Orthopedic Massage

May 28, 2008 by admin  
Filed under Massage & Wellness, Physical Therapy

Orthopedic Rehabilitative Massage is an advanced form of bodywork in the current mainstream health care community. This type of massage is indicated for post-surgery, chronic pain, overuse, and repetitive stress injuries. It is indicated for people of all ages and body types. This deeper (more pressure, deeper layers) type of massage is very useful when patients/clients are in some sort of discomfort or pain and is useful (and in some cases more results with) as preventative medicine, which seems more important in this day and age. It compliments treatments by physical therapists, chiropractors, acupuncturists, osteopaths, and medical doctors.

This advanced style of bodywork requires more training from therapists specifically in the areas of anatomy, physiology, and pathology of injury. This work can be applies to any body part ranging from the neck all the way down to the feet. You will find practitioners of this work in multiple work settings, whether it is in a physical therapy or chiropractic clinic or day or resort spa. But if you decide to receive this type of therapy, please do your research. Not every massage therapist is qualified or for that matter good. So do your homework, find out the massage therapist’s history, education, and experience in body work. At North Tahoe Physical Therapy we are constantly increasing our understanding of how to address pathology, as continuing education is required for all licensed therapists.

Orthopedic Massage is a form of manual therapy that specializes in the treatment of musculoskeletal pain and dysfunction. In addition to the benefits of traditional massage such as relaxation and increased circulation, orthopedic massage has several other treatment goals. These include increasing the range of motion, decreasing and managing pain, and normalizing musculoskeletal function. The therapist works to dissolve adhesions in muscle and connective tissue, lengthen connective tissue, balance muscle function by strengthening weak muscles and releasing tight ones, as well as normalize the position of soft tissue, restore joint function, release entrapped nerves, and facilitate normal neurological function.

What to expect from Orthopedic Massage

You may ask, why a deeper more rehabilitative massage as opposed to your traditional Swedish massage? I prefer to label what I do as body work as opposed to massage. For a few reasons; when people think of massage they tend to correspond it to your every day Swedish massage, “which is nice to get”. Yes, I am doing tough “massage strokes”, but I am providing the body the therapy is desperately needs to return it to normal working order. I provide this type of work when everything else fails with traditional massage therapy and the pain and dysfunction persists. Also, I will incorporate other therapies such as Myofascial Release, myofascial stretches, manual traction, muscle energy techniques, and craniosacral therapy. So it is not necessarily massage strokes.

A session typically lasts from ½ hour to 1 hour. The work will be both gentle and deep. For lasting results, the therapist will want to see the patient 2-3 times a week initially, as frequency is the key. During the course of a session, the therapist will evaluate the entire body and address the body as a whole, to see how is responding to the injury. The therapist will then specifically address the area of trauma to increase the fluidity in the tissue and range of motion in the effected joints. This can be done by a postural evaluation, checking passive range of motion, or movement analysis.

-Brian Hrindo, MT

Stay Physical, With Therapy

May 23, 2008 by admin  
Filed under Physical Therapy

Ask five people what physical therapy is and I’ll bet you a Spring Pass you get five different answers. The beauty is that physical therapy is very different depending on what the individual requires to optimize health and quality of life. A good therapist customizes treatment to reach a patient’s goals and improve quality of life. This means that the process should be very different for a competitive skier and a deconditioned elder, even if both have knee injuries. Physical therapists are trained to identify limitations or dysfunction on many levels and problem solve in a way that best serves the patient.

Many don’t realize that for those entering the field today, a Master’s of Science or Clinical Doctorate (DPT) is necessary to qualify for the licensing exam. In addition, the American Physical Therapy Association is advocating for all educational programs to be DPT accreditated by 2020, generally 6-7 years of college education. All this training is geared toward evaluation and treatment sensitive to each individual’s needs. This includes integration of a variety of body systems affecting one’s health. Musculoskeletal, neurological, cardiovascular, respiratory, integumentary, digestive/urinary, and emotional health are all part of this assessment process.

The advantage to this background is that a physical therapist can gear treatment toward the larger picture of health. An injured shoulder is not a separate entity, but a piece of the puzzle affecting daily activity, mental health, recreation, occupation, and social life. It is most therapists’ intention to see this spectrum and work toward improvement through treatment, lifestyle changes, patient education, and home exercise. For the patient with pain, the treatment approach should include identifying the problem, working toward relief, and then preventing future pain. The injured athlete may need guidance in pacing his/her progression for optimal recovery. The client with neurological dysfunction and balance deficits should be instructed on home environment modifications to prevent falls. These are very different situations with different needs. Also, taken into account are individual characteristics. Factors including fear, attitude, motivation and bodily awareness must be recognized. Responsibility also lies on the therapist to educate the patient so they understand their body and can help prevent future impairments. To work with the patient and understand this broad approach will create the best outcomes.

What many don’t realize is that one doesn’t have to be suffering to benefit from therapy. Wellness promotion can be the sole purpose with prevention of future ailments being the primary goal. For someone that has had a heart attack and isn’t quite sure just how to improve their fitness, physical therapy can be a great place to start. For the office worker with slight aches and pains, education in ergonomics and stretching to prevent carpul tunnel or thoracic outlet syndrome may be indicated. Unfortunately, our society has valued reaction instead of prevention in healthcare for much too long. Most problems are more successfully treated early in their course than later when dysfunction has escalated and negatively impacted physical activity or movement patterns.
Furthermore, every patient has the right to choose the physical therapist they utilize. As with any profession, some people work well together and some don’t.

Communication is the key to successful treatment to ensure that both understand the plan of care and how the patient is reacting physically and emotionally. Specialists in physical therapy may also better serve you. Training and expertise in many fields are part of physical therapy and can be overlooked. Physical therapists who are specialists in Women’s Health, pediatrics and geriatrics, wheelchair evaluation, orthotics and brace fitting, Myofascial Release, and other manual therapies can help manage specific problems or pain. This can supplement or prevent a need for medication or more invasive medical options. If it’s important to you, a bit of research may give you other alternatives.

To those young people looking for direction and wondering what occupation to pursue, I encourage an investigation of the field of physical therapy. Options are numerous with this degree. Sports physical therapy or rehabilitation from athletic injury is often the only mental picture people get when they think of this field. In actuality, one can work in hospitals, schools, with animals, in education, in research, or as specialist, among other options. It’s an exciting time in our history to be involved with healthcare as technology changes, research diversifies, and health trends evolve. If working with a broad range of people and studying the human body and its condition interest you, physical therapy may be a good fit. With permission, shadowing a physical therapist for a day can be a good opportunity to learn more.

For more information, visit the APTA website, www.apta.org, or, contact a clinic with your questions. Be well and enjoy the day.

-Andrew Emery, PT at North Tahoe Physical Therapy

Pelvic Floor Dysfunction

May 20, 2008 by Jane O'Brien  
Filed under Women's Health

Commonly, people associate pelvic floor dysfunction (PFD) with incontinence. However, there are a myriad of diagnoses that fall under this category such as overactive bladder, pelvic pain, prolapsed uterus, interstitial cystitis, coccyx pain, painful intercourse, and many others. Symptoms may limit a woman’s ability to perform her daily activities, change or limit her exercise habits, and create embarrassment. Problems in this area are often not discussed with medical professionals, and therefore, go untreated.

Physical therapy can greatly benefit the pelvic floor. Exercises geared for this area greatly enhance muscle function. Relaxation techniques may be utilized to assist with decreasing tone and pain. Manual techniques, such as Myofascial Release and soft tissue massage are often used to relieve tension. Biofeedback is used to increase awareness of proper muscle recruitment or to quiet overactive muscles. Electrical simulation may be used to recruit and train pelvic floor musculature. In addition, patient education can assist with prevention of dysfunction.

When choosing a physical therapist for treatment of a pelvic floor dysfunction, it is important to ascertain if she is qualified to treat this area. Be sure she has taken coursework specifically for PFD. Ask her how many clients she has treated for your issue. Ask outcomes of treatments. Ask if she can help you gain relief of your symptoms and improve your lifestyle.

PFD is common, but not normal. You do not need to simply accept your symptoms as a process of growing old or due to childbirth. You can take control of your symptoms and often relieve them completely.

Jane O’Brien, MSPT works with clients ( male and female) who have Pelvic Floor Dysfunction at North Tahoe Physical Therapy.

The Certification of Achievement in Pelvic Physical Therapy

May 15, 2008 by Jane O'Brien  
Filed under Women's Health

The Certification of Achievement in Pelvic Physical Therapy is offered by the Section on Women’s Health of the American Physical Therapy Association. The Section on Women’s Health offers three levels of Pelvic Physical Therapy courses. These courses provide evidence-based education for the learner to acquire skills and knowledge to provide Physical Therapy interventions for male and female clients of all ages with pelvic floor dysfunctions, including pelvic pain, urinary incontinence, endometriosis, and many other conditions. This certification prepares the learner for the Women’s Health specialization Exam.

The requirements are attendance at the SOWH Pelvic Physical Therapy classes level 1,2,3, pass the competency skills tests for each level, pass didactics tests for each level, and submit a case report. Experienced therapists who have completed previous training in pelvic physical therapy can apply for the transitional CAPP. I qualify for the tCAPP.

I have nearly completed the requirements for the Certificate of Achievement in Pelvic Physical Therapy. I just received my certificate of completion for the Level 3 class I took in March 2008 in Portland. I received a 94% on my post test. All that is left to do is to complete my Case Study and submit it. This could take some time as it involves both evaluating and following a client through their pelvic floor therapy, writing the requirements for the case study, and having it accepted. I expect to complete this process in the next 6 months. I’ll keep you posted!