Proudly Serving the Twin Cities Area Since 1994
This is an image of White Shoes in a Puddle of Water.

How Old Are the Shoes You Wear

Do you notice general fatigue or soreness at the end of a long day on your feet? Do your feet or back hurt after exercise? Do the bottoms of the shoes look worn? If you answered yes to any of these questions your shoes may need replacing!

Your foot is comprised of 26 bones, 33 joints and more than 100 tendons, muscles and ligaments. All of these structures need correct padding and support to prevent injury and premature wear. Quality shoes are the first line of defense when it comes to your body and how it reacts to exercise.

Walking or exercising in worn shoes is one of the most common causes of injuries. Shoes lose their shock absorption, cushioning and stability over time and sometimes simply walking in worn out shoes can send stress through your entire body. The midsole, which provides cushion and stability, can break down before the bottom shows wear and tear. Therefore this is not a good indicator of shoe life as they can wear out long before this. If you experience pain in joints or muscle fatigue, your shoes may be wearing out. An example of such pain may include back or spine pain because all of your weight goes through your feet as you walk and the force of the impact goes up your leg then up through your spine. Consequently you may experience joint and muscle pain as they attempt to assist in absorbing the shock.

Running and walking shoes should be replaced every 300-500 miles. If you don’t participate in a formal or rigid exercise schedule, you should still attempt to count the miles per day walking around doing normal activities. Continued use of worn out shoes will increase the stress and impact on legs and joints thus putting you at risk for shin splints, plantar fascitis, stress fractures, Achilles tendonitis and back pain. As a general rule you can follow this schedule:

10 miles/week: Replace after 12 months
15 miles/week: Replace after 8 months
20 miles/week: Replace after 6 months
30 miles/week: Replace after 4 months

Good supportive, shoes will help add cushioning to the joints from your feet up through your spine which may prevent a lot of pain from occurring. Invest a few dollars replacing your shoes now may save you from a lot of pain and future expenses spent on pain reduction later.


* Did you know you can recycle your tennis shoes? Check out to find out where you can donate them. The closest drop off areas in the Twin Cities are at the Nike stores at MOA, Albertville, Medford and North Branch.

This is an image of a woman displaying functional strength training techniques.

Functional Strength Training

The specificity of training principle states that in order to improve physical performance of a particular skill, the body must be trained for that activity. This applies to the particular muscle group, movement pattern, and type of muscle contraction. This principle is widely used in the athletic population with weight training programs. Athletes train very specifically to their physical event, varying the amount of resistance, speed, and movement pattern that their muscles must perform to best enhance the sport activity.

This principle should also be applied in physical and occupational therapy, to help individuals gain the best movement performance of the body for work and every day activities, following injury. We call this “Functional Strength Training.” Functional strength training allows muscles to improve strength, endurance, and coordination for daily use.

Goals of the Functional Strength Training Program Include:

1. Increase in lifting tolerance and capacity
2. Practice of safe lifting and bending techniques
3. Generalized conditioning to enable use of spine for functional movements
4. Increased confidence in activities that have previously been avoided
5. Determination of safe lifting capacities

Many individuals that are recovering from an injury will have better success in functional training programs after building specific muscle strength in an isolated environment, such as MedX strengthening, floor exercise, or isometrics. Once the body has learned how to recruit the proper stabilizers, it is important to progress the program into functional training to allow the spine to be trained for daily use.

Functional strength programs are best prescribed by a physical or occupational therapist, who can evaluate the person’s activity demands upon the spine, set starting weight parameters, and safe goals. The program may entail doing repetitive lifting, carrying, balance, and coordination type activities and involve a progression from lighter to heavier weights, longer endurance, or more difficult movement tasks.

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Looking at Our 2016 Patient Outcomes

PDR differentiates itself from other rehabilitation programs by specializing specifically in neck and back treatment. We are experts at what we do because that is all we do – and have done for over 23 years. We help treat the “whole” person by looking not only at the physiological issue but also at the psychosocial barriers that may exist as a result of chronic neck and back pain. Our Road To Recovery combines MedX rehabilitation with Cognitive Behavioral Coaching (CBC) to ensure the greatest opportunity for overall, long-term recovery.

This is an image that displays the patient outcomes for 2016 for PDR Clinics patients.
Click to view full-sized image

We are proud to present our patient outcomes for 2016. The results of this data is the culmination of years of refinement to our program, and the talent and dedication of our staff. Our data shows that patients that treat at PDR Clinics report reduced pain, reduced use of medication, and more.

For those looking for a short-and-sweet overview of our 2016 outcomes, we’ve created a handy infographic to read. If you want a more detailed look at our data, continue reading.


Patient Outcomes – 2016

The following information has been made publicly available by Physicians’ Diagnostics & Rehabilitation. It allows patients and physicians to learn more about the world-class neck and back pain treatment provided at PDR Clinics. Healthcare providers can request physical copies of our 2016 Outcomes & Quality report by emailing

Total Perceived Recovery

Definition: Patients report overall recovery on a scale from 0-10 (0 = no improvement, 10 = complete recovery).

Outcome: Patients rated their recovery at 7.5 out of 10 on average. This demonstrates therapy to be effective and yet assumes that patient will continue ongoing recovery with home exercise. This is the desired outcome level to ensure cost-effectiveness and reduce over utilization of services. (N = 1212).

In a six month follow up survey, 48% of patients reported continued improvement.

Reduced Pain

Definition: Patient reported reduction of pain at discharge.

Outcome: 74% of patients rate their reduction in pain between 50 – 100%. (N = 1053).

Reduced Medication

Definition: Patient reported reduction of medication use at discharge.

Outcome: 66% of patients rate their reduction in medication use between 50 – 100%. (N = 506).

Reduced Headaches

Definition: Patient reported reduction of headaches at discharge.

Outcome: 70% of patients rate their reduction in headaches between 50 – 100%. (N = 396).

MedX Spinal Function

Objective: Objective spinal strength and range of motion testing using standardized test procedures on MedX spinal equipment. PDR collected data over 12 years.


Cervical Flexion & Extension – Improvement 132.1%. (N = 3929).
Cervical Rotation – Improvement 164.9%. (N = 5022).
Lumbar Flexion & Extension – Improvement 107.1%. (N = 5219).
Rotary Torso – Improvement 121.5%. (N = 5662).

Psychological Metric – Keele STarT Back Tool

Definition: The Keele STarT Back inventory stratifies patients into a low, medium, or high risk of poor outcomes based upon fears, catastrophization, and anxieties about pain, mood, and motivation.

Data suggests that a reduction in Keele Scores can be a long range indicator of one’s ability to cope effectively. Addressing psychosocial effects of chronic pain can lead to improved recovery and over-all reduced downstream healthcare costs.1


Initial High: 87% converted to Medium or Low Risk
Initial Medium: 78% converted to Low Risk

Functional Oswestry Low Back Pain Disability Index (ODI)

Definition: Standardized inventory of functional abilities. Inventory scores (0 – 100) compared of final and initial averages, and within disability category.

A 10-12 point and/ or 30% improvement in ODI scores is determined to be clinically significant.2 (N = 1105).

Outcome by Category:

Moderately limited – improved an average of 14 points
Severely limited – improved an average of 21 points
Crippled – improved an average of 27 points


Definition: PDR provides patients the ability to participate in a Maintenance Program to maintain the gains they made during rehabilitation. It is recommended patients come in one time every three to four weeks for MedX Core training. A study was performed to measure the effectiveness in maintaining gains made during rehabilitation.3

Outcome: Participants involved in the Maintenance Program were able to maintain their recovery scores, pain levels and dynamic strength at a reduced frequency.4


1  Hill J.C., Dunn K.M., Lewis M., Mullis R., Main C.J., Foster N.E., A primary care back pain screening tool: identifying patient subgroups for initial treatment. Arthritis Rheum. 2008;59(5):632-641.
2  Ostelo RW, Deyo RA, Stratford P, et al. Interpreting change scores for pain and functional status in low back pain. Spine 2008; 1:90-94.
3  Tucci J, Carpenter D, Pollock M, et al. Effect of Reduced Frequency of Training and Detraining on Lumbar Extension Strength. Spine 1992: 17:1497-1501.
4  Narveson M., et al. Recovery Scores and Dynamic Strength of Patients Participating in a Decreased Frequency MedX Maintenance Program. Unpublished study: 2009.