Physical Therapy: Eight Great Methods to the Madness

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Your first physical therapy appointment may feel like an interrogation. That’s because your therapist wants to design the unique treatment plan that’s best for you. If he or she doesn’t get to the underlying causes of your injury, you’ll continue to get hurt.

Based on your answers, your therapist will recommend one or several of the eight best physical therapy methods:

Manual Therapy

This lays the foundation for restoring tissue function. It’s a hands-on approach that uses massage, stretching and exercises that are specific to an injury. Manual therapy frees up movement and guides the body into proper alignment. It’s the most basic and important physical therapy method.

Upon that building block, methods called passive modalities are added.

Cold Snap

Most people are used to applying ice, but they don’t know why it works.

Ice constricts blood vessels to reduce inflammation. It supports manual therapy by making joints easier to manipulate, and it significantly reduces swelling.

It’s a mistake, however, to continue with ice long term or use it for more than a few minutes at a time.

Warm Regards

Heat should be used sparingly for muscular tightness or spasms. It makes soft tissue more pliable for stretching. Injuries that involve ligaments or tendons usually benefit from a little heat.

Light Up Your Life

Low-level laser treatment is effective for pain, inflammation and muscle fatigue. Therapists use small hand-held devices to deliver low-level wavelengths of light, and mitochondria respond by producing energy. Energy heals and regenerates tissue deep below the skin.

Picking Up Good Vibrations

Ultrasound therapy, which has been around since the 1940s, is completely safe and painless.

Sound waves are applied directly to the skin through the ultrasound wand. The resulting pulses or vibrations have been shown to increase blood flow, relax strained tissue and break down scar tissue. It is often used for patients with ligament injuries or chronic inflammation. Its most common purpose is to prepare damaged tissue for manual physical therapy.

You’re Not in for a Shock

Functional electrical stimulation is anything but shocking.

Electrical stimuli are applied in low, steady doses to cause contractions in dormant muscle tissue. The gentle contractions restore function and ease of motion to speed recovery. Patients who have endured knee surgery, a torn Achilles, partial paralysis or traumatic injury are good candidates for electrical stimulation.

Gain Some Traction

The goal of traction is to separate vertebrae, decompress joints and bring the spine back into proper alignment. It’s usually recommended to patients with herniated lumbar discs because it reduces pain and improves quality of life. Traction may be manual or mechanical.

Exercise Patience

All the experts agree: Exercise, along with a healthy diet and quality sleep, is a mainstay of physical, mental and emotional health.

Exercises in physical therapy are kicked up a notch. Your therapist will teach you specific movements that target muscular imbalance. These movements may be designed to treat an injury, prevent an injury or simply work out the kinks of a sedentary lifestyle.

You won’t feel better overnight, but be patient. The goal of therapy is to get you back in action, and there’s a method to the madness.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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