Below is a short list of services we provide which include; Joint Mobilization, Exercise Prescription Bike Fitting, Electrical Stimulation, Neutral Spine Mechanics, Orthotics, Infra-Red Therapy, Vasopneumatic Device, Taping and Bracing. If there is a service not listed below please give us a call to discuss other viable alternatives.
Please feel free to download our Walking Brochure here in PDF format.
Joint Mobilization
What is Joint Mobilization?
Joint mobilization is the careful use of skilled graded forces to move a joint in a desired direction. It is usually used to improve motion and normalize joint function but it may also be used to help control pain.
Which Joints Benefit From Being Mobilized?
Any joint that is lacking sufficient motion may be mobilized. We use joint mobilization on the neck, upper, middle and lower back, sacroiliac and coccygeal joints as well as to all of the joints of the extremities such as the shoulder, wrist, hand, hip, knee, foot and ankle.
What Happens to Joints That Lack Motion?
When a joint’s mobility is impaired, structure and function of the region change. Cartilage nutrition starts to decrease within the joint, and adjacent joints begin to move excessively to compensate for the stiff (hypomobile) joint. These adjacent joints begin to break down due to excessive use. Muscles surrounding a stiff joint lose their ability to contract and relax sufficiently and become tight. Soon the whole region is involved in the dysfunction surrounding the stiff joint.
What Benefits Are Derived From Joint Mobilization?
- Improved joint mobility & joint nutrition
- Decreased muscle spasms & tension
- Decreased pain
How Is Joint Mobilization Done?
The person is often placed in a position of comfort where they can relax and allow the region to move freely. The therapist will use his hands to localize the joint in need of mobilization and apply needed force through his hands in the appropriate direction. Soft tissue mobilization, stretching, deep breathing and various resisted motions/exercise patterns may be used at the same time to help achieve the desired results. High speed mobilizations may be administered by more experienced, skilled clinicians. Joint mobilization is a strength of Advanced Physical & Sports Therapy, especially as applied to the neck, low back & sacroiliac portions of the spine.
Electrical Stimulation
What Is Electrical Stimulation?
Electrical stimulation is the controlled use of electromagnetic current using sophisticated devices that can create a variety of waveforms which are used selectively or in combined formats to stimulate nerves and therefore muscles in order to decrease pain. We use two main types of electrical stimulation, Neuromusclar Electrical Stimulation (NMES), and Interferential Electrical Stimulation (IES).
NMES is a treatment used to aid in the reeducation of skeletal muscles after injury, disuse or prolonged muscle spasm. The application of NMES to weak muscles while exercising helps you to reestablish your own control over your muscles that my have been lost after a painful event, or after prolonged immobilization. IES is typically used after manual work and exercise to decrease pain, increase circulation and promote relaxation.
Who Can Use Electrical Stimulation?
Most people can use NMES or IES safely. Inform your health care provider if you have any of the following:
- Decreased sensation in the proposed treatment area
- Pacemaker or seizure disorder
- Current pregnancy or attempting pregnancy
How Does It Work?
The muscles and nerves of the body can be activated by external sources. An external electrode is placed over the muscle or nerve and attached to either a battery operated hand-held machine in the case of NMES or a stationary device in the case of IES. The machine has preset readings which deliver a comfortable, timed stimulation to the area causing the muscles to contract or the nerves to be simulated in a way that promotes relaxation and pain relief.
Individual treatment may vary from one session to several weeks usage. They can be used to help you identify the muscles, create a stronger awareness of your muscle contraction and provide a timed exercise session.
How Do I Start a Program Of Electrical Stimulation?
After a complete examination and evaluation your health care provider will recommend the proper program. Some people may benefit from rental of home devices. Every insurance plan has different benefits regarding the purchase and rental of medical equipment. Advanced Physical & Sports Therapy will assist you in checking with your company about your durable medical equipment benefits.
Neutral Spine Mechanics
Why are Body Mechanics Important?
The lack of ability to assume a good posture & utilize good body mechanics for any reason will affect our ability to perform a wide variety of active functional activities. When a patient has a pathology problem that is painful, or certain movements blocked by the problem, even simple activities and positions may be severely affected. Sitting, standing, lifting & carrying, walking & running, and recreational activities are examples of activities that typically will need specific retraining by skilled therapist. Unless addressed, subsequent healing of the body may be blocked by poor posture/body mechanics.
How Does Good Body Mechanics Go Bad?
Ideally our body uses the least amount of energy possible to maintain good posture (structural efficiency) and to move (muscle efficiency). Injury, pain &/or poor postural habits can cause progressive loss of motion in joints & weakness in muscles, which in turn limits options of position & movement, resulting in structural and muscle inefficiency. The body can develop and maintain compensations for lack of flexibility & strength, but only for a while. As time goes on, these inefficiencies take their toll on the body, with more and more bone, joint and muscle breakdown.
What Does Functional Retraining Include?
The first step is taking an accurate inventory of the functional loss. A typical loss with a low back problem is an inability to sit/drive for more than 20 to 30 minutes. This can be a problem with any one that has to either commute to or sit at work. Another example is loss of ability to lift or carry; this would place a young mother at risk, as she must participate in an activity that is both painful and harmful if she can’t find a way to pick up her child safely. Our physical therapists are specially trained to identify these problems and prescribe one-on-one training to help our patients get their life back.
Don't All Physical Therapists Use Functional Retraining?
Like many things in life, good training and thoroughness occurs on a bell-shaped curve. Some therapists always do, some (regretably) never do, and most are somewhere in beween. At Advanced Physical & Sports Therapy we have incorporated posture/body mechanics training into our rehabilitation program since 1988 to allow patients to become much more aware of their position and movement utilizing these learned skills daily, life-long benefits of their rehabilitation efforts.
Orthotics
What are Orthotics?
Orthotics for the foot are devices that can be support the foot, encourage even weight distribution and provide more shock absorption. There are many types of orthotics that have various benefits. Diabetic foot orthotics, for example, will be much softer than those made for long-distance runners. 'Pronators' will get more arch support from their orthotics, whereas 'supinators' will get more shock absorption from a properly prescribed orthotic. Typically made of high-tech plastics, they can be full-length in your shoe or shorter (for ease in shoe interchangeability), and can be covered with a variety of materials that will affect cushioning, durability and care requirements.
Who Needs Orthotics?
Both exessive pronation a.k.a. 'flat feet' or excessively supinated feet a.k.a 'high arches' are the most common problems that foot orthotics may be prescribed for. The next most common group of people that need orthotics are people with knee pain. Your physical therapist may trace the source of knee pain tothe foot. For example, with excessive pronation the arches of the feet drop lower to the ground, especially when walking, running or squatting. When this happens the leg and knee will turn in, and promote a 'knock-knee' position. Over time this will undoubtably cause uneven cartilage wear and tear to the knee joint and kneecap. Tendinitis, 'maltracking patella', and loss of ability to squat or use stairs are some of the examples of a foot problem affecting the knee.
Who Prescribes Orthotics?
Physical therapists, podiatrists and orthotists all make orthotics. Physical therapists however, are specifically trained and licensed in looking at the whole body, and will make the best decisions regarding the necessity of orthotics.
How are Orthotics Fitted?
We use the recommendations from Sole Supports and find that they have consistently made the best orthotics for our patients. Some of our therapists have been trained and certified by the podiatrists at Sole Supports to properly custom make orthotics for you. Check out www.solesupports.com
Taping and Bracing
How Is Taping and Bracing Used In Sports?
Traditionally, when athletes injure their ankles, medical braces and/or athletic tape is used to support the weakened limbs. This concept is alive and well, all college programs and in almost all high school programs have athletic trainers who tape their athletes (football) before practice and competition.
Post-surgical ACL reconstruction patients are often fitted with custom knee braces to support the new ligament while participating in sports with a higher propensity for knee injuries such as skiing.
Does Ankle Taping Work?
According to a new study, using braces and tape on healthy ankles can help prevent injuries from happening in the first place. Researchers at Vrije University in Amsterdam reviewed eight studies on ankle-sprain prevention. Among their findings: one study of more than 2,500 college basketball players showed that athletes who taped their ankles suffered less than half the number of sprains than those who did not tape. Another study, conducted for six years with some 300 football players, found that ankle braces were twice as effective as tape in preventing sprains. This study’s authors suggested that, since tape loosens during activity, braces could provide more consistent sturdy support. In addition to those reviews, the Dutch research team found that other methods of ankle-sprain prevention were not as well proven, including wearing high-top shoes and conducting balance training. In the case of high-top shoes, the researchers noted that the newness and subsequent stiffness of the shoe, rather than its height, might be a factor in helping prevent injury.
The Vrije University study was first reported in the Clinical Journal of Sports Medicine, October 2000. Article source: IDEA Personal Trainer January 2001
How Is Taping and Bracing Used In Spine Care?
A second type of taping and bracing refers to the protection and rehabilitation of the spine. Your physical therapist may use taping to give you a better sense of your back or neck position. This gives you the best chance of learning a new posture that allows and promotes healing of an injury. A simple piece of tape on your back or chest will give you immediate, valuable feedback on your posture in relation to slouching or overlift of chest.
Low back braces and cervical collars have fallen out of favor with physical therapists and orthopedic surgeons, as they felt that patients would not develop the necessary strength if they wore them too long. While this is true, at Advanced Physical & Sports Therapy the management pendulum is swinging the other way, with people with known spine problems being encouraged to strengthen their 'core muscles' but also to go ahead and use an external brace if they know that they have a full day of garden chores, lifting or anything that will put the neck or back at risk. Protecting yourself for one day will NOT promote weakness. It is better to protect yourself and resume a desired activity, rather than to give it up altogether.
Occasionally we resort to moderate-term (6-8 weeks) cervical collar use if a patient is not responding to normal neck rehabilitation after trauma (e.g. whiplash). There are cases in which the healing of over-stretched ligaments must be immobilized to allow healing, exactly like a bone, both are types of connective tissue needs to be casted after fracture to allow healing.