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Jim earned his Doctorate of Physical Therapy from Saint Louis University. He is a certified Orthopedic Clinical Specialist and trained in the Selective Functional Movement Assessment (SFMA) and Functional Movement Screening (FMS) systems. His educational and clinical background have made him an expert in manual and manipulative physical therapy as well as functional movement. Jim opened Heafner Health Physical Therapy in February, 2016.  ​When Jim is not treating patients in the clinic, he focuses his attention on educating fellow physical therapists in the profession, teaching manual therapy courses in Arizona and Texas, and writing. Jim has authored 3 books, including “Making Sense of Pain” and “The Yoga Fix”. Additionally, his Student Physical Therapy based blog attracts upwards of 65,000 views per week. His areas of expertise include Orthopedics, Manual Therapy, Chronic Pain Management, Functional Movement, Patient Education.

David Mesnick is a licensed Physical Therapist with over 25 years experience in owning and operating multiple outpatient physical therapy practices. David is originally from Toledo, Ohio and was raised in Palm Beach Gardens, Florida. David graduated from the University of Florida in 1997 with a B.S. in Zoology and then again in 1999 with a B.S. in Physical Therapy.
David’s clinical emphasis is in manual osteopathic physical therapy with a focus on spine and sacroiliac joint dysfunction (SIJD). David is a board Certified Orthopedic Specialist (OCS) as well as a certified McKenzie Therapist (CMDT). He is also a Certified Functional Dry Needling Practitioner (FDN) and a certified Selective Functional Movement Assessment (SFMA) practitioner.

He has taught several continuing education courses to other health practitioners, and Has authored both articles and books on SI joint dysfunction. David has also authored Cash-Based Physical Therapy: A Step by Step Guide to Your Successful Start Up.

Melissa graduated with a Bachelor’s Degree in Movement Science and completed her Masters in Physical Therapy from Touro College (now University) where she received the “Maimonides Award for Excellence”. She attained a Doctorate of Physical Therapy (DPT) from Simmons College. She worked at NYU Langone’s Medical Center/Rusk Institute of Rehabilitation with orthopedic and neurologic patients, and transitioned to the outpatient physical therapy setting. She is known for her compassion and great listening skills.

Occupational Therapist specializing in Pelvic Health

Tennis Elbow Queen, Olympic / Team GB physical therapist and best-selling author, healing tennis players and golfers around the world.

Melissa is a physical therapist at the Veterans Hospital in Dover, Delaware. She works in a community based outpatient clinic.

Hi, I’m Mitch! I’m a PT, and strength coach based out of Miami, Florida! Currently I work for Old Bull Athletics as a clinician and performance coach. Additionally I teach a CSCS prep course at the university level with Gifted Education, and I have my own online fitness coaching business.

My background started at the University of South Carolina, where I studied exercise science and got to do sport science with their D1 athletics programs. Additionally I facilitated the creation of Apex Athletic Performance’s sport biomechanics lab during this time.

I have my doctorate in physical therapy from the Medical University of South Carolina. During this time, I got experience working with EXOS and professional athletes. I also have experience working with the University of Florida’s running medicine staff.

Personally, my sport background includes competing in martial arts as a junior at the national and international levels. Currently, my sport focus is on powerlifting and general athletic development. 

On my page you can expect a biopsychosocial approach to fitness and rehab, as well as a pragmatic view of the current evidence.

The question is, what is the pelvic floor? The pelvic floor is a group of muscles that resides at the bottom of the pelvis. I have a female pelvic model right here. Everything you see in white is bone. Everything you see in red is the pelvic floor which is muscle. It's bordered by the pubic symphysis in the front, the spine, and the sacrum and the tailbone in the back and bottom, and the hip bones on the side. The pelvic floor has three muscle layers. The first being the most superficial. That's around the anal opening, the vaginal opening, and the urethral opening. The second layer is a little bit deeper in and surrounds the urethra. And the third layer term, typically the levator ani muscle group is a little bit deeper in the pelvis. These three muscle layers help to support bowel function, bladder function, sexual function, and are an integral part of the core. You have your pelvic floor at the bottom. You have your diaphragm at the top, in the bottom of the thoracic cage. You have multifidi muscles which are segmental spinal stabilizers in the back, and your transverse abdominis which is a broad, flat core muscle that help to cohesively and effectively engage your core muscles, and make sure that you have full function to provide support for your daily activities.

The pelvic floor is a group of muscles located at the bottom of the pelvis that helps to support bowel, bladder, and sexual function. It consists of three layers (the most superficial around the anal, vaginal, and urethral openings) and works together with the diaphragm, multifidi muscles, and transverse abdominis to provide full core muscle activation and support for daily activities.

The Intricacies of the Pelvic Floor: A Vital Component of Core Function

The pelvic floor is a group of muscles located at the bottom of the pelvis. It is bordered by the pubic symphysis in the front, the spine and sacrum in the back, and the hip bones on the sides. The pelvic floor consists of three muscle layers. The first layer is the most superficial and surrounds the anal, vaginal, and urethral openings. The second layer is deeper and surrounds the urethra. The third layer, known as the levator ani muscle group, is even deeper in the pelvis.

These muscles play a crucial role in supporting bowel function, bladder function, and sexual function. They are also an integral part of the core, which includes the pelvic floor at the bottom, the diaphragm at the top of the thoracic cage, the multifidi muscles in the back, and the transverse abdominis, a broad, flat core muscle. Together, these muscles work cohesively to provide support and enable proper functioning for daily activities.

What are your top 5 to 10 exercises to avoid swimmers shoulder? Not necessarily to rehab but for prevention. Great question. I'm going to go over to George Alderman and Julie Alderman swim exercises for warm up. George is on this app. So it's working on swim specific dynamic warm up to warm up the rotator cuff and the scapula muscles. So you're going to do this. I like to do it for time based. I have the athletes stand and think about tall posture. So you're moving in and out, windshield wipers. The next one you put your hands in your back pockets. And then you're going to emphasize tall posture. Trying to bring your shoulders around and your elbows to touch and then squeeze. Just be careful that you're not lifting your chest but you're really doing it from your shoulders and your scapula. This will help with internal rotation and work with external rotation for pulling muscles. And then the next one is scarecrow. Again, anywhere between 25 and 30 seconds. And you just continue to move from one exercise to the next. And then the next exercise, I'm going to go to the side. You want to start with your elbows at shoulder level and then press them out and back. Or out and forwards and then squeeze them back. Most athletes will emphasize always the back movements. But what you want to emphasize is the forward movements to help that upward rotation. And the last one is I tend to reach forwards, a bad streamline, and then down. Hopefully that will help, Rachel. If you can get this information out to your team and spread it around. This is really helped to prevent shoulder injuries. Hopefully you like it. Let me know if you got any questions.

Windshield Wipers, Scarecrow, Shoulder Level Elbows Press Out and Back, Reach Forward and Down are exercises to avoid shoulder injury.

What are the top 5-10 exercises to avoid “swimmer’s shoulder”? Not necessarily to rehab it but for prevention?

Prevent swimmer's shoulder with these 5 key exercises!

To avoid swimmer's shoulder, here are the top 5 to 10 exercises for prevention. These exercises focus on swim-specific dynamic warm-up to warm up the rotator cuff and scapula muscles. 

1. Windshield wipers: Stand with tall posture and move your arms in and out, mimicking windshield wipers.
2. Hands in back pockets: Place your hands in your back pockets and focus on bringing your shoulders around, trying to touch your elbows together. Emphasize this movement from your shoulders and scapula.
3. Scarecrow: Perform scarecrow movements for about 25 to 30 seconds, moving from one exercise to the next.
4. Shoulder press-outs: Start with your elbows at shoulder level and press them outwards and forwards, then squeeze them back in. Emphasize the forward movements to help with upward rotation.
5. Streamline reaches: Reach forward as if in a streamline position, then bring your arms down.

These exercises have been helpful in preventing shoulder injuries among swimmers. Feel free to share this information with your team and let me know if you have any further questions or need clarification.

What is a good exercise to increase SI joint mobility or sacroiliac joint mobility? So the SI joint is at the bottom of the spine and it sits right in between your two big pelvis bones and this joint is actually not supposed to move a ton. I think that oftentimes whenever we have SI joint pain, we think that that means we need to get it moving better. You might have been told that that's something that has to happen, but it actually just doesn't move that much at all and it's not supposed to. So Good et al did a systematic review in 2008 that showed the SI joint only moves 0 to 8 millimeters, like maximum, and that's all you really need. This isn't supposed to be a super mobile joint. And so oftentimes whenever we think about needing to improve SI joint mobility, really more than likely we just need to work on moving the muscles that surround the SI joint rather than think about moving the joint itself. And so any type of movement where you are going into deep extension or flexion with your back in a comfortable range tends to work well. And spending time doing things with one leg, so lunges, step ups, things like that can be helpful for moving one side of the hips at a time around the SI joint. But yeah, the SI joint really isn't supposed to move that much. It moves very little, so if it feels like it's not mobile, that's okay.

The SI joint is not designed to move a lot, so exercises that focus on surrounding muscles are best. This can include deep extension and flexion of the back, as well as exercises like lunges and step-ups which work one side of the hips at a time.

What is a good exercise to increase SI joint mobility?

Unlocking SI Joint Mobility: Debunking Myths and Focusing on Surrounding Muscles

A good exercise to increase SI joint mobility, or sacroiliac joint mobility, is to focus on moving the muscles surrounding the joint rather than trying to directly mobilize the joint itself. The SI joint, located at the bottom of the spine between the pelvis bones, is not meant to have extensive mobility.

Research has shown that the SI joint typically moves only 0 to 8 millimeters, which is all that is necessary. Therefore, the goal is not to force excessive movement in the joint. Instead, focus on exercises that involve deep extension or flexion of the back within a comfortable range.

Engaging in movements that work one leg at a time, such as lunges or step-ups, can be beneficial for mobilizing the hips around the SI joint. Remember, the SI joint is naturally designed to have limited mobility, so if it feels like it lacks mobility, that is normal.

The best piece of advice that I could offer someone with a sports-related injury is to listen to your body. If your body is hurting or feels tired or possibly that you're overusing your legs, your arms, such as a softball pitcher, really not to push through an injury. Your body is the best piece of advice for you to listen to. Never feel that you should keep playing or just keep working through an injury because that could actually hurt your body more. If the injury is persistent, then to really consider resting and not playing your sport and possibly taking a season off or even deciding that maybe your body isn't meant to do the sport that you're playing or working towards, injury really is your first sign that your body isn't adapting well to what you're doing. And you should always listen to it and take care of it and seek medical help if needed and when needed. And never to be a warrior like a lot of athletes are and try to be.

Listen to your body and don't push through an injury. If it persists, consider resting, taking a season off, or even changing sports. Seek medical help if necessary.

What is the best piece of advice you can offer someone with a sports-related injury?

Listen to Your Body: Key Advice for Sports Injuries

The best advice I can offer someone with a sports-related injury is to listen to your body. If you're experiencing pain, fatigue, or overuse in certain areas like your legs or arms (such as a softball pitcher), it's important not to push through the injury. Your body knows best. Ignoring or playing through an injury can actually worsen the situation. If the injury persists, seriously consider resting and taking time off from your sport. It may even be necessary to take a full season off or reevaluate if the sport is suitable for your body. Injuries are signals that your body isn't adapting well to the physical demands you're putting on it. Always prioritize caring for your body, seeking medical help when necessary. It's crucial not to fall into the mindset of being a warrior and trying to play through pain, as many athletes tend to do.

Okay, the question is, what's the best way to release and stretch the psoas? I'm going to show you my favorite way to get at it with a lacrosse ball. Lacrosse ball, split the difference between your belly button and your hip bone. Your psoas is right in the middle. So you're going to put the lacrosse ball right in the middle, roll back onto it, sink in until you start to feel a stretch. You can take your other leg up to the side to kind of lean into it more on the right. You can also bend your leg up and do a little bit of a side to side motion to further increase the stretch. You can also pull yourself forward to let your pelvis drop into the floor a little bit more.

To stretch and release the so as, use a lacrosse ball in the middle of your belly button and hip bone. Roll back onto it, sink in and start to feel a stretch. Then take one leg up to the side, bend the leg up, do a side-to-side motion, and pull yourself forward to let your pelvis drop into the floor.

Best way to release and stretch the psoas?

Psoas Release: The Ultimate Stretch with a Lacrosse Ball

To release and stretch the psoas, my favorite method involves using a lacrosse ball. Here's how you can do it:

1. Locate the midpoint between your belly button and hip bone, where the psoas muscle is situated.
2. Place the lacrosse ball at this spot and roll back onto it, allowing it to sink in.
3. As you feel a stretch, you can enhance it by raising your other leg to the side, leaning into the stretch on the right side.
4. Another option is to bend your leg and perform a gentle side-to-side motion, which will further increase the stretch.
5. Additionally, you can pull yourself forward to encourage your pelvis to drop closer to the floor.

By following these steps, you can effectively release and stretch the psoas muscle using a lacrosse ball.

The question is, what are the best positions to give birth in to reduce tearing and tailbone fracture? When we give birth vaginally, the pelvic floor muscles have to expand like almost three times their length. What also needs to happen is there needs to be flexibility in the sacroiliac joint and in the sacral coccygeal joint, which is the joint between the sacrum and the tailbone. A lot of times, women give birth on their back with their knees up. And while this is a really good relaxation position for the pelvic floor, it also immobilizes your sacrum, your tailbone, and your SI joints because this lying flat on your back against the table, and they can't expand appropriately. Some positions that might be more optimal are actually in side lying, squatting, whether it's holding on to the bed or holding on to a thera ball also in the quadruped position on your hands and knees. And all of these positions allow more flexibility in the pelvic floor itself, but also in the associated joints that need to move around it.

The best positions to reduce tearing and tailbone fracture during childbirth are side-lying, squatting, and the quadruped position on hands and knees. These positions allow more flexibility in the pelvic floor and associated joints.

What are some good positions to give birth in to help reduce tearing and tailbone fracture?

Optimal birth positions: reduce tearing & tailbone fracture

When considering positions for giving birth to reduce tearing and tailbone fracture, it's important to understand the mechanics involved. During vaginal birth, the pelvic floor muscles need to expand significantly. Additionally, flexibility in the sacroiliac joint and the sacral coccygeal joint (between the sacrum and tailbone) is necessary.

The common practice of giving birth on one's back with knees up can restrict the movement of the sacrum, tailbone, and SI joints. While this position is helpful for pelvic floor relaxation, it may not allow for appropriate expansion.

Optimal positions to consider include side-lying, squatting (holding onto the bed or a thera ball), and the quadruped position (on hands and knees). These positions allow for greater flexibility in the pelvic floor and the associated joints that need to move during birth.