Techniques

Low-level light therapy produces a multitude of clinical benefits, including tissue repair and pain control. Studies pertaining to laser therapies have indicated that laser irradiation on joint areas can be an effective pain relief treatment when appropriate energy doses are selected. It has also been noted that applying laser/light therapy in addition to exercise might result in greater pain reduction effects than using laser therapy alone.

Pain relief from low level light therapy may be a good alternative to the use of NSAIDs, particularly for elderly people, because light therapy has no reported side effects.

Indications for light therapy

The U.S. Food and Drug Administration has approved light therapy for the treatment of head and neck pain, as well as pain associated with carpal tunnel syndrome. In addition to these conditions, literature indicates that light therapy may be beneficial in three general areas:

1. Inflammatory conditions (bursitis, tendonitis, arthritis, etc).
2. Wound care and tissue repair (tendon ruptures, ligamentous tear, torn cartilage, etc).
3. Pain control (low back pain, neck pain, and pain associated with inflammatory conditions—carpal tunnel syndrome, arthritis, tennis elbow, golfer's elbow, etc).

Graston Technique^® (GT) is a unique, instrument-assisted, soft tissue mobilization therapy that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes.

It is beneficial in breaking up fascial restrictions, scar tissue adhesions, and detecting areas of chronic inflammation and/or fibrosis. Graston has been known to help conditions such as a cervical sprain/strain, tennis elbow and golfer's elbow, lumbar sprain/strain, rotator cuff tendinosis ,and even Achilles tendinosis.

There are several techniques that make up manual therapy.

Strain/counter strain

Strain/counter strain is an extremely gentle and pain-free treatment that will get rid of muscle pain, tightness, spasm, joint stiffness and other "hard to explain" symptoms. The physical therapist uses their hands to guide the patient's body and muscles into a position of comfort or ease that will decrease abnormal reflex spasms in your body. Strain counter/strain works by correcting an overactive stretch reflex that exists in the painful muscle. This abnormal reflex causes the muscle to contract constantly, instead of just when it is needed.

After a strain/counter strain treatment, you should have less pain and improved movement immediately following treatment. Even though the treatment is extremely gentle, you can have soreness for 1 to 2 days following treatment due to the release of waste products from the trigger points.

Conditions can be treated with this technique include chronic pain, fibromyalgia, degenerative disc disease, bulging discs, headaches, heel spurs, low back pain, muscle strains, sports injuries, neck pain, myofascial pain, plantar fasciitis, rotator cuff injuries, carpal tunnel syndrome, tendonitis, tennis elbow, jaw pain, whiplash, ankle sprains, and balance issues and vertigo.

Muscle energy

Muscle energy techniques (METs) are a broad class of manual therapy techniques directed at improving musculoskeletal function or joint function and improving pain. METs are used to treat somatic dysfunction, especially decreased range of motion, muscular hypertonicity, and pain.

Muscle energy is a direct and active technique, meaning it engages a restrictive barrier and requires the patient's participation for maximal effect. As the patient performs an isometric contraction, the following physiologic changes occur:

• Golgi tendon organ activation results in direct inhibition of agonist muscles.
• A reflexive reciprocal inhibition occurs at the antagonistic muscles.
• As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion.

There are peer-reviewed studies that have shown that METs can significantly decrease disability and improve functionality in patients with disorders such as low back pain.

Muscle energy techniques can be employed to reposition a dysfunctional joint and treat the affected musculature. Indications include muscular shortening, low back pain, pelvic imbalance, limited range of motion, somatic dysfunction, respiratory dysfunction, cervicogenic headaches and many others.

Myofascial release

Myofascial release (or MFR) is a type of physical therapy often used to treat myofascial pain syndrome, a chronic pain disorder caused by sensitivity and tightness in the tissues that surround and support the muscles throughout your body. Myofascial release focuses on reducing pain by easing tension and tightness, and by stretching and relaxing the fascia.

Fascia is a thin, tough, elastic-type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. This tissue can become restricted due to disease, overuse, trauma, infectious agents or inactivity, often resulting in pain, muscle tension and corresponding diminished blood flow.

During MFR, our physical therapists will locate pain points through the use of gentle palpation. After locating the hardened muscles, the physical therapist will loosen them one by one. When the tissue starts to relax, the physical therapist will increase the pressure and force that is applied. This method is repeated until the whole muscle is fully relaxed.

MFR can be used to treat pain and increase mobility in patients with a wide range of conditions, including:

• Back pain.
• Neck pain.
• Fibromyalgia.
• Repetitive strain injuries.
• Muscular imbalances.

Joint mobilization

Joint mobilization is an effective treatment for joint stiffness, muscle guarding and pain. Joint mobilization is a skilled passive movement technique of the joint surfaces performed by a physical therapist to decrease pain or increase joint mobility. The result of an injury may be a loss of motion, contracture of connective tissue or resistance of contractile tissue to stretch. If left untreated, the joint may become HYPO-mobile, meaning there is a decreased range of motion. Joint mobilization is a technique that can be used to treat these limitations.

Aquatic therapy is perfect for patients of all ages that need to improve their movement and function while unloading the weight of their bodies. Performing specific exercises and activities in aquatic therapy allows for improved strength, coordination of muscle groups, and reduction of swelling and enhanced nervous system feedback.

Conditions helped by aquatic therapy:

• Arthritis.
• Total joint rehabilitation.
• Post-surgery.
• Shoulder pain.
• Low back pain.
• Hip, knee and ankle pain.
• Rehabilitation after injury.
• Difficulty with walking.
• Sports rehabilitation.

Helping arthritis

Aquatic therapy is perfect for treating arthritic joints. The water helps to provide compression, resulting in less swelling. In addition, the buoyancy of the water unweights the joint, allowing greater range of motion without the weight of the body compressing joints together. Water resistance allows for use of numerous muscles groups around the affected joint, increasing strength and coordination of supporting muscles.

Walking and strengthening

The ability to walk with less weight and resistance in the water can have significant improvements in one's ability to walk. The resistance of the water strengthens a wide variety of muscles through the torso, pelvis and legs. The uniform resistance of the water also allows for unique feedback to the nervous system, improving coordination with walking.

Medical therapeutic yoga is a research-based practice that can benefit everyone seeking an integrative approach to healthcare. It offers a holistic assessment and treatment plan while catering to the individual needs of one's body, mind and spirit. Medical therapeutic yoga is performed under the guidance of a physical therapist trained in medical therapeutic yoga.

Our therapist reviews a patient's medical health history and lifestyle activities, while also being attentive to the care needs and interests of the individual. This is followed by a step-by-step progressive movement and ability assessment. The program used is one of optimal safety as all movements are performed with the spine and extremities in their neutral supported position. The sessions additionally include education within the self-care principles, which further develops a personalized holistic and integrative health care program.

Manual therapy and the use of additional treatment modalities may also be integrated into these treatment sessions as indicated by the care needs of the individual. Medical therapeutic yoga addresses the goals of pain relief, stress management, injury recovery and improved strength, flexibility and balance in a multifaceted approach for optimal health and healing.

For additional information please contact Roselee Wondra, PT at 952.428.2001 or by emailing roselee.wondra@allina.com.

Spinal traction is a form of decompression therapy that relieves pressure on the spine. It is a nonsurgical way to relieve pain and correct problems in the spine. While it does have some potential side effects, spinal traction offers consistent relief for most patients.

Spinal traction stretches the spine to take pressure off compressed discs. This straightens the spine and improves the body's ability to heal itself. Patients with spinal conditions benefit from this therapy because the traction reverses the force of gravity. It is most commonly used to treat bone spurs, degenerative disc disease, herniated discs, facet disease, sciatica, foraminal stenosis, pinched nerves and more.

Spinal traction can be administered manually or mechanically. In manual spinal traction, a physical therapist uses their hands to put a patient in a state of traction, then uses manual pressure on the joints and muscles to widen the spaces between vertebrae. In mechanical spinal traction, a patient lies on a table that has special tools to stretch the spine. A physical therapist will attach a series of ropes, slings and pulleys to the patient to mechanically relieve pressure.

The results of spinal traction include pain relief, proper spinal alignment and decompressed joints. Spinal traction stretches the muscles and bones in the back to combat the effects of gravity.

Orthotic inserts are custom, prescribed medical inserts for your shoes. To create custom orthotics, a doctor uses casts, impressions or scans to perfectly fit your foot. When inserted in your shoes, they allow the feet and lower legs to function at their highest potential.

Orthotics can decrease pain, alleviate pressure and increase stability in an unstable joint. In addition, orthotics are used to treat specific ailments such as diabetes, plantar fasciitis, hammer toes, heel spurs and arthritis.

Although custom orthotics are more expensive than off-the-shelf devices, they last much longer and provide more support or correction for your specific needs.

If you suffer from the conditions below, you can benefit from our custom orthotics and physical therapy treatments:

• Plantar fasciitis, a common painful inflammation of the sole of the foot towards the heel.
• Arthritis.
• Diabetes, which interferes with circulation in the feet.
• Metatarsalgia, a painful disorder that affects the bones and joints at the ball of the foot.
• Heel spurs, a growth of dense tissue or bone growing out of the calcaneus bone on the heel.
• Knee pain.
• Shin splints.
• Achilles tendonitis.
• Bunions.

The human body is not symmetrical. The neurological, respiratory, circulatory, muscular and vision systems are not the same on the left side of the body as they are on the right, and vice versa, but the human body is usually balanced out by these system imbalances.

When these normal imbalances are not regulated by your body during walking, breathing or turning, a strong pattern emerges creating weaknesses, instabilities and pain. Our physical therapists recognize these imbalances and can identify weaknesses that develop. Balancing muscle activity using the postural restoration approach helps restore appropriate balance and function.

A major goal of postural restoration is to regain symmetry during activity. Body balance means there is decreased stress on joints and soft tissue and movement can occur with improved ease. To restore this balance, each patient is given individualized exercises and techniques to retrain the neuromuscular system.

The AlterG^® Anti-Gravity Treadmill^® enhances therapist's ability to help patients recover faster. The Alter-G's unique and patented unweighted rehabilitation treadmill technology:

• Allows patients to rehabilitate with less pain while reducing the risk of further injury, enabling patients to heal faster.
• Provides physical therapists a precise way to track patient progress, keeping patients engaged and motivated during rehab.

The Alter-G Treadmill is used for patients looking to regain mobility, develop strength and fitness, and increase range of motion and natural movement—all while minimizing stress on injuries.

St. Francis' Alter-G Treadmill is conveniently located at our Chaska rehabilitation clinic and can be used for:

• Physical therapy following an injury or surgery on a lower extremity (hip, knee, ankle or foot).
• Rehab after total joint replacement.
• Gait training and strengthening for neurological patients.
• Strengthening and conditioning in a fall-safe environment for older patients.
• Weight-loss programs.
• Injury prevention during sport specific conditioning and fitness improvement programs.

Total motion release (TMR) is a therapy approach with several advantages over traditional therapy approaches. First and foremost, it teaches you how to fix yourself, regardless of where your pain is. Once you have learned the overall concept, you can apply it to pain anywhere in the body.

TMR looks at the movement patterns throughout the body to identify where restrictions are. The idea behind this technique is that it uses the good movement patterns to "teach" the faulty movement patterns to improve. This means that you are using only comfortable, easy motions to improve patterns, instead of forcing into painful movement.

We find that patients can learn to fix themselves very quickly when in pain, and when applied on a regular basis, this technique can help prevent painful patterns from developing. Because you are using just motions as the basis for treatment, no special equipment is required. This technique is by far the least invasive approach you can take to alleviate pain.

TMR can be taught in individual or group sessions. It can be used as an adjunct to traditional therapies, or as a stand-alone treatment.

If you suffer from an injury; arthritis; carpal tunnel syndrome; or other painful conditions of the hand, wrist or elbow, our physical therapists can help.

Patients who are candidates for hand therapy may have been affected by an accident or trauma leaving them with wounds; scars; burns; injured tendons or nerves; fractures; or even amputations of the fingers, hands or arms. Others include patients who suffer from conditions such as carpal tunnel syndrome and tennis elbow, as well as from chronic problems such as arthritis or a neurologic condition (like stroke).

Hand therapy can provide a treatment without an operation to help reduce recent or long-lasting pain. The therapy provided can also help to reduce sensitivity and improve feelings after a nerve injury. There are a variety of exercises available to help improve movement and strength and reduce stiffness.

Hand therapists can also help a patient's recovery after surgery. This may include assistance with helping wounds heal, preventing infection, scar management and reducing swelling. The hand therapist can also fit or fabricate your splints to help aid the recovery and healing process following the surgery.