Physical Therapy Helps Patient Recover from Major Auto Accident and Avoid Surgery

On July 22, 2010, Josh Hutslar, a 31-year old sprinkler fitter from Floyds Knobs, was rear-ended on the interstate by a semi truck. While he initially thought the lower back pain he was experiencing was just soreness from being involved in such a major accident, the development of pain radiating down his right leg made him realize that he needed to seek medical attention.

Diagnosis: Ruptured Disc

Josh visited his family physician, Stephen Karem, MD, of Physicians Associates of Floyds Knobs. Dr. Karem described his condition at that time. “Josh was three months out from an auto accident and still experiencing lower back pain that included tenderness in his right lumbar area, poor range of motion and pain radiating into his right leg, which are all classic signs of an irritated nerve root. My first approach was to give him steroids to reduce the swelling along with pain medications to decrease his pain level. When this didn’t work, I ordered an MRI, which showed a ruptured disc in his lower back, so I referred him to Dr. Doyle at the Baptist Health Floyd Spine Center for a consultation.”

“A common misconception is that a diagnosis of a ruptured disc automatically means surgery. Josh is a perfect example of how the right physical therapy plan can help the disc to shrink down and partially re-absorb. If he continues to strengthen and maintain his core muscles that support his spine, there’s a very good chance that he could permanently avoid surgery.”

Michael Doyle, MD
Board Certified Neurosurgeon
Baptist Health Floyd Spine Center

“I referred Josh to the Baptist Health Floyd Spine Center because my patients have had great success with their conservative and operative treatments. And I appreciate that they keep me in the loop at all times, because at the end of the day, I feel responsible for the outcome as well.”

Stephen Karem, MD
Board Certified Family Medicine Physician
Physicians Associates of Floyds Knobs

“Josh was really motivated to avoid surgery,” explained Dr. Doyle. “His symptoms were manageable enough to try a conservative approach like physical therapy first, so I explained to him that if he could strengthen his core muscles that support the spine, there was a good chance he could get better on his own. When the core muscles are well maintained, they can absorb the stress and strain of daily activities so that the spine has to absorb less. I like to tell my patients that it’s like building your own internal back brace.”

Physical Therapy Aids in Recovery and Prevention

Nate Nevin, PT, DPT, a licensed physical therapist at Baptist Health Floyd PTWorks in Floyds Knobs, was Josh’s physical therapist. “On my first visit with Josh, I developed a treatment plan that included twice weekly sessions with exercises at home in-between, so that he could learn how to perform the techniques I was teaching him on his own.”

“My first objective was to teach him proper ergonomics for sleeping and sitting to avoid further aggravation of his condition. Next we moved on to what’s known as positional distraction, a self stretching technique in which more space is created in the spine to relieve pressure off the affected nerve root. This included showing him how to lie on his side with a pillow between his knees to create a neutral hip position, and a pillow under his side to create a gap in the nerve space, and thus relieve pain and pressure.”

Learning to Create an Internal Brace of Muscles

Nate continued, “Finally, we moved into lumbar stabilization exercises, which are aimed at developing strength in the core muscles that support the spine known as abdominal stabilizers. These exercises are designed to improve abdominal stability and re-train the stabilization muscles to perform during normal activities as well as higher-level work-related activities so that the spine is better protected against stress or injury. To assist, we used a biofeedback device that I placed under his back during the exercises to help him maintain a physiologically neutral position so that all of his efforts were aimed at strengthening his abdominal stabilizers.”

Josh concluded, “Between working with Nate in the clinic and doing my exercises at home, I was feeling completely better in no time. Nate released me to exercises at home after just five weeks and seven sessions. While I was glad to be pain-free, I almost missed my physical therapy sessions because they were actually really enjoyable. I’ll definitely continue to use everything I’ve learned from him.”

Physical therapy training with Nate Nevin, PT, DPT, has helped auto accident patient Josh Huslar avoid spine surgery.

For more information about the Baptist Health Floyd Spine Center…

Call (812) 949-5933 or 1-877-487-5933, or visit

Baptist Health Floyd’s Rehabilitation Services Department Offers Four Convenient Locations

Baptist Health Floyd Outpatient Rehabilitation
Offering physical therapy as well as massage therapy
1700 State Street, New Albany
(812) 948-7416

New Albany YMCA
Offering land and warm water-based therapies
33 State Street, New Albany
(812) 948-7416

PT Works Highlander Point
756 Highlander Point Drive, Floyds Knobs
(812) 923-0630

PT Works Corydon
2207 Concord Ave NW #100, Corydon
(812) 738-3616