How Physiotherapy Can Tune Your Body and Repair It
Physiotherapy or physical therapy is a treatment for patients who are experiencing limited motion, strength or function in an area of their body. The patient may experience these limitations as a result of an injury, accident, or may have limitations from birth. Work injury physiotherapy can help restore movement, and improve the quality of life for its patients. Almost everyone could benefit from sports physiotherapy at some time in their lives. Day to day living is hard on our bodies, we continually put them to the test with sports and work activities, and sometimes experience injuries through no fault of our own, such as in the case of a car accident.
A qualified physiotherapist can help you recover from an injury or simply help relieve your pain and bring you more movement in the case of medical conditions such as cerebral palsy or after a stroke. He or she will do an assessment on you to determine what the problem is, take a medical history, and explain to you what is needed for recovery. Diagnostic tests such as x-rays or an MRI may be necessary to determine the nature of the condition. Next comes a treatment plan, involving the physiotherapist and you, as he or she will most likely give you some exercises to do on your own at home to help aid in your recovery and speed up the healing process.
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Some of the treatment choices for physiotherapy are exercise programs geared towards the specific condition and patient ability and lifestyle, massage, heat or ice packs to assist with pain and reduce inflammation, muscle re-education, and joint manipulation and/or mobilisation to help regain movement in the affected area.
A physiotherapist may also prescribe the use of a mobility aid, such as crutches, a walker, cane or wheelchair as either a temporary or permanent measure.
Another instance where physiotherapy may come in to play is post surgery. Post operative patients having had surgery for a fracture or joint replacement may need assistance in re learning how to use the limb or joint, and physiotherapy can help. In the case of amputation, physiotherapy can help a patient learn how to live with and make use of a new prosthetic limb.
Physiotherapy plays an important role in health care and overall well being. Whether you come to need physiotherapy as the result of a disability, an injury, surgery, stroke or medical condition, you will be working with a trained professional who can help you get the most out of life.
The Importance of Physiotherapy.
Many times individuals seek the help of a physiotherapist in order to minimize the amount of pain that they may be feeling throughout their muscles and general body. The majority of individuals who seek the help of physiotherapists are experiencing pain and/or discomfort from age, injury, or diseases.
The main priority of embarking on a physio therapeutic journey is to identify what the issues with the body are and determining a course of treatment in order to maximize the life potential of the patient and to increase their general mobility throughout the day. With the implementation of treatments, and rehabilitation, physiotherapy can drastically create a better living experience for the patient.
With the combination of the patient’s history and a physical examination, physiotherapists will be able to determine a diagnosis and a reputable treatment and management plan that should be followed. Physio is used throughout a variety of different medicinal fields including: cardio, geriatrics, neurology, orthopedics, pediatrics, and other common areas of medicine. With the ability to practice medicine within any practice in the world, physiotherapists are easily and readily available whenever the patient seeks assistance.
If you have determined that your body has been giving you an abundance of pain, you can expect physiotherapy to assist you with:
1. Reducing overall body pain
2. Improving joint movements
3. Increasing the overall strength of an individual
4. Helping with rehabilitation from sports injuries
5. Aiding in the recovery of the individual after an injury
6. Recovery aspects before and after a surgery
7. Maintaining a treatment for chronic pain
8. Reducing headaches
9. Improving respiratory functions
Absolutely anyone will be able to benefit from the use of physiotherapy, regardless of whether they are experiencing an injury or if their age has reduced their range of movement. With the ability to attend a few sessions of muscle and strength building, individuals are provided with the opportunity to completely revolutionize their lives. For individuals who are old or young, physiotherapists can actively diagnose the issue and then come up with a method of treatment that is suitable for every individual. As one of the most popular methods for reducing pain and increasing mobility, physiotherapy has drastically changed the lives of many individuals throughout the world
Physiotherapy For Knee Injuries.
If you have ever experienced an injury to the knee then you will know that it can be one of the most painful places to get hurt. Its not an experience that you would wish upon anyone. It can really be a killer especially for those that play sports. There are athletes all over the world that experience the pain of knee injuries every year, and it can be as simple as a small sprain to something as serious as a tear. Thankfully most of the injuries that athletes experience are minor and they do not have to go into surgery. The great thing with small injuries is that an athlete can do physiotherapy treatment to the injured area to relieve the pain that they may be experiencing and get themselves back in action for the sport that they play in.
The first thing that doctors recommend to most patients that have experienced a knee injury is to seek physiotherapy treatment. More specifically they recommend it those that have experienced any kind of strain, torn ligaments, or torn tendon. Where an injury is serious and physiotherapy is not working to relieve the patient of the pain that they are experiencing then will a doctor consider the option of surgery to be done. Surgery is the last thing that the doctor considers, and never seen as the first resort, when a person has injured their knees. The problem of doing knee surgery on a patient is that the pain experienced can be horrific and recovery can take a long time.
There are many different kinds of knee injuries that a patient would experience some pain. The most common type of injury caused to the knee is a ligament sprain which happens when there is a sudden twist caused to the knee usually done by jumping or running. If a ligament gets torn then it can cause internal bleeding in the knee which will result in the knee swelling up. In some cases a torn ligament does require surgery but it can often be fixed with physiotherapy, but a sprained ligament can usually be sorted with just physiotherapy treatment.
So there you have it if you do experience a knee injury then in most cases the doctors advise would be to seek out physiotherapy treatment which will most likely solve the problem. Only if a doctor sees the injury as serious will surgery ever be considered.
Treating Sports Injuries With Physiotherapy
There is nothing more devastating than a sports injury in the life of an athlete. For people fueled with passion for a career in sports and athletics, being physically hampered is the least they want to be. The dreadful thought of not being able to get back on track is often the culprit of frustration; however, it is also the driving force that pushes athletes to seek for immediate means of recuperation. Aside from athletes, more and more people are submitting themselves into the thrill and hype of sports for recreation and health reasons. Because majority of these people are not skillfully trained in this field of action, they easily succumb to the pressures of physically demanding activities, thus becoming highly predisposed to the likelihood of ending up with sports-acquired injuries.
Muscles of an injured body part if left immobile or unused will atrophy – this is a medical condition that suggests decreased muscle mass possibly leading to complete or partial muscle wasting. To avoid such, physicians, after a series of lab work-ups and medical regimen, would recommend rehabilitation measures to injury-inflicted individuals to hasten recovery. Physiotherapy is an option highly suggested because it allows recovery of strength and function of the injured part.
In physiotherapy, patients who have had sports-induced musculoskeletal injuries would be subjected to manual therapies, massage treatment, electrotherapy techniques or range of motion exercise programs with the aid of a competent physiotherapist. All of these treatment procedures are aimed to rejuvenate the function of affected areas by inducing blood supply and regaining muscle strength. The duration of this rehabilitation option might take weeks, months or even close to a year depending on the severity of acquired sports injury. Through physiotherapy, a previously injured athlete or sports enthusiast can be assessed as to whether or not they are capable to get back on track and resume their enthusiasm for that sport activity that they do best.
Physiotherapy for Shoulder Rotator Cuff Injury.
The shoulder is one of the most mobile joints in the body, allowing us to reach out and grab an object and place it almost anywhere. This is all possible because of our rotator cuff muscles, which are always active during arm movements to keep the ball of the shoulder in the socket. It is no surprise then that the rotator cuff is subject to overuse and injuries are commonplace in the physiotherapy clinic.
The rotator cuff is made up of 4 small but important muscles which play a key role in the stability of the shoulder. These are the supraspinatus, infraspinatus, subscapularis and teres minor muscles. More often than not, it is the supraspinatus that is at fault however any one of these muscles can be injured either in isolation or in conjunction with one another.
While injury can occur from an acute incident, such as falling onto an outstretched arm, it is more likely to be caused from repetitive overload of the shoulder musculature and come on gradually. Due to this fact, these conditions usually affect people over the age of 35, however they are also quite common in the sporting population, especially “overhead athletes” such as swimmers, throwers and those involved in racquet sports.
Common complaints are:
1. Pain when moving the arm out to the side
2. Difficulty sleeping on the injured side
3. Difficulty doing overhead activities, such as hanging out the washing, putting things away on the top shelf
4. Dull ache in shoulder after activity
Several things can predispose a person to a rotator cuff disorder, however the most common cause is impingement of the rotator cuff due to abnormal scapulo-humeral rhythm (the integrated movement of the shoulder blade and arm) and weak rotator cuff muscles. Poor scapulo-humeral rhythm is often the result of muscular tightness and strength imbalances and can be effectively treated by physiotherapy. It is important to get your assessed early on. the longer you leave getting your shoulder treated the harder it becomes to treat and the more likely you are to get secondary problems.
Physiotherapists are well trained in assessing the shoulder and identifying the cause of rotator cuff disorders. A consult with one of these health professionals should involve a thorough examination of the shoulder biomechanics, the spine, and the muscles of both the rotator cuff and scapula. They will then go on to treat the problems that they find using evidence-based treatment techniques such as massage, mobilisation and dry needling. Furthermore, a rehabilitation program specific to you will be prescribed and should include a range of exercises and stretches to help correct the abnormalities and strengthen the rotator cuff.
Physiotherapists have the clinical skills to assess and treat posture and muscle imbalances, and overuse injuries of the shoulder muscles. The physiotherapist will develop a strengthening program to restore normal function of the shoulder and prevent recurrence of
Physiotherapy For Spinal Cord Injury.
Spinal cord injuries (SCI) are one of the most serious consequences of high speed accidents or sporting activities, a rare but devastating injury which can also occur after infections, tumours or ischaemic damage. The largest risk group are younger people due to their propensity to perform risky activities but a person of any age can suffer from SCI. Car and motorcycle accidents account for the highest proportion of injuries and due to the complicated picture after this injury a multi-disciplinary team of professionals is vital to ensure the patient reaches the highest level of independence for their particular condition. The terms quadriplegia and paraplegia are used to describe the resulting disability.
The initial medical evaluation is performed to establish the respiratory status of the patient and deal with any other of the likely multiple injuries. Once the patient is stabilised the doctors try and work out the level in the spine where the damage has occurred, an important fact as it relates closely to medical and therapy management. A low lumbar fracture will have no effect on the arms or the ability to breathe so the patient will have good trunk and arm power and the aerobic ability to develop independence. Cervical and upper thoracic injuries impair the respiratory ability of the patient and limit arm function, making rehabilitation much harder.
The first thing to establish is the level of the injury, a diagnosis that is very important as it indicates the whole path of medical and physiotherapy management. If the spine is fractured low down in the back there should be few, if any, respiratory consequences and the patient will have full power in their arms and chest to achieve independence. If the injury is high, in the thorax or the neck, this may compromise the patient’s ability to breathe spontaneously and will mean a much more difficult rehabilitation period with limited independence overall.
Respiratory physiotherapy consists of assessing the patient’s respiratory ability, teaching the patient to deep breathe and expand the lungs fully, and cough to expectorate. If the lower abdomen is paralysed the patient may need to stabilise the area with their arms to allow a propulsive cough. In more disabled patients the physiotherapist may stabilise, helping the air to exit suddenly in coughing. A cough assist machine can be used to provoke a cough, and initial management in intensive care may also involve respiratory suction.
If the spine is unstable, which it often is in spinal trauma resulting in paraplegia, a spinal surgeon will stabilise the spine, usually with instrumentation and bone grafting. This allows the patient to start their rehabilitation without the long wait for the spinal fractures to heal naturally. Initial physiotherapy management is to monitor the respiratory status, encourage active movement of unaffected areas and perform passive movements of paralysed body parts to retain and improve the ranges of motion which will be required later for independence.
The physiotherapist will progress the patient gradually into a more upright posture by putting the back of the bed up. If got up too quickly, the patient’s blood pressure can drop suddenly and this must be avoided, so the patient is eventually transferred into a wheelchair with a sloping back and elevating leg rests. Gradually they become more upright and can start practising sitting balance on a plinth as trunk control is often poor and must be mastered before arm and trunk strengthening and wheelchair transfers can be safely practised.
By this time the patient will have learned trunk control in sitting, wheelchair transfers and strengthening work, so at this stage they should be routinely transferred to a unit specialising in spinal injuries. Experienced advice from the multidisciplinary team about the large number of skills they need to learn is available there to foster the highest level of independence. Many factors impact on whether the patient can lead a fully independent life including their age, other medical difficulties, family support, motivation and attitude and the spinal level affected. Some people with higher lesions may need routine care from a pool of carers throughout the day.
Physiotherapist Treatment of Acute Lower Back Pain
Acute Lower Back Pain is one of the most common conditions that Physiotherapists see. It can occur from even the most minor of events, such as leaning over to pick something small off the floor, or sneezing. The pain experienced can range from being reasonably mild to the point of being unable to move. The area in which the pain is felt can also vary – from being concentrated in the Lower Back to being felt into the leg. The Lumbar Spine (lower back) has a number of structures in it that can be affected when an injury is sustained. The major ones include: – the discs between vertebrae – the Facet joints (the joints joining vertebrae together) – and/or the muscles in the lower back. In many cases, there will be a combination of the above.
So what does diagnosis actually mean?
When you first consult your Physiotherapist, you will be made to perform a series of movements and tests that will help the therapist get a better idea of where the pain is actually coming from. When the disc is involved, it usually means that the outer ring, the Annulus Fibrosis, is damaged, and could be causing a “disc bulge”. In severe cases, the disc can tear right through, causing what is known as a Disc Herniation or more commonly known (but incorrectly) as a “slipped disc”. When the facet joints are involved, the pain may be more concentrated on one side of the lower back, with accompanying restriction in movement.
The Joints in the lower back can be injured in the same way as other joints in the body, such as the ankle. This means that they can also suffer from sprains, and cartilage dysfunction. Commonly with injuries to the facet joints the swelling process is set off, as with any other joint injuries. This means that swelling will occur, which puts pressure on the surrounding structures in the lower back, and increases the intensity and area of the pain felt. In many conditions, there will be an element of neural or ‘nerve’ involvement, with either tightness or a loss of sensation being felt in your extremities. Although indicative of a more serious problem, this does not mean that the problem cannot be resolved reasonably quickly.
What Do to Do?
STAGE 1: Pain Management Rest:
Avoid using the back in anything even remotely strenuous. Ice: Early; Often in the first 48 hours, over the area of pain; 15-20 minutes every 2-4 hours. Try to keep the back moving within your range without pain – this will reduce stiffness and prevent muscle wasting. Contrary to popular belief, complete immobility is not ideal. Taping may be an option to help with immediate pain relief.
STAGE 2: Sub-Acute Management.
Pain reduction and Restoration of movement will be the focus of treatment at this stage. Manual Therapy applied by the Physiotherapist will likely be the main treatment modality used. Soft Tissue (e.g. Muscle) manipulation are likely to be used by the Physiotherapist. Your Physiotherapist will guide you as to what you should expect, according to you individual condition.
STAGE 3: Return To Function.
Once movement has started to return, and pain begins to subside, the focus of treatment will turn towards restoration of function. In some cases, a graded rehabilitation programme will begin, aiming at ensuring that no muscle strength is lost, and that core stability is maintained. Your Physiotherapist will guide you through any rehabilitation programme step by step. Return to normal function at work will be a major goal – ensuring that you are able to perform your work tasks safely and comfortably. In this stage, time frames can be hard to quantify for injury resolution. The initial severity and the structure injured in many cases is the main determinant as to how long the injury may take to resolve. If you are at all concerned about how long the injury is taking to resolve, do not hesitate to speak with your therapist.
Physiotherapy Management of Hamstring Injuries.
The accurate diagnosis of the injury and the degree of its severity is the crucial factor to be decided initially as this indicates how the injury is to be expected to improve and how long it will be until the patient has functionally recovered. The mainstay of treatment is physiotherapy and the physio has to decide the how to progress the treatment according to the level of tissue injury and the time which has elapsed since the event. There is no effective scientific evidence for managing this kind of injury and the physiotherapist will design the rehabilitation programme individually to suit the particular and variable requirements.
There are three initial phases which hamstring injuries can be classified into: the acute phase, the sub-acute phase and the remodeling phase. There is a different treatment plan and strategy for each phase and the time elapsed since injury. The acute stage can last up to the end of the week since injury and the main aims are to reduce the levels of inflammation, pain and swelling secondary to the tissue damage. Treatment normally follows the PRICE system: protection; rest; ice; compression; elevation. Protection is aimed at eliminating any significantly harmful stresses to the damaged tissues, with the treatment options of using crutches to limit the amount of weight on the leg or bracing the knee in flexion.Rest is the second requirement to protect the damaged muscle tissue by eliminating force through the area although athletes find this difficult to adhere to. Ice is a primary treatment for acute injuries and reduces pain when applied for approximately 20 minutes, with a check after 10 to ensure skin health. Cold inhibits inflammatory changes in the local area by reducing metabolism and so the amount of circulation coming to the area. Compression may be more useful than cold, which is typically used by physios, and controls local swelling, with elasticated bandages applied to the limb an effective strategy.
For acute injuries elevation of the affected parts is usually advised with the part lifted above heart level to give the best effect in providing build up of tissue fluid. The position of the injury to the hamstrings makes elevation impractical and it may be unnecessary. A reduction in the levels of pain and inflammation allows the physiotherapist to start passive movements to the limb and to prescribe active assisted movements. Physios avoid stretching at this point as this may aggravate the symptoms and damage the area. Minor hamstring injuries typically recover in a few days but should still be managed appropriately.
Soft tissue injuries take at least six weeks to heal, even minor ones, so once feeling much better athletes should be encouraged to ease slowly into doing more stressful activities and should pay attention to strengthening muscles, stretching and balance to reduce the likelihood of the injury recurring. In the sub acute phase, which lasts until about three weeks after injury, the pain and inflammation of the acute injury should be reducing and so the physiotherapist can progress the treatment on to active range of motion exercises and then to muscle strengthening.
To facilitate hamstring rehabilitation without a high degree of weight bearing on the limb it can be appropriate to use pool therapy and patients can continue with their aerobic training to maintain their cardiovascular ability and arm training. The injured area will be exercised with sub maximal training effort. The phase of remodelling takes the injury towards the six week time after the injury and the physio will test to see if the patient can cope with a full strength contraction without any pain. If successful the rehab can be progressed via through range exercises (isotonic) with light weights and high repetitions.
The patient starts this process in prone with light ankle weights, progressing to heavier and heavier resistance provided the pain in the injured area is not provoked. The progression of weights should be conservative as too rapid an increase may lead to relapse and a more long term problem. Once the patient has achieved good strengthening with the muscle shortening (concentric contraction) they should be progresses to strengthening with the muscle lengthening (eccentric contraction).