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Road to Recovery — Each Step Along the Way

road-to-recovery

Road to Recovery — The Assessment

The first step in any effective treatment process is a thorough evaluation. Expect our therapists to ask detailed questions about how the injury came about, but also do some expert sleuth work (since the injured area may be a result and not the starting point of poor movement). We may be able to reduce the pain quickly, but that will only be temporary unless we address the root cause of the problem.

Although patients may come to see us for a variety of causes, low back aches, knee pain, and overuse injuries are among the most common complaints. Following a thorough investigation, our therapists will begin to lay out a treatment plan, which will commonly include passive modalities (ice, heat, laser therapy, and electrical stimulation to name a few). But more often than not, manual therapy— a term that includes many methods of restoring tissue function like massage, stretching, and exercise — is the foundation for the assessment and treatment of an injury. Just don’t anticipate jumping (or running, swimming, or lifting) back into activity right away. The average length of care for musculoskeletal ( bone and muscle injuries) can be anywhere from four to six weeks.

Steps Along the Way — The Treatment

Manual Therapy

Best for: Any injury

This hands-on approach separates physical therapists from other health practitioners. Although manual therapy may refer to many things, our therapists usually employ common tactics like stretching, massage, and hands-on strengthening exercises to reeducate the body into proper movement and mechanics. Manual therapy is a prime method to removing movement restrictions and helping patients move better. Manual therapy should form the backbone of any treatment plan, not modalities like ice and electric stimulation.

Ice

Best for: Injuries involving inflammation and swelling

Ice can be a major component of injury treatment. By constricting blood vessels after application, ice is an effective way to reduce and even prevent inflammation immediately following an injury. Cold therapy can also leave the joint more mobile and enhance manual therapy. Although it’s difficult to nail down the most effective protocol, applying cold packs to inflamed areas has been shown to significantly reduce swelling in soft tissue injuries   .

Heat

Best for: Injuries involving muscular spasms and tightness

Applying heat has been shown to decrease pain and increase mobility after some injuries — mainly those involving soft tissue like muscles, tendons, and ligaments. By making the tissue more pliable, our therapists can better stretch the affected area. Note: Heat is just one tool to help us be more effective, it shouldn’t be the main focus of a treatment plan.

Ultrasound

Best for: Connective tissue injuries

By using sound waves (undetectable to the human ear) to generate heat deep in the body, ultrasound therapy can help loosen up tissues in preparation for manual therapy or exercise. How it works: Therapists use a wand (unfortunately not the magic kind!) to apply the sound waves directly — and safely — to the skin. Ultrasound has also been shown to increase ligament-healing speed in our furry counterparts, though more studies are needed to show whether the same holds true for us .

Low-Level Laser

Best for: Muscular or connective tissue injuries

Laser therapy uses specific wavelengths of light to stimulate healing (well below the skin so you don’t feel a thing). Best-case scenario: The treatment can help reduce inflammation, muscle fatigue, and pain  . It can also allow our therapists to move the affected joint around easier with less discomfort.

Traction

Best for: Disc herniation

When we stand, our spine is consistently bearing our weight making recovery from back pain difficult. Traction involves separating vertebrae to allow more space for nerves and less compression on disc cartilage. Some research shows that traction can be effective for reducing pain and enhancing quality of life in patients with a herniated lumbar disc  . And since it doesn’t involve going under the knife, this can be an effective treatment option for those who can’t afford a long recovery.

Functional Electrical Stimulation

Best for: Restoring muscular strength

Electrical stimulation, also referred to as ESTIM, is a common treatment option to restore muscular function following a traumatic injury. By applying a minor but steady electrical stimulus, our therapists can cause contractions from muscles that may otherwise remain dormant. This leads to restoring proper movement and function sooner than relying on exercise alone. While ESTIM can’t restore movement in every case, research shows it can speed recovery following ACL and total knee replacement surgery over the course of a few weeks. Additional research confirms the use of ESTIM as an effective treatment option to restore function in hemiplegic patients (those with one side of the body paralyzed)  .

Exercise

Best for: Any injury to stay healthy after treatment

It may sound obvious, but exercise is a go-to strategy to treat and prevent pain. But these aren’t just any old run of the mill exercises — they’re hand-picked to help patients move better by strengthening targeted muscles and addressing any muscular imbalances that may exist. Also, keep in mind that many injuries can crop up (or recur) from a sedentary and repetitive lifestyle. (Think: hunching over the computer or obsessing over that Instagram feed.) By performing any sort regular exercise, those with even the most sedentary day-to-day can avoid common nagging aches and pains.

Ready to get checked out? Many of our patients are referred to us by their primary care physicians after an initial checkup. Additionally, new state-by-state direct access laws now allow those in pain to head straight to their local therapist (check your state guidelines for specifics).
Disclaimer: Remember that none of this information should substitute professional medical advice. Always check with one of our therapists first once those aches and pains arise!

Credits - Click the arrow

Ice therapy: how good is the evidence?Mac Auley DC. Institute of Postgraduate Medicine and Health Science University of Ulster, Northern Ireland. International Journal of Sports Medicine, 2001 Jul;22(5):379-84.

The use of ice in the treatment of acute soft-tissue injury: a systematic review of randomized controlled trials. Bleakley C, McDonough S, MacAuley D. Rehabilitation Science Research Group, University of Ulster at Jordanstown, Antrim, Ireland. American Journal of Sports Medicine, 2004 Jan-Feb;32(1):251-61.

Superficial heat or cold for low back pain.French SD, Cameron M, Walker BF, et al. Monash Institute of Health Services Research, Australasian Cochrane Centre, Monash Medical Centre, Clayton, VIC, Australia. Cochrane Database of Systematic Review, 2006 Jan 25;(1):CD004750.

The effect of heat applied with stretch to increase range of motion: a systematic review. Nakano J, Yamabayashi C, Scott A, et al. Unit of Physical Therapy and Occupational Therapy Sciences, Graduate School of Health Sciences, Nagasaki University, Nagasaki City, Nagasaki, Japan. Physical Therapy in Sport, 2012 Aug;13(3):180-8. Epub 2011 Dec 29.

Cold therapy of athletic injuries.Thorsson, O. Kliniskt fysiologiska laboratoriet, Universitessjukhuset MAS, Malmö. Lakartidningen, 2001 Mar 28;98(13):1512-3.

Effect of ultrasound therapy on the repair of Achilles tendon injuries in rats. Jackson BA, Schwane JA, Starcher BC. Department of Health and Kinesiology, University of Texas, Tyler, TX. Medicine and Science in Sports and Exercise, 1991 Feb;23(2):171-6.

Efficacy of low-level laser therapy in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active-treatment controlled trials. Chow RT, Johnson MI, Lopes-Martins RA, et al. Nerve Research Foundation, Brain and Mind Research Institute, University of Sydney, Sydney, Australia. Lancet, 2009 Dec 5;374(9705):1897-908. Epub 2009 Nov 13.

Conventional physical therapy with lumbar traction; clinical evaluation and magnetic resonance imaging for lumbar disc herniation. Kamanli A, Karaca-Acet G, Kaya A, et al. Division of Rheumatology, Department of Physical Medicine and Rehabilitation, Firat University, School ofMedicine, Elazig, Turkey. Bratislava Medical Journal, 2010;111(10):541-4.

Neuromuscular electrical stimulation. An overview and its application in the treatment of sports injuries. Lake DA. Department of Physical Therapy, Northeastern University, Boston, MA. Sports Medicine, 1992 May;13(5):320-36.

Effects of functional electric stimulation on upper limb motor function and shoulder range of motion in hemiplegic patients. Wang RY, Yang YR, Tsai MW, et al. Faculty of Physical Therapy, National Yang-Ming University, Taipei, Taiwan, Republic of China. American Journal of Physical Medicine and Rehabilitation, 2002 Apr;81(4):283-90.

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