Exercise and Rehabilitation, and Rehabilitative Exercise

ecGenerally speaking, the more fit our bodies are, the less prone to injury we will be. Now, this depends on a lot of different factors, and given those factors, also affects recovery and rehabilitation after an injury.

Height and Weight Ratio

Depending on your height, your weight can indicate that you are underweight, of average weight, overweight, obese, or morbidly obese. There are many health issues that can compound the matter of weight, but the bottom line from a musculoskeletal standpoint is that an overweight body puts extra pressure on our joints and can cause cartilage to wear away much faster as we age. Cartilage is important because it helps cushion our joints (especially in the knees) and the vertebrae in the spine. Extra strain on the joints as well as the muscles can inhibit movement and increase the likelihood of osteoarthritis.

Keeping active is essential to maintaining a strong musculoskeletal structure (including proper bone density).

NOTE: The reason people say that muscle weighs more than fat is because muscle is more dense. If an increase in muscle mass corresponds with a decrease in body fat, you could very well see your weight go up, even if you’re in better shape.


We cannot stress enough how important flexibility is to the body. You don’t have to be a yogi or a contortionist, but keeping your body flexible decreases your chance of injury and can increase speed of recovery. Your muscles, tendons, ligaments, and ultimately your skeleton all need to move with you, not fight your movement. This is within reason, of course. If you’ve never done a backbend in your life, doing one on a whim will likely cause both pain and injury. Baby steps.

Strong ligaments can mitigate the effects of sprains as well.

Muscles and Bone Density

In some cases, swimmers who rarely did workouts outside of the water developed arthritis at a very young age. Swimming is a very low impact (if no impact) physical activity, and while it is truly one of the best forms of exercise you can do, it should not be the only one. In fact, swimming is a great rehabilitative activity because of its low-impact nature.

Bottom line… there needs to be a balance in your physical activity. You do not have the full effects of gravity when swimming. As a result, those who spend a disproportionate amount of time in the water do not develop the bone density that will help their joints weather normal wear and tear (or athletic strain).

At the other end, there are high-impact exercises that cause unnecessary strain on your joints. This is why many will tell you not to run downhill, take a high-impact aerobics class, or run stairs. Sometimes, it’s just a matter of using proper technique. CrossFit has come under fire because most gyms seem to stress intensity over form. The result? Avoidable injuries. (So if you are a CrossFit aficionado, definitely do your homework on your gym and trainer).

Exercise and Rehabilitation

Exercise in a controlled, gradual, and progressive manner is the only way we can tell our body to heal. Too much too soon will exacerbate the problem and may cause more damage than the original injury.

Injections, medications, and other passive therapies can be important in providing pain relief, but they cannot stimulate the healing process. The natural stimulus for the healing process is active exercise, movement. Active exercise means we use our nervous system to tell the muscles what to do, and it requires dedication to an appropriate, comprehensive exercise and rehabilitation program. One cannot come without the other.

Injuries can occur no matter how fit we are, but the process of rehabilitation, of healing, follows the same process. We make progress at different rates because we are all different… we have different fitness levels, body types, bone densities, and degrees of flexibility. What we do know is that the body needs to be lead to heal itself.

How to Treat the Pain Associated With Plantar Fasciitis

juPlantar fasciitis is a painful condition caused by inflammation of the thick, fibrous band of tissue (”fascia”) that reaches from the heel to the toes. This fascia is responsible for supporting the muscles and arch of the foot. The plantar fascia is made of three distinct parts: medial, central, and lateral bands. The central band is the thickest and strongest and is most likely involved in plantar fasciitis pain. Tiny tears are created on the surface of the fascia when it’s stretched too far causing inflammation and pain. In addition to inflammation and pain, the stress on the muscles and ligaments from plantar fasciitis can cause heel spurs. There isn’t a single treatment for plantar fasciitis, but physical therapy utilizes several tools which can alleviate the pain and inflammation.

Plantar Fasciitis accounts for about 10% of runner related injuries and is more likely to affect women than men. Because of the high incidence rate of plantar fasciitis in runners, the primary cause is believed to be microtrauma from repeated stress.

In normal function, the plantar fascia acts as a shock absorber and support for the arch of the foot. While walking or moving, the plantar fascia is like a spring that simultaneously conserves energy and provides propulsion. Tension increases while the foot is on the ground and is then released during toe-off to help with acceleration.

5 Modalities to Treat the Pain of Plantar Fasciitis

1. Kinesio Tape: Evidence has shown using Kinesio tape is effective alleviating pain and promoting the healing process. The Kinesio tape provides support for the arch allowing the foot to relax, which relieves pressure and the fascia and reduces inflammation.

2. Cold Compression Therapy: Cold compression therapy combines the benefits of ice which helps decrease pain along with compression which helps decrease edema and swelling. Cold compression therapy is useful when treating acute pain from plantar fasciitis, particularly following any stretching done to the foot during a physical therapy session.

3. Ultrasound Therapy: Using sound waves ultrasound therapy stimulates the tissue beneath the skin’s surface. The heating effect of ultrasound therapy aids in increasing blood flow in the plantar fascia which helps reduce swelling and edema, leading to a reduction in pain.

4. Low Level Laser Therapy: Laser therapy applies light (red and infrared) over the plantar fascia. Laser therapy converts light into biochemical energy, which initiates tissue repair in the cells. Additionally the stimulation created by the laser helps reduce pain and decrease inflammation.

5. Therapeutic Stretching: Once the acute pain of plantar fasciitis has been addressed, it becomes important to stretch the calves and feet in order to relieve the pressure on the plantar fascia.

Another one of the primary populations affected by this ailment are those who are overweight. The pain caused by plantar fasciitis makes it difficult for this population to exercise making a cycle of not enough movement but being stopped by prohibitive pain. It’s important for people experiencing symptoms for longer than a week to seek treatment from a physical therapist in order to reduce down time and increase the ability to return to normal activities.

How Multi-Layered Approaches to Patient Care Can Be Effective: A Case Study

32Let’s look at a patient case study to examine the way hybrid healthcare can work towards providing the best possible care for patients.

Low Back Pain Case Study

John is a patient who complains of low back pain. He has had a history of back pain, but his present pain was made worse by a vehicular accident a month ago in which the car he was a passenger in was rear-ended. He works in marketing and sits at his desk on a computer for several hours on end. By the end of the day he says he experiences radiating pain down his legs. He presents with a pelvic rotation, poor posture and lack of core control.

1. Chiropractic Care: In this case, the Chiropractor would address the patient’s pelvic rotation with a manual adjustment. This manipulation would help move the pelvis back into its correct articulation. Additionally, the patient may be placed on a traction table to help alleviate some of the pressure and subsequently pain on the lower back disks.

2. Physical Therapy: The physical therapist would address the pelvic rotation also with mobilizations and manual therapy. Additionally, therapeutic exercise will be used to strengthen the core to add support to the low back. Pain relieving modalities will also be used such as: ultrasound, low-level laser therapy and TENS units.

3. Acupuncture: This non-traditional therapy is gaining popularity in treating back and neck pain. In a study posted in the Clinical Journal of Pain, Acupuncture was found to be effective in reducing pain and the reduction was effective for up to 6 months. Needles are placed at specific points along the body and stimulated with electrical stimulation for short periods of time. Participants reported reduced back pain and increased relaxation.

4. Massage: This adjunct therapy will be used to address specific issues or injuries, in this case radiating sciatic pain. Trigger point release and deep tissue massage will be used to help release the sciatic nerve and inhibit the experience of radiating pain.

5. Pilates: Another great adjunct therapy, Pilates will address the lack of core strength using mat exercises as well as modified work on the Reformer and Cadillac machines. Core strengthening is an essential component in this case study to help lower the risk of reoccurring back pain.

Healthcare and patients choices with how to approach their health needs are evolving. Using a multi-layered approach is a wonderful way to offer patient’s cutting edge care that addresses their unique set of needs.

How Physical Therapy Helps Elderly People With Diseases

poAs we age, our bodies lose their ability to function as well as they used to when we were younger. After living a full life, our muscles, joints, and bones wear down, and we need extra help to stabilize our health and wellness. Physical therapy is a great service for the elderly, especially those who are suffering from diseases such as Parkinson’s disease, Alzheimer’s disease, cerebral palsy, and multiple sclerosis. Here are some of the ways that physical therapy helps elderly patients to cope with these debilitating diseases.

Parkinson’s Disease

Parkinson’s disease is a progressive disorder of the nervous system that affects a person’s movement. Parkinson’s is often seen as hand tremors and slurred speech, and commonly causes stiffness and the slowing of the body’s movements. Physical therapy helps those with Parkinson’s by developing aerobic exercise routines for them, which can help reduce stiffness and improve the body’s mobility, balance, and posture. Those who suffer from this illness also experience varying degrees of depression, and regular exercise can also help with those symptoms.

Alzheimer’s Disease

Alzheimer’s disease is a type of dementia that causes problems with a patient’s memory, thinking, and behavior. The condition normally worsens over time and makes it difficult for the patient to even perform daily tasks. Physical therapists help those with Alzheimer’s by designing exercise routines for them. Studies have shown that exercise can improve memory, delay the onset of Alzheimer’s and dementia, and delay the decline in the ability to perform daily tasks in those who have been diagnosed with Alzheimer’s. Those who are suffering from this illness also are prone to falls and breaking bones, which physical therapists can also treat when necessary.

Cerebral Palsy

Cerebral palsy is a disorder of movement, muscle tone, or posture that is caused by some kind of problem that occurred with a patient’s developing brain, most often before birth. Those who have the disorder suffer from imbalance, exaggerated movements, abnormal posture, and uncontrolled movements. Although the effects of this disorder do not worsen with age, people with cerebral palsy still experience increased problems as they get older, such as increased pain, difficulty walking, and falls. Physical therapy helps elderly patients who have cerebral palsy by giving them exercise routines that can help them to maintain strength and prevent joint problems.

Multiple Sclerosis

Multiple sclerosis is a disease of the central nervous system in which attacks from the immune system cause issues between the communication of the brain and the rest of the body as well as permanent damage and deterioration of nerves. Symptoms of multiple sclerosis vary depending on the amount of nerve damage, but this illness may cause some to completely lose their ability to walk. Physical therapists can provide workout routines in the areas of aerobic exercise, aquatic exercise, and even yoga that can help improve a patient’s balance, ability to walk, and possibly slow down the progression of the illness.