Ultrasound as a Modality used in Spine Rehabilitation

Physical Therapists have many different treatment modalities to choose from when treating back pain or as part of a Spine Rehab program.  One such modality is the use of Ultrasound.  Ultrasound is a modality with many treatment uses.  Today we will discuss how Ultrasound works and why it is such a useful tool in Spine Rehabilitation.

Ultrasound machines are a treatment modality used by physical therapists that utilize high or low frequency sound waves (those that are out of the range in which we hear). These sound waves are transmitted to the surrounding tissue and vasculature. They penetrate the muscles to cause deep tissue/muscle warming and this warming effect causes vessel vasodilatation and increased circulation to the area that assists in healing. This promotes tissue relaxation and therefore is useful in treating muscle tightness and spasms and is used to minimize muscle pain and movement dysfunction. 
 
The physical therapist can also adjust the frequency on the machine to use waves that will decrease inflammation. The treatments help reduce stiffness, swelling, and pain and also increase circulation, and promote pain-free movement.

With back pain and injuries inflammation sets in and causes stiffness, pain and restriction of movement which further worsens the pain and stiffness.  The heat that ultrasound waves produce cause the vessels in that region to dilate and increase blood flow to the area, which helps to decrease inflammation and promote healing of the injured tissues.

Ultrasound therapy is a painless procedure, and many people find it relaxing.

Our staff is very experienced in the use of Ultrasound as a treatment modality to treat Spinal injuries.  Call us today to schedule an appointment if you or someone you know is suffering from back/spine pain and needs an expert who specializes in Spine Rehab! 386-898-0443

What is the Graston Technique® and how can it help with Spine Rehab/Back Pain?

In our last blog we discussed our specialty in Spine Rehabilitation and mentioned we would further explore some of the modalities we use to treat Back Pain.  In this issue we discuss the use of the Graston Technique® as one option in treating Back Pain.  Read more to learn what the Graston Technique® is, how it works, what a patient can expect prior to, during and after treatment.

Graston Technique®

There are many treatment options available for back pain caused by soft tissue problems, such as a back muscle strain. One method of treatment is soft tissue instrument assisted mobilization, also known as the  Graston Technique®. 

Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The Technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

The Graston Technique®, originally developed by athletes, is changing the way clinicians — including athletic trainers, chiropractors, physical therapists, occupational therapists — and patients view treatment of acute and chronic soft tissue injuries.

The majority of practitioners specializing in this technique are osteopathic physicians, athletic trainers, physical therapists and occupational therapists, and it is also available to medical doctors and registered nurses.

Fairly extensive training is required in order to use the technique and we are trained and experienced in using the Graston Technique® for many conditions including back pain.

Soft Tissue Injuries and Back Pain

Most of the back is comprised of muscles, ligaments and tendons, and injuries to these soft tissues play a significant role in the pain and dysfunction associated with back problems. While it may not sound like a serious injury, a simple muscle strain or torn ligament in the back can cause excruciating pain and difficulty with movement.

When an injury within the soft tissue occurs, the tissue repairs itself in a haphazard pattern, forming scar tissue. While the scar tissue itself is not painful, it does tend to limit range of motion, and the ongoing stiffness may contribute to back pain or neck pain on an ongoing basis.

How the Graston Technique® Works

This form of manual therapy comprises soft tissue mobilization and incorporates the use of stainless-steel instruments. The goal of the therapy is to separate and break down the scar tissue, as well as stretch connective tissue and muscle fibers. There also appears to be a neurologic component to treating patients with the Graston Technique Instruments.

The Graston Technique® uses the instruments with a specialized form of massage that is designed to help the practitioner identify areas of restriction and break up the scar tissue. The concave and convex stainless steel instruments are used to comb over and catch on injured fibrotic tissue.

Using a cross-friction massage, which involves brushing or rubbing against the grain of the scar tissue, the practitioner re-introduces small amounts of trauma to the affected area. This temporarily causes inflammation in the area, which in turn increases the rate and amount of blood flow in and around the area. The theory is that this process helps initiate and promote the healing process of the affected soft tissues.

Treatment is rendered along the kinetic chain and thus a patient presenting with back pain might also receive treatment to the hip flexors, abdomen, hamstrings and other regions of the body.

Patients undergoing therapy with the Graston Technique can expect the following:

Prior to Treatment

• Prior to an appointment with your physical therapist, patients are advised to complete five minutes of cardiovascular activity, such as riding a stationary bike or walking on a treadmill
• At the office of the physical therapy clinic, ultrasound or heat treatment may first be applied to the injured area to warm up the soft tissue

During Treatment

• The practitioner will utilize the appropriate Graston Technique® instruments to scan, then treat, the affected area of the back
• Treatment generally consists of the clinician rubbing the affected area(s) with the handheld stainless steel Graston Technique® instruments, using very specific, calculated massage techniques
• Treatment time is usually 30 to 60 seconds per area treated

After Treatment

• The patient is advised to stretch the areas treated
• Following stretching, the patient may begin low load, high repetitions of exercises using an elastic band.
• It is common for patients to experience some discomfort during the procedure and possibly some bruising. Ice application for 15 to 20 minutes following the treatment may ease the discomfort.
• Patients are advised they may be sore, bruise or exhibit small red dots over the area treated called petechiae.

It is recommended that an exercise, stretching and strengthening program be used in conjunction with this technique to rehabilitate the back and help the injured tissues heal.

The typical course of treatment generally range from 6 to 10 visits. No medications are required in conjunction with this specific treatment.

Contraindications

Not all candidates with pain related to soft tissue injury are candidates for Graston Technique® therapy. Patients any with the following are not good candidates for the treatment:

• Open wounds
• High blood pressure
• Cancer (depending on the type and location)
• Pregnancy (pregnant women should avoid having the therapy done over the spine, pelvis, abdomen or along certain acupuncture points)
• Unhealed, complicated fractures

For a full list of both absolute and relative contraindications to the use of this therapy, please consult a trained Graston Technique® clinician by calling us today!

(web sources for this article include: http://www.spine-health.com and http://www.ssprehab.com/services/graston-technique)

Spine Rehabilitation

Did you know that Progressive Physical Therapy specializes in Spine Rehabilitation?

Your recovery from spine pain or injury can be improved by learning new ways to strengthen your spine and prevent future problems. Our physical therapists can teach you ways to help reduce your pain now and form new habits to keep your spine healthy in the future without becoming dependent upon weekly or monthly interventions for years.

At your first physical therapy visit, our physical therapist (PT) will gather information about your spine condition. You may be asked questions about when it started, where you hurt, and how your symptoms affect your day-to-day activities. This helps your PT to begin zeroing in on the source of your problem and to know what will be needed to help relieve it.

Your therapist will evaluate your answers and your exam results to determine the best way to help you. He/she will then write a plan of care, which lists the treatments to be used and the goals that you and your therapist decide on to do your daily activities safely and with the least amount of discomfort. The plan also includes a prognosis, which is your therapist's idea of how well the treatments will work and how long you'll need therapy in order to get the most benefit.

The main goal of therapy is to make sure you have ways to take care of future spine pain or problems. You'll be shown ways to help control pain or symptoms if they don't go completely away and if they return in the future. Because you've experienced spine pain, there is a possibility you may have soreness in the future. You may be encouraged to continue with some of the exercises to help keep your spine healthy over time.

Treatment to control pain and symptoms includes a variety of options that your physical therapist will choose based upon your individualized care plan that he/she developed based upon his/her exam of your spine.  They may include rest, positioning, ice, heat, ultrasound, electrical stimulation, soft tissue mobilization/massage, manual therapy, joint mobilization, traction and the Graston technique.

The next step in your therapy course would be the introduction of therapeutic exercise which is individually designed to help you to work on flexibility, stabilization, coordination and fitness conditioning.

This step is then followed by functional training which helps you with doing specific activities with greater ease and safety. Examples include posture, body mechanics, and ergonomics.

Once your pain is controlled, your range of motion has improved, and your strength is returning, you will be progressed to a final home program. Your therapist will review some of the ideas listed above to help take care of any soreness at home. You'll be given some ways to keep working on your range of motion and strength. Before you are done with therapy, more measurements may be taken to see how well you're doing now compared to when you first started in therapy.
We will be exploring some of the treatments and modalities discussed above in more detail with future blogs. 

We hope you found this overview of Spine Rehabilitation helpful and will keep Progressive Physical Therapy, Inc. in mind for all of your or your family and friends' Rehabilitation needs!

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(source referenced for this blog: allaboutbackpain.com)

Manual Physical Therapy for Pain Relief

Did you know that Charlie is Manual Therapy Certified? 

Manual physical therapy is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, practitioners use their hands to put pressure on muscle tissue and manipulate joints in an attempt to decrease back pain (as well as other painful conditions in the neck and throughout the body) caused by muscle spasm, muscle tension and joint dysfunction.  This certification is a graduate level program consisting of up to 20 additional college course credits.  Charlie completed this graduate program at the University of St. Augustine where he earned his Doctorate in Physical Therapy.

It has been heavily researched and proven that Manual Therapy techniques work best for many painful conditions including Back and Neck Pain. 

Also, did you know that while patients may be referred for physical therapy treatment by their primary care doctor, an orthopedic surgeon, or other doctor involved in their back care, most states, including Florida, have direct access laws permitting patients to seek help for low back pain from a licensed physical therapist without having to seek a written referral.

Check out this link to learn more about how Manual Therapy can help with painful conditions that you or someone you know may be suffering from!

http://www.spine-health.com/treatment/physical-therapy/manual-physical-therapy-pain-relief

Knee Replacement and Physical Therapy

Knee replacement surgery is the most common joint replacement procedure. Many people have knee arthritis, but it can be difficult to know when the right time to have a knee replacement surgery is. Furthermore, there is confusion about what to expect from knee replacement surgery. Do you have questions? Look no further. You can find all you need to know about knee replacement surgery right here.

 

Click on this link to learn more about reasons people may need a Knee Replacement: http://orthopedics.about.com/od/hipkneereplacement/tp/kneereplacement.htm

 

Knee replacement surgery is very successful, but the success of the procedure is partly due to the rehabilitation period that follows the surgery. For patients to expect a good result from knee replacement surgery, they must be an active rehab participant.
Rehabilitation after knee replacement begins immediately. Patients will work with a physical therapist as soon as the surgical procedure has been performed. The emphasis in the early stages of rehab is to maintain motion of the knee replacement and to ensure that the patient can walk safely. The body reacts to surgery by making scar tissue, and patients may never recover normal motion if they do not focus on bending and straightening their knee replacement.

Call us today if you or someone you know is planning to get a knee replacement soon. We can schedule a visit for you to talk with Charlie or Jessie about what to expect with your rehab! 898-0443.

Suffering from Arthritis?

Suffering from Arthritis or know someone who is? Check out this link to learn how Physical Therapy can improve your quality of life and call us today! 898-0443

http://www.medicinenet.com/arthritis_physical_and_occupational_therapy/article.htm

Progressive Physical Therapy, Inc.

Progressive Physical Therapy, Inc. is a family owned and operated outpatient therapy clinic in Ormond Beach, Florida.  Charlie Piazza, our owner/president, holds a Doctorate Degree in Physical Therapy and is also a Certified Athletic Trainer, Certified Manual Therapist, Certified Lymphedema Therapist, and Certified Hand Therapist.  We specialize in treating all patients with any of these conditions as well as Sport/Orthopedic Injuries, General PT and Women's Health/Pelvic Floor Rehab.  We also have an Occupational Therapist who is a Certified Hand Therapist on staff as well as on-site Massage Therapy.  Follow us on Facebook, Twitter and Linkedin!  Visit our Web site at: http://www.progressiveptinc.com/