Physical Therapy Evaluation
Elderly patients are most vulnerable to injury due to strength and balance impairment. The injury in elderly patients can lead to reduced indoor and outdoor activity and mobility which in turn can increase other health risks and affect quality of life. Our focus in Leverage Physical Therapy is to use therapy techniques to improve balance, strength and posture. We will provide education and suggest environmental modifications to ensure safety. Our aim is to improve patient’s quality of life by reducing pain, emphasizing exercises and injury prevention all to regain optimum wellness.
Musculoskeletal Pain remains the main and crucial limiting factor for patient's day to day activities. We look at the pain as a symptom and not as the root cause. May it be inflammation due to recent trauma or surgery, postural imbalance, improper body positioning during activity or rest, tightening or lengthening of muscles along with muscle weakness, poor ergonomics, presence of trigger points, muscular spasm associated with stress and myo-facial tightness - some or all of these can contribute to pain and dysfunction. Pain due to neurological issues such as stroke and nerves involvement causing radiating pain are other main contributors towards discomfort. The aim here is not only to alleviate pain with hands on manual therapy techniques and electrotherapy, but also to eliminate root cause such as improper posture and muscle weakness. With this approach, patient can enjoy long term improvement and reduce the chances of any pain recurrence..
Neurological Assessment and Rehabilitation
Neuromuscular re-education is training muscles, brain and nerves to communicate effectively with each other to improve balance, coordination, proprioception (awareness of position and movement of body) and posture. Conditions such as stroke, multiple sclerosis, Parkinsons, etc. that affects the nervous system and affects functional activities are addressed. Balance, coordination, weight shifting, proprioception exercises, gait training along with postural re-training and PNF patterns are applied to improve outcome.
This is an exercise based approach in the management of dizziness and balance disorders associated with vestibular pathology. Vertigo can affect patient’s mobility and increases fall risk. The treatment is directed for the conditions such as BPPV (Benign Paroxysmal positional vertigo), traumatic brain injury, mechanical and musculoskeletal impairments in neck region, gait impairment and balance deficits post stroke or other neurological deficits. Examples of exercises are: Gaze stabilization exercises, postural training, neck and shoulder mobility exercises, balance training and vestibular compensation/ habituation exercises.
Pre and Post-Operative Care
Patient greatly benefits from pre and post operative care with Physical Therapy. In pre-operative care , physical therapy improves patient’s understanding of exercises that he/she will perform post surgery, reduce pain and inflammation, improve range of motion in joints, improve muscle strength and stability of the involved joint and restore emotional and overall well being. In post-operative care, physical therapist uses her knowledge to restore function of joint and musculature, assist with reduction of inflammation and alleviate pain that will assist with recovery. Physical therapist collaborates with doctor and surgeon to understand and implement post-op restrictions / precautions to avoid re-injury. The primary focus of the care is to have patient regain his/her prior level of strength and mobility.
Different Techniques used in Manual Therapy
Trigger Point Therapy
Trigger points are small knots in myofascial tissue. These are micro-muscle-spasms, where only a small part of the muscle goes into spasm and affects blood supply to that area. This builds metabolic waste and causes muscle soreness. The radiating pain in the surrounding region can appear due to referred pain. Continuous pressure in this area relaxes muscle spasm and improves blood circulation which in turn removes metabolic waste. Physical therapist will adjust pressure as per patient tolerance. Trigger point therapy improves patient’s functional outcome due to reduction in pain and spasms.
Myo means muscles. Fascia is a type of connective tissue that wraps around different body parts in human body including muscles. Physical Therapist uses cross-hand technique and unwinding technique to relax tight muscles and facial entanglements to reduce spasm and improve blood circulation. This is a gentle technique and has significant benefit to reduce pain and improve functional mobility.
Joint mobilization is a manual therapy technique that is a skilled passive movements provided to joints to improve range of motion , relieve pain and muscle spasm and overall improve flexibility of the joint. Joint mobilization improves patient’s awareness of the joint function and mobility.
Trigger Point Dry Needling is use of solid filament needle inserted through the skin into the muscle to relieve painful trigger points. Dry needling provides deepest tissue relief for some type of muscular pain and stiffness. In addition, easing the trigger points may improve flexibility and increase range of motion. That’s why this method is often used to treat sports injuries, muscle pain, and fibromyalgia pain.
Soft Tissue Mobilization
Soft tissue mobilization uses hands-on manual technique to break adhesion in muscles, ligaments and fascia to improve range of motion of joints by reducing muscle spasm and pain. Soft tissue mobilization involves different techniques such as oscillation, friction massage and deep pressure to the area as per need of each patient’s biomechanical and myofascial dysfunction. Physical therapist will use one or multiple combinations of these hands-on manual therapy technique as per individualized patient’s needs.