Physical Therapy @ Enfield Health &
Wellness Center
Enfield Health & Wellness Center is a private
practice that incorporates physical therapy as
part of the process of wellness. Our goal is to
improve your quality of life by decreasing pain
and improving your function and mobility. We
specialize in manual integrative therapy which
includes such techniques as Myofascial Release,
Jones Strain and Counterstrain, Mulligan, Muscle Energy,
McKenzie, Graston Technique and Core
Stabilization. We treat chronic pain,
fibromyalgia, strains, sprains, back and neck
pain, and post surgical patients. We also offer
ergonomic analysis of your workstation and will
work with you and your employer to help set-up
you up in an ergonomically sound work area.
The Initial Visit to your Physical Therapist
On your first visit, the physical therapist
will have you complete a form about your past
medical history and your current problem. The
information you give will determine the goals
and objectives of your personal treatment plan.
Your level of pain will be measured on a scale
of one to ten. This will enable the physical
therapist to evaluate your improvement during
and after treatments. The physical therapist
will be especially interested in learning about
changes in your pain during your daily
activities. What activities make the pain more
intense? When is the pain less intense or
alleviated altogether? How long has the pain
persisted? Is your pain accompanied by any
numbness or tingling? The physical therapist
will spend time listening carefully to your
symptoms and gathering information about the
problem. The next step will be a thorough
evaluation.
THE PHYSICAL THERAPY EVALUATION
During the evaluation, the physical therapist
will examine your posture, check your range of
motion, complete a manual examination, screen
you for possible neurological problems, perform
specific tests, and check the skin for tender
points or muscle spasms. The physical therapist
will begin by observing your posture. Poor
posture will cause various problems with
muscles, joints, and nerves. Maintaining the
same position for extended periods of time can
also cause problems. By helping you to improve
your posture, the physical therapist will reduce
the strain on your body.
It is important to check the patient’s range
of motion at the problem area. How far can you
bend and/or turn your neck? How much movement do
you have in your back? How much mobility do you
have with your arms or your legs? By carefully
measuring the mobility or lack of mobility of
your neck, back, arms, and legs, the physical
therapist next determines a treatment plan that
is personally designed to fit your needs.
During the manual examination, the physical
therapist is checking the flexibility of the
involved joints. Is a particular joint too tight
or is a certain joint allowing too much
mobility? The physical therapist will complete a
neurological screening. This screening will
determine any problems with your reflexes,
sensations, or muscle weakness. Your physical
therapist may determine that a specific test
should be included in your examination.
Different tests that are sometimes completed
include the Quadrant Test, Adson’s Test,
Phalen’s Sign, and the Squish Test. Selecting
which test is appropriate will be determined by
the physical therapist. Palpation is also used
and it is basically touching the muscles to find
tender points and feel for possible muscle
spasms. Warmth or swelling in an area may
indicate inflammation of the muscle.
When the initial evaluation is completed, the
physical therapist will determine the number of
visits as well as the frequency of visits. The
treatment goals will be based upon documented
impairments and functional limitations which are
specific to your diagnosis.
THE PHYSICAL THERAPY TREATMENT PLAN
Your therapist may choose from the following
interventions and modalities in order to help
improve your symptoms:
Rest: Resting the muscles and joints reduces
the amount of irritation and often relieves the
pain. Any activities that increase the level of
pain should be temporarily avoided.
Ice or Heat: Ice is used to constrict the
blood vessels and reduces the amount of blood
flow to a specific area in order to reduce any
swelling. Heat, on the other hand, will cause
the blood vessels to dilate allowing more blood
flow to a specific area. Increased blood flow
means an increase in nutrients and oxygen to
help the healing process.
Ultrasound: Ultrasound is a deep heating
agent that increases tissue temperatures to
depths up to five centimeters. It uses inaudible
acoustic mechanical vibration to produce thermal
and non-thermal effects. It can increase
extensibility of collagen structures, decrease
muscle spasm, increase blood flow, relieve pain,
decrease joint stiffness, and repair soft
tissue.
Iontophoresis: Iontophoresis describes the
use of ultrasound for trans-dermal delivery of
medication. This means that some medications are
transferred or carried directly through the skin
and into the treatment site. Anti-inflammatory
agents or analgesics are delivered directly to
the painful area bringing needed relief from
pain.
Massage: Massage is a manual therapeutic
modality that can reduce swelling, relieve
muscle spasms, loosen adhesions, enhance
circulation, stimulate nerve endings, remove
metabolic waste from an area, and improve
lymphatic return.
Electrical Stimulation: An electrical current
is gently sent through your skin. The electrical
stimulation travels through the skin heading
toward the central nervous system. The
electrical impulse reaches the central nervous
system before the pain message and subsequently
reduces your level of pain.
Traction: What is traction? Traction is a
modality that uses mechanical forces (or a
pulling motion) to the body in order to separate
joint surfaces and decrease pressure on the
spine.
Exercises: Your physical therapist will
determine which specific exercises are needed as
you recover from your injury or pain. Your
personal treatment plan should include
positioning instructions, stretching techniques,
and relaxation exercises. As your condition
improves and movements become less painful, your
physical therapist will concentrate on
increasing your muscle flexibility, improving
your strength and coordination, and enhancing
your aerobic conditioning. The physical
therapist wants to reduce your pain, as well as
reduce or prevent the possibility of a relapse
in the future.
Ergonomics: Health and wellness strategies in
the work place will also be reviewed. How can
you be more productive at work without
jeopardizing your health? What strategies could
be used at work to reduce the risk of injury?
What safety precautions could be taken to ensure
a better future?
A FINAL HOME TREATMENT PROGRAM
Once you pain is under control and your
overall condition is improved, your physical
therapist will develop a home treatment program
specifically for you and your needs. The home
treatment plan will included specific exercises
to continue working on range of motion and
strength training. Remember that rest,
relaxation, and exercise and important
components of any recovery process. Whether you
are at work or at home, it is important to do
everything you can to reduce the possibility of
recurrent pain or future injury. Together with
your physical therapist, you will both plan a
final home treatment program that will increase
your chances for health and wellness in the
future.
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