Tuesday, January 12, 2010

Seeing With Our Hands, Not Just Our Eyes

When I was in physical therapy school, a lot of my professors would tell us that as physical therapists we "see not only with our eyes, but also with our hands."

For a good manual therapist that is absolutely true. We use our palpation skills to look for soft-tissue tension, check for alignment issues, and assess proper motion/movement. We do more than simply ultrasound and exercise you as a patient. There are in fact a plethora of tools at our disposal. Below I'll describe a few of them for you.


Soft Tissue Mobilization
Often times muscle tension needs to be addressed or joint dysfunction may persist/return. For example, after an injury or surgery, adhesions and scar-tissue may form in the area, limiting normal range of motion (ROM). With soft-tissue mobilization, those adhesions can be broken down. In addition tissue fluids can me moved so swelling is dissipated and circulation can improve.


At ESPT, we are one of the few clinics in the area that offer
Sound-Assisted Soft-Tissue Mobilization. By using special tools to help break down the soft-tissue and fascial restrictions, we can better treat ongoing muscle and tendon issues (tendinosus) in ways our competitors can't.

Joint Mobilization
Muscle spasms can also respond to a restricted joint, so simply heating and stretching an area may not produce lasting results. By mobilizing a stiff joint, we can restore proper movement and range of motion, thus taking stress off of the surrounding muscles. These mobilizations should be painless, but on occasion can be a little painful if the joint is very stiff. In any case, there should be no lasting symptoms after the mobilizations.

At ESPT, we are the only clinic in the area with the ATM2 by Back Project. You can read more about it in our blog here. With the ATM2, we can "reset" your neurological system so that you do not perceive pain. Muscles often respond with guarding/spasm, when we are in pain. By supporting your body with the ATM2 apparatus and eliminating your pain, your muscles will have a chance to relax and return to their normal function, instead of tightening up to protect you.

Muscle Energy Techniques
This is a special technique using voluntary contractions by the patient to mobilize restricted joints and lengthen shortened muscles. This procedure is a little more active as compared to joint mobilizations, since it requires patient interaction to contract certain muscles against a counterforce provided by the therapist. These are tolerated very well and do not usually stress the joint.


High Velocity, Low Amplitude Mobilizations
This is a more aggressive technique that takes a joint to its restrictive barrier and thrusting with a low amplitude to restore proper joint motion. If it is used properly, increased motion and decreased muscle spasm should be noticed immediately. Therapists have to go through special coursework/training in order to perform these mobilizations.

At ESPT, we are fortunate to have the only Certified Orthopedic Manual Therapist in the area. You can read about it in our blog here. And Joey is qualified to perform these high velocity, low amplitude mobilizations. Come see him if you have back pain/neck pain that has not improved with physical therapy elsewhere.

In today's health care environment, physical therapy clinics can no longer just be "gyms." Patients cannot come in and simply run through exercises. Therapists have to show what they are capable of and how they can provide a unique, professional service that others cannot. We need to prove our worth, so that patients know they are getting quality service and care with their insurance dollar.

If you haven't experienced any of the above techniques in your physical therapy treatment or would like to find out more about them, feel free to contact us at
Elite Sports Physical Therapy @ 510.656.3777.

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