Overview

Overlake Medical Clinics Musculoskeletal Medicine

Overlake Medical Clinics (OMC) Musculoskeletal Medicine is a multispecialty rehabilitation clinic. Musculoskeletal Medicine specializes in coordinated care of muscular injuries, spine disorders, neurological injuries, migraine headaches, neck pain and lower back pain. Our unique team approach coordinates your care around your goals and needs. Our staff has a wide range of skills for the diagnosis and treatment of your condition, centered on the function you desire, whether it be returning to work, gaining peak athletic performance, or managing a chronic painful condition.

We offer the best trained physicians, physical therapists, massage therapists, psychotherapists, athletic and conditioning specialists, nutrition counseling and acupuncture. We perform virtually all of the procedures you will need to assist in your recovery using the latest ultrasound technology, fluoroscopic guided injections and Botox for headaches.

What We Treat

  • Headaches and migraines
  • Back pain and injuries
  • Neck problems
  • Joint injuries, including shoulders, ankles and knees
  • Diet and nutritional issues
  • Sports injuries
  • Sports and performance
  • Fitness evaluation
  • Neurological conditions
  • Workplace (L&I) Injuries
  • Auto accident injuries

Services

  • Physiatry
  • Physical Therapy
  • Massage
  • Psychotherapy
  • Special tests and procedures
  • Evaluation for fitness and athletic performance
  • Personal training and functional fitness

Physiatry

Physiatry

Doctors in physical medicine are also called physiatrists and focus on improving function and quality of life. A physiatrist (fizz-ee-at’-trist), treats a wide range of problems from sore shoulders to spinal cord injuries. They see patients in all age groups and treat problems that touch upon all the major systems in the body. Physiatrists focus on restoring function, allowing us to be at our best in our jobs, with our families and in our recreation.

How We Can Help

Physiatrists care for patients with acute and chronic pain, and musculoskeletal problems like back and neck pain, tendonitis, pinched nerves and fibromyalgia. They also treat people who have experienced catastrophic events resulting in paraplegia, quadriplegia, or traumatic brain injury; and individuals who have had strokes, orthopedic injuries, or neurologic disorders such as multiple sclerosis, polio or ALS. They may see a person who lifts a heavy object at work and experiences back pain, a basketball player who sprains an ankle and needs rehabilitation to play again, or a knitter who has carpal tunnel syndrome. Physiatrists’ patients include people with arthritis, tendonitis, any kind of back pain, and work- or sports-related injuries.

Physiatrists also treat serious disorders of the musculoskeletal system that result in severe functional limitations. They would treat a baby with a birth defect, someone in a bad car accident, or an elderly person with a broken hip. Physiatrists coordinate the long-term rehabilitation process for patients with spinal cord injuries, cancer, stroke or other neurological disorders, brain injuries, amputations, and multiple sclerosis.

Our physiatrists are Dr. Michael Hatzakis, Dr. Kevin Berry and Dr. Igor Uritisky.

Physical Therapy

Physical Therapy

Our Musculoskeletal Medicine team emphasizes a comprehensive approach combining therapeutic exercise, manual therapy, patient education, and multiple modes of treatment to enhance the recovery of our patients and return them to function in the shortest time possible. Treatment is provided by physical therapists (PT).

Physical therapy (also physiotherapy) is a health profession that assesses and provides treatment to individuals for the development, maintenance, and restoration of movement and function throughout life. This includes providing treatment in circumstances where movement and function are threatened by aging, injury, disease or environmental factors.

Our physical therapists promote healing by reducing pain and inflammation, by increasing range of motion and strength, and by improving posture, body awareness and body mechanics.

We employ multiple treatment strategies such as therapeutic functional exercise, joint mobilizations, soft tissue release techniques, modalities, and education programs to help people recover from orthopedic surgeries, joint and soft tissue injuries/conditions, workplace injuries, auto injuries, and sports injuries.

Meet our physical therapists Greg Fore and Lindsay Sturtevant.

What to Expect About Your Treatment

Evaluation: Your course of therapy begins with a specialized and focused evaluation, which involves collecting information about the current problem as well as your general health and therapy goals. A physical exam is then conducted to assess the range of motion, neurological status, level of pain, strength, posture, flexibility, and ability to perform specific functional tasks. This visit generally lasts the majority of one hour.

Treatment: After the initial evaluation visit, treatment visits will commence. Your treatment program will initially focus on reducing your symptoms and establishing a foundation for proper strengthening, endurance and flexibility. Once, the foundation is set, treatment sessions will progress steadily. It is of critical importance that you adhere to both your treatment schedule in the clinic and your home exercise program so that you increase the chance of recovering.

Education: Since your understanding and participation is essential in achieving your goals, you will be taught strategies to take control of your body and the process of healing. Education is part of what we do as physical therapists. Expect to receive a written home program that will include flexibility, endurance, and strengthening techniques.

Communication: Open communication is vital between you and your therapist, and we encourage you to ask questions during your course of therapy.

Treatment Modalities
  • Electrical Stimulation: Decreases pain, increases circulation and decreases swelling
  • Electrical Muscle Stimulation (EMS): Increases muscle activity and contraction ability
  • TENS Unit: Home electrical stimulation unit designed to provide pain relief
  • Traction: Applied to the cervical spine to reduce pressure on spinal segments, nerves or discs
  • Ice Pack/Ice Massage: Decreases pain and inflammation
  • Laser Light Therapy (Low Level Laser Therapy/Cold Laser Therapy): Decreases pain, increases cellular activity and increases circulation
Frequently Asked Questions About Laser Light Therapy

What is Laser Light Therapy?

Laser light therapy (LLT) also known as low level laser therapy (LLLT) or cold laser therapy (CLT) is a treatment option that utilizes specific wavelengths of light (red and near infrared) to promote therapeutic healing. It is FDA cleared and is widely used by healthcare professionals and clinicians.

Who is a Candidate for Laser Therapy?

It can be used for patients who suffer from a variety of acute and chronic conditions or injuries in order to help reduce pain and swelling as well as increase functionality.

What Are Some Conditions Commonly Treated With Laser Therapy?

  • Knee pain
  • Rotator cuff/shoulder injuries
  • Back pain
  • Post-surgical conditions
  • Carpal tunnel syndrome
  • Arthritis
  • Tendonitis
  • Muscle strains/pulls
  • Hip bursitis
  • Neck pain
  • Plantar fasciitis/achilles tendonitis
  • TMJ
  • Tennis elbow
  • Bruising/contusions
  • Ankle sprains

What Does Research Demonstrate?

  • Enhances the repair of tissue
  • Decreases post-surgical healing time
  • Improves lymphatic drainage
  • Reduces pain/inflammation
  • Increases circulation

How Does It Work?

Laser light therapy is delivered directly over the injured area for 30 seconds to several minutes, depending on the size of the area being treated and the dose of energy provided by the laser unit. During this time, the beams of light emitted from the laser pass through the layers of the skin to the target area. When cells absorb the light energy, a series of events are initiated in the cells to help normalize damaged or injured tissue and regenerate faster. This helps to reduce pain, inflammation and swelling which can speed up the process of healing.

Does it hurt? What does the laser feel like?

You will no experience pain with laser treatment. Patients typically report feeling a small amount of tingling, coolness or warmth.

How Long Does Each Treatment Session Take?

The typical course of treatment is up to 10 minutes per area being treated.

How Many Treatments Does it Take?

Depending on the nature of your condition or injury, your treatment may range from 10 to 15 visits, but some conditions may require longer treatment plans. Individuals with rheumatoid arthritis, fibromyalgia or other autoimmune conditions will typically need more than 15 treatment sessions.

How Often Should a Patient Be Treated?

Acute conditions may be treated daily, particularly if they are accompanied by significant pain. Conditions which are more chronic or long-standing respond better when treatments are received two to three times per week, tapering to once per week or every other week based upon improvement.

Massage

Massage

No matter what your fitness goals are, massage is an ideal way to help your body perform its best. Sports-specific massage focuses on the muscles used most frequently during exercise as well as draws attention to other muscles that can contribute to muscle soreness or injury. Massage effectively improves flexibility and range of motion, aids in muscle recovery, prevents and treats injuries. By stretching and broadening shortened muscles as well as increasing circulation to joints, both muscles and joints are able to move more freely. Specific massage breaks up scar tissue and adhesions that play a role in muscle tightness and soreness. In addition, massage can release tight muscles and painful trigger points in the muscle. Our therapists use deep tissue and neuromuscular techniques. Find out more about massage on our education page.

Our massage therapists are Pete Connolly, Kiley Roesch, Mandy Tapp and Leah Goldberg.

What to Expect During a Medical Massage Session

You will be taken into a private massage room where you can undress to your level of comfort. The massage therapist will direct you how to lay on the table and you will be draped with a sheet to ensure privacy. Depending on the areas that are to be worked in a massage, you may start face up or face down on the table. They will leave the room while you undress and get on the table.

The therapist will discuss your levels of pain, tightness and what areas need treatment. The therapist will also have your physician’s referral and treatment plan.

One of the main issues to discuss is the amount of pressure that is used in a massage session. Each person varies as to what pressure feels best to them. The massage therapist should be able to work within your comfort level and achieve therapeutic results. You can request more or less pressure at any time. Do not be afraid to talk with your therapist about any concerns you might have.

Massage Techniques

Deep tissue is a technique that releases chronic patterns of tension in the body through slow strokes and deep finger pressure on contracted areas, either following or going across the grains of muscles, tendons and fascia.

Craniosacral therapy is a light-weight, non-invasive form of touch that focuses on the health of your craniosacral and nervous system. Our craniosacral systems are comprised of the deep membranes and cerebral spinal fluid that surround our brain and spinal cord. As with any connective tissue in the body, this deep fascia is susceptible to tensions, strains and adhesions. The craniosacral system also irrigates and chemically balances our nervous system. Stress, injuries, posture can all affect this system. For those who cultivate their palpation skills, it is possible to feel the internal rhythms of movement that manifest as cerebrospinal fluid bathes and irrigates the tissues of the head down through the spine. Therapists can listen in and feel these rhythms to find areas of restriction and holding in the body.

Restrictions located in these deep regions of the body can create pain, anxiety and dysfunction. A skilled therapist can help identify and release these restrictions, providing release, often where other modalities do not. Craniosacral therapy can be a powerful technique for head trauma, headaches, sinus conditions, low back pain, and post-surgical rehabilitation.

Lymphatic facilitation reduces swelling in the body’s tissue (interstitial space). If you are managing swelling due to a traumatic injury or a chronic orthopedic condition or surgery, this may speed your recovery, possibly dramatically.

This work is light and non-invasive. The amount of pressure it uses is comparable to the pressure it takes to slide your eyelid over your eyeball. As such, and contrary to most forms of bodywork, it can be used immediately following an injury and will support the body’s physiology in what is called the acute stage of healing.

For almost every injury the body encounters, swelling is part of the body’s normal recovery process. There are two kinds of swelling involved in traumatic edema. The first is "primary" edema which is the swelling that is the direct result of the initial injury. The "secondary" edema is the swelling that gravitates to an injury site as a result of the primary edema. It can take up to 24 to 48 hours for secondary edema to fully manifest following an injury, as many of us who have had significant sprains/ strains can attest. Lymphatic facilitation can stimulate the drainage and removal of this secondary edema, in essence creating more ‘breathing’ room around the primary edema, thus expediting recovery of the tissue.

This technique has many applications. If you are an athlete in training, this can support your body’s preparation for its next big training or competition event by removing micro swelling associated with training and workouts. It simply accelerates what your body would do on its own. If you are dealing with an annoying chronic condition that won’t seem to go away, part of this might be excess fluid in your tissue, inhibiting your body’s normal recovery process, (stuck in sub acute healing phase). Fibromyalgia patients whose tissue is tender to the touch have benefited significantly from a session or two of this work.

Reiki is a Japanese modality which works with the energy centers of the body. It helps balance the body on a physical, emotional and spiritual level.

Special Tests + Treatment Procedures

Special Tests + Treatment Procedures

In order to enhance the recovery of our patients and return them to function, we may recommend the following procedures to provide information about a diagnosis or to treat your condition.

Electromyography (EMG) is a test that is used to discover if the bodies nerves are working properly. They can tell the doctor if nerves are compressed in your wrist, such as carpal tunnel syndrome, figure out if nerves are pinched in your neck, along with many other locations.

The test listens to the electrical activity of muscles. When muscles are active, they produce an electrical current. This current is usually proportional to the level of the muscle activity. EMGs can be used to detect abnormal electrical activity of muscle that can occur in many diseases and conditions, including muscular dystrophy, inflammation of muscles, pinched nerves, peripheral nerve damage (damage to nerves in the arms and legs), and other conditions.

Frequently Asked Questions About Special Tests and Treatment Procedures

Why Did My Doctor Order the Test?

An EMG is often performed when patients have unexplained muscle weakness. The EMG helps to figure out if and where a nerve or a muscle is not working properly. The EMG can also be used to detect true weakness, as opposed to weakness from reduced use because of pain or lack of motivation. EMGs can also be used to isolate the level of nerve irritation or injury.

Does the Test Hurt and What Do I Need to Do to Prepare?

There is some discomfort at the time the needle electrodes are inserted (if needed). The needles are very small, about the size of an acupuncture needle. They may feel like shots (intramuscular injections), although nothing is injected during an EMG. There is no special preparation needed for the test. For upper body EMG it’s preferable to wear a short sleeved or loose fitting top.

Nerve conduction velocity (NCV) is a test often done at the same time as an EMG. In this test, the nerve is electrically stimulated while a second electrode detects the electrical impulse downstream from the first. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the speed of impulse transmission (nerve conduction velocity). A decreased speed of transmission indicates nerve disease. The NCV test can be used to detect true nerve disorders (such as neuropathy) or conditions whereby muscles are affected by nerve injury (such as carpal tunnel syndrome). As with EMG, for upper body NCV it’s preferable to wear a short sleeved or loose fitting top.

Musculoskeletal ultrasound-guided injections uses ultrasound, which has become an indispensable modality to guide many injections for musculoskeletal disorders. Ultrasound offers many benefits over other forms of image guidance including its lack of ionizing radiation and its ability to identify soft tissue and vascular structures. With this modality, a needle is guided under constant visualization towards the targeted tissue so that therapeutic medication can be placed precisely at the area of injury. The end result is improved pain and function. Examples of ultrasound-guided injections include:

  • Shoulder injections (rotator cuff/subacromial bursa, acromioclavicular joint, shoulder/glenohumeral joint, biceps tendon)
  • Elbow injections (lateral epicondyle, medial epicondyle, elbow joint)
  • Wrist and hand injections (thumb/first CMC joint, carpal tunnel, trigger finger, DeQuervain’s tenosynovitis)
  • Hip injections (hip joint, bursa/greater trochanter, piriformis, sacroiliac joint)
  • Knee injections (knee joint, Baker’s cyst)
  • Foot and ankle injections (Achilles tendon, ankle joint, plantar fasciitis, Morton’s neuroma, tarsal tunnel)

Is There Any Special Preparation for the Exam?

There are no special preparations for a musculoskeletal ultrasound injection examination.

How is the Injection Performed?

You will be instructed to lie or sit on an examining table. A small device called a transducer is placed on the skin surface after a gel is applied to your skin to provide better contact. The gel can feel cool and could leave a dry white powder on your clothes, so you might want to wear easily washable clothing. A paper or cloth gown will be provided if necessary. The room is usually darkened during the examination so the examiner can see a monitor screen more clearly. The sonographer will position the transducer over the body part to be injected while the physician will administer the injection.

Will it Hurt?

There will be some discomfort as with any injection procedure, however ultrasound provides guidance so the physician can more accurately place the needle. This reduces the risk of additional pain and discomfort while increasing patient safety.

How Long Will it Take?

The length of time for the injection varies with the complexity. A general guideline is between 30 and 60 minutes. After the injection you may safely drive home and eat and drink normally.

Additional Information and Education

Visit our education page to learn important ways to help keep your body healthy, free of pain and more responsive to treatment. Learn more.