How We Treat

DRY NEEDLING

Dry Needling is a medical technique performed by a skilled physical therapist to immediately reduce pain, muscle tension and improve mobility. It is used in a variety of musculoskeletal problems including, but not limited to:

• Acute or chronic injuries
• Headaches
• Neck pain
• Back pain
• Tendinitis
• Muscle spasms
• Sciatica
• Hip or knee pain
• Muscle strains
• Fibromyalgia
• Tennis or golfer’s elbow
• Overuse injuries
• and much more.

WHAT IS DRY NEEDLING?

Dry Needling is a treatment technique often used by physical therapists to relieve pain. It requires using a sterile acupuncture needle that is inserted through the skin into muscles, tendons, ligaments, and/or close to nerves to immediately reduce pain, decrease muscle tension and increase mobility. Dry Needling is not acupuncture; it is based on a modern scientific study of musculoskeletal and neuromuscular systems. This treatment technique provides an environment that enhances the body’s ability to heal which ultimately reduces pain.

IS THIS ACUPUNCTURE?

There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states can use dry needling under the scope of their practice. Our Physical therapists are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.

WHAT CAN BE TREATED BY DRY NEEDLING?

Dry Needling can be used for a variety of musculoskeletal problems. When combined with traditional physical therapy and the advanced manual therapy techniques, we have had success treating most pain-related problems from head to toe and from acute to chronic conditions. Also, Dry Needling can be used to help athletes overcome delayed onset muscle soreness. As athletes push the envelope to become bigger and faster or to reach new goals, recovery becomes an essential phase in the process.

Often times dry needling can be used to speed up this recovery time and allow the athlete to return to training or to playing as soon as possible.

IS DRY NEEDLING PAINFUL?

For most people, there is little to no discomfort with the insertion of the needle. We strive to make the treatment virtually painless, however, at times, you may experience a “twitch response” which often feels like a quick muscle cramp or ache. These sensations are normal and even desirable at times. Following this technique muscle soreness can be felt up to 24-48 hours. The application of heat or ice and drinking plenty of fluids usually reduces the soreness.

Dry Needling is a powerful treatment technique that when in used in conjunction with our other physical therapy treatments, can help you relieve your pain and improve your function quickly. Contact us at 219-561-0828 to learn more about our dry needling therapy.

WHAT IS ELECTRICAL STIMULATION?

While it may sound a bit intimidating, electrical stimulation really isn’t at all! When used correctly and provided under the guidance of a licensed and skilled physical therapist, electrical stimulation is a safe and efficacious modality that can be used to treat a variety of conditions.

While individual units and modes of delivery can vary, the standard electrical stimulation device utilizes self-adhesive electrodes placed around the target treatment area on the body. These electrodes are connected via wire leads to the unit, through which electricity can pass and ultimately interact with sensory and/or motor nerves (depending on the type of current utilized).

WHAT IS ELECTRICAL STIMULATION USED FOR IN PHYSICAL THERAPY?

There are several electrical stimulation modes that use different types of currents intended to stimulate different nerves in a variety of specific ways. These include modes such as transcutaneous electrical nerve stimulation (TENS), interferential, pre-modulated, Russian, and symmetrical or asymmetrical bi-phasic. Don’t let the words confuse you, though. Your physical therapist will decide on the right one to meet your unique needs.

Our clinic frequently utilizes electrical stimulation in order to provide a variety of beneficial healing effects, including:

• Reduce, eliminate, and/or control pain (both acute and chronic)
• Increase local circulation
• Decrease swelling
• Improve range of motion
• Reduce muscle spasm
• Provide biofeedback (aka improve body awareness)
• Improve motor coordination
• Provide neuromuscular re-education
• Prevent or reverse muscle atrophy (especially after prolonged immobilization, such as a limb being casted as a fracture heals)

Pain control and reduction is probably the most frequent indication of electrical stimulation usage. Specifically, this modality can trigger an innate and completely natural analgesic effect by stimulating specific sensory nerve fibers (including A-beta, A-delta, and C fibers) which both disrupt or decrease the sensation of pain and also elicit the release of certain neurotransmitters which can prolong the pain-relieving effects.

While it’s not for everyone (including people with deep vein thrombosis, people who are pregnant, people with pacemakers, and people with impaired cognition) or safe to use on every body area (including on the anterior neck, eyes, or over areas with damaged skin or decreased sensation), electrical stimulation can be used for a wide variety of conditions as indicated, including acute sports-related or auto accident-related injuries, repetitive stress injuries, muscle strains, ligament sprains, and even neurological conditions including stroke.

DOES ELECTRICAL MUSCLE STIMULATION HURT?

No!

The intensity of the electrical muscle stimulation or sensory nerve stimulation is easily modifiable and ultimately will only be as much as you, the patient, can tolerate. Typically, electrical stimulation will feel tingly or prickly (some patients describe it as a comforting “pins and needles” sensation). Sometimes, as in the case when used for muscle strengthening, the intensity level can be high and somewhat uncomfortable, but it should never cause pain.

WHAT SHOULD I EXPECT DURING AN ELECTRICAL STIMULATION SESSION?

Our patients’ comfort, safety, and dignity are the number one priority. For this reason, we’ll ask you to come in comfortable loose-fitting clothes and sturdy shoes when you come to see us for an appointment.

At your initial consultation, expect to be taken through a thorough patient history questionnaire (we’ll ask questions about your current, past, and family medical history) and physical examination. Your physical therapist will be able to diagnose your condition and then devise an appropriate treatment plan to meet your unique needs.

If your physical therapist decides that electrical stimulation is an appropriate part of your plan of care, he or she will first educate you about the specific modality. You’ll be asked to sit or lie in a comfortable position, your skin in the target treatment area will be cleaned and prepped, and your PT will guide you step-by-step through the entire treatment.

KINESIO & ROCK TAPE

Kinesio/RockTape is an elastic adhesive tape used to treat a variety of injuries. It can be used for several different treatment goals:

DECREASE PAIN

More specifically, it runs interference on pain. Ever whack your shin and rub it, and suddenly realize you feel better? Kinesio/RockTape on the skin can interfere with painful signals which are directed to the brain.

When the signals arriving at the brain are altered, it does not produce the sensation of pain. When kinesiology tape is properly applied, many of our customers call it “magic” or think that it fixed their injury instantly. In fact, it helps to change how your body interprets pain, turning down the pain “volume” that your body hears.

DECOMPRESSES SWELLING AND INFLAMMATION

When kinesiology tape is applied to the skin, it has a microscopic lifting effect underneath the skin and between the many layers. This allows the by-products created by inflammation to be removed more quickly.

DELAYS FATIGUE

Research has shown that kinesiology tape on the skin can attenuate muscle fatigue. In rehab, this is very important, not only for the parts of your body that are currently hurting but also for the surrounding areas as they help to pick up the slack for muscles that are currently not working well.

NORMALIZES MUSCLE TONE

When someone is injured, fatigued, sick, or inflamed, the symphony of muscle action that normally takes place with great accuracy often falls out of tune. This can happen all over the body. For instance, research has shown that people who sprain their ankle tend to have altered activity of their hip muscle as a result. kinesiology tape helps bring dormant muscle back to life and help calm down the overactive muscles. It helps your body coordinate movement as if it weren’t hurt, hence allowing it to heal properly.

DISTRIBUTES PHYSICAL STRESS

Unlike conventional taping, which prevents movement – Kinesio/RockTape allows full movement of a taped area. Through elastic properties and quick recoil, kinesiology tape can help distribute forces to other nearby areas through the fascia, ligaments, and even bones.

Functional and Kinetic Treatment with Rehab (FAKTR) is a unique approach to patient care using IASTM (instrument-assisted soft tissue manipulation), similar to Graston but is combined with manual and instrument-assisted soft tissue techniques and incorporates functional rehabilitation through provocation and movement. FAKTR can be performed with or without instruments, but the focus is to reduce soft tissue adhesions with manual or tool-assisted techniques and motion. The use of FAKTR promotes the reduction of soft tissue and fascial restrictions to allow the athlete to get back to peak performance as quickly as possible.

INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION (IASTM)

FAKTR treatment is a therapy a type of IASTM that regenerates healthy soft tissues (muscles, tendons, etc.), and eliminates or reduces unwanted scar tissue that may be causing pain or movement restrictions. FAKTR treatment is highly effective and even works when other approaches routinely fail. One of the main reasons FAKTR treatment is so much more effective than other treatments is that it was scientifically developed to resolve the underlying cause of soft tissue problems, rather than just trying to temporarily relieve symptoms. It is one of the most researched and effective therapy treatments available. Doctors regularly prescribe FAKTR treatment specifically for their patients, and elite athletes and knowledgeable patients seek out IASTM treatment for superior results. When your health and ability to stay active is at stake, only the best will do.

Generally, chronic soft tissue problems are due to scarring or degeneration. Soft tissues include muscles, tendons, and ligaments. Both scarring and degeneration are common and can result in pain and limitations in movement.

The body’s soft tissues degenerate when inadequate healing occurs, and over time the tissues degrade. Degenerated tissues are weak and prone to injury. Degeneration can be caused by many factors, including age, intense use, improper movement, weakened muscles putting extra stress on other tissues, disease, etc. Most chronic tendinopathies are primarily degenerative in nature.

Scarring can happen on top of the skin, but often the biggest problems come from scar tissue that forms inside the body around joints, muscles, tendons and/or ligaments. The body naturally lays down some scar tissue in response to irritation or injury. The fibrous, strong scar tissue is meant to reinforce an area, but often it ends up restricting movement and causing pain. The causes of problem scar tissue can be injury (such as a sprained ankle, car accident, etc.), a surgery (good surgery can be done, but the body’s response with scar tissue can prevent a full recovery), intense or overuse of soft tissues (such as sports, repetitive work, activity beyond your fitness level, etc.), sprains or other strains on soft tissues.

Good news: FAKTR treatment works both to regenerate tissues and eliminate or reduce internal scar tissue. By eliminating the cause of your problems, your symptoms will resolve.

IASTM is the acronym for instrument-assisted soft tissue mobilization, FAKTR is a type of IASTM technique that mixes several soft tissue treatments for the best results. The first part of the treatment is a warm-up. Areas of the soft tissue fibrosis are moved to make the scar tissue more receptive. A stainless steel tool is used to follow the affected soft tissue injury. The edge of the tool slowly slides along the skin surface and comes into contact with what is known as adhesions. It’s scar tissue, and the clinician rubs over the adhesions with the tool to cause movement. It’s this friction that helps heal soft tissue injuries. The area of the injury is treated with repeated movements of the tool rubbing over and around it. The rate of rubbing and amount of pressure are adjusted during treatment. After treatment, the affected area is stretched. A physical therapist may apply cold packs if there is any soreness. Typically, patients receive two treatments for a week over a period of about five weeks. Patients can expect relief by the third or fourth treatment. Other healthcare providers who utilize IASTM include occupational therapists, chiropractors, and athletic trainers.

The benefits of the FAKTR technique include:

• Increased rate of volume and blood flow to affected areas to enhance healing
• Breakdown of collagen cross-links
• Boost in cellular activity for good health
• Reduction in inflammation
• Reduction in pain for better quality of life
• Increased mobility and ability to perform daily tasks

THE THEORY BEHIND FAKTR: IT’S SCIENCE BASED

Scar tissue is a type of fibrous connective tissue that receives less blood than normal tissue and stretches much less. It tends to be thick and may build up around the ligaments, tendons and muscles after an injury. The buildup of soft tissue is referred to as adhesions. Injuries that may result in adhesions include shin splints, pulled hamstrings, meniscal tears and much more. When an individual is injured, adhesions and scar tissue may occur either in the tissues or in the skin. It is believed that scar tissue and adhesions prevent the underneath body structures from moving properly. This is because the ligaments, tendons and muscles are unable to freely move. It’s problematic because scar tissue and adhesions may bend to fascia and cause a condition known as fascial restriction. Adhesions and scar tissue can also occur on a smaller scale as a result of a cross-linking of muscle fibers. Over time, even the wear and tear of everyday life can cause muscle fibers to adhere to each other irregularly. With IASTM and the FAKTR technique, the treatment causes a muscle fiber separation, which releases pain and increases functional mobility.

ULTRA SOUND

Ultrasound is a type of mechanical energy that has been used for many years to treat chronic pain and improve the healing process. There are several specific ways a physical therapist can use ultrasound therapy to treat injuries and reduce pain. Contact us to learn more about how ultrasound therapy can help you promote healing, reduce pain, and improve your ability to perform daily activities and tasks.

HOW ULTRASOUND TECHNOLOGY WORKS

Ultrasound therapy is the use of sound waves to treat a variety of muscle, bone, and ligament conditions. The sound waves cause vibrations which generate heat. When tissues in the body are vibrating, the friction produced occurs at the molecular level. This ultimately causes the temperature in the tissues to rise. This is one of the many advantages ultrasound application provides. It can penetrate deep into the tissues in ways that a hot pack can’t.

During physical therapy, gel is normally used on the surface of the applicator to minimize friction as well as to promote the transmission of the ultrasound waves. The waves are then absorbed by your tendons, ligaments, and connective tissues.

WHAT ULTRASOUND THERAPY DOES IN THE BODY

There are generally two ways ultrasound can work in your body to heal and repair tissues during physical therapy services. The first is that it provides thermal energy, or heat. The second is the non-thermal benefits.

Thermal – When using ultrasound, heat enters the tissues at a deep level. This can increase circulation while reducing pain. Heat can also enable muscles to more easily stretch. Thermal energy produced by ultrasound during physical therapy can therefore loosen tight muscles and tendons.

Non-Thermal – Ultrasound also works in specific ways that are unrelated to the transfer of heat. When energy enters the body through ultrasound it creates tiny gas bubbles that gather around the tissues. These bubbles contract and expand at a rapid pace. This is called cavitation.

BENEFITS OF ULTRASOUND THERAPY

Increase Blood Flow – Just as cold decreases blood flow, heat will increase it. Ultrasound therapy will cause your blood vessels to increase in size and therefore increase the blood flow. Increased blood flow means more nutrients will be delivered to the area of your injury while waste is carried away. This ultimately enhances the healing process.

Reduce Swelling and Inflammation – Ultrasound therapy has been shown to reduce stiffness in muscles and joints while increasing range of motion. Once blood flow is increased and swelling and inflammation is reduced, this will allow your muscles and joints to respond more favorably to manual stretching exercises and different types of massage.

Promote Tissue Healing – Ultrasound not only improves your muscles and joint range of motion, but can aid in the healing of wounded tissues. The metabolism of the cells in the tissue are affected by ultrasound. The vibration produced by the ultrasound can help prevent scar tissue from forming.

CONDITIONS TREATED WITH ULTRASOUND

While increased blood flow, reduced swelling and inflammation, and tissue healing are general benefits of ultrasound, there are several specific conditions these processes can help heal. The following are a few of the physical conditions that can be treated.

Bursitis and Tendonitis – Frozen shoulder is a form of bursitis that can be effectively treated with ultrasound therapy.

Muscle Strains and Tears – The use of ultrasound therapy can reduce the amount of time sprains, strains, and tears take to heal.

Muscle Spasms – Heat applied at various places on or near the site can help relax the muscles and decrease spasms.

Rheumatoid Arthritis and Osteoarthritis – These are chronic conditions that respond well to the deep heat provided by ultrasound.

Bone Fractures – Healing of bone fractures can be promoted by the use of low intensity ultrasound. Ultrasound has also been found to be a more cost efficient and less invasive tool for diagnosing certain types of stress fractures.

These are just a few of the many conditions that can be treated with ultrasound physical therapy. Other conditions and diseases that may be improved or healed include whiplash, phantom limb pain, dental pain, and even certain types of cancer.