Pilates to improve balance, flexibility and strength

We can’t deny it, we are all getting just a little older!

One of the biggest concerns we get from our clients and patients is how balance starts to suffer and weakness in the legs especially! Continuing to address balance and strength can be especially important in neurological conditions, such as Parkinson’s and Multiple Sclerosis.

Balance deficiencies, lower limb muscle weakness and slowed reaction time have been identified as independent risk factors and may have the potential to lead to dependency and an increased risk of falling. We DEFINITELY don’t want anyone falling!

Regular exercise participation, at this point, appears to be essential and is considered an appropriate, healthy and cost effective way of both improving and sustaining physical aspects of health. There are many ways to exercise, including:

  • simply walking around the block,

  • strength training at the gym or home

  • even going to group fitness classes.

At PhysioFit of North Carolina, we have 3 pillars within our Fitness department that is essential as you age! We utilize Yoga, Pilates and Tai Chi to help our community gain and maintain flexibility, core strength and balance. For this post, we will talk about Pilates.

Pilates is “a unique method of physical fitness that uses a combination of muscle strengthening, lengthening and breathing to develop trunk muscles and restore muscle balance”.

Pilates exercises require activation and coordination of several muscle groups at a time. The beauty behind this is that you are working several muscle groups in a well-rounded manner during your sessions!

Pilates exercises have been shown to reduce the risk of falling as a result of improvements in balance, muscle strength and coordination (Irez et al 2010).  Pilates exercises has also been shown to be a preventive intervention method in reducing the risk of falling in the elderly (Kloubec 2010).


In a recent study by Irez et al, the authors found an improvement in strength, reaction time, balance, and coordination in the elderly after a 12-week Pilates program. The interesting thing behind this study —- the program included group fitness using resistance bands and balls —- and no reformer was used! Therefore, you can still get the benefits of Pilates without the use of a reformer!


Pilates exercise may reduce the number of falls in the elderly by increasing these fitness parameters — dynamic balance, reaction time and muscle strength.

At PhysioFit of North Carolina, we offer Pilates through weekly classes and class series. We offer Pilates, Yoga and Tai Chi in Wake Forest, NC.

We even have specialized Pilates classes mixed with other exercise approaches for special populations, such as Parkinson’s & Multiple Sclerosis.

Contact us to learn more about our approach and program or sign up for our next class!

Are Migraines linked to Neck Movement?

Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound.

Many of us suffer from migraines with the cause being from many reasons!


One of the aspects of Migraines that can be modified is the strength, flexibility and endurance of neck muscles. Additionally, posture of the neck and head can make a big difference on avoiding and treating Migraines!

A study in 2016 identified a relationship between Migraines and Active Trigger Points and Neck/Head Posture.

The authors found active TrPs are associated with reduced cervical lordosis and head extension in individuals with migraine.

Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. The spots are painful on compression and can produce referred pain, referred tenderness, motor dysfunction, and autonomic phenomena (Simons & Travel 1999).


The link between Neck/Head Posture and pain has been scrutinized in the last few years and the research is leaning against a strong relationship. With that being said, most of the research is on static (body at rest) posture vs dynamic (body in movement) posture.

Dynamic movements and range of motion of the neck may be linked more than just static posture.


In the 2016 study by Ferracini et al, the authors found a relationship between the number of active trigger points AND the higher number of active TrPs was positively associated with a reduction in cervical lordosis and head extension of the head on the neck.

Here are pictures with labels of the muscles that the authors examined:

If you are having tenderness or hypersensitivity in the above muscles, in combination of not having proper cervical (head) extension, then this could be a reason why you are having migraines!

It may not be the SOLE reason for Migraines, but what if it was 25-40% of your pain—- wouldn’t you want your intensity or frequency of headache pain to be less?!

Here is a video of myself performing cervical (neck) extension and how much range you should have! Remember that cervical (neck) extension is related to cervical lordosis (curvature of your neck)

Here is a video that you can do to improve cervical lordosis through a common exercise, “Cervical Retraction”. Remember to feel it where you should per our Feel it to Heal it Physio Approach!

The Post-Partum Female Athlete and Urinary Incontinence

What is the Post-Partum Female Athlete?

Many times when I suggest the word, ‘Post-Partum Female Athlete’, many of my ladies say they aren’t athletes! That is not true!

I use the word athlete to ANYONE who gets up in the morning, has a task for the day and goes about accomplishing it. This can be going to work, taking care of the kids at home, going for a walk/jog and if be, training at a high intensity workout facility such as CrossFit, Orange Theory or Burn Boot Camp.

Therefore, we are ALL athletes! We use this term as we like for everyone to compare their own injuries and recovery to a professional athlete.

How does the Post-Partum Female Athlete relate to the Pelvic Floor?

One alarming statistic concerning is how common symptoms of pelvic floor dysfunction are with the Post-Partum Female Athlete!

Pelvic floor dysfunction is a term used to describe a variety of disorders involving moderate to severe impairment of the pelvic floor muscles. The pelvic floor is a sheet of muscles designed to support the abdominal viscera as well as maintain urethral, anal, and vaginal continence. floor dysfunction.

pelvic floor.jpg

Pelvic floor dysfunction symptoms are common among all women. A study of almost 2,000 women in the United States revealed that around one in four had at least one symptom or physical finding including urinary incontinence, fecal incontinence, or organ prolapse.

A common symptom in the female athlete that we hear about ALL OF THE TIME is urinary incontinence., especially when being active and exercise.

Urinary incontinence is the involuntary leakage of urine. It means a person urinates when they do not want to. Control over the urinarys phincter is either lost or weakened. 

You should NOT just expect that since you have had children, then it is normal to have urinary leakage while exercising! The following exercises are ones in which most women describe their symptoms:

Jumping Jacks

Jumping Jacks





It has been found from Arau ́jo et al. that 62.2% of long-distance runners reported urinary incontinence. These high rates in athletes are thought to result from an imbalance of con- traction strength of the pelvic floor with increased intra- abdominal pressure during exercise. Additionally, Da Roza et al. found that women who exercised the most demonstrated the highest prevalence of symptoms.

From just these two studies, if you are a runner or exercise most days of the week (>3 days), then you may have more risk of urinary incontinence.

How is Urinary Incontinence Treated?

Comprehensive treatment of pelvic pain should include a multidisciplinary approach, including seeing a physical therapist. Early intervention including both medical and therapeutic management is recommended. We always recommend that you seek advice from your physician and from your Physio.

Physical therapy has been an important treatment for women’s health issues for almost 50 years and has proven effective in treating pelvic pain and urinary incontinence. Physical therapists are trained in soft tissue mobilization of myofascial trigger points and mobilization of the joints in the pelvis and lumbar spine, which can address pelvic pain symptoms, as well as bladder and bowel dysfunction.

Because urinary incontinence is associated with weakness in pelvic floor muscles, exercise involves increasing muscle strength of the pelvic floor specifically but also surrounding musculature. At times, it may involve relaxing muscles that may be hypertonic. Your therapist will be able to determine which is the best approach.

Dr. Danielle Vaughan, a women’s health specialist AND post-partum female athlete, also can address movement reeducation. She instructs patients with pelvic pain on exercises for lumbopelvic stabilization and core strengthening to address any deficits in the kinetic chain that may be caused by your knee or even ankle.

A multimodal approach of pelvic floor muscle exercise and manual therapy has a positive impact on pain, disability, and urinary incontinence in the Post-Partum Female Athlete.

If you are having urinary incontinence while you lift your children, exercise, or even just squat; this doesn’t have to happen! Schedule an evaluation and treatment today to start changing your life.

Treatment of Vulvodynia without drugs or surgery

Vulvodynia is chronic pain or discomfort of the vulva (the area surrounding the outside of the vagina) that lasts for three months or longer without any evidence of other skin or gynecological causes. Vulvodynia is usually characterized by burning, stinging, irritation or rawness of the area. The most common complaint is a burning sensation.

There are many options to treat this condition, including pharmacological (i.e. drugs), surgery and non-pharmacological methods (i.e. physical therapy). It is how for women to be persistent in seeking an accurate diagnosis so they can receive appropriate treatment. We highly recommend you determine if vulvodynia is the cause of your symptoms as there are some treatments available conservatively.

As Physical Therapists, we strive on treating many conditions associated with pain without the use of medications and strive on keeping the community out of surgery! There are obviously many people who need drugs and surgery, but, majority of the time, symptoms can improve with a detailed physical therapy assessment and treatment.

This is especially true for Pelvic Pain and Women’s Health issues. Just recently, Rosen et al in 2019 wrote an article in Drugs magazine with the following conclusion for treatment of vulvodynia:

There is strong evidence to support and recommend non-pharmacological interventions including psychological therapy, pelvic floor physical therapy, as well as surgery (i.e., vestibulectomy for provoked vestibulodynia) for the treatment of vulvodynia.

As you can tell, there are many options to treat this condition. If you are looking for a Women’s Health specialist in Wake Forest, NC, we hope we can be of service to help you with your pain and improve your life!

Dr. Danielle Vaughan is a Women’s Health Specialist focusing on Pelvic Physical Therapy in Wake Forest, NC. She is co-owner of PhysioFit of North Carolina, alongside her husband. They offer their 1:1 treatments with specialized care, as well as group studio classes of Yoga, Pilates & Tai Chi.

Can neck pain cause dizziness?

Symptoms of dizziness or imbalance are often present in individuals with a variety of neck-disorders.

Dizziness and imbalance may originate from altered proprioceptive signals from the cervical spine due to trauma, fatigue and pain. Considering there is an abundance of proprioceptive receptors in the neck, which are located in the joints, ligaments, and deep cervical neck muscles.

Dizziness has been shown to be prevalent in 50% of individuals with cervical spondylosis (arthritis) and with individuals who have suffered some type of neck trauma (such as concussion or whiplash), this percentage can be over 80%.

Cervical proprioception contributes to the perception of head motion and converges with vestibular and visual information for spatial orientation and balance. Therefore, if cervical proprioception is altered, it is feasible that unsteadiness, lightheadiness or dizziness can be from the neck.

It is pertinent that a differential diagnosis is performed by the treating clinician as there are many causes of dizziness, which could be from more dangerous reasons, such as instability, vascular and myelopathy.

If you are having dizziness with head movements or even change positions, the cause could be from the neck.

We recommend consulting with your physical therapist or physician to determine if an evaluation is right for you.

Dr. Harrison and Danielle Vaughan teach other professionals across the country on the Diagnosis and Treatment of Cervicogenic Dizziness. Our unique approach of combining manual therapy and vestibular rehabilitation helps patients who have dizziness and pain.

Do you get dizzy when you lie down in your bed?

Vertigo Treatment in Wake Forest

Have you ever experienced dizziness when laying down, rolling to the side, or looking up?

Check out this video below to see what happens with the eye that causes you to feel that spinning sensation 👇

Positional vertigo occurs when you have a blockage in the inner ear, causing a change in the signal sent to the brain which results in a "nystagmus", which is what you see below. No wonder you feel dizzy- check out that eye!!! 👁

PhysioFit has the equipment and experience to diagnosis and treat in the clinic, in most cases within 1-2 visits!

Dizziness, Vertigo, Physical Therapy, Wake Forest, NC

Repositioning treatment is the #1 way to treat this type of dizziness, so don't just live with it-- let us help you resolve it!

Schedule an evaluation with our vestibular specialist, Dr. Danielle Vaughan.

Is Tai Chi right for me?
tai chi.jpg

Tai Chi is a form of art that can be observed by its beautiful movements.  Most of these movements are slow, graceful and fluid. 

 Think of it as slow dancing vs fast dancing.  Which type of dancer are you?!

tai chi.jpg

A common misconception is that Tai Chi is only for old people. 

Granted, it is a great exercise program for the elderly due to the slow, gentle and low impact on the joints. 

However, Tai Chi can be for everyone and not just for seniors.


If you are looking for:

  • Better flexibility

  • Better proprioception

  • Better balance

  • Better lower limb strength


 I would also say Tai Chi can be great for you if:

You perform high impact exercises (such as high intensity exercise, running, etc) but looking for a low-impact, active recovery approach.

You have a fast paced job and live a fast paced lifestyle but looking for a slow and balanced exercise approach to clear the body and mind.


I always encourage my patients and clients that they should find an exercise routine, in itself or in combination with another program, that makes them feel good.

 Then, Tai Chi may also be for you. 


 Whatever you do, you need to feel good about yourself.  You cannot succeed if you don’t feel good about yourself.

 Contact us to find out more about our program and see if Tai Chi can be a right fit for your active lifestyle.

PhysioFit of North Carolina offers Tai Chi classes in our studio in Wake Forest, North Carolina. We hope it can be a great exercise program in itself for your lifestyle or in combination with other exercise routines.

Vertigo Treatment in Wake Forest, NC

Benign paroxysmal positional vertigo (BPPV) is a condition characterized by brief episodes of vertigo evoked by changes in the position of the head.

The diagnosis is established if there is a combination of typical symptoms with a positive Dix–Hallpike test, which is a maneuver that provokes both typical vertigo and torsional–vertical nystagmus and is diagnostic for the presence of canaliths in the posterior semicircular canal.

Physical Therapy Wake Forest, NC

These patients can be easily treated using the Epley maneuver, resolving vertigo complaints in 80%–90% of the patients.

However, in some cases, the Dix-Hallpike test is negative, meaning that during Dix-Hallpike positioning either vertigo or nystagmus does not recur. In that case, the diagnosis is based solely on the patient’s history of temporary, isolated episodes of positional vertigo with characteristic triggers (bending, turning, or rolling in bed). This type of BPPV is classified as probable BPPV .

Among patients with probable BPPV, more than half have been shown to have recurring complaints of positional vertigo within 8 weeks, which can be objectified as definite BPPV in 16%. (Zaag-Loonen et al 2018)

It is recommended that by advising patients to actively contact the clinic in case of recurring symptoms, BPPV could be confirmed and treated.

Physical Therapy Wake Forest, NC

Research guidelines advise professionals to adopt a policy of low-threshold access for patients with recurring symptoms when confronted with a patient with symptoms of BPPV but with a negative Dix-Hallpike test.

This is one reason we have direct access, so you can get for treatment fast for quick and effective results when you need to.

We also have a Physio Membership program that allows for monthly wellness visits to address deficits in strength, balance, pain and flexibility; as well as address any dizziness complaints that may be coming from your inner ear.

Feel free to contact us today to determine if your vertigo or dizziness symptoms are BPPV.

Dr. Danielle Vaughan is a Vestibular Specialist who treats balance, dizziness, and vertigo conditions in Wake Forest, North Carolina.

What does exercise do to help my knee arthritis?
Yoga in Wake Forest, NC

When it comes to having pain, the last thing someone wants to do is exercise!

However, exercise can have huge benefits and a now the healthcare profession is definitely pushing the concept of “Movement is Medicine”.

So, the question is, how will exercise improve my knee arthritis?

First, exercise can enhance cardiovascular benefits, muscular strength, balance, and coordination; all of these are thought to be able to reduce joint pain. 

As the severity of pain is directly correlated with the degree of muscle weakness, stronger muscles and better coordination improve the stability of the joints and lessen pain. Increased peri-articular muscle strength may also protect joints from traumatic impacts. 

Second, evidence suggests that the mind-body component may influence immune, endocrine, neurochemical and autonomic functioning. An improved restful state and mental tranquility may help break the arthritis “pain cycle”.

Why choose PhysioFit’s Knee Arthritis Yoga Class?

Our group environment with individuals who have similar condition as you can help build confidence, get support and overcome fears of pain. Together, these can lead to improved physical, psychological and psychosocial well-being and overall quality of life.

This is in addition to the science behind our approach of providing exercise that can build strength, balance and flexibility without “picking” at your knee, so you can be certain that we will not (or try not to!) flare up your symptoms!

How can I learn more?

Feel free to contact us to speak with us personally to see if our class is right fit for you!

Physio Membership
Physical Therapy Wake Forest, NC

Our Physio Membership is a subtype of concierge medicine.  We accept a small group of members into the practice.  Members make a small, monthly membership investment that allows them access to medically necessary Physio care.

There is no insurance involved.  No pre-authorizations or authorizations, co-payments or deductibles, denied treatments or benefit limits for the patient to worry about.  Likewise, the health care provider does not have to employ a small army of staff to contend with the insurance company's' red tape or wrestle reimbursement from them.  This produces better care at lower costs.

Without the “sting” of co-payments and deductibles which make people hesitate to seek medical care (and use their insurance), people can come in as soon as needed instead of trying to “wait and see” or “tough it out”.  The problem can be addressed quickly and effectively before it has snowballed into something that requires far more care!

Most people will save significantly by receiving care at our office. By having your personal Physio who knows what you need, when you need it — you ultimately get treatment faster and get back to doing what you love —- biking, walking, gym work or even just life! —- quicker!


Frequently Asked Questions

Physical Therapy Wake Forest, NC

How can I become a Physio Member?

After an initial evaluation and initial treatment plan with your injuries, your Physio will determine if a Membership Plan is right for you.

What is the best plan for me?

Your Physio will discuss with you the best option available to keep you healthy.

Is the initial evaluation covered in the cost of the Physio Membership?

No, an initial evaluation cost is a separate fee.

What if I am currently seeing you for neck pain but I hurt my knee. Can I have this body part examined and evaluated?

As long as you are an active PhysioFit Member, there is no charge or additional fees associated with evaluating a different body part. This is one of the best perks of the program!

I think this is a great idea and want my spouse to be a member too so we can both continue to be active as we age together! Any family discounts?

Contact us for this request and we can chat :)

What if I need further treatments for my condition other than the full, 60 minute 1:1 treatment with you under my membership plan?

Everyone’s conditions are different and frequency and duration of treatments vary. For the most part, more than one treatment per month is necessary for an ailment, especially if an acute injury!

We realize this and offer a percentage off any other Physio treatments for our members! How awesome is that!

Physical Therapy Wake Forest, NC

What if I am out of town and cannot make it in to treatment?

Our Physio Membership plans have a Tele-Health option! This can be perfect if you do not have the time to come into the clinic, but still would like advice on any painful issues or exercise questions. This works perfectly for our patients who travel for work!

What if I need to cancel my Physio Membership?

There is no charge or penalty to cancel. However, if you do cancel and want to return for treatment of a different condition at another time, an initial evaluation fee will be charged.

How can I pay?

The chosen membership package will be automatically charged to your account each month.

Can I submit my membership payment with a superbill to insurance?

Unfortunately, no. At this time, we cannot provide a superbill for the monthly fee.

Have any other questions?

Feel free to contact us!

Carpal Tunnel Syndrome Relief in Wake Forest, NC

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. The condition occurs when one of the major nerves to the hand — the median nerve — is squeezed or compressed as it travels through the wrist. 

What treatments are available?

Typically, carpal tunnel syndrome is a mechanical disorders on the pressure of the median nerve. You can learn to take pressure off this nerve with exercises and stretches, but in some instances, especially if long-standing and chronic conditions, you may need more measures. Sometimes surgery or injections are indicated, but in majority of cases, conservative care with physical therapy can improve symptoms.

Procedures that we perform are manual therapies to the wrist, fingers, elbow, shoulder and neck that can includes joint and soft tissue mobilization. In some instances, we perform dry needling to this area.

What is dry needling

Dry needling is an invasive technique widely used in the physiotherapy field. Not only is dry needling used on muscles, its action on the connective-fascial tissue, the other aspect of a single, unique and indivisible functional whole: the myofascia. This can be the key to treatment of carpal tunnel syndrome and ultimately how you can get the most relief.

What does dry needling do?

In regards to carpal tunnel syndrome, the transverse carpal ligament can a major culprit. In fact, if you went in for surgery, the surgeon snips this ligament. The specialized Physios at PhysioFit of NC use Dry Needling , but instead of just the “ fast in and out technique” that most use, we rotate the needle and the fascial connective tissue winds around to the point where it is fastened and trapped.

Studies, especially the strong work by Langevin et al, show the needle grasp strength is 167% greater if manipulated unidirectionally than if it is not manipulated. However, if an alternate rotation is applied bidirectionally (winding and unwinding) the same studies quantify this grasp strength at 52% greater than if it is not manipulated.

We apply a technique for manipulation of DN needles with unidirectional rotation, which we call the “fascial winding technique”.

We apply a unidirectional rotation (winding) based on the stronger needle grasp thereby obtained, which has been quantified and included in previous studies to improve connective tissue and myofascial changes in carpal tunnel syndrome.

We also present “four-pole carpal dry needling” for the carpal tunnel directly but also trace the muscles, fascia and nerve back up to the elbow to provide benefit to blood flow and decrease inflammation to the median nerve before and after the carpal tunnel.

Carpal Tunnel Syndrome Relief in Wake Forest, NC

Carpal Tunnel Syndrome Relief in Wake Forest, NC

We believe that these procedures would lead to the grasp, and consistent traction-stretching on the TCL, being more powerful and effective. This will cause both local and remote changes in this tissue and lead to healing.

Also, this may lead to a relaxation of tension and increased flexibility of the transverse carpal ligament. This would reduce the pressure inside the carpal tunnel, also decreasing the compression on the median nerve, which is ultimately responsible for the clinical profile of sensory and motor impairment that you may have.

Why choose PhysioFit of North Carolina?

The action of dry needling in connective-fascial tissue, expanding the possible therapeutic potential of this technique beyond its action on the muscular element. Dr. Harrison Vaughan has extensive training in dry needling and only one of several Fellows in Orthopedic Manual Physical Therapy in the region. You can trust in his care and expertise, as well as 1:1 time with you!

After manual therapy, we then follow-up with exercises through our Feel it to Heal it Physio Approach to make sure you “feel the stretch” and “feel the strength” in your muscles where you should! You will not get this type of technique and combination anywhere else!

Have you been told to improve core strength for your low back pain?

Do you eat soup with a fork?

Of course not, as this is silly since there is a better product. The spoon—it is designed to work specifically for specific foods.

So, how does this relate to core strength and back pain?

I have been treating low back pain for over 10 years and I can tell you, cookie cutter approaches typically do not work!

There are many strategies to help your pain and improving core strength is always a viable one that is recommended by doctors, specialists and physical therapist.

I agree that getting stronger can make you more durable, but sometimes you may be NOT be maximizing your benefit from all of your hard work!

Take this picture for example:

The dotted green lines down at pant line and up towards top of shirt are the borders to where this patient can FEEL their low back!

What do you mean feel?!

We test tactile acuity with two point discrimination (see picture below) and this gives an inside look of how the sensory cortex in the brain detects the back!

How cool is that?!

But what does this mean?

Basically, this can mean the difference if you can get better or not!

Check out this picture and numbers written on this patient’s back:


What these numbers show is that this patient went from NOT being able to feel two points on the caliber to having this improvement in discriminating the tissues with touch on his back!

The back is mirrored in the sensory cortex as shown below, which lines right beside the motor cortex. Therefore, if the sensation with two point discrimination is impaired, then how good are your core exercises?!


So what does this mean with physical therapy?

The improvement seen here is within 1 session and it allowed the patient to perform movements (as we know movement is medicine!) and get the most out of treatment vs just “doing exercises”.

We don’t just “prescribe” exercises but take a whole look and maximize your performance in the clinic.

Because how can you “feel” your core when you don’t have the best connection from your core/back to your brain!

PhysioFit is not your typical rehab setting. Our 1:1 sessions and specialized treatment approaches are unlike anywhere else!

Contact us to Learn more about how we can help you!

How to know if you have pain from TMJ
TMJ Pain Relief in Wake Forest, NC

The assessment of temporomandibular disorders (TMDs) is recognized as integral to the practice of dentistry and physical therapists who treat these conditions.

The context of joint sounds as a predictor of temporomandibular joint (TMJ) pain is not highly predictable due to a common variation of normality amongst people.

Therefore, pain associated with activities using the jaw (such as eating, yawning, etc) is much more predictable of actually benefiting from treatments by a physical therapist or dentist.

Diagnosis must be followed by appropriate intervention at the early stage of identification to minimize chronicity. Following a diagnosis, a formal treatment plan addressing your exact impairments can be formulated.

Tuncer et al. found that physiotherapy performed by a therapist in combination with home physical therapy was more effective in terms of TMD pain and pain-free maximal mouth opening than home physical therapy alone.

If you think you have TMJ issues, answer the questions above and then contact us to establish a plan of care, alongside your dentist, to help you!

Migraine Relief in Wake Forest, NC

Do you have sensitivity to cold or even sensitivity while wearing a necklace?

You could have cutaneous allodynia and this has been proposed to be a risk factor for chronic migraine. Since research shows 70% of migraine patients have neck pain, the pain in your neck could be a reason for this sensitivity.

Want to find out more?

Click here to fill out the 12-item Allodynia Symptom Checklist then Contact us to see how we can help you! We are the only clinicians in the area that can treat your TMJ, neck and sensorimotor system through our Manual and Vestibular Specializations.

Cutaneous allodynia interferes in the effectiveness of abortive therapy with triptans, reducing their effectiveness in total pain relief and in preventing relapse within 24 hours. In order to be effective, triptans must be administered before the presence of cutaneous allodynia. Therefore, identifying the presence of allodynia and educating patients on the particularities of this symptom are essential for adequate treatment.

Doctors Harrison and Danielle Vaughan are Physical Therapists practicing in Wake Forest, North Carolina. For headache sufferers, we offer pain relief, education on dietary changes, improvement in anxiety and sleep and other self-help methods to help you! PhysioFit of North Carolina also offers meditation in Wake Forest with our Tai Chi, Pilates and Yoga classes. Contact us to learn more.

Why do I get dizzy when I roll over in bed?

Do you ever get a short bout of dizziness when you roll over in bed?

You typically can brush it off as it it only short term but it can progress and require medical assistance.

More than likely, the problem is Benign paroxysmal positional vertigo (BPPV):

  • This is a benign condition but can be easily fixed by a Vestibular Trained Physical Therapist.

    • Benign paroxysmal positional vertigo is a common inner-ear problem affecting the vestibular system, a system used to maintain balance.

    • Benign paroxysmal positional vertigo (BPPV) is one of the most common causes of vertigo — the sudden sensation that you're spinning or that the inside of your head is spinning.

Benign paroxysmal positional vertigo causes brief episodes of mild to intense dizziness.

Benign paroxysmal positional vertigo is usually triggered by specific changes in the position of your head.

This might occur when you

1. Tip your head up or down

2. When you lie down

3. Or when you turn over or sit up in bed.

How can a Physical Therapist help me?

Fortunately, most people recover from BPPV with a simple but very specific head and neck maneuver performed by a specialty trained physical therapist. Your therapist will take you through a series of diagnostic manuevers to diagnose and treat the condition.

These repositioning treatments are designed to move the crystals from the semicircular canal back into the appropriate area in the inner ear (the utricle). A repositioning treatment called the Epley maneuver is used for the resolution of posterior canal BPPV, the most commonly involved canal. 

If you are having dizziness when you roll over in bed, contact our office to speak with our Vestibular Trained Physical Therapist, Dr. Danielle Vaughan, for a consultation and treatment. We offer our Vestibular Physical Therapy services at our office in Wake Forest, North Carolina.

Visit our specific website page to learn more about our treatments for Dizziness, Balance and Vertigo conditions.

Shoulder Pain Relief in Wake Forest, NC

👊🏻Having arm and shoulder pain?!

👊🏻This is a technique using electrical stimulation combined with Dry Needling in fascial points along multiple joints.

👊🏻Alongside joint mobilization and exercise, this is a Great way to improve pain to get you back on your feet!

We offer manual therapy, exercise and pain relief for shoulder and elbow conditions in our physical therapy office in Wake Forest, North Carolina.

Contact us to learn more!

Diastasis Recti Relief in Wake Forest, NC
Women’s Health Diastasis Recti Wake Forest North Carolina

Women’s Health Diastasis Recti Wake Forest North Carolina

I need to brag on this super momma, who came to therapy with a significant diastasis recti (abdominal separation) feeling weak with pain.

In just 6 sessions with her dedication, she has shown HUGE gains and is on the road to a great recovery!👍. I couldn’t be more proud of her! 

Just because you had a baby, doesn’t mean you have to live with the common complaints postpartum. Let us help you gain control again, because being a mom is an athletic event 💪🤸‍♀️

Dr. Danielle Vaughan is a Women’s Health Specialist for Physical Therapy Services in Wake Forest, NC. As a mother of two who continues to exercised before, during and after pregnancy; she knows the importance of a healthy lifestyle for a healthy mom and baby!

Contact her to determine if she can help you!

Medication Overuse Headache

Medication overuse headache (MOH) is a chronic daily headache and a secondary disorder in which acute medications used excessively causes headache in a headache-prone patient.

It is usually is diagnosed after failure of headache relief with episodes with multiple painkillers, i.e., triptans and nonsteroidal anti-inflammatory drugs (NSAIDs).

If you feel you have this condition, please talk to your physician about it and potentially discontinuing your medication per their guidelines.

If you want a natural optional, feel free to seek out our services for joint mobilization to the upper cervical spine joints, dry needling to the soft tissue and muscles of the neck and face, and potentially need sensorimotor and vestibular training in addition to strengthening the neck muscles.

We provide pain relief for headaches, TMJ and other facial pain at our convenient location in Wake Forest, North Carolina.

Harrison Vaughan
What does knee adduction moment mean in Yoga, exercise & knee arthritis?

The external knee adduction moment represents the net medial-to-total joint distribution of load at the knee. As shown in picture above, during the stance phase of walking, an external adduction moment acts around the knee joint, which tends to rotate the tibia medially with respect to the femur in the frontal plane.

What does this mean?

A higher knee adduction moment when you step on your foot (to load your knee), could be a reason why you’re having pain!

A high knee adduction moment reflects increased compressive forces acting on the medial aspect of the knee and is widely regarded as a surrogate measure of medial knee compression.

Therefore, more knee adduction moment = could be more pain!

What does this have to do with Exercise & Yoga?

A major goal in use of therapeutic exercise is to minimize osteoarthritis progression at the knee, which entails minimizing the knee adduction moment. The role of abnormal knee joint loading can be implemented in the progression of structural knee osteoarthritis.

Knee adduction moment magnitude has been shown to increase with knee OA severity and exercise programs need to be designed to limit knee adduction moment.


How does PhysioFit of NC’s class help arthritis of the knee?

Using research and combined 20 years of experience, our physical therapists have teamed up with certified Yoga instructors to provide exercises that maximize muscle strength of the limbs and minimize knee adduction moment.

Our exercise program is designed to maximize strength and minimize overloading the knee joint.

Considering the loads on the knees are different between the front and back leg (during some poses), we keep that in mind too!

Harrison Vaughan
Would Yoga cause my knee arthritis to hurt more?

One of the biggest concerns we get as Physical Therapists is,

I don’t want to exercise as it will flare up my arthritis!

Of course this is a major issue that should not happen with exercise as it does two things:

  1. Firstly, it creates fear to exercise and get the many benefits of being active.

  2. Secondly, it may lead someone to saying, “any exercise” didn’t work for me so gives when this is relayed to a physician, he/she usually thinks ….well, if exercise didn’t help, let’s try injections, medications and/or surgery.

When it comes to exercising with pathology or injury, PhysioFit of NC promotes ourselves in our model of Feel it to Heal it Physio. This basically means you should feel exercises where you SHOULD, but more importantly, you should NOT feel it where you should NOT! This is the ultimate solution to getting the benefit of exercise without “picking” at the joint.

Yoga has been shown to improve strength and flexibility, but it is a general exercise approach. Therefore, the physical therapist and certified Yoga instructors at PhysioFit of NC have teamed up to provide a specific Yoga exercise approach just for knee osteoarthritis!


The program will provide poses and moves to improve quadricep strength, flexibility in the hamstrings and calves while minimizing stress on the knee joint.

Oh — and we couple it with the powerful manual approach of dry needling to give you the ultimate combo of relief and movement medicine!

Harrison Vaughan