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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.

Hey Jacob, thanks for the question. What are some things I can do to help with immobile stiff ankles? Um, well I want to try to show you something that is going to help you work on not just the flexibility of the ankle, but a little bit of foot control as well. So I'm going to pop in this video here for you to see, but basically we're going to try to do a little bit of both. Keep the knee nice and still. Keep the big toe and the ball of the toe on the ground as you sweep across as far as you can and then up, over, and back down. As you're sweeping, you want to make sure that you don't let your foot do this. There should be no space there. You need to come all the way across, keeping this part down, knee still, then up, out, down, across, up, out, down. Nice big sweeping circles. Okay, now you know how to do ankle CARs. Give it a try and let me know what you think.

To help with mobile stiff ankles, try doing ankle circles while keeping the knee still and the big toe and ball of the foot on the ground. Sweep a frog as far as you can and then up over and back down. Make sure there is no space in between the circles.

What are some things I can do to help with immobile/stiff ankles?

Improve Ankle Mobility with Sweeping Circles

To help with immobile or stiff ankles, I recommend trying ankle CARs (Controlled Articular Rotations). This exercise focuses on improving ankle flexibility and foot control. Here's a brief description of how to perform ankle CARs:

1. Keep your knee stable and stationary.
2. Keep the big toe and the ball of your foot on the ground.
3. Sweep your foot across as far as you can, then up, over, and back down.
4. Ensure that your foot remains flat on the ground throughout the movement, without any lifting or tilting.
5. Repeat the sweeping motion in nice, big circles.

I've included a video demonstration for you to see the exercise in action. Give ankle CARs a try and let me know how it works for you.

How do I protect my back when working with patients? The number one tip I will tell you is avoid hanging on your hips. I wish I knew this 10 years ago. I was having awful problems with my back. Chronic back pain. Didn't understand what the cause was and would get it treated by friends. Started working on my back. Didn't work out. Until I started to figure out that I was hypermobile. So just like this example. Gumby. Rainy flexible. So a lot of times I stand hyper-extended because as a swimmer I thought my back pain was from swimming. And so I would stand and let my hips kind of rest on the table. And then I would have a client. This table is too low. And I would start working and doing resistance. It wasn't until I started to figure out that if I strengthen up my hamstrings. Strengthen up my core even more. And unlock my knees. Keep it soft. Then I had access to be able to move and glide. And that would have saved me tons of pain, time and energy. And actually this is what got me so particular about looking at what the root cause of the problem is. Instead of just treating the symptom. You have to understand why people are having back pain, when they're having it. And really understanding the mechanism of injury instead of just treating the actual symptoms. So number one thing. Avoid hanging on your ligaments or your end range. You do that. Be soft. And then do all the regular body mechanics with squatting and moving. You won't have any problems. I wish somebody had told me that when I started my career.

The number one way to protect your back when working with patients is to avoid hanging on your hips. Additionally, strengthening your hamstrings and core muscles, squatting, and adhering to proper body mechanics can help to prevent chronic back pain.

How do you protect your back when working on patients all day?

Prevent Back Pain while Working with Patients: Expert Advice

To protect my back when working with patients, the number one tip I can give is to avoid hanging on your hips. In the past, I struggled with chronic back pain and couldn't figure out the cause. I would get treatments and work on my back, but it didn't solve the issue. Eventually, I realized that hypermobility was a factor. As a swimmer, I would often stand with hyper-extended posture and let my hips rest on the table while working with clients. It wasn't until I started strengthening my hamstrings and core, and keeping my knees unlocked and soft, that I had better mobility and reduced pain. This experience taught me to look for the root cause of problems rather than just treating symptoms. Understanding why people experience back pain and considering the mechanism of injury is crucial. So, my top advice is to avoid hanging on ligaments or pushing yourself to your end range. Be soft in your movements, practice proper body mechanics like squatting, and you'll minimize problems. I wish someone had given me this advice when I started my career.

How do you address the challenges of rehabbing injuries in a high stress, high performance environment such as elite level swimming or triathlon? So this is majority of what I see on a daily basis in our clinic. And I think that how I deal with it is you need to number one, be really confident in your skills as a provider. But you also need to be a really effective communicator so that everyone's on the same page. And I think that talking to the athlete with confidence breeds confidence about their rehab and having a successful outcome. Unfortunately, PTs as a whole aren't a super confident bunch. And how we talk to people is kind of like maybe a little bit more of a concerning or anxious conversation and breeds some anxiety about their injury versus coming up with a plan and executing the plan and having a lot of confidence in the plan. And athletes respond really well to that. So I think on top of just being a really sound clinician and feeling strong in the fundamentals, you need to be confident and communicate confidently as well.

In order to address the challenges of rehabbing injuries in a high-performance environment, it is important for providers to be confident in their skills and to be effective communicators. This means talking to athletes with confidence about their rehab and having a plan of action that is executed with confidence. Doing so will help alleviate any anxiousness or concerns the athlete may have.

How do you address the challenges of rehabbing injuries in a high-stress, high-performance environment such as elite level swimming or triathlon?

Unlocking peak performance: Rehabbing injuries in high-stress sports.

Addressing the challenges of rehabbing injuries in a high-stress, high-performance environment like elite level swimming or triathlon requires a combination of skills and effective communication. As a provider, it's important to have confidence in your abilities and be a strong communicator to ensure everyone is on the same page.

When working with athletes, instilling confidence in their rehab and the potential for a successful outcome is crucial. Unfortunately, as a whole, physical therapists may not always exude confidence, which can create anxiety for the athlete. Instead, it's important to develop a plan, communicate it confidently, and execute it with conviction. Athletes respond well to this approach.

In addition to being a skilled clinician and having a solid foundation in the fundamentals, being confident and communicating confidently are key factors in addressing the challenges of rehabbing injuries in high-performance environments.

Okay, so the question is, how does someone get rid of tightness or tendinitis inside the crook of my elbow? Again, there's a lot of reasons why someone may be experiencing pain in that area. There's some classic stretches that you may already know, so I'm going to go with a slightly different answer here and go for some nerve gliding or some nerve flossing, which often can be a culprit for why someone may have tightness in that area. So check this out. Median nerve glides. The median nerve runs from your spine all the way down your arm. So we're going to break it up into some segments to go ahead and mobilize, floss, or glide this nerve. We're going to start off, good posture. You're going to push your shoulder down, keeping your elbows straight and your fingers straight and up toward the ceiling. And then you're going to go up and down five times with your shoulder. And then after you do that, we're going to keep the shoulder down in a pretty neutral position and then you're going to go up with the elbow and then back down, keeping your fingers as straight as you can for five reps. And then after that, you're going to do just the hand up and down for five reps. Then after you run through that, you can go ahead and put the neck on a little bit of a stretch if you want more. And then you can do the same thing first at the shoulder, then at the elbow, and then at the hand.

To get rid of tightness or tendonitis in the crook of your elbow, try some nerve gliding/flossing. Start by pushing your shoulder down with your elbow and fingers straight and up towards the ceiling. Then move your shoulder up and down 5 times. Keep the shoulder down and neutral while moving your elbow up and down 5 times with your fingers as straight as you can. Finish by moving your hand up and down 5 times. You may also want to do some stretches afterwards.

How does someone get rid of tightness/tendinitis inside the crook of my elbow?

Eliminate Elbow Tightness with Nerve Glides: Quick Relief for Tendinitis

To address tightness or tendinitis inside the crook of your elbow, there are various approaches you can take. While classic stretches can be helpful, I'll provide an alternative method involving nerve gliding or nerve flossing.

One technique to try is median nerve glides. The median nerve runs from your spine down your arm, and by mobilizing or gliding this nerve, you may alleviate tightness in the area. Here's how to do it:

1. Start with good posture, keeping your shoulder down.
2. Keep your elbows straight and your fingers pointing straight up toward the ceiling.
3. Perform five repetitions of lifting your shoulder up and down.
4. Maintain a neutral shoulder position and perform five repetitions of raising and lowering your elbow while keeping your fingers as straight as possible.
5. Next, perform five repetitions of moving just your hand up and down.
6. If desired, you can also stretch your neck a bit before proceeding.
7. Repeat the same sequence, starting with the shoulder, then the elbow, and finally the hand.

By incorporating these nerve glides into your routine, you may find relief from the tightness or tendinitis in the crook of your elbow. However, it's important to note that there can be various causes for this pain, so if the issue persists or worsens, it's advisable to consult a healthcare professional.

The question is, what is the most common misconception about pelvic floor, Physical Therapy. There are a couple that come to mind, but I think the main one is that, most people think that pelvic Health PT is only for women in like the prenatal and postpartum period. And while we can do so many things with people who are about to give birth, who have just given birth and who are in that postpartum period from a bowel dysfunction perspective, from a urinary dysfunction perspective, from a pain perspective from a Turnt activity perspective, men children and people who have undergone gender reassignment surgery also have a pelvic floor. And if are they are having any of the previous stated issues that are of musculoskeletal nature. Those, those people can also be helped by a pelvic floor, physical therapist men who are experiencing sexual dysfunction urinary dysfunction bowel dysfunction, and they've been to a GI a gyro A urologist and haven't had appropriate relief either with medication or activity modification and have had testing done. Sometimes it can be due to dysfunction of the pelvic floor, children, who are experiencing bedwetting, constipation. Same thing. If the pediatrician is not really sure where it's coming from and doesn't think it's organic in nature. Sometimes, pelvic Health PT can really be the answer for behavior modification. And also giving them toileting strategies And exercises to help improve pelvic floor function and the transgender Community. There needs to be more coursework. There needs to be more education. But again, working with these patients to, really, optimize pelvic floor. Function, is something that there needs to be more education, about more knowledge about not just in the general Community but in the Healthcare Community in as a whole. So here I am trying to spread the word about pelvic Health PT and how it's not just for pregnant folks and postpartum women. It really can benefit everyone if the treatment plan is appropriate for their symptomatology.

The most common misconception about pelvic floor Physical Therapy is that it is only for pregnant and postpartum women. In reality, men, children, and people who have undergone gender reassignment surgery can also benefit from working with a pelvic floor physical therapist to optimize their pelvic floor function and address symptoms such as urinary dysfunction, bowel dysfunction, pain, and sexual dysfunction.

What’s the biggest misconception about pelvic floor PT?

Demystifying Pelvic Floor PT: It's Not Just for Women!

The biggest misconception about pelvic floor physical therapy is that it is only for women during the prenatal and postpartum period. While pelvic health PT is indeed beneficial for individuals in these stages, it can also help men, children, and those who have undergone gender reassignment surgery.

Men experiencing sexual dysfunction, urinary dysfunction, or bowel dysfunction, and who have not found relief through medication or other interventions, can benefit from pelvic floor PT. Children dealing with bedwetting or constipation, where the cause is not organic, can also find help through behavior modification and pelvic floor exercises.

In the transgender community, there is a need for more education and coursework. Working with these patients to optimize pelvic floor function requires increased knowledge and understanding, not only within the general community but also within the healthcare community as a whole.

It is important to spread awareness that pelvic floor PT is not limited to pregnant individuals and postpartum women. It has the potential to benefit anyone if the treatment plan is tailored to their specific symptoms and needs.

This is a good question. In treatment for swimmers and triathletes, I think, you really have to pick your exercise prescription and potentially event types of treatment that you do based on where the athlete is in their season. I'm going to treat this person potentially differently if we have to get this injury ready, or if we're managing this injury to be ready to race in the next couple of weeks, versus if this is the beginning of the season and we have several months to address this. The ways that we go about that are going to be a little bit different. And the priorities become a little bit different as well.

In treatment for swimmers and triathletes, the exercise prescription and type of treatment should be tailored to where the athlete is in their season.

How do you tailor your treatment plans for swimmers and triathletes, given the unique demands of these sports on the body?

Customized Treatment Plans for Swimmers and Triathletes Based on Seasonal Needs

Tailoring treatment plans for swimmers and triathletes requires considering the unique demands these sports place on the body. One important factor is the athlete's position in their season. Depending on whether we need to prepare an injury for an upcoming race or manage an injury for long-term recovery, the exercise prescription and treatment approach may vary.

If an athlete needs to be race-ready in a few weeks, our focus will be on getting the injury ready for competition. However, if it's the beginning of the season with several months ahead, we have more time to address the injury comprehensively.

The specific ways we approach treatment and prioritize certain aspects will differ based on the athlete's season and goals. By considering these factors, we can tailor the treatment plan to meet the unique needs of swimmers and triathletes.