All posts by Nola

Finding us on the Spokane Bus Routes

After being in this building for so many years, you’d think we would know the bus routes we’re on.

Well, we don’t, but after a bit of research, we’ve found out that answer and have this handy Spokane Transit Authority map to help folks get to us at our South Hill office.  The #2 and #44 buses go right near us and the bus stop is about 300 ft east of us in front of Sacred Heart Hospital.

STA 2011System Map

At all times, we’re just a phone call away to help with any information that you need to find us.  Give us a call at 509.326.8878 and “Feel Better!”

The Roots and Philosophy of DMI by Frank Lowen

A Turning Pointe PT has always been proud of our association with Frank Lowen and his associates.  Many of our therapists have attended Dynamic Manual Interface training sessions that he has moderated and they always return wiser and with a greater sense of healing and a greater awareness of the capabilities of the human body.

In his newest book, The Roots and Philosophy of DMI, Frank highlights how DMI came about, the influences on him and his practice, and his vision for the application and evolution of DMI.  “A beautiful blending of art and science, DMI uses the body’s self-corrective mechanisms to restore balance, accelerate healing, decrease pain, and improve mental clarity.”

A few words of praise for Frank and his book:

“Frank Lowen performs miracles with his hands on even the most difficult patients and the illnesses they present with. Effortlessly bridging the gap between science, anatomy, and healing, Lowen has the gift of communicating what he perceives with his hands, his outer and inner vision, and his unique intelligence. Lowen is one of the most gifted healers of our time. I am excited that finally this sensitive, beautiful, and important work is now in writing and accessible to all of us.”
—Dietrich Klinghardt, MD, PhD, founder of the American Academy of Neural Therapy

“Frank Lowen has once again shown himself to be a master pearl diver. He dives into the ocean of information and consciousness, and subtly brings up the most exquisite pearls.”
—Judy Osborne, PT, LMT, LAc

You’ll find the book available for purchase on Amazon HERE.


Another protest?  Not quite.  Just an idea to nudge you towards better health and a better life.

How does your chronic pain affect your daily life?  Does it make you grumpy towards your family and friends?  Do your co-workers know full well when you’re having a flare-up?  Does the idea of going out and playing in the beautiful fall colors fill you with dread?

The most powerful tool in any person’s care plan is the desire within you to rid yourself of ailments and strive to live a fuller, pain-free life.  You hold the key to your own fitness.

Now, how do you get there?  It’s usually a combination of factors; diet, exercises, visiting your physician and, of course, physical therapy.  At ATP and Medical Lake PT, our therapists give you their full attention for the duration of your visit.  No undertrained PT Assistants, no under-paid/trained aides that just put hot packs on you.  You get nothing but the full attention of a highly trained therapist that has dedicated to removing or reducing your pain through alternative yet proven therapies.

Rolfing, Somatics, Dynamic Manual Interface, Visceral Manipulation, Pelvic Floor work, Craniosacral Techniques, Trigger-Point….more than I can mention.

Our great folks can only do so much until you great folks decide to take charge of your health.  If you think that physical therapy may fit in with your health and wellness goals, give a us a call or drop us an email to find out how we can help.

“Feel Better!”

Available Appointments

Today is National Fall Prevention Day

Osteoporosis, Falls and Broken Bones

Falls Prevention Awareness Day is a great time to learn about the link between fall-related injuries and osteoporosis.   The good news is it is never too late to identify and treat osteoporosis or to prevent falls to avoid broken bones.   Speak to your healthcare provider about how to reduce your risks for osteoporosis and falls, about getting a bone density test, and about medications, if necessary, to treat osteoporosis.

How are falls and osteoporosis linked?

  • 1 in 10 falls in older adults end in serious injury such as a broken bone. If we can prevent falls, we can prevent broken bones of the hip, spine and wrist.
  • Vitamin D deficiency is a risk factor for both falls and broken bones. Daily vitamin D intakes of 800-1000 IU (international units) and 1200 mg (milligrams) of calcium are associated with reduced falls and broken bones in older adults.
  • Regular physical activity and exercises that combine weight, muscle strengthening and balance helps reduce the risk of falls and actually improves the health of your bones

Take action to prevent osteoporosis and falls

-Eat a balanced diet rich in calcium.

-Take vitamin D supplements.

-Get regular physical activity.

-Don’t smoke.

-Limit your alcohol.

-Check your home for safety.

-Talk with your doctor about a screening test.

What is osteoporosis?

Osteoporosis is a disease that causes bones to become thin, weak, and more likely to break. Although you can break a bone in any part of your body, the most common broken bones associated with osteoporosis are the spine, wrist, and hip.

You have the power and ability to minimize your risk of injury-by-falls and increase your health.  We can help!

“Feel Better!’

Group Health Update – 3:45pm on 9/2/11

Group Health has spoken.

GH Termination Letter

We received this letter via courier just this afternoon.  We have made appropriate notifications to those directly affected and will be attempting to contact each and every ATP and ML client we have that is in the Group Health network.

Over the weekend, we will be mulling our options but in the meantime, we encourage you to notify your GH representative for clarification of your status and to voice your opinion.

More on Monday.

Enjoy your weekend, dear Friends.


Understanding Pain

The human body and brain are marvelous devices with interacting complexities that science and medicine are barely beginning to unravel.  Despite the vast amounts of what we don’t know, we DO know quite a lot about pain and pain management.  In just the past five years, we have found that it’s quite often personal and lifestyle choices we make that affect our chronic and persistent pain level more than anything else.  There is a time for pharmaceuticals and there is a time for surgery but those times are not nearly as often as conventional medicine normally dictates.

More often than not, with a stronger knowledge of pain types and how our bodies send and receive pain, we can be empowered to manage or mitigate our pain more effectively.  The end goal is to live a rich and full life, no?  Imagine how much improvement there could be in your life with your persistent pain reduced by 50%.  How about 25%?  While the goal is a 100% reduction in pain, any lessening is an improvement.

The amusing video below explains, in clear and simple terms, how pain works and affects us.  Simply by understanding pain better, we can make positive choices in our own care.

Watch, learn and, go ahead, “Feel Better!”

Group Health Update


Hello, dear Friends

Here is the latest word regarding Group Health’s decision to remove  A Turning Pointe PT and Medical Lake PT  from their provider network.  First, a recap:

Several weeks ago, we were notified that effective September 4th, Group Health (GH) will remove us and several other clinics from their network.  We appealed this decision based on the clear fact that A Turning Pointe is an alternative clinic that provides service not found elsewhere in the greater Spokane area and that Medical Lake PT is the only physical therapy clinic in all of Medical Lake.  The GH decision would strip their members of their only choice for alternative care in Spokane or any kind of care in Medical Lake.  At the August 17th meeting that we had with the director of GH Provider Relations, our arguments were heard and, we think, well received.  At that point, we were told that a final decision would be forthcoming in approximately two weeks.

On August 30, we were notified that the final decision has yet to be made and that it may be another twenty days until it is made.

So, what does all this mean?

It means that as of Sunday, September 4th, until further notice, if your current authorization ends on or before September 4th, your visits past that date will not be covered.  If your authorization ends after Sep 4th, those authorizations WILL be covered.  This information came directly from Maureen Brooks, the regional Provider Relations manager.  Their decision stands until they rescind it, IF they rescind it.

We cannot guarantee that GH will make their decision in a timely matter or if it will be in our favor.  Some GH members have out-of-network benefits with their plan but that also may come with a higher out-of-pocket-expense.  We recommend that each of you consult your plan administrator or GH Customer Service to determine this.  We are happy to offer a reduced, out-of-pocket rate of $100 to or GH patient.  While we would regret the possible loss of providing service to our GH clients, we would understand if the out-of-pocket expense were prohibitive. The budget vs. health battle is a very real one and hard decisions must be made with your finances.

As soon as we get the final word from Group Health, we will be contacting all of our active patients to let them know the news.  Whether it is in our favor or not, you’ll need the information so that you can plan accordingly.  You may feel free to contact us at any time to ask us for an update on this matter.

If you wish to contact Group Health at their Spokane office to make direct inquiries, their number is 509.838.9100 or 1.800.497.221.

Visceral Manipulation for Low Back Pain

Though written by therapists for therapists, this article gives patients a wonderful and informative view of this innovative healing practice. On our staff we have two highly experienced therapists that are more than proficient with Visceral Manipulation; Laurie and Linda.

Give us a call and “Feel Better!”




Visceral Manipulation for Low Back Pain

Published in Massage Message Journal, January/February 2009

By Dee Ahern, P.T. and Judy Russell, B.A., B.SC,


As we watch a graceful ballerina or enthusiastically cheer on our favorite tennis or football players, is it only the agility and ease of movement of the musculoskeletal system that we observe?

Or is it that which lies within the cylinder that forms the torso that often is responsible for creating the flow of movement patterns visible to the naked eye?

Have you worked with clients precisely applying manual therapy techniques that relate to the fascial system, the neuromuscular system, or the craniosacral system, yet your clients are not experiencing long lasting relief from low back pain and dysfunctional movement patterns?

A primary focus of orthopaedic and musculoskeletal education for massage therapists when addressing low back pain has been the study of how the structures that lie behind the spine influence the spine’s mobility and function. The curriculum presented in the Visceral Manipulation Program offers a method for assessing and treating the influence of those structures that lie in front of the spine. Those influential structures can include organs and their fascial attachments, peritoneum, the greater omentum or blood vessels. Visceral Manipulation is commonly called “organ specific fascial mobilization”. It addresses dysfunction within the contents of the cylindrical torso.

Visceral Manipulation was developed by Jean-Pierre Barral, a Registered Physical Therapist and Osteopath. He holds many positions including Director (and Faculty) of the Department of Osteopathic Manipulation at the University of Paris, School of Medicine, in Paris, France and Chairman of Department of Visceral Manipulation on the Faculty of Medicine Paris du Nord. He developed this form of manual therapy based on his theory that each internal organ rotates on a physiological axis. Each internal organ also has a relationship through fascial attachments to the spine. Today, his Visceral Manipulation courses are taught around the world by certified teachers who successfully complete a rigorous training program with the Barral Institute.

Consider the following orthopaedic dictum: any structure that crosses a joint has the ability to restrict that joint. It is certainly true for muscles. This also holds true for organs. Barral’s in-depth study of patterns of stress in tissues of cadavers at the Lung Disease Hospital in Grenoble, France complemented his interest in biomechanics in living subjects. He recognized the potential for the organ system to create lines of tension within the body. This observation was fundamental to his development of Visceral Manipulation. His interest was also piqued when a client confirmed he felt relief from back pain after going to an “old man who pushed something in his abdomen.” Since that time he has worked with researchers in France and North America to create evidence-based data, documenting changes in the viscera with the use of x-ray fluoroscopy, endoscopy, Doppler and ultrasound before and after manipulation of the organ.

How do organs become restricted? They can become restricted by a direct trauma (fall on a soccer ball), acute/chronic illness (pneumonia), absorbing the force of a motor vehicle accident (seat belt trauma), or scar tissue formed after surgery. We take approximately 24,000 breaths a day. Our heart beats 120,000 times per day. Any lack of mobility in these structures could promote chronic spinal restrictions – e.g. the attachment of the pericardium to the lower cervical and upper thoracic spine via the thoraco-pericardic ligament.

The mesenteric root of the small intestine can limit the mobility of the spine as it crosses the third and fourth lumbar vertebra. A mechanical restriction at the first lumbar vertebra may be influenced through constant irritation of an old appendectomy scar stimulating the autonomic nervous system. The cecum/appendix and L1 share this viscero-somatic interchange. Decreased flexibility of the fascial connection between the bladder and the head of the femur can limit the mobility of both structures. Chronic dysfunction of the right and left sacro-iliac joint can result from decreased mobility of the cecum and sigmoid respectively. A ptosed kidney on the anterior surface of the psoas muscle can compress one of five nerves (e.g. ilio-inguinal) in the vicinity. In fact, Jean-Pierre Barral has found through his clinical treatments and research that up to 90% of musculoskeletal problems have a visceral component.

The key in Visceral Manipulation is to find the most significant area of reduced mobility. A restriction will pull the surrounding tissue towards it. Another Orthopaedic dictum is that „the body hugs the lesion (restriction).? With training, your hands will feel the pull of tissue to the area that is causing the greatest mechanical tension in the body – this is an evaluation technique known as „Listening?. You will also learn to evaluate visceral mobility – the ability of an organ to move freely in three dimensions in its anatomical environment. In addition, you will be able to feel visceral motility – the organ’s inherent tissue motion. Like joints, organs must move to stay healthy. They have sliding surfaces that articulate with each other, with muscles, with ribs and with the spine. You will be able to ascertain what is normal or abnormal. This is not unlike what we learn about joints. The efficacy of treatment depends on the accuracy of your assessment and the specificity of the application of gentle manual forces in three dimensions to promote the health of the organ and relief of restriction in the body. There can be an immediate response to treatment or a response that becomes apparent over several weeks time as the body unravels a long standing restriction.

Gail Wetzler, P.T. of Orange County, California performed a clinical study that examined the neuroreflexive and structural relationship between the internal organs, their attachments and the musculoskeletal low back when in a state of dysfunction. The conclusion of the study showed that low back spinal dysfunction may be more effectively and efficiently resolved with the addition of Visceral Manipulation into the treatment program.

We cannot imagine our practices without these tools. It is exciting, rewarding and challenging. Visceral Manipulation tests your knowledge of anatomy and inspires you to learn more. We invite you to be curious and learn to look inside the body for possible organ specific fascial restrictions that may be causing low back pain, as well as other dysfunctions in the body. For more information about the Visceral Manipulation, the Barral Institute and the availability of courses in your area, we encourage you to visit


To Life!

Allow me to crow about a project that I’m involved in……and that I would love your support with.

I have scratched an item from my bucket list.  After finding reasons over the years to NOT try it, I have finally run out of excuses and have auditioned for a community theater production; Lake City Playhouse‘s upcoming presentation of Fiddler on the Roof.  For many years this has been my favorite production, with many reasons why.  It touches on a whole host of themes that relate to family, faith, friendship and the ability to live life regardless of the oppressive circumstances.  Plus, the music, songs and dances are simply fantastic!

With Steve Kane as Tevye and Renei Yarrow as Golda leading their family and fellow villagers through their struggles, you are certain feel the richness of this wonderful story.  Under the creative direction of Abbey Crawford, accompanied by the beautiful music created by Carolyn Jess and with the invigorating choreography of Ali Waud, this production is sure to please all comers.

I invite you and your family to support local businesses, community theater, and of course, me.  For tickets of any information, please call Lake City Playhouse at 208.667.1323.




Barefoot Running

Often times as therapists, we become the go-to person for our patients when there is a new or returning exercise trend.  The barefoot running phenomenon has created a lot of buzz lately, and several of my Rolfing clients are curious if they should give it a go.

I, myself, have tried barefoot running several times over the past two years. From my years of ballet, I have very tight feet and legs and barefoot running proved to enlighten me on this fact. Each time I that I have run barefoot, I’m sore for usually 3 days. This brings up a few questions. Is the abnormal soreness a good thing or a bad thing?  Should I even be barefoot running if I’m experiencing extended soreness? What does the soreness indicate?

I stumbled on the article below a few days ago.  Maybe this will help you in your decision whether to give this new fad a try……or not.


Are We Built to Run Barefoot?


At a recent symposium of the American College of Sports Medicine’s annual meeting in Denver, cutely titled “Barefoot Running: So Easy, a Caveman Did It!,” a standing-room-only crowd waited expectantly as a slide flashed up posing this question: Does barefoot running increase or decrease skeletal injury risk?

“The answer,” said Dr. Stuart J. Warden, an associate professor of physical therapy at Indiana University, “is that it probably does both.”  But in the past year, anecdotal evidence has mounted that some runners, after kicking off their shoes, have wound up hobbled by newly acquired injuries. These maladies, instead of being prevented by barefoot running, seem to have been induced by it.  Barefoot running remains as popular and contentious a topic among exercise scientists as it is among athletes, even though it is practiced by only a tiny subset of American runners. These early-adopter runners, however, tend to be disproportionately enthusiastic and evangelical. Many cite the best seller “Born to Run,” by Christopher McDougall, which touts barefoot running, and claim that barefoot running cured them of various running-related injuries and will do so for their fellow athletes. “There are people who are convinced that barefoot runners never get injured,” said Daniel E. Lieberman, a professor of human evolutionary biology at Harvard who runs barefoot himself and spoke on the topic during last week’s symposium.

So what really happens to a modern runner when he or she trains without shoes or in the lightweight, amusingly named “barefoot running shoes” that are designed to mimic the experience of running with naked feet? That question, although pressing, cannot, as the newest science makes clear, easily be answered.

Most of us, after all, grew up wearing shoes. Shoes alter how we move. An interesting review article published this year in The Journal of Foot and Ankle Research found that if you put young children in shoes, their steps become longer than when they are barefoot, and they land with more force on their heels.

Similarly, when Dr. Lieberman traveled recently to Kenya for a study published last year in Nature, he found that Kenyan schoolchildren who lived in the city and habitually wore shoes ran differently from those who lived in the country and were almost always barefoot. Asked to run over a force platform that measured how their feet struck the ground, a majority of the urban youngsters landed on their heels and generated significant ground reaction forces or, in layman’s terms, pounding. The barefoot runners typically landed closer to the front of their feet and lightly, without generating as much apparent force.

Based on such findings, it would seem as if running barefoot should certainly be better for the body, because less pounding should mean less wear and tear. But there are problems with that theory. The first is that the body stubbornly clings to what it knows. Just taking off your shoes does not mean you’ll immediately attain proper barefoot running form, Dr. Lieberman told me. Many newbie barefoot runners continue to stride as if they were in shoes, landing heavily on their heels.

The result can be an uptick in the forces moving through the leg, Dr. Warren pointed out, since you’re creating as much force with each stride as before, but no longer have the cushioning of the shoe to help dissipate it. Most barefoot runners eventually adjust their stride, he and the other presenters agreed, landing closer to the front of their feet — since landing hard on a bare heel hurts — but in the interim, he said, “barefoot running might increase injury risk.”

Even when a barefoot runner has developed what would seem to be ideal form, the force generated may be unfamiliar to the body and potentially injurious, as another study presented at last week’s conference suggests. For the study, conducted at the Biomechanics Laboratory at the University of Massachusetts, runners strode across a force plate, deliberately landing either on the forefoot or on the heel. When heel striking, the volunteers generated the expected thudding ground reaction forces; when they landed near the front of the foot, the force was still there, though it generally had a lower frequency, or hertz.

Earlier research has shown that high-frequency forces tend to move up the body through a person’s bones. Lower-frequency forces typically move through muscles and soft tissue. So shifting to a forefoot running style, as people do when running barefoot, may lessen your risk for a stress fracture, and up your chances of developing a muscle strain or tendinitis.

So where does all of this new science leave the runner who’s been considering whether to ditch the shoes? The “evidence is not concrete for or against barefoot or shod running,” said Allison H. Gruber, a doctoral candidate at the University of Massachusetts and lead author of the hertz study. “If one is not experiencing any injuries, it is probably best to not change what you’re doing.”

On the other hand, if you do have a history of running-related injuries or simply want to see what it feels like to run as most humans have over the millenniums, then “start slowly,” said Dr. Lieberman. Remove your shoes for the last mile of your usual run and ease into barefoot running over a period of weeks, he suggests, and take care to scan the pavement or wear barefoot running shoes or inexpensive moccasins to prevent lacerations.

And pay attention to form. “Don’t overstride,” he said. Your stride should be shorter when you are running barefoot than when you are in shoes. “Don’t lean forward. Land lightly.”

On this point, he and all of the scientists agree. Humans may have been built to run barefoot, “but we did not evolve to run barefoot with bad form.”