Conservative Care

Whether you’re coming in for a simple sprain or chronic back pain we are here to help.  Our number one goal is to treat our patients with conservative care as often as possible. This is accomplished by developing tailored plans to promote the body to heal itself. Your body can heal itself, but it needs the proper amount of loading to stimulate healing and not cause more injury.

That’s where Balanced comes into play. Our physical therapists and chiropractors have experience in dealing with a variety of injuries from acute to chronic and from head to toe. This experience allows us to develop comprehensive plans to promote healing and get you on the road to recovery. Plans will be progressed and patients can expect to be doing something new each session they attend.

Our goal with conservative care is to provide the appropriate stimulus for healing. As injured tissues begin to heal, so must your rehab plan. This is achieved at Balanced by:

  • Progression in weight used throughout sessions
  • Starting with simple movements then increase the complexity
  • Changing the stability requirements of the exercise
  • Moving from low impact to high impact movements
  • Exposing the body to different movements patterns

 

There are so many ways to progress a patient through their program, and we try to ensure our patients are doing something new at each visit.

Why Physical Therapy or Chiropractic First

Both physical therapy and chiropractic doctors should be the first stop when someone is dealing with an injury. We are specialists in examining, diagnosing, and treating musculoskeletal injuries. Starting with one of these professions following an injury has been shown to decrease the overall cost of treatment, the use of medication and pain killers, and the burden on the rest of the healthcare system.

Why Conservative Care

Conservative care has been shown to treat a variety of conditions that were previously thought to only be treated with surgery. Most surgeons may even recommend a course of physical therapy to see if improvements can be made and surgery prevented. Through a combination of manual therapy, therapeutic exercise, neuromuscular reeducation, and other modalities conservative treatment may be effective for your condition.

Some benefits to trying conservative care first:

  • Lowers the overall cost of care
  • May prevent expensive testing including MRI’s
  • May prevent expensive surgeries
  • Very low risk of complications
  • Improvements in strength and range of motion if surgery is necessary
  • Allows the patient to actively participate in their care and recovery

Pre-Operative Care

If you’ve had a major musculoskeletal injury like an ACL rupture, a hip labrum tear, or an ankle fracture and have decided to undergo an orthopedic surgery, were here to help. Whether you are looking to establish a home program to begin before surgery, would like to go through a progressive in-clinic program, or just want to ask our doctors questions about what to expect before during and after the surgery, we are here for you.

Pre-operative care can be as important as the surgery and post-operative care to get you back to the activities you miss the most. Although not always prescribed before a surgery, physical therapy is one of the best things you can do to ensure an optimal outcome following your surgery. If your doctor hasn’t mentioned “pre-hab” to you, be sure to ask about it or call our office to find out more.

Benefits of Pre-Op Care

  • PT is beneficial in helping you go into the operating room with full range of motion and optimal strength; the stronger you go in, the easier the post-op rehab will be and the better outcome you will achieve
  • Allow patients to ask questions about what to expect after surgery
  • Allows you to establish a clinical relationship with your PT before your surgery so that you are comfortable and confident with your provider
  • Allows the PT know about your preferences and expectations for treatment
  • Gives the PT more knowledge of your case and your goals

Our Doctors are ready to get you in shape and ready for optimal outcomes following your surgical procedure. Here are some of the conditions that we see most often:

  • Rotator cuff repair
  • SLAP or Bankart repair
  • Shoulder stabilization surgery
  • UCL reconstruction or “Tommy John” surgery
  • Hip Labrum repair (with or without osteoplasty and microfracture)
  • Hamstring or Gluteal tendon repair
  • Fracture fixation surgery (ORIF)
  • ACL reconstruction
  • MPFL reconstruction
  • Multiligament knee surgery
  • Meniscus repair
  • Lateral ankle reconstruction
  • Joint replacement surgery

What to Expect

Although the injury is present at the time of pre-operative care, there are a variety of exercises that can be performed safely and without risk of further injury. We will work closely with you and your physician to determine your needs during your first appointment. We will then develop a progressive program with a home program for you to work on at home to allow you to progress as much as possible before your surgery date. During this care is  a great time to ask your PT about what to expect following your surgery.

Post Operative Rehab 

Following any major musculoskeletal injury, your post-operative rehabilitation is just as important for a full return to function as the surgery itself. It allows your body to progressively adapt to the changes in the tissue and return to a higher level of function. Without a proper progressive rehab program following surgery, the surgery itself may be ineffective.

 

Benefits of Post-Op Rehab

The benefits are many for post-op rehab:

  • Reduce pain
  • Reduce muscle guarding and spasm
  • Return joint or tissue to full range of motion
  • Improve strength and muscular endurance
  • Improve active stabilization of the joint
  • Improve proprioception and movement patterns
  • Progress into activity specific movements to help reach your goals

Our Doctors are ready to get you in shape and ready for optimal outcomes following your surgical procedure. Here are some of the conditions that we see most often:

  • Rotator cuff repair
  • SLAP or Bankart repair
  • Shoulder stabilization surgery
  • UCL reconstruction or “Tommy John” surgery
  • Hip Labrum repair (with or without osteoplasty and microfracture)
  • Hamstring or Gluteal tendon repair
  • Fracture fixation surgery (ORIF)
  • ACL reconstruction
  • MPFL reconstruction
  • Multiligament knee surgery
  • Meniscus repair
  • Lateral ankle reconstruction

What to Expect

  1. Most surgeons will give you a post-op rehab protocol to follow. This will give you a good idea of how rehab will progress.
  2. Following your surgery, you may have a period of immobilization and/or weightbearing restrictions which are important to allow the surgical site to heal.
  3. The early goal with many post-op rehab programs is progressively improving range of motion. This is generally the focus within the first few sessions. Manual therapy will also help to reduce post-op pain.
  4. Gentle strengthening and proprioceptive exercises will usually be performed early on as well, maintaining any precautions given by your surgeon.
  5. Strength and ROM will be progressively increased and become more challenging over the later weeks, eventually progressing you into sport or activity specific movements.

Before Your First Visit

We ask that you have the surgical office fax your prescription for physical therapy as well as the operative report. The operative report is a written explanation of the procedure that details which tissues were involved, which were anchored, etc. This allows our Doctors to know which tissues need to be unloaded and allows us to progress our patients more safely and effectively. We also ask that the post-op protocol is either faxed or brought with the patient on the first visit.

Resources

UVA Post-op Protocols

Sentara Post-op Protocols

VCU Post-op Protocols

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