Physical Therapy

Our Modern Approach to Rehabilitation

1. PURPOSE

The two main purposes of your customized exercise prescription are first to speed tissue healing, recovery, and pain relief. Secondly, rehab will help to restore function to the “key link(s)” responsible for your problem.

2. JOINT STABILITY

Strength training (which builds mostly superficial muscles) commonly leads to injury and does very little to speed recovery or decrease your risk of future pain and injury. Our modern approach to rehabilitation emphasizes core stability, coordination, and control of movement. You will train your muscles to protect your joints by “co-contracting” around the joints of this region.

3. MUSCLE BALANCE

Our approach is also different from traditional strength & conditioning programs in that it addresses the important issue of muscle balance. First, joint manipulation helps to restore normal muscle balance by decreasing nerve irritation, which can cause increased muscle tension and/or muscle inhibition. Next, your tight or "overactive" muscles are relaxed and/or stretched. This facilitates your weaker or "inhibited" muscles to function better and respond to the exercises faster& more completely.

4. PROPRIOCEPTIVE TRAINING

Proprioception involves communicating (via the nervous system) the exact position & movement of our joints, so that our muscles contract as quickly as possible to properly balance the body and stabilize these joints. Proprioception becomes slow and altered after an injury and as we age. So even if you “recover” from an injury, and even if your muscles are “strong”, your body cannot protect your joints and coordinate proper movement if they are not getting the proper messages. This can cause impaired balance & coordination, leading to repetitive stress on all the muscles & joints of the body, making them more susceptible to injury and pain. Since we balance on one leg 80% of the time we walk, impaired proprioception leads to repetitive strain on the body with every step. Improving it leads to better joint stabilization, decreased pain, and reduced chance of re-injury.

5. FUNCTIONAL TRAINING RANGE

In order to get the best results from your exercises, and to prevent further injury, all exercises should be performed in your own functional training range. This is defined as the range of movement which can be performed comfortably, and while maintaining proper form & control. This range is unique to you, and may change over time as you improve. We will help you to identify your own range, and then continue to monitor your ability to train independently within your range. Unless otherwise instructed, none of your exercises should cause you any increased pain or discomfort. In fact, it is essential that your stretches and muscle relaxing exercises (PIR's), are done gently, with no discomfort and no "intense" stretching sensations. Your stabilization & strengthening exercises may cause mild to moderate muscle "burn" or soreness, but only in the target muscles which you are attempting to train.

6. REPS & SETS

The best general advice for most of your stretches and muscle relaxing exercises (PIR’s) is to perform them gently, as often as you like, but at least once or twice per day. In the beginning, you may get better results performing your stretches several times throughout the day. As your condition begins to improve, you may find that once per day may be enough – just let trial & error be your guide. As you progress, more emphasis is placed on your stabilization & strengthening exercises. In general, you should do as many “good” reps as you can, before becoming tired or unable to properly control the movement(s). More specifically, you should do somewhere between 5-15 reps of each exercise. Usually, these should be done once or twice per day. As you improve, you will have the option of experimenting with decreasing the number of sets (once per day or every other day).

7. WILL I HAVE TO DO MY EXERCISES FOREVER?

This will depend on many factors including your age, how active you are, how long ago your condition began, how many prior episodes of pain you’ve had. In general, if you continue to perform all of your exercises, you will have a better chance of feeling better, performing & functioning better, and decreasing your risk of future episodes. It's beneficial to stretch every day, but the amount of stretching you’ll "need" to do will vary depending on how stiff or tight you feel. You will probably find that you can maintain the improvement you’ve made by doing your stabilizing exercises 2-3 times per week.

8. HOW TO WARM UP AND STRETCH

Regardless of if you have been prescribed specific stretches for your condition, it is important to follow guidelines for proper warm-up & stretching whenever engaging in any strenuous activity. Whether it be sports, exercise, heavy lifting, or shoveling snow, the best way to prepare for any strenuous activity is to first warm-up, then stretch, then perform the activity, then stretch again. (If you have to skip a step, skip the pre-activity stretch. Don’t skip the warm-up – this is the most important part!) Your warm-up should be 5-10 minutes of gentle movement. The purpose is to increase blood flow to the muscles, joints, tendons, and ligaments, which will cause them to literally become warmer. Warmer muscles, joints, tendons, and ligaments are more elastic, and therefore more resistant to injury, pulls, tears, and cramps. Examples of warm-ups are walking, light jogging, easy cycling, or any activity that takes your body through a similar motion as the particular activity you will be performing. Stretching should be comfortable, relaxing, and gentle. Less is more. Stretching to pain or discomfort may cause increased muscle tightness, and possibly harm. Holding a stretch for less than 20 seconds may cause increased muscle tightness, and possibly harm. Recommended hold time for stretching is 30-60 seconds per stretch.