The 21 Day Challenge

I have written before in previous blogs about how I am always experimenting on myself to test out the safety of products before we recommend them to patients. The latest test lasted 21 days and was extremely beneficial for my waist line. I dropped six pounds and lost four inches of unwanted belly fat on our new healthy lifestyle system now offered at FYZICAL - Naperville.

The 21 Day Challenge is a program through Transitional Life Systems (TLS), which is a part of our advanced science-based nutraceuticals called nutraMetrix. We have been utilizing these products with great success for almost three years. I went into the program with a friend of mine who was looking to improve her health. She lost 13 pounds and is looking forward to many more on her transition to the Rapid Results program (one of the five program choices available). It was very helpful to go through this with a partner, as we were able to text little comments back and forth or share recipes during the three weeks that we found to be helpful.

TLS is a weight management system that has been in place since 2005 and has scientific studies to back up the results. It focuses on promoting healthy lifestyles and training individuals that increasing one's metabolism helps reform the body to lose fat and to increase muscle. The system itself is predicated on four factors:

  1. Low glycemic impact eating
  2. Exercise - moving one's body
  3. Supplementation as needed
  4. Education (which is available either in book form, in person, or on-line).

The idea of using the low glycemic index was popularized by the late Dr. Shari Lieberman, who had a PhD degree in Clinical Nutrition and Exercise Physiology. She was instrumental for importing the glycemic index from Australia to the United States. She was a nationally recognized expert in the nutrition field, was featured on many TV shows and was a spokesperson for employing the index as a method of assisting people is achieving a healthy lifestyle. Dr. Lieberman was the individual that helped establish the TLS System.

There are several things that I appreciate about the TLS Weight Management System. What I really liked about the program is that you eat your own food and a lot of it, so I was never hungry and gained energy from the added nutrients I was putting in my body. I never had to count calories or points; just monitor my servings. It is a completely customizable system that is geared towards the motivation and the needs of the individual client. A prospective client can take a Weight Loss Profile either at our office (in paper form) or on-line. Based on the responses on this form, the system will suggest several different alternative lifestyle programs.

A great resource provided by nutraMetrix to assist with the process is a free website that can be found at

The Products

The 21 Day Challenge Kit can be ordered on-line and is delivered right to your door with no shipping charges. The kit costs $149.95 and contains the following:

  1. A Challenge Guide that explains how to implement the program
  2. A 30 serving supply each of "Isotonix" products (a daily multi-vitamin and a product known as OPC 3, which is an antioxidant and anti-inflammatory supplement)
  3. A 30 day supply of CORE, a specific TLS product that helps with body reformation, reducing cravings and is a carb and fat inhibitor
  4. The NutriClean seven day detoxification and cleansing system
  5. Two canisters of nutrition protein shakes which are in powder form, one chocolate and one vanilla, that assist the client with weight loss or body reformation. (I have never been big on drinking protein shakes but I have to say these were both quite tasty and really helped reduce the stomach growls that usually start with me around 10:00 and 3:00. I have since kept up the habit of one shake a day and have mixed it into other smoothies and recipes.)

One other additional product I recommend my clients order is a printed spiral bound manual entitled "Create Your Own Success, TLS Health Guide and Journal", which costs $24.95. Research shows that any weight loss program is more successful when you document throughout the day what you are eating. This journal provides spaces for this as well as areas to log completed exercises and questions. It provides 12 chapters of reading materials that teach you how to read labels, handle stress, improve metabolism and many other lifestyle skills that will help you become a healthier version of yourself in 12 weeks. I have really enjoyed logging things every day and I am quite surprised when often I cannot come up with something to write in the space that says "One thing that I did for myself today". Walking the dog and going to a child's game does not count.

Sadly, like most working moms, we are often the last ones to take time out to do something relaxing for ourselves. I have slowly tried to incorporate baths into my routine, thanks to another great product I am now a believer in and one that we carry at the clinic called Medicine Springs Mineral Therapy. See for details.

There is a host of on-line TLS recipes found on Pinterest boards and Facebook pages which have almost 24,000 followers. These were fantastic resources for me as I was trying many different ways to prepare vegetables. Another great help came in the form of a local chef who owns her own catering business. She is Chef Christy and has a fantastic website called I ordered several soups and salads from her at the beginning of my detox week which helped keep me in line over the week and they were all delicious. She has since come up with a menu for anyone going through the 21 Day Challenge with approved foods made into delicious soups, salads or smoothies at a very reasonable price.

My Client's Success Story

I have been gathering the success stories of 12 clients participating in the Challenge right now. One of the first participants sent me a nice comment after his Challenge was over that I would like to share. He has lost over 25 pounds in 21 days and more importantly started running for the first time in years. He states, "I decided to go for a run today. First time jogging in several years, It was awesome, I wasn't sore. I didn't feel my gut busting through my own skin and had none of that bleeding throat sensation I usually have after a long hiatus from running. I literally just ran along feeling pretty darn good. Simply amazing. I hope that others can experience what I have experienced. It feels awesome and after several frustrating attempts to get in shape on my own, I am psyched this actually worked. I have literally worked my ass off for 6 months before and while I got stronger, I lost no weight and still had a lot of extra fat. Now that I have slimmed down I am going to start working out a little more intensely and see what happens. Some people from work didn't recognize me when they saw me at a social function this past Saturday."

Client testimonial

Although, I don't like sharing photos of myself, for the sake of this blog and to show "before" and "after" photos, I am. Thanks to my daughter's photography skills and creative app you are able to view a nice collage of my results.

Thanks also to Sid and Deb DeLair who have been instrumental in educating me about the nutraMetrix products and the TLS system. If you are interested in filling out a weight loss profile to see if TLS is the right system for you, drop me a line at You can also read more about the products in the 21 Day Challenge and the research behind it by clicking on this link

Note: If any of the links do not take you to the specific website please copy and paste in to your browser.

Love Your Life (LYL) - Mary

Float Your Pain Away

At FYZICAL Therapy & Balance Centers - Naperville, we have a fantastic group that meets the second Saturday of every month to learn about new tools and techniques that may help with battling chronic pain. I am always investigating new research based treatments that may benefit my patients and looking for practitioners outside of my practice to speak at our Chronic Pain Forum. That is what lead me to the Anicca (pronounced a-nee-cha) Float Club in May of this year.

The day I walked into the center was the day after the owners, Lindsay and Paul, signed on to be a part of a research study dealing with Fibromyalgia patients and floating. Since a large percentage of my physical therapy patients have Fibromyalgia, I was excited to hear what they had to say. I was so impressed with the tour that I signed up for a float the following week. I was not planning on entering the baths loaded with 1,000 lbs of Epsom salt, however, I realized that it would be hard to convince my patients to try a new treatment, which by some may be considered "alternative", if I had not tried it myself.

I made the appointment for the Friday of Memorial Day weekend, after a long, exhausting week of working on patients. I use an array of manual therapy techniques and although I don't have any musculoskeletal disorders, I do feel some muscle tightness and fatigue by the end of the week. So, I was quite interested to see if I would feel any different following an hour of sensory deprivation.

After signing off on the necessary paperwork and receiving a thorough orientation from the delightful Lindsay, I stepped into my own private wave room to begin my hour vacation, as it’s described on their website ( I molded the provided plugs snugly into my ears, took a tepid shower and stepped into the large (6ft x 5ft x 8ft) private pool with about a foot of 94 degree water loaded with the therapeutic magnesium salts. Immediately, I was so surprised how easy it was to float without any effort. In less than a minute the lights went out and I closed my eyes tightly, a little embarrassed to admit now, but I was scared for a few seconds. I missed the part of her instructions that told of the underwater switch which would provide a soft blue light should I not appreciate the total darkness.

I tried to settle my over active brain and relax. However, I couldn't. My mind kept wandering and I told myself I had to stop doing crazy things like this for my patients. After a few minutes, I really wanted to get out, "What time is it?", "How much longer do I have to be in here", "Is that water I feel in my ears", "Why can't I hear my heartbeat like I read I may”. All of these crazy thoughts kept invading my mind and I thought "I will never do this again". Well, I was wrong. Somewhere within that last half hour, I slipped into some type of meditative state. I know I wasn’t sleeping, but I am not really sure where my brain was, maybe the “theta state” the brain gets to when you are able to get into a deep meditation. The soft lights began to turn on and I stepped back into the warm shower to remove all of the salt. I felt surprisingly relaxed. All of the muscle tension had melted away and I re-entered the lobby to enjoy a cup of tea and share my experience with Lindsay.

She said everyone's experience is completely different. Some have visions, some sleep and some have incredible creative thoughts solving difficult personal struggles in the process. Although mine started out uncomfortable, I felt good enough to buy a new floater 3 pack and give it another try.

Soon, I was back with my husband, Gary. For over 20 years he has been a guinea pig for many of my new techniques. This time I baited him with the promise of a naked date night. Unfortunately for him, we were naked in separate rooms. Sidebar - disposable swimsuits are available for purchase on-line if you choose not to use your birthday suit. Gary had none of the reservations I had prior to my float, as he grew up around the water and floating was nothing new to him. He felt the most important tip was to find a comfortable place for your arms. Four positions were offered and when he finally raised his arms above his head and arched his back, he was out. The next thing he remembered was the lights were going on. The pain he felt in his neck and shoulders was gone and he slept better than usual that night. That may have been from all of the Magnesium in the water.

My second float was easier to settle into with the help of a small pool noodle that I used under my neck although I didn't get to the same "theta" state I had on my first float. This time my mind was concentrating on ways to get the word out to the community on floating and promote their business. Gary later playfully reprimanded me that I should be thinking about ways to promote our business!!

I then began bringing groups of patients and friends to float. One patient with significant soft tissue restrictions from a double mastectomy and plantar fasciitis enjoyed her first float so much she brought her 13 year old son back the next trip. I had no idea she had a deathly fear of water and claustrophobia, as she told me afterwards. She didn’t want her fears to interrupt the healing plan I had for her. I was shocked that she was able to do it with those extreme fears and truly found benefits from floating.

One word of caution would be for those that may have difficulty rising from a low position without help. I did have one 68 year old Fibromyalgia patient who had a total hip replacement several years prior who found it extremely difficult to get up after floating. I should have had her practice turning on all fours and try pushing up from there with the help of the grab bar. She is back in the clinic now working on her core and leg strength.

In summary, I am a fan of floating. I would do it every week if I had the time. I feel just as good as I do after an hour massage and the benefits for me last longer, plus it is not as expensive as a massage. I do sleep better, according to my Fitbit, on nights that I float. Lindsay gave me a great tip prior to my last float when she said, "When you try a new sport or activity you are not good at it right away, it takes practice, so don’t try so hard." I gave myself permission to be bad at meditating the last time and it worked, I had the most enjoyable float yet.

If you are interested in finding out more about how floating can help reduce pain, please plan on attending our next Chronic Pain Forum at Anicca Float Club on Saturday, September 12th at 10:00 AM. Register by calling (630) 369-1015 or by emailing

Illinois Physical Therapy Association Clinical Educator of the Year for 2015 – Ben Grotenhuis

Last month, Ben Grotenhuis celebrated his 20th year at our clinic. Staying at one job is not something that happens very frequently in today’s crazy healthcare industry, but we are thrilled Ben has stayed at Fyzical. In April, Ben also was honored by the Illinois Physical Therapy Association for Clinical Educator of the Year, earning a tremendous award that is only given to one PT in the state. I was excited to be at the breakfast where he was presented with the award and was able to listen in on the excellent presentation he gave immediately following to physical therapists and students interested in learning about dry needling.

  • Day 2_-32
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  • Day 2_-42

When I opened our practice in 1994 and was ready to hire a physical therapist a few months later, there was only one person I called, Ben. Since that time, I have watched him develop into a leader in the field and become a phenomenal clinical educator. He truly takes each student under his wing and provides them with the utmost attention. He has mentored countless PT students, PTA students, volunteers and even PT’s who have taken time off of their jobs to shadow Ben and learn from the best. We are so lucky Ben chose Illinois as his destination over 25 years ago when he came from Holland to pursue his career in physical therapy, as jobs were scarce in the Netherlands.

This is not the first honor humble Ben has been given. In 2007, he was given the Hallvard Award by the Ola Grimsby Institute. This is the highest honorary award given at the school where Ben has taught for over 20 years. This award has been given to some of the world’s more renowned scientists and clinicians. The founder of this institute, Mr. Grimsby, had this to say about Ben, "His profound knowledge, his extensive teaching experience, his professional services in private and public activities and his clinical expertise make Ben Grotenhuis a unique physical therapist and an asset to our profession."

His co-worker, Dr. Bill Block summed it up best, "Ben is a caring practitioner. He is a dedicated and passionate teacher. He is devoted to learning and keeping up to date with evidenced-based practice. He is an innovator. He leads by example and for that we are all better practitioners. He goes above and beyond what is expected of him to provide the highest quality of care for patients, students and co-workers. Ben is a one-of-a-kind clinician and educator in the field of physical therapy."

In my large extended family there is a Ben fan club. I make it a point of not working on relatives because there are so many of them. When in need of rehabilitation I direct them to see Ben even if several of them drive for over an hour to seek his services. When surgery was recommended to several relatives after failed attempts at therapy (elsewhere), I urged them to see Ben before seeking the scalpel and he was able to prevent a few needless surgeries from happening. Here is what one patient, who is not a family member, had to say about Ben, “Ben is always very kind, compassionate and sensitive to my pain and limitations. The patience, unending support and encouragement he continually provides is beyond words. I have worked with several therapists over time and Ben is the only therapist who has been able to reduce my pain. He uses a variety of techniques in therapy, including dry needling and fascial manipulation. He personally supervises my exercises at the clinic and closely monitors my home exercise program. Consequently, I have been able to manage my pain more effectively, increase my functionality and remain independent."

I have been fortunate to work side by side with Ben since my first year out of PT school. He continues to inspire me to be a better therapist and inspires countless others through his magical touch and his kind heart. Thank you, Ben, for all that you do to make the world a little more pleasant for the many patients that you treat and the therapists that you teach. Mary

Fascial Manipulation

Fascial manipulation© (FM) is a manual therapy method specifically designed to address restrictions and densifications of the deep fascia tissue that surrounds and interconnects muscles, tendons, bones, nerves, blood vessels and internal organs throughout the body. Restrictions in the gliding and sliding ability of separate facial layers of connective tissue due to overuse, trauma or immobilization contribute to densifications. This means that the dysfunctional tissue at specific points within the human body feels denser when felt and it has also been shown to have increased thickness on ultrasound imaging (Stecco et al. 2014; Luomala T, et al. 2014). These densifications often change the direction of the way muscles and tendons pull. The mechanics of the joints are then compromised causing acute and chronic pain and further injury of the musculoskeletal system.


Tibialis anterior muscle and crural fascia. Stecco C et al. Surg Radiol Anat (2014) 36:25–32

What Is Fascia and What Is Its Function?

Fascia is a structure of connective tissue that surrounds and interconnects muscles, groups of muscles, bones, nerves and internal organs. Fascia is also part of the nervous system. It has many nerve endings and receptors, making it very suitable to detect variations in tissue tension caused by any movement in the human body. It perceives these movements through adaptations in fascial tension and it also assists in the execution of movement patterns.

Fascia provides a gliding and sliding environment for muscles. Any disturbance in the gliding and sliding ability of fascia could alter movement patterns and result in an abnormal transmission of forces in muscles. This can lead to compensatory movement patterns which over time, can contribute to pain and dysfunction and further injury in any part of the human body. Langevin et al. (2009 and 2011) found a 25% increase in fascial thickness in the lumbar region in a group of chronic low back pain patients compared with those without low back pain by using ultrasound imaging. In a follow up study in 2011 Langevin et al. showed that the fascia shear strain in the lumbar spine was 20% lower in subjects with chronic low back pain affecting connective tissue function. Using similar diagnostic imaging, Stecco et al. (2014) also showed an increase in fascial thickness in the muscles covering the front part of the neck in patients with chronic neck pain compared to a control group.


  1. Scalenus medius muscle in control subject. (Arrow is fascia)
  2. Scalenus medius muscle in patient with chronic neck pain. (Arrow is fascia)
  3. Stecco A et al. Surg Radiol Anat (2014) 36:243-253

How Does Fascial Manipulation Work?

Due to (old or more recent) trauma or inflammation, fascia may shorten and what was previously a pain-free range of motion may become painful, restricted and weak. The ability of fascia to allow for gliding and sliding of tissues now has become compromised and so-called densifications of this dysfunctional fascia tissue can be felt. These points of densifications very often are localized and can be felt in areas away from the localization of pain as experienced by the patient.

Once a limited and/or painful movement in this segment has been identified, then a specific point on the fascia is manipulated. By manipulating this specific fascia point for 2-5 minutes the densification in fascia disappears. An improvement in the ability of the fascia to glide and slide allows for normal movement patterns to be restored and pain is reduced. Clinical experience has shown that multiple points in several muscles throughout the body can be affected and need to be treated.

Clinical studies have shown that freeing fascial alerations in these key areas decreases pain, restores movement and muscle strength in patellar tendinopathy (Pedrelli et al. 2009), subacute whiplash disorders (Picelli et al. 2011), chronic ankle sprains (Stecco et al. 2011) and chronic neck pain (Stecco et al. 2014) with long lasting benefits. Ultrasonic imaging also showed a decrease in the thickness of loose connective tissue of the deep fascia following Fascial Manipulation persisting 6 months after ending treatment (Stecco 2014).

How Does It Feel?

Dysfunctions in movement patterns, suggesting abnormalities in the function of fascia, are assessed through range of motion and strength testing during a physical therapy evaluation. Densifications within the fascia tissue can be felt through specific palpation. These points are unusually tender to the touch with very often an unusual sharp sensation when compared to other parts of your body. Very often these densifications and tender points can be identified away from the site if of pain. Again, they are very often correlated to dysfunctional movement patterns with loss in range of motion and strength accompanied by pain.

Following a whole body assessment, manipulation of the densified fascial tissues through direct contact with the skin lasting for 2-5 minutes will result in a gradual and significant decrease in local tenderness. Movement patterns are then re-checked to see if the movement has improved and pain has decreased. Patients are informed that the areas being treated can be sore and tender for 24 to 48 hours due to what we think is a local inflammatory response. Palpation of the treated areas during subsequent treatment sessions often reveals a marked decrease in local tenderness as these points don’t feel as dense to touch. Movement patterns and strength are often improved as pain and dysfunction subsides.

Fascial Manipulation as Part of Physical Therapy can Produce Relief of:

  • Low Back Pain
  • Neck Pain
  • Hip Pain
  • Knee Pain
  • Shoulder Pain
  • Foot and Ankle Pain
  • TMJ Pain
  • Tension Headaches

Ben Grotenhuis, PT, CMTPT, FAAOMPT

Currently one of only a few clinicians in the state of Illinois that has been trained in the evaluation and treatment of the Stecco Method for Fascial Manipulation.


  1. Stecco, C., et al. (2014). "Investigation of the mechanical properties of the human crural fascia and their possible clinical implications." Surgical and Radiologic Anatomy 36(1): 25-32.
  2. Luomala, T., et al. (2014). "Case study: Could ultrasound and elastography visualized densified areas inside the deep fascia?" J Bodyw Mov Ther 18(3): 462-468.
  3. Langevin, H. M., et al. (2009). "Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain." BMC Musculoskelet Disord 10: 151-151.
  4. Langevin, H. M., et al. (2011). "Reduced thoracolumbar fascia shear strain in human chronic low back pain." BMC Musculoskelet Disord 12: 203.
  5. Stecco A et al. (2011). “RMI study and clinical correlations of ankle retinacula damage and outcomes of ankle sprains.“ Surg Radiol Anat 33(10): 881-90
  6. Stecco, A., et al. (2014). "Ultrasonography in myofascial neck pain: randomized clinical trial for diagnosis and follow-up." Surg Radiol Anat 36(3): 243-253.
  7. Pedrelli, A., et al. (2009). "Treating patellar tendinopathy with Fascial Manipulation." J Bodyw Mov Ther 13(1): 73-80.
  8. Picelli, A., et al. (2011). "Effects of myofascial technique in patients with subacute whiplash associated disorders: a pilot study." Eur J Phys Rehabil Med 47(4): 561-568.

Tips for Better Sleep

Happy February Everyone!

We had a great turnout at our recent Fibromyalgia (FM) Forum. This was the first meeting of a new monthly lecture series that we have started at the request of a client who has FM. Those with FM, and other chronic pain sufferers, can now benefit from this forum which will offer more information about the Who? What? Where? How? and Why? of FM and chronic pain.

The first lecture was FM101. It covered the basics of what Fibromyalgia is, how it is diagnosed and most importantly how it is treated. I presented information on the latest research regarding: diet, sleep, nutritional supplements and exercise. For those interested, I will briefly highlight the important topics in future blogs. If there is interest, I would be happy to do FM101 again. My one hour lecture ran over by 45 minutes, thanks in part to all of the great comments shared by the group. The energy was extremely positive. I am sure future meetings will continue to be informative and time well spent.

Some notes from the meeting:

The most critical factor in getting FM symptoms or any type of chronic pain under control is proper sleep. Many with FM do not get long periods of restful sleep which then does not allow the body time to heal. Thus, many people wake up feeling exhausted, even after being in bed for 9-10 hours. One great piece of advice that was shared by Diane was that a FitBit can track how much "deep" sleep you actually get at night. These devices are also great for tracking calories and exercise.

Here are a few tips to get a better, more restful sleep at night:

  • Exercise 1-2 hours before bed, if you find you are too revved up, scale back to 2-3 hours before bedtime.
  • Be consistent with your night and morning routines. Go to bed and wake up at the same time every day. Catching up on weekly missed sleep on the weekends helps a great deal.
  • Drink 3-4 oz of tart cherry juice before going to bed.
  • Eat a light snack with a little protein before bed, such as, a baked potato or a small piece of chicken with a glass of milk. This will help to release serotonin which assists with sleep.
  • Have a few walnuts, they have melatonin which induces sleep.
  • Take magnesium as a natural sleep aide before graduating to a prescription medication. Magnesium helps promote deeper sleep. (Prime Dreamz from nutraMetrix is one supplement recommended. Pick a bottle up from our office for $23.00.)
  • Massaging your calf muscles before bed helps with a better night’s sleep. Using a heated acuball is one easy way to do it yourself. Go to or stop by the clinic and pick one up for $30.
  • Get a little sunlight every day. It helps regulate your circadian rhythm.
  • Unplug from all electronics one hour before bed and put your phone in another room while charging.
  • Keep lighted clocks turned away from you so your room is completely dark, while maintaining a cooler temperature for sleeping.

If you are doing all of these things and still having sleep issues, it's time to see a sleep doctor. Ask your primary care physician for a recommendation. There are many new technologies to assist with determining what is causing sleep disorders, so do not hesitate to get further help.

Our group will meet the second Saturday of every month at 10:30 AM.

The next meeting is Saturday, February 14th. A great way to start your Valentine’s Day!! The topic is Trigger Point Dry Needling and Fascial Manipulation Treatments presented by Ben Grotenhuis, PT. An on-line support group is also forming and information on how to join will be given at this meeting.

Thomas Aquinas said it best, "Sorrow can be alleviated by good sleep, a bath and a glass of wine."

Private: What is Trigger Point Dry Needling?

Trigger point dry needling (TDN) is an extremely effective technique that uses a very fine mono filament needle to "de-activate" or "shut down" painful and knotted areas in your muscles. Many of us have areas in our body that chronically feel tense, that are painful and feel like a hard ball when being touched. By inserting a thin needle into these contracture knots, we try to elicit a "twitch response" or a brief contraction (lasting less than a second) which causes the muscle to get rid of inflammatory products (such as lactic acid) and allows for a long-lasting relaxation of the muscle. Because the needle can treat very deep parts of the muscle very specifically, the technique can achieve amazing pain relief and improve muscle function.

dry needling NPTBlog

At Fyzical Therapy & Balance Centers of Naperville we use TDN every day to:

  • Provide long-lasting pain relief from head to toe
  • Eliminate muscle tension
  • Help muscles heal after injuries
  • Improve blood flow at a deep level
  • Speed healing and recovery time after injury
  • Improve range of motion and flexibility
  • Stimulate a muscle to work better
  • Prevent future injuries from occurring
  • Get people back to exercise and activities of daily living ASAP

Will TDN Help Me?

Does a massage give you relief but it doesn't last as long as you would like? People who respond well to massage, but are disappointed when the discomfort returns, often find that TDN can offer them a longer-lasting pain relief. TDN works very well for people with acute injuries as well as chronic overuse and sports injuries. We can treat nearly any muscle in the body from head to toe with greater specificity and at greater depths than is possible with other types of body work. TDN can be very effective in treating headaches related to muscle tension. TDN is not appropriate for treating swelling in a muscle as result of an acute injury when bruising is present. A physical therapy evaluation will help to determine if TDN can be indicated for you to help you with your recovery.

Does The Needle Hurt?

Because the needles are very thin and solid, they don't hurt as they pass through the skin like a hollow (much thicker) injection needle does. The sensations people report from the desirable twitch response of the muscle tissue are "deep aching", "electrical", "pressure", "releasing", "blood flow" or "soreness". The procedure is brief and the needle is left in for a short period of time, just long enough to get the muscle to twitch and to relax. TDN can be performed at various trigger points in the same muscle or in multiple muscles during one session, depending on your response. Because we treat sensitive areas that have been tight (sometimes for a long time), there is some discomfort. However, most patients experience that short-term discomfort is well worth tolerating considering the long-term relief TDN provides.

How Many Needles Will I Need?

We will start very slowly during the first session to give you a feel for the technique. The first session will focus on one or a few muscles that are key to your problem. Treating these key areas can give you excellent relief and result in less soreness and an improvement in flexibility. Subsequent sessions can also treat other areas related to your problem. It is not uncommon to find tightness in other muscles due to compensation patterns. Sessions are usually 3-5 days apart and you should feel a marked difference after 1-3 sessions.

How Will I Feel Immediately After TDN?

You will know if a positive change has occurred right after the session, because you can expect to feel some soreness similar to how you would feel after working out your muscles with weight resistance. The muscle will feel fatigued and the soreness can last from a few hours to 1-2 days, but should not interfere with your everyday activities. We encourage you to be active during this time to keep the soreness to a minimum. You can also use some heat or ice to temporarily alleviate the soreness. After a day or so, you will experience a new feeling of less pain and improved flexibility. The chronic injury you thought was here to stay will actually start to improve.

TDN should be performed by a qualified health care professional. Ben Grotenhuis, PT, CMTPT, FAAOMPT has received extensive post-graduate training in TDN. He has been using TDN as part of his daily physical therapy practice since 2010.

FYZICAL is Physical – Spelled Different Because We Are Different


In September, Naperville Physical Therapy will celebrate 20 fantastic years in business.  It truly has been a dream job for me and it got even better when Gary joined me 15 years ago.  Over the years, we have never tried to grow the business too much as we were concentrating our efforts on growing our children.  Well, now that they are at a very manageable age (are teenagers really manageable?) we have decided to take our business in a new direction in hopes that we can grow it, in this ever changing healthcare market, over the next decade.


This summer we spent a considerable amount of time learning about a new P.T. franchise.  We were so impressed with the team of professionals and the opportunities that exist to expand our business that we have teamed up with this group.  Over the next month, we will be transitioning our name to FYZICAL Therapy and Balance Centers – Naperville!!  The name change is a result of a rebranding effort designed to mirror the growth and transformation of our organization. This is no small endeavor but we are excited to share the news and hope that you will spread the word and continue to support our clinic.


Our clients have always been and will remain our number one priority.  We are expanding programs to meet more needs within the community.  One such offering is a state of the art balance, dizziness and fall prevention program.   You will see our facility and equipment improve to directly benefit our clients.  Although our name is changing, we are still the same practitioners who have treated you with care and expertise for over two decades.  We now look forward to serving the community, focusing on health and preventive medicine, in conjunction with the current services we already provide.


If we have not seen you in a while, please reach out and let us know how you are.  We will still be the same “mom and pop shop” you experienced but now we will have “grandparents”.


Thank you and LYL (Love Your Life)!


Mary Rachford, PT

FYZICAL is Physical – Spelled Different Because We Are Different

In September, Naperville Physical Therapy will celebrate 20 fantastic years in business. It truly has been a dream job for me and it got even better when Gary joined me 15 years ago. Over the years, we have never tried to grow the business too much as we were concentrating our efforts on growing our children. Well, now that they are at a very manageable age (are teenagers really manageable?) we have decided to take our business in a new direction in hopes that we can grow it, in this ever changing healthcare market, over the next decade.

This summer we spent a considerable amount of time learning about a new P.T. franchise. We were so impressed with the team of professionals and the opportunities that exist to expand our business that we have teamed up with this group. Over the next month, we will be transitioning our name to FYZICAL Therapy and Balance Centers - Naperville!! The name change is a result of a rebranding effort designed to mirror the growth and transformation of our organization. This is no small endeavor but we are excited to share the news and hope that you will spread the word and continue to support our clinic.

Our clients have always been and will remain our number one priority. We are expanding programs to meet more needs within the community. One such offering is a state of the art balance, dizziness and fall prevention program. You will see our facility and equipment improve to directly benefit our clients. Although our name is changing, we are still the same practitioners who have treated you with care and expertise for over two decades. We now look forward to serving the community, focusing on health and preventive medicine, in conjunction with the current services we already provide.

If we have not seen you in a while, please reach out and let us know how you are. We will still be the same "mom and pop shop" you experienced but now we will have "grandparents".

Thank you and LYL (Love Your Life)!

Mary Rachford, PT

Yardwork Yoga

This past weekend I watched my neighbor kneel in the same position for hours while gardening in her beautiful yard.  She loves to garden and we often laugh about how much I hate it. I did think to myself as I drove by well into the evening and she was still in the same position, “I wonder how her back will feel tomorrow?”

The next day it was my turn to head out to the yard. We really don’t have a garden, just lots of bushes and a few flowers (which I can’t even tell you the names of) – but we sure have plenty of weeds! After a few minutes into it, I thought, “How can I make this more enjoyable because this really is one of my least favorite things to do?” I thought about the position my neighbor was in all day and decided to try a little lunge action to pick the weeds and wow did that feel good, a little stretching and strengthening all at the same time. Next, I got an old blanket and put it under my knees to try pulling the weeds from a child’s pose and, by golly it worked. Soon, I was in a plank position, then threading the needle position and finally resting in a comfortable pigeon position to stretch my buttocks.

As my excitement grew with each new pose I tried, my husband just looked over and laughed, saying “What do you think people driving by are thinking as they see you in these positions.” I could care less, I had just invented a new exercise that I’m sure would sweep the nation.

I ran into the house to get my daughter to come to take pictures of me so I could remember how I was doing this and, of course, blog about it. My son then suggested we try partner Yoga pulling techniques. Why not I thought. Soon enough, my daughter and her friend were getting in poses, actually pulling weeds and they were having a blast doing it. I suddenly had a realization that maybe I could offer classes in my yard and have people pay to learn how to do Yardwork Yoga and get them to pull those dreaded weeds at the same time. A little Tom Sawyer-ish if you recall the painting of the white picket fence.

OK, that probably is never going to happen, but I have to say I wasn’t sore when I finished all of the yard work. I had fun doing it and when my neighbor drove by she did tell me her back was hurting from all of the weeding she did the prior day. You can see from the photos the various poses I tried. Try and incorporate a few poses into your own yard work only if you have experience with Yoga. These poses are not for beginners.

  • Namaste
  • Namaste
  • Warrior 2
    Warrior 2
  • Warrior 3
    Warrior 3
  • Pigeon Pose
    Pigeon Pose
  • Thread the Needle
    Thread the Needle
  • Side Angle Pose
    Side Angle Pose
  • Plank
  • Low Lunge
    Low Lunge
  • Kneeling Plank
    Kneeling Plank
  • Downward Dog
    Downward Dog
  • Child's Pose
    Child’s Pose
  • Chair Pose
    Chair Pose
  • Cat Pose
    Cat Pose
  • Cow Pose
    Cow Pose
  • Bird Dog
    Bird Dog

Why Do We Get Frozen Shoulders?


Frozen shoulder, also called adhesive capsulitis, is often called “idiopathic” which means the cause is not known or it arises spontaneously. I have wondered through my many years as a physical therapist if the cause would ever be found and why it seems to primarily occur in women. At a recent course I attended in St. Louis, the presenter, Dora Partridge, a Texas physical therapist, had some interesting views to the “whys”. She questioned the role of hormones, especially estrogen, in this process.


Research has shown that estrogen is a powerful hormone stimulating the building of new bone, promoting muscle growth and repair, maintaining the integrity of the connective tissue, reducing inflammation and overall facilitating the healing process in addition to its more well know affects (reducing hot flashes, night sweats and vaginal dryness). Though she discussed other underlying conditions that have been connected to frozen shoulder, such as diabetes and thyroid dysfunction, she felt that estrogen levels had been ignored.


Over a four-year period she collected data on 69 female patients diagnosed with frozen shoulder. She requested that they all have their serum estradiol levels tested and found that 59 of the 69 were estrogen deficient. As to date, there are no medical journal reviewed  studies to support the effect of estrogen on frozen shoulders, so not all of the doctors of these patients would agree to prescribe estrogen replacement therapy.


Overall what she found in the estrogen replacement group was –

  • Many women obtained pain relief within 24 hours of initiating estrogen replacement.
  • For most of the women it took 2 weeks of initiating estrogen replacement to see significant improvement in their frozen shoulder symptoms
  • The response time depended on how long they had been estrogen deficient with younger women turning around more rapidly than older women.

Both the estrogen replacement and non-treated group received the same physical therapy but the untreated group progressed much slower with continued inflammation with difficulty gaining muscle mass and overall strength.


Hopefully there will be further research on this subject in the future. In the meantime, it is something to think about.


This information is presented by Barbara Casey, PT.  If you have any questions about a frozen shoulder please contract her at our office number on the right.