Neurologic Conditions

A concussion is a brain injury, and it deserves to be treated like one. Whether yours happened on the sports field, in a car accident, or from a fall, the effects can linger far longer than people expect. Headaches, dizziness, difficulty concentrating, sensitivity to light, and balance problems are all common, and all treatable with the right physical therapy approach.

We commonly treat:

• Sports-related concussion and return-to-sport progression
• Post-concussion syndrome (symptoms lasting beyond 4 weeks)
• Concussion-related dizziness and vestibular dysfunction
• Visual and oculomotor dysfunction following concussion
• Post-concussion headaches with a cervical or vestibular component
• Mild to moderate traumatic brain injury (TBI) rehabilitation
• Cognitive fatigue and activity pacing after brain injury
• Balance and coordination deficits following head injury
• Return-to-school and return-to-work programming

Our concussion specialists use evidence-based assessment tools and a carefully graded approach to rehabilitation, never pushing too hard, never moving too slowly. We coordinate closely with your medical team and work to get you back to school, work, sport, and life safely and fully.

Few things are as disorienting (literally), as a vestibular disorder. The spinning, unsteadiness, and unpredictability of vertigo can make it hard to drive, work, care for your family, or simply feel safe moving through your day. The good news: vestibular physical therapy is one of the most effective treatments available, and many patients experience dramatic improvement in just a few visits. 

We commonly treat: 

• Benign Paroxysmal Positional Vertigo (BPPV) — the most common cause of vertigo 
• Vestibular neuritis and labyrinthitis 
• Vestibular hypofunction (reduced inner ear function) 
• Cervicogenic dizziness (dizziness originating from the neck) 
• Persistent Postural-Perceptual Dizziness (PPPD) 
• Dizziness and imbalance following concussion or head injury 
• Meniere's disease-related balance dysfunction 
• Motion sensitivity and visual vertigo 
• Fall prevention related to vestibular dysfunction 

Our therapists are trained in specialized vestibular assessment and treatment techniques, including canalith repositioning maneuvers (such as the Epley maneuver for BPPV), gaze stabilization exercises, habituation therapy, and balance retraining. We'll help you understand what's happening in your body and give you the tools to feel steady again. 

Recovery after a stroke is possible, and physical therapy plays a critical role in how far and how fast that recovery goes. The brain has a remarkable ability to rewire itself through a process called neuroplasticity, and movement-based therapy is one of the most powerful ways to harness that ability. Whether your stroke was recent or occurred years ago, our therapists can help you regain function and independence. 

We commonly treat: 

• Gait and walking rehabilitation after stroke 
• Upper and lower extremity weakness and paralysis 
• Balance and fall prevention after stroke 
• Spasticity and tone management 
• Fine motor skill retraining 
• Coordination and movement pattern rehabilitation 
• Functional mobility training (transfers, stairs, community navigation) 
• Fatigue management and activity pacing 
• Shoulder pain and subluxation related to stroke 
• Long-term stroke recovery and maintenance programming 

Our approach to stroke rehabilitation is intensive, progressive, and deeply personalized. We draw on the latest evidence in neuroplasticity and motor learning to help your brain rebuild the pathways that control movement, and we celebrate every step forward with you. 

Parkinson's disease affects movement in ways that can feel like a slow loss of control, tremors, rigidity, shuffling gait, and the fear of falling can make even familiar activities feel uncertain. Physical therapy cannot stop the progression of Parkinson's, but it can significantly slow its functional impact and help people with Parkinson's live more fully and safely for longer. 

We commonly treat: 

• Gait training and fall prevention 
• Balance and postural stability 
• Freezing of gait management 
• Rigidity, bradykinesia, and movement initiation 
• LSVT BIG® — evidence-based intensive therapy for Parkinson's 
• Transfers and functional mobility 
• Dual-task training (walking while talking, etc.) 
• Fatigue management and energy conservation 
• Caregiver education and safety strategies 
• Wellness programming to maintain gains long-term 

Apex therapists trained in LSVT BIG® use a proven, high-intensity approach that teaches patients with Parkinson's to make bigger, more deliberate movements, recalibrating the brain's perception of normal movement size. Combined with ongoing exercise and maintenance therapy, this approach helps patients maintain independence and quality of life. 

Multiple sclerosis is an unpredictable condition, symptoms can fluctuate, flare, and affect people in very different ways. Physical therapy for MS is not about pushing through symptoms; it's about working smarter, building resilience, and adapting your approach as your needs change. Our therapists understand the complexity of MS and will build a plan that respects your energy, your limits, and your goals. 

We commonly treat: 

• Fatigue management and energy conservation strategies 
• Gait and walking difficulties, including foot drop 
• Balance and fall prevention 
• Spasticity and tone management 
• Upper and lower extremity weakness 
• Heat sensitivity and exercise adaptation 
• Coordination and tremor 
• Cognitive fatigue and dual-task training 
• Functional mobility and activities of daily living 
• Relapse recovery and return to baseline function 

We take a collaborative, whole-person approach to MS care, working alongside your neurologist and other providers to support your health between appointments and through every stage of your journey with MS. 

Not all headaches are created equal, and not all of them start in your head. Many chronic headaches, including a significant portion of migraines, have a strong musculoskeletal component rooted in the neck, jaw, or upper back. Physical therapy can be a powerful tool for reducing headache frequency, intensity, and duration when the right structures are identified and treated. 

We commonly treat: 

• Cervicogenic headaches (headaches originating from the neck) 
• Migraines with cervical or vestibular involvement 
• Post-concussion headaches 
• Tension-type headaches 
• TMJ-related headaches 
• Occipital neuralgia 
• Headaches related to posture or prolonged screen time 
• Vestibular migraines and migraine-associated dizziness 

Our therapists assess the cervical spine, jaw, posture, and vestibular system to identify contributing factors to your headaches. Treatment may include manual therapy to the neck and upper back, postural correction, dry needling, vestibular rehabilitation, and self-management strategies to reduce the frequency and severity of your headaches. 

Falls are one of the leading causes of injury and loss of independence, and they are not an inevitable part of aging or illness. Many balance problems have specific, treatable causes, and physical therapy can dramatically improve your stability, confidence, and safety whether your balance issues stem from a neurological condition, an inner ear problem, or simply years of inactivity. 

We commonly treat: 

• Balance impairment related to aging 
• Fall history and high fall risk 
• Balance disorders related to Parkinson's, MS, or stroke 
• Vestibular-related balance dysfunction 
• Peripheral neuropathy affecting balance
• Balance problems following hospitalization or surgery 
• Fear of falling (post-fall syndrome) 
• Community mobility and navigating uneven terrain 
• Otago Exercise Program for older adults (Senior Strength Class) 

At Apex, we offer individualized balance assessments that identify exactly where your balance system is breaking down, and targeted programs, including the evidence-based Otago Exercise Program, to rebuild your stability from the ground up. Our goal is to help you move through your world with confidence. 

Peripheral neuropathy (numbness, tingling, burning, or weakness in the hands and feet), can make walking, gripping, and daily tasks difficult and sometimes dangerous. Whether your neuropathy is related to diabetes, chemotherapy, a vitamin deficiency, or an unknown cause, physical therapy can help you manage symptoms, improve function, and reduce your fall risk. 

We commonly treat: 

• Diabetic peripheral neuropathy 
• Chemotherapy-induced peripheral neuropathy (CIPN) 
• Idiopathic peripheral neuropathy 
• Neuropathy-related balance and gait problems 
• Foot drop related to peroneal nerve involvement 
• Sensory retraining and desensitization 
• Strength and functional mobility with neuropathy 
• Fall prevention for people with neuropathy 

Our therapists use a combination of sensory retraining, strengthening, balance training, and functional movement work to help you adapt to and manage the effects of neuropathy, so you can stay active, independent, and safe. 

Spinal cord injuries vary enormously, from incomplete injuries with significant recovery potential to complete injuries requiring lifelong functional adaptation. Whatever the extent of your injury, physical therapy plays an essential role in maximizing your independence, function, and quality of life at every stage of recovery. 

We commonly treat: 

• Incomplete spinal cord injury rehabilitation 
• Gait and mobility training after spinal cord injury 
• Upper extremity function and strengthening 
• Transfers and wheelchair mobility 
• Spasticity management 
• Pain management related to spinal cord injury 
• Respiratory function and endurance 
• Long-term maintenance and wellness programming 

We approach spinal cord injury rehabilitation with both clinical precision and deep respect for each patient's individual experience and goals. Recovery is rarely linear, but we are committed to helping you find and push your potential, however that looks for you.