Agnes Said:

What kind of exercises/treatment is involved in physiotherapy/physical therapy? See details?

We Answered:

it all depends on what your problem is. myself i had a neck/spine/shoulder injury from being hit on the head with over 30 pounds from 2 flights up. there are all kinds of different things they will do to help.

they have a stretch cord hooks it to a machine and you pull it. its like a rubber band.. u pull it in all these different movements. like u are opening and shutting a door. or pushing and pulling something toward and away from you . across your chest and back out. its helpful it builds up your strength in your arms and back.

if its your legs. they will have you sit and flex your legs back and forth. straight out andback in. or try to climb a set of short stairs. or sit on an exersize machine and lift a bar with your legs. to strengthen them. theres also the bars.. 2 bars side byside you can walk though holding onto the bars. to keep your balance one step at a time. theres a tredmill and a exersize bike as well to work on the legs.

they could also have you lay on a raised table on your stomach right at the edge of it and give you a barbell and have you curl your arms with that holding onto it. first your right one at the edge of the right side then the left at the edge of the left side. up and back up and back. they give you a good work out. they do help.

Jared Said:

what is the physical therapy protocol for treatment of total hip replacement?

We Answered:

Physical Therapy Goals:Pre-Operative
Explanation of the role of physical therapy in Total Hip Arthroplasty rehabilitation.

1. Instruction and demonstration of post-operative physical therapy procedure/treatment (i.e., dislocation precautions, gait training with assistive devices, exercise regiment, Activity of Daily Living restrictions).

2. Establish home exercise program to prepare for surgery/hospital admission.

Acute (In Hospital)
1.Early cardinal plane motion of the operative hip with progression as rapidly as possible toward full anatomical range of motion, limited only by the prosthetic design and the patient’s potential.

2. Muscle strengthening primarily of the hip abductor and extensor muscle groups.

3. Gait training: Assistive devices are used to enable the patient to achieve the proper weight bearing status on the operative extremity. These devices are discontinued at the discretion of the Orthopedic Surgeon.

Sub-Acute (Post Discharge)
1. Achieve maximal hip range of motion, within cardinal planes of movement.
2. Muscle strengthening of the entire hip girdle of the operative extremity with emphasis on hip abductor and extensor muscle groups. Attention should also be directed toward any weakness present in the operative extremity as well as any generalized weakness in the upper extremities, trunk or contralateral lower extremity.
4. Proprioceptive training to improve body/spatial awareness of the operative extremity in functional activities.
5. Endurance training to increase cardiovascular fitness.
Functional training to promote independence in activities of dialing living and mobility.
6. Gait training: Assistive devices are discontinued when the patient is able to ambulate without a positive Trendelendberg test based upon the ambulation guidelines.

PHYSICAL THERAPY REHABILITATION GUIDELINES Precautions/Restrictions
Avoid SIMULTANEOUS/COMBINATION movements of the operative hip.
Patients are allowed to flex, extend, abduct, adduct, or rotate their operative hip in cardinal planes of motion with NO restriction to movement. Any combination of motion during the initial three (3) months, post operative period should be avoided.
No straight leg raises (SLR) as a repetitive exercises for 6 weeks-as a functional activity, leg lifting is permissible.
No sleeping on the operative hip for 6 weeks post-operative.
Low, soft, contour-type furniture should be avoided.
Sexual activity may be resumed when comfortable.
Patients may return to work at the discretion of their physician.
Patients are allowed to resume driving as outlined below:
- Operative left lower extremity-6 weeks post-operative.
- Operative right lower extremity-10 weeks post-operative.
Ambulation Guidelines:
Cemented Prosthesis: Weight bearing as tolerated (WBAT) ambulation.
Patients are required to initially use a walker/crutches for a period of time, then are progressed to cane ambulation. The cane is discontinued when the patient is ambulating without a positive Trendelenberg test.

Uncemented Prosthesis: Patients are required to ambulate using a walker/crutches with either bearing as tolerated or touch down weight bearing (TDWB) status for the initial six (6) post-operative weeks.
If touch down weight bearing at six (6) post operative, a progressive weight bearing program is initiated- 1/3 body weight on the operative extremity at (6) weeks post-operative; at eight (8) weeks post operative, progress to 2/3 body weight on the operative extremity; at ten (10) weeks progress to full body weigh on the operative extremity, continuing to use the walker/crutches for two (2) more weeks; at twelve (12) weeks post operative, patients are progressed to cane ambulation; when the patient is able to ambulate without a positive Tredenlenberg, the cane is discontinued and the patient is encouraged to ambulate without any assistive devices.

No running or involvement in sporting activities requiring running and/or jumping.

Acute Care ~ Treatment protocol instituted day of surgery with efforts to achieve discharge 2-3 days after surgery.

Days of Surgery:
Begin to lower extremity isometric exercises and ankle pumps. Encourage the patient to perform these exercises every two hours while awake.
Begin assisted bed-to-chair transfers using an assistive device to a chair of appropriate height. Weight bearing status is dependent upon the type of prosthesis implanted. Patients are not required to “slouch” sit but may sit in an upright position if comfortable.
Discuss post-operative dislocation precautions/restrictions.
Post-Operative Day 1:
Continue lower extremity isometrics and ankle pumps.
Initiate upper extremity and contralateral limb strengthening exercises.
Begin assisted ambulation on level surfaces using an assistive device, weight bearing status dependent upon prosthesis used.
Begin discharge planning and home needs assessment.
Review dislocation precautions/restrictions.
Post Operative Day 2:
Review lower extremity isometric and ankle pumping exercises.
Begin supine lower extremity active assisted range of motion exercises to the operative extremity. Motions are to the patient’s tolerance and in cardinal planes.
Continue assisted ambulation on level surfaces.
Reinforce hip dislocation precautions/restrictions.
Post Operative Day 3-Discharge:
Continue comprehensive exercise program with emphasis on increasing hip range of motion and general muscle strength in the operative extremity.
Begin sitting exercises.
Refine gait pattern and instruct in stair climbing.
Review home instructions/exercise program with emphasis on hip dislocation/precautions.
Finalize discharge plans. All patients require an assistive device for ambulation, an elevated toilet seat, and follow-up physical therapy.

Suggested physical therapy treatments/activities are listed below:
Modalities for Pain Control and Edema Reduction:
Moist Heat
Interferential
Ice
Tens
FES
Therapeutic Exercise:
Passive, Active-Assisted, and active lower extremity range of motion
Closed Kinetic Chain Activities
Stationary Biking-No resistance to motion
Lower Extremtiy Strengthening Exercises using Theraband
Nordic Track
Stair-Step Machine
Aquatic Therapy/Activities
Iliotibial Band Stretches-Supine stretches may be initiated at two (2) weeks post operatively, standing at twelve (12) weeks post-operatively
Scar Massage/Mobility-May be instituted after suture removal when the incision is clean and dry.
Endurance Training:
UBE
Upper and/or Lower Extremity Restorator
Ambulation Activities
One-Leg Cycling –Using non-operative leg, with resistance to motion
Aquatic Therapy
Balance/Proprioception Training:
Tandem Walking
Lateral Stepping over/around objects
Obstacle Course
Weight-Shifting Activities
Closed Kinetic Chain Activities
Gait Training:
Level Surface
Forward Walking
Sidestepping
Retro Walking
Uneven Surfaces
Functional Training:
Standing Activities
Transfer Activities
Lifting
Carrying
Pushing or Pulling
Squatting or Crouching
Return-To-Work Tasks
Sport Tasks

Home Instructions Following Total Hip Replacement~
Do not combine two or more of the following movements: bending way over, turning toes inward, twisting body.
When lying on your back, keep your operative leg positioned so that toes and kneecap point up toward ceiling.
Do not lie on your operative hip for six weeks following surgery. When lying on your non-operative side, make sure you have a pillow between your knees.
Do not sit in a low chair or recliner. Sit in frim, high chairs (or place cushions in lower chairs), preferably with armrests. This will make it easier for you to get out of the chair.
Do not sit in booths or low chairs when dining out.
Do not sit on a low toilet. Use an elevated toilet seat for the first twelve (12) weeks following surgery.
Walk in short sessions to gradually improve your physical endurance.
Continue to use your walker or crutches until your surgeon specifies otherwise.
Stairs: UP: Step up with your non-operative leg first, then raise your operative leg up to the same step.
DOWN: Step down with your operative leg first, and then lower your non-operative leg to the same step.

Terri Said:

is low level physical therapy laser treatment worth the money. for neck pain from severe narrowing of c5-6 dis

We Answered:

It has to be better than the fusion surgery I had which was $70,000 in 2001 I had it 7 years ago and I still take pain medication every day and will be disabled for life.

This link might help you with the laser info
http://www.healthatoz.com/healthatoz/Ato…

maybe look into any spine studies in your area at universities or medical centers

Good luck

Felix Said:

What is the best treatment for sciatica--injections or physical therapy?

We Answered:

Research demonstrates that overall, most people who have injections are no better off a week or two later. However, in people whose symptoms persisted even with physical therapy, therapy often becomes more effective once an injection has been administered. This is especially true for those whose symptoms are constant and radiate all the way to the foot.

Physical therapy is an excellent choice. While it's true that the term "sciatica" is often misappropriately applied, it is NOT true that you HAVE to know the exact source of the sysmptoms before it is treated. Rather, research demonstrates that sciatica (whether a true "radiculopathy" or a referred "somatic" pain from the intervertebral disc, or sacroiliac joint, or hip), or any musculoskeletal pain can be treated without expensive imagining or ever knowing the true pathoanatomic cause of the symptoms. It remains unknown in 85% of cases anyway.

Rather, assessment and treatment by LISTENING to YOUR history and observing what happens to the symptoms when you move is demonstrated to be a reliable and valid way to direct treatment...all by showing you how you can fix it yourself with very little intervention from a clinician. This approach to treating it is prevalant by physical therapist and chiropractors who are certified in Mechanical Diagnosis and Therapy (www.mckenziemdt.org). I would recommend you locate a practicioner who is certified in this.

Tina Said:

Are there any homeopathic and/or physical therapy treatments for spinal stenosis?

We Answered:

Although spinal stenosis does have to be confirmed on imaging studies, mere presense of "stenosis" does not imply that it correlates with one's symptoms.

When most people say "stenosis" they automatically think that it refers to a narrowing of the spinal canal or vertebral foraemen by boney obstruction which can cause pressure on the spinal cord or nerve roots, respectively. Yet, the term stenosis can also refer to a narrowing due to disc protrusion or other lesion.
The former is irreversible, the later is very often reversible.

No matter what the imaging study shows, however, it needs to be correlated with a physical exam. This is because imaging studies...especially MRI, often show anomalies that exist in a pain-free population. In otherwords, if you x-ray or MRI 100 pain-free people, a certain percentage will show spinal stenosis, a disc protrusion etc. Therefore, we often prefer that patients come to us WITHOUT any imaging studies (unless there are any red flag signs that warrant it) before they are told they have an "incurable" or "degenerative" type of condition that may or may not be true and does nothing but upset the patient.

Only after a mechanical evaluation (seeing how the pain responds to movement/positioning) can it be determined if this is a "reversible" stenosis, or if boney obstruction does, indeed, appear to be the compelling factor.

I do recommend that your friend seek out physical therapy from a therapist who is credentialed in performing mechanical evaluations. It should be known within the first 1-3 visits if this can be helped with conservative methods. You can find a list of credentialed providers at: http://www.mckenziemdt.org
If reversible, she will be shown what exercises to do to correct it, prevent it, and monitor it.