What’s a therapeutic exercise?
This is the most valuable physical therapy treatment tool we offer at our practice. Therapeutic exercise consists of a variety of different movements that help to restore and build physical strength, endurance, power, and flexibility. The goal is to progressively load injured tissues to return our patients to a pain-free, fully functioning state.
Based on the initial assessment, the chiropractor or physical therapist will develop an exercise program tailored to the patient’s physical therapy needs. Depending on the patients tissue irritability and overall case presentation, exercises can be manipulated to fit each patients stage of healing to ensure no wasted time in the clinic. Programs are carefully monitored by your doctor and emphasize an appropriate progression to allow tissues to adapt appropriately and thrive. Our ultimate goals is to have our patients performing the movements or tasks that they wanted to get back to doing by their discharge.
How does therapeutic exercise work?
- Movement at the joint level helps to nourish joint surface by reabsorbing tissue waste and bringing in new nutrients.
- It promotes muscle activation to reduce loading of joint surfaces, and improves active stability through improvements in strength.
- When performed appropriately, stimulates muscle to breakdown and rebuild stronger than it was.
- Increases neural recruitment to stimulate more muscle fibers to perform a given task.
All of these effects work together to help the body heal and function optimally. This is why our clinic has a large focus on this to help your body heal.
As a whole, exercise has been shown to reduce anxiety and depression, improve cardiovascular health, improve weight maintenance, promote blood sugar regulation, and reduce inflammation. The benefits to exercise are extensive, but our providers will tune your program to your specific needs to get you the best outcome from care possible.
How does Balanced do it Differently?
Therapeutic exercises should be performed to closely mimic the functional tasks required by a patient. We use free weights and other equipment that allows your body to move in the most unrestricted way possible. Large machines generally provide too much stabilization and don’t let your body move naturally. Appropriately adaptation to a movement is not only essential for healing, but also for preventing future injuries. We have a big open gym equipped to allow our patients ample room to move around and reach their goals.
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General Program Inclusion
- Strengthening exercises: Assists with improving strength with emphasis on dosing to match the requirements of patient stated goals. We want to make you stronger than you were before you became injured. Strength will also help to provide active stability around joints and prevent future injury.
- Endurance exercises: To develop endurance when necessary in target muscle groups. Especially importance in endurance athletes and low back pain patients. Endurance helps the muscle build up tolerance to contracting continuously.
- Flexibility exercises: Helps to restore tissue extensibility to allow patients to move through a greater range of motion.
- Plyometric exercises: Restores muscle power to meet the demands of most functional activities. This is especially important for returning a patient to sport, running, or higher level activities. This crucial step is often overlooked when recovering from an injury.
Neuromuscular Reeducation (NMR) for physical therapy treatment
NMR works to training our body to use our joint sensors more effectively again. Proprioceptors, the small sensors located in all of our tissues, surrounding joints including ligaments, tendons, muscles, the joint capsule, and bones. These sensors usually give our brain extremely accurate information about the state of each joint when we are moving. They tell the brain what muscles are contracting, how strong they are contracting, and the amount of strain on our tendons and ligaments. This information helps the brain decide how to fine tune movement and muscle contraction to prevent injury.
Our brains have an internal picture of what the body looks like and works closely with sensors in joints and other tissues to create this picture. The brain uses this sense to determine muscle contraction strength, joint movements, etc. to ensure smooth and accurate motion. Our brains also use information from these sensors to correct faulty movement and prevent injury. One example of this is when you roll your ankle, your brain quickly reacts to signals given by tendons and ligaments to quickly correct and contract muscles to prevent injury.
With tissue damage or injury, this system usually doesn’t work as well due to either tissue damage, muscle inhibition, or underlying swelling When this happens, you are more prone to re-injury since your brain does not have the capacity to make split second decisions due to faulty information. Our physical therapists in Charlottesville usually apply this technique early in treatment, as movement control is necessary for recovery.
How our Physical Therapists in Charlottesville use NMR
NMR is a collection of techniques and exercises that can be used to train the movement system. To effectively train proprioception, slow purposeful movements in typical patterns must be performed. Each body region has specific exercises that can help to retrain muscle activation in typical, atypical, and reactive patterns. All three of these are necessary to prevent injury and get you moving more normally again.
NMR is used to train joint sense using targeted movements and exercises to challenge balance and muscle activation. This helps to restore proprioception by challenging the the tissues surrounding the joints to work together in a coordinated way. Exercises are generally progressed from relatively predictable movements and surfaces to more plyometric movements with compliant surfaces. Our staff can help you improve your proprioception through an individualized program to help you reach your goals and prevent future injuries.
Physical Therapy Treatment Techniques
- Balance Exercises: Promotes co-contraction of muscles surrounding the joints and stimulates proprioceptors through predictable and unpredictable movements.
- Stabilization exercises: Body reacts to random perturbations to promote activation in a reactive pattern.
- PNF Patterns: Moves the body segment through multiple angles to train functional movements.
- Spinal manipulation: Has been shown to have a short term effect on proprioception.
Why we use Manual Therapy in Physical Therapy Treatments
Manual therapy is a physical therapy treatment technique that can help to speed up and improve recovery. These are the hands-on techniques that people think of when going to a physical therapist or chiropractor. While they are generally included as part of most patients programs, other treatment techniques are usually needed to maintain the effects. Generally, a patient’s treatment course will incorporate more manual therapy during the first few sessions in order to reduce pain.
Manual therapy is thought to be an effective treatment by “resetting the tissue”. Endorphin release and inputs to joint sensors through these techniques help to decrease guarding and improve motion around an injured area. Once this area is able to move more freely, pain and disability begin to reduce and function returns.
These hands-on treatments can help recovery in a few ways:
- Aids in building a therapeutic alliance between the provider and patient.
- “Calms down” an overactive nervous system that may be causing trigger points and tightness.
- Promotes endorphin release within the body.
- Allow for an opportunity for pain free movement when exercising in the clinic.
- Stretches tight tissues which may include muscles, the joint capsule, etc.
Types of Treatment
- Soft tissue mobilization: Similar to deep tissue massage to reduce guarding, release trigger points, and improve tissue mobility.
- Joint mobilizations: Rhythmic movements to a joint in order to stretch the joint capsule and promote endorphin release.
- Joint manipulation: A movement to create a quick stretch of joint tissues. Also promotes endorphin release within the body, improves proprioception and uses the stretch reflex to decrease muscle tone.