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Types of Physical Therapy: Manual Therapy

When a patient visits a physical therapist due to the fact that they’re having pain in the soft tissues and joints, and once the physical therapist examines the patient, the medical professional may recommend manual therapy. This is one type of physical therapy that is quite effective in relieving joint and soft-tissue pain, thus allowing the patient to have mobility that is pain-free.

Manual therapy is a skillful, reflexive method of manipulating joints and the soft tissues that are giving the patient discomfort. In some ways, manual therapy is similar to massage; however, it is much more localized and therapeutic. One area of focus with physical therapists is the specific and centralized motions that occur between the surfaces of the joints that result in the mobility of the joints. The physical therapist looks closely at what is prohibiting the joints from moving without pain as well as the soft tissues that support the affected area.

The main purposes of manual therapy are: to restore or increase range of motion, reduce inflammation in the tissues, aid in soft tissue repair, help with stability and movement, and generally to improve the function of the affected area.

When a physical therapist performs manual therapy on a patient, he uses his knowledge of the proper placement of hands as well as the distribution of pressure to stabilize the painful joints and tissues. With several sessions, depending on the injury, normal and pain-free movement will be restored. Also, manual therapy can be combined with other modalities, such as stretching and exercising, for optimal healing and restoration.

 

“The Evidence-Based Practice of Joint Manipulation/Manual Therapy | Sportscare Physical Therapy.” Sportscare Physical Therapy. 2016. Web. 22 May 2016. <http://www.sportscarephysicaltherapy.com/article-manualtx/>.


How to know if a Child Needs Physical Therapy

When parents notice something amiss in their child’s developmental milestones and mobility, they may wonder if their child needs to see a physical therapist. The first step often taken by the parents is visiting the child’s physician with their concerns. With a complete physical examination, the physician will explain to the parents his findings. He will also offer his professional opinion as to if the child can benefit from physical therapy.

There are several different factors that will lead the physician to confirming the child needs physical therapy, either long-term or short-term. These factors include:

  • There is a delay in accomplishing specific milestones, such as rolling over, sitting up, standing and walking.
  • The child appears to be using one side of the body more than the other, as in turning the head primarily to one side.
  • The child is walking in an abnormal manner.
  • The child is having difficulty keeping up with children that are the same age during social activities and play.
  • The child falls frequently.
  • The child is in pain when walking, running, or performing gross motor tasks.
  • An injury is not healing in a timely manner.
  • The child is having difficulty with gross motor activities, such as kicking a ball, throwing a ball, or other active play activity.

If the child’s physician recommends physical therapy, and once the child begins therapy on a regular and consistent basis, the child will begin to make progress in the area or areas of concern. Parents may also be able to attend the therapy sessions and learn what they can do at home to further the child’s progress. Before they know it, their child will be doing once-difficult tasks with ease.


Physical Therapy after Heart Surgery

After a heart procedure, many patients will receive cardiac rehabilitation while still in the hospital. This usually begins very slowly, and is often in the beginning to manage the care of the incision area and swelling. While most patients begin cardiac rehabilitation after a heart attack or procedure, the time in between the procedure and the rehabilitation in terms of exercise varies greatly.

Cardiac rehabilitation consists of several facets and levels of care. The rehabilitation program is catered to each patient by providing education about their particular illness and health, build up their physical fitness regimen, and move forward in reaching the goal of a healthy lifestyle. Often within the rehabilitation programs, counseling is provided to help patients understand the process of making healthy dietary choices, smoking cessation, weight loss, and how to effectively manage stress.

Many patients that have had a heart attack or a heart procedure require continued physical therapy to regain their daily functions. Usually, individuals that have had a heart condition will be assigned a therapist while they are still in the hospital in order to keep them on a regular schedule for recovery.  This professional works with the physician and surgeon to develop the proper cardiac-care therapy for each patient.

Physical therapy after a heart procedure will vary depending on the patient and diagnosis, and will begin slowly and build up over time. Activity can include walking, balancing activities, mobility exercises, and activities to increase the amount of oxygen to the heart. Once released from the hospital, it will be recommended that they continue physical therapy either as an outpatient at the hospital, at a rehabilitation center, or at a clinic. Some physical therapists even come to the patient’s home for the sessions. Either way, physical therapy done consistently after a heart procedure will greatly help the patient once again live a normal life.

 

 

 

 

https://healthonline.washington.edu/document/health_online/pdf/Physical_Therapy_After_Cardiac_Surgery_5_11.pdf

 

 

 


The Benefits of Physical Therapy after Stroke

When a person suffers from stroke, the flow of blood to a section of the brain is obstructed. As a result, vital brain cells lose oxygen and die, causing all abilities that are controlled by that section of the brain to dissipate.  Once recovered from the stroke, the patient must relearn all abilities. For some people, the after effects of a stroke can be very mild, and for others, they may be more debilitating. The effects of a stroke can include short-term weakness of one side of the body, such as the face, leg, or arm area. However, a stroke can also lead to a patient being paralyzed within a specific area of the body or no longer be able to speak.

Physical therapy can help a person through the recovery process in several ways. Stroke rehabilitation through the use of physical therapy, in addition to other therapy types (speech therapy and occupational therapy), is comprised of movement activities of the effected limbs, such as relearning how to walk or lift an arm. This type of therapy can also help individuals who are paralyzed on a particular part of the body learn to do tasks for everyday living, such as bathing or cooking and dressing with one arm and hand.

In order for physical therapy to be effective, the physical therapist needs to schedule regular sessions and the patient needs to attend each session. The therapy sessions need to be carefully directed, concentrated on the area, and repetitive. With this type of therapy, survivors of stroke can possibly regain strength, mobility, coordination, and balance.

 

“NINDS | Post-Stroke Rehabilitation.” Post-Stroke Rehabilitation. NINDS. Web. 25 May 2016. <http://stroke.nih.gov/materials/rehabilitation.htm>.


Physical Therapy and Exercise

The benefits of physical therapy for any type of injury, pain, or movement difficulties are many. A physical therapist uses research-based methods to assist people of all ages with proper mobility. The physical therapist is trained to take a look at a variety of ailments and decide on the proper method of treatment.

One method of treatment that this professional may use is exercise. The therapist is able to establish an individualized exercise program for his patient after evaluating the client’s individual movement, body type, capabilities, and his activity level. Once the physical therapist studies these characteristics of his patient, he will be able to create the perfect exercise program.

There is a wide variety of methods to help treat and improve musculoskeletal conditions. Some methods focus on strengthening the muscles and others are used to help the muscles heal. Exercise that many physical therapist use include: aquatic therapy, muscular rehabilitation, aerobic and cardiovascular conditioning, exercises for the back and shoulder areas, therapeutic training for increasing balance and posture, exercises and movements to help the soft tissues and joints, and many more.

While focusing on the problem area (or areas), the physical therapist will guide the patient through different forms of exercise and strengthening, at first starting out very slowly and then increasing the amount of repetitions. In order for the patient to see the results of the exercise program in terms of healing and well-being he must be properly taught how to eventually do the exercise routines at home.


Physical Therapy and Alzheimer’s disease

The type of dementia known as Alzheimer’s causes memory loss, difficulty thinking, and problems with behavior. Alzheimer’s begins slowly and the symptoms worsen over time, thus interfering with daily living. Many patients with Alzheimer’s receive physical therapy to help delay the worsening of symptoms and to prolong a satisfactory lifestyle.

Physical therapy with Alzheimer’s patients consists of exercises in various movements. Physical activity has been shown to slow down the negative effects of dementia, as it can improve memory. The physical therapist is trained to design individualized exercise regimens for people with dementia, including Alzheimer’s disease. The exercises are not always physical; they also operate mental awareness activities as well.

At the onset and into the next stage of Alzheimer’s, keeping patients mobile is the focus of physical therapy. There is no cure for Alzheimer’s; however, the physical therapist can facilitate movement and activities to keep the patient active.

In the advanced stages of this disease, the physical therapist can continue to work with the patient in a new role. The professional can assist the patient with everyday tasks in order to reduce the burden on family members. The physical therapists can also educate the family about the disease and teach them techniques for improving the safety of their loved one. The therapist can also teach family members or caregivers how to take care of their loved one’s needs.

 

“Alzheimer’s Disease.” American Physical Therapy Association. Move Forward, 2011. Web. 30 May 2016.


Carpal Tunnel Syndrome and Physical Therapy

Numbing and tingling pain in the palmar side of the hand, fingers and thumb can make typing, writing, and other use of the hand quite painful. Carpal tunnel syndrome is caused by a nerve that becomes compressed in the wrist area. The actual carpal tunnel is a very narrow passage within the wrist that is formed by small bones in a ligament. Tendons are also included in this area, and when the tendons swell the nerve becomes compressed.

With carpal tunnel syndrome, when the wrist is flexed or extended it can feel as if pain shooting through the arm. In severe forms of the syndrome, the affected individual’s grip decreases; this makes simple, everyday tasks extremely difficult. Physical therapy is an ideal way to alleviate the pain of carpal tunnel syndrome.

Methods of therapy can include gliding exercises (the movement of fingers in a specific pattern to ensure the tendons and the corresponding nerves glide effortlessly and without pain through the carpal tunnel), the Graston Technique (utilizes soft tissue ability), manual therapy (hands-on methods), ultrasound therapy, and traction. When the patient is not in therapy, wearing a brace that keeps the wrist in a specific position when typing or performing other tasks that constrain the wrist can help.

With the above methods of therapy accomplished by seeing a physical therapist regularly, the carpal tunnel syndrome may diminish. Physical therapy may help sufferers of this condition so that surgery may be avoided.

Mishock, John, PT, DPT, DC. “Physical Therapy: A Treatment Option for Carpal Tunnel Syndrome – Mishock Physical Therapy and Associates.” Mishock Physical Therapy and Associates RSS. 2012. Web. 30 May 2016. <http://www.mishockpt.com/physical-therapy-a-treatment-option-for-carpal-tunnel-syndrome/>.


Physical Therapy for Chronic Pain

The nervous system is responsible for sending pain messages to the brain, and the brain determines that there is a real threat to the person.  In some conditions, even after the person seems to be healed, pain still does occur.  Chronic pain is pain that lasts for more than three months, and can be quite troublesome and debilitating.

Many conditions can lead to take this type of pain; however, there are specific illnesses that are more susceptible to chronic pain.  These illnesses include: severe trauma and injury, diabetes, fibromyalgia, migraines, phantom limb pain, shingles, and multiple sclerosis.  Of course, there are many diseases that have pain that is ongoing, such as rheumatoid arthritis and the many types of cancers, yet with chronic pain the discomfort is generated in the nervous system even though the point of pain and tissues have recovered and healed.

Physical therapists are trained to help patients deal with chronic pain.  They do so by reviewing the patient’s medical history, listening to the patient, and discussing all symptoms and any diagnosis from the primary physician.  With this information, the physical therapist will be able to develop a plan of treatment through specific and combined therapies.

To begin, the physical therapist will educate the client about chronic pain in the precise reason her patient may be experiencing the pain.  She will involve the client in developing the therapy plan.  The plan of therapy may include: flexibility and strengthening exercises, manual therapy, movement and posture exercises, and other modalities incorporated into therapy.  These may include the application of ice, heat, and electrical stimulation therapy.

It is important to understand that everyone is different, and everyone’s chronic pain is unique to the individual and to the condition. Once the physical therapist and the client begin to consistently work together, the client will begin to see marked improvement in the ability to manage the chronic pain and enjoy a sense of well-being.

“Types of Chronic Pain Syndromes.” – RightDiagnosis.com. Health Grades, Inc., 13 Aug. 2015. Web. 22 May 2016.


Physical Therapy after Rotator Cuff Surgery

In order to regain proper use of the shoulder after a full tear of the rotator cuff, surgery is the only option. After surgery, physical therapy is the ideal way to heal properly in order to regain full use of the shoulder. However, Physical therapy is not performed until the patient receives permission from the physician stating that the sling (worn to protect the shoulder and arm after surgery) may be removed.

In order for the shoulder to have full functionality and mobility after surgery, the patient needs to attend physical therapy sessions on a regular basis. In the beginning, the activities chosen by the physical therapist are very simple. As physical therapy continues, and the patient regains mobility in the shoulder area, the exercises become more rigorous. Each patient is different, and because of this the physical therapist will evaluate the patient in the beginning to ensure proper exercises given.

The first few weeks after the surgery is when the shoulder is very tender and can be reinjured very easily. The sling is worn to protect the shoulder area and must be worn at all times with the exception of bathing and dressing. Once the sling can be taken off, physical therapy will begin, very gradually, to help the shoulder move properly once again. There are many different range-of-motion exercises that the physical therapist will do with you; manual therapy may also be formed at this time to alleviate any pain. In addition to this, icing and stimulation by electrical current can also relieve the pain.

As the therapy sessions increase over time, the strengthening exercises may become a challenge for the patient. The physical therapist will help the patient perform the exercises and begin to work through the pain without over doing it. In addition to the physical therapy sessions, the patient will begin to use his arm more often throughout the day; however, there will be limits placed on what the patient can and cannot do with the arm (such as heavy lifting).

Strengthening the main muscles of the trunk area, the shoulder blade, and of course the rotator cuff muscles are the goals of the physical therapist. Performing exercises to strengthen these muscles will help the patient over time develop a normal range of motion and mobility in the shoulder area. With these activities, the patient will slowly be able to perform normal everyday tasks with the shoulder and arm, but it will take time. It is a gradual process and the client must be patient with the process so another injury to the rotator cuff does not occur. Full mobility will eventually come again, and the patient will be able to live a life without shoulder pain.

 


Physical Therapy and Managing Diabetes

Everybody needs insulin in order to use blood sugar, or glucose, for energy by carrying the sugar from the blood to the cells. When this isn’t done properly, the blood sugar increases in the blood and causes complications, such as heart disease, high blood pressure, and side-effects of feeling very ill.

Individuals that have diabetes can manage their diabetes and other vascular conditions by having a physical therapist guide them through a proper exercise plan. Physical therapists are trained to develop an exercise program catered to the individual. Controlling blood sugar can help the effects of this disease, and an exercise plan will help manage the blood sugar levels.

Strengthening and aerobic exercises help manage blood sugar levels by helping the cells use the glucose in the blood for energy. When the muscles contract during exercise, another mechanism is stimulated that is not related to insulin.  This unrelated mechanism aids the cells in absorbing the glucose rather than having it dangerously build up in the blood. Glucose is taken up during exercise and after. Aerobic exercise and resistance training are ideal for managing diabetes, and a physical therapist can help you be the healthiest you can be with this illness.

The physical therapist may also work alongside the physician to keep the diabetes monitored for a healthy and positive well-being. Activities provided can include aerobic exercise of moderate intensity, depending on the patient’s abilities. Walking briskly, swimming or water exercises, and dancing are activities the therapist may feel is a good match for the patient.  For some clients, a more vigorous work out will be necessary, such as jogging, hiking, martial arts, aerobic exercises, and dancing. With Type Two diabetes, resistance training may be offered if the patient is able to use weights or bands. Whatever the therapy prescribed, it will need to be given no less than three days a week on a consistent basis to keep the diabetic patient feeling great and being the healthiest he can be.

 

 

“Diabetes.” American Physical Therapy Association. American Physical Therapy Association, 2011. Web. 25 May 2016. <http://www.moveforwardpt.com/symptomsconditionsdetail.aspx?cid=892c2628-6e96-41fa-93e1-4c973c247010>.

 

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