Sports Medicine


Sports medicine comes in many forms. Many clinics keep licensed athletic trainers on staff that will go on-site to schools and other sporting events to act as an initial care-giver at the time of an injury. If an injury occurs, your physician may refer you to physical therapy. From there, your physical therapist will have an array of different programs tailored to your specific type of injury, the severity of the injury, and your fitness level. However, you don’t have to wait until you have an injury to get help from a physical therapist. Sometimes the best medicine is prevention.

When you start to experience pain:
  • First clue your body is telling you something is wrong
  • Your body can accommodate to the pain, but eventually a breakdown will happen
  • While you accommodate to your pain, weakness and stiffness begins
  • Once you have a breakdown, pain will happen and more than likely you will stop training
Programs for Runners:

Overuse musculoskeletal injuries occur frequently in runners. Running with aches and pains or an injury that fails to go away causes frustration and despair for millions of runners across the country. Proper stretching and training principles can reduce your risk for developing a running injury. A running injury program may include:

  • Running mechanics
  • Musculoskeletal symmetry
  • Kinetic chain function
  • Soft tissue mobilization
  • Strength /flexibility/balance/agility
  • Nutrition For optimal performance and recovery
  • Footwear /need for custom made functional orthotics
  • Lifestyle behaviors
  • Personal running goals/race preparation to set a personal record
  • Gait analysis: Includes videography and a biomechanical analysis with recommendations for areas of improvement
  • Custom foot orthotics: Determination of appropriate foot orthotic, fabrication and on-going adjustments as needed
  • Anti-Gravity Treadmills: Some clinics are equipped with an AlterG Anti-Gravity treadmill™: G-Trainers enable people to improve mobility and health, recover from injury and surgery more effectively, overcome medical challenges that limit movement, and enhance physical performance.
Programs for Training Injuries:

Training injuries are those experienced while weight training or sport-specific training. Common training injuries include:

  • Strains & sprains (pulled muscles)
  • Tendonitis
  • Back/neck pain
  • Tennis elbow
  • Carpal tunnel
  • Muscle tear/rupture
  • Separated or dislocated joints
  • Bursitis
  • Contusion

FMS: One way to determine physical weaknesses is to perform the Functional Movement Screen. FMS is an innovative system used to evaluate movement pattern quality for clients and athletes. The functional movement screen is used to:

  • Identify individuals at risk for injury
  • Help find weak links in movement
  • Assist with development of a fitness/exercise program
  • Provide corrective exercise to improve movement/performance
  • Create a baseline for movement quality

The Functional Movement Screen has been used by major sports leagues including the NFL, NBA, NHL and MLB. It has also been used in our military forces.

If you do experience a training injury your physical therapy treatment may include:
  • Education on faulty or improper posture or body mechanics with training
  • Education and help with technique on exercises that help your muscles stretch farther
  • Flexibility training that helps prevent cramps, stiffness, and injuries, and can give you a wider range of motion
  • Correction of muscle imbalances through flexibility and strength training
  • Endurance training
  • Kinesiotaping
  • Alleviation of pain
  • Correction improper movement patterns

Worker's Compensation


PTandME has partnered with Fit2wrk to bring you a comprehensive approach to industrial rehabilitation. This model is directed at mitigating risk and exposure, specifically towards lost time, expedited return to work and prevention. Fit2wrk is a national program with local expertise and the ability to customize programs to an employer’s specific needs, ensuring a maximum return on investment. From start-up to program implementation we have the tools to make the process seamless and most importantly, medically and legally compliant.

About Fit2wrk

Continuum of Care:

From preventive measures to post injury rehabilitation and safe, sustained return to work duties, Fit2wrk provides an integrated approach to ensuring overall client satisfaction. Our industrial specialists will review your own needs and co-develop programs designed to expedite return to work as well as positively impact future injury costs.

National Consistency of Care, Delivery & Custom Solutions:

Fit2wrk’s national approach with local care delivery provides them with the ability to roll out industry specific programs including completely customizable solutions for their clients.


The basis behind treatment and services is the generation of objective outcome data, focusing on evidence based medicine. This provides clients with up to date information at all times on an employee's status. Objective testing provides clear and concise reporting based upon peer-reviewed and published data.

Services Provided by Fit2wrk Include:
  • Job specific rehabilitation
  • Work conditioning/hardening programs
  • Fit for work assessment
  • Post offer pre-employment screening
  • Functional capacity evaluations
  • Job demands analysis
  • Job transfer testing
  • Preventative maintenance - testing for the aging workforce
  • Fitness programs for the industrial athlete
  • Ergonomic workstation assessments
  • On-site therapy support
  • On-site exercise and stretching program development
  • Educational programs

Fit2wrk’s direct line 1-877-FIT-2WRK (1-877-348-2975) provides you with access to their national partner provider network. Fit2wrk will take your request, confirm appointments and follow through to ensure you are always taken care of. From specific specialty requirements to immediate time conscious requests we are here to help.


Certified Hand Therapy


“Hand therapy is the art and science of rehabilitation of the upper limb, which includes the hand, wrist, and shoulder girdle. It is the merging of occupational and physical therapy theory and practice that combines comprehensive knowledge of the structure of the upper limb with function and activity. Using specialized skill in assessment, planning, and treatment, hand therapists provide therapeutic interventions to prevent dysfunction, restore function, and/or reverse the progression of a pathology of the upper limb in order to enhance an individual’s ability to execute tasks and to participate fully in life situations” (HTCC, 2009).


Why Choose a Certified Hand Therapist

As human beings we value the use of our hand and arm to perform all of the occupations that encompass our lives. Whether it is driving to work or getting dressed, the loss of upper extremity use during these activities as a result of an injury or surgery can be debilitating. A certified hand therapist has the highest level of training in the profession for treating the hand, wrist, elbow, and shoulder. They are required to have at least 5 years of experience including 4000 hours of direct practice in hand therapy. They must also pass a comprehensive exam testing the advanced knowledge of skill and theory required to treat the upper limb.

Common injuries treated by a CHT

  • Tendonitis (i.e. shoulder impingement, trigger finger, DeQuervains, epicondylitis)
  • Ligament injuries, strains, sprains
  • Cumulative trauma disorders (i.e. carpal tunnel syndrome)
  • Shoulder injuries ( i.e. Rotator cuff tear/ repair, thoracic outlet, labral tears/repairs)
  • Fractures and crush injuries
  • Tendon and nerve repairs
  • Arthritis (OA and RA)
  • Complex regional pain syndrome/RSD
  • Dupuytren’s contracture (post-surgery)
  • Post CVA rehabilitation of upper extremity
  • Wound and burn management

Services provided by CHT’s may include

  • Customized splint fabrication (static & dynamic)
  • Joint mobilization
  • Range of motion exercises
  • Strengthening
  • Scar management
  • Wound care
  • Pain management
  • Soft tissue mobilization (strain/counterstrain)
  • Arthritis joint protection
  • Joint stiffness
  • Functional deficits
  • ADL evaluation
  • Cold laser
  • Modalities
  • Edema control (link)
  • Worker's compensation
  • Functional capacity evaluations (FCE's)



The human body goes through a number of changes as it grows older. A decline in muscle mass and bone density can lead to muscle fatigue and joint pain. There is good news! Seniors can remain physically active and lead happy, healthy, and productive lives with the help of physical therapy. Exercise in a safe, controlled environment under the supervision of a licensed physical therapist goes a long way to improving the quality of life. A physical therapist can design exercise programs that help seniors cope with some of the issues associated with aging which may include:

Decreases in Strength and Mobility: Physical therapists can develop exercise and strengthening programs designed to keep you as independent as possible as you age. We focus on the tasks in your life that you value most, as well as work to strengthen the body as a whole.

Increased Risk of Falls: Falls can occur due to a loss in the body’s ability to maintain balance, posture, and equilibrium. A physical therapist can create an exercise program to improve muscle tone, strength, joint movement, and balance. This can prevent dangerous consequences like broken bones and allow seniors to stay active and healthy. (Also see balance and fall prevention) (link)

Osteoporosis: This is a condition characterized by loss of bone density and bones that become brittle and prone to fractures. Physical therapy prescribe weight training exercises to increase bone density and improve muscle strength as a cornerstone of prevention.

Pain and Discomfort from Arthritis: Joint wear and tear can result in osteoarthritis. This leads to joint pain and swelling which can restrict movement. Physical therapy includes a variety of treatment options including hot and cold treatments, massage, and range of motion exercises. Splints and orthotic devices can also help.

Urinary Incontinence: Incontinence can occur at any age but becomes more prevalent as we get older. Physical therapists can assist by providing bladder training exercises that can help treat this problem and reduce incontinence in the future.

How Physical Therapy can help

Prevention and management of these problems associated with aging is much more satisfying than the inactivity and isolation that can occur without active exercise. The human body can always respond, adapt, and grow stronger as long as it is challenged. Physical activity combined with healthy nutrition is important to maintain health and vitality in older individuals. If you feel that you need help in the areas listed above please call your physical therapist or talk to your doctor to discuss how they can help.

Pediatric Rehabilitation


In the pediatric population, physical/occupational therapists use purposeful play in the evaluation and treatment of each child. Skills are learned and mastered through the context of therapeutic play in hopes of enhancing performance of functional and purposeful activities. This approach addresses the child’s physical, social, and emotional needs. Following the child’s lead, a therapist will create a fun and empowering treatment session. Developmental skills are emphasized allowing for progress toward age appropriate activities and movement patterns. Family participation is encouraged for successful implementation and carry over into the home environment. Comprehensive individualized home programs are created, further empowering the family and child.

Most physical and occupational therapy clinics can accommodate children 8 years and older for sports/ physical rehabilitation, but some clinics offer specialized services for children starting in infancy. In all cases it is imperative that a close relationship develop between the parents, pediatrician and therapist.

In treating the pediatric population, physical and occupational therapy can:

  • Facilitate normal movement patterns
  • Inhibit abnormal tone and premature reflexes
  • Avoid secondary complications and compensatory patterns
  • Inhibit the central nervous system from learning abnormal movement patterns
  • Teach functional activities
  • Foster independence
  • Activate normal movement patterns/postural reactions through functional goal-related activities
  • Improve sensory motor processing abilities
  • Assist with increasing overall internal organization, focus, and attention

Pediatric conditions that may benefit from physical therapy:

  • Gait disorder (toe walking)
  • Orthopedic injuries
  • Torticollis
  • Sports injuries
  • Low/high tone
  • Gross motor skills
  • Scoliosis & back pain
  • JRA
  • Osgood-Schlatters disease (OSD)
  • Severs
  • Incontinence/ Pelvic floor dysfunction

Pediatric conditions that may benefit from occupational therapy:

  • Development delay
  • Sensory integration
  • Prematurity
  • Torticollis
  • Neuro: CP, anoxic (birth trauma)
  • Low/high tone
  • Gross/fine motor skills
  • Handwriting
  • Juvenile Rheumatoid Arthritis (JRA)
  • Migraines (link)
  • Visual motor
  • Fibromyalgia
  • Feeding difficulties

Balance & Fall Prevention


One in every three adults 65 and older fall each year in the United States - WWW.CDC.GOV

A fall is defined as coming down suddenly from an upright position. In 2001, it was reported that 1.6 million seniors were treated in the emergency room as a result of fall-related injuries. After the age of 60, the incidence and resulting complications of a fall increase. Falls can occur anywhere and at any time while at home or in the community. Falls can cause serious injury and even death. Often a person who has fallen is too embarrassed to report the fall because it signals a significant change in his/her stage of life. It is not just the frail elderly individual who may fall, but even those who are active.

Balance, the ability to control and maintain your body's position as it moves through space is an integral part of daily life. There are conditions that may impair your sense of balance and contribute to falls. The effects of aging are the most common causes of balance problems, but injury and disease can also create problems:

Causes of Increased Fall Risk Include:

  • POOR POSTURE (Slouching forward and rounded shoulders can cause unsteadiness)
  • DISEASE (Diabetes, Osteoporosis)
  • HOME HAZARDS (lighting, obstructed walkways, small pets, cords, etc)
  • WINTER CONDITIONS (slick sidewalks, high winds, icy parking lots)
  • MEDICATIONS (tranquilizers, heart medicines, blood pressure, etc)

Fall Prevention Conditioning Program

Fall prevention conditioning programs offered by physical therapists are designed to increase independence with functional activities, functional mobility, and safety awareness while decreasing fall risk. Research has shown that a successful fall prevention program must be multi-dimensional. A program must address all underlying factors in addition to strength and balance. Physical therapists use valid and reliable assessments to determine all the factors affecting each individual's fall risk. Therapy focuses on reducing the factors and decreasing fall risk. This is consistent with the protocols recommended by: The American Geriatrics Society and the American Academy of Orthopedic Surgeons’ Panel on Fall Prevention Guidelines.

Program Objectives

  • Increase independence with Activities of Daily Living (ADLs)
  • Increase independence with functional mobility
  • Decrease fall risk
  • Prevent future fall
  • Increase safety

Factors Assessed

  • Medical history
  • Static/dynamic balance
  • Functional balance
  • ADL (Activities of Daily Living) performance
  • Strength
  • Range of motion
  • Proprioception: The sense of the relative position of neighboring parts of the body that indicates whether the body is moving, as well as where the various parts of the body are located in relation to each other.
  • Cognition/vision/perception
  • Safety awareness
  • Extrinsic factors/home conditions

The program is tailored around each individual’s needs. The length of the program is dependent on the severity of the symptoms and the goals of each individual. If you are concerned that you or a family member may be at risk for a fall, please use the fall risk screening questionnaire included on the right.

Vestibular Rehabilitation


Dizziness and disequilibrium are second only to low back pain in frequency of occurrence in the adult population. Balance and vestibular deficits are a major medical concern, and the resulting effects of an untreated balance disorder can be devastating. The good news is that in many cases a physical therapy treatment plan can successfully treat the problem, preventing subsequent injury.

Understanding Vertigo

Vertigo is the feeling that either you or your environment is moving when you are staying still. It may be described as spinning, light-headedness, or a sense of disequilibrium. It can occur suddenly or gradually. Your symptoms may last seconds, minutes, hours, or days. Your treatment depends on its cause. It is most often caused by problems in the brain or inner ear.

Understanding BPPV

Benign Paroxysmal Positional Vertigo (BPPV) is characterized by a brief episode of vertigo (spinning) when the head moves into a specific position. Common causes for this disorder are trauma to the head (concussion, motor vehicle accident, etc.) and acute infection, but frequently the cause is unknown. Patients usually complain of a spinning sensation being provoked by lying down, rolling over in bed, bending over, or looking up. Common activities that can provoke this sensation include getting out of bed, gardening, washing hair in the shower, and going to the dentist or beauty parlor.

The main symptom that people with BPPV complain of is having a feeling of spinning related to a certain position of the head. Other symptoms may include nausea, occasional dizziness, occasional light-headedness, and an overall sense of not feeling quite right. The symptom of spinning may come on immediately when in the provoking position or it may be delayed from 0 to 40 seconds.

Signs and Symptoms

  • Feelings of vertigo, dizziness, light headedness or disequilibrium
  • Loss of balance or falls
  • Difficulty walking
  • Difficulty standing in line or in busy places
  • Difficulty walking in the dark
  • Veering or weaving when walking (sense of being pulled)
  • Sensitivity to motion
  • Headache
  • Nausea/vomiting
  • Ear pressure
  • Ringing in the ears
  • Hearing loss
  • Fatigue/deconditioning

Vestibular disorders that respond well to physical therapy treatment

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Meniere's disease
  • Migraine Associated Vertigo (MAV)
  • Vestibular neuritis/labrynthitis
  • Motion sensitivity
  • Post-concussion syndrome (link)
  • Other musculoskeletal or neurologic disorders resulting in balance or dizziness problems

Vestibular Rehabilitation Therapy Program

Vestibular rehabilitation therapy is an exercise-based program designed to promote central nervous system compensation for inner ear deficits. A licensed physical therapist will be able to offer a variety of initial services to all patients experiencing dizziness and balance deficits. These include:

  • Evaluation of vertigo and dizziness, balance, posture, gait deficits, mobility, strength, and flexibility dysfunction
  • Evaluation of fall risk
  • Consultation with physical therapists and other health care providers regarding balance and dizziness impairments
  • Patient education
  • Treatment for balance and dizziness dysfunction
  • Regular communication with the referring medical practitioner

Once the initial evaluation is complete, the physical therapist will be able to tailor a specific rehabilitation program specifically to your needs that may include:

  • Canalith repositioning techniques for anterior, posterior, and horizontal canals
  • VOR adaptation and habituation exercises
  • Balance re-education
  • Gait training and recommendations for assistive devices
  • Eye/head exercises for gaze stabilization
  • Education in fall prevention and safety
  • General conditioning, strengthening and ROM
  • Relaxation techniques & soft tissue mobilization
  • Motion sensitivity habituation

Concussion Recovery


Estimates suggest that 1.6 to 3.8 million concussions occur from participation in sports and recreational activities every year. A head injury is a serious condition which can be life threatening. A concussion is an injury that changes how the brain works. A concussion is caused by a blow to the head or body that causes the brain to move rapidly inside the skull. Even a “ding,” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. Concussions may also result from a fall or colliding with obstacles, such as a goalpost or in a work or home environment.

People with a concussion need to be seen by their physician. If you think you or someone you know has a concussion, contact your health care professional. Getting help soon after the injury by trained specialists may speed recovery.

Signs and Symptoms of a Concussion

  • Loss of consciousness (LOC), confusion
  • Post-traumatic amnesia (PTA), retrograde amnesia (RGA), disorientation
  • Delayed verbal and motor responses
  • Inability to focus headache, nausea, vomiting, excessive drowsiness
  • Visual disturbances (photophobia, blurry phono/ photophobia vision, double vision)
  • Disequilibrium
  • Feeling “in a fog”
  • Emotional liability
  • Dizziness
  • Slurred/incoherent speech

About the program:

Research shows that athletes demonstrate decreased stability up to 3 to 5 days post injury. This can be result of ineffective use of one or more sensory systems. The recovery period related to concussion coincide with the recovery of postural stability as well as normalization of eye-head coordination and return of cognitive function. There is strong evidence demonstrating the impact of balance deficits on functional performance and increased risk of re-injury.

A physical therapist can help treat post-concussion syndrome by designing an individualized rehabilitation program.

EVALUATION: A licensed physical therapist will take the time to talk with you and perform a thorough examination of your condition.

THERAPY: Your physical therapist will plan a treatment program suited to your individual condition, which will involve exercises for your balance, vision, inner ear and more in order to restore brain function.

TEACHING: Your physical therapists will spend time reviewing information with you regarding your diagnosis and progress as well as answering your questions. It’s important to empower patients to make a lifelong impact on their health.

RETURN TO SPORT/WORK: Your physical therapist is uniquely qualified to guide you towards safe return to sport. They will guide you through a stepwise protocol to keep you symptom free throughout the process and to prevent you from serious, life-threatening conditions associated with a second head injury due to early return to sport.

Parents: Available for download is a factsheet created by the CDC, on what to look for and what actions to take in the occurrence of a concussion. FLYR_ConcussionABC_PTandME

Women's Health


Women’s Health Programs are typically designed to provide women with comprehensive services for the treatment of sensitive issues such as Urinary Incontinence, Pelvic Floor Dysfunctions & Pregnancy and Postpartum-related musculoskeletal disorders. Specially-trained physical therapists provide assessment and treatment in a supportive and private environment. A personalized treatment approach is designed to meet each patient’s needs. A therapist specializing in women’s health may treat the following:

Urinary Incontinence (UI)

According to the National Association for Continence (NAFC), urinary incontinence (UI) affects 25 million Americans; 75-80% of those affected are women.

UI is a social and hygienic problem for women of all ages. It is characterized by involuntary, uncontrollable leakage of urine. The social embarrassment experienced by those who endure loss of bladder control can often be powerful enough to prevent them from seeking help from a healthcare provider. It is a myth that urinary incontinence is a normal part of aging and there is nothing that can be done about it. Physical Therapy is effective in treating two main types of urinary incontinence:

  • Stress Incontinence: When laughing, sneezing, coughing, or lifting a heavy object causes leakage
  • Urge Incontinence & Overactive Bladder: When there is urgency to urinate with a sudden bladder contraction, but there is inability to get to the toilet in time.

Women’s health programs take personal approaches providing:

  • Comprehensive review of medical history and bladder habits
  • Assessment of pelvic floor muscle function with biofeedback equipment as indicated
  • Musculoskeletal and/or pelvic floor muscle examination
  • Education through teaching models, videos, books, and handouts to better understand urinary tract function, increase awareness about symptoms and create a customized exercise prescription
  • Pelvic floor re-education to prevent leakage and regain bladder control that includes timed- voiding, bladder training, and functional re-training

Management of Pelvic Floor Uro-Gynecological Dysfunctions

Pelvic floor disorders may present individually or as a cluster. Some of the most common conditions listed below can be treated effectively through a combination of pelvic floor muscle strengthening, neuromuscular re-education and manual therapy techniques.

  • Disuse Dysfunction: lack of awareness & use of PFM
  • Supportive Dysfunction: laxity and weakness of PFM
  • Hypertonus Dysfunction: excess tone in the PFM
  • Incoordination Dysfunction: difficulty in contraction or relaxation sequencing of PFM
  • Pelvic organ prolapse
  • Vulvodynia
  • Interstitial cystitis
  • Episiotomy scars
  • Chronic pelvic pain
  • Endometriosis
  • Painful scars
  • Painful intercourse
  • Adhesions
  • Coccygeal pain

A urinary incontinence program typically focuses on strengthening weak pelvic floor muscles, increasing tone and flexibility, decreasing pain, and restoring optimal function. Sessions with each patient will be conducted in a private environment, where women will learn to regain muscular and will be able to restore their active lifestyles.

Management of Pregnancy and Postpartum Musculoskeletal Disorders

Pregnancy can cause a number of physical changes such as weight gain, strain on the abdominal muscles and lumbar spine, and ligamentous laxity. These changes may cause pain that result in difficulty performing daily activities. A pregnancy and post-partum therapy program may provide:

  • Assessment of posture, strength and flexibility
  • Treatment for sciatica pain
  • Application of pain control modalities safe for pregnancy
  • A customized exercise and manual therapy program to promote optimum musculoskeletal health and preparation of labor and delivery
  • Consultation on the use of braces, supports, or assistive devices

Biofeedback re-education Programs

In women, the pelvic floor muscles are often damaged during childbirth and can lose strength as hormone levels decrease after menopause.

Biofeedback was first used by Dr. Arnold Kegel in the late 1940s to teach patients how to strengthen pelvic floor muscles (PFM). Unfortunately, most people find it difficult to identify and correctly perform Kegel exercises. The good news is that special computerized biofeedback devices can identify PFM and can assist you in controlling the performance of these muscles through visual and tactile feedback.

How does Biofeedback work?

All muscles in our body give off a small electrical signal that can be monitored with electromyography (EMG). By placing small surface electrodes close to the muscles being monitored (SEMG) and then connecting it to a computer, biofeedback devices provide visual feedback. This information can be utilized to generate a customized exercise prescription.

Some of the benefits of Biofeedback include:

  • Individualized progressive treatment by trained professionals
  • Awareness of pelvic muscles and achieving correct contraction/relaxation
  • Improved efficiency, control, strength, endurance, conditioning & flexibility
  • Pain relief

Cancer-Related Fatigue


Cancer-Related Fatigue (CRF) is a feeling of extreme tiredness and is usually accompanied by other symptoms. CRF is a debilitating condition that can seriously affect your health and quality of life. Most importantly it can significantly interfere with your home life and may limit the effectiveness of chemotherapy cycles. It is the number one complaint of cancer patients and it is a nearly universal problem affecting 78% to 96% of those undergoing treatment.

Signs and Symptoms

  • Chronic pain
  • Leg pain
  • Difficulty with balance
  • Shortness of breath after light activity
  • Difficulty walking short distances
  • Difficulty performing daily tasks
  • Extreme weariness and tiredness
  • Difficulty sleeping

Why Fatigue Happens

  • Reduced energy to repair damaged tissue
  • Buildup of toxic substances
  • Effect of biologic therapy on immune system
  • Changes in sleep/wake cycle

Previous advice for cancer patients was often to get more rest and avoid activities that are physically challenging. However, recent studies have shown that exercise was found to be effective in preventing or reducing CRF. No adverse effects from exercising have been reported. “Identified as remarkably underutilized, exercise is one of the few interventions suggested to diminish CRF and other psychosocial symptoms. The positive affect of exercise on CRF should underscore the need for physical therapists’ involvement in the rehab of patients with cancer.”

Cancer Related Fatigue Program

Licensed physical and occupational therapists can provide specialized therapeutic services that address the needs of CRF patients. Therapy sessions last approximately thirty minutes to one hour, depending on the patient’s tolerance. Average number of visits a week is 2-3. The program is concurrent with the cancer therapy and may last throughout the entire treatment phase. CRF is a very complex problem that requires a thorough physical therapy evaluation, where a team approach with the physicians is maintained.

Program Objectives

    • Address pain—which in turn can alleviate fatigue
    • Use non-drug based treatments such as physical modalities:
    o Soft tissue & joint mobilization
    o TENS
    o Heat/Cold
  • Alleviate musculoskeletal dysfunction
  • Improve posture
  • Combat effects of bed rest
  • Help to maintain muscle strength and flexibility, and restore muscle balance
  • Help to decrease depression by increasing endorphins
  • Improve balance
  • Improve endurance
  • Core body strengthening

Physical and occupational therapy can help a patient regain/keep their strength and mobility as they are treated and recover from cancer. Licensed therapists have the tools to bring a patient to their full function safely through exercise and education.

Lymphedema Management


Orthopedic Edema Reduction

Patients who present with edema from a variety of diagnoses such as oncological, orthopedic, lymphatic, or vascular can benefit from peripheral edema management. The goal of physical and occupational therapy is managing any of these types of edema is rapid reduction of edema in the involved area to hasten return to normal function.

Trauma, surgery, and sports injury can cause acute swelling in the affected joint. This edema leads to a reduction of joint mobility, range of motion, and proprioception combined with pain and stiffness. Manual lymphatic drainage (MLD) combined with compression bandages can increase the interstitial fluid pressure, facilitate lymphatic drainage, and accelerate the healing process. Some diagnoses that respond well to this type of care are

  • Ankle sprains
  • Knee contusions
  • Post-op joint replacements
  • Hand effusion

Lymphedema Management Program

Lymphedema, the accumulation of fluids, is due to the disruption in the lymphatic system. This type of swelling is seen after trauma to the body, radiation treatment, and often when lymph nodes are surgically removed. Patients may develop lymphedema after breast surgery. The good news is this is a treatable condition that can be controlled through the combination of:

  • Manual lymphatic drainage
  • Multi-layered compression bandages
  • Self-treatment with bandaging and/or compression garments
  • Exercising
  • Patient education with precaution awareness

This program makes significant improvements by restoring functional mobility and strength, reducing swelling and pain, and improving cosmetic appearance.


The treatment of peripheral edema requires a combination of techniques to be successful. Complete decongestive therapy consists of the following essential treatment components:
  1. Evaluation - To determine the proper course of treatment
  2. Manual lymph drainage - A specialized manual technique to move edema from a congested area into an uncongested area where the lymph fluid can be readily absorbed
  3. Exercise - simple exercises performed daily can improve the flexibility, increased strength, and promote lymph flow. These contractions in the edematous area quicken the reduction of the limb, enhancing range of motion, and decreasing pain.
  4. Compression bandages - increase the tissue pressure which promotes lymph flow and thus reduces lymphedema and orthopedic edemas.
  5. Compression garments - are primarily used in the treatment of Lymphedema but can be used to control chronic orthopedic and vascular edemas. They are worn once the swelling has been reduced to maintain limb size.
  6. Home program - Individualized for each patient to include the above treatment techniques.