The most critical factors for successful treatment is performing your home exercise program consistently, making the assigned modifications in activity, attending therapy at the frequency prescribed by your therapist, and giving your therapist specific feedback regarding your status.
Your exercise program is developed to address specific problems found during the course of your treatment. The exercises are assigned to relieve symptoms or make progress in areas such as strength, flexibility, balance and stability. The progress that can be made during your weekly sessions is a small percentage of the progress that can be made if performing your exercises on a daily basis. The time that you are the busiest or in pain is often when the exercises are most important. We will try to avoid assigning exercises that are to difficult for you to perform. If you experience unexpected pain during or after the exercises, simply discontinue the exercise until the next session and discuss this problem with your therapist. In addition, if you feel you have been assigned too many exercises and are not capable of performing them consistently, just talk to your therapist and they can often remove the easier exercises as you progress or change the frequency the exercises need to be performed.
The therapists may ask you to discontinue an aggravating activity for a period of time, or demonstrate an alternate way in which you are performing an activity. This may include work tasks, household chores, or recreational activity. Combined with your exercises, these modifications will shorten your recovery time. This avoids prolonging your symptoms unnecessarily and saves you time and money by reducing the number of treatments needed.
Consistent and timely therapy attendance and providing your therapist with specific feedback regarding your symptoms are also important factors in recovery. You will be asked about your symptoms at the beginning of each session as symptoms frequently vary and should change during the course of treatment. Reporting how intense, how often, and how long the symptoms last, what activities made the symptoms worse or better, and/or how the symptoms have changed since the previous session is very helpful. These factors often give the therapists important clues for treating specific aspects of your problem.
In general, the more effort you put into your therapy, the more you get out of it. This is your part of the team approach to solving your problem. Therefore, take the time to take care of yourself. You’ll be glad you did.
Additional suggestions...
Over the years, therapists have found certain actions often help patients in overcoming their presenting complaints. If any of the suggestions on this page increase your symptoms or if you have a question, please stop the activity until you consult with your therapist. These are provided because occasionally we will forget to cover certain concepts during our treatment time.
1. Eliminate or decrease the frequency of activities which cause pain. This perpetrates the inflammatory and degenerative process. Ask your therapist to provide you with different strategies to perform those activities.
2. If you have delayed onset of pain, play Sherlock Holmes and discover which activity you are performing that causes your pain. Ask your P.T. to provide you with different movement or postural suggestions to help decrease the irritation.
3. With acute or recent injuries always apply ice. Most authorities advise no more than 15 minutes at a time every hour.
4. Ice is also helpful with chronic or inflammatory pain, especially pain which comes on after an activity.
5. Heat helps with aching and stiffness, but should not be used with acute symptoms as it causes swelling.
6. If you do not get increased symptoms with walking, you should take therapeutic walks. The ideal is twice a day to tolerance, or 15 minutes. You may walk longer if it does not increase your symptoms.
7. To improve, you must do your exercise program as prescribed by your therapist and utilize proper body mechanics. This is your part of the team approach to solving your problem.
8. Many patients have found that drinking more water has helped them reduce the soreness from treatment and to assist their problem. Drink up to eight tall glasses of water a day, especially on treatment days.
9. Many physicians recommend taking vitamins during the recovery stages of a physical injury. However, always contact your physician before taking any supplements. For example, Vitamin C, which is important in developing scar tissue, has been recommended to assist the healing process.
10. Become aware if pain is increased by muscle tension and stress. If you tend to hold the area of pain tightly, begin to train yourself to keep the muscles of the area relaxed. If you find this difficult, bio-feedback can often be helpful in training you to be more relaxed.
Tell me about my team treatment…
The team approach is an important aspect of your physical therapy program. Two minds and sets of hands are better than one, and certainly three are even better. Typically, a patient is assigned a team of three therapists. Each therapist may look at your problem from a slightly different angle and/or utilize different treatment techniques, providing a much more comprehensive approach as they combine their extensive experience to optimize your rehabilitation program. In addition, this is also more convenient for you by providing more flexibility in the times available for you to schedule appointments, since you are not locked into availability of only one therapist.
Tell me more about my treatment sessions…
Each session lasts approximately 50-75 minutes, generally beginning on the hour. Because Nesin Therapy provides one-on-one treatment, the hour of your appointment is generally reserved for you alone to work with your therapist. Therefore, to get the most benefit, arrive on time or preferably early. If you arrive early, you may change clothes, stretch and/or warm up before your session, allowing you to be better prepared when the therapist is ready to begin. As we strive to run as close to on time as possible and be fair to all patients, we cannot extend a treatment session if you arrive late, as that interferes with the next patient’s appointment time.
The frequency of sessions per week is usually two times per week in the beginning of a course of treatment. However, under special circumstances, the frequency may be three to five times per week, such as immediately after surgery. At two times per week, we make forward progress in addressing the problem while also allowing recovery time between sessions. We generally decrease the frequency of sessions to one time per week or every other week towards the end of a course of treatment. This allows us to monitor your status to assure you will not regress with less frequent intervention and to update your home program as you progress to doing more on your own.
In general, the first part of the session is spent doing hands-on treatment. We typically work on exercises, postural education, and other activities including your home program during the second part of the treatment. At times, we utilize a modality to help reduce soreness at the end of the treatment. This may extend the treatment time to 60-75 minutes.
At the end of the session, you check out at the front with the administrative staff, scheduling future appointments and/or paying co-payments.
Tell me more about specific treatment techniques
Here are just a few of the treatment techniques we use in the clinic:
Manual Techniques
Manual techniques include both soft tissue and joint mobilization. When we use the term soft tissue, we are primarily referring to muscles, tendons, ligaments, and fascia. These structures often lose mobility with pain, injury, inflammation, degeneration, disease or immobilization with casting or bracing. Soft tissue mobilization is performed with hands-on techniques to address tight or dysfunctional areas within these structures. A joint is the point where two or more bones connect and often lose mobility for the same reasons as the soft tissue. The joints that come to mind may include shoulder, elbow, knee or hip…but did you know there are over 25 joints in the human foot? And that doesn’t even include the ankle! Again, we use hands-on techniques to address problems within the joints.
Neuromuscular Re-education
This is one of the recent buzz-words in many orthopaedic and sports-medicine circles, but we’ve been doing this for a long time. Neuromuscular re-education is a way of re-training muscles in their patterns of action to perform more efficiently. It involves strengthening-type activities performed in specific functional directions and with specifically-applied resistance by the therapist to improve the muscular control of a region of the body.
Back Education
“Sit up straight”… “lift with your legs” – these are phrases we’ve heard all our lives – but what do they really mean? We spend time teaching you proper ways to sit, stand and walk, lift, move, drive and exercise so that you are posturally stable and safe. Poor posture can contribute to musculoskeletal problems. Learning appropriate posture and body mechanics may reduce your risk of injury and to decrease your current pain.
Balance Training
Balance can be a life-threatening problem for many people, and balance problems affect many of our lives. Balance training specific to your problem, encompassing the brain’s control of the muscular system as well as the visual system’s contribution, is something which helps many people to improve function and independence in their daily lives.
Strengthening and Stretching
Have you ever hurt yourself while exercising? Understanding the concepts and importance of strengthening and stretching can help us all to exercise with more efficiency, as well as allow our workouts to be more beneficial. Poor posture, improper stretching, and poor neuromuscular control (there’s that word again J) during workouts may contribute to exercise injuries that can be easily avoided with proper technique.
Modalities
We use modalities, such as electrical stimulation, ice, heat, and ultrasound as an adjunct to our hands-on treatment. These modalities are used primarily to control pain and decrease inflammation, helping to improve your overall function.
Do you do massage?
We do use manual techniques to treat soft tissue or joint dysfunction. Massage is a more broad-based technique applied to common areas of tightness within the muscle tissue, but is generally not applied to treat specific tissue pathologies. We do not have massage therapists on staff. However, we often refer patients for massage therapy, typically towards the end of a course of treatment to assist in maintaining gains made during physical therapy.
