A man in his late 50s who is trying to bend his prosthetic knee after recovering from a total knee replacement. A 20-year-old woman who has been in a car accident that has drastically impaired the range of motion in her shoulder. A 5-month-old baby with torticollis, a shortened neck muscle that prevents his ability to look to the left. A college baseball player recovering from rotator cuff repairsurgery. What these different types of individuals have in common is that a physical therapist plays a crucial role in their rehabilitation.
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Physical therapy is a rehabilitation profession with the goal of diagnosing and treating people with medical or health-related conditions, that limit their movement and ability to carry out normal daily activities, also known as activities of daily living (ADLs). Physical therapists evaluate each patient individually and develop a customized plan for treatment that best meets their needs and goals. Some common physical therapy goals include: improving mobility or range of motion, balance, and endurance, increasing strength, and preventing injuries. Each goal in physical therapy is tied to a specific function. For instance, a post-operative shoulder patient may need to increase right shoulder flexion to 180 degrees so she is able to put groceries away in the top cupboard. Another example would be a patient that needs to increase right lower extremity strength so he can stand from his chair independently.
What are common “treatments” physical therapists use with their patients?
The most common treatment physical therapists use with their patients is therapeutic exercise to strengthen muscle and improve flexibility and range of motion. Other modalities physical therapists may prescribe include electrical stimulation, ultrasound, ice therapy, and massage. Ultrasound is a deep form of heat using sound waves used to break up edema or inflammation and treat chronic inflammatory conditions such as tendonitis. Electrical stimulation (e-stim), on the other hand, is a non-thermal treatment most commonly used for pain control as it effects the polarity and chemistry of the tissues to serve an anti-inflammatory function. E-stim can also be used to stimulate and strengthen muscle contractions.
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Physical therapists may also use therapeutic taping techniques to prevent injuries, treat biomechanical problems, and relieve pain. For example, a physical therapist may tape a patient’s knee in order to help the kneecap move in a more efficient and less painful way.
With further training physical therapist may be able to perform joint manipulations and mobilizations. These modalities are given a “grade” to define the amplitude of the oscillations given and whether they are given at the beginning of range of the joint or at the end range. Physical therapists commonly use grades one through four joint manipulations to manually and passively moving a joint. The purpose of the manipulations are to increase the patient’s range of motion or decrease pain or spasm by stretching the non-contractile tissues such as joint capsules and ligaments. The therapist makes a skilled decision on which grade will be most beneficial based on the patient's symptoms. Chiropractors are most well known for mobilizations. They use grade five mobilizations, called manipulations, which are quick forceful thrusts of the joint.
Home education is also an important job function of physical therapists. It is necessary to teach patients what they need to do at home once they leave the one-on-one treatment so they can continue seeing improvement. Physical therapists also instruct patients on proper posture and body mechanics involved in everyday tasks to help prevent injury. If a patient has low back pain and they sit at a desk all day at work, the physical therapist will teach them to sit correctly and use proper posture to prevent further irritation.