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Pain is unnecessary

Aero Performance & Physical Therapy in North Liberty is ready to help you achieve your goals
Troy Bockenstedt, PT, DPT (holding his daughter Willow), opened Aero Performance & Physical Therapy at 7 Hawkeye Dr., Ste. 105 in North Liberty in August and brings individualized care tailored specifically to his clients’ needs to the community.

NORTH LIBERTY– From receiving an ankle sprain to earning a doctorate, and from treating multiple clients at once to providing exclusive one-on-one care sums up in the briefest manner the career path of Troy Bockenstedt, physical therapist (PT), and doctorate of physical therapy (DPT), as well as his Aero Performance & Physical Therapy clinic in North Liberty.
A native of Dyersville, Bockenstedt played football for the Blazers of Beckman Catholic High School and graduated in 2005. A football injury on the Monday of his senior year Homecoming Week inadvertently set Bockenstedt on a career path.
“I had an ankle sprain and a (physical) therapist took me in, and he said we’re going to create some goals. You’re going to play in the Homecoming Game, you’re going to score a touchdown, and you’ll be the Homecoming King. He kind of smiled like he was joking around, but then Friday came around, and everything came true.”
Bockenstedt continued with therapy after playing in the game, scoring a touchdown, and being crowned.
“It seemed like a good idea to pursue,” he said, so after recovery, he continued to shadow the therapist. “It’s one of those things where if you try something and it feels right, you keep doing it.”
He attended the University of Iowa, where he graduated from the physical therapy school and later earned his DPT in 2011. After graduation, the doctor worked in a variety of settings, both in the area as well as around the country. “I traveled around to different mentors. I went to Arizona for a while, to Oregon, to Maine, and then I met my wife (Becky) and decided we were going back to Iowa.” Bockenstedt then worked for some clinics in Eastern Iowa, with corporate ownership, and multiple layers of management. “It wasn’t for me so I decided, OK it’s time (to go into business for himself, and for his patients and clients).”
The goal, he said, was to provide more personalized care. “Everything is moving toward, ‘Do this to help the business,’ and I think, the light was getting shined in the wrong direction. I wanted to keep the focus on the client.”
His philosophy of care is strictly one-on-one, for the full hour if need be. “Other places asked me to treat two or three people at a time and I just thought, I can’t stay focused on that, and it didn’t feel right.”
Roughly three years ago, Bockenstedt began working out of his home, gratis, on the side. “Neighbors were telling me stuff and I felt guilty that I wasn’t helping them,” he said, “So I started helping them, one thing led to another, and I said alright, I can probably go into business on my own.”
In early February, Bockenstedt was ready to go, but the rapid proliferation of the COVID-19 virus made him hold off until August to officially open his door.
“I did question going into business, but it’s been growing,” he said.
While Bockenstedt’s business has been growing, his field has been evolving.
“What we thought of as pain previously was way different than what we have now,” he explained. “Now, when I test someone for their movement, or their pain, there’s this thing called pain modulation, or pain adaptability.”
In short, exercising a painful extremity will actually reduce the pain. “You have endorphins, all these chemicals that are released from doing a repeated motion. If you push through (the initial pain), the pain can be modulated by your own means.” This ties in with a push to move away from treating pain with opioid drugs such as codeine, morphine, oxycodone, and hydrocodone due to their highly addictive nature. “Once you take opioids, your ability to modulate pain changes,” he observed.
Progressive exercises, or gradually building strength, is a key component of Bockenstedt’s physical therapy regimen. X-Rays, CT scans, and MRIs are all tools in a physical therapist’s tool box, but Bockenstedt also has another way to locate and map out trouble spots. It’s a tablet-based app, and sometimes it tells a more detailed story than the imaging devices.
“Even if you have an MRI and it shows a disc that’s protruding onto a nerve. Half of people that are walking around that are healthy with no back pain have a disc protruding on a nerve, and there’s no pain,” he said. “And the other half, sometimes it creates pain.”
Some of his mentors even advise against MRIs. “If they (the patient) feel better after doing 10 reps, how does that MRI prove they should be in a lot of pain if I just clearly took their pain down, just by moving them?” One thing people need to remember, he said is that “Tissues heal. For some reason we think that pain should linger.”
Bockenstedt has another tool available, which helps combat the opioid crisis, called dry needling. “We use needles just like acupuncturists, but in a different way.” While an acupuncturist goes after “the flow of chi,” Bockenstedt goes after trigger points.
He described trigger points as a “ball” or a “knot” of muscle tissue. “If that’s tender, then we know it is an active trigger point, so we’ll put the needle through that and that can release your natural endorphins.”
Chronic pain, neck pain, low back pain and vestibular disorders (dizziness and vertigo) are among the most common complaints through Bockenstedt’s door. Sometimes, as with dizziness, making the patient more dizzy, or temporarily increasing their pain, is a necessary part of the therapy with the ultimate goal of eliminating or at least reducing the discomfort.
“We want to reduce the threat of movement,” he explained. “After an injury recovers, we might still fear things (which could result in re-injury), so my goal is to teach them different ways to trick the nervous system that you should not fear that movement.”
Patients typically range in age from 5 years old on up. “I have a special place in my PT background with geriatric patients, so I really love the older crowd. I do push them hard, but I think they appreciate it when they start feeling better.”
Patients on federal insurance (Medicare, Medicaid, veterans benefits) need a referral from their physician before seeking Bockenstedt’s services.
“If you don’t have a federal payer, you can come straight here (no referral).” Some insurance plans could require a referral, “But we can look that up,” he said, adding private pay for a flat fee is also an option.
Regardless of how payment is rendered, provided the services and treatment needed for the best possible result is the goal. And, being independent, Bockenstedt has more latitude in providing treatment options. “You don’t have someone above you influencing your choices based solely on the bottom line.”
His bottom line is making sure the client is independent. “You know how to handle your pain, if it comes back. Let’s give you the playbook so you can control it.”
The performance side reflects more of Bockenstedt’s athleticism. In 2007, Bockenstedt started doing triathlons. Since then he’s moved into Iron Man competitions and coaching athletes in endurance. “Any athletic event can be broken down to improve the motion and improve the mobility of the athlete. I can do all sports, but coaching I will specifically work on endurance athletes.”
Performance equals a balancing act between your body’s capacity and the demand (load) you put on it. “If you’re going to run three miles, that’s a lot of load, and you need to build up your capacity to accept that load on your body. That means you have to be strength training constantly.”
He hears from runners who put on several miles a day but aren’t doing any strength training, and then wonder why their knees hurt. “You need to build up that capacity of your hips and your knees through strength training.”
Bockenstedt said once the schools are (eventually) back open to volunteers, he intends to offer pro-bono assistance to Liberty High School’s athletic trainer to ensure she has what she needs, and to offer an option for therapy if needed. “If I see something, I can tell them, ‘work on this,’ just to make sure they’re top-notch.” He also wants to volunteer with the various 5k and fun runs in North Liberty, once they are able to be held again. “I’m North Liberty-owned and operated, and I want to support the North Liberty community. So, if there’s anything in North Liberty, I want to be involved.”
Due to the ongoing pandemic, masks are required at Aero Performance & Physical Therapy along with a temperature check of both the client and Bockenstedt. In addition, cleaning is an ongoing process, including cleaning equipment immediately after each use, in front of the client, before moving on to the next exercise.
“It’s extremely private here. There’s no one else here, there’s no judgment, and it’s just me and the patient,” he said. “No matter where you go in town for physical therapy, you’re going to be treated well. But in my clinic, if you need a full hour, I’ll get reimbursed for 45 minutes and eat the final 15 because I want to be sure you have time for questions and to review anything.”
Aero Performance & Physical Therapy is located at 7 Hawkeye Dr., Ste. 105 in North Liberty. Phone (319) 930-2868, online at https://aeroperformanceandpt.com, on Facebook, or via email at troy@aeroperformanceandpt.com.