Physiotherapy Modalities/Treatments
Spinal and Peripheral Manipulation Therapy
Joint and Soft tissue mobilization
Low Level Laser Therapy (LLLT)
Electromuscular Stimulation (EMS/ muscle stim)
Therapeutic Exercise
Therapeutic exercise can be one of the most effective elements of a physiotherapy-based rehabilitation. A PT will essentially prescribed certain exercises for an individual to perform during appointments and when they are away from the clinical setting. The exercises recommended by a PT attempt to do one or more of the following:
• Mobilize joints
• Release contracted muscles, tendons and fascia
• Improve muscle strength and joint stability
• Improve functional mobility and balance
• Enhance performance
The power of therapeutic exercise in a rehabilitation program is that often individuals can complete the exercises on their own time. This further promotes physiotherapy’s goal of independent injury recovery and prevention. The PT acts more like a teacher, guiding patients through the correct movements so that they can properly perform the exercises and continue them even when their clinical treatment is complete. It is important to consult a PT before beginning. Their advanced understanding of the human body allows them to tailor a program to a specific individual, their abilities and their injury.
Manual Therapy encompasses the treatment of health ailments of various etiologies through ‘hands-on’ physical intervention and manipulation. This form of physical treatment usually refers to hands-on techniques and includes:
Spinal and Peripheral Manipulation Therapy:
This involves the skillful movement of joints beyond their active limit of motion but within their anatomical abilities. It is a localized, high-speed, controlled thrust, and may cause an audible click or “popping” sensation that is usually painless. Joint manipulation can be performed on most joints of the body.
Joint and Soft tissue mobilization:
The therapist gently coaxes motion through subtle but precise movements.
Myofascial release is the mobilization of neural tissue and various connective tissue. Using various hands-on techniques, the therapist stretches the neural and connective tissues such as the fascia. Fascia is a connective tissue that connects bones, muscles and organs.
Craniosacral Techniques:
The use of delicate manual techniques of light touch to detect and correct imbalances, release problem areas and relieve undue pressure on the brain and spinal cords.
Low Level Laser Therapy (LLLT)
LLLT is the application of red or near infrared light (600-1000nm) to tissue to assist in the healing of injuries and to reduce pain.
The effect of LLLT is Photochemical and not thermal. LLLT aids in the production of ATP (the energy source of all cells) and thus helps the cells achieve an optimal state to assist in the natural healing process.
LLLT is used to increase the speed, quality and tensile strength of tissue repair, resolve inflammation, and give pain relief. The technical term often used to describe this form of therapy is “photobiostimulation.”
LLLT is indicated, but not limited to, in the following:
• A soft-tissue injury
• Chronic pain
• Post-op pain
• Joint dysfunctions
• As a substitute for acupuncture
LLLT is an attractive form of treatment for athletes and the weekend warrior due to the prospect of shorter recovery and lay-off times.
IFC is used to reduce pain, promote healing of soft tissue, decrease local swelling, and aid in the restoration of normal movement. By sending electrical impulses through electrodes in the tissue in the area of pain, it changes the firing of the nerves and their conduction of pain signals to the brain. IFC also increases local blood flow which can improve healing by reducing swelling and as a result helps to remove damaged tissue and bring nutrients necessary for healing to the injured area.
Most treatments last ten to fifteen mintues and patients descried as relaxing with a ‘pins and needles’ sensation. This feeling should be strong but not strong enough that it feels painful.
IFC should not be used on patients with pacemakers or cancer. It should also not be used over the uterus, pelvis, or lumbar spine of a woman who is pregnant.
Electromuscular Stimulation (EMS/ muscle stim)
EMS generates a weak electric impulse, which produces a strong muscle contraction similar to a normal voluntary contraction. With the use of EMS, the specific muscle involved can be controlled by the placement of the electrode. Therefore, the use of EMS allows a muscle to be activated, which may be otherwise difficult to activate through regular exercise.
EMS is often used post-surgically when the muscles need to be re-educated. It is also used to activate the smaller muscles in the spine, which help to achieve core stability. The goals are to provide muscle re-education and increase client awareness of muscle activation. Therefore clients who are having difficulty initiating/recruiting specific muscle activity may benefit from EMS.
Treatments usually last ten to fifteen minutes, and it will feel like a strong tingling feeling that is slightly uncomfortable but not painful. It should be strong enough to visibly see muscle contractions.
Ultrasound is a therapeutic modality used by physiotherapists. A round-headed wand is put in direct contact with the patient’s skin. Ultrasound gel is used to assist in the transmission of the ultrasonic waves into the tissue. The waves are generated by a piezoelectric effect caused by the vibration of crystals within the head of the wand. The sound waves that pass through the skin cause a vibration of the local tissues. This vibration or cavitation can cause a deep heating locally, although, usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, such as a fresh injury with acute inflammation, the ultrasound can be pulsed rather than continuously transmitted.
A typical ultrasound treatment will take from three to five minutes. In cases where scar tissue breakdown is the goal, this treatment time can be much longer. Some conditions treated with ultrasound include:
• Tendinitis
• Muscle Spasm
• Bursitis
• Swelling
Ultrasound can produce many effects other than just the potential healing effect. It has been shown to cause increases in tissue relaxation, local blood flow, range of motion and scar tissue breakdown. The effect of the increase in local blood flow can be used to help reduce local swelling and chronic inflammation.The intensity or power density of the ultrasound can be adjusted depending on the desired effect. A great power density (measured in watt/cm2) is often used in cases where scar tissue breakdown is the goal.
Acupuncture is a method of encouraging the body to promote natural healing and to improve functioning by inserting needles and applying heat or electrical stimulation at very precise acupuncture points.
Needling into the acupuncture points stimulates the nervous system to release chemicals in the muscles, spinal cord, and brain. These chemicals will either change the experience of pain, or they will trigger the release of other chemicals and hormones which influence the body’s own internal regulating system.
The World Health Organization recognizes the use of acupuncture in the treatment of muscular and neurological disorders such as:
• Low back pain
• Headaches
• Tennis Elbow
• Various forms of tendonitis
• Neck pain
• Frozen shoulder
• Sciatica
• Osteoarthritis
Patients are video-taped for analysis of biomechanics, techniques, movement disfunctions and injury compensation.
- Running/Gait analysis
- Throwing Analysis
- Golf swing Analysis
PTs will design sports-specific exercise regimen to speed recovery and strengthen joints and muscles with a particular sport/activity-related outcome.
