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Techniques used by therapist

 Range of motion exercise (ROM) refers to activity aimed toward improving movement of a selected joint. This motion is influenced by several structures: configuration of bone surfaces within the joint, joint capsule, ligaments, tendons, and muscles working on the joint.


There are three sorts of range of motion exercises

Passive
Active
Active assistive

Limited range of motion refers to a joint that features a decrease in its ability to move. Motion could also be limited due to a problem within the joint, swelling of tissue round the joint, stiffness or tightness of the muscles, or pain.

Manual therapy.
In the assessment of the findings, manual therapy deals with the functional limitations of the muscles, ligaments and skin as well as the examination of the joint mechanics.

The greater part of manual therapeutic techniques consists of passive mobilizations in which the patient is positioned painlessly. The targeted treatment of the bony joint partners and the soft tissues surrounding the joint lead to improved and painless mobility.

In a rough breakdown, three mechanical approaches can be described:

Traction: the two joint partners are removed from each other by pulling gently.

Translation: the joint surfaces of the two joint partners slide past each other.

Soft tissue treatment: the soft tissues surrounding the joint are adapted to the new joint situation and the muscles are guided to their joint-specific function.
Typical symptoms for which manual therapy is indicated:
Functional restriction of the spinal joints.
Functional restriction of the sacroiliac joints.
Herniated discs.
Shoulder-arm syndrome.
Osteoarthritis (wear and tear in joints).
Rheumatic diseases.
Post-accident treatment.


Manual therapy according to the “Maitland-Concept®”.
The concept includes a specific way of thinking and acting when collecting findings and treating functional disorders in peripheral joints and the spine.

Characteristic of the therapy with the ” Maitland Concept®” is:

Detailed assessment of the findings, on the one hand for the purpose of identifying and assessing the problem as precisely as possible, on the other hand, in order to immediately record subtle changes in the behavior of the complaints that appear later.

Dosed reproduction of the complaints through the movement tests, whereby both the problematic direction of movement and the quality of the pain should correspond as closely as possible to the complaints described by the patient.

Gentle mobilization techniques with passive movements of lesser or greater extent, which can be carried out at different points of the possibility of movement and serve both to record findings and to treat.

A treatment that is oriented towards the specific problem of the patient and seeks to confirm its effectiveness through constant monitoring. It is quick to adapt to changing findings.

The physiotherapist’s thought process, which is constantly moving on two levels: a more theoretical and a more complaint-oriented level. This characteristic is central to the Maitland concept.

The concept was founded by GD Maitland (Physiotherapist Australia).

Bobath
This is a physiotherapy treatment on a neurophysiological basis, which is carried out as a single treatment for central movement disorders.

The Bobath method tries to provoke higher posture and balance reactions in order to stimulate and automate useful voluntary movements with the help of the remaining brain functions. Weak muscle groups should be functionally strengthened, spastic muscle groups are restored to normal muscle tension using various methods.

This treatment is particularly indicated for brain or spinal cord disorders:
After head trauma
In hemiplegia after apoplexy (stroke)
In multiple sclerosis

 

Mobilisation and manipulation are when the physiotherapist moves your joints for you – either joints in your limbs or joints in your spine – in order to improve movement of that joint or to stimulate nerve signals associated with that joint so that it can function better. Manipulation is a small amplitude movement of a joint that is carried out at the end of it’s range. This is only done by specifically qualified practitioners.

What is kinesiotaping?
It is a relatively young therapeutic method developed by a doctor. In Asian countries it was used for the first time in the years 1970-1980, in the United States and Western Europe in the mid-90s, while in Poland only at the beginning of the present century, mainly by physiotherapists in sports clubs.

Kinesiotaping action

it affects the skin (mainly  pain receptors, deep sensation), muscles, joints and the lymphatic system . The basic physiological functions of kinesiotaping are to reduce pain and sensory hypersensitivity in the skin and muscles, correct the position of the joint and reduce lymphoedema. 

Kinesiotaping patches and their main features:

C.They are characterized by 30-40% stretchability of the initial length of the tape, thanks to which it is possible to achieve almost perfect elasticity resembling human skin, a special glue on the upper side is activated by heat and is antiallergic and waterproof.

Thanks to this advantage, the tape can be worn for 5-7 days and does not come off while bathing. The most commonly used tape is stretched to about 10-20%, the method of cutting depending on the treatment site is the shape: X, Y, I, fan.  

General use of kinesiotaping patches:

– Ligaments and tendons,
– Lymphatic,
– Functional,
– Mechanical,
– Fascia, space.
– Regulates blood circulation
– Reduces tissue stagnation
– Reduces inflammation
– Problems with muscle imbalance – Muscle
function too stretched
– Reduces muscle fatigue
– Improves range of motion
– Reduces excessive muscle tension
– Reduces the feeling of pain
 
 Kinesiotaping in pregnant women:
– Lymphatic edema of the legs and varicose veins,
– Pain in the lumbosacral section.

Dry needling is an effective technique for treating pain in the musculoskeletal system and muscle-related complaints.
Dry needling
Dry needling is not new. In America and Canada, dry needling is part of many physiotherapy treatments. The results are astonishing in humans . In recent years, the technology has therefore become strongly on the rise in India.

What is dry needling?
Dry needling is an effective technique for the treatment of muscle pains and muscle-related complaints. The treatment is characterized by the insertion of special fine needles at specific places, the so-called trigger points or muscle knots, in underlying muscle tissue. The goal of the treatment is to eliminate or relieve pain.

Literally translated it means: The use of a “dry” needle. It is explicitly emphasized that no liquids, so no injections are involved. Dry needling is performed with acupuncture needles that are found in the so-called trigger points of the patient.

What are trigger points?
A trigger point can be compared to a painful knot in an already cramped muscle. If you press such a painful muscle button, it can often give a painful appearance in the body. For example, a painful muscle in the back can cause radiation to the leg. We tackle this pain by treating the trigger point.

Relaxation & cocking
After the treatment, the muscle can relax again, but also deliver a healthy contraction. Dry needling treatment often leads to immediate pain relief. Muscle tension noticeably decreases and mobility increases. In addition, the blood circulation in the muscle is significantly improved.

What does a dry needling treatment feel like?
If the muscle hardening is punctured, the muscle may tighten briefly. This gives a kind of cramping feeling and can be accompanied by some local pain. After that, the muscle usually relaxes immediately. You will not feel the needle insertion.

Not comparable to acupuncture
Dry needling cannot be compared to acupuncture. Acupuncture treats the meridians, the energy channels. With dry needling, the muscle that causes the direct pain and possible radiation pain is addressed.

Indication:

Dry needling treatment

Fortunately, further, often successful, steps can be taken with dry needling and trigger point therapy!

Your complaints will be mapped on the basis of a conversation and investigation. Then the muscles that cause pain are examined. They specifically look for trigger points, which are often painful and feel like a local thickening.

The complaints below are handled by me:

Neck complaints & headaches
With or without a long history of therapies.

Low back pain & low back pain with radiations to one or both legs.

Acute and often years existing pain, without demonstrable abnormalities in X-ray or scan.

Tennis elbow: Tennis elbow is a very common condition. It gives rise to pain complaints on the outside of the elbow, sometimes radiating to the forearm and wrist.

RSI complaints.
Pain in one or both arms, often radiating to the hands.

Knee problems: where no injury or damage could be found.

Pain in the buttocks, thighs, calves & ankles

Frozen shoulder: Limitation of movement and pain in the shoulder joint. 
Often referred to as bursitis.

Cupping is an ancient therapy that has found a place in modern alternative medicine. Cupping is a form of therapy where a vacuum is created in glass, or silicone cups. The cups are then applied to the body in strategic places for the relief of pain.  Folks who have tried it have had incredible results and it can be a pleasurable experience. 

The suction created by the cups is used to soften tight muscles, loosen adhesions, increase the blood flow to the tissues, bring toxins to the surface for release and drain excess fluids by mobilizing lymphatic flow. 

In massage cupping the cups are moved around on the surface of the skin to maximize the effect. Often the movement of the cups is in line with the meridians of Traditional Chinese Medicine (TCM). Cupping is an ancient modality that started with the Chinese and has been a part of TCM for centuries.

There is a wide variety of techniques used with cupping that include lymphatic drainage and deep tissue release. It is often practiced by massage therapists, chiropractors, physical and occupational therapists. 

PNF – Proprioceptive Neuromuscular Facilitation

Patients usually come to physical therapy because they cannot cope with everyday tasks. Walking is unsafe, the cup cannot be brought to the mouth, the back hurts when sitting, or turning to the side is not possible, etc. All these functional disorders exist because of limitations in perception, movement control or movement itself. Here is the start of the PNF concept. Through targeted stimulation, we “feed” our perceptual senses. This leads to an optimization of the previously unsuccessful movement control. This makes movement easier.

The “PNF” idea

Creation & further development

The concept of “Proprioceptive Neuromuscular Facilitation” emerged in the USA in the 1940s. The founders of the treatment concept broke new ground in order to facilitate movement The many different “feelers” in our body, without which coordinated movement would be impossible, were given importance.

“PNF” means translated: The interaction of nerves and muscles is facilitated by stimulating “movement sensors”

The ideas of the early days and new findings from the relevant medical fields and biomechanics make PNF a dynamic concept.

Creation & further development

Principles of PNF treatment

The aim is for a patient to improve their functions with our help. To do this, he should use his own possibilities that he has previously ignored. How is that supposed to work? We motivate the patient to expose themselves to the “experience” of movement. We make the exercises easier so that it becomes a “sense of achievement”. Because the movement sensors are repeatedly “fed” with new situations, the body adapts ever closer to the real everyday requirements.

Which patients can be treated with PNF?

Since PNF is supposed to facilitate the transmission of nerve impulses to the “movement executors” (muscles), the treatment concept is widely used.

All neurological disorders of the brain and spinal cord

after traumatic brain injury

after apoplexy (stroke)

in Parkinson’s disease

in multiple sclerosis

in muscular dystrophy

with paraplegia

All orthopedic disorders of the movement segments

lack of mobility

Pain

lack of stability

decreased strength in coordinated movement

All post-traumatic or post-operative disorders

after fractures

after muscle tears

after hip replacement, knee replacement.

 

The connective tissue massage is a reflexology massage. It aims to loosen adhesions and hardening in certain connective tissue regions. Due to the improved blood circulation and oxygen supply, certain organs are positively influenced in a reflex way. There is a special line layout for each complaint. Usually, the first treatments always begin in the sacrum region (“small build-up”), since most symptoms are already reflected here with swelling or swelling of connective tissue.

With one or two fingertips, the skin regions are then slowly stroked over a wide area (pull, pressure, tick marks, roll wrinkles). If a doctor prescribes this, a (partial) reimbursement of costs will also be provided by the health insurance company for this massage technique.

typical application for:

Headache (including tension headache, migraine)

Disorders of the respiratory organs (including bronchial asthma)
Disorders of the urinary tract organs (including nocturnal wetting in children)
gynecological disorders (including menstrual cramps)
Back pain (in connection with physiotherapy)
Circulatory disorders.

With lymphatic drainage, congestion in the lymphatic system is removed with a circular stroking massage. The outflow of the fluids in the intermediate tissue is promoted and the venous return flow is supported. The manual lymphatic drainage carried out by the physiotherapist is a form of therapy with which different clinical pictures can be positively influenced. 

Manual lymphatic drainage is used – mostly in combination with compression treatment – for the treatment of edema that cannot be treated with medication or for which a satisfactory reduction in edema cannot be achieved with dehydrating medication alone.

Since manual lymphatic drainage differs significantly from other massage techniques in terms of its grip technique and system, knowledge and skills are expanded and deepened in a special training course.

typical application for:

Lymphedema

Traumatic edema / postoperative edema

Edema in arterial circulatory disorders

Lipedema

Phlebedema

Idiopathic edema

Sympathetic reflex dystrophy = Sudeck syndrome

Inactivity edema

Stretching is applied to soft tissues in order to ensure healthy muscle/tendon/ligament/fascia fibre allignment and to prevent contractures and adhesions developeing which may restrict your range of movement.

 Trigger points are local areas of tenderness which develop in muscles. Trigger points usually occur if the muscle is particularly tense or overused. Trigger point therapy is a method of releasing these muscles so that they can function more freely with less discomfort

Education and advice
Physiotherapists diagnose the cause of problems. Sometimes the cause is from a single structure like a muscle that has been strained, and sometimes it is more complex and involves multiple structures such as whole joints and surrounding ligaments. Following a full examination, you will be provided with an explanation of what is causing your pain. You will be given treatment and also advice on how you can best adjust what you are doing in order to help the structure recover, or to prevent the problem from recurring.

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