Knees and the green: Meet Missy

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On a warm summer day, Missy threw her clubs over her shoulder and made her way to the course at Whitetail Run. Golf has always been her passion. It has been a part of her life since childhood. She even grew up across the street from the Whitetail Run golf course. Later in life, she would coach the sport for Wadena-Deer Creek High School. Unfortunately, life has a way of pulling us away from the activities that bring us joy. During a game of volleyball, she tore her ACL. Missy went through two ACL surgeries that resulted in severe arthritis. She could still play golf and exercise, but not without pain. Missy has a unique story and proof that knees and the green are a great match.

Surgery and recovery 

Missy is not the type to regress casually into inactivity. Her club belongs tightly gripped in hand, not collecting dust in a closet. Arthritis would not stop her, so she started looking for help. In her own community, she discovered Ben Robertson, MD. Guided by a myriad of glowing reviews, she took the leap and met with the orthopedic surgeon.  

Missy was immediately blown away by Dr. Robertson’s knowledge of the bones and muscles that make up the body. After a consultation, she decided to pursue surgical correction. All went as planned, but surgery was only half the battle. Then began the recovery period. According to Missy, a physical therapist, rehab is crucially important. Every day must be about healing to recover fully. 

Knees and the green!

Knees and the green! Missy golfs again.

After only seven weeks, Missy was playing golf again.

After only a few weeks of physical therapy, Missy made her way to the green. When asked if she had any advice for people in a similar situation, she simply replied, “Don’t wait.” A love for physical activity and a single consultation changed her life forever. 

Putting surgery off can limit or keep you from doing what you love. If you feel a shooting pain or your joints just aren’t what they used to be, maybe it’s time to think about meeting an orthopedic specialist. Tri-County Health Care has one of the most comprehensive orthopedic and sports medicine programs around. To schedule an appointment with Dr. Robertson, call 218-631-3510 or utilize our online scheduling option. Also, remember to follow Tri-County Health Care on social media. 

New chiropractor! Brock Spandl joins the team

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Brock Spandl, DC

Chiropractic care is growing fast! Hundreds of patients have found pain relief working with the talented Carissa Mitchell, DC. Her hands have helped over 300 people since joining the Tri-County family in June 2021. The high demand for chiropractic care led to the expansion of the service, which included Brock Spandl, DC joining the team.

Carissa Mitchell and Brock Spandl are chiropractors at Tri-County Health Care.


Dr. Spandl is a former athlete, having played soccer, hockey, and track while in high school. Running is a passion and that passion took him all the way to the University of Minnesota, where he competed in track and field. He was the freshman record holder in the heptathlon, 7-time top-3 finisher in the Big Ten conference, 2-time NCAA Division-I national qualifier and 1-time NCAA first-team All-American.

As an athlete, Dr. Spandl understands the physical conditioning the human body goes through to compete at a high level. He can speak the language of the sports and connect with athletes on a visceral level. He knows when they are at peak performance, and he knows when they need help. Dr. Spandl gained a great deal of his knowledge through firsthand experience.

“When I was younger, I suffered a significant lower back injury while competing in a Pole vault competition. Seeking treatment for that injury really inspired me to learn the innerworkings of the human body which led me to the world of chiropractic medicine”

The Staples community

Before joining Tri-County Health Care, Dr. Spandl did operate his own chiropractic office in Staples. Throughout the course of running his own practice, Dr. Spandl formed great relationships with the families and individuals of the Staples community. He hopes those people will come with him to receive care at Tri-County Health Care. A unique chiropractor like Dr. Spandl is hard to come by but he’s not really going anywhere, just moving to a bigger building.

A typical appointment

An initial appointment is a bit longer because Dr. Spandl needs to complete a basic examination. There is no set formula for how to treat a patient; each person is different and requires tailored treatment. According to Dr. Spandl, his most common appointment usually involves lower back or neck pain. He also helps with many headaches and radiculopathies. Dr. Spandl likes to keep his appointments concise so his patients can get back to doing what they love.

About Dr. Spandl

Brock Spandl, DC

After growing up in Moorhead, Dr. Spandl now resides in Staples with his wife, Missy. They have two children, Blair and Paxton. In his off time, he enjoys golfing, fishing and maintaining a healthy body. To schedule an appointment with a chiropractor, please call 218-631-3510 and follow Tri-County Health Care on social media for regular updates.

Learn about Chiropractic Care at Tri-County Health Care

Sports Physicals Remain Important

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The pandemic has thrown off the schedules of area sports. The future may be unclear for athletes excited to get back on the playing field. However, sports physicals remain important to ensure athletes are ready to jump back into action when competition resumes.

Sports Physicals Remain Important Tri-County Health CareBefore school begins, it’s a good idea to schedule a sports physical to be ready for the season. Tri-County Health Care’s clinics offer these examinations. Cleaning, disinfecting, and screening procedures ensure it’s safe to come in for a visit.

  • Patients are screened for COVID-19 exposure and symptoms
  • Patients, visitors, and staff must wear face masks while inside the building
  • Exam rooms are cleaned and disinfected between patients

Why are sports physicals important?

Minnesota requires sports physicals before participation, and it helps determine if it’s safe to start a new sport or season.

During these examinations, a provider will determine if the individual is in good health, measure physical fitness, and learn about current and past injuries. They can also advise on how to protect yourself from injury while playing a sport.

Sports Physicals Remain Important Tri-County Health Care

What happens during a sports physical exam?

A sports physical may vary depending on the provider and the individual. However, it will always include reviewing medical history and a physical exam.

A medical history will include information about the patient’s health, medical problems, and medications, and family health.

The physical exam is like an annual check-up but will relate to playing sports. A provider will look at the health of the lungs, heart, bones, and joints. These are all important areas when participating in sports. An exam may include:

    • Measuring height and weight
    • Checking blood pressure and pulse
    • Testing vision
    • Examination of the heart, lungs, belly, ears, nose, and throat
    • Checking joints, strength, flexibility, and posture

The provider may also ask about diet and the use of drugs, alcohol, and supplements.

Schedule your sports physical today!

Tri-County Health Care is here to support local families, school districts, and athletics. Call 218-631-3510 to schedule a sports physical at one of our clinic locations.

Strength and Conditioning is key to Injury Prevention

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By Sarah Maninga, Tri-County Health Care Certified Athletic Trainer

The winter sports season continues to wind down and spring is right around the corner. It’s the time of year where athletes transition from the comfort of the gym to the sunshine of the outdoors. That is, if the snow ever melts! While athletes patiently wait for the warmth of spring to come, it’s a crucial time to prepare for the upcoming season. The month of March is not only a bridge between sports seasons, but also National Athletic Training Month! Sports Medicine Providers and Certified Athletic Trainers offer much more than just evaluating and treating injuries.

We can also help prevent injuries in the first place. But, how is that possible?Attractive sports people are strength training with dumbbells in gym

It all starts with strength and conditioning. Most of the people I work with use this for injury prevention. Muscle imbalances and weakness can lead to injuries, so it’s key to get athletes in the weight room in between seasons and in the summer to keep them injury-free. Coaches or physical education teachers open the weight room after school between seasons, and I stop in to help as much as I can.

This training isn’t just for athletes, however, it’s for people of all age groups and activity levels. Programs instead focus on each individuals’ goals and interests to establish a program they will benefit from. Progression will occur as the person is ready to ensure that they continue to see improvements and enhance their overall body strength. Studies show that lean muscle mass decreases as you age, which makes strength and conditioning even more important to your health. Improving balance can be vitally important to fall prevention.

The strength and conditioning programs for athletes expand in the summer months.

At the schools I work with – Wadena-Deer Creek, Menahga and Sebeka – athletes complete hour-long workouts in the weight room, three days a week. We train using a wide range of exercises that focus on the whole body and in addition to conditioning. A major injury we see at the high school level is anterior cruciate ligament (ACL) tears, so we focus on hip and core strengthening along with proprioceptive exercises to try to prevent them. The conditioning exercises we do can range from sprints to plyometric circuit training.

We also do plenty of work on single leg balance exercises to prevent injuries to the ankles and knees, which are common injuries at the high school level. The shoulder is known to be an unstable joint, so we make strengthening it another area of focus.

Adult wstrength training at the gym with a personal trainer and looking very happy - healthy lifestyle conceptsFor those without access to weight rooms, there are many options and tools at your disposal right in your own home. Soup cans or milk jugs can be used as weights while doing exercises. Stairs can be perfect for running up and down for conditioning or step up exercises. If you look around, your home has plenty to offer to assist with workouts!

You can even use your own body weight to do many different exercises. Squats, lunges, push-ups, planks and step ups are just a few common exercises that require no equipment and provide a good workout right in your home.

Athletic trainers wear plenty of hats in our line of work. From high school outreach to injury evaluations to training programs, we aim to help you recover from an injury or help prevent it in the first place. We would prefer to see you happy and healthy. So, whether you are an athlete competing in a state tournament or someone preparing for your first 5K race, we want to emphasize the importance of strength and conditioning.

If you are unsure about starting an exercise program, please consult your provider to make sure it is right and safe for you. To learn more about our Sports Medicine program at Tri-County Health Care, click here.

In the event of an injury, Tri-County Health Care’s Rehab Services can help you regain your strength through services that include Aquatic Therapy, Occupational Therapy, Physical Therapy and Speech Therapy.Athletic Trainer, Sarah Maninga with her family

About the Author: Sarah Maninga has been an athletic trainer at TCHC since January 2015. She works with athletes at three area schools: Wadena-Deer Creek, Sebeka and Menahga. During her time off, she enjoys spending time with her husband and daughter on their small farm and doing anything that involves being outside, especially hunting and running.

What does an athletic trainer do?

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By Sarah Maninga, Certified Athletic Trainer


If you’ve ever attended a home game in Sebeka, Menahga or Wadena-Deer Creek, you might have seen me standing on the sidelines. As a certified athletic trainer, it’s myAthletic Trainer - Door Decor job to watch over student athletes in case of injury. To celebrate this month as National Athletic Training Month, let me tell you a little more about what I do and why athletic trainers are so important for students.


Community outreach

I serve three area schools – Menahga, Sebeka and Wadena-Deer Creek – on a contractual basis. Under that contract, I see elementary through high school students and provide them anything they might need that is sports health related. During the school year, it’s evaluating injuries during practices or games and making treatment recommendations. In the summer, it’s providing strength training and other conditioning services.

My day typically starts around noon in Menahga, and then I travel to Sebeka and finally Wadena. While at each school, I check in with students, whether it’s tending to new injuries or following up with old ones, and update coaches on their students’ status. Before practice, students come to me to get their injuries taped or looked at, and then I’ll peek in a few times during practice.

Along with communicating with coaches, I will also involve the student’s parents and their provider if needed.



My game schedule is predetermined in the fall. I sit down with the schools’ athletic directors, and we go day by day to decide where I should be. We try to make it as even as possible between the schools.

Athletic trainer applying a bandage to the inured knee of a female volleyball player.I attend home games to provide first aid, treat new injuries, and be there in case of a medical emergency. That’s not just limited to athletes. If someone in the stands has a heart attack, if a referee is injured or if a kid falls in the hallway, I would treat them as well.

Before each game, I check in with students to see if anything needs to be taped or evaluated, I make sure I have all the equipment I need such as ice packs or crutches, and provide water.

Anytime a visiting team comes to one of my schools, I’m in charge of them too. In the case of serious injuries, I contact their athletic trainer that night or the next morning to alert them of the situation.

If a team makes it to the postseason, I’ll travel with them to every game. I’ve also gone to state with a few of the teams, and that’s always a really fun experience.

Some of the most common injuries I see are concussions, scrapes, sprains, strains or jammed fingers, but I’ve seen everything from allergic reactions to broken femurs. You never really know what’s going to happen. I always say that it’s good when I’m bored because that means no one’s getting hurt.


Fostering relationshipsAthletic Trainer, Sarah Maninga, sits at her desk behind her computer and smiles for the camera.

My favorite part of being an athletic trainer is building relationships with the kids. A lot of times, kids will come visit me just to chat.

I love sharing with them all about what I do to hopefully generate curiosity about the world of sports medicine. I think it’s huge to get kids excited about this field, especially if they plan to come back here someday. There aren’t many athletic trainers in the area, and it’s huge for a school to have one.

There are a lot of kids that I look out for, and getting to know their individual personalities is really fun. One of the joys of my job is getting to watch them grow and succeed.


For more information about Sarah’s services and sports medicine, click here.



Athletic Trainer - Maninga FamilyAbout the Author: Sarah Maninga has been an athletic trainer at TCHC since January 2015. She works with athletes at three area schools: Wadena-Deer Creek, Sebeka and Menahga. During her time off, she enjoys spending her time with her husband on their small farm and doing anything that involves being outside, especially hunting and running.

When sports injuries strike, TCHC is there

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By Sarah Maninga, TCHC Certified Athletic Trainer


The fall sports season is well under way, and with that comes the risk of injuries associated with athletes.

As an athletic trainer, I am trained in evaluating injuries and make suggestions for the next step after injuries happen. This can include immediate care on the sidelines or a visit to sports A nurse applying a bandage to the inured knee of a female volleyball sports player.medicine, ReadyCare or the emergency department.


The right care, right away

When an injury happens at a sporting event, an athletic trainer is typically the first to run out onto the field or the first person to meet the athlete after they walk off the field. We see a wide variety of injuries ranging from bloody noses to broken bones.

When an athlete is down on the field or the court, the first thing we do is determine the extent of the injury. From there, we decide if we need more medical responders such as an ambulance. If we decide it does not require an ambulance, we can move the athlete to the sidelines and begin an evaluation.

This includes:

  • History (location of pain, peripheral symptoms, mechanism of injury, associated sounds and symptoms, history of injury)
  • Palpation (bony alignment, joint alignment, swelling, painful areas, deficit in muscles or tendons)
  • Joint and muscle function (range of motion, weight-bearing status)

After we go through the evaluation, we need to decide how to manage the injury. This can include putting a bag of ice on a sprained ankle, splinting a broken wrist or having the parents bring the athlete to the emergency department.


Care choices

So how do you choose where to take your child athlete when he or she gets hurt? It mostly depends on the injury, and you have multiple options to choose from.


Sports medicine. TCHC offers a Sports Medicine Clinic Monday through Friday from 8 to 9 a.m. at the Wadena Clinic. It is also offered at the Henning Clinic Monday through Friday byYoung injured boy playing the sport of basketball holding an ice bag on his head. appointment. This service includes a free sports injury evaluation by one of TCHC’s medical providers. All student athletes from elementary to high school are eligible.

This is a great option for overuse injuries such as tendinitis and for non-emergency acute injuries such as joint sprains and muscle strains.

If the medical provider determines that there needs to be additional testing or services after the evaluation, then fees for those services will be charged at that time.


ReadyCare is a walk-in clinic offered by TCHC. It is open Monday through Thursday from 8:30 a.m. to 7 p.m., Friday from 8:30 a.m. to 4:30 p.m., and Saturday from 8 a.m. to noon. This is a great option for a variety of illnesses and sports injuries including:

  • Minor lacerations
  • Minor traumas
  • Muscle aches and pains
  • Skin rashes/infections
  • Sprains
  • Strains


The emergency department is a 24-hour service open seven days a week. The emergency department is for more serious injuries such as broken bones or dislocations, but it is also an option when everything else is closed and an injury or illness can’t wait until the next day.



Photo of Sarah with her family.About the Author: Sarah Maninga has been an athletic trainer at TCHC since January 2015. She works with athletes at three area schools: Wadena Deer Creek, Sebeka and Menahga. During her time off, she enjoys spending her time with her husband on their small farm and doing anything that involves being outside, especially hunting and running.

Concussions: An Athletic Trainer’s Perspective

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Concussions, type it into Google© and you will end up with 14,500,000 results and all those articles can leave you with your head spinning in hundreds of different directions. Many of us hear about concussions daily and probably see something about them on the national news almost every night. If you have a child who plays sports you may be wondering if you should continue to let them play. I’m here to tell you that yes concussions can be scary, but that doesn’t mean we should wrap our children in bubble wrap and sit them on the couch.

So, what exactly is a concussion? A concussion is a mild traumatic brain injury. It occurs when direct and indirect forces are applied to the skull that result in the brain either rapidly accelerating or decelerating. This causes impairment of the brains functions.

The symptoms of a concussion can vary and all of them do not need to be present for you to be diagnosed with a concussion. Symptoms include a loss of consciousness, headache, nausea, vomiting, dizziness, poor balance, sensitivity to light, ringing in ears and sensitivity to noise, blurred vision, poor concentration, memory problems, drowsiness, fatigue, sadness, depression, irritability and neck pain.

A word of caution here: NO concussion is the same. If someone you know gets a concussion, don’t diagnosis yourself with their symptoms. People will react differently to them and there’s no set timeline saying how long a concussion will last.

One of the biggest things I think people forget is that concussions don’t just happen in sports. They can happen doing almost anything. Yes, anything! Sure, they are more likely in sports; however, you could be walking out to get your mail and get a concussion because you slipped on the ice and hit your head. You could be heading out to do your favorite winter activity like ice fishing and get a concussion because you slipped and bumped your head on the ground. Anyone can get a concussion.

So what do we do about concussions? In the sports medicine world, if we suspect a concussion in an athlete we remove them from the game and do a sideline assessment. This consists of rating symptoms on a scale of 0 to 6, immediate memory questions, concentration exercises, an eye/pupil exam and motor and balance exercises. We also check to ensure that all cranial nerves are functioning during this time. Once an athlete is diagnosed with a concussion they can’t return to play until they are symptom free and they have completed the “Return to Play” protocol. The “Return to Play” protocol lasts four days with each day consisting of the athlete gradually getting a little more into practice. The student athlete must remain symptom free through this protocol and if they don’t, then they go back and start over once symptom free again.

It is hard for anyone to completely prevent a concussion, but there are things we can do. We can make sure football and hockey players have up-to-date helmets and that our athletes/children are learning proper hitting and tackling techniques. We can educate coaches, parents and athletes about concussions, their symptoms and the importance of early diagnosis. If a concussion goes undiagnosed or an athlete returns to play before it is resolved it can have long-term effects, including post-concussion syndrome or second impact syndrome. Individuals with post-concussion syndrome can have concussion symptoms that persist for more than three months. Second impact syndrome is when a patient receives a second concussion before the first one is resolved.

Yes, concussions can be scary. That is why parents and coaches need to be aware of concussions, what the symptoms are, understand they can happen to anyone and know if you suspect a concussion to make sure the individual sees a health care professional as soon as possible. Early diagnosis will help the student athlete get back to the sport they love and help an adult get back to their daily activities sooner.

Bubble wrap not necessary.


About the author:

4x5 Maninga Sarah
Sarah Maninga has been the Athletic Trainer at Tri-County Health Care since January 2015. Her services are contracted with the Wadena Deer Creek and Sebeka schools. When she is not busy at the schools, she enjoys spending time with her husband on their small farm near Menahga and doing anything that involves the outdoors.