Now think about chronic pain. When pain lasts for months or years, your brain shifts into protection mode. It scans for danger. It expects the worst. Repetitive thoughts like:   “My pain will always control my life.”   can increase stress, muscle tension, fear of movement and pain sensitivity. Over time, this can keep the nervous system on high alert.   Let’s try a shift:   “My pain has been persistent, but my body is adaptable. With the right plan, I can improve.”   This doesn’t ignore the pain. It simply creates space for possibility and progress. Chronic pain is real. Your frustration is valid. But learning to gently change repetitive negative thoughts can calm the nervous system and support both pain and brain health. If you need help navigating chronic pain, I am here to help. Lauren DeYoe   Doctor of Physical Therapy Reiki Master Owner Reiki PT   Ye, N., Peng, L., Deng, B. et al. Repetitive negative thinking is associated with cognitive function decline in older adults: a cross-sectional study. BMC Psychiatry 25, 562 (2025). Marchant NL, Lovland LR, Jones R, Pichet Binette A, Gonneaud J, Arenaza-Urquijo EM, Chételat G, Villeneuve S; PREVENT-AD Research Group. Repetitive negative thinking is associated with amyloid, tau, and cognitive decline. Alzheimers Dement. 2020 Jul;16(7):1054-1064.

Dry needling is a Western, biomedical technique used primarily in musculoskeletal rehabilitation. It focuses on inserting thin, sterile needles directly into myofascial trigger points — tight, hyperirritable bands of muscle that contribute to pain and limited movement. The goal is to improve muscle function, reduce local pain and enhance blood flow. This practice has become common in Physical Therapy and Sports Medicine settings.     Acupuncture comes from Traditional Chinese Medicine (TCM), where needles are placed along specific pathways (meridians) to restore balance within the body’s energy system (Qi). Modern acupuncture is used for pain relief but also for broader wellness purposes — stress reduction, overall balance and holistic care.     Key Distinction:  the purpose and framework differ — dry needling is rooted in Western anatomy and neuromuscular science, whereas acupuncture is based on TCM and systemic theories of balance. Both use similar thin filiform needles, but their point selection and goals vary.     What Each Treats Dry Needling: Primarily targets muscle tightness, trigger points and movement restrictions. It’s often part of a larger rehab plan that includes exercises and manual therapy.     Acupuncture: Used for pain and a wide range of health concerns, including stress, headaches, digestive issues, sleep disturbances and more. The point selection is holistic rather than localized to a specific muscle trigger.     Both modalities can be effective for pain and sometimes each crosses into the other’s territory — for example, some acupuncturists also target trigger points within their broader treatment.     The T.J. Watt Incident: What Happened? Recently, Pittsburgh Steelers linebacker T.J. Watt suffered a partially collapsed lung (pneumothorax) following a dry needling session at the team’s facility. Reports state he later underwent surgery to stabilize the lung and was released from the hospital. The incident brought public attention to the rare but serious risk of pneumothorax associated with needling near the chest or upper back. Experts emphasize this type of complication is rare relative to the volume of treatments performed each year, but it does underscore the importance of precise anatomical knowledge and training for needling in high-risk areas.     Key Takeaways • Dry needling and acupuncture are distinct therapies with different philosophies and typical uses, even though the tools (thin needles) look similar. • Both can be useful adjuncts in pain management when performed by properly trained professionals. • Serious risks like pneumothorax are very rare, but they are real — especially when needling near the lungs — and highlight the importance of training and anatomical expertise. • Transparency about who is performing the technique and their credentials matters — especially for advanced needling near sensitive areas. Lauren DeYoe   Doctor of Physical Therapy Reiki Master Owner Reiki PT

If you’ve been living with chronic low back pain, you’ve probably learned to move carefully. You think twice before bending, brace your core without realizing it and constantly scan for warning signs. During a busy, end-of-year season filled with travel, gatherings and long days, that constant vigilance can feel even heavier. That’s not weakness — it’s a nervous system trying to protect you.   Recent research looking at Cognitive Functional Therapy found something surprising. People didn’t improve because their spine was “fixed.” They improved because their body stopped feeling under constant threat.   As pain eased, people became less afraid to move. They weren’t holding their breath, clenching their muscles or moving with constant caution. Their nervous system finally got the message that it was safe to stand, bend, walk and live again.   This approach focuses on changing how pain is understood, how the body moves and how stress and emotions feed into pain — not by ignoring symptoms or pushing through them, but by restoring a sense of safety and trust in the body.   That’s also the foundation of my Mindfulness for Chronic Pain  course. We explore why pain sticks around, identify habits and thoughts that amplify it and gently retrain the nervous system to calm down. We focus on pacing daily life, rebuilding confidence in movement and breaking the cycle of fear and flare-ups — without forcing anything. The goal isn’t to eliminate every sensation or pretend pain doesn’t exist. It’s to stop letting pain run your life. When the nervous system feels safer, pain often becomes quieter and movement more natural.   As the year comes to a close, this can be a powerful time to choose a different relationship with your pain — one that supports you moving into the new year with more ease and confidence.   You don’t need a perfect back. You need a body that feels safe enough to move. Lauren DeYoe   Doctor of Physical Therapy Reiki Master Owner Reiki PT O’Keeffe M, O’Sullivan K, Purtill H, et al. Mechanisms of change in cognitive functional therapy: A longitudinal mediation analysis of the RESTORE clinical trial for disabling chronic low back pain. Pain. 2024.

There’s no shortage of health advice out there—some helpful, some confusing and some that sticks around even when research says otherwise. This month, I’m breaking down four common myths I hear and what the evidence actually shows.   Myth #1: “Pregnant women should avoid lifting weights.”   For years, resistance training during pregnancy was discouraged due to fears about safety. But current research paints a very different picture. A 2024 review by Duchette and colleagues looked at the benefits of strength training during pregnancy and found that it supports both maternal and fetal health. Safe, appropriately guided resistance exercise can help improve cardiovascular fitness, reduce the risk of excessive weight gain, support blood-sugar regulation and lessen back and pelvic pain. The researchers also noted no link between properly supervised strength training and poor pregnancy outcomes. In fact, continuing or beginning a moderate resistance program can make labor, delivery and postpartum recovery smoother.   Bottom line: With professional guidance, resistance training is not only safe—it’s often beneficial. Myth #2: “If you have back pain, you need imaging.”   Many people believe that X-rays or MRIs are necessary anytime back pain shows up. However, most cases of low back pain are uncomplicated, meaning they are not caused by dangerous or structural conditions. A BMJ article by Hall and colleagues stresses that routine imaging often does more harm than good. Imaging rarely changes treatment plans, can lead to unnecessary worry when normal age-related changes are seen and may trigger unnecessary procedures. In most cases, the best first approach includes movement, exercise, activity modification and reassurance—not imaging.   Bottom line: Unless there are red flags (such as trauma, major neurological changes or systemic illness), imaging isn’t needed.   Myth #3: “Custom orthotics are always better than prefabricated ones.”   It’s easy to assume that custom equals better, but evidence doesn’t always support that. A 2019 review from the Canadian Agency for Drugs and Technologies in Health compared custom orthotics to prefabricated ones for foot pain and function. Their analysis found little to no meaningful difference in clinical outcomes between the two and custom orthotics were significantly more expensive. For many patients, high-quality prefabricated inserts can provide just as much benefit at a fraction of the cost.   Bottom line: Custom orthotics are sometimes helpful, but they are not automatically superior.   Myth #4: “Mindfulness is just sitting quietly and meditating.”   Mindfulness is much more than meditation. It’s an evidence-based approach that helps people change how they relate to stress, pain and difficult emotions. Mindfulness includes noticing sensations in the body, shifting automatic thought patterns, practicing pacing, improving emotional regulation and becoming more present in daily activities. This is why it’s a powerful tool in chronic pain management: it helps people reduce fear, build awareness and respond to their symptoms with more control instead of avoidance.   Bottom line: Mindfulness is not about emptying your mind—it’s about training your attention and your nervous system.   If you ever have questions about how research applies to your specific situation, I’m always here to help you sort through the noise. Let’s keep building a community where evidence and empowerment guide each decision. Lauren DeYoe   Doctor of Physical Therapy Reiki Master Owner Reiki PT Duchette C, Perera M, Arnett S, White E, Belcher E, Tinius R. Benefits of Resistance Training During Pregnancy for Maternal and Fetal Health: A Brief Overview. Int J Womens Health. 2024 Jun 19;16:1137-1147. Hall AM, Aubrey-Bassler K, Thorne B, Maher CG. Do not routinely offer imaging for uncomplicated low back pain. BMJ. 2021 Feb 12;372:n291 Tran K, Spry C. Custom-Made Foot Orthoses versus Prefabricated foot Orthoses: A Review of Clinical Effectiveness and Cost-Effectiveness [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Sep 23.

As Halloween approaches and the chill starts to creep in, let’s talk about another kind of freezing — one that happens inside your shoulder. Frozen shoulder, also known as adhesive capsulitis, is a condition where the shoulder becomes painful and gradually loses its range of motion. According to a 2022 review by Millar and colleagues in Nature Reviews Disease Primers, it affects about 2–5% of adults, most commonly between the ages of 40 and 60. Women are slightly more likely to develop it and people with diabetes or thyroid disorders are at higher risk. It can also appear after an injury or period when the shoulder isn’t being moved much — for example, following surgery or wearing a sling.   Inside the joint, the problem starts with inflammation of the capsule — the soft tissue that surrounds the shoulder. Over time, this tissue thickens and tightens, forming scar-like bands that limit movement. The process involves special cells called fibroblasts turning into myofibroblasts which contract and make the capsule even stiffer. Nerves and small blood vessels also grow into the area, contributing to pain and sensitivity. In simple terms, the shoulder’s “soft jacket” becomes too tight, restricting motion and causing discomfort.   Frozen shoulder usually unfolds in three phases. The first, known as the “freezing” phase, is marked by gradually increasing pain, often worse at night, along with a slow loss of movement. The second, or “frozen” phase, is when stiffness dominates — the pain may ease slightly, but reaching overhead, behind your back, or even getting dressed can be tough. Finally comes the “thawing” phase, when the shoulder slowly regains motion. The entire process can take many months or even a few years, though most people do improve over time.   Diagnosis is based mostly on a physical exam. Your healthcare provider checks both your active motion (how far you can move your arm yourself) and passive motion (how far it can be moved for you). Imaging like X-rays or MRI isn’t used to confirm frozen shoulder but to rule out other issues like arthritis or a rotator cuff tear.   Treatment focuses on managing pain and maintaining movement while the shoulder goes through its natural recovery process. Gentle stretching and physical therapy are key to preventing further stiffness. Anti-inflammatory medications or corticosteroid injections may help in the early stages, and a procedure called hydrodilatation — where fluid is injected into the joint to stretch it — can offer some relief. In more severe or stubborn cases, options such as manipulation under anesthesia or arthroscopic capsular release (a minimally invasive surgery to loosen the capsule) may be considered.   Although frozen shoulder can be frustratingly slow to heal, the good news is that most people eventually regain functional motion. Think of it as your shoulder getting “stuck in the ice” — with the right care, time and gentle movement, it will thaw. This Halloween, as you look at the snow-covered skeleton in the image above, remember that while creaky joints can feel spooky, they often just need warmth, patience and mindful motion to come back to life. Lauren DeYoe   Doctor of Physical Therapy Reiki Master Owner Reiki PT