Cryotherapy (Ice/Cold Therapy)
- Ice or cold therapy is used to decrease swelling, inflammation and pain associated with joint sprains and muscle strains. It is most often used initially after an injury or surgery, but can often times be used throughout the recovery process to help with healing and help with controlling pain levels.
- Cold in a local area of the body initially causes vasoconstriction (constriction of blood vessels decreasing blood flow to an area) which can limit inflammation and reduce nerve conduction velocity slowing the transmission of a pain stimulus to the brain.
- After the initial vasoconstriction, a vasodilation (opening of the blood vessels) in the area of the cold can occur to help with controlling the exposure of cold to an area of the body. This helps with the body flushing nutrients through an area which will help with healing.
- A cold stimulus to the brain can also overload the pain signal to the brain providing a temporary relief of the constant pain signal which may help you be able to relax.
Electrical Stimulation (E stim)
- E stim is used for pain management, improving joint range of motion, improving neuromuscular dysfunction, and improvement motor control and strength. Other benefits of E stim include limiting muscle atrophy, improving local blood flow, and muscle re-education.
- Walking normally often becomes difficult after sustaining and injury to a lower extremity. Learning to walk in a normal and symmetrical gait pattern is an important part of the injury recovery process. A physical therapist is trained in assessing gait abnormalities, determining the cause, and retraining you how to walk normally again after surgery or injury.
- Iontophoresis is a treatment in which an electrical current is used to help drive an ionized medication (e.g. the steroidal anti-inflammatory dexamethasone) to deeper tissues in the body. Iontophoresis is used to treat acute and subacute inflammation. Most people do not report any discomfort, but sometimes minor irritation occurs with the passage of the medication and electrical current through the skin. Tendonitis is a common condition treated with iontophoresis.
- Joint mobilization is a manual therapy treatment that involves the passive movement of a skeletal joint. Joint mobilization has therapeutic effects such as improving joint mobility, decreasing pain and changing muscle function.
- Joint mobilization can occur in low grade joint oscillations or may include more high velocity thrust techniques. When joint mobilization is applied to the spine, it is known as spinal mobilization.
- Moist heat is an effective heating intervention that has the ability to penetrate a little more deeply to have a greater effect on muscles, joints, and other soft tissues. Moist heat can help reduce muscle spasms, reduce joint stiffness, and make soft tissues more flexible.
- Heat is typically not used initially after sustaining an injury while more inflammation and swelling are occurring, but it can be an effective technique for improving mobility and decreasing pain at later stages of recovery. Moist heat can increase blood flow to a local area and provide temporary pain stimulus relief as the heat stimulus overloads the pain signal transmission to the brain.
- Neuromuscular re-education techniques attempt to retrain the neuromuscular system (nervous system and its connection to the associated muscle group) to function properly. Neuromuscular re-education involves exercises that are used to improve balance, coordination, posture, kinesthetic sense and proprioception.
- Patient education is used to help each individual better understand their condition and what things that they may need to do to help improve their functional level to improve the quality of life. Patient education may also teach people things they may need to do to decrease the potential for further injury.
Range of Motion (ROM)
- ROM is a treatment focused on increasing joint mobility and restoring lost motion of an injured joint. Improving joint ROM helps improve joint surface lubrication, decrease joint restriction, and reduces pain.
- ROM is described as passive range of motion (PROM), active assistive range of motion (AAROM), or active range of motion (AROM). PROM involves the therapist passively moving the joint as you relax. AAROM involves you moving the joint (and associated extremity) along with the assistance of the therapist. AROM involves you actively moving the joint (and associated extremity) on your own.
Soft Tissue Mobilization
- Soft tissue mobilization helps relieve muscle and tissue restrictions, stiffness and pain. Soft tissue mobilization can increase soft tissue flexibility, help clear lactic acid and other waste, and improve circulation.
- Soft tissue mobilization can be relaxing, but it may also be uncomfortable as adhesions that restrict tissues often need to be broken up. Soft tissue restrictions can form from overuse, from direct trauma, constant fatigue, and post-surgical scarring.
- Traction is a modality given by physical therapists for the purpose of applying a force that draws two adjacent bones apart from each other in order to increase their shared joint space. Traction also stretches the muscles, ligaments and tendons that surround the joint. Traction may be given manually, by means of a device or via positioning.
- The elongation of the spine provided by traction allows joint motion to improve, increases circulation and relieves pressure on the spinal cord, its blood vessels and nerve roots. The improved circulation has an added, indirect benefit of decreasing chemicals in damaged tissues brought about by inflammation.
- Traction is commonly performed in the lumbar and cervical areas.
- Strengthening exercises are used to make muscles stronger and increase your capacity to do work. Resistance training with weights or resistance bands are typically used to improve strength. Strength is often lost after injury, surgery, or illness. Stronger muscles improve the ability to control body motions and functional activity.
- Stretching is used to improve mobility of tissues and joints. Stretching improves joint function, muscles tolerance for physical activity, and improved circulation.