This image portrays Snow Shoveling Safety: Protecting Your Spine in Winter Wonderland by East Tennessee Spine and Sport.

Snow Shoveling Safety: Protecting Your Spine in Winter Wonderland

Winter’s charm often comes with a hefty side of responsibility – snow shoveling. While clearing driveways and sidewalks is a common winter chore, it can take a toll on your musculoskeletal health, particularly the neck and back. Let’s delve into some eye-opening statistics, with a notable finding from the American Journal of Emergency Medicine, and essential tips to ensure you stay injury-free during this winter season.


A comprehensive study published in the American Journal of Emergency Medicine reveals a concerning trend – injuries to the lower back accounted for over 34% of all soft tissue injuries suffered from shoveling snow. This statistic underscores the specific vulnerability of the lower back during this winter activity.

Common Injuries & Conditions

Beyond low back pain, individuals may suffer from a range of injuries or conditions when shoveling snow, including strained muscles, herniated discs, and even heart-related issues in extreme cases. Understanding these risks empowers you to prioritize your musculoskeletal well-being.

Do’s and Don’ts

1. Posture Matters: Maintain a neutral spine position by bending at the hips and knees, avoiding excessive twisting.

2. Take Breaks: Pace yourself and take regular breaks to prevent muscle fatigue and reduce the risk of injury.

3. Know When to Stop: Listen to your body. If you experience pain or discomfort, it’s crucial to stop immediately and seek assistance.

Encouragement & Solution

If you’ve sustained a musculoskeletal injury while shoveling snow, don’t hesitate to seek professional help. Our spine specialists at East Tennessee Spine & Sport are here to support you. Visit to make an appointment and get expert evaluation and care.

This winter, let’s prioritize safety and well-being while enjoying the snowy landscapes. Your spine will thank you for it!

Local Ownership: Deep Roots in East Tennessee’s Health and Well-Being

At East Tennessee Spine & Sport, we take immense pride in our local ownership and deep roots within the communities we serve. Our journey in providing exceptional physical therapy care began over two decades ago, and our unwavering commitment to East Tennessee is at the heart of everything we do.

East Tennessee Spine and Sport

Greg DeFilippo – Our Visionary Founder

Our founder, Greg DeFilippo, a true visionary, embarked on a mission to serve the East Tennessee community back in 1995. This marked the beginning of our enduring commitment to providing high-quality physical therapy care to our neighbors, friends, and fellow community members.

East Tennessee Spine and Sport

Graeme Keys – 20+ Years in Farragut

One of our partners, Graeme Keys, has been practicing in Farragut for over two decades. This remarkable tenure not only reflects the passion and dedication he has for his work but also his deep connection to the community. Being an integral part of the Farragut area for so long, he has had the privilege of witnessing the growth and evolution of the community, all while providing invaluable physical therapy services to its residents.

East Tennessee Spine and Sport

Donnie Sharp – Born and Raised in Oak Ridge

Another partner, Donnie Sharp, born and raised in Oak Ridge, has spent most of his career working in the very community that shaped him. His local roots run deep, and his commitment to Oak Ridge is unwavering. Serving the place he calls home is a source of pride and fulfillment, and his contributions have positively impacted the lives of countless individuals since his return to Oak Ridge after graduating from PT school in 2010.

East Tennessee Spine and Sport

Bill Pendergrass – 15+ Years in North Knoxville

Our fourth partner, Bill Pendergrass, originally from East Tennessee, has been living and working in the North Knoxville community for 15 years. Over this time, he has established deep connections with the community, treating patients and becoming an integral part of the North Knoxville landscape. His passion for improving the well-being of those he serves is palpable.

The Importance of Community

Our long-standing presence and deep local ties are a testament to our dedication to East Tennessee. We take pride in being your trusted partners in health and well-being, and we look forward to many more years of serving and supporting our vibrant and thriving communities.

Thank you for placing your trust in East Tennessee Spine & Sport. Your health is our priority, and we are honored to be a part of your journey to wellness.

Celebrating Emily Pace: A 40 Under 40 Knoxville Honoree and Pillar of the Pelvic Health and Birth Worker Communities

This image portrays Celebrating Emily Pace: A 40 Under 40 Knoxville Honoree and Pillar of the Pelvic Health and Birth Worker Communities by East Tennessee Spine and Sport.

We are excited to share some fantastic news with our community - one of our very own, Emily Pace, has been named to Knoxville's 40 Under 40 Class of 2023! This prestigious recognition is a testament to her unwavering dedication, hard work, and remarkable contributions to both our clinic and the broader healthcare landscape. Join us in celebrating Emily as she enters this elite group of young professionals in Knoxville.

Emily's journey in the field of physical therapy has been marked by her commitment to improving the quality of life for countless patients in our clinic. Her expertise in pelvic health has not only transformed the lives of her patients but has also had a profound impact on the birth worker community in Knoxville. Here's why her recognition is so well-deserved:


  1. Pelvic Health Expertise: Emily Pace's dedication to pelvic health has been a game-changer for our patients. She has become a beacon of hope for individuals struggling with pelvic health issues, offering them a path to recovery and a better quality of life. Her compassionate care and vast knowledge in this field have touched the lives of many.
  2. Advocacy and Education: Beyond her clinical work, Emily has been actively involved in educating the community about pelvic health and raising awareness of its importance. She has hosted workshops, webinars, and events to empower individuals with knowledge about their bodies, fostering a culture of wellness and self-care.
  3. Support for Birth Workers: Emily's contributions to the birth worker community are invaluable. Her expertise in pelvic health and her willingness to collaborate with midwives, doulas, and other birth professionals have enhanced the support available to expectant mothers in Knoxville. Her efforts have contributed to safer and more comfortable childbirth experiences.
  4. Building our Practice: Emily's dedication to building up our practice outside the clinic has been instrumental in our growth. Her commitment to community engagement, networking, and outreach efforts has helped us reach a wider audience, ensuring that more people can benefit from our services.

We are incredibly proud of Emily's achievements and the positive impact she has had on the pelvic health and birth worker communities. Her recognition as one of Knoxville's 40 Under 40 is a testament to her exceptional commitment and the transformative work she does every day.

If you'd like to learn more about the other outstanding young professionals in Knoxville who made the 40 Under 40 Class of 2023, please visit this link.

Women’s History Month: Famous Women in History Who Impacted Physical Therapy

March is Women’s History Month! There have been plenty of women that’s impacted the world we know as today. This has bled into the Physical therapy world and women have made an impact on the PT industry. Nearly 64% of the profession is dominated by women. The following women have the most prominent influence in PT:

Mary McMillan

Mary is considered to be the “Founding Mother” of the Physical Therapy profession.  She received education and training in England and returned to the United States, working with P.E. graduates who were responsible for rehabilitating our WWI survivors.  

In 1918, Mary became the first “reconstruction aide” in the United States which eventually led her to train other women in the profession.  She is remembered for her sparkling personality, warmth and sense of community which led to more women pursuing physical therapy as a career.

Margaret Morris

Well known British dancer who pursued an interest in breath and pelvic floor muscle training to control leakage back in the 1930s – a few years before Dr. Kegel published his findings.  Despite Dr Kegel, and the misnomer of “kegels” being attributed to him and his work – Margaret first outlined and published the foundational work from which a majority of Dr. Kegel’s “exercise regimens” were derived.  She is recognized as the founder for pelvic floor rehabilitation in modern medicine as we know it today.

Elizabeth Noble

A Physical Therapist credited with founding the Women’s Health Section of the APTA in 1977.  Elizabeth was recognized internationally as the expert of, and an advocate for, the physiology of pregnancy, birth and postpartum experiences.

Elisabeth Bing

German Physical therapist.  Known for establishing a course in prepared childbirth education at Mount Sinai Hospital in NYC. Additionally, in 1960 she co-founded the American Society of Psychoprophylaxis in Obstetrics. She has also published numerous books in psychoprophylaxis which have become the mainstays in prepared childbirth education.  She was a large advocate for the Physical Therapist’s role for birth preparation in the United States.  Which is something we’re still fighting for today, 60 years later.

There are so many more honorable mentions of women impacting the PT industry as we know it today, we could go on forever. Especially since female representation at the executive level is growing, there will be so many more female physical therapists that will influence the profession in the future.

Pelvic floor physical therapist teaching patient about the pelvic floor using a pelvic model.

The Nest

You’ve asked and we’ve answered!  Our pelvic floor program is growing and we now have a stand-alone specialty clinic for all of your pelvic floor needs!  The Nest opened on February 1, 2023, and we are so excited to offer this specialty service for the greater Knoxville area.  

At the Nest, all of our physical therapists have significant training allowing us to treat pelvic health conditions like urinary incontinence, bowel incontinence, diastasis recti rehabilitation, pelvic pain, pain with intercourse, and so much more!

Pelvic floor physical therapy is for all ages and all genders because we all have pelvic floor muscles!  The pelvic floor has 5 very specific jobs:

  1. Stabilize the pelvis as a whole
  2. Support the pelvic organs (bowel, bladder, and uterus)
  3. Help with sexual function
  4. Helps with bowel & bladder function
  5. Support lymphatic function

Problems in the pelvic floor muscles can show up in any of those 5 jobs mentioned above or it can show up as pain in the back, abdomen, legs, and genitals. If your pelvic floor is doing its job, then it is not something that we think about.  When the muscles are not doing their job, it can consume so much of your brain power and put a halt to your everyday activities.

But the pelvic floor muscles don’t live on an island by themselves! So our pelvic floor therapists are also well-trained to treat all of the joints around the pelvic floor ensuring our patients get the best care possible. 

Additionally, we understand that there can be a lot of other issues that go hand and hand with pelvic floor problems and services can be hard to access.  To make this easier for our patients, The Nest will also be home to additional services provided by Kristin Williams, lactation consultant, Maggie Klotz, psychiatrist, and The 4th Trimester Fitness Method. We are so excited to have all of these amazing providers in one place. 

Call our location to set up an appointment to meet your needs. Our staff is excited to help you get back to full function and back to your life!

This image portrays Running Assessment  by East Tennessee Spine and Sport.

Running Assessment 

Gait Analysis, or simply, a running assessment is studying how we walk or run. We use this to identify and diagnose gait disorders. Athletes and active individuals, people with musculoskeletal conditions, and individuals dealing with injuries in the lower limbs are people who should be seen to do a running assessment. 

At East TN Spine & Sport, our running assessment begins with talking to our patients about their current training program–if any, running shoes and surface, running goals and aspirations, and current or previous history of injury. This is then followed by having our patients warm up on the treadmill until they reach a comfortable speed. A therapist will videotape their patients running on the treadmill, capturing views from both the side and the back. Using slow-motion software, we are able to watch the replay of our patients running frame-by-frame. This allows us to look closely at where our patients are landing, how they are landing, and any other biomechanical misalignments. At the conclusion of your gait analysis, your therapist will make recommendations to address issues that may be causing your pain/injury or to maximize your running efficiency.  

Examples of training recommendations that may be made following your running assessment include:

  • Hip strengthening or core exercise program to address excessive pelvic movement while running that could lead to hip or knee pain
  • Landing drills to address runners who land too hard while running that could cause stress injuries
  • Recommendations for shoes or inserts in addition to foot strengthening exercises to address excessive foot movement (pronation or supination ) while running that could cause ankle pain or tendinitis
  • Cadence training using a metronome to address runners who take longer strides leading to heel striking which could increase force while running and cause injuries from the ankle to the hip. 

Some of our locations provide the AlterG anti-gravity treadmill, this treadmill is mainly used to shorten recovery times, reduce injury, and improve mobility for patients. Using its weight-reducing ability, The AlterG anti-gravity treadmill was designed to return to walking after injury, surgery, or pain sooner than before while still walking or running normally. Our AlterG Treadmills also provide gait analysis. Locations that offer this NASA technology include Hardin Valley, Farragut, and Oak Ridge. 


This image portrays Let’s Stretch Together! by East Tennessee Spine and Sport.

Let’s Stretch Together!

National Stretching Day and most people would say they understand the benefits of stretching, but not everyone is committed to staying loose with a regular routine.  While regular long stretching sessions are beneficial, especially for athletes or active individuals, how can we maintain flexibility if we do not have the time to commit? Here are some tips to help you stay loose even if you are stuck at the office.

The most common stretches are focused on “flexibility” or lengthening the muscles which is important to prevent injury. These should be completed in a dynamic movement fashion to warm up before activity and should be completed as 30-60 seconds static holds after activity. 

However, muscles are not the only part of our body that get “tight”.  We also have to consider our joints or “mobility” as well.  We like to say that Motion is Lotion. These repeated movements assist with lubricating our joints with nutrient-rich fluid which in turn will help maintain range of motion and decrease pain and stiffness.  

Most of the population (around 80%) will complain of back or neck pain in their life.  Our spine is made up of lots of different joints, so it is susceptible to stiffness resulting in common complaints of neck and back pain.  When we stay still for too long, such as sitting at our desk, our joints are not lubricated and we can lose mobility over time. 

For those that are stuck behind a desk, try these easy office stretches to break up your day, improve your posture, improve your mobility, and reduce your chance of developing back or neck pain.  

Try to perform up to 10 reps at a time and do at least one stretch every 1-2 hours. 2-3 minutes of stretching periodically throughout your day can be more beneficial than 1 intensive hour-long session.

If you have any specific questions or concerns and would like a personalized evaluation, please contact one of our six locally-owned clinics. We will provide you with a personalized plan of action based on your goals. We want to get you back to doing the activities you enjoy as quickly as possible. 


extending backwards
Stand up and extend backward.
Rotate to the left and right on a chair.
Rotate to the left and right.
Tuck chin straight back.
Tuck chin straight back.
Stetch your arm straight back.
Stretch your arm straight back.



Extend upper back over your chair.
Extend your upper back over your chair.
Mothers participate in lunge workouts with their newborns.

Female Pelvic Health Through the Lifespan

Women experience continuous changes throughout their lifespan; from puberty to childbearing years, perimenopause, and into postmenopause…the female body is an ever-evolving landscape! Oftentimes the symptoms and their effects on women’s lives is underappreciated. After all, women comprise 49.6% of the world’s population, so nearly half of the world is going through it. Pelvic Floor Therapists have a unique perspective into the struggles of women throughout their lifespan and tend to be diligent in delineating between a condition or experience being “common” versus “normal”.

It is important to not confuse the two terms; just because something is common among a population of people, does not make it normal. It is common for women to have pain during their menstrual cycles and during pregnancy. It is common for women to struggle with returning to prior levels of function, including sexual function, following the birth of a child or with the journey of menopause. It is common for women to experience bladder leakage, and have difficulties with constipation. It is common for them to develop vaginal changes affecting personal relationships during and following menopause. But – is it normal?

Being intentional to support women throughout their lifespan and the journey their body makes along with them is important. Empowering women to pursue care proven to improve quality of life measures, throughout their lifespan, is imperative. Pelvic Floor Physical Therapy can be a tremendous tool allowing women to reclaim their bodies, and often their lives.

What Is Pelvic Rehabilitation?

Pelvic floor rehab, or Pelvic Floor Physical Therapy, is treatment provided by a licensed Physical Therapist who has completed additional and specialized training for pelvic floor conditions. It involves an assessment of the low back, pelvis and hips, along with an external and internal pelvic examination. This examination is different from the one performed by a medical provider because it is assessing the “musculoskeletal” system; bones, joints, ligaments, and muscles.

Treating Women Through The Lifespan…

Experiencing the evolution from childhood to adulthood can be challenging for many children and adolescents. The development of new body parts, changes in appearance, acne and the beginning of menstruation can make this a very confusing time for kids. It’s difficult for parents too when the language has typically been “it’s normal to have pain during your period”. But what if your child is missing school, unable to attend social events, can’t tolerate tampon use, or is having severe acne? Pelvic floor therapy can be beneficial in assisting teens and parents to navigate these challenges and provide additional medical support when necessary.
For adult women, the changes don’t stop there – there’s the journey of pregnancy and postpartum to consider as well. How do women handle the increasing demands of their bodies while making another human? Are they supposed to buy the lie that “pain is normal”? Or should they pursue additional care when their back, hips, and feet start to bother them with their advancing pregnancy? What about changes in bladder or bowel continence – when women start leaking are we really going to tell them that’s normal? Or when women aren’t able to resume previous activity, like running, strength training, or sexual relationships; do we accept that dysfunction as the new normal too? The short answer: Absolutely not.
Then there’s menopause, the final change. Menopause may bring new dysfunction; changes in vaginal and vulvar tissues, their robustness, pliability, and strength which can affect a woman’s ability to tolerate sexual relationships. There are changes that occur with new weight gain and the aches of an aging body. And then the misconception that these issues have been going on for “too long” and there’s “no helping them now”. The body is resilient! And it doesn’t matter if your urinary incontinence has been around since that first baby 30+ years ago, or if it just sprang up with the changes of menopause; pelvic floor rehab can still be beneficial.

Common conditions may include…

  • Urinary Incontinence (Leakage)
  • Urinary Frequency or Urgency
  • Pain with Urination
  • Bowel Incontinence (Smearing, or Gas)
  • Pain with Bowel Movements
  • Constipation
  • Pelvic Organ Prolapse
  • Pain with Vaginal Penetration (Dyspareunia)
  • Painful Periods (Dysmenorrhea)
  • Low Back/Pelvic Pain
  • Menstrual Management

How Are We Treating It?

Pelvic floor rehab utilizes many treatment approaches including:

  • Manual therapy: Soft tissue or muscle mobilization, joint mobilization, myofascial release
  • Therapeutic exercise: Strengthening and flexibility interventions
  • Neuromuscular re-education: Teaching your muscles how to turn on/off appropriately and improving your awareness, coordination and control
  • Therapeutic Activities: Helping you function within your specific life activities like lifting children or grandchildren, exercising and running, or being able to make it to the bathroom without leaking

What Does This Mean For You?

If you are struggling with any urinary (bladder), bowel, or reproductive/sexual health concerns, pelvic floor rehab may be appropriate and helpful for you. You do not have to live with your dysfunction, there is help – and Pelvic Floor Therapists are happy to join you in the journey.

This image portrays Knee Osteo-Arthritis (OA) – Common Misconceptions and benefit of Physical Therapy by East Tennessee Spine and Sport.

Knee Osteo-Arthritis (OA) – Common Misconceptions and benefit of Physical Therapy

Knee Osteo-Arthritis (OA) – Common Misconceptions and benefit of Physical Therapy

For years we have just accepted that knee OA is just a byproduct of getting older and not much can be done for it until it’s time for a total joint replacement. Recent studies have shown this not to be accurate and we now have a much better understanding on one of the leading causes of disability in the United States.

OA is a condition in which the cartilage (aka articular cartilage) covering the surfaces of you bones becomes worn down and exposes the bone underneath that can lead to bony osteophyte formations (bone spurs). In your knee, the articular cartilage covers the end for your femur (thigh bone), tibia (shin bone) and the back of your patella (knee cap) and provides a frictionless surface for these joints to move over one another. This cartilage lives in what is known as ‘splendid isolation’ and has no blood vessels or nerve endings. When an area of this cartilage becomes damaged it will expose the bony surface which has nerve endings and will then send the pain signals to the brain and the symptoms appear to the patient. This can take up to 10-15 years to occur and a patient a lot of time will be asymptomatic until the bony surface is exposed. Symptoms of knee OA can include pain, swelling, loss of ROM and difficulty with normal levels of daily activities including prolonged sitting, walking and stair mobility. Unfortunately, when these symptoms do occur the damage to the cartilage has been done and due to the poor healing ability, it will not regenerate and it’s time to transition into management of the condition.

Common Misconceptions associated with OA:

As I get older my knee pain is from normal ‘wear and tear’.
Answer: False – Articular cartilage has the mentality of ‘use it or lose it’ and actually lives to have forces put through it which allows it to stay healthy and not deteriorate.

Exercise will make me worse
Answer: False – Exercise (land or water based) is the only treatment option that is ‘Highly Recommended’ by the American Academy of Orthopedics and the American College of Rheumatology – An exercise suitable for the individual would be recommended by a licensed Physical Therapist and would include low impact activities to reduce stress and pressure on the effected joint surfaces.

There is an association between weather and knee OA.
Answer: Depends. Rainy climates do not cause OA, but those with OA may have increased pain during rainy weather.

One is more likely to develop knee OA if a parent had knee OA.
Answer: Depends. One is at a higher risk of OA with a family history, but development is avoidable through a healthy lifestyle.

A diagnosis of OA does not mean that someone will just have to ‘live with it’ or ‘just wait as long as possible for a replacement’ which are both common phrases. Setting up an evaluation with a licensed PT is critical in the process of reducing pain, improving range of motion and strength and resumption of previous levels of activities including exercise. Typical treatments will focus on low impact exercise, education on reducing BMI if necessary, strategies to improve range of motion and reducing swelling and discomfort. We also recommend hands on physical therapy and the AlterG Anti-Gravity Treadmill. For more information about this service, click here.

This image portrays MedX: The Importance of a Strong Back by East Tennessee Spine and Sport.

MedX: The Importance of a Strong Back

One of the primary myths surrounding back pain is that exercise, especially weight training, should be avoided because of back pain.

The importance of exercise and a strong back is often underestimated in the case of both acute and chronic LBP. Studies have found the recovery from acute back pain occurs more quickly with the right type and progression of exercise. Even chronic back pain shouldn’t keep you from the activities you enjoy, including exercise.

Your back needs movement to be healthy like any of the other joints in the body. Exercise helps maintain your range of motion and prevents your muscles from weakening, in turn allowing you to heal more quickly. Underworking your back can be equally as detrimental as overworking your back.

The deep muscles that stabilize the spine are small and often inhibited by the body’s response to pain. This guarding response can result in weakness during reduced activity levels associated with prolonged periods of pain. In turn, allowing these deep stabilizers to be overridden by the larger muscles of the hips and back. This can result in abnormal muscle firing and pain as you begin to resume daily activities. Unless these larger muscles are prevented from being used during back strengthening exercises, it is difficult to directly target the correct muscles groups required to have a strong spine and full return to normal function without pain.

The lumbar MedX machine has proven to be extremely effective in the treatment of back pain. The patented restraint system provides an effective way to isolate the deep spinal muscles by preventing movement in the pelvis and firing of the hip and leg muscles. This isolation allows the spine to move smoothly and restore normal firing of the deep spinal stabilizers through a pain free range of motion.

Another benefit of the MedX is the ability to test an individual’s low back strength effectively with comparison to normal values taking into account the patient’s age, weight, and gender. This allows us to determine how strong your back should be if it was healthy.

Following this baseline test, a training program with individualized progression of resistance levels is performed, in addition to core stability exercises, in order to normalize the overall physiologic strength of the lumbar spine, decrease pain, and reduce susceptibility to future back injuries

Back pain is common, but a strong spine can allow you to continue doing the things you love.