What Test Should My Doctor Order?

In this article we will be discussing the one test your doctor must order for you when you are in pain as well as what to expect during your first physical therapy appointment.  You could be a runner, dancer, gymnast, or an aerial circus artist who is having pain in your knee, foot, or shoulder.  You may have googled your diagnosis to be patellofemoral syndrome, plantar fasciitis, or rotator cuff tendinitis.  If this is you then you need to read this article before seeking help from your local medical community!


This is a topic that I am very passionate about and for those of you that are more visual and auditory learners, you may prefer to watch the live video below!



The most important thing a medical provider needs to assess when you have pain is NOT an expense x-ray or an MRI believe it or not.  It is something that is far cheaper and will actually result in you getting better quicker!  What is this secret test?  It is Movement!


Movement dictates what is causing your pain and will help your medical provider identify the contributing factors to why you developed pain in the first place so they know how to keep it from coming back!  At SPARK Physical Therapy, every single client we see gets an evaluation of their movement patterns whether it is watching and recording them run or watching them squat.  A common pattern of pain in our aeralists is mid-back stiffness and pain in the back of the shoulder blade area.  As an onsite provider at Air Temple Arts, we get them up in the silks so we can see how they move in their element.


Aerialist in the silk apparatus


We want to see what their patterns are in the silks.  We want to see which muscles are firing and which muscles are not.  This will help us to better dictate the clinical examination and then come up with a treatment plan that’s best for them!  By assessing this we can even talk about modifications that the athlete can make to their movement to help heal during their injury process.


So, what are we saying here?  This isn’t the expensive medical test.  You don’t need an x-ray when you have pain.  You don’t need an MRI.  You don’t need a CT scan.  What you need is a good, detailed evaluation that includes MOVEMENT!


For example, if you are a runner and you’re seeing a medical practitioner because you’re having achilles pain or hamstring pain and they haven’t seen you run, that is a problem! With our runners, we take them outside during an evaluation and we watch them run.

Taking a video of runner doing their sport

Analyzing and breaking down running pattern frame by frame to identify root causes of their pain


We don’t just put them on a treadmill because the mechanics of running on a treadmill are going to be different than running on the road! We’re lucky to be onsite at Multisports Academy and we are able to utilize the Farmington Canal Line Trail.  If a patient says they don’t really notice pain until the third or fourth mile of their run and they don’t have pain at rest, we have the opportunity to tell them to come early to their next appointment and go for a 2 or 3 mile run so we can do our thorough evaluation following that run when they actually have their symptoms!  This way, we’re able to analyze their mechanics at the end and recognize why they are having pain at that specific point in their movement pattern.


With our gymnasts, a common injury we see is low back pain!  It is so important for us to look at their mechanics during a back walk over or if they’re doing a bridge when they’re a younger gymnast.


Assessing movement into a bridge position


We’re looking at their lumbar spine and checking to see if they’re hinging from one segment only as opposed to the entire spine.  This can be a huge contributing factor to low back pain in gymnasts!  Evaluating that movement gets us down to what the cause of their pain and correcting it will be essential to not only fixing their pain but keeping it from coming back!



In summary, it is not enough to only provide you with simple “band aid” treatments to alleviate your pain.  There are specific techniques that will make you feel better.  Whether it’s a massage, a soft tissue technique,  dry needling or you seeing an acupuncturist – these things will all help to decrease pain and make you feel a little better.  However, if you don’t get to evaluating movement and getting down to the root cause of why you got your pain to begin with your are just going to keep having this pain come back later in the year.  A detailed evaluation and movement based treatment approach is going to set you up for success in the long run and keep your pain from coming back.  We need to get down to what’s causing that root cause of your pain and you as the patient needs to be diligent is doing the proper corrective exercises to get yourself better.  It’s not simple enough to go to a practitioner once or twice a week for short term fixes!  You may feel better for a few hours but the pain is still there and it will come back with a vengeance once you get back to the workouts and sports you love!


What we do at SPARK Physical Therapy is really get down to evaluating your movement and putting you on a plan to empower you to do your corrective exercises so that you can remain healthy and continue to do the activities and sports that you love to do!


We hope this article helped to give you some insight on the one test your doctor must order for you when you are in pain as well as what to expect during your first physical therapy appointment.  If you are a runner, dancer, gymnast, or an aerial circus artist we would love to help you not only fix your pain but build up the strength and resilience in your body to prevent it from coming back!

Are you trying to stay healthy but can’t train because pain is stopping you from meeting your goals?Are you worried that an injury will limit you from doing what you love like working out and training?


Have you wondered what it will cost you in the long run if you continue to train through pain?


Have you seen other medical providers in the past that just tell you to stop your activity?



We have a unique treatment approach that focuses on solving these problems with our clients. We combine manual hands-on techniques with guided supervised exercises to help you get stronger, pain-free and perform at your peak level to get you back to the workouts and sports you love. Our goal is to help keep you active and training, while recovering from injury by guiding you in ways to modify your training, rather than eliminating it!



The SPARK Physical Therapy Commitment



No long waits or multiple trips to providers’ offices every week. We see you either onsite at a partnering gym or in the comfort of your home when it is convenient with your schedule.

One on one for a full hour with your doctor of physical therapy, every visit. We provide you with a customized plan specifically designed for you, based off your unique injury and goals.

Full transparency in what you pay. You will never get a bill from us a couple of months after your visit.

Access and availability to you! Have a question about your pain or exercise program? Get an answer from your therapist directly.




If you’re in the greater Hamden, CT area and are a runner, dancer, gymnast, or aerialist that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in this CONTACT REQUEST LINK  and we’ll set up a free-minute phone consultation with a doctor of physical therapy


Are you a runner looking for a community that is dedicated to helping you stay happy and healthy doing what you love?

You could be an active adult starting out with a couch to 5k program or you may be an experienced marathoner!

The FREE Healthy Runner CT facebook group is your answer!


Our specialty here is prehab, rehab, recovery, and performance for all types of runners!


Our Healthy Runner CT group warmup before the New Haven Road Race!


CLICK HERE to join our community http://bit.ly/HealthyRunnerGroup



Thank you for taking the time to read,



– Duane Scotti, PT, DPT, PhD, OCS


A special thanks goes out to Allie Eldridge, SPT for her contributions to this article

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What Test Should My Doctor Order?

In this article we will be discussing the one test your doctor must order for you when you are in pain as well as what to expect during your first physical therapy appointment.  You could be a runner, dancer, gymnast, or an aerial circus artist who is having pain in your knee, foot, or shoulder. … View ArticleRead More

“I struggled to get back into running after being diagnosed with Osteoarthritis in my left knee. A friend of mine suggested I check out the Healthy Runner podcast and I’m glad I did! I was lucky to grab a spot in the Healthy Runner Coaching Program and I have gained so much from miles away. I’ve gained tools to be a lifelong runner through the run and strength plan. I’m constantly gaining more mobility and look forward to my future of running. Duane is a great coach that gives you personalized assistance and helps you understand any questions you have! I’m definitely getting my spark back!”


Theresa L.

Theresa L.

Working with Duane has been a game-changer for my running. I’ve been in an endless cycle of injuries for the past five years and needed to make a change.

I connected with Duane through his Healthy Runner Facebook group, and then we began our virtual physical therapy visits. Virtual sessions work great for me because I’m constantly traveling and can access care wherever I reside. Even though I’m not in the clinic, I still receive the same quality of experience!

The best part is Duane is a physical therapist, runner, and coach, so he understands how important running is for our physical, mental, and emotional well-being! If you want to become a stronger, healthier, and faster runner, look no further!

Jenn H.

In April, I was diagnosed with proximal hamstring tendinopathy, or PHT. If you haven’t heard of it or experienced it, let me tell you…it’s a real pain in the BUTT! Not only did it derail my training (I’m a runner/cyclist), simply sitting for more than 10 minutes at a time was unbearable. There’s very little research out there on this injury and finding credible information on how to effectively treat was difficult. The initial advice I got from my ortho was to stop running, rest, and stretch. This did absolutely nothing to improve my symptoms or help me get back to running. In fact, stretching made it worse! I also tried massage, dry needling, shockwave therapy…nada. In September, I stumbled on a podcast with Duane where he spoke in depth about his own experience with PHT and how he beat it, and how he helped others overcome this stubborn injury. I was also intrigued by his philosophy of not having to give up the sport you love while recovering from injury. I contacted Duane for a consult and have been working with him on a customized, structured program focused on progressive loading of the hamstring tendon and supporting muscles WITHOUT giving up running! Gradually, my pain began to lessen and my strength has continued to increase. I am now running four days a week and am closer than at any point in the past 8 months to putting this injury in the rearview mirror for good. I’m looking forward to getting back to structured training and racing again in 2021…an unimaginable goal two months ago. Duane is awesome! His techniques and approach to injury rehab and prevention work. If you’re an athlete who has struggled with injuries that constantly disrupt your training, Duane is your guy!

Tim U.

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