Physiotherapy is a healthcare profession that assists people with injuries, pain, stiffness, weakness and other movement problems. It aims to identify a patient’s functional needs and then apply individualized treatment to restore, enhance and/or maintain the ability to move and function. This is achieved through a proper historical analysis and hands on biomechanical assessment, followed by the creation of an appropriate treatment plan.
There are many instances when it is beneficial to consult a physiotherapist. Some of these include:
- If you have sustained an injury, swelling, bruising or deformity in any body part
- If you are experiencing stiffness, pain or aching in your joints (particularly if your symptoms have persisted for more than 3 days)
- If you are experiencing numbness or tingling (“pins and needles”)
- If your limbs fail or give way occasionally, and you need advice on improving strength, flexibility, balance or fitness
- If you have postural problems
- If you need advice on injury prevention or other aspects of musculoskeletal health
- If you wish to improve your physical performance for sports, or are planning to return to sport or activity following a prolonged period of inactivity
In order to determine appropriate treatment techniques for your condition, first and foremost physiotherapy ensures that the injury is thoroughly assessed and correctly diagnosed. After that, an individualized treatment program is developed to address your specific needs and remedy the problems you are facing.
Overall, physiotherapy treatment can accelerate your return to sports or physical activity, and by addressing factors which may have contributed to the development of your condition, physiotherapy will also reduce the likelihood of the recurrence of the injury. Physiotherapists are experts in advising patients on which activities are appropriate for their injury to maximize recovery and ensure an optimal outcome.
Physiotherapists treat many conditions related to the musculoskeletal system, including:
- Sports injuries
- Post-surgical concerns, such as after joint replacements, ligament reconstructions, disc surgeries, bone fixations
- Painful conditions of the neck and back from disc problems, causing local pain and/or numbness and tingling spreading to the arms and/or legs
- Myofascial Pain - pain that occurs in the musculoskeletal system without any obvious cause
- Arthritis and arthritic related pain
- Whiplash and other injuries from MVA (Motor Vehicle Accidents)
- Work related injuries, i.e. repetitive strain from desk/computer work
- Headaches – physiotherapy helps determine if the problem is myofascial (related to pain in musculoskeletal system) or cervicogenic (related to neck dysfunction) in nature
1- Manual therapy is the main treatment tool our physiotherapist at FSRI use. It involves hands-on treatment to the area affected by moving the surrounding bones, joints and muscles either by stretching tight muscles and nerves, or mobilizing (moving) stiff joints with graded amounts of movement, to manipulation (which is a high velocity, low amplitude thrust to a stiff joint).
2- Adjuncts treatments may include:
o Individualized exercise programs and group exercise programs (i.e.: back classes and Pilates)
o Acupuncture: a needling technique for acute and chronic conditions
o Dry Needling: a needling technique for chronic tight muscle bands
o Taping: use of specialized tape to hold and guide muscles and joints into correct positions
o Mechanical Cervical & Lumbar Traction: a machine is used to provide a gentle and consistent stretch to the neck or back joints, in order to help alleviate disc and nerve pain caused by a disc bulge and/or joint compression
o Electrical Modalities: this involves the use of machines such as ultrasound, electrical current, and laser stimulate circulation. Useful only with acute injuries
Your physiotherapy treatment is tailored to your individual needs, so it is not possible to determine in advance how many sessions will be required. At the first appointment, your physiotherapist will suggest the number of treatments you will require based on your assessment findings. In general, you should feel a change within 6-8 sessions of physiotherapy in conjunction with posture and position modification and exercise.
The therapist will discuss the following:
· Your medical history
· Your current problems and complaints
· Pain intensity; what aggravates and eases the problem
· How this is impacting your daily activities or your functional limitations
· Your goals for physical therapy
· Medications, tests, and procedures related to your health
The therapist will then perform the objective evaluation which may include some of the following:
· Palpation - touching around the area of the pain or problem, to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
· Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
· Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted, and often the muscle strength is graded. This is also part of a neurological screening.
· Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
· Special Tests - the therapist may perform special tests to confirm or rule out the presence of additional problems.
· Posture Assessment - the positions of joints relative to the ideal state and each other may be assessed.
The therapist will then formulate a list of problems you are having, and ascertain how to treat them. A plan is subsequently developed with the patient's input; this includes frequency and duration of treatment, home programs, patient education, short-term and long-term goals, and what is expected after discharge from therapy.
Initial assessments usually last for one hour with subsequent sessions of 30 minutes. Your therapist may request subsequent one hour sessions if your condition is more complicated or requires more time for a specific treatment.
On your first visit, please bring along your referral, if you have one, as well as any important insurance information, any hospital reports related to the injury and a list of any medication you are taking. Please wear comfortable clothing that allows visual assessment of the problematic area, such as shorts if it is a leg problem or a tank top for women if it is a neck or shoulder problem. In case you forget, there will be clean shirts and shorts available at the clinic for you to use. If you are not comfortable exposing the area to be assessed this can be accommodated by your therapist.
No, you do not need a referral to start physiotherapy. You can just call our clinic to arrange an appointment for an initial assessment with one of our physiotherapists.
Special arrangements can be made to provide treatment at home for patients with certain conditions or physical disabilities that prevent them from seeking treatment at the clinic. Please contact our clinic for more information.
Many headaches have a mechanical component to them that is often related to the neck. These types of headaches are called cervicogenic headaches and can mimic migraines or can trigger migraines in those who suffer from them; this can develop into a condition called chronic daily headache. Treating the neck, upper back and shoulders can relieve the neck headaches that may be mimicking or triggering the migraines, thus reducing their frequency and intensity. Manual therapists, have the tools to assess and treat the various factors that can contribute to headaches.
Respiratory physiotherapy is aimed at increasing endurance and improving quality of life in patients with lung conditions .There are many treatments that can be administered, including:
· Coping strategies for breathlessness
· Chest clearance techniques
· Breathing retraining
· Lifestyle management
· Postural draining
Pediatric physiotherapy involves treatment for any child with developmental delays, congenital problems or childhood diseases such as cerebral palsy, spina bifida, muscular dystrophy, arthrogryposis and spinal cord injuries.
Our specialist pediatric physiotherapist can offer advice and support for parents. Following a detailed assessment, specific treatment plans will be developed based on your child's needs. These may include:
· Stretching and strengthening programs
· Education of normal movement patterns
· Gait training/retraining
· Milestone development
· Fine or gross motor skill practice
For an appointment with our Pediatric Physiotherapist please contact our specialized pediatric team at FSRI’s Children’s Evaluation and Rehabilitation Center (CERC) at 22052877.
Acupuncture is a therapeutic method used to encourage natural healing, reduce or relieve pain and improve function of affected areas of the body. Acupuncture involves the insertion of very fine needles through the skin and tissues at specific acupuncture points on the body. This method is a 2500 year old Chinese system of natural healing that is a safe and effective method to reduce or relive pain, improve function of affected areas of the body and to encourage healing in the body. Many times, acupuncture is used as an alternative to medications. Electrical stimulation can be added to the acupuncture needles to enhance its effectiveness for certain conditions. Acupuncture has been around longer than Western medicine and is now a very common and effective tool used in physiotherapy practice to treat conditions varying from back pain, nerve pain, headaches to jaw pain (TMJ region).
Chinese Eastern Medicine Theory
The Chinese theorized that the body had an energy force, known as Qi (pronounced Chee) running throughout it. The Qi consists of all essential life activities, which include the spiritual, emotional, mental, and physical aspects of life. A person’s health is influenced by the flow of Qi in the body. If the flow of Qi is insufficient, unbalanced or interrupted, the person's body becomes unbalanced, circulation becomes affected and illness may occur. Qi travels throughout the body along “meridians”. The meridians (or channels) are the same on both sides of the body (paired). The acupuncture points are specific locations where the meridians come to the surface of the skin, and are easily accessible by “needling” or acupressure. The connections between them ensure that there is an even circulation of Qi, meaning energy constantly flows up and down these pathways freely.. Acupuncture is said to restore the balance of Qi.
Western Medicine Theory
In the last 30 years, attempts have been made by scientists to explain some of the pain-relieving effects of acupuncture in Western terms. Western medicine believes that acupuncture stimulates the body to produce its own pain relieving chemicals called “endorphins". Endorphins help to block pathways that relay pain messages from the body to the brain, resulting in relief of pain, general relaxation and biochemical restoration of the body's own regulation systems. The improved energy and biochemical balance produced by acupuncture stimulates the body's natural healing abilities, reducing inflammation, and promoting physical and emotional well-being.
People experience differing sensations with acupuncture. Most patients feel only minimal discomfort as the needles are inserted; some feel no pain at all. Once the needles are in place, there should be no significant discomfort. Acupuncture needles are extremely fine and are made from stainless steel, thereby they are much thinner than needles you receive for injections. The sensations common with acupuncture during treatment can be described as an electrical, achy sensation, or feelings of heaviness, numbing or a flowing sensation in the area being needled. Think of the meridian system as plumbing, when there is a problem in the body, our bodies “plumbing” meaning “the energy flow according to the Chinese” has become blocked. When the described sensations are felt, it means the “clog in the plumbing” has been opened, and in our bodies it means the energy and blood circulation to the tissues affected can properly be attained.
One of the most striking aspects of acupuncture is the almost complete absence of adverse effects and complications from its use when performed by a qualified professional, such as a physiotherapist with advanced training. Most patients find that the treatments are relaxing and cause minimal discomfort. Only sterile disposable needles are used at our clinic, preventing the risk of infection.
The most common adverse effect that can occur involves the development of a small bruise, with a small amount of bleeding that may appear at the needle site. Other treatment effects that may arise in some people are: fatigue, feeling of dizziness, mild pain while the needle is in place or after the needle is removed, nausea, and fainting. Infection is a small possibility with any invasive technique, but when clean, sterile needles are used this minimizes the chances of an infection ever happening.
People who have pacemakers can still be treated but such conditions should be brought forward to the therapist so that no electrical stimulation is used.
The number of treatments required will vary for each individual and depending on the condition being treated. For acute problems, only a few treatments may be required. Some people will notice improvement right away, whilst others may need a dose of treatment which gives a cumulative effect before a benefit is noticed. Generally at least 5-6 treatments are recommended to see if acupuncture has any benefit for you.
For chronic, complex or longstanding conditions, 1 to 3 treatments a week for a period of several weeks may be recommended, with less frequent treatments as improvement occurs. Treatment sessions usually last between 15 to 30 minutes. Relief may be immediate, or it can occur within a few hours or days, or in some cases only after receiving a few treatments. Acupuncture’s main goal is to balance the body, therefore some people may experience an increase of their symptoms for a few hours or for a day or two before they start to feel some relief; this is a normal side effect for some. An escalation of symptoms or an immediate lessening of symptoms are both good responses showing your body is responding to the treatment.
Acupuncture can be used as the only form of therapy or it may be combined successfully with other forms of medical or physical therapy.
Acupuncture treatment can be done at any time. Patients are advised not to eat unusually large meals before or after treatment. It is best to avoid alcohol or sedatives for four hours prior to treatment. Pain medications may be taken as required.
Acupuncture is a very effective method to treat ailments of the body. It is a safe, effective and natural alternative to treat pain and dysfunction.
Contrary to popular opinion, acupuncture and dry needling are not the same. Although both treatments are carried out using the same type of needles (sterile, single-use, stainless steel needles which contain no medicine), the treatment styles and objectives of these modalities are vastly different. Whereas acupuncture is based on the principles of ancient Chinese medicine and energy flow, dry needling works to reverse physiological adaptations which muscles undergo in response to stress, overuse and pain. A common effect of both treatments is the release of the body’s natural painkilling chemicals in order to reduce propagation of pain signals through the nerves of the body; in essence these chemicals “turn down the volume” of your pain.
This ancient treatment involves the insertion of needles into the muscles in order to treat imbalances in the body’s energy, referred to as De Chi by Chinese Medicine. Acupuncturists manipulate the body’s energy flow by stimulating distinct points mapped out on meridians, the network of lines within the body through which this energy moves, in order to restore the natural flow of energy and thus restore wellness to the body. The application of acupuncture is wide-ranging; it is indicated for issues from musculoskeletal pain and dysfunction to migraines, fibromyalgia, menstrual cramps, addiction, infertility, nausea, insomnia, depression and anxiety.
Dry Needling (DN)
When a muscle is put under repeated or elevated levels of strain, it tends to assume points of continuous contraction along its length, in order to increase its tension and therefore better equip it to respond to physical demands. However, these tight points tend to cause pain and reduce the muscle’s ability to work, as a muscle that is already continuously contracted to a certain degree has a limited capacity left to contract and relax. Dry needling relaxes these tight areas by restoring the natural chemical balance and promoting healing within the dysfunctional muscle, resulting in a muscle that is better able to assume its role within the body. Dry needling is useful for all chronic musculoskeletal dysfunction and pain. The safety, feeling, and number of treatments follow the same principles as for acupuncture. Both methods are used only for musculoskeletal conditions at FSRI.