Treatment and Conditions – Niagra

Treatment and Conditions

 

Spine Care

UP Rehab Services believes evidence-based care is the best approach to treatment, and spinal dysfunction is no different. Our treatment team has designed the HealthySpine program which incorporates a wide variety of treatment methods, based on current best evidence, to manage spinal dysfunction. Our team of professionals regularly meets to review current literature ensuring that all clients, no matter the diagnosis, receive the very best therapy care.

 

The HealthySpine Program was designed to treat a vast array of pathologies that can affect the spine, including:

 

  • Degenerative disc disease
  • Sports or work-related injuries
  • Traumatic injuries
  • Herniated, ruptured or bulging discs
  • Osteoarthritis
  • Sprains and strains
  • Dysfunction related to posture
  • Headaches

 

The evaluation process begins with a thorough examination. There is a dialogue between the treating clinician and the client which assists in directing the therapist in how to proceed with the exam. In collecting all of this information, the therapist will work with the client in establishing a plan of care. The client is educated on their condition and how therapy will work to improve their limitations. Each individual is given a unique treatment plan with the primary goals centered around:

 

  • Preventing, controlling, and/or eliminating spinal dysfunction
  • Education in safe and effective exercises and movements that will protect the spine
  • Improving strength, flexibility, and endurance
  • Restoring

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Injury Prevention

Wouldn’t it be convenient if we could minimize post-injury care?  Injuries are accidents and unfortunately, are not entirely avoidable; however, observation of movement patterns and screening to identify pathologic structures allows for intervention before injury.  Just a few of the injuries that can be prevented include:

 

  • ACL tears of the knee
  • Mechanical low back pain from improper ergonomics and/or mechanics with daily activities
  • Shoulder injuries in the throwing athlete

 

By recognizing any imbalances, our team of professionals is equipped to utilize individualized treatment plans as corrective action, thereby decreasing your risk of injury.

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Rehab of the Shoulder

The shoulder is a “ball-and-socket” joint that is extremely flexible and very susceptible to instability and/or injury. The clavicle (collarbone), scapula (shoulder blade), and humerus (upper arm bone) come together to form the shoulder joint. There are multiple ligaments, tendons, and muscular structures throughout the shoulder. The rotator cuff is one of the most commonly injured muscle groups. It is made up of four separate muscles that not only control active rotation of the arm, but is a dynamic stabilizer of the shoulder holding the humerus in the joint. When the rotator cuff becomes injured, the integrity of many shoulder structures is threatened.

 

The shoulder joint is mobile and allows for many degrees of motion. It moves into forward flexion (straight arm raised in front of the body), abduction (straight arm raised to the side of the body), internal and external rotation, to name a few.

 

Shoulder pain is a commonly treated condition. The origin of the discomfort may arise from muscles, ligaments, tendons, or bones. Our team rehabilitates a variety of diagnoses, including: sprains, rotator cuff tear/sprain, muscle imbalance, shoulder dislocation, shoulder separation, tendonitis, SLAP lesion, labral tear, bursitis, arthritis, adhesive capsulitis (frozen shoulder), and post-surgical rehabilitation.

 

Shoulder pain typically worsens with movement of the shoulder/arm but if not, it is likely “referred pain” caused by a condition in a structure of the cervical spine or chest. If you are experiencing chest pain, it may be symptoms of a heart attack and you should seek immediate medical attention.

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Rehab of the Hip

The hip is a “ball-and-socket” joint that is strong and vital in maintaining our balance, and responsible for propulsion (walking, running, and jumping).  Like the shoulder, it is a very mobile joint.  The hip joint is made up of the femur (thigh bone) and the acetabulum (this is the “socket” made up of a fusion between the ilium, ishium, and pubis.)  There are multiple ligaments, tendons, and muscular structures throughout the hip joint.

 

This joint is mobile and allows for many degrees of motion.  It moves into forward flexion (straight leg raised in front of the body), abduction (straight leg raised to the side of the body), extension (straight leg raised behind the body), internal and external rotation.

 

The hip joint is extremely durable but like any other region of our body, it is not indestructible.  Hip pain is often treated in physical therapy.  The origin of discomfort may arise from muscles, ligaments, tendons, or bones.  Our team rehabilitates a variety of diagnoses, including:  sprains/strains, degenerative/arthritic joints, hip fractures, bursitis, tendonitis, labral tears, piriformis syndrome, gluteal tendinopathy, avascular necrosis, and post-surgical rehabilitation.

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Rehab of the Knee

The knee is a “hinge joint.”  Like the hip, it has a very important role in functional movement.  The knee is formed by three bones: the femur (thigh bone), the tibia (shin bone), and the patella (knee cap) which are connected by multiple ligaments. The femur and tibia are cushioned by a tough a rubbery fibrocartilage called the meniscus. To reduce friction and wear, the joint is lubricated by synovial fluid.

 

The lateral collateral, medial collateral, anterior cruciate, and posterior cruciate ligaments play a vital role in maintaining stability of the knee.  The lateral collateral ligament (LCL) connects the lateral side of the femur to the lateral side of the tibia preventing the knee from moving laterally caused by a medial force. The medial collateral ligament (MCL) connects the medial side of the femur to the medial side of the tibia to keep lateral forces from medial knee displacement. The anterior cruciate ligament (ACL) limits hyperextension of the knee by limiting anterior movement of the tibia. The posterior cruciate ligament (PCL) which prevents posterior movement of knee tibia relative to the femur.

 

The knee joint moves into flexion (bending the knee) and extension (straightening the knee).  There is also a slight rotational pattern of the tibia and femur when moving into extremes of motion.  This rotational movement pattern is crucial in obtaining end range extension, as well as during the gait (walking) cycle.

 

Our clinic can rehab a multitude of injuries to the knee including: sprains and/or tears of the ligaments or meniscus, total joint replacement, patellofemoral pain syndrome, fractures, and dislocations.

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Rehab of the Ankle and Foot

The foot and ankle are extremely complex joints.  These joints combined, are made up of 28 bones and a multitude of muscles, tendons, and ligaments.  The true ankle joint is made up of three bones:  the tibia forms the medial (inside) side of the ankle, the fibula forms the lateral (outside) side of the ankle, and the talus lies underneath.  The bones of the ankle are held together by multiple ligaments, including the anterior tibiofibular ligament (found in the front of the ankle), the lateral collateral ligaments (found on the outside of the ankle), and the deltoid ligaments (found on the inside of the ankle).

 

The ankle joint has four primary motions.  Dorsiflexion and plantar flexion move the foot up and down.  We can also move our foot side to side or invert and evert our foot.  There are three arches in the foot (the medial arch, lateral arch, and fundamental longitudinal arch).  The arches of the feet distribute the forces created during walking.  They distribute them throughout the foot making walking (running, jumping, etc.) easier and less taxing on the body.
The ankle joint endures significant train and stress as we walk, run, and jump.  Ankle sprains, also commonly referred to as “rolled” ankles, constitute a large portion of injuries seen in sports medicine clinics around the country.  A sprained ankle does not always occur as a result of a sports injury; it can also be seen in individuals having walked on an uneven surface or after stepping on an object and not landing flat on their foot.  The foot is also very susceptible to injury due to the high forces within the foot.

 

Plantar fasciitis is a common and painful foot condition.  It is often seen in individuals who are on their feet for extended periods of time and/or have recently increased their physical activity level.  Plantar fasciitis often causes severe pain, like a “hot poker” sensation that runs from the heel to toes.  The pain is typically worse in the morning with the first few steps out of bed.

 

Other frequently treated injuries or conditions include:  stress fractures, Achille’s tendon ruptures/tendonitis, calf muscle injury, ankle sprain, muscle strain, pinched nerve, and shin splints.

 

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Pregnancy-Related Low Back Pain

Pregnancy-related low back pain, also referred to as, “peripartum posterior pelvic pain,” or “pregnancy-related pelvic girdle pain,” occurs in 60-70% of pregnancies.  Most cases are mild in nature, but occasionally women will experience severe, debilitating pain.  Low back pain can come on at any point during the pregnancy, more commonly during the fifth and sixth months, and the exact cause of the discomfort is unknown.

 

The lumbar spine is a complex system made up of vertebrae, muscular structures, tendons, ligaments, as well as the spinal cord and nerves.  During pregnancy there is an increased intra-abdominal pressure, altered lumbosacral spinal mechanics, changes in gait pattern, and weight gain, all of which may contribute to low back pain.  Weight gain lends to increased forces through the spinal joints and also alters the body’s center of gravity.  The change in center of gravity causes an increased curvature in the lower back placing stress on the discs, ligaments, and joints.  It also causes weakening and stretching of the abdominal musculature.  The hormone, Relaxin, is produced during pregnancy creating a laxity within the ligamentous structures preparing your body for delivery.  This increase in laxity also lends to a deficit in spinal stability and possibly back pain.

 

Post-partum back pain is also common and typically a result of diastasis recti.  30-40% of all pregnancies result in diastasis, a separation of the rectus abdominal muscles in the abdomen.  Anyone can be diagnosed with diastasis as it can occur with exercise and excessive weight gain but is more commonly associated with pregnancy.

 

Pregnancy-related low back pain and diastasis are often undertreated.  If you are questioning whether or not this may be an issue for you, contact your physician or physical therapist for an evaluation.  A physical therapist will help to identify the pathologic structures and imbalances and assist in proper treatment.

 

Our therapists are trained in the treatment of pregnancy-related low back pain both during and after pregnancy.  We will work to improve stability, coordination, and function with active back exercises.  Other treatment options include soft tissue mobilization, mobility training, postural education, and relaxation exercises with a focus on breathing.

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Urinary Incontinence

Urinary incontinence is an involuntary loss of bladder control.  It affects men and women of all ages and more than 25 million US citizens.  Urinary incontinence is most prevalent in women after pregnancy, individuals who are obese, and after prostate procedures.  This is not solely a physical condition; the experience often leaves individuals feeling socially isolated, embarrassed, and depressed. “A recent study in the Annals of Internal Medicine reports that pelvic floor muscle training, in conjunction with bladder training, resolved the symptoms of urinary incontinence [in women].” (www.apta.org)

 

According to the APTA, proper preventative measures and examination and treatment by a physical therapist can help manage, if not alleviate, this often debilitating condition.  Treatment begins with a thorough evaluation to determine the type of urinary incontinence.  There are two types, stress and urge, though some individuals have both.  The examination will also reveal the severity of incontinence, strength, and motor control of the pelvic floor musculature.  Like any other examination, the therapist will thoroughly assess your past medical history.  With the information gathered, the clinician will educate you on your condition and develop a plan of care that is individualized to improve your incontinence.


Balance, Dizziness and Falls


There are many factors that can contribute to balance, dizziness, and fall issues.  Evaluation begins with an examination of vital signs and an overview of nutrition.  A thorough review of patient’s past medical history is completed.  There are many medical conditions that contribute to balance and falls, including:  Parkinson’s disease, multiple sclerosis, lasting deficits after lower extremity injury/surgery, and spinal dysfunction, just to name a few.  There are also many vestibular conditions that can contribute to balance, dizziness and falling.  If you are experiencing balance, dizziness, and/or falls, please contact our office for an injury screen to determine if physical therapy is right for you.