A Unique Approach to Physical Therapy and Sports Fitness

While there is an urgency to all rehab there are certain important questions that need to be addressed right away in the care of an athlete.  Among these are:  complete rest vs continuing to train or altered training schedule, to play in the upcoming game or not, absolute optimization of the exercise progression, the use of anti-inflammation agents such as heat, ice, whirlpool, massage, ultrasound, electrical stimulation, etc, the use of braces or other devices to promote healing and relief of the injured area.

By far the most important thing is for the athlete (patient) to have FULL KNOWLEDGE of the process that will lead to the quickest recovery and the responsibilities of all concerned, especially the patient themselves.  It is very valuable to talk through the choices confronting the patient and the sports medicine team (patient, physician, therapist and trainer).  The goal is to get the athlete back safely, productively, and especially quickly.

At Harmeling Physical Therapy we have three therapists who are also experienced athletic trainers so we know not only what the athlete is thinking but also the concerns of the parents as well as the coach’s interest.

Let us help you get back in the game!

Taking care of a patient who has recently had a joint replaced is an interesting combination of  stretching  to recover range of motion, strength work, rest, gait progression (for hips, knees and ankles), and the use of modailites (what we call the “feel good stuff” like heat, massage, ice, electrical stimulation, etc) to relieve the occasional discomfort which arises.

The trick though is to do this in the right combination so that the patient is WELL INFORMED and mentally comfortable with the process. This is where the skill comes in. The patient must be involved in the process or else progress is hard to come by.  The patient and the therapist have to form a true team (as in all successful therapy) to advance function and mobility.  The therapist has to help the patients figure out when to push and when to back off.  Every case is different.

Let us help you get back to moving better and having fun again!

The shoulder is a beautiful joint.  No other joint is like it in that the shoulder has an amazing range of movement.  The keys to therapy are to make sure that the range of movement of the shoulder joint is full or maximized.  Many shoulder conditions rob the joint of its movement and this must be restored in order for good pain free function to return.

Also the muscles which cross the shoulder joint have to be strengthened.  The very important rotator cuff muscles are the key here.  Equally important are the muscles surrounding the shoulder blade, the bone to which the arm is attached. If the shoulder blade muscles are too weak then there is no way the shoulder can work properly. The shoulder needs a strong, fixed platform (the blade) from which the arm, via the shoulder, can push and pull. 

Lastly, if the shoulder is inflamed (where there is pain there is inflammation), which it usually is when people come to therapy, then this must be addressed.

As in all PT the skill is knowing when to do what- that is get back the range of motion, strengthen, and reduce inflammation.  The ultimate goal is to have a FULLY informed patient with regard to what is going on in the joint and EXACTLY what the patient should be doing and also what NOT to do.

Let us help you get rid of your shoulder pain, free up movement, teach you what to do, enjoy your sleep more, and get you using your shoulder again.

Tendinitis and bursitis (shoulder, elbow, wrist, hip, knee, ankle and Achilles, plantar fascia) are very common overuse conditions that really get a person down after awhile.  They usually start slow and are not a big deal. The offending activity continues and slowly increases the inflammation.  Then the patient sees a doctor and a diagnosis is given-some “itis”.  So, often the patient takes anti-inflammation medicine thinking this will solve the problem.  The problem is way beyond a few pills! This does not work.  Occasionally the patient ices the area.  Sometimes the patient will rest a few days.  All to no avail!

What the patient is looking for whether they know it or not is COMPLETE  knowledge and information about exactly what is going on here with these conditions especially from an anatomy point of view.  There is a definite logic to what is happening in these common conditions and the treatment is very straight forward ONCE THE PATIENT UNDERSTANDS WHAT IS GOING ON.  Besides very gentle exercises and the application of anti inflammation modalities (heat, cold, ultrasound, massage, electrical stimulation etc.) much of the treatment is behavioral. In other words, the patient will have to change their behavior in some fashion in order to give the affected area a “break”. This is hard to do even when the patient has full knowledge but IMPOSSIBLE to do if the patient is ignorant of what is going on.

Come on in and let us help you figure it out and try to get rid of that long standing pain.

Neck pain usually is a result of a combination of many factors:  overwork of muscles, poor posture, poor ergonomics (posture at your desk or job situation), weak muscles, tight muscles, arthritis, disc problems, overuse of your arms (which are connected via muscles to your neck), muscle spasms (bodies way of telling you that you have a problem-perhaps a bad problem) and, last but not least, gravity.  That’s right, gravity.

Imagine holding up a bowling ball all day against gravity.  This is what your neck does all day every day. This is tough work even when everything is working properly.  When there are painful muscle spasms it is an even tougher task.

So you want a therapist who is going to help you figure out each of the above factors like adopting neck friendly positions, easy but progressive exercises to stretch and strengthen your neck muscles (carefully), help you get rid of those spasms (with heat, cold, ultrasound, massage, electrical stimulation), and possibly try traction to relieve some of the pressure caused by gravity.  Most importantly, as in all therapy, you need to have a FULL understanding of EXACTLY what to do and what not to do and it has to make sense to you otherwise you won’t do it.

So let us give you a hand in getting rid of your neck pain.

Usually as you age you become less active and sit more.  Over time muscles become too tight and too weak.  This impairs your ability to get up and move around. Of course this occurs little by little. Sometimes this slow process of increasing immobility is accompanied by pain in various places.  Physical Therapy can help you reverse this process.

What you are looking for in a physical therapist is someone who understands these changes, why they occur and most importantly what to do about it.  The body has an amazing ability to improve once it is “pointed in the right direction”. Such is the case with PT and the elderly. The goals are to decrease pain and improve balance, mobility, endurance, and most important, CONFIDENCE!  This therapy, when done correctly and meaningfully, works. Pain lessens, gait improves, endurance gets better, fear goes away and fun takes it place.

Let us see if we can help you have more fun!

Following surgery there is usually pain, and some amount of fear and anxiety.  With each type of orthopedic surgery there is also some things that are important to accomplish sooner rather than later and some things to stay away from.  I will call these “do’s and don’ts”.

The purpose of pre-surgical physical therapy is to fully educate the patient on the process of PT, the anatomy involved, the purpose of the surgery especially as it relates to returning to good function, the early goals for post-op therapy, how to manage their pain and post-op situations, and a thorough discussion of these do’s and don’ts. By doing all of this the patient is more involved in the process and an active participant in getting a great outcome.  In some cases, pre-op PT has reduced the length of stay in rehab facilities.  And perhaps best of all, fear and anxiety are minimized through education and understanding.

This PRE-OP PT is only a few visits at most.  Let us help prepare you for this important surgery so that you are more comfortable mentally and physically with the process.