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Common Physical Therapy Techniques

Physical Therapy

Standard Physical Therapy Techniques include heat and cold treatment to encourage vasodilation (expansion of blood vessels). This helps your body get more oxygen, decrease swelling, relax stiff muscles, reduce pain, and enhance range of motion. Physical Therapy

Instrument-assisted soft tissue mobilization uses tools that give your therapist extra leverage to move muscles and joints. Myofascial release is a manual therapy technique that feels around for tight spots in your fascia to restore their flexibility.

Joint mobilization is a hands-on treatment technique used by physical therapists and chiropractors (healthcare professionals that specialize in treating disorders of the musculoskeletal system including bones, muscles, and soft tissue). This manual therapy technique involves using skilled graded forces to move a painful or stiff joint in specific directions. Depending on how it’s implemented, joint mobilization can help improve motion around the joint, minimize pain, and reduce stiffness.

There are different types of joint mobilization based on how aggressively or passively the movement is delivered to the joint. The most conservative type is called gliding, which is similar to stretching of a muscle but is specifically targeted at the joint capsule. The most aggressive technique is called manipulation or chiropractic adjustment and can be performed at a number of grade levels.

In general, most therapists would only utilize joint mobilization if the diagnosis was of a hypomobile or “locked” joint. This can be diagnosed through the use of a goniometer, which measures the largest angle that the joint moves at a specific point. The therapist can also determine whether the joint is restricted by tight muscles, tight ligaments, or a bone out of place.

Once the diagnosis is determined, the therapist can use several techniques to mobilize the joint. They can start by gently gliding the joint and then progress to more forceful thrusts. The technique has been referred to as high-velocity low-amplitude thrust (HVLAT) mobilization/manipulation by some authors.2

There is a general concern that joint mobilization/manipulation may damage the joint structure. However, if the therapist is cautious and precise with the movement, this should not be the case. Seven different sources cited a list of 51 concerns regarding joint mobilization/manipulation, with most being related to incorrect positioning of the joint during mobilization and/or a reversal in direction of the movement.

Several studies have shown that joint mobilization is an effective treatment for adhesive capsulitis (frozen shoulder). Yang et al,3 found that end-range and mid-range mobilization produced more effective outcomes than mobilization with movement in their study of 28 subjects with adhesive capsulitis.

Soft Tissue Release

Soft tissue release is a hands-on manual therapy treatment technique that manipulates muscles, tendons and ligaments to relieve pain and improve movement. Physical therapists use a variety of techniques to stretch and massage these tissues to loosen them up and help improve circulation. This can reduce inflammation, promote healing and decrease muscle spasms. Soft tissue release is often combined with other PT techniques to maximize their effectiveness.

When a muscle is healthy, the fibres within it alternate neatly with each other and with attachment points to bones and other tissues. Acute or chronic injury can disrupt this balance, causing tightness and reduced flexibility. Injured muscle fibres can also become tangled together, leading to pain and stiffness. This type of injury can result in swelling, adhesions or fibrosis (scarring). Soft tissue release is used to break up and loosen these damaged fibres, reducing pain and improving mobility and function.

This type of therapy involves the therapist kneading, rolling and manipulating the muscles and tendons. While this may be painful at times, the therapist will only apply pressure to the area where the patient experiences pain. This type of massage is not meant to be deep, but rather light and soothing. The therapist will also use the patient’s breath to control the tension in the muscles and tendons, helping them relax.

Unlike conventional massage, this type of PT is often performed on specific areas of the body such as the shoulders or hips. This is because these are the muscles that are more prone to developing tightness and restricted movement, such as tendinopathy.

Improvements in motion and reductions in pain can be seen immediately after a session of soft tissue mobilization. However, these improvements are often short-lived, and the therapist must continue to perform the techniques over time to achieve lasting results.

This book is intended for a wide range of massage therapy practitioners who wish to enhance their skills with manual techniques in treating soft tissue dysfunction. It covers a mixture of the approaches that others in the profession may call myofascial release, therapeutic massage and active assisted stretching, with an emphasis on combining precise technique application with dynamic movements. It is an approach that has been refined by years of clinical massage therapy practice to deliver the most effective treatments possible.

Edema Control

Edema is the build-up of fluid in the tissues. The lymphatic system helps to move excess fluid away from the tissue and towards the blood vessels. This is to maintain the body’s fluid balance and also transports waste products from cells. However, sometimes the body can have difficulty removing the fluid from the tissue, and this can cause problems. Symptoms can range from mild to severe. Mild cases of edema are often caused by sitting in one position for long periods of time (such as when you’re flying or sleeping) or eating too much salty food. Mild edema may also be due to the effects of certain medications such as diuretics, steroid drugs, or estrogen.

A physical therapist can use a variety of techniques to help treat edema. They will usually start by examining the patient and taking a detailed history to find out what is causing the edema. Depending on the reason for the edema, they will then create a treatment plan.

Most commonly, the therapist will use manual therapy techniques such as joint mobilization and soft tissue manipulation to increase the mobility of joints and tissues. They may also use electrical stimulation to decrease pain and promote healing. Heat and cold treatments are also useful to increase mobility, reduce pain, and relieve muscle spasms. They can use different types of heating methods including heat packs, warm tubs, and alternating hot/cold water.

If the underlying problem is not treated, it can lead to more serious conditions such as a pulmonary effusion which happens when the fluid fills the lungs and restricts breathing. It is important to see a physical therapist who can diagnose the problem and recommend proper treatment to prevent complications such as this.

Physiotherapy has been shown to be effective in decreasing edema by increasing the mobility of the joints and soft tissue, relieving pain, and reducing swelling. In addition to physiotherapy, patients can take steps at home to manage their edema. They should elevate their legs when seated and sleep, wear compression garments, and keep moving around. They can also try consuming less salt and using diuretics to improve their symptoms.

Electrical Stimulation

Electrical stimulation is a type of pain-free treatment that involves using electrode pads placed on your body that deliver electric impulses to the muscles. This stimulates muscle contraction, which improves muscle strength, increases the speed at which muscle tissue heals and reduces the symptoms of chronic pain conditions.

The therapist places the electrode pads on the affected area, then attaches wires to a battery-powered device. The therapist controls the device by using dials to regulate how much electrical stimulation is delivered. It is important to inform your physical therapist of any discomfort during e-stim therapy, as it is not supposed to be painful.

There are two main types of e-stim, also known as transcutaneous electrical nerve stimulation (TENS) and electrical muscle stimulation (EMS). TENS uses low-level electrical pulses to block pain signals from reaching the spinal cord and brain. EMS uses a stronger current to get the muscles to contract.

These devices come in many shapes and sizes. They usually include an external box, a wired connection from the box to the electrodes and the electrodes themselves. These electrodes can be placed on the skin and adhered to with adhesive pads, or they can be implanted directly under the skin. Regardless of the type of device used, it is important to balance the amplitude (also referred to as intensity) with the pulse width. This helps to optimise the muscles response, whilst ensuring that the therapist is able to use the electrodes comfortably.

If the amplitude of the pulses is too high, it can cause skin burns. This is very rare, but if it does happen, the therapist should stop the session immediately and apply appropriate skin care.

Another common technique is instrument-assisted soft tissue mobilization (IASTM). This method uses specialized tools that vary in shape, size and design to help mobilize the tissues and muscles around the treated area. This allows the therapist to achieve a deeper level of tissue manipulation and provides them with extra leverage to work with. The therapist may also use these instruments to increase the effectiveness of manual therapy techniques such as joint mobilization and stretching.