Monday, November 28, 2016

New Trends in Physical Therapy by WebMD

Image Credit: Southport and Ormskirk Hospital

When it comes to rehab from surgery or an injury, it's a whole new ball game these days. Gone are long stretches of bed rest and weeks off from work. Today, doctors want you going right away with a round of physical therapy. That's because research suggests it's safe and leads to a speedier, better recovery.

"Treatment has become more aggressive," says Kosta Kokolis, PT, clinical director of TheraMotion Physical Therapy Studio in New York. He says today's physical therapists try to create change and make corrections, instead of waiting for your body to take its natural course.

"We guide the healing process," he says.

Get Moving

In the past, your doctor would tell you to wrap your injured area to keep it still, Kokolis says. He would also suggest you take a break from your regular activities and rest in bed. But research flipped that way of thinking. Studies show that people who are active during recovery do better than those who take it easy.

Dan Collins, a 53-year-old media relations professional in Baltimore, is a shining example. He bounced back quickly after a spinal disc laminectomy.

"I believe much of that has to do with the fact that they get you up and moving ASAP," he says. "I went right into physical therapy the morning after my spinal surgery."
Years ago, if you had shoulder surgery to fix a torn rotator cuff, you might wear a sling for 6-8 weeks and hold off on physical therapy until 4-6 weeks. "Now my patients are usually out of the sling, except when sleeping, and start physical therapy by the end of the first week," says Brian Schulz, MD, an orthopedic surgeon and sports medicine specialist at Kerlan-Jobe Orthopaedic Clinic in Los Angeles.

Doctors today want you to start building your strength back up as soon as possible. The idea, Kokolis says, is simple: Use it or lose it.

Hands-on Techniques

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In the past, your physical therapist may have relied on treatments like electrical stimulation, ultrasound, or iontophoresis to treat your pain. "But that doesn't really resolve your problem," Kokolis says. "It doesn't correct or fix anything."

Today, physical therapists take a more hands-on approach. They prefer manual therapy, also called bodywork, to get to the source of your pain and correct the issue. It helps with relaxation, flexibility, and pain relief.

For instance, your therapist may use skilled massage or manipulate your bones and joints with careful, controlled force. He may do exercises that twist, pull, or push your bones, to improve your range of motion.

Today, therapists are more likely to push your body's limits. They may sometimes want you to feel some pain, instead of avoiding it.

Limit Your Use of Assistive Devices

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A few decades back, if you had lower back problems, your doctor may have told you to wear a brace. If you mowed the lawn, for example, you'd strap it on for extra support. If you had a neck injury, you may have worn one while driving.

Today, assistive devices like braces, canes, crutches, splints, or special footwear are still used when necessary. But they're no longer go-to items.
"We try to use them as little as possible," Kokolis says. Therapists now understand that keeping the injured area still actually makes it weaker.

Return to Your Regular Activities

In the past, the main goal of rehab was to increase your range of motion. If you had shoulder surgery, for example, your therapist would try to help you get back to moving it a full 180-degrees.
But hitting that number doesn't guarantee you can do everything you'd like to do, whether it's cleaning your house or playing tennis. And even without a full range of motion, you may function just fine.

So therapists shifted their focus to making you able to use your joint better. Now the goal is to get you back to your regular activities. At first, it may be getting you to the point where you can dress yourself or brush your hair. That may lead to walking, going up stairs, or lifting things.
For Collins, picking up his sports equipment to pursue his passion was the ultimate success. "I was eventually able to return to my sport -- fencing," he says. And that, he adds, was therapy in and of itself.

Curated by Erbe
Original Article

Monday, June 6, 2011

A Night with My Physical Therapy Classmates

It was 14 years ago since I graduated from college.  I remembered my college years when I went out for dinner with my old classmates from our physical therapy college years.

How come we were reunited after 14 years?
I was roaming around SM Naga to buy some stuffs at Ace Hardware when I came to see the wife of one of my classmates in college.  I recognized her coming down from the escalator (I was going up to the mall’s second floor).  I begun with, “Is Dennis here in Naga? Please say hello to Dennis for me.”  She smiled as the escalator brought them down.

I was at the hardware when I recalled that I have to go to the nearby ATM machine to withdraw some money for my stuffs.  Going to the ATM machine, I saw Dennis in front of a laboratory clinic beside the machine.  “Padi, kumusta?” I greeted him in Bicol and told him that I just saw his wife a while ago (who just went out from the lab clinic).  “Who’s going inside there?”  I asked.  Anyways, the conversation between me and Dennis went on as he told me about his struggles to pass the NPTE (National Physical Therapy Examination) and how he passed the Physical Therapy Assistant examination in the States.  He also told me about the content of the examination and so on.  Then, he told me that he was planning to meet some of our classmates too one of these days.  I gave him my number and then he told me that he will just text me when the date will be.

I received a text from Roel (another college classmate of mine who is teaching at our alma mater’s Physical Therapy Department).  He told me that Dennis had asked him that we will meet that night for some get together.  After that, Dennis texted me about the plan.  They fetched me at our house at around 8:00 pm that night.  We fetched another classmate of ours, Tong and suggested to dine at Gerry’s Grill in the mall.

Roel, Tong, Dennis and Me at Gerry's Grill, SM Naga

It was a good dinner at Gerry’s Grill.  We asked the waiter to take pictures and we continued to exchange stories about us and our families.  Dennis, as a ‘balikbayan’ from the States told us how he acquired his US citizenship, how physical therapists are in demand in the States and many more.  We left Gerry’s happy.  The night is still young; we decided to transfer to a nearby bar.  We had some beer and ‘pulutan’ and then the ‘kurumustahan’ and story-telling went on.

Good company

It was good to hear that as a Filipino physical therapist, Dennis demonstrated mastery of his craft with fellow PT's in his work.  He told us how he was amazed by an old American physical therapist that he was assisting in treating his patients.  How he uses techniques that he had developed over years of physical therapy practice.  That there are PT techniques that weren’t taught in college, which can be learned upon scrutinizing the PT reviewers and the PT books or assisting other physical therapists.  That being a physical therapist is envied by some of his neighbours in their place.  That, if we want to go to the States, we should see to it that we pass the TOEFEL and the NPTE.  That it is much better to have an agency for the employers trust these recruitment agencies.  The examination in the States as compared to Philippine PT examination consists more practical questions being asked in the test.

I thought his experiences in the Middle East as physical therapist made his journey to the United States much easier.  And having a wife who is a nurse added to the fast processing of their papers too.

Well, we had a good time.  Thanks for our ‘balikbayan’ classmate, Dennis.  We had enough of information from him.  Someday, when we are the ones who will need to process our papers to work abroad, we are equipped from the information he had given us.

Good luck!

Wednesday, March 23, 2011

Benefits Accrued From Engaging in Resistance Training in Bodybuilding

The first step to building a fantastic macho looking body is getting into the gym and training hard, and it is the food of all bodybuilders. Yet this is always misinterpreted by bodybuilders to mean ignorant, disorganized hard work in the work out room. The best way which always brings positive and fast results is to organize training consciously with precise objectives. One of such best objective training strategies is resistance training.

Ideal resistance training should involve workout activities that primarily employ body weight, dead weights and training machines to exhaust and stimulate muscle groups completely. That is why resistance training is variously referred to as strength or weight training in body building circles. Recent research into body building exercises has irrefutably proved that resistance training is among the most essential ingredients of a body building program. It is actually commonly used by all kinds of athletes who require strong muscles in their particular endeavors like football, weight lifting, basket ball among others.

The trainee must however remember that resistance training does not essentially increase body size because the core factor is building on the muscle strength. That is why resistance training is ideal for almost every individual with a training program for body building or physical fitness. Resistance training builds up power and tones precisely the muscle groups that result to a compact, attractively solid body that makes the girls go gaga.

Resistance training is simple to implement because it basically involves the use of ordinary exercise equipments and body building machines such as bench press, barbells or even dumbbell. These weight equipments help challenge the muscles against the weights, over and over again always hitting the most extreme limit the muscles can go. Muscle cells must therefore adapt to the challenge offered daily by moderated extra weight added on course of the program by bulking up more fibers and tissues or strengthening the existing ones. More precisely what happens is called hypertrophy meaning the enlargement and growth of nerve cells within the muscle sites which essentially help the muscles during contraction.

Before initiating a resistance training program however, the athlete should go for a thorough check up especially if there is a preexisting medical condition or if he or she is overweight. Besides learning of the best weights to use, the athlete must stimulate and condition the body gradually before thrusting it to intense weight exercises. Actually, resistance training can be started without weights by adopting exercises like push ups.

Contemporary literature into bodybuilding exercises and fitness therapies recommend resistance training because it has numerous advantages. Among the most dynamic benefits that a person can reap from an effective resistance training program include increasing bone-mineral density which is almost impossible to maintain otherwise especially after the post-menopausal body can not produce hormones. Resistance training greatly increases muscle strength and bone firmness, essential for physical fitness. It thus helps the trainee be more active and productive in his normal life as a result of the boost in strength. More importantly, resistance training maximally burns calories and helps the body loose excess fats. Fat combustion and improved fitness and body strength will therefore lead to more healthy lifestyles without risks of cardiac and overweight conditions especially in elderly people. Indeed the heart rate and blood pressure is adequately lowered to the extent of preventing major heart diseases.

Dane Fletcher is the world's most prolific bodybuilding and fitness expert and is currently the executive editor for If you are looking for more bodybuilding tips or information on weight training, or supplementation, please visit, the bodybuilding and fitness authority site with hundreds of articles available FREE to help you meet your goals.

Sunday, February 13, 2011

The Modalities of Physical Therapy

Rehab Room
Physical therapy is the treatment of neurological, musculoskeletal, circulatory, and skin disorders using various physical therapy modalities. The goal of physical therapy intervention is for patients to regain maximum potential and to have a productive life with or without the presence of disability.

Physical therapists may use a number of different modalities for your problem(s) or condition for a variety of reasons, including:
  • Reduction of pain
  • Increasing range of motion
  • Decreasing swelling
  • Increasing the rate of healing
  • Stabilizing areas needing support

“Four basic modalities are employed in physical therapy, each applied where and when it will do the most good. Not all of the modalities are used in every case.


Cold therapy

Cold therapy or cryotherapy is an effective means of reducing inflammation following an accident or injury. Cold therapy is applied in the form of ice packs, sometimes combined with massage, cold water bath of the injured area, and other methods. The reduced temperature will quell the firing of the nerve-muscle units and reduce muscle spasms, and that along with the anesthetic effect of the cold temperature will ease pain. Also, the cold reduces blood flow into the injury and reduces any bleeding that may be present and reduces oxygen demands of the injured tissue, thus preserving the muscle cells. An ice pack often is applied with a compression wrap to reduce swelling, and with elevation of the injured extremity above heart level for maximal reduction in swelling.


Heat therapy

Heat or thermotherapy may be employed only after the active swelling of the injury has abated, 24-48 hours following the injury. Heat is conveyed into the injured area by the use of moist heat packs, hot paraffin, hot air or hot water as in a whirlpool bath, by infrared lamp, and by conversion. Conversion is the development of heat brought about by the passage of sound waves or electric current through tissue. Diathermy is an example of electrical waves directed into tissue and converted into heat. Ultrasound, very high-frequency sound waves, bring about the vibration of the tissues, which increases the temperature within them. A form of application of sound waves called phonophoresis consists of application of a medication to the injured area followed by ultrasound to drive the medication deep into the tissues.
Heat increases blood flow to an area, so should not be used when internal bleeding accompanies an injury. However, like cryotherapy, heat reduces muscle spasms by increasing the blood flow to an area, which helps to wash out metabolic waste products and increase the amount of oxygen reaching the tissues.


Electrical stimulation

Application of electrical stimulation can restore muscle tone by stimulating muscles to contract rhythmically. This method is used often when an injured person has been confined to bed for a long period of time. Over time, muscles will atrophy and the patient will require long, arduous periods of exercise once he is mobile. The use of electrical stimulation can prevent muscle atrophy and reduce the necessary physical therapy regimen required later. Electricity is also used to drive molecules of medication through the skin into the tissues. This is called iontophoresis. A special machine called a TENS machine (transcutaneous electrical nerve stimulation) beams electric current through the skin (transcutaneously) into the injured area specifically to stop pain. Why TENS has this ability to assuage pain remains open to question, but it is thought that it prevents pain perception by the sensory nerves in the injured area. That is, the nerves that normally would detect pain and carry the impulse to the spinal cord do not sense pain. The electrical signal from the TENS machine can be adjusted for frequency and strength to achieve its effect without patient discomfort. All electrical stimulation is delivered by placing pads on or around the injured area to conduct the electrical current.


Mechanical manipulation

The use of massage, manipulation of the injured limb, traction, and weight lifting are part of the mechanical form of physical therapy. Massage is the rubbing, tapping, or kneading of an injured area to increase blood circulation and relieve pain. Manipulation consists of putting an injured joint through its movements from one extreme to the other. This is designed to restore full range of motion to the joint and eliminate pain from movement. Traction is the application of weight to stretch muscles or to help increase the space between vertebrae and relieve nerve compression. Manipulation may be carried out by a trained technician or by using a machine especially constructed to exercise the injured joint. Resistance can be altered in the machine to make joint extension or flexing more difficult, thus helping to build the muscles that control the joint movement.

Many forms of physical therapy can be carried out at home, but the exercises must first be carefully explained by a trained therapist. Incorrect application of a physical therapy modality can be as harmful as any traumatic injury. Most modalities are applied two or three times daily over a period of time to help restore movement, flexibility, or strength to an injured area.

Through the use of tests, evaluations, exercises, treatments with modalities, screening programs, as well as educational information, physical therapists:
  • increase, restore or maintain range of motion, physical strength, flexibility, coordination, balance and endurance
  • recommend adaptations to make the home accessible and safe
  • teach positioning, transfers, and walking skills to promote maximum function and independence within an individual's capability
  • increase overall fitness through exercise programs
  • prevent further decline in functional abilities through education, energy conservation techniques, joint protection, and use of assistive devices to promote independence
  • improve sensation, joint proprioception and reduce pain


Common Conditions

A vast number of conditions are treated effectively with physical therapy intervention. Examples of specific diseases and conditions that may be improved with physical therapy include:
  • arthritis
  • sports/orthopedic injuries
  • joint replacements
  • cerebral vascular accident (stroke)
  • coordination and balance disorders
  • Alzheimer disease

To ensure the best treatment outcome for the patient, the physiatrist and the physical therapist must ensure that the correct physical therapy modalities are prescribed.

Many researches supported that treatment outcome differ from patient to patient depending upon the severity and extent of the disability, methods used, and also the level of cooperation of the patient to rehabilitation.

Monday, February 7, 2011

The Power of Physiotherapy Exercises - Why Are They So Beneficial?

Health care providers referred to as physical therapists or physiotherapists are qualified in giving assessments and treatments on different conditions. They are more focused in providing relief and wellness through a more physical approach such as manual therapy, acupuncture and physiotherapy exercises.

Physiotherapists or "PT's" are highly trained professionals who can identify weaknesses or imbalances in the body. Physical therapists can help in targeting specific areas in the body where weakness or pain is felt and then prescribe the suitable treatment plan. Physiotherapy exercises are methods that can truly help relieve and soothe stress, as well as help the body function without pain and limitation.

How Exercise Helps the Body

When you incur an injury, the pain felt should serve as a guide to where the sensitive areas are located. Physiotherapists stress that there are two major types of pain: first is the pain due to stiffness and the second is pain due to damage. Pain due to stiffness may be quite bearable when you are doing exercise, and may be relieved gradually once you finish an exercise. The pain basically means that your muscles are a bit out of sync, and need to be eased back into working condition. Pain due to damage can be unbearable, which is an obvious indicator that your muscles are damaged, and are not ready for any exercise yet.

Once your physiotherapist determines the extent and cause of your pain, he or she will ask you to perform an array of physiotherapy exercises. There are practically hundreds of PT exercises for different injuries, from injuries to the neck, lower back, shoulders, spinal cord, legs, and feet. Your Physiotherapy clinician may also specify additional personalized stretching exercises for you. Stretching, as you should know, is important for maintaining proper range of motion of the joins, and also promotes flexibility of muscles.

For example, if you have tight muscles or stiff joints, performing normal activities like climbing the stairs or reaching for items above the cupboard may be tough to do. With proper stretching exercises, the normal body functions can either be preserved or enhanced. Scar tissue is formed and soft tissue becomes contracted as a result of an injury or a surgery. It's important that you regularly perform physical therapist-assisted stretching exercises, to ensure that the scar formation does not impair your movements.

How Prescription Exercises Help to Improve Muscle Strength

Prescription physiotherapy exercises are generally employed to specifically target muscle deficiencies, and also to help rehabilitate patients after an injury or after undergoing surgery. Therapeutic or prescription exercises are often used to improve the patient's strength, function and mobility, as well as to significantly lessen pain and swelling in the affected part of the body. Family doctors and PT practitioners often prescribe simple and easy home-based physiotherapy exercises, and also provide their patients with handouts and easy-to-understand instructional manuals or guides. Many agree that supervised physiotherapy exercises are more effective than home-based exercises, especially in patients who have osteoarthritis of the knee, low back injury and intermittent claudification. Still, physiotherapy exercises performed at home have their own advantages as well, more so for the post-operative recovery of anterior cruciate ligament.

Exercise is truly vital for the treatment and management of a wide array of chronic health conditions and injuries. Supervised physical therapy exercise programs consist of individualized prescription exercises that are specifically designed by trained physiotherapists, and are done in conjunction with the patient's condition and fitness level. Physical therapists are specialists in movement impairments, and are effective in developing or designing therapeutic exercise programs and modalities which suit a patient's specific needs.

One past study by a group of physicians from The Netherlands concluded that supervised physiotherapy exercises also result in less pain and improved function for tested patients, both in short term and long term durations.
Resources on Physiotherapy Exercises and other Information
A number of helpful physiotherapy resources are available online, to give you more helpful information on new and improved modalities for easing pain and improving strength and mobility. The American Family Physician's website offers relevant information related to physiotherapy exercises. Another authority site when it comes to information and resources about any specific therapy program, such as physiotherapy exercises, is the Canadian Physiotherapy Association.

Discover the benefits of physiotherapy exercises - for a healthy lifestyle, safe weight loss and effective injury rehab - you are sure to be on the path to wellness. Learn more about Exercise Prescription with the help of the PT Health Team. Get in touch with one of the competent health professionals today. 

Book your free consultation with PT Health now!

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Sunday, January 30, 2011

Nursing vs PT

Part of the constant battle between nurses and therapists.

Saturday, January 29, 2011

Benefits of Home Physical Therapy

There are many settings that physical therapists practice their craft.  Schools, hospitals, private outpatient clinics, nursing homes, and private homes are some of these settings.  The most common setting for a patient that is unable to commute to an outpatient clinic or for patients that are homebound is home care physical therapy.  New trend in physical therapy such as the clinic is brought to the patient is now a common practice. Some models are being used. One model is that some physical therapists have a mobile clinic in the form of an RV.  Equipments such as treatment tables, exercise equipments and the typical modalities you would find in a PT outpatient clinic can be found in the RV. A second model which is cheaper would be a physical therapist coming to the patient’s home with a portable treatment table and other hand-held physical therapy modalities such as ultrasound machine, ES, TENS, walking aids and more.

What are the benefits of treating patients in their homes?

  • Patients will not miss any treatment sessions thereby improving compliance.
  • Evaluation of patients by physical therapist in their REAL natural environment.
  • More time efficient since patients don’t have to travel to the clinic
  • Patient’s privacy with their family
  • Elimination of disruptions such as other clients/patients being treated, etc.
  • Physical therapist can have a quality time with the patient as it is a one on one treatment session.
  • Allows effective treatment sessions and reduces the risk of injury
  • Your whole family is present to support you throughout the treatment session
  • Can eliminate complications of driving or riding a car or a public vehicle and the hassle of going to an outpatient physical therapy clinic after a surgery.

Why is home physical therapy right for you?

You must consider some few questions if the home physical therapy is right for you. 

Are you comfortable with a stranger in your home? 

The first few minutes in a therapy session is the adjustment period.  After the physical therapist has introduced him and the treatment approach, you may now be comfortable with him since you are divulging personal information regarding your medical history.

Can you concentrate without any distractions in your home?

Just enough space for the therapy session is required by the physical therapist.  They just need to set up the treatment table and may require an outlet for modalities.  Therapists are trained to be creative in such a way to take advantage of a small area to achieve the required room for exercise.  In addition, most equipments and modalities required for therapy is light and portable.  Thus requires just a little space.

In my experience, patients prefer home therapy because it is more comfortable, more convenient, and promote patient compliance.  They can also take advantage of not going to travel anymore.  It is typical for the patients who undergo home physical therapy to have their therapy sessions scheduled in the morning before going to work or late in the evening after office or working hours.

What about insurance coverage?

Your insurance coverage is dependent on your physical therapist.  Some therapists are connected with Medicare and other commercial plans while others are out of network. It is important to communicate with the therapist prior to the first visit to find out how your treatment sessions will be covered.

Not all patients are candidates for home therapy program.  Physiatrists and physical therapists may advice outpatient care.  However, if you are enjoying your home therapy program you can ask your physiatrist and physical therapist so that they can provide adjustments in your treatment program.