Plantar Fasciitis Treatment in Southern Maine

If you are looking for plantar fasciitis treatment in Southern Maine, the information below will help you make a better decision, as well as help you avoid unnecessary and expensive healthcare treatment.

What is Plantar Fasciitis and What Causes It

Plantar fasciitis is an inflammation of the plantar fascia which is a think, wide, ligament-like soft tissue on the bottom of your foot.  The plantar fascia runs from your heel bone (calcaneus) down to your toes.

Plantar fasciitis symptoms include sharp pain at the base of your heel that can radiate into the arch of your foot.  Sometimes there’s noticeable swelling as well.

Causes of plantar fasciitis include:

  • A rapid increase in physical activity
  • Repetitive motions like distance running
  • Limited flexibility of the gastrocnemius and soleus muscles (your calf muscles),
  • Poor arch support and/or excessive foot pronation
  • Overweight patients are also more likely to develop plantar fasciitis.

What You Need to Know – Don’t Insist on an X-ray Right Away

Over 2 million people experience heel pain each year.  It’s a common condition.  In many cases, x-rays offer no additional information as to the cause of your pain and as such, are not needed.  The first line of action should be conservative care.

Physical Therapy First is Clinically Proven to Help

There are a variety of options for the treatment of plantar fasciitis.  We are strong advocates for natural, conservative, hands-on treatment and clinical research support our view:

The guidelines present evidence that strongly suggests a combination of manual therapy and rehabilitative exercises to help patients with this foot condition. In a more recent study published in the February 2017 issue of JOSPT, researchers reviewed the records of people with plantar fasciitis who were sent to physical therapy. The results of this study support prior studies that show faster recovery time for those who receive evidence-based physical therapy for their foot pain.

Reference: https://www.jospt.org/doi/full/10.2519/jospt.2017.0501

What to Do First – See One of Our Plantar Fasciitis Experts at Riverview Physical Therapy

If you are experiencing plantar fasciitis, you shouldn’t wait more than a week to see if it gets better on its own. Conservative, natural care, which is what we provide here at our practice, is what you should try first.

The advantages of seeing one of our physical therapy experts are as follows:

  • No side effects – In most cases, the treatment we provide has little to no side effects and can make you feel much better
  • It’s more affordable – an average course of treatment
  • Seeing one of our physical therapists within 14 days means you’re not likely to need additional care, special tests, injections or surgery
  • Seeing one of our physical therapists first means you are less likely to need addictive opioid drugs

How Our Plantar Fasciitis Specialists will Care for You

The key to rapid and successful recover is to see one of our plantar fasciitis specialists right away.

We will perform a thorough initial evaluation, discuss your treatment goals, provide you with a custom treatment program, and schedule follow-up visits based on the agreed-upon plan of care.

How will Your Plantar Fasciitis Specialist at Riverview Physical Therapy Treat This Condition?

Your treatment plan depends on what we learn during your initial evaluation but often includes the following:

  • Modifications to your daily activities,
  • Stretching,
  • Avoiding aggravating activities,
  • Over-the-counter orthoses,
  • Hands-on soft tissue and mobilization techniques, and
  • A home program

Practical Advice

If you are experiencing plantar fasciitis, we can help.  We’ve successfully treated many without the use of addictive drugs, risky injections, expensive tests, or surgery.

TO GET STARTED GIVE US A CALL AT ONE OF OUR FOLLOWING CLINICS
RIVERVIEW PHYSICAL THERAPY

  • Bath: 207-386-0351
  • Westbrook: 207-797-3477
  • Windham: 207-892-3952
  • Yarmouth: 207-846-8725

Shoulder Pain Treatment in Southern Maine

If you are looking for shoulder pain treatment in Southern Maine, the information below will help you make a better decision as well as help you avoid unnecessary and expensive healthcare treatment.

Seven Medical Diagnoses that Cause Shoulder Pain

There are seven common diagnoses that cause shoulder pain and usually respond very well to physical therapist directed treatment. These diagnoses are:

  • Shoulder Impingement
  • Shoulder Tendinitis
  • Rotator Cuff Tears
  • Subacromial Bursitis
  • Frozen Shoulder (Adhesive Capsulitis)
  • Calcific Tendinitis
  • Shoulder Dislocation

What You Need to Know – Don’t Insist on an MRI

Before you go down the path of expensive imaging studies like MRI and CT scans, you should know that these types of tests often produce false positives.

What this means is the test might indicate that something is wrong in your shoulder but it isn’t the source of your pain or doesn’t require immediate surgery.

To illustrate this point, consider the conclusion of this study and this article published in the NY Times:

Magnetic resonance imaging identified a high prevalence of tears of the rotator cuff in asymptomatic individuals. These tears were increasingly frequent with advancing age and were compatible with normal, painless, functional activity. The results of the present study emphasize the potential hazards of the use of magnetic resonance imaging scans alone as a basis for the determination of operative intervention in the absence of associated clinical findings.

Reference: https://www.ncbi.nlm.nih.gov/pubmed/7822341

The pitchers were not injured and had no pain. But the M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent. “If you want an excuse to operate on a pitcher’s throwing shoulder, just get an M.R.I.,” Dr. Andrews says.

Reference: https://www.nytimes.com/2011/10/29/health/mris-often-overused-often-mislead-doctors-warn.html

What to Do First – See One of Our Shoulder Treatment Experts in Southern Maine

If you are experiencing shoulder pain, you shouldn’t try to self-diagnose the problem.  Our specialists can help you with this.

In almost all of the patients we see, natural, hands-on physical therapy is the treatment that you should try first.  The advantages of seeing one of our physical therapy experts are as follows:

  • No side effects – In most cases, the treatment we provide has little to no side effects and can make you feel much better,
  • It’s more affordable – an average course of treatment cost much less than tests, injections, or surgery,
  • Seeing one of our physical therapists right away means we can quickly alleviate the pain and help you avoid additional doctor visits,
  • Seeing one of our physical therapists first means you are less likely to need addictive opioid drugs

How Our Shoulder Specialists Will Care for You

We want to make sure that we are providing you with the appropriate treatment.  As such, here are the steps that new patients go through:

  • An in-depth initial evaluation where we ask you about your pain, medical history, and current condition.
  • A detailed physical exam looking at movement, strength, flexibility, soft tissues and nerves of the neck, shoulder blade, shoulder joints, and arm.
  • A personalized plan of care to meet your goals.
  • Patient education – details of what we’ve found during the exam and how we will help you address these limitations.
  • Manual Therapy – hands-on techniques for pain relief and to restore mobility.
  • Neuromuscular Reeducation to address restrictions, weakness, and range of motion
  • A Home Program – we teach you what you can do to optimize healing at home as well.
  • Modalities – specific treatments to address your pain if needed.

See One of Our Experience Shoulder Professionals Right Away

Physical therapist directed care is proven to be an effective treatment approach for the shoulder conditions described above.  For more information, visit our contact page.  We look forward to helping you.

To Get Started Give Us a Call At One Of Our Following Clinics
Riverview Physical Therapy

  • Bath: 207-386-0351
  • Westbrook: 207-797-3477
  • Windham: 207-892-3952
  • Yarmouth: 207-846-8725

Is CrossFit Right For You?

SHOULD YOU CROSSFIT?

CrossFit is no longer a form of exercise performed in small gyms; it is a phenomenon that has taken the world by storm. At its roots, CrossFit is a popular form of exercise utilizing high-intensity fitness programming that incorporates elements from many disciplines: including weightlifting, traditional cardiovascular exercise (running, jumping rope, biking, rowing), and basic gymnastic movements. The sport has grown to an international stage and the sport’s most elite athletes perform once a year at the popular televised CrossFit Games. Originally CrossFit started as a gym in Santa Cruz, CA and evolved into an online blog that offered free programming to anyone; with its growth CrossFit is now known worldwide for both the “Sport of Fitness” and as a training methodology.

 

HOW DO I KNOW IF I AM READY:

CrossFit is a challenge for even the most experienced and fit of athletes. That being said, the untrained or unfit should not shy away. Many CrossFit ‘boxes’ (the name for a CrossFit gym) offer a 6-week beginners’ class to gradually work you into the sport and safely introduce you to the movements. Movements performed in CrossFit can be scaled to a reasonable level of difficulty which can be completed by any individual at any fitness level. This allows Olympic athletes, grandmothers, and beginners to work out side by side. For example, if you cannot do a pull-up, coaches would have you stand on a box under the bar where you would utilize your leg strength to offset using just your arms; making the task of a pull-up easier.

 

ENVIRONMENT:

CrossFit boxes have a supportive community of members who are always encouraging throughout workouts and are always willing to share their personal progress story. Each box ‘gym’ has its own personality, which is feel based on the personas of the members. Although each box is different, they all have one common theme of providing a positive environment for each participant and encourage the improvement an individual’s fitness and function.

SAFETY:

CrossFit has been in the news since 2005 regarding the safety of the sport. Two common CrossFit misinterpretations are: the movements are too hard leading to injuries, and the coaches teaching classes are not properly educated. These statements are false. CrossFit routines contain movements that would be risky for anyone with a preexisting injury to perform, but that is the case with every sport. Research of peer-reviewed literature provides statistics stating CrossFit has a significantly lower injury risk than running and a similar injury risk to Olympic lifting, gymnastics, and powerlifting. Below is a chart visualizing the injury rates of 1000 hours of training per sport:

With the evidence of the aforementioned, done correctly, CrossFit is a safe choice. Let us now move onto the CrossFit Coach. To become a CrossFit coach, one must go through a comprehensive certification process. This process has received criticism by some over the past 4-5 years for not being rigorous enough, even though, a CrossFit coach must attend a 2-day course followed by an in-person examination. The two goals of the course are;

  1. To provide attendees with the knowledge to use CrossFit Methodologies successfully for themselves.
  2. To provide attendees with initial and foundational education to begin training others using CrossFit.

 

Despite the critique of the CrossFit Coach certification process, CrossFit certification programs require in-person attendance of a live course and demonstrate the ability to perform the movements. In comparison, to be certified as a personal trainer through some of the more popular associations such as ACE, NASM, NCSF, and ASCM only require a home study course and an online exam. This provides evidence that CrossFit is more hands on in their certification process and requires coaches to have the ability to perform and teach movements safely and correctly.

 

FREE CLASSES:

Becoming a member at a CrossFit box is expensive, but there are other options to get your toes wet in the sport. Some CrossFit boxes offer a “Sweaty Saturday” workout that is free to the general public. Many of the Sweaty Saturday classes are designed for individuals with no prior lifting experience and do not incorporate Olympic lifts or power lifts. The typical Sweaty Saturday is a mix of cardiovascular exercise and general strength training. Check with your local CrossFit affiliated box for details.

CROSSFIT FROM A PHYSICAL THERAPIST PERSPECTIVE:

CrossFit is an exciting sport that can be performed with a injury risk no higher than many popular sports. The key is to ease into the sport like you would any other sport. An individual cannot go from little exercise to playing 15 hours of tennis a week and be surprised when they get a tennis elbow injury. It is my opinion, as a physical therapist and CrossFit athlete, that CrossFit is a great activity to participate in if you are healthy enough for exercise. That being said, I am 100% for each individual finding any activity that gets them up and moving! Before beginning any new physical activity routine, it is suggested that you first consult with your physician.

 

AUTHOR:

Dr. “Ted” Edward S. Greeley II, P.T., D.P.T., C.S.C.S. is a physical therapist at Riverview Physical Therapy in Westbrook, ME. He enjoys CrossFit because of the internal competition the sport provides for him to better himself. When outside of

patient care or CrossFit, Ted enjoys skiing, rock climbing, ice hockey, and passing on his love of the outdoors to his son. He also enjoys attending conferences and courses to stay up to date with the newest research in his field.

ARTICLE RESOURCES: The Epidemiology of Injuries Across the Weight-Training Sports – Sports Med. 2017 www.fitnesspainfree.com

Running Injuries. A review of the Epidemiology Literature – Sports Med.

1992https://www.ncbi.nlm.nih.gov/pubmed/1439399

Incidence of Running-Related Injuries Per 1000 h of running in Different Types of Runners: A Systematic Review and Meta- Analysis – Sports Med. 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4473093/

Quantifying the risk of sports injury: a systematic review of activity‐specific rates for children under 16 years of age – British Journal of Sports Medicine. 2007 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2465389/

CrossFit course website https://training.crossfit.com/

American Academy on Exercise websitehttps://www.acefitness.org/fitness certifications/default.aspx

Running to Breathe: Why I drove 5800 miles for a trail race

Imagine hobbling into a doctor’s office the first week after getting off of crutches and then imagine that you ask him if you can run a trail marathon in a few weeks. You probably can guess how he would look at you. And that’s exactly how physical therapist Greg Knapton looked at me. Ever the consummate diplomat, he said, “I’m not going to tell you you can’t do it, but…” He trailed off and proceeded to put me through the paces of PT exercises I never knew existed. He tired out muscles I didn’t know I had. Masking both of our struggles, another patient and I joked that Knapton was a sadist, as we groaned our way through the exercises that we knew were good for us. He played along.

In truth, it was a long shot that I was going to do this. My left quad, I was told, had “stopped firing” in order to protect my left knee. Why? Because I had hammered my left knee downward into a tree root on a training run in the forest. A few stitches, a tetanus shot, and a week on crutches later, it was as though my left leg had amnesia. After months of training for this race–running for sometimes four hours at a time–I was now a hot mess. The doctor saw tears in my eyes.

“I get it.” he said. “When does it hurt most?”

“When I walk. And,” I added, helpfully, “when my knee is bent in a sitting position for awhile.”

“You’re telling me that you want to drive across the country to Utah to race and it hurts to sit?”

There it was. The idiocy of my desire was out in the open. That was exactly what I wanted to do. Drive 5800 miles round trip to compete in the Moab Trail Marathon through rugged Utah terrain. Yup. When he put it that way, it sounded hopeless.

Breathe. Breath. Air. Oxygen. We can’t live without it. As much as we have explored the

deepest oceans, have climbed the highest mountains, and have rocketed to the most distant heavens, we have had to figure out how to breathe where there is no oxygen. Millions of people had been struggling to breathe. More than a quarter of a million people have now died over the past several months from the pandemic, losing their battle to take their next breath. Millions more had their conscience permanently pierced–mine included–by George Floyd’s last cry, “I can’t breathe.” Countless–no, generations–of African Americans have not been able to breathe for the knee on their collective neck. It felt as though injustice and the pandemic were sucking the very air out of all of our lives, yet some were impacted far more than others.

I felt the weight of it all on my chest. I felt suffocated. I thought I would go mad if I couldn’t breathe. I looked at my knee that had recently approached the appearance of an oversized baseball; it was nothing but a tiny malady against the backdrop of a national disaster. Get over it, I told myself.

My fear of flying during the pandemic was another hurdle to my goal. There was no way I was getting on a plane and sharing air for hours with other people, even if the airlines

produced ten more videos about air circulation safety. My husband and I had already worked out a safe way to cross the country earlier this year–camping, cooking our own food on a camp stove, carrying our own water and avoiding people like the plague we all really are at this point. We were a bubble on wheels. We started out from Maine on October 30th and hoped the blizzard on our first day of driving wasn’t a bad omen.

Four days of driving and lots of remote-work using- hotspots later, we pulled into the red rock country of Moab, Utah. We arrived a few days before the race to acclimate to altitude. When we drove through Colorado, we stopped at a gem of a trail running place–Staunton County State Park. The 8000+ foot elevation had handed our backsides to us with a polite smile. Even though the Moab race would crest between 5000-6000 feet, our seaside homeland put us at a distinct disadvantage. Imagine throwing a bag of bird seed on your back and trying to run with that. Add a slight headache and some intestinal distress and you get the picture. Not exactly prime racing form. Between adjusting to altitude and rehabbing my leg as we drove across the country, I decided I should run in the half marathon length instead of the full 26 miles. This would at least make me half sane, right? Coronavirus in Utah worsened considerably as we crossed the country. Conditions were making the national news. I contacted the race director who was answering the same question hundreds of times. The list of protocols was long; the plan sounded solid and safe, even to me. It felt like the universe was throwing every possible obstacle in the book. But, of course, it wasn’t done. Race day dawned with two weather warnings: extremely high winds and thunder and lightning in the afternoon. Anyone who knows me knows that my eyes roll into the back of my head at the mere prospect of being outside in a lightning storm, never mind being miles and miles from a finish line and up on top of a mesa.


Pritchett Canyon, Moab, Utah

“We are what we breathe.” To me, this is as true as “we are what we eat.” What we put into our bodies–food, water, air–defines us in so many ways. On this day–race day–I would breathe dust, sagebrush, fear, and healing.

The sun shone brightly, making it surprisingly hot for November. Twenty of us stood at the mouth of Pritchett Canyon, spaced carefully apart from one another by bright red disks nailed into the dirt. We all wore masks. The previous wave of runners had left five minutes earlier. My husband’s marathon had departed hours ago. The wind lifted fine sand from the mesas around us and tried to scour our exposed skin. I congratulated myself for deciding to wear glasses; the eye protection would be necessary today.

The race director, Danelle Ballengee, began a long pep talk as our wave awaited our start time. I thought about how she was famous as an ultra runner because she had survived a terrible accident on a solo training run with her dog. Danelle fell 80 feet, then crawled for hours with a broken pelvis, until her dog eventually led rescuers to her 48 hours later. This gave her advice authority when she advised that we hydrate frequently throughout the four-mile ascent through Pritchett Canyon. She said when we ascended the mesa, we didn’t want to be dizzy or light-headed because we would be running along cliff edges. Cliff edges? She had my full attention. Correct; as someone with a fear of heights, I did not want to feel light headed on a cliff edge, thank you very much. She casually mentioned that they had already extracted one man from a prior wave. She hoped there wouldn’t be more. Yeah, me, too.

One minute remained to start. Danelle pointed out to us all how the marathoners–on a trail high above us–were disappearing into a red rock tunnel and then re-emerging further down the face of the cliff. I looked to see if I could glimpse my husband, hoping he hadn’t been the man that they had to extract. Anything could happen to anyone. I flexed my left knee; I had definitely made the right decision not to run the 26 mile length. Thirteen would be enough. But I vowed to get through the half marathon and come back next year for the full marathon. Would all the PT and anti-flammatory hold? I really wasn’t sure.

“5-4-3-2-1-have fun!” Danelle shouted. We were off. Running up Pritchett Canyon meant following the wash–or eroded floor of the canyon. We alternated between running over bedrock–worn smooth by a millenia of flood waters–and plowing through red sand, deep as a beach dune. The wash was wide enough that we remained spread out as we ran. The beauty of the landscape demanded my attention; cliffs shot skyward in castle-like formations, set against a crystal blue sky. The thunderstorms forecasted were nowhere in sight, yet.

They had warned us that many different types of sportsmen used Pritchett Canyon and that we would need to watch out for mountain bikers and ATVs. Somehow, this didn’t prepare me for the spectacle of a convoy of five vehicles in the middle of nowhere, each resembling a cross between a Humvee and a dune buggy. Think Mad Max. A crowd of people stood on the edge of a high ledge on the canyon wall. They spectated as though from bleachers. One ATV was attempting to drive up the nearly vertical wall. Its motor roared and people watched with rapt attention. Without a doubt, they considered the runners a nuisance because the vehicles needed to either stop or slow to allow our wave to pass.

In the last mile of the canyon, we were ascending more steeply onto the mesa. Here we came across a souped-up pickup truck doing much the same as the ATVs previously. My father would have been able to tell you the make, model, and year of the truck, in addition to how it had been modified. I can only tell you it was big, white, and perched vertically–stuck, really–on a cliff face that was so vertical, I needed to use both hands to climb up the cliff face myself.

The truck lurched back and forth off to the left of where my running mates were disappearing over the canyon rim high above my head. A white-haired man stood above the truck, shouting instructions. The young driver gunned the motor again, but the truck remained stuck.


Looking down onto the Pritchett Canyon Trail. Tiny runners visable on the trail

Maybe I’m not proud of what I did next, but I couldn’t help myself. I had now clambered up high enough that I was eye level with the driver. The passenger window was open. The whitehaired guy shouted to the driver–who was maybe in his twenties–” I think it would work better over where she is,” and he pointed at me. The driver turned and looked me in the eye.

I grinned and said, “You know it’s faster to just climb up.” And I was gone. I know people enjoy the thrill of motorized vehicles on rugged terrains. I’ve taken an off-road jeep ride–once; it was fun. But when a woman twice your age scrambles up a cliff face in the blink of an eye while you remain stuck with your headlights skyward, well it just strikes me as a bit absurd. But, then, most people would view doing this race as absurd.

That was the last of vehicles, though, because I had crested onto the mesa, some 1000 feet above the starting line. By the time I reached the first aid station, my water bottles were empty and needed refilling. I gulped down a second gel and started to run back and forth among short juniper trees. The short reprieve from climbing was most welcome. Then, I saw the black clouds amassing behind the next mesa. If a storm overtook the runners, there was absolutely nowhere to go. The only way to get out of this race was to finish it. I tried to focus on my running form, remembering what the physical therapist had told me, keeping my stride as uniform as possible. So far, my knee was holding up.

Then, below the trail to my left, the next canyon–Hunter Canyon– yawned like a cavernous slash in the earth. It was breathtakingly beautiful. Running time and storm clouds be damned, I had to stop and take pictures. I wanted to remember this feeling of elation and surprise; I wanted to breathe this millenia of geological history into my lungs (filtered by my buff, of course). I picked my way along the trail, sometimes running between trees and boulders. Other times, I was climbing carefully over bedrock outcrops where the trail pinched out at the canyon edge. I wanted to remember how alive I felt, how each step I took mattered and where I couldn’t afford a moment of inattention or mindlessness.


Pausing to capture a view down into Hunter Canyon from its rim trail

Step. Grab. Pull. Breathe. Follow the trail. Keep going. Drink. Eat. Breathe. And breathe again.

During the rim trail section, I overtook a man from a previous wave who was quite elderly. In the running world, this category is called “master runner,” though. He ran with two trekking poles to balance his stooped spine. He moved slowly, but steadily, clearly knowing his own pace. I briefly felt the impulse to ask him how he was doing, but I knew that would be patronizing. Instead, I offered a “Hello” and “Isn’t it a beautiful day?” as I passed him. He smiled broadly and nodded. He was definitely okay and I hoped I could do this well when I was his age.

The storm clouds crowded closer and droplets splattered on the dry sand. The wind continued to pound, push, and scour. The glasses and buff were welcomed shields.


Storm clouds threaten on the horizon.

It was all bedrock now and the trail turned sharply rightward and downward. The descent into Hunter Canyon had started. The trail narrowed and narrowed until I looked almost directly down beneath my feet.

Suddenly, a young man appeared, standing facing me on the trail, patiently waiting. “Hi,” he said. “I’m here to help you get down.”

“Oh?” I was really thinking “uh-oh.”

 “You need to climb down this rock face here,” he pointed. “Then follow that ledge to your right.”

“Okay,” I replied, with the bravest voice I could manage.

It was clear that if you missed this exact route, you could get stuck on a vertical face. If it weren’t for the coronavirus (and perhaps two decades of age difference), I could have kissed him with gratitude for being there as a support.

“Be careful,” he said, as I started down. And then as I hit the ledge, “You okay?”

“Thank you,” I called up. And he went off to reposition himself for the next runner.

Volunteers manned the second aid station at the bottom of the canyon. I refilled water again, gratefully. “Having fun?” the volunteer asked.


Ascent out of Hunter Canyon on Kane Creek Road. Tiny runners visible on road

I paused. My most recent emotions had trended closer to fear and then relief. But his question re-centered me. “Yes,” I replied. “I love this.”

Thankfully, the core of the weather front had not yet hit. Hot sunshine and dark clouds took turns flipping the temperature back and forth. Given that the next section of the race, wound mile after mile through deep canyon washes of Kane Creek, the delay in the rain was a blessing. Thunderstorms in the desert could turn these washes into flash flood zones. For now, they remained corridors of dry cobble and deep sand that were lined by cliffs or scrub oak and occasional cactus.

As had been the case for the past hour, I ran alone. No sound of planes. No sound of automobiles. No sound of people. Just footfalls and the rhythm of my breathing–heavy breathing, at this point. I felt tired and my left quad was starting to complain. With the finish line only a few miles away, I ran through more deep washes, dodged cactus, hand-scrambled up steep slopes, kept a strong pace down a long stretch of dirt road, tiptoed across a narrow wooden footbridge, and slogged through more deep sand. Naturally, the final approach to the finish line required a crawl up the sandy face of a bluff. How appropriate.


Running the half marathon in Moab, Utah

You know the moment when you hug a family member and the embrace lingers? You each take multiple breaths and feel your ribs rise and fall against each other. You know the moment when you sit with a dear friend and you put your heads together? You feel the warmth of the friendship in the breath on your cheek. You know the moment when you check on a sleeping loved one, when you draw close enough for the rise and fall of their breath to meet your own? You feel reassured that all is well. Then there’s that moment when you and your friends’ conversation dissolves into uproarious laughter.

Nearly all of this is missing from my life right now; the absence of this shared breath is like suffocation. I needed to breathe deeply, to feel alive, to fill myself with a healing breath. As I stepped over the finish line and bent over to gasp for more air, I felt filled.

For those trail runners or readers who might also feel suffocated by the injustices around us, I encourage you to consider donating to Murdered & Missing Indigenous Women. Indigenous women are murdered at a rate ten times higher than other groups, making it the third leading cause of their death.

 Patricia Erikson blogs about writing, trail running, travel, and science from the award-winning city of Portland, Maine. If you haven’t already, follow her on Instagram at @seashorewrite (https://www.instagram.com/seashorewrite/) or subscribe to Peaks Island Press.

Greg Knapton

Greg Knapton, PT, ATC, Partner
Clinic Director - Westbrook

Greg, a native of Westbrook, earned his physical therapy degree from the University of Vermont in 1992. Greg also completed a fellowship in Sports Medicine through the American Sports Medicine Institute in 1998 and has been a certified athletic trainer since 2000. He is currently the owner of Riverview Physical Therapy, established in 2002, with locations in Bath, Westbrook, Windham and Yarmouth. Riverview PT also provides Athletic Training services at both Westbrook and Yarmouth High Schools, averaging 30 hours/week during the school year.

As a runner himself, Greg has first-hand knowledge of the demands running puts on the body. Through his own experience and that of his patients, Greg has developed the necessary skills and knowledge to assist all levels of runners returning to their sport. In addition to treating patients, Greg regularly teaches runners & triathletes at area companies and specialty retail stores about injury prevention, warm-up and cool-down techniques, proper footwear and how to avoid and care for some of the most common injuries. When not treating patients, Greg enjoys running and spending time with his wife Karen and their three boys.

'Ted' Edward S. Greeley II

"Ted" Edward S. Greeley II, PT, DPT, CSCS

What led you to become a PT?

I am one of the few therapists I know that did not receive any physical therapy as an athlete through my youth. I first attended college for mechanical engineering and wanted to find a career that kept me active through the day but still challenged my mechanical mind. I eventually made my way to the career I love.

With all of the PTs available, why should a patient choose you?

I treat the whole body and multiple body systems not just the area that hurts. The main dysfunction is often not the pain location. I try to make therapy fun and have some laughs on the road to recovery.

What do you like to do outside of work?

Spending time with my wife and kids in the outdoors preferably hiking, camping, disc golf, hunting, or attending my kids sports games.

Catherine Heath

Catherine Heath, DPT

What led you to become a PT?

Fascination with the human body and its response to exercise led me to physical therapy. I was originally interested in professional coaching but then found I was more interested in rehabilitation.

With all of the PTs available, why should a patient choose you?

I gear every treatment plan towards an individual’s fitness level to aid them with meeting their personal goals. We are all unique individuals; therefore, your treatment should be unique to you. As an endurance athlete, I know the importance of proper care and training.

What do you like to do outside of work?

I enjoy a variety of outdoor activities Maine has to offer: hiking, camping, biking, rock climbing and skiing. I’m an avid triathlete and compete in long-distance running events.

Derek Milone

Derek Milone, MS, PT

What led you to become a PT?

I found myself injured frequently as a high school athlete which naturally landed me in a physical therapy office. I experienced the healing effects that a seasoned therapist can provide. I also noticed that all the physical therapists were having fun. This led me to pursue PT in college and here I am talking to you.

With all of the PTs available, why should a patient choose you?

I have the ability to assess both the root cause of dysfunction and empower people to find their physical and mental strength. I partner with my patients to motivate them to reach their goals.

What do you like to do outside of work?

I like to stay active whether it is snowboarding, hiking, boating, taking in a car show or hanging out with my wife and kids. I am a weekend warrior car mechanic and you can find me in church on Sunday.

Nathaniel Runge

Nathaniel Runge, DPT

What led you to become a PT?

I was a second-year pre-med major with no occupation in mind. I knew I wanted a job that was hands on and interacted with people. After shadowing many medical positions, I knew PT was the one for me.

With all of the PTs available, why should a patient choose you?

Both my patient and I can often forget we’re doing work during our interaction because we slip a lot of fun and music appreciation in with my comprehensive PT program. And at day’s end, I think to myself, “Oh, yeah, I have to document this!”

What do you like to do outside of work?

I have three daughters under the age of 10 so much of my life focuses around them. When I am not contributing to all the interactions of family life, I am volunteering for various coaching positions.

Nancy Crawford

Nancy Crawford, PT
Clinic Director - Windham

What led you to become a PT?

My interest in Physical Therapy began in High School. At the time, I was exploring possible career paths that would blend my love for science and desire to work with people. I quickly found that Physical Therapy was the ideal blend of my interests. After over 20 plus years of PT, I have not regretted my decision. I continue to find it to be a satisfying and interesting profession.

With all of the PTs available, why should a patient choose you?

I offer over 20 years of experience, not only in outpatient orthopedics but also in rehabilitation of neurological disorders. I regularly attend continuing education classes to keep my skills current and innovative. We have a strong team approach at Riverview and work together to improve our patients’ function and minimize pain.

What do you like to do outside of work?

On the weekends, I can usually be found doing some kind of activity in the outdoors. I enjoy hiking, skiing, cycling and kayaking.

Jodi Mitchell

Jodi Mitchell, PTA, ATC

Coming soon...
Matt Douglas

Matt Douglass, PT

Coming soon...
Chris Heuss

Christine Dube, PT

What led you to become a PT?

A friend of the family who had a background in physical education led me into it. He was working with a chiropractor, I shadowed him and found that I liked being in the medical field.

With all of the PTs available, why should a patient choose you?

I think sometimes people are very fearful when they come in for physical therapy. I try to get to know them outside of the injury and that leads to developing a good plan of care.

What do you like to do outside of work?

I enjoy cooking and hanging out with friends, watching my kids play volleyball, paddle boarding, snowshoeing and walking my dog.

Michael Viricel

Michael Viricel, MSPT, CSCS

What led you to become a PT?

Growing up, I was always enjoyed math and science classes. In high school, I took an Anatomy and Physiology class, which sparked my interest in pursuing a career in a health-related profession. I wasn't sure which direction to take when looking at colleges, so I applied to multiple schools with different choices of major. I settled on Husson College and chose Physical Therapy as my major. The choice was made based on being able to live at home and maintain a part-time job while in school. I was not sure how much I would enjoy Physical Therapy when I started, but once I got into science and anatomy classes, I was hooked.

What motivates you professionally?

I really love when I can improve a patient’s quality of life and return them to pain-free functional mobility. I know I've done my job well when a former client refers family and friends to me. That’s what keeps me motivated in continuing my career as a physical therapist.

Chris Heuss

Chris Heuss, PT
Clinic Director - Bath

What led you to become a PT?

I was working as a counselor and advocate for adults with disabilities and I saw the significant benefit that occurred when I took my clients to their physical therapy sessions and I thought, “I want to be a physical therapist.”

With all of the PTs available, why should a patient choose you?

I’m very good at listening to my patients and finding out their personal goals. People seem to feel really comfortable hanging out with me and our clinic has a very friendly environment.

What do you like to do outside of work?

I like the outdoors so backpacking, kayaking and, more recently, I’ve taken up rock climbing. I like to hike in the White Mountains and the Katahdin region, and I am most happy when I’m doing this with my wife and two teenage boys.

Carrie Mitchell

Carrie Mitchell, ATC & PTA

What led you to become a physical therapist assistant?

I wanted to pursue a medically based profession. Also, I've always been interested in sports/health, so athletic training/sports medicine and physical therapy were a logical choice.

What makes you a great assistant to work with?

I have been in my career since 1990, so I do have years of experience on my side. My first job out of college allowed me to work in an environment that fostered forward-thinking and learning. I was lucky enough to work with many exceptional clinicians, one of whom is the owner of Riverview. I feel so lucky to work in a profession I love and am able to constantly learn and grow in.

What do you like to do outside of work?

I enjoy teaching Vinyasa Flow yoga and have for 4 years. I love trail running at our local land preserve all year round. My husband and two chocolate labs also love skiing, hiking and boating. We have lived in the Midcoast for 24 years and love every minute of it!

Hallee

Hallee Breton, DPT

What led you to become a PT?
I grew up dancing with a focus in ballet and always had an appreciation for the human body and human movement. I learned how to use certain muscles in my body to create very specific movements and developed acute sense for body awareness which translates perfectly to physical therapy practice. I was always interested in medical sciences and knew I didn't want to have a desk job so physical therapy was a perfect fit!
With all the PT's available, why should a patient choose you?
I love getting to know people. I really try to understand people and the lives they lead and incorporate that in how I evaluate and treat my patients. Everyone is different and going through different challenges in their lives and I try to be a support for them for their physical and mental health. Plus I like to have a good time with my patients!
What do you like to do outside of work?
I am an avid snowboarder in the winter; Sugarloaf is my mountain! And in the spring and summer, I love going camping, hiking, and have taken up golfing. I love being outdoors in any way, shape, or form.
Greg Knapton

Greg Knapton, PT, ATC, Partner
Clinic Director - Westbrook

Greg, a native of Westbrook, earned his physical therapy degree from the University of Vermont in 1992. Greg also completed a fellowship in Sports Medicine through the American Sports Medicine Institute in 1998 and has been a certified athletic trainer since 2000. He is currently the owner of Riverview Physical Therapy, established in 2002, with locations in Bath, Westbrook, Windham and Yarmouth. Riverview PT also provides Athletic Training services at both Westbrook and Yarmouth High Schools, averaging 30 hours/week during the school year.

As a runner himself, Greg has first-hand knowledge of the demands running puts on the body. Through his own experience and that of his patients, Greg has developed the necessary skills and knowledge to assist all levels of runners returning to their sport. In addition to treating patients, Greg regularly teaches runners & triathletes at area companies and specialty retail stores about injury prevention, warm-up and cool-down techniques, proper footwear and how to avoid and care for some of the most common injuries. When not treating patients, Greg enjoys running and spending time with his wife Karen and their three boys.

'Ted' Edward S. Greeley II

"Ted" Edward S. Greeley II, PT, DPT, CSCS

What led you to become a PT?

I am one of the few therapists I know that did not receive any physical therapy as an athlete through my youth. I first attended college for mechanical engineering and wanted to find a career that kept me active through the day but still challenged my mechanical mind. I eventually made my way to the career I love.

With all of the PTs available, why should a patient choose you?

I treat the whole body and multiple body systems not just the area that hurts. The main dysfunction is often not the pain location. I try to make therapy fun and have some laughs on the road to recovery.

What do you like to do outside of work?

Spending time with my wife and kids in the outdoors preferably hiking, camping, disc golf, hunting, or attending my kids sports games.

Catherine Heath

Catherine Heath, DPT

What led you to become a PT?

Fascination with the human body and its response to exercise led me to physical therapy. I was originally interested in professional coaching but then found I was more interested in rehabilitation.

With all of the PTs available, why should a patient choose you?

I gear every treatment plan towards an individual’s fitness level to aid them with meeting their personal goals. We are all unique individuals; therefore, your treatment should be unique to you. As an endurance athlete, I know the importance of proper care and training.

What do you like to do outside of work?

I enjoy a variety of outdoor activities Maine has to offer: hiking, camping, biking, rock climbing and skiing. I’m an avid triathlete and compete in long-distance running events.

Derek Milone

Derek Milone, MS, PT

What led you to become a PT?

I found myself injured frequently as a high school athlete which naturally landed me in a physical therapy office. I experienced the healing effects that a seasoned therapist can provide. I also noticed that all the physical therapists were having fun. This led me to pursue PT in college and here I am talking to you.

With all of the PTs available, why should a patient choose you?

I have the ability to assess both the root cause of dysfunction and empower people to find their physical and mental strength. I partner with my patients to motivate them to reach their goals.

What do you like to do outside of work?

I like to stay active whether it is snowboarding, hiking, boating, taking in a car show or hanging out with my wife and kids. I am a weekend warrior car mechanic and you can find me in church on Sunday.

Nathaniel Runge

Nathaniel Runge, DPT

What led you to become a PT?

I was a second-year pre-med major with no occupation in mind. I knew I wanted a job that was hands on and interacted with people. After shadowing many medical positions, I knew PT was the one for me.

With all of the PTs available, why should a patient choose you?

Both my patient and I can often forget we’re doing work during our interaction because we slip a lot of fun and music appreciation in with my comprehensive PT program. And at day’s end, I think to myself, “Oh, yeah, I have to document this!”

What do you like to do outside of work?

I have three daughters under the age of 10 so much of my life focuses around them. When I am not contributing to all the interactions of family life, I am volunteering for various coaching positions.

Nancy Crawford

Nancy Crawford, PT
Clinic Director - Windham

What led you to become a PT?

My interest in Physical Therapy began in High School. At the time, I was exploring possible career paths that would blend my love for science and desire to work with people. I quickly found that Physical Therapy was the ideal blend of my interests. After over 20 plus years of PT, I have not regretted my decision. I continue to find it to be a satisfying and interesting profession.

With all of the PTs available, why should a patient choose you?

I offer over 20 years of experience, not only in outpatient orthopedics but also in rehabilitation of neurological disorders. I regularly attend continuing education classes to keep my skills current and innovative. We have a strong team approach at Riverview and work together to improve our patients’ function and minimize pain.

What do you like to do outside of work?

On the weekends, I can usually be found doing some kind of activity in the outdoors. I enjoy hiking, skiing, cycling and kayaking.

Jodi Mitchell

Jodi Mitchell, PTA, ATC

Coming soon...
Matt Douglas

Matt Douglass, PT

Coming soon...
Chris Heuss

Christine Dube, PT

What led you to become a PT?

A friend of the family who had a background in physical education led me into it. He was working with a chiropractor, I shadowed him and found that I liked being in the medical field.

With all of the PTs available, why should a patient choose you?

I think sometimes people are very fearful when they come in for physical therapy. I try to get to know them outside of the injury and that leads to developing a good plan of care.

What do you like to do outside of work?

I enjoy cooking and hanging out with friends, watching my kids play volleyball, paddle boarding, snowshoeing and walking my dog.

Michael Viricel

Michael Viricel, MSPT, CSCS

What led you to become a PT?

Growing up, I was always enjoyed math and science classes. In high school, I took an Anatomy and Physiology class, which sparked my interest in pursuing a career in a health-related profession. I wasn't sure which direction to take when looking at colleges, so I applied to multiple schools with different choices of major. I settled on Husson College and chose Physical Therapy as my major. The choice was made based on being able to live at home and maintain a part-time job while in school. I was not sure how much I would enjoy Physical Therapy when I started, but once I got into science and anatomy classes, I was hooked.

What motivates you professionally?

I really love when I can improve a patient’s quality of life and return them to pain-free functional mobility. I know I've done my job well when a former client refers family and friends to me. That’s what keeps me motivated in continuing my career as a physical therapist.

Chris Heuss

Chris Heuss, PT
Clinic Director - Bath

What led you to become a PT?

I was working as a counselor and advocate for adults with disabilities and I saw the significant benefit that occurred when I took my clients to their physical therapy sessions and I thought, “I want to be a physical therapist.”

With all of the PTs available, why should a patient choose you?

I’m very good at listening to my patients and finding out their personal goals. People seem to feel really comfortable hanging out with me and our clinic has a very friendly environment.

What do you like to do outside of work?

I like the outdoors so backpacking, kayaking and, more recently, I’ve taken up rock climbing. I like to hike in the White Mountains and the Katahdin region, and I am most happy when I’m doing this with my wife and two teenage boys.

Carrie Mitchell

Carrie Mitchell, ATC & PTA

What led you to become a physical therapist assistant?

I wanted to pursue a medically based profession. Also, I've always been interested in sports/health, so athletic training/sports medicine and physical therapy were a logical choice.

What makes you a great assistant to work with?

I have been in my career since 1990, so I do have years of experience on my side. My first job out of college allowed me to work in an environment that fostered forward-thinking and learning. I was lucky enough to work with many exceptional clinicians, one of whom is the owner of Riverview. I feel so lucky to work in a profession I love and am able to constantly learn and grow in.

What do you like to do outside of work?

I enjoy teaching Vinyasa Flow yoga and have for 4 years. I love trail running at our local land preserve all year round. My husband and two chocolate labs also love skiing, hiking and boating. We have lived in the Midcoast for 24 years and love every minute of it!

Hallee

Hallee Breton, DPT

What led you to become a PT?
I grew up dancing with a focus in ballet and always had an appreciation for the human body and human movement. I learned how to use certain muscles in my body to create very specific movements and developed acute sense for body awareness which translates perfectly to physical therapy practice. I was always interested in medical sciences and knew I didn't want to have a desk job so physical therapy was a perfect fit!
With all the PT's available, why should a patient choose you?
I love getting to know people. I really try to understand people and the lives they lead and incorporate that in how I evaluate and treat my patients. Everyone is different and going through different challenges in their lives and I try to be a support for them for their physical and mental health. Plus I like to have a good time with my patients!
What do you like to do outside of work?
I am an avid snowboarder in the winter; Sugarloaf is my mountain! And in the spring and summer, I love going camping, hiking, and have taken up golfing. I love being outdoors in any way, shape, or form.
Nathaniel Horton

Nathaniel Horton, PT, DPT

What led you to become a PT?

Both of my parents were teachers, and my original plan was to become a math teacher myself. However, I developed a passion for learning about the human body, injuries, and performance during my senior year of high school after a running injury ended my cross‐country career early. I switched from running to weightlifting but encountered repeated shoulder and back injuries that limited my ability to make progress. Through these experiences, I learned that the way your body feels can profoundly impact the rest of your life, for better or for worse. The summer before starting college, I switched my degree plan from math education to exercise science and pre‐physical therapy, and the rest is history. The best part is that I still get to be a teacher, because teaching others how to feel better is the most rewarding part of my job.

With all the PT's available, why should a patient choose you?

My priority for each patient is that they feel heard and respected. Nobody knows your body better than you do, and your input is of utmost importance throughout the physical therapy episode of care. I work hard to provide individualized and holistic treatments to each patient, and to serve primarily as a guide on the journey of healing.

What do you like to do outside of work?

My wife and I moved to Maine in May of 2021 because we love spending time outdoors and wanted to live somewhere that felt like a community. We are always looking for new trails and places to explore around Maine, as well as new activities and events. Some of my favorite activities include running, hiking, weightlifting, and recreational sports such as pick-up basketball and disc golf.

Matthew

Matthew O'Brien, PT, DPT

What led you to become a PT?

I decided to become a physical therapist when I had a severe hip injury resulting in surgery when I was 15. I was told by multiple doctors that running and sports were out of the question for my future. Since exercise and movement are integral to who I am as a person, this was devastating. Thankfully I was set up with a physical therapist who not only helped me recover, but helped me return to running and sport so that I could compete throughout my entire education without issue. That therapist helped give me that part of my life back and I want to do the same for others.

What makes you a great PT to work with?

As a therapist, I strive to provide an approachable and positive atmosphere for my patients to help develop a working relationship with their individual needs and goals in mind. My education and passion for movement are what motivate me to stay as current as possible on research and seeking new ways to help others help themselves.

What do you like to do outside of work?

When I am not in clinic I am doing anything outside: mountain and trail running, hiking, backpacking, skiing, biking, and paddling with my fiancé and my three dogs. Anything that involves fresh air and moving!

Morgan Segale

Morgan Segale, DPT

What led you to become a PT?

Ever since I was a kid I have been involved in sports. From pre-K soccer to a three season athlete in high school and eventually playing rugby at Stonehill College. I was always drawn to sciences in school but it wasn’t until being a lab assistant for anatomy and physiology that I realized how to merge my love for sports with my passion for science and the human body.

What makes you a great PT to work with?

I enjoy meeting and making new connections with people and it’s a plus that I get to help people feel better while doing so! I strive to take a full body approach to treatments taking into consideration individualized goals and outcomes.

What do you like to do outside of work?

On my free time I enjoy spending time outside with our two dogs, Tito and Jax. In the summer you’ll find me paddle boarding, hiking and camping and in the winter on the ski slopes

Kayla Hernderson

Kayla Henderson, PTA

What led you to become a physical therapist assistant?

I knew that I wanted to be in the field for a long time. I love working with people and helping them get better, reaching the goals that they may have thought were out of reach; getting back to things that they may have thought were out of the question again. After earning my bachelor's degree, I took some time off and after a few years decided to go back to school to achieve my goal, and I was able to do it without any more student load debt!

What makes you a great assistant to work with?

I feel like I am personable and can connect with people easily. I am very compassionate, and that really helps people feel more comfortable. I like to talk and find out what their interests are so I can connect on a personal level as well. I am very confident in my skills and that translates through my treatments.

What do you like to do outside of work?

I spend a lot of time with my kids; but when I get time I love to cook and bake; our menu generally includes one new recipe per week. I also do a lot of sewing. Most recently I have made reusable zipper snack bags.