Tag Archives: stretching

bladder control during pregnancy

Bladder Control During Pregnancy

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Aside from a growing belly, you may notice other changes in your body now that you are pregnant. One thing you may notice is the loss of urine when you are not trying to urinate. Loss of bladder control, also called incontinence, is common during pregnancy and after childbirth. Needing to run to the bathroom often or leaking urine can make you feel embarrassed. Do not feel shy about asking for physical therapy for incontinence. They can help you understand and manage bladder control, and make sure there are not other conditions causing your incontinence. Here is some information to help you learn more.

HOW DOES THE BLADDER WORK?
Urine is stored in your bladder, which is an organ located in the pelvis. The muscles of the pelvis help keep your bladder in place. When you urinate, urine travels from your bladder and out of your body through a tube called the urethra. Ring-like muscles (sphincter muscles) keep the urethra closed so urine does not pass until you are ready to urinate. Muscles at the end of the urethra (sphincter muscles) and in the pelvic floor also help to hold back urine.

HOW CAN BEING PREGNANT CAUSE BLADDER CONTROL PROBLEMS?
The weight of a baby in your belly and the act of giving birth will put pressure on your bladder and may cause your pelvic muscles to stretch and weaken. This causes your bladder to sag, and your urethra to stretch. Nerves can also be damaged. It is this damage to muscles and nerves that can cause bladder control problems to persist.

pregnant woman

HOW CAN I CONTROL MY BLADDER?
The good news is that incontinence may go away once your pelvic muscles heal, usually 6 weeks or so after giving birth. But you can take steps after childbirth to minimize bladder control problems by doing exercises to strengthen your pelvic floor muscles. Kegel exercises are one type of pelvic floor muscle exercise.

Kegel exercises do not require equipment and can be done anywhere—while sitting at your desk, standing in line at the bank, or even lying down in bed. They are done by squeezing your sphincter muscles in the same way you would when stopping urine flow. After 6-8 weeks of doing the exercises, you may find that you have fewer leaks.

Talk to your doctor to learn more about how to correctly do Kegel exercises. Following pregnancy, if Kegel exercises do not control the incontinence, your doctor may discuss other treatments or refer you to a specialist who can help.

Here are some general steps for doing Kegel exercises from the American Pregnancy Association:

• Squeeze your pelvic floor muscles as if you were trying to stop the flow of urine. Do not squeeze the muscles in your belly, legs, or buttocks.
• Hold for 5-10 seconds, then relax.
• Repeat 10-20 times.
• Try to do at least 3 sets per day.

If incontinence is still bothersome, talk to your doctor about other options, such as wearing absorbent pads or briefs. With support from your healthcare team, you will be able to manage incontinence, as well as other bodily changes that come with pregnancy.

by Marjorie Montemayor-Quellenberg, MA

RESOURCES:
American Congress of Obstetricians and Gynecologists
http://www.acog.org

Office on Women’s Health
http://www.womenshealth.gov

CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca

Women’s Health Matters
http://www.womenshealthmatters.ca

REFERENCES:
Kegel exercises. American Pregnancy Association website. Available at: http://americanpregnancy.org/labor-and-birth/kegel-exercises. Updated Aug. 2015. Accessed Feb. 10, 2016.

Treatments of common complaints in pregnant women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 1, 2016. Accessed February 10, 2016.

Urinary incontinence fact sheet. Office on Women’s Health website. Available at: http://www.womenshealth.gov/publications/our-publications/fact-sheet/urinary-incontinence.html. Updated July 16, 2012. Accessed February 10, 2016.

Urinary incontinence in women. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 9, 2015. Accessed February 10, 2016.

What I need to know about bladder control for women. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/urinary-incontinence-women/Pages/ez.aspx. Updated June 2012. Accessed February 10, 2016.

3/5/2013 DynaMed’s Systematic Literature Surveillance: http://www.ebscohost.com/dynamed: Boyle R, Hay-Smith EJ, Cody JD, et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012;10:CD007471.

Last reviewed February 2016 by Michael Woods, MD Last Updated: 2/10/2016

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

at the gym

At the Gym: Exercising Do’s and Dont’s

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In the second installment of our “At The Gym” exercise series we examine the proper ways to exercise at the gym from start to finish. If you have any sudden significant increase in pain, swelling, or discoloration while performing or following exercise, discontinue immediately and contact your therapist at your next therapy session.

Plus Push Up 1

PLUS PUSH-UP

START POSITION
• Get on elbows and knees.
• Knees bent
• Straight or neutral back done by drawing the stomach in and the buttocks down.

ENDING POSITION
Push elbows into mat while trying to increase the space between the shoulder blades (round out your back between the shoulders).DON’T

DON’T
• Drop the head.
• Raise the buttocks or let the low back excessively curve inward.

Plus Push Up 2

PLUS PUSH-UP: STAGE 2

START POSITION
Push-up position

ENDING POSITION
• Push hands into mat while trying to increase the space between shoulder blades.
• Rounded upper back appearance.

DON’T
• Drop the head.
• Raise the buttocks or let the low back excessively curve inward.

Scapular Depression

SCAPULAR DEPRESSION

START POSITION
• Seated with shoulder blades drawn downward (don’t shrug shoulders).
• Hands hold just outside of the curvature of the bar to comfort.
• Knees bent underneath knee pad and feet on the floor.
• Keep your back straight with a slight posterior lean from the hips.

ENDING POSITION
Bring bar to chest with elbows bent.

DON’T
• Lift feet off the ground.
• Rock at the waist.
• Elevate or let shoulders pull forward.
• Hyperextend the low back as you pull in.

Empty Can 1

EMPTY CAN

START POSITION
Standing with hands at your side and thumbs pointing downward with feet shoulder width apart.

ENDING POSITION
Arms raised to about 60⁰ with thumbs facing down and slightly to your side.

DON’T
• Swing body back and forth.
• Shrug shoulders.
• Lift above 60⁰.

Full Can
FULL CAN

START POSITION
Standing with hands in front of you with thumbs pointing upward and feet shoulder width apart.

ENDING POSITION
Arms raised to 90 – 120⁰ with thumbs facing up.

DON’T
• Swing body back and forth.
• Shrug shoulders.
• Lift above 120⁰.

This information was written by STAR Therapy Services, an outpatient physical therapy group with six locations in Houston, Texas. At Star Houston Therapy Services, their number one priority is the patient. They strive to provide individualized treatment with hands-on, compassionate care. They perform comprehensive evaluations and encourage patient input for treatment planning and goal setting. For more information click here.

View the complete Exercising Do’s and Don’ts series below:

   

   

exercising do's and dont's

what to expect from physical therapy

What to Expect from Physical Therapy

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PHYSICAL THERAPY IS INTENDED TO MAKE CHANGES WITHIN YOUR BODY

We will accomplish this in several different ways. First, through the use of manual therapies, such as massage and mobilization of the joints. The goals of change are to:

  • Stretch short tissues to make them longer.
  • Strengthen weak tissues to make them stronger.
  • Improve and correct bad/abnormal biomechanics and asymmetries to alleviate pain and take the stress off the body.

THERE ARE SEVERAL THINGS THAT WE EXPECT DURING THE PHYSICAL THERAPY PROCESS, ESPECIALLY IN THE EARLY STAGES OF PT

  • You can expect that you will be sore after the first visit, and most likely the first 2 – 3 weeks until their body gets adapted to PT. Your body is just not used to doing the things that we are going to ask it to do, so there will be a period of adjustment.
  • The pain WILL move. As we make changes to your tissues and mechanics, the stresses on your body will change, thus altering where you will feel the pain or your symptoms.
  • The pain WILL change in terms of intensity, meaning that your pain is expected to fluctuate along the 10 point scale, starting between your high and low levels and changing based on your position, activity, and stress on the body.
  • The pain may also change in terms of the quality of pain. The pain may be: sharp, dull, achy, throbbing, burning, tingling, numbing.
  • It is important to know that all of the aforementioned statements are completely normal. There is nothing that you will experience that will surprise us. Everything that you experience will be normal. Even if what you feel is not normal to you, it is normal for your condition and what your body is experiencing.
  • Physical therapy is not an overnight miracle. Improvement takes time. It is important to understand that no one gets better every day from day one until they leave. Everyone will have good and bad days. In the beginning, you will have more bad days than good. As time progresses, this ratio should flip-flop and you should be having more good days than bad.

If you are looking for a physical therapist, we have you covered with over 500 locations nationwide!

physical therapy near me

 

This article was written by Life Fitness Physical Therapy, an outpatient physical therapy group with fourteen locations in the surrounding Baltimore, Maryland area. Life Fitness Physical Therapy is focused on improving the quality of life for their patients. They strive to provide individualized, evidence-based care that meets every patient’s unique needs. Their objective for each patient is to restore their function, achieve their goals and have them resume an active lifestyle as quickly as possible. For more information click here.

Protect, Stretch & Rest: General Tips

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These are some general healthy tips to remember during your day-to-day activities.

• If you are doing strenuous, household or outdoor work protect your hands with gloves in order to prevent injury and/or loss of moisture.
• Take frequent breaks or switch to a new activity. Overuse of repetitive motions, such as pressing buttons, can cause tendonitis of the elbow or lead to Carpal Tunnel Syndrome.
• If you find yourself sitting at your computer for hours each day, stop each hour and stretch your fingers, arms and the rest of your body to help prevent injury to your bones, joints and muscles.
• If you have pain during your activity, stop. Pain is one of the ways your body is letting you know that you are overextending a particular muscle group.

Plantar Fasciitis

Hamstring Tightness and Plantar Fasciitis

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Plantar fasciitis is classically characterized by pain in the central to medial plantar heel. It is thought to be caused by chronic inflammation of the plantar fascia due to repetitive strain and trauma to the fascia. There are many other purported causes including, calcaneal spurs and increased intraosseous calcaneal pressure, among others. Many studies have shown inflammatory and histological changes at the origin of the plantar fascia and surrounding structures that are consistent with repetitive strain and degenerative changes including a thickening of the fascia.

Biomechanics has long been looked at when investigating possible causes of injuries. Alteration of the load-bearing characteristics of the foot has been suggested by several studies to be the underlying problem in plantar fasciitis. Microtears and chronic degenerative changes result from the increased tensile stress placed on the fascia due to the changes in biomechanics. Muscle tightness is one factor that can lead to changes in gait mechanics and load bearing of the foot. Hamstring tightness has recently been investigated as a factor in plantar fasciitis and has been shown to induce prolonged forefoot loading due to increased knee flexion during gait. A rapid progression through the contact phase of gait results from increased knee flexion and in turn increases forefoot pressure. The fascia is a fixed-length ligament, so an increase in forefoot pressure results in increased tension at its insertion on the calcaneus. The increased time spent on the forefoot in gait leads to a chronic traction injury that is localized to the hindfoot insertion of the fascia; which is consistent with the symptoms of heel pain.

plantar

Biomechanical deficits have long contributed to injuries. Only recently has hamstring tightness been shown to have an effect on plantar fasciitis. Hamstring tightness affects every step, resulting in a biomechanical deficit which may contribute to a tensile overload of the plantar fasciitis. Recent studies suggest that all patients with plantar fasciitis should be evaluated for hamstring tightness. Physical therapy treatment for plantar fasciitis should include hamstring stretching.

More information about Plantar Fasciitis can be found in the PTandMe injury center.

physical therapy near me

This information was written by Plymouth Physical Therapy Specialists. They are committed to using evidence-based treatments in their practice. This means that their therapists utilize the most current and clinically relevant treatments in their approach to rehabilitation. For more information click here.

Low back pain

Exercise May Reduce Risk of Low Back Pain

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Low back pain is a common complaint that can last a few days or weeks or become a chronic condition with significant impact on well being. Treatments can vary depending on the cause.Chronic back pain can be difficult to successfully treat and it may take some time to find what treatment works best for each person. Since treatment is not guaranteed to work, prevention is the best option. Back pain is often the result of long term stress on the back such as poor posture, sedentary behavior, or regular strain on the back. Prevention will likely involve a number of different steps to reduce these stresses. However, existing studies have not found clear recommendations for the best methods to go about it.

Researchers wanted to investigate the effectiveness of a number of interventions for the prevention of low back pain. The study, published in JAMA Internal Medicine, found that exercise alone or in combination with education was most effective for preventing low back pain.

About the Study
The systematic review of 21 randomized controlled trials included 30,850 men and women without low back pain. The participants were randomized to 6 different prevention strategies, including exercise, education, exercise plus education, back belt, and shoe insoles. The control groups received no intervention, minimal interventions, or placebo.

When compared to the control group exercise was associated with:
• Fewer low back pain episodes in the first 12 months (in 4 trials with 898 people)
• Fewer sick days due to back pain in follow up 12 months or longer (in 2 trials with 128 people)
• Reduction in short-term (4 trials with 422 people) and long-term low-back pain episodes (2 trials with 138 people) when combined with education

Education alone, back belts, and shoe insoles did not appear to have any benefit during the trials.

man stretching

How Does This Affect You?
A systematic review combines the results of several smaller studies to arrive at one result. The benefit of this type of review is that it increases the number of participants which increase reliability of results. However the review is only as reliable as the studies that are included and the method used to combine the results. There were some flaws in every trial that were included in this analysis. For example, many of the included trials had a high dropout rate during the trial which decreases the reliability of their results.

Low back pain is often associated with an imbalance or weakness of certain back muscles. An exercise program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Regular physical activity may also help maintain a healthy weight which can also put strain on your back. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include 30 minutes of moderate aerobic exercise per day.

Check with your doctor before starting any exercise program.

by Cynthia M. Johnson, MA

RESOURCES:
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Ortho Info—American Academy of Orthopaedics
http://orthoinfo.aaos.org

SOURCES:
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 2, 2016. Accessed March 22, 2016.

Steffens D, Maher CG, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016 Feb 1;176(2):199-208.

Last reviewed April 2016 by Michael Woods, MD

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

runner stretching routine

Pre Run Dynamic Stretching Routine

runner stretching routine; pre run stretches

Pre Run Stretches, Why? How? When? For how long? Dynamic? Static? Ballistic?

Lately, it seems as though this simple principle has become increasingly difficult to understand. Ask a group of healthcare professionals how to stretch, and you are likely to get varying responses. This is in part due to the fact that stretching is ‘personal’. By that, we mean that each unique individual has different requirements to maximize ‘their’ benefit from stretching. This individualization of routine is largely influenced by age, health, exercise profile, and injury history. A good program will encompass both dynamic (actively moving a joint through the range of motion required for a sport) and static stretching (holding a stretch with no movement). Below, we will give an example of dynamic stretches for runners, followed by running and finishing with static stretching.

Pre-run, a good dynamic routine will incorporate sport-specific movements. The program below targets the major muscles of running. Remember to start slow with small movements, focus on form, and pick up the speed/increase the range of motion as the exercises get easier. A good dynamic warm-up lasts approximately 10 minutes:

  • Leg Lifts (Swing one leg out to the side and then back across your body in front of your other leg. Repeat 10 times on each side.)
  • Butt Kicks (While standing tall, walk/jog forward with an exaggerated backswing so that your heels come up towards your glutes. Repeat 10 times on each side.)
  • Pike Stretch (Get in a “pike” position (hips in the air). Put your right foot behind your left ankle. With your legs straight, press the heel of the left foot down. Release. Repeat 10 times on each side.)
  • Hacky-Sack (Lift your left leg up, bending the knee so it points out. Try to tap the inside of your left foot with your right hand without bending forward. Repeat 10 times on each side.)
  • Toy Soldier (Keeping your back and knees straight, walk forward, lifting your legs straight out in front and flexing your toes. Advance this by adding a skipping motion. Do 10 reps on each side.)
  • Walking Lunges (Step forward using a long stride, keeping the front knee over or just behind your toes. Lower your body by dropping your back knee toward the ground. Maintain an upright posture and keep your abdominal muscles tight. Repeat 10 times on each side.)

POST-RUN A good static stretching routine will target the major muscles of running including the calves, hamstrings, and hip flexors. For maximum benefit from static stretching, hold each stretch for a minimum of 30 seconds and not more than 2 minutes. Repeat for each side of the body, and complete at least one stretch per muscle group on a consistent basis. This is just one example of a sport-specific routine that we can develop. Our professionals’ knowledge as movement scientists coupled with our understanding of the complexities of the sport, position us uniquely to design, develop, and individualize comprehensive stretching routines.

The article above provided by Plymouth Physical Therapy Specialists

Dynamic WarmUp for Runners
Watch this Dynamic Stretches for Runners video created by The Jackson Clinics.

physical therapy near me

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics.

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1.Degenerative Disc Disease and the Role of Physical Therapy
Written by the therapy Team at The Jackson Clinics Physical Therapy

The symptoms of degenerative disc disease are varied but regardless, it can limit the patient’s mobility and ability to perform daily activities. Painkillers can help patients with degenerative disc disease but they also benefit from physical therapy. Let’s take a look on the role of Oregon Spine & Physical Therapy in Eugene, Oregon in managing degenerative disc disease. Read More

 

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2. Early Signs of Dehydration

Written by the therapy team at ARCH Physical Therapy & Sports Medicine

You have commonly heard the phrase, “MAKE SURE YOU ARE DRINKING ENOUGH WATER.” Hydration is important for the body not only as a daily practice, during physical activity, but also plays an important role in the aid of weight loss. The human body is made up of approximately 50-75% water. The percentage of water varies based on age and gender. Read More

 

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3. You Win Some, You Lose Some- Lessons Learned as a Marathon Walker
Written by Tiffany Basore PT, DPT at The Center for Physical Rehabilitation

Growing up I was an athlete. While being a perfectionist and competitive by nature helped me reach some goals, it has also held me back. There were times in my life where I avoided things because I was afraid to fail. In 2009, I took a chance and trained for a ½ marathon. Despite playing multiple sports, long distance running has never been “my thing”. I was nervous to participate for fear of failure, but I put these thoughts aside and I trained. I followed a plan, I was consistent, and I didn’t get hurt. When race day rolled around I was nervous but I felt I had prepared well. I had been experiencing some mild health issues at the time which had altered my diet, but I didn’t worry too much about it. I woke up the morning of the race with my legs feeling like lead. I attributed this to being nervous and over-thinking things. I started the race hoping I just needed to get into my rhythm, but I never did. I trudged on for 12 of the 13.1 miles willing my non-cooperative body to keep moving. Just past mile 12, there was a hill. I knew there was no way my body would carry me to the finish line if I tried to run up it. My entire body was letting me down in a way it never had during any of my training runs. As I began to walk, a medic asked if I was okay. I stubbornly said yes, but when asked to walk a straight line, I couldn’t come close. He checked my blood pressure, oxygen, and blood sugar, all of which were too low. I had to stop. My body had failed me. I had failed. Read More

Tennis Elbow

How to Treat Tennis Elbow

How to Treat Tennis Elbow; Tennis Elbow

What Causes Tennis Elbow?

Tennis Elbow, also known as lateral epicondylitis is an inflammation of the tendon fibers that attach the forearm extensor muscles to the outside of the elbow. More recently it is believed that this condition is due to the degeneration of the wrist extensor tendons. Either way, this affects the muscles that lift the wrist and hand. Pain may be felt where these fibers attach to the bone on the outside of the elbow or along the muscles in the forearm. Overuse of the muscles and tendons of the forearm and elbow are the most common reasons people develop the injury. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily high-level sports competitions. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain. Some patients, however, develop tennis elbow without any specific recognizable activity leading to symptoms.

How to Treat Tennis Elbow

Splints: Your physician or therapist may fit you with a strap to provide support to the involved muscles. Remember not to fasten the strap too tight as this can cause more problems. You may also be given a wrist splint to wear to provide rest to the muscles and tendons that bend and straighten the wrist. If your elbow is extremely tender, you will be provided with a heelbo or cushion to prevent the elbow from being hit. Wear these devices as directed. You can’t get better unless you wear the splints properly.

Ice and/or Heat Applications: Discuss with your physical therapist how to correctly apply ice or heat to the parts of your elbow and forearm that are involved. Icing can help reduce swelling/inflammation in the muscles and tendons that cause epicondylitis. Your therapist may also recommend heat to increase circulation in the area and decrease symptoms, especially if your condition is more chronic. Do not apply either for longer than 10 to 15 minutes at a time.

Stretching and Strengthening: Your physical therapist will instruct on how to treat tennis elbow by showing proper stretching and strengthening techniques as prescribed by your physician. Stretching improves the range of motion, increases circulation, and decreases muscle fatigue and swelling. Stretching the extensor muscle mass also provides tissue elongation to relieve muscle contractions. Strengthening helps build and tone the small muscles affected in epicondylitis, while hopefully decreasing pain and preventing a return of symptoms. Your therapist and physician will instruct you on what exercises to perform, when to begin them, and how often to complete the exercises.

Exercise Example from The Jackson Clinics

Sports: You may want to stop playing any racquet sports for now to allow adequate healing and reduction of pain. Also avoid sports such as baseball, bowling, or golf until you are pain-free. Weightlifting and bike riding can also pose problems. For tennis players, your serve, racquet, and ball all play important parts in your recovery, so be sure to speak about this with your physical therapist before resuming play.

Rest: Now that you have sought medical attention, you only get one opportunity to rest the arm and decrease your symptoms. This doesn’t mean you should stop using your arm and put it in a sling. It does mean you need to stop doing the activities and movements that cause inflammation and pain Follow the advice of your physician and therapist and discontinue activities that provoke pain.

Look at what you do and how you do it, not only in your work setting but at home, too. Remember, while tendonitis occasionally occurs from a one-time incorrect movement, it usually occurs from the overuse of a small muscle group. In other words, the continual repetition of incorrect movements will eventually stress the body, setting the stage for pain and inflammation.

physical therapy near me

PT News

This Month in PT News. Featuring articles from PTandMe partnering clinics.
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1. Raising Early Awareness of Flat Feet and Fallen Arches
Written by the therapy Team at The Jackson Clinics Physical Therapy

If the soles of your shoes show unusual wear patterns, one of the culprits might be the common condition of flat feet. Flat feet are normal in babies whose arches have not yet developed. The arch develops in childhood, and by the time you reach adulthood, a normal arch should be present. Read More

 

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2. The Kinesio Taping Method: What’s It All About?

Written by Melissa Coon at ARC Physical Therapy+

Barb Lewis is an Occupational Therapist and Certified Hand Therapist who specializes in upper extremity and wound injuries. She is also a Certified Kinesio Taping Practitioner. In honor of Pain Awareness Month this September, Barb shares her expertise on Kinesio Taping and explains how it benefits patients. Read More

 

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3. The Dual Role of Physical Therapy
Written by the therapy Team at Cornerstone Physical Therapy

A period of rest and recovery is essential after any injury, bwoman getting chiropracticut hip and pelvic fractures pose unique challenges. An extended period of bed rest is needed to allow time to heal. Reduced muscle tone and weakness may ensue. It can also result in a reduction in joint mobility. Physical therapy helps mitigate the effects of bed rest. Once a patient is weight bearing, a therapist can facilitate recovery using some of the following methods: Read More