What is pain?

What is pain?

Pain is the body’s natural response to any type of injury or harm to the body. For example, if you touch a hot stove, the pain is there to protect your body from a burn. This response is important in our everyday life. We would not be able to make it through our everyday lives without it and avoid painful actions such as holding onto hot pans or stepping onto sharp nails.

How does pain work?

Pain is a normal response to keep your body safe. It works by using the miles and miles of nerves in your body to send signals to your brain. If you step on a nail, your nerves will send a signal to your brain which will pull your foot off of the nail. Your foot will continue to communicate with your brain about the injury and how it hurts. In a “normal” pain response your foot will eventually start feeling better and you will forget that you stepped on the nail.

Why doesn’t my pain go away?

At times, pain response can be altered causing you to experience more pain or be more sensitive to movements or activities that you typically wouldn’t be. This heightened sensitivity to activities can be caused by many different factors such as stress, anxiety, fear, family concerns, and job issues, to name a few.

How do I get better?

Exercise and movement have been shown to help decrease this pain response. An example of this would be the “runners high” that many long distance runners experience during their run that allows them to keep running. While it is not required to exercise at this level to get the pain relief benefits, it is a great example. During your exercise session it is important to find the right balance between avoiding pain and causing pain. This is something that your physical therapist can help you with. As you continue exercising you will see that you are able to do more with less pain.

Written by:
Christopher Stull SPT
3rd Year DPT Student
Des Moines University

Louw, Adriaan. “Teaching People About Pain: Pain Neuroscience Education”. 2016. Presentation.

What is pain?

Cold Weather Running Tips

Running. Runners exercising in winter

Colder weather doesn’t have to mean the end of your running season! Even though the temperatures are dropping, you can continue your fitness routine with a few modifications to avoid injury and stay healthy year-round! Here are some tips and guidelines to follow from our Optimum Stride team.

  1. Avoid running on roads in snowy conditions. When the weather gets worse, it impacts drivers’ ability to maneuver on the roads and can decrease stopping time. It’s recommended to stay off the roads, and run on sidewalks or other designated spaces.
  1. Winter means fewer daylight hours, so make yourself more noticeable to traffic or others around you. Wearing bright colored, reflective clothing or a reflective vest can help you be visible. Another suggestion is a lightweight headlamp or flashing light.
  1. Make sure you wear clothes that will help maintain your core body temperature throughout your run. Layering clothes will help keep you warm during warm-up and cool-down phases, and allow you some flexibility if you get too warm.
  1. Consider wearing traction devices on your shoes in snowy or icy conditions. You’ll be able to grip the sidewalks and trails better, and you’ll be less likely to slip or injure yourself.
  1. If you drive to an area to run on a trail or route, be sure to bring a change of dry clothes to wear on the ride home. You might also consider keeping a blanket in the car for emergency situations.
  1. Stay alert and aware of your surroundings and the weather conditions. Oncoming storms can quickly drop the temperature, putting you at risk for frostbite or hypothermia if you are wearing the wrong clothes or too far out from your end point.
  1. Don’t ignore shivering. It is an important first sign that the body is losing heat, and you may be in danger of hypothermia. End your run as soon as your shivering begins, and go inside to warm up.

For more tips on running or to schedule an appointment with our Optimum Stride therapists, please visit http://www.neorthohospital.com/our-services/physical-therapy/optimum-stride.

Cold Weather Running Tips

What to Expect During Your Therapy Appointment

Put your pain in the hands of a pro

Physical and occupational therapy can be key to helping you recover after an orthopaedic surgery. Nebraska Orthopaedic Hospital offers a full therapy department on campus to help you get back to your daily activities as quickly and safely as possible.

Here are some helpful tips from our therapists to prepare you for rehabilitation after surgery:

Schedule your Appointment:

  • Talk to your physician or surgeon to discuss the best time to start and what type of rehabilitation is best for you.
  • Call to schedule your therapy appointment once you know your surgery date – even if it is a few weeks out, you’ll have one less thing to worry about as you begin your road to recovery.

Getting there:

  • It’s important to arrive about 10 – 15 minutes early to allow enough time for any remaining paperwork. Even with all of the electronic records used today, there are still many pieces of your health history and personal information that must be obtained in person.
  • For follow-up appointments it is also important to arrive a little early.
  • We get it – “life happens” – and when it does it is good to have the clinic’s direct number in your cell phone to call and tell us you are running late. We will do our best to accommodate and make sure you receive the best comprehensive care possible when you arrive.

What to Bring:

  • For first appointments, it’s recommended to bring your driver’s license, insurance cards, prescription for therapy and a list of current medications and medical conditions.
  • T-shirts and loose fitting pants/ shorts are helpful when performing various exercises and to make it easier for the therapist to examine you.
  • Our clinic does have shorts and t-shirts if you happen to forget. (*disclaimer – these are not always stylish!)
  • When the outside temps drop, remember to wear layers.
    • You may be chilly when you arrive – but you will warm up quickly!
  • We do not recommend leaving valuables in your car. Personal items, cell phones, purse, wallet, and keys can all be brought along.
    • Our clinic has lockers for your belongings.

What to Expect:

  • Initial evaluations will typically take an hour, so our team can get to know you, your goals, and how your condition is impacting your quality of life.
    • You can expect a thorough evaluation, looking at body mechanics, strength, posture, functional motion and many other aspects.
    • Based on this evaluation, your therapist will tailor your rehabilitation program to your specific needs and provide education and instruction on what you can do at home.
  • Follow up appointments typically run 30 – 45 minutes.
    • This will be a one-on-one session with your provider who is a licensed physical or occupational therapists or physical therapy assistant.
    • During this time, we will progress exercises or activities, use hands-on techniques and a variety of machines/ modalities that are appropriate to manage your symptoms and speed up the healing process.
  • You play an active role in your therapy, so feel free to ask questions, be honest, and let us know if you have any concerns. We are here to help you take ownership in your recovery process.
  • Our dedicated team of providers is committed to the orthopedic and post-surgical patient population.
    • We each have areas of specialty (much like your physician). We seek out training to treat specific body parts or learn specialized hands-on techniques to ensure we provide the best care possible for your specific injury.
    • We work collaboratively to make sure you have access to the best care from the best providers possible.
      • As your care progresses, we may have you work with a fellow provider to fit your goals.
        • For example: if you want to get back to running or golf, we may have you spend a couple sessions with our running or golf therapists.
      • We all work together to provide you with the best care and get you back to what you love!


  • At Nebraska Orthopaedic Hospital, face-to-face communication between providers is key when it comes to your rehabilitation success after an injury or surgery.
  • We have the privilege of working directly with the physicians at Orthowest.
    • We can stop over to give them personal updates on your progress or discuss any issues that may arise.
    • We work closely with the inpatient rehabilitation team for smooth transitions to the outpatient clinic.

To learn more about our physical and occupational therapy services, please visit www.neorthohospital.com/our-services/physical-therapy.

What to Expect During Your Therapy Appointment

October is Physical Therapy Month!

All month long, we are celebrating our team of Physical Therapists. At Nebraska Orthopaedic Hospital, we’re lucky to have 23 certified Physical Therapists and Physical Therapy Assistants on staff to help our patients get back to their best. From inpatient post-operative therapy to outpatient sports rehabilitation, our team works with patients of all ages and fitness levels.

Our therapists also offer programs to help athletes specialize in their sports, including:

  • Perfect Pitch – consisting of injury prevention, rehabilitation, team education and mechanical analysis, this program is tailored to the demands of softball and baseball athletes. Therapists provide expert instruction and care to reduce the occurrence and re-occurrence of injury and improve overall athletic performance.
  • Optimum Stride – a running program designed specifically with runner’s needs in mind. Whether you have been running for years or are just getting started, our team of professionals will provide you with an expert assessment and treatment of your running related concerns. Our Optimum Stride team also offers monthly screenings at Scheels. Check the website for more details: neorthohospital.com/our-services/physical-therapy.
  • Golf Therapy – we’re proud to have a Titleist-certified golf therapist on our staff. Paul Murray, PT, DPT, OCS, CSCS, offers instruction and technique enhancement advice to golfers to help them play without pain, improve their game and avoid injury.
  • Above the Barre – this program caters to the unique needs of dancers, cheerleaders and gymnasts. Therapists work with the athlete, their physician and teacher to help them get back to performing quickly and safely.
  • Sportsmetrics – these sessions are set up like a workout class rather than a therapy session. The program is designed to educate athletes on proper jumping and cutting mechanics, and to build strength in the knees to prevent injuries and enhance performance.

Outside of the clinic, our therapists participate in many community events and help organizations prepare their athletes for upcoming meets, matches and games. Featured below are some photos from these events!

Eric Smoyer received the Athletic Trainer of the Year award from the Nebraska State Athletic Trainers Association
Some of our therapists participated in the annual FORE SIDS golf tournament. This event helps raise awareness of SIDS.
Ryan Ertz leads youth softball players in their warmup waiting for the Jennie Finch softball clinic to begin.
Paul Murray is a TPI certified golf therapist and works with golfers in our Golf Therapy program.
Our Optimum Stride team makes an appearance at Peak Performance’s running happy hour!

So, whether you’re looking to get back in the game or want to explore non-surgical pain relief for joint problems, our therapists are here to help you! For more information on our programs, or to schedule an appointment, visit www.neorthohospital.com/our-services/physical-therapy.

October is Physical Therapy Month!

What is a scaphoid fracture?


A scaphoid fracture is a break in one of the small bones in your hand and is generally caused by falling on your outstretched hand. Signs of a scaphoid fracture include pain below the base of the thumb.

The wrist is formed by the two bones in your forearm, the radius and the ulna, and eight carpal bones at the base of your hand. The scaphoid bone is on the thumb side of your wrist and is important for motion and stability in your wrist.

Scaphoid fractures can happen in people of all ages and can cause pain and swelling on the thumb side of your wrist. Sometimes a scaphoid fracture can be mistaken for a wrist sprain because the pain may not be overly severe. If the pain in your wrist does not go away within a day, that may be a sign of a fracture, so plan on scheduling an appointment with your doctor.

Your doctor will ask questions about your symptoms, how it happened, and your overall health. X-rays, MRI’s or CT scans may be done to help further diagnose the extent of the fracture. Swelling, bruising, and loss of motion are all things your doctor will look for during your examination.

A number of factors will go into determining your treatment, such as the location of the break, if the bone fragments are displaced, and how long ago the injury occurred. Nonsurgical treatment generally includes some type of cast or splint.

Surgical treatment may be required if your scaphoid is broken at the wrist or proximal pole. The purpose of surgery is to realign your fracture and help provide stability.

Scaphoid fractures heal rather slowly and a cast may have to be worn for up to six months post-surgery and even for nonsurgical treatment.

During this time you should avoid:

  • Lifting anything more than a pound
  • Contact sports
  • Heavy machinery
  • Participating in activities that may risk you falling on your hand

After surgery your doctor will refer you to a trained hand therapist to help you regain as much of your range of motion and wrist strength as possible.

As with any procedure it’s important that you follow your doctor’s recommendations to ensure the best recovery and treatment.

To learn more or schedule an appointment with our hand and wrist specialists, please visit http://www.neorthohospital.com.

What is a scaphoid fracture?

21 Running Tips


Looking for some tips to help with your run? Our Optimum Stride therapists are full of information on improving your run while avoiding injury. Below are the 21 tips they think are most helpful for runners:

  1. When shopping for running shoes, have an associate look at your feet and how you walk to help you determine what kind of shoe is right for you. They will determine if your arch is high, low, or regular and whether your feet pronate in, supinate out, or land neutrally when you walk. Our team has regular screenings at some area events, so check out our events calendar to find the next screening: https://www.neorthohospital.com/our-services/physical-therapy/optimum-stride.
  2. Many running clothes have built-in underwear, but if your apparel does not, invest in tight-fitting, non-cotton underwear to wick away any moisture and avoid chafing.
  3. Focusing on your form can help make for more efficient runs and avoid injuries. Keep your head up, shoulders low and loose with your arms swinging forwards and backwards. Run tall and keep your hips pointing straight ahead. When running with proper stride length, your feet should land directly underneath your body. Your feet should lightly touch the ground.
  4. If you run in the morning, try to grab a quick meal like half of a peanut butter sandwich or a bowl of oatmeal before your run. This will convert to fuel in 45 minutes leading to an effective run. If you can’t tolerate food before a run, try to eat a carb-heavy bedtime snack the night before.
  5. While you’re in running training, be careful about adding too many additional activities such as spin classes or boot camps. To be a successful runner, you have to run.
  6. When seeking out food sources, focus on whole grains, fruits, and vegetables. Good sources of carbs include whole grain breads, brown rice, whole grain pastas, etc. Aim for the 3-5 servings of veggies a day along with 2-4 servings of fruit.
  7. When it comes to water, shoot to drink half of your body weight in ounces.
  8. Trouble finding time to fit running into your schedule? Schedule it in, literally, and treat it as if it’s an appointment. Once you have it scheduled in, you can relax.
  9. It’s normal to feel shin pain once you get into a running routine. Icing your shins several times a day can help to relieve the pain. Anti-inflammatories, stretching, and strengthening will help too.
  10. While running, be aware of signs that you may be experiencing an injury versus discomfort. When the pain seems to be coming from your overall muscle, for example, your quads, hamstrings, etc., this could be a sign of an injury. If the pain starts to impact your running form or persists despite decreased training, consider getting medical treatment.
  11. Stretching is always an important factor in avoiding injury. Take a few minutes after your run to stretch out your warm muscles. Hold each stretch between 20 to 60 seconds.
  12. When washing your running clothes, use a detergent that’s designed for athletic clothes to help maintain their breathability. Most sport detergents are now sold close to the regular detergent in stores.
  13. During exercise the American College of Sports Medicine recommends drinking 4 to 8 ounces of fluid every 15 to 20 minutes of hard running.
  14. After a long run, it’s crucial to replenish your body with protein and carbs to help your muscles rebuild. Some ideas of what to eat and drink include a turkey sandwich, chocolate milk, yogurt and fruit, and so on.
  15. Pacing, or running at a uniform speed for the entire distance of your run, is crucial in expending your energy throughout the course of your run.
  16. When shopping for winter running attire, it isn’t necessary to spend a fortune on gear. Your base layer is the most important and should be made of a synthetic moisture wicking material. Your second layer is your insulation layer. Something like a fleece running top will help keep in the warm air. Your last layer should be a wind proof jacket or vest. It’s also important to wear fleece lined pants, a hat, and gloves.
  17. Eat well, but don’t overeat. Make sure to get plenty of sleep.
  18. Take a day off when you need to, but try to stick to your running schedule as much as possible.
  19. Jot down what you did or didn’t do after your run to help figure out what contributed to your performance.
  20. If you feel like you are suffering from heavy leg syndrome, make sure you are eating enough carbs, drinking enough water, and getting enough rest between training sessions.
  21. Stay positive and believe in yourself that you can reach your running goals.

To learn more about our Optimum Stride team, or to schedule a running evaluation, visit https://www.neorthohospital.com/our-services/physical-therapy/optimum-stride.

21 Running Tips

Ankle Sprains


Ankle sprains are injuries that occur when your ligaments that support your ankle stretch beyond their limits and tear. Ligaments are strong tissues that connect bones to other bones. Ankle sprains can be anywhere from mild to severe and can happen in people of all ages.

Most ankle sprains can be treated at home with rest and ice, but if you have trouble putting weight on it make sure to consult your doctor. If you do not properly treat your ankle sprain, you will increase your chances of injuring it again.

Most ankle sprains happen on the outside of the ankle in your lateral ligaments.

Symptoms of ankle sprains include:

  • Swelling
  • Bruising
  • Tender to the touch
  • Inability to put weight on it

What will the doctor examine?

Your doctor will diagnose you with an ankle sprain by examining your foot and ankle and checking your range of motion. X-rays, stress x-rays, MRI’s, or an ultrasound may have to be done. Your sprain can be classified as mild, moderate, or severe.

Depending on your type of sprain crutches or physical therapy may be recommended for a period of time.

Surgery is rare for ankle sprains, but if nonsurgical treatment is ineffective after an amount of time, surgery may be an option determined by your doctor.

The best way to avoid ankle sprains is to warm up properly and wear the correct shoes for exercise and participating in athletic events. If your ankle begins to feel pain during these activities make sure to stop or slow down.

To schedule an appointment with one of our ankle specialists, visit http://www.neorthohospital.com/orthopaedic-services/foot-ankle.


Ankle Sprains