Training and
Performance

The World Class Pain Solution for Athletes and Active Adults.
Revolutionizing Physical Therapy, one success story at a time.

Online Program

The Most Innovative Online Pain Solution for Active Adults and Athletes. Eliminate pain from the deepest root, no matter where you are in the world.

Post-Surgical
Rehabilitation

You took a big step. Let’s cross that finish line with confidence. Undivided attention and care to guarantee your surgery is a success.

Sports
Rehabilitation

No one understands the athlete like Next Level. Experience the only pain solution trusted by the world’s top athletes.

Physical Therapy

The World Class Pain Solution for Athletes and Active Adults.
Revolutionizing Physical Therapy, one success story at a time.

Just because they say “Sports PT”, doesn’t mean they are.

 

Treating the athlete is more than just adding lifts into rehab. It’s more than doing sprints and agility.

It’s about understanding the needs of the athlete at the deepest level

The chances of re-injury are significantly higher after the first injury, so let’s make sure that . . .

YOU GET IT RIGHT THE FIRST TIME!

3 Core Influences
We know what it takes to get the athlete back on top.
This deeper understanding of the body and mind is what propels them to success.

Physical


Sports demand higher loads on the body with advanced movements and coordination. The body compensates when there is an imbalance.

These compensations accumulate through repetitive movements and lead to multiple stress points on the body.

Mental/emotional


The fear of not getting better. The disappointment of being on the sideline. The pressure to perform after recovery.

These psychological stressors have an overwhelming effect on recovery.

Social


Athletes have coaches who are telling them one thing, trainers who are advising another, and teammates who have expectations.

Treatment must involve everyone who has an influence on the athlete so they can work together towards the same goal.
Download Our Free Guide Now to Learn More About the Next Level System
We've created a transformational guide that details our unique approach and gives actionable steps so you can get on the right path to recovery.

FOUNDATION

Pain is the result of a weakness in your foundation.

Regardless of location, severity, and age, recovery relies on 4 key foundations.

This is our “4 Pillars of Recovery.”

Failure to address each pillar leads to pain and poor results. Long-term pain relief happens only when each pillar is strengthened at the right time.

PILLAR 1:
STRUCTURE
Structural damages must be addressed first. Any internal processes that have potential to limit your physical ability to recover must be identified.
PILLAR 2
MINDSET
There must be clarity around what you actually think about your pain. Your thoughts and beliefs are a major indicator of your body’s ability to recover. We must ensure that they are healthy, empowering, and most importantly, accurate.
PILLAR 3:
MOVEMENT
You must possess a level of mobility and stability in your functional movement patterns. How you move at the most basic level is the building block of everything. In order to load your body with advanced movements, you must possess strength and control in your basic functional movement patterns.
PILLAR 4:
CAPACITY
Solid movement with strength and control is what leads to long-term pain relief. You need to understand the specific movements you are trying to do in your activity, and load the body with a sound strategy. As your body builds capacity, you’ll feel stronger and more confident to get back to doing what you love.

STRATEGY

We start with the end in mind so that your treatment has intent and purpose.

We get clear on your goals and what you want to achieve from the start.

We implement our 7 Level System to identify the root cause of your pain and develop a personalized treatment plan that is solely focused on your goals.

The system has transformed lives from professional and Olympic level athletes, to the everyday fitness enthusiast.

It is the perfect bridge that will get you from being limited in pain, to doing what you love again.

  • 07:
    Physical Mastery
  • 06:
    Transformation
  • 05:
    Power & Capacity
  • 04:
    Integration
  • 03:
    Control
  • 02:
    Position & Range
  • 01:
    Understanding
  • 00:
    Acute Management

Execution

Sound strategy with precise execution results in lasting transformation.

We have tested the most effective treatments and combined the most proven methods.

What we’ve created is a world-class treatment system where you’ll feel a difference at each session, one where you’ll have deep-rooted pain-relief at the end.

Video Testimonials

Denny B.
“I came to you guys and everything fell into place… and out of nowhere I was the best I’ve ever been within such a short period of time.”
Amanda E.
“This is a completely different system than anything I’ve ever tried…the specific methods they use are different…they train not only your body but your mind.”
Michelle C.
From Hamstring Pain To Back On The Court Pain-Free “As a Professional Basketball Player… I was looking for someone who was actually interested in your case, and not just throwing a plan at you that they use for everybody.”
Kyle H.
“Coming here has been different because it has given me different routes…the breathing exercises…analyzing what worked and what didn’t… I exploded this summer.”
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BLOG

Your Scapula Is NOT Dysfunctional
I think we can all agree that shoulder pain sucks. Personally, I use my arms all of the time. To put on clothes, shower, feed myself, drive, lift weights, do pushups, write this article, and a whole lot more. If you’re anything like me, you do too. There are a lot of possible causes of shoulder pain, but if you’re in a group of people diagnosed with scapular dyskinesis, scapular instability, or scapular dysfunction, which are essentially the same thing, I have something to tell you. It’s the truth, but I don’t know if you’re ready for it. Are you sure? Really really sure? Alright, you asked for it... There is no such thing as a dysfunctional scapula 😱 I know, you must be shook, but allow me to climb onto my soap box for a minute. I believe that the word “dysfunctional” has no place in a discussion about how bodies move. It reinforces unhelpful narratives around our bodies being fragile or broken, which can lead to hesitation, fear avoidance, and increased risk of repeat injuries. How? Our good friend Dumbledore said it best: (his beard is filled with wisdom) Using the word dysfunctional implies that there is a functional, normal, and/or correct way for a shoulder to move. Those who are dysfunctional are therefore abnormal, incorrect, and at risk for harming themselves. The terms dyskinesia, abnormal mechanics, and instability have similar issues. They’re binary. You’re either normal or abnormal with no room in the middle. It’s unintentional mental framing that leads to a self-limiting belief. People with these diagnoses commonly avoid activities out of a fear of making things worse, which in the end actually makes things worse! Just because your shoulder doesn’t work as well as you want doesn’t mean there’s something wrong with it. You just need to figure a few things out. The anatomy is important here. There are three main structures to consider when thinking about the shoulder: the ribcage, the scapula, and the humerus. The scapulo-thoracic joint is between the ribcage and scapula while the glenohumeral joint is between the scapula and the humerus. The scapula is responsible for about 30% of your total shoulder motion, and the scapulo-thoracic joint operates as a “floating” joint with no direct bone-to-bone attachment to the body. Your upper arm bone, the humerus, connects into a socket on the outside edge of the scapula. Your shoulder blade floats because as it moves so does the socket. It can therefore orient and position itself in a wide variety of ways, allowing you to get your hand into a lot of different positions. The shoulder has more range-of-motion than any other joint in the body. The more motion you have available the more complex movement becomes, and the harder it is to control. This is where the conversation of stability comes in. For the sake of this discussion I’m going to define stability as the ability to resist unwanted motion and/or to return to a desired state after being moved. This is why the common treatments for an “unstable” shoulder include activities like bosu planks, having your therapist slap your arm around while you hold it in one place, lifting and carrying weights hanging from bands, etc. The intent is good but the application is often poor, leading to inconsistent and incomplete results. These activities are complex, with a lot of variables to control. For someone who is already having issues, it’s a lot to ask. A better approach would be to start with development of passive motion, allowing access to the arm positions needed. Next step would be active motion within this newly acquired motion. From there we need to start producing force in all of these positions and developing both strength and consistency in the desired motor patterns. If the issue still exists at this point then, and only then, do we get into the fancy stuff. For example, I wouldn’t have a client do any form of an “unstable surface” pushup until they can clearly demonstrate 20 crisp and consistent repetitions of the strict pushup first. While complex, highly variable, dynamic activities might look sexy they are the top of the pyramid, not the bottom. You need to properly build the foundations before you get there. If you’ve been struggling to get your shoulders back to where you want them to be, and you feel like you’ve tried everything, I highly encourage you to go back and master your basics using the progression above. If you can’t figure it out, hire a skilled professional who truly understands the process. There’s nothing wrong with your shoulder, it’s just struggling to manage complexity.
The #1 Missing Piece In Resolving Shoulder Pain
Are you Treating the Problem or The Result?  Shoulder “problems” are incredibly common amongst the athlete and active adult population that we see. As therapists, we see traditional diagnoses such as shoulder impingement, tendonitis, and rotator cuff injuries daily. Traditionally, these common issues are blamed on weak rotator cuff muscles, scapular winging, imbalance of muscle activity, etc. One major thing to understand about these diagnoses is that they are not the actual problem…they are a result. A result of deeper-rooted movement habits and mechanics that usually go unaddressed in the traditional rehab process. Typical solutions for these “results” are equally short- sighted. Frequently these solutions, which include stretching, rotator cuff strengthening, and general strength training, miss the mark as far as resolving pain. Why? Because they are addressing symptoms and not the thing that has caused the faulty mechanics, the need to over- use certain musculature or orient musculature in a disadvantageous position. To truly understand what the biggest missing piece is in resolving these common shoulder issues we first need to understand how the shoulder behaves.  A Quick Anatomy Lesson of the Shoulder Complex  The shoulder complex is made up of 4 major components: The glenohumeral joint (ball and socket), the scapula (shoulder blade), the sternum and clavicle, and the rib cage. Shoulder movement in any direction requires rotation of the humeral head (ball) within the glenoid (socket).  Because the shoulder has so much freedom of movement, stability of the joint needs to be ensured. That is why every shoulder movement is accompanied by scapular movement. Since the actual socket of the shoulder joint is on the scapula, its movement is vital in maintaining the humeral head centered within the glenoid during shoulder movement. When the humeral head doesn’t stay centered within the socket is when things like shoulder impingement occur, proximal biceps tendonitis rotator cuff injuries occur For a shoulder joint to move well, you need a scapula that can move in congruence with the humerus. What allows the scapula to move? The scapula has a slight curvature to its shape. The scapula sits on a rib cage that has a roundness to it due to normal thoracic kyphosis or curvature of the upper back. The roundness of the upper rib cage and the curvature of the scapula allow the two to maintain congruency with each and allows the scapula to rotate about its normal motion in support of the humeral head. The position of the rib cage and its ability to expand appropriately to support the scapula is essential for normal scapular movement that allows for normal shoulder movement without compensation.  Rib Cage Position and Expansion  The rib cage, under normal circumstances should be able to expand circumferentially (360 degrees) during normal breathing. During every inhale, the lower ribs should move outward in what’s called bucket handle movement while the upper ribs and sternum move up and out in a pump handle movement. The backside of the rib cage should reflect a similar movement, especially in the upper rib cage. It is when the rib cage lacks these normal, requite movements that things like scapular position and as a direct result, shoulder mobility, are negatively affected.  For example, when the back side of the upper rib cage becomes too restricted in its movement or flattened due to chronic muscular tension in the upper back you will see a limitation in scapular movement. A curved scapula on a flat surface does not achieve the same movement and rotational capabilities as one that is on rounded, congruent surface. Remember, without scapular movement the shoulder joint either cannot access normal movement or will have to move through compensatory mechanics to get there. Chronically moving in to ranges that you don’t have access to or compensating for movement limitations is exactly what leads to frequent pressure and tension in the same area i.e., shoulder impingement, biceps tendonitis, wear and tear of rotator cuff tendons, etc. How does one lose normal rib cage mechanics? This is easiest to see in an activity like resistance training. Most movements in the gym emphasize “shoulder blades back and down” for “stability.” No matter whether you’re pushing or pulling, back squatting or deadlifting, the rib cage and scapular position are relatively the same. A similar effect occurs from the ill-fitted advice to pull your shoulder blades back and down for “good posture.” Chronically spending time in a scapular retracted position will both prevent normal scapular movement and flatten the upper rib cage resulting in the need to compensate to achieve the desired shoulder movements.  The Solution To truly resolve shoulder pain, you must start at the source. Yes, there are many other factors involved in shoulder pain; rotator cuff strength, dynamic stability, local tissue inflammation, etc. Regardless of these issues you must understand and resolve what lead to these issues in the first place, otherwise you are just treating a symptom. If your goal is to improve the mechanics and motion at the shoulder joint, you need to ensure proper scapular movement. To have normal scapular movement requires a rib cage that is positioned properly and can expand in all directions to provide a foundation and support for the scapula. Once you have established a proper foundation, all factors mentioned before can be addressed with much greater success.  Below are 2 examples of drills to implement into your program to improve ribcage expansion: Seated Zercher Breathing Video [embed]https://www.youtube.com/watch?v=3CtDqIZnC_U[/embed] Seated Back Expansion Video  [embed]https://www.youtube.com/watch?v=24K6f7OMDXE[/embed]
Hand Going Numb? Check Your Thumb – How the Relationship Between Your Hand and Wrist Movement Can Affect Your Carpal Tunnel Syndrome Symptoms (Part 1/2)
Carpal tunnel syndrome is a collection of symptoms that most commonly appear in the thumb, index and middle fingers on the palm side of the hand.  The hallmark symptom of this is aching or a loss of sensation in those three fingers specifically.  Typically, these symptoms are arising because the median nerve is experiencing a prolonged compression where it crosses into the hand at the “carpal tunnel” – or a small loop of tendon overlapping several muscles that run into the hand and the median nerve at a very small space near the bones of your wrist. (Figure 1).  [caption id="" align="aligncenter" width="600"] Figure 1: Anatomy of the carpal tunnel region and the median nerve. The nerve in the middle that runs to the thumb and middle finger is the median nerve. Source: https://qph.fs.quoracdn.net/main-qimg-2effc0be8c4ff02f065339aebda08596-c[/caption] The most common courses of treatment that I see recommended are prolonged static stretches of the muscles on the front of the wrist and forearm, active range of motion exercises for the wrist and hand in all motions, stretching of the thumb muscles, and tendon and nerve glide activities.  What all these activities have in common is that they are being prescribed with the goal of reducing the compression on the median nerve. Nerves love movement, blood flow, and space around them. The intent of what needs to happen during treatment is spot on – it’s why the surgical option to try to alleviate the symptoms is to cut that white-colored tendon you see running between the thumb and pinky muscles, to make more space over the median nerve.  While there is nothing wrong with these activities, not all interventions have the same effect. If we are trying to create room around the carpal tunnel, we need to appreciate the position of the hand versus the wrist, because many of the muscles that cross the carpal tunnel cross or directly attach to these bones.  Stretching muscles statically mostly just increases the tolerance of a muscle to being lengthened, and does not do much to address the qualities or behavior of muscles or tendons from what the latest research on stretching tells us (PubMed ID# 28801950). Plus, prolonged tension put onto a nerve that is already compressed can be like stretching an already taut rubber band more – it’s not going to help to reduce the tension in that structure. So, instead of just focusing on a muscle or muscles that are “tight”, let’s instead focus on helping the bones of the hand and wrist be able to get into a position to “unstretch” the rubber band and help give that nerve more space around it to help it be able to move more freely.  The picture below shows an example of a thumb that is internally rotated (the yellow area) relative to the position of the wrist. The blue arrow shows a thumb that is better able to externally rotate relative to the wrist than the yellow arrow. (Figure 2) [caption id="" align="aligncenter" width="960"] Figure 2: An example of differing thumb and wrist orientations. Source: https://i2.wp.com/plasticsurgerykey.com/wp-content/uploads/2020/06/10-1055-b-002-98003_c049_f001.jpg?w=960[/caption] Can you see how stretching the muscles of the yellow hand might have a completely different result than the blue hand?  The same solution applied to these two different hands does not yield the same outcome.  In the next part of this discussion, we’re going to talk about how to tackle getting a more effective solution to create space and movement around the median nerve and possibly eliminate symptoms in the carpal tunnel that are tailored to the specific presentation of the yellow hand. 
The Infamous Tommy John & Baseball
If you were to assess how great a pitcher in baseball truly is, you might find yourself looking at a lot of statistics…specifically the ERA or Earned Run Average. With the goal to strike out everyone who dares to step into the box against them, they must not only possess a superior amount of talent and skills, but an ability to demonstrate a large amount of power. Multiplied by about 100…pitches that is. Across sports, only a small number of athletes have to exert the same level of power quite as frequently as a baseball pitcher. Now, if specialized at a young age to be a pitcher and across several teams per year, this amount of power, volume and overall stress placed on the elbow and its surrounding structures can not only take a toll, but potentially wreak havoc on the players future…at least that is what we thought.  Typically beginning as a low level condition, such as Little League Elbow (a condition that is simply a byproduct of insufficient rest periods between pitching outings) or Acute bursitis (inflammation of localized fat pad), a baseball player’s elbow joint has to be able to absorb a tremendous amount of force and repetitive stress across seasons. This type of overhead throwing irritates not only surrounding tendons and ligaments that are responsible for support, but predisposes pitchers to more serious issues, such as an Ulnar Collateral ligament (UCL) injury.  As a result of increasingly large prevalence in young players over the last few years, this once seen injury in mostly adults has prompted many governing bodies to change the rules. The American Sports Medicine Institute (ASMI), USA Baseball, Little League Baseball, Major League Baseball organizations to establish Pitch Count Guidelines.  With many efforts being made to protect the new generations of baseball, higher level players continue to remain at risk.  The Ulnar Collateral ligament (UCL) injury The ulnar collateral ligament (UCL) has been amongst the most commonly injured ligament in repetitive throwing / overhead athletes. In order to accommodate the large volume of power that is created to throw a baseball 60 feet, the ligaments stretch and elongate until it can no longer bear the capacity to maintain the elbow’s integrity. Like any ligamentous injury they can range in severity and true structural damage/complexity. They range from a minor sprain with light damage and inflammation to a complete tear.  UCL Symptoms Include:  Pain with throwing or inside of the elbow Instability  Decreased strength or power in throwing Increased sensitivity around the ulnar nerve “funny bone” causing numbness and tingling in the ring and pinky finger Diagnosis and Treatment A UCL injury is diagnosed following the results and clinical presentation together after a physical examination, in conjunction with diagnostic imaging, such as X-ray & MRI. Indications on next best step are contingent upon severity of structural damage, healing time, rehabilitative exercises, inflammation management, further evaluation may be indicated. Further assessment with a physical therapist or athletic trainer may be warranted to determine if throwing mechanics, inefficient body positioning, compensatory techniques/strategies, and sequencing caused excessive stress on the elbow. Oftentimes if a pitcher does not have full access to shoulder motions required to pitch effectively, the torque to generate the power required needs to come from another place…I bet you know where that is! INSIDE THE ELBOW!  Yes, inside the elbow. Now, normal pitching mechanics on average require 300 N (67 lbs) of torque along the inside elbow… normal. Can you imagine the level of stress taken on by the elbow due to abnormal pitching mechanics multiplied by 100 pitches per game over the course of a full season? Tommy John and His Influence Named after former LA Dodgers Pitcher, Tommy John, the surgery has dramatically impacted baseball and throwing athletes. Used as a last resort now for UCL injuries, outcome measures have drastically increased since this surgery gained traction in the baseball community. TJ Surgery is a surgical graft procedure where the injured UCL is replaced by a tendon graft taken from the forearm or hamstring tendons. The procedure is followed by an intense rehab program that consists of several phases on average lasting 6 to 12 months.  What was once a career ending injury is now a symbol of hope for many overhead athletes looking to continue the sport they love! Today the UCL Reconstruction is a commonly performed procedure and emphasized in rehabilitation education programs.  If you have any questions regarding this topic please consult your primary care physician or stop by Next Level Physical Therapy and we will gladly speak with you about it.

Reviews

Denny B.
Professional Baseball Pitcher

Dr. Mike has helped me with several injuries and it blows my mind every time. I would go to a doctor and they would not be able tell me why I am in pain. Then I would go to Dr. Mike and he would have the problem fixed within the hour. I recommend Dr. Mike to all of my teammates and anyone with an injury. If you are hurt, he is the guy to go to.

The other day I came to Dr. Mike with a sore arm and no answers as to why. He ran me through a few test and told me to go home and get a different pair of shoes. So I did. Once I got back he proceeded to prove to me that my shoes were causing my arm pain. I was shocked to say the least. Two days later he helped me find a pair of shoes that accommodate to my feet and I have been feeling great ever since. That is just one of the many times Dr. Mike blew my mind.

Last year I travelled to every state on the East coast for baseball. I worked with many physical therapists along the way. Not one of them came close to comparing to Dr. Mike’s ability. He is by far the best physical therapist I have ever worked with.

Rasheed B.
Professional Football Player

As a pro athlete I’ve been looking for services in which I receive the same treatment I receive when in my teams facility. And it’s been a perfect match, we came up with a strategic plan to work on my weak muscles , foot Contacts & Mobility , Hip Mobility and Strength , & overall muscle activation in my legs feet and hips. Artem has been intentional and very professional, he has a whole lot of knowledge and I know when he speaks he knows what he’s talking about and thats what I look for in people when trying to elevate my game and my understanding of my body . I’d highly recommend ppl as I already have to go see him and his team at next level. The environment is good the tunes are always on point and Nikki at the front desk is the cherry on top . She cares and she’s a very good listener and always has the best advice . If you are looking for a PT home NEXT LEVEL is the place 🤞🏾🙏🏾💙

Amanda A.
College Field Hockey Player

I could not be more grateful for the years of physical therapy I went through at Next Level in Robbinsville. I began my journey at Next Level after injuring my back playing field hockey my junior year of high school. After my initial injury, I could not play my sport and experienced brutal pain and discomfort consistently throughout the day. Before starting physical therapy with Dr. Ben Fan, I was discouraged and worried about my ability to hold up my commitment to play Division I collegiate field hockey. However, after weekly visits with Dr. Ben, I was soon enough back onto the field and managing the bulging disks in my back thanks to the exercises and cues I learned at Next Level. 4 years later, I am currently a junior in college with a successful field hockey career that I very much owe to the work I did with Dr. Ben. To this day, I continue using breathing exercises and manual techniques I was taught years prior.
Not only did my experience at Next Level transform my back pain, but it also was a primary contributor to my desire to become a physical therapist myself. Seeing the influence that Dr. Ben had on me, as well as interacting with the other physical therapists and patients in the practice, I was incredibly inspired and realized I wanted to have that same impact on others in the future.