VIDEO: How to Know When it’s Time for Hip or Knee Surgery – In Case You Missed It!

Click below to watch the video of Dr. Michael Sumko’s presentation on How to Know When it’s Time for Hip or Knee Surgery. Dr. Sumko was the third speaker at our Managing Hip Pain Through Diet and Exercise seminar.

To watch Jeff Petersen’s portion of the presentation, click here. His topic was “Practical Exercises for Managing Hip & Knee Pain.”

To watch Kelli Shallal’s portion of the presentation, click here. Her topic was “Inflammatory vs Non Inflammatory Foods.”

VIDEO: Inflammatory Vs Non-Inflammatory Foods – In Case You Missed It!

Click below to watch the video of Kelli Shallal’s presentation on Inflammatory vs Non-Inflammatory Foods. Kelli was the first speaker at our Managing Hip Pain Through Diet and Exercise seminar.

To watch Jeff Petersen’s portion of the presentation, click here. His topic was “Practical Exercises for Managing Hip & Knee Pain.”

To watch Dr. Michael Sumko’s portion of the presentation, click here. His topic was “How to Know if It’s Time for Surgery.”

VIDEO: Practical Exercises for Managing Hip & Knee Pain – In Case You Missed It!

Click below to watch the video of Jeff Petersen’s presentation on Practical Exercises for Managing Hip & Knee Pain. Jeff was the second speaker at our Managing Hip Pain Through Diet and Exercise seminar.

To watch Kelli Shallal’s portion of the presentation, click here. Her topic was “Inflammatory vs Non Inflammatory Foods.”

To watch Dr. Michael Sumko’s portion of the presentation, click here. His topic was “How to Know if It’s Time for Surgery.”

Fighting Inflammation With Food

This post is a reprint of information found in a handout used by Kelli Shallal, Registered Dietician. The original handout can be accessed here.

Inflammation is a love/hate relationship. In moderation, it’s a natural process that helps your body heal and defend itself from harm. But too much can become harmful! We can lower inflammation with our diet through a multitude of ways:

  1. Reduce the amount of added sugar and increase natural sugars.
    • Candy, brown sugar, maple syrup & soda are examples of added sugars.
    • Fresh fruit & veggies are examples of natural sugars.
  2. Eat more whole grains to reduce inflammatory response.
    • Brown rice, oats, 100% whole wheat & quinoa are whole grains.
  3. Swap out Omega-6 for Omega-3.
    • Foods such as soybean oil, safflower oil, sunflower, and corn oil are sources of omega-6 fatty acids.
    • Foods such as salmon, flaxseeds, chia seeds, and walnuts are sources of omega-3 fatty acids.
  4. Curb alcohol consumption and increase water intake.
    • Every day, drink half your body weight in ounces of water.
  5. Choose to eat unprocessed meat instead of processed meats.
    • Chicken, beef, pork, and fish are examples of unprocessed meats.
    • Deli meats, bacon, and hot dogs are examples of processed meats.
  6. Go for green tea.
  7. Don’t forget turmeric.
  8. Say yes to dark chocolate.

We can also reduce inflammation by examining our lifestyle choices. Excess stress and lack of sleep affect inflammation, as well as carrying excess weight (particularly in the mid-section), and having unresolved GI issues (suck as leaky gut and/or food sensitivities).

Inflammatory Foods

  • Added Sugar
  • White Bread/Pasta
  • Soybean Oil
  • Safflower Oil
  • Sunflower Oil
  • Corn Oil
  • Vegetable Oil
  • Alcohol
  • Processed Meats
  • Preservatives
  • Added Chemicals

Anti-Inflammatory Foods

  • All Fruits & Veggies
  • Whole Grains
  • Fish
  • Walnuts
  • Chia
  • Flaxseed
  • Water
  • Green Tea
  • Turmeric
  • Dark Chocolate

Save the Date!! Upcoming Seminar on Managing Hip Pain Through Diet and Exercise

Living with hip pain is NO FUN. We just wanted to make you aware that Jeff Petersen, PT will be speaking at an event this month, along with two of our great friends, Kelli Shallal (registered dietician) and Dr. Michael Sumko! This two hour seminar’s topic is “Managing Knee & Hip Pain through Diet and Exercise.”

This FREE event is taking place at the end of the month and you are invited. This event will be great if you:

  • Suffer from any sort of Hip or Knee pain
  • Want your hip or knee pain explained to you in layman’s terms
  • Want to know some practical solutions that can get you free of your hip pain in no time!
  • Would like to have your hip pain management and/or therapy questions answered by professionals who do this for a living

Light snacks will be provided, and three speakers will discuss topics relating to two of the most common types of pain.

The speakers will be:

  • Kelli Shallal, MPH, Registered Dietician
  • Jeff Petersen, MOMT, Physical Therapist
  • Dr. Michael Sumko, DO, Orthopedic Surgeon

Where: Tempe St. Lukes Hospital, MOB Building
When: October 30 at 6:30pm
Cost: FREE

Please click the link below to RSVP in advance:

Click Here to Register for the Event
Click Here to Download a PDF of the Flyer

Is Your Hip Pain Coming From Arthritis?

Dealing with hip pain can be extremely discouraging. Like low back pain or knee pain, it affects every area of your life! If you’re struggling to move the way you used to, pick up your grandchildren, get in and out of vehicles, etc, you are not alone!

Hopefully, by the end of this article, you will have a basic understanding of whether or not arthritis may be the cause of your hip pain, and more importantly, what to do about it!

First, some background on Arthritis

The Arthritis Foundation reports t hat 26% percent of women and 18% of men have been diagnosed with some type of arthritis. Osteoarthritis, the wear and tear type, is the most common. Almost two thirds of these individuals are of working age. Arthritis and other non-traumatic injury joint disorders are among the costliest conditions to treat and manage in the United States. According to the Center for Disease Control, 2016, there are over 100 types of Arthritis. For more information about each type of arthritis, visit

There are several chronic conditions in which arthritis is commonly associated:

  • 49 percent of adults with heart disease have arthritis.
  • 47 percent of adults with diabetes have arthritis.
  • 31 percent of adults who are obese have arthritis.

In each of these conditions most people are limited in their level of activity and movement. But don’t stop moving! What we know is that physical activity can reduce pain and improve physical function by about 40 percent. Hopefully, the exercises listed in this article will help reduce your pain enough to return to an active lifestyle.

Osteoarthritis (OA) affects more than 30 million Americans. It is the most common arthritis and is not limited to older adults. In normally healthy individuals OA can develop in joints that have sustained an injury and/or required surgery. High demand jobs and involvement in athletics makes one vulnerable to wear and tear of joints, leading to OA. OA is a chronic condition that can affect any joint, but it occurs most often in knees, hips, lower back, neck, small joints of the fingers and the bases of the thumb and big toe. Currently, there is no cure for OA.

In normal joints, cartilage covers the end of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between the bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. As the condition worsens over time, bones may break down and develop growths called spurs. Bits of bone or cartilage may chip off and float around in the joint. This can cause inflammation and further damage the cartilage. In the final stages of OA, the cartilage wears away and bone rubs against bone, leading to joint damage and more pain. When OA becomes severe, one may need a joint replacement surgery.

How can one identify the root cause of hip pain and deal with it before needing to resort to surgery?

Even with an X-ray that shows minimum to moderate hip joint degeneration (another name for arthritis), often the pain is associated with the tissues surrounding the joint. In the case of hip arthritis, that would mean ???[JW1] .Additionally, other structures such as the sacroiliac joint [JW2] and the low back can cause pain that seems to come from the hip.

Common ways to differentiate whether your hip pain is coming from arthritis in your hip.

A progressive loss of mobility in your hip will be our first clue. If the following motions are limited and/or painful, it may indicate issues in your hip joint.

  • Lie on your back, pull your pain free hip to your chest as far as it will go. If your painful hip comes off the bed or floor, this indicates tightness in your hip flexors.
  • Pull your involved hip up toward your chest. If it is tight and limited, this indicates hip joint involvement.
  • While seated, keeping your knees together, roll your feet out.
  • Increased joint stiffness and pain with prolonged sitting and inactivity.
    • Moderate movement decreases your hip pain and stiffness.
    • Early in AM worse pain and stiffness.
    • Prolonged standing and walking may increase your pain and stiffness.
    • End of a long day walking will increase your pain and stiffness.
    • Your Doctor may inject your hip with pain medicine. If the pain disappears, even for only a couple of hours, then the source of your pain is likely your hip.
    • You might try using a cane in the opposite side as your hip pain. If this increases your tolerance to activity, the hip may be the source of your pain.
    • The location of your pain can implicate the hip.
      • Pain from Osteoarthritis of the hip usually will be localized to the front and outside of the hip as well as the groin. Pain low in the buttocks, up on the flair of your hip, (at or below the belt line) or in the back of the hip near the sacrum are usually caused by other structures.
      • Ironically knee pain described as an ache may be from arthritis in the hip.
      • Sharp burning pain, shooting down into the buttocks and back of the leg is likely not arthritis of the hip.
      • Some pain in the buttocks may be related to a group of muscles in the hip, with the piriformis being a likely culprit.

What is one to do?

Irrespective of the type of Arthritis or the likely cause of your symptoms, beginning a flexibility and strengthening program will help reduce the level of pain and allow you to be more active. However; if your pain gets worse and there is no improvement please consult your physician or physical therapist.

Flexibility Stretches:

1. Piriformis Stretch

2. Hamstring Stretch

3. Calf Stretch

4. Hip Flexor Stretch

5. Opposite Arm Leg


  1. Bridging

2. Short Arc Quadriceps Sets

3. SLR

4. Hip abduction

Camp with a Ramp 2019

Our East Mesa location, Neuro & Brain Performance Centers, is highly involved in the spinal cord injury community. They have created Neuro & Brain Community Foundation to help provide funding for therapy services & continuing research for individuals affected by neurological disorders. One of the great events they sponsor is the annual Camp with a Ramp trip for those living with spinal cord injuries.

The Camp with a Ramp provides three full days of activities that include; horseback riding, fishing, kayaking, archery, crafts, animal interaction, basketball, over-the-line, quad rugby, morning hikes on the rim, lacrosse, hand-cycling and educational discussion groups.

This year we will be hosting the trip on August 1st-4th. Please visit the Camp with a Ramp website to learn more about how to join us. We are also looking for sponsors and donations to help make this an experience of a lifetime for the campers!

Ergonomics 101: Choosing the Right Ergonomics Work Chair

Office Ergonomics

Our Top Ergonomics Work Chair Picks

Ask any architect and they will say, “The building is only as good as the foundation it is built upon”. This principle applies to the human body. As a provider of ergonomics for over 20 years, we have worked with many different companies, and many evaluating many different jobs. The work chair is the foundation for the work environment for many people that work in front of a computer for a majority of their work day. A good ergonomics work chair, that is set up properly, will support proper posture and provide a safe and comfortable work environment. A poor chair will encourage poor postures that can lead to issues in the back and neck.

What should you look for in a “good” task chair for a computer workstation?

  1. Height adjustable – Make sure the chair is able to adjust to “your” height, not necessarily the desk height. It is important that your feet are able to be placed flat on the floor with a 90 degree bend at the knees with your thighs parallel to the floor.
  2. Seat pan depth suited for your size (prefer adjustable) – Make sure the seat pans depth allows you to sit fully back in the seat with you back against the lumbar support in an upright position. You should have 2-3 fingers widths distance between the back of your legs and the seat pan. Make sure the seat pan is not too wide or too narrow for you to put your arms comfortably on the armrests.
  3. Adjustable armrests – The best armrests are adjustable up and down, but also in and out. This should provide light support on your forearms with your arms a 90 degree angle at the elbow.
  4. Adjustable lumbar support – The lumbar support should be able to adjust up and down so that it can be positioned to fit your back. It also should have the ability to lock in an upright position, so that you have proper support when you begin to fatigue and want to lean back into the lumbar support.
What chair should you choose?

The most important thing is for the chair to have the functionality to adjust to the individual. The chairs included on our list below are design primarily for people who are at least 5’2” to 6’4” and weigh less than 300lbs. If you fall outside these ranges, contact an ergonomist to help you with finding a chair to meet your needs. While we are not particular to any vendor when it comes to chairs. We have used many different chairs to meet client’s needs and there are a few that pop up as our “preferred” chairs. Below is a list based on price and the advantages/disadvantages of these selections.

$100-$200 Range Task Chairs

To be honest anything less than this price point should not even be considered as a work chair. It just won’t have the features needed. You may find a good used chair for less, but make sure it has the functionality. These chairs have limited warranties, so don’t expect them to last as long as the higher priced chairs. This price range is what you will find at many office supply stores like Staples, Officemax, and even Costco.

Staples Hyken Technical Mesh Task Chair ($129.99)

Staples Hyken

Advantages: Price, Adjustable Height, Arms, and Lumbar support, Mesh seat pan and lumbar support offers good breathability.

Disadvantages: Armrests do not adjust in and out, seat pan depth is not adjustable, mesh in chair is not as durable as foam cushions. Durability is not as good as higher priced chairs.


OfficeMax WorkPro 3000 Series Ergonomic Chair

WorkPro 3000

Advantages: Adjustable Height, Arms, and Lumbar support, Foam cushions offer more durability and support than mesh. Arms are width adjustable.

Disadvantages: Foam cushions not as breathable, seat pan depth is not adjustable. Durability is not as good as higher priced chairs




$200-$700 Range Task Chairs

This group is broad, they can be have more specialized in form and features, and differences in quality of materials. This area is the sweet spot when buying a good ergonomics chair. Chairs in this price range will have all the necessary features to adjust the chair to support a proper posture. Some of these types of chairs may be found in local office supply stores, but often they are carried by specialty office vendors or through online purchasing only. Look for companies that have a showroom or offer demos on these chairs to make sure the chair meets your needs and personal preference. Chair warranties are often extended up to 12 years. Quality vendors of these types of chairs are Steelcase, Knoll, and Herman Miller.

Steelcase Leap Chair ($350-450) (Personal all around preference)

Leap Chair

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support. Seat pan tilt, Multiple fabric color choices, including leather. Very good durability

Disadvantages: No mesh option for improved breathability, cushioning is thinner than in other cushion chairs, heavier and more bulky chair than others.



Steelcase Amia Chair ($640) –

steelcase amia

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support. Multiple fabric color choices, lighter than Leap and smaller platform

Disadvantages: No seat pan tilt, no mesh option for breathability




Herman Miller Aeron ($500-$800)

herman miller aeron

Advantages: Adjustable height, seat pan depth, armrest (in and out too), lumbar support, seat pan tilt. Mesh for increased breathability, good-looking design

Disadvantages: Few color selections, no foam cushion option, heavier chair, mesh may give over time.





As you can see chair prices can range between $200 to over $1000 dollars. Finding the right chair that looks good to you and feels good for you is going to be a matter of trying it out.

Treating Pain: Why it is different for everyone.

Why is treating pain different for everyone?  Pain is the common reason individuals seek medical care and I would suggest a primary reason people come to physical therapy. It is often an elusive phenomenon that can be disruptive to the quality of one’s life.  *The International Association for the Study of Pain‘s widely used definition states: “Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” There are many classifications of pain including:**

1.”sensory-discriminative” (sense of the intensity, location, quality and duration of the pain)

2.”affective-motivational” (unpleasantness and urge to escape the unpleasantness)

3.”cognitive-evaluative” (cognitions such as appraisal, cultural values, distraction and hypnotic suggestion).

**It has been theorized that pain intensity (the sensory discriminative dimension) and unpleasantness (the affective-motivational dimension) are not simply determined by the magnitude of the painful stimulus, but “higher” cognitive activities can influence perceived intensity and unpleasantness. Cognitive activities “may affect both sensory and affective experience or they may modify primarily the affective-motivational dimension. In other words, your emotional state has a large impact on “how much pain” you feel. An individual’s framing of the painful experience can dramatically influence the intensity of that experience. As a therapist I work specifically to address physiological, biomechanical and postural factors impacting pain. In this blog I want to address other issues impacting pain.

Melzack and Casey suggest pain should not only be treated by trying to cut down the sensory input by anesthetic block, surgical intervention and physical therapy, but also by influencing the motivational-affective and cognitive factors as well. How does one accomplish this?

The first step is to get a clear picture of the physiological stimulus that is at the root of one’s pain. Different tissues will respond with different patterns of pain. Keep in mind, that though all pain is unpleasant, not all pain is of equal urgency.  It has been my observation from thirty years of experience as a physical therapist helping people in pain, that the intensity of one’s pain is most often NOT correlated with the severity of the “problem”. What I mean by that is; many conditions that are in fact life threatening, specifically certain types of cancer and auto immune diseases often offer very little pain.  Conversely conditions that are intensely painful will not threaten your life.  Examples such conditions are child-birth and sciatica.  Understand that this does not mean that one should ignore pain. The mere presence of pain is enough to alter one’s quality of life and negatively impact one’s longevity.  But, an individual experiencing pain can be helped by having a clear understanding of the cause and potential threat posed by that pain.

Another important point to consider is that all pain is mediated in the central nervous system.  It actually occurs in the brain regardless of what part of you body hurts. Take for example “phantom limb” pain, a condition in which individuals who have had a traumatic or surgical amputation of one of their limbs may continue to feel pain in that limb long after it is gone.  The pain is mediated by the brain and is by definition an unpleasant emotional experience.  Finally it is important not to judge yourself because you are experiencing pain and do not compare your pain experience to other. In our country we tend to judge pain as “bad”.  Though it is unpleasant pain is not morally bad.  Additionally, comparing one’s experience to friends and neighbors can often lead to frustration and shame.  Consider a positive emotional experience.  When my wife and I go to see a comedy, “Nacho Libre” for example, I may belly laugh through the entire movie and she may offer a polite chuckle.  Same stimulus but very different responses and neither of us is right or wrong for our response.

So what to do? If you are experience a persistent episode of pain;

  1. 1. Have your condition evaluated by an objective and qualified specialist. This will help establish a plan to handle the physiological contributors to your pain.
  2. 2. Understand your condition and its severity (you may not fully understand the pain itself and that is OK)
  3. 3. Talk to an objective third-party about how you feel. This will assist you in handling the emotional contributors to your condition.
  4. 4. Do not judge yourself, or allow others to judge you, for experiencing pain
  5. 5. Eliminate those external stressors factors that might make your experience more unpleasant.
  6. 6. Do those positive actions that will help reduce the painful stimulus and improve you tolerance to your condition

If you have questions about pain please call me at 480-833-1005.