What is Manual Therapy and how can it help me?

A lot of patients mistakenly think physical therapy is just exercise programs and modality regimes for pain. Although both exercise and pain modalities are important pieces to a comprehensive physical therapy plan of care, manual therapy is proven to reduce recovery times, increase range of motion, and improve overall tissue mobility. Manual therapy is basically … Continue reading “What is Manual Therapy and how can it help me?”

A lot of patients mistakenly think physical therapy is just exercise programs and modality regimes for pain. Although both exercise and pain modalities are important pieces to a comprehensive physical therapy plan of care, manual therapy is proven to reduce recovery times, increase range of motion, and improve overall tissue mobility.

Manual therapy is basically different hands-on techniques that professionally trained physical therapist’s implement to relieve pain and restore mobility. Manual therapy includes different massage techniques and manipulating of soft tissue such as muscles, fascia, and connective tissues with the goal of increasing circulation, tissue mobility, reducing scar tissue, and relaxing  muscles, which ultimately can lead to reduced pain. Manual therapy can also include joint mobilization and manipulation, where the physical therapist uses specific, directed movements used to target joint restrictions and restore normal motion. These movements can loosen tight tissue around the targeted joints to improve flexibility, mobility, and pain. Manual therapy is typically used in conjunction with an individualized exercise program that will complement the gains made and restore function in the treated area.

Manual therapy is the foundational approach to any painful or stiff joint. There are no limitations on the joints that can be treated including your jaw (TMJ), spine, shoulder, elbow, wrist, hand, hip, knee, and ankle.

Techniques Used in Manual Therapy

  1. Soft Tissue Mobilization (STM) / Myofasical Release (MYR): While muscle tension is usually reduced when joint motion improves, the other surrounding tissues can still be affecting motion and causing pain. Soft tissue mobilization addresses muscle tension by moving tissue fluids, reducing tension, and breaking up fibrous or inelastic tissue such as scar tissue (also known as “myofascial adhesions”), through repetitive stretching and pressure.
  2. Strain-Counterstrain: With this technique, the physical therapist will place the target area in a position where the least pain is experienced for a couple minutes, while applying mild stretching. The patient is slowly brought out of the position, allowing the body to restore the muscles to their normal tension. This technique is suitable for those who are suffering from acute pain given the placement in an area of least amount of pain.
  3. Muscle Energy Techniques (METs): Muscle energy techniques are used to lengthen shortened muscles and move restricted joints. Unlike other manual therapy techniques, METs are an active technique, meaning the patient participates in the movement. The patient contracts their muscles for several seconds against a counterforce precisely applied by the physical therapist. This is repeated as the joint’s range of motion increases, but does not stress the joint.
  4. Joint Mobilization:  Joint mobilization is needed to increase range of motion and improve overall joint mechanics by slowly and painlessly moving the joint in ways that the patient is unable themselves thereby achieving decreased muscle tension and pain.
  5. High Velocity, Low Amplitude Thrusting: This procedure is the most effective at restoring joints that are restricted in movements in one direction. It involves taking the joint to the end of its range of motion, and providing a quick thrust in the same direction just beyond a joint’s range of motion. It is more aggressive than joint mobilizations, but does not move the joint beyond its anatomical limit.

Does Manual Therapy Hurt?

Manual therapy does not always hurt, however there is often some discomfort inherent in the process since the physical therapist is actively manipulating a painful or tight area. Before beginning manual therapy, physical therapist’s will have a consultation with the patient to understand their unique condition and baseline their current range of motion, strength and flexibility. Physical therapists will modify the amount of force they are using depending on the injury and if the pain is chronic, acute, or post-surgical. After treatment, patients may experience some soreness for a day or two, but usually report an immediate increase in range of motion and reduced pain levels.

4 Workstation Ergonomic Tips You Can Try Today

    You’ve probably heard of ergonomics – the study of efficiency and comfort in the workplace – but are you taking the right actions to make your workstation or home office as easy on your body as possible? If you work in an office environment, you can prevent pain and injury and work more … Continue reading “4 Workstation Ergonomic Tips You Can Try Today”

 

 

You’ve probably heard of ergonomics – the study of efficiency and comfort in the workplace – but are you taking the right actions to make your workstation or home office as easy on your body as possible? If you work in an office environment, you can prevent pain and injury and work more effectively when you carefully consider every aspect of your work situation, including these:

1. Your chair.

Start with a good chair that includes lumbar support, then sit with your hips as far back in the chair as possible. If the back angle is adjustable, aim for 100 to 110 degrees, ensuring that you have support for your upper back as well as your lower back. Inflatable cushions or pillows can help. Move arm rests down so that your shoulders are relaxed rather than supporting the weight of your upper body. If the armrests don’t adjust, consider removing them.

2. Your keyboard and mouse.

For the greatest comfort and to keep from straining muscles over time, place your keyboard directly in front of you, and make sure both your keyboard and mouse are close to your body so that reaching isn’t necessary. Adjust the height of your keyboard so that your elbows bend to about 100 to 110 degrees and definitely not less than 90 degrees. If you sit properly, you may find it comfortable to adjust your keyboard to tilt slightly away from you. A palm support can help maintain a health wrist position as long as it isn’t taller than the space bar. You may even want to consider a special split keyboard if it’s more comfortable for you.

3. Your monitor.

Your monitor should also be centered in front of you. But the viewable area should be located 2 to 3 inches above your seated eye level – much higher than most people place it. (Lower it a bit if you wear bifocals – or consider getting computer reading glasses.) Make sure the monitor is at least arm’s length away and out of any glare from windows or overhead lights. Use glare filters and task lights as necessary, and make sure your landline phone and documents are within arm’s length and easy to reach without straining.

4. Your work schedule.

Breaks are essential to good blood flow. No matter how carefully you design your workstation, staying in any one place too long will take a toll. You need to stretch every 20 to 30 minutes for at least a minute. If possible, do something other than your usual work for 5 to 10 minutes per hour. Try to get away from your desk at lunch and look around to rest and refocus your eyes. Take every opportunity possible to stand, move around, look in the distance and stretch. Cover your eyes with your hands periodically to allow your eyes to relax and your body to rest. It all makes a difference.

Whether you have pain or stiffness that has just started or troubling you for months from too much sitting, typing, or other close work, physical therapy can help.  If you need suggestions on setting up your work station at the office or at home, physical therapy has solutions for you.

We’re here when you need us at Innovative Physical Therapy!

What Causes Chronic Neck Pain? And Can A PT Help?

Your head weighs 11 pounds or more – as much as a bowling ball! – and keeping it in the right position is hard work. Fortunately, your neck is a collection of bones, joints, muscles and nerves designed to be strong and stable. But small and large problems can lead to pain in the neck … Continue reading “What Causes Chronic Neck Pain? And Can A PT Help?”

Your head weighs 11 pounds or more – as much as a bowling ball! – and keeping it in the right position is hard work. Fortunately, your neck is a collection of bones, joints, muscles and nerves designed to be strong and stable. But small and large problems can lead to pain in the neck as well as in the head, shoulders, arms and hands.

Most neck pain goes away in just a few days or maybe a few weeks, but persistent pain may be a sign of a medical condition that needs treatment. If you have pain and/or stiffness that makes it hard to turn your head, stabbing pains in one or more spots, pain, numbness or tingling into either or both arms, soreness or tenderness of any kind that is not going away, it may be time to consider treatment.

The cervical spine starts at the base of your skull and involves seven vertebral segments called C1 through C7, each of which can have many different kinds of problems that cause pain, including disc herniations, disc degeneration, bone spurs, arthritis, muscle strains and/or ligament sprains.  You should get immediate medical help if you have any of these symptoms, which could be signs of a severe neck injury or condition:

  • Trouble holding onto or lifting items
  • Problems with balance, coordination or walking
  • Severe pain that makes daily activities impossible
  • Nausea, vomiting, blurred vision and/or dizziness

As many as 15 percent of us experience neck pain each year, according to research, but it certainly seems like more based on our experience. In many cases, poor posture is the primary cause of neck pain.  Learning better ways to sit and stand can alleviate this kind of pain. Your pillow can also cause neck pain. A pillow that is too hard or too soft, or providing the wrong amount of support, can cause nighttime neck issues that persist during the day.  How your desk or workstation is set up can also cause and/or contribute to your neck pain not going away.

How Physical Therapy Helps Neck Pain

If you are experiencing neck pain, please get help now. Research published last year in the journal Physical Therapy from the American Physical Therapy Association shows that getting physical therapy within 4 weeks of first experiencing neck pain means a better outcome for you, an easier job for your physical therapist and less cost for whoever is paying.  Your physical therapist uses special manual techniques to reduce your pain along with modalities that might include ultrasound, electrical stimulation, mechanical traction and cold laser.  You will also be taught exercises that will benefit you for years, including:

  • Neck stretches for flexibility to improve range of motion and elasticity in the cervical spine
  • Neck strengthening to maintain better head and neck posture
  • Aerobic (cardio) conditioning to increase blood flow to the muscles and soft tissues

Don’t let neck pain derail your plans. Get help from a physical therapist. The sooner you get treatment the quicker you can get on with your life doing the things you enjoy!

The Real Truth About Hip Pain

Do you have pain in your hip that limits your ability to walk, put on your shoes and socks, work, or enjoy your life? Do you have sharp, shooting, or a dull achy pain in your hip, groin, thigh, knee or buttocks? Do you have stiffness in your hip joint which is worse after sleeping … Continue reading “The Real Truth About Hip Pain”

Do you have pain in your hip that limits your ability to walk, put on your shoes and socks, work, or enjoy your life?

Do you have sharp, shooting, or a dull achy pain in your hip, groin, thigh, knee or buttocks?

Do you have stiffness in your hip joint which is worse after sleeping or sitting?

Do you have difficulty or pain when getting out of bed, standing up from a sitting position, or climbing stairs?

If so, you may have hip osteoarthritis. According to the American Physical Therapy Association, hip osteoarthritis is inflammation of the hip joint, a condition that is more likely to develop as people age. Osteoarthritis results when injury or inflammation in a joint causes the soft, shock-absorbing cartilage that lines and cushions the joint surfaces to break down.  Muscle weakness, being overweight, previous injury and hip joint instability are thought to contribute to the deterioration of cartilage. When the cartilage is damaged, the joint can become painful and swollen. Over time, this condition can cause stiffness and even more hip pain.

How can Physical Therapy help?

Your Physical Therapist will evaluate your body to determine where your deficits lie whether it be loss of motion, decreased strength, poor balance, or just pain in the hip.  They will then differentiate if it is truly just hip involvement or whether the back, knee, and ankle for example play a role in your pain.  He or she may recommend that you consult with an orthopedist, who can order diagnostic testing such as an x-ray or MRI, to confirm the diagnosis.  Together you and your therapist will then determine a treatment plan and get you back to your normal daily activities.

Your physical therapist can use different types of treatments and technologies to control and reduce your pain, including manual (hands-on) therapy techniques, taping, ice, heat, infrared, ultrasound, and electrical stimulation.  They may offer an assistive device such as a cane or crutch to help off load the affected joint.

As your hip pain and inflammation settles, your therapist will turn their attention to restoring your normal hip joint range of motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and proper walking pattern.

What Is TMJ and How Can a Physical Therapist Help?

People commonly mistake referring to conditions affecting the jaw as “TMJ”. TMJ actually refers to the jaw joint itself, or the temporomandibular joint. The correct reference to conditions limiting or affecting the natural function of the jaw is TMD, or temporomandibular disorder. TMD interferes with the normal movement of the jaw, limiting or restricting opening … Continue reading “What Is TMJ and How Can a Physical Therapist Help?”

People commonly mistake referring to conditions affecting the jaw as “TMJ”. TMJ actually refers to the jaw joint itself, or the temporomandibular joint. The correct reference to conditions limiting or affecting the natural function of the jaw is TMD, or temporomandibular disorder. TMD interferes with the normal movement of the jaw, limiting or restricting opening and/or closing of the mouth, which can affect talking, eating, and/or yawning. TMD is so common a disorder that current statistics has it affecting more than 10 million people in the US. TMD affects more women than men, and more common amongst people aged 20 to 40.

Causes for TMD vary greatly. The most common are the result of chronic grinding, excessive jaw clenching, jaw locking due to the jaw muscles going into spasm from the mouth being open too long (commonly seen after extensive dental work), and poor teeth alignment (called malocclusion) that may also require braces, mouth guards or mouth splints. Less common is direct forceful trauma (bruise or fracture) to the jaw itself, and even after healed, joint pain and stiffness may result.

Poor posture plays a big role in TMD causing strain to the jaw and neck structures. Issues with the neck play a significant role in TMD. Not every person with a neck problem has TMD, but most people experiencing TMD have issues with their neck. Arthritis in the jaw may result from TMD or be a cause of TMD resulting in painful inflammation. And surgeries to the face and especially to the jaw may restrict joint mobility resulting in TMD.

What is the role of a physical therapist in treating TMD?

A physical therapist specializing in treating the TMJ can significantly help people experiencing signs and symptoms of TMD through treatment designed to ease jaw pain and restore normal jaw function. Not all physical therapists are trained in the treatment of TMD so it is important to find one that has experience in this area.

Upon completing a thorough evaluation the physical therapist will devise an individualized treatment plan that will include posture training, go over TMD guidelines for pain relief, prevention and relaxation; use manual therapy techniques inside and outside the mouth to restore normal joint and muscle function; provide neck and upper back strengthening exercises to improve posture; teach gentle jaw exercises to restore normal movement; and use a variety of treatment tools including cold laser, ultrasound, electrical stimulation, heat and/or cold to relieve pain and inflammation.
If the physical therapist determines that the TMD is caused by problems with teeth alignment and/or that a specialized mouth guard or appliance will help, a referral to a dentist or a dentist specializing in treating TMD will be recommended.

If you are experiencing jaw pain, jaw popping with opening and/or closing the mouth, having difficulty opening your mouth to talk, eat and/or yawn, having neck pain, headaches, unexplained dizziness, ear pain, and/or ringing in the ear you may be having symptoms of TMD. If so, scheduling an evaluation with properly trained Physical Therapist may be your best medicine.