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Active rehabilitation including exercises for stabilization and strength training along with various stretching techniques are an integral part of the treatment philosophy at Pioneer. We recognize the healing benefits of active rehab on the body as you go through the remodeling and repair phases of the injury rehab process. The majority of the rehab we do at Pioneer would be considered "low tech" rehab. Your first thought might be, low tech?...That doesn't sound very sophisticated. Well the reality is that with a good exercise/fitness ball and some theraband (strength training bands) you have a really good workout station. Although some post-surgical rehab may require stationary exercise equipment you would find in a gym for progression, the majority of the rehab done for the common neck, back and extremity pain can be done at home with very little equipment. We give you the tools you need and the education on what to do in the office and then ask you to do the rehab at home to compliment the treatment we are providing in the office setting.
We provide mainstream physiotherapy modalities to facilitate quicker healing and reduce pain. These include:
Used primarily to increase cellular metabolism in an area of dysfunction to promote quicker healing. Ultrasound is a "heating" modality and usually feels good during treatment and can have immediate benefits to pain control. Ultrasound uses "sound waves" to effect cellular metabolism. These waves cause friction which in turn causes heat. This effects the blood supply to the area and can increase the healing response in the area applied.
This modality is used most often as a way to "shut off the pain signals going to the brain." By applying pads to the skin that are attached to a machine that provides an electrical current we can interrupt irritated nerve endings and "quiet" pain. This modality can also be used to try to reduce muscle spasm as well and provide stimulus for neurological re-education. This is the modality of choice for "acute" injuries where pain is high and movement is very limited due to muscle spasm and joint fixation.
Light therapy is applied with similar principles as Ultrasound. It to is a heating modality. The purpose of light therapy is to stimulate the cells to produce more ATP (Adenosine Tri-phosphate). ATP is the energy of the cell, thus if we want to stimulate a healing response in the body it would make sense to increase the energy or metabolism of the cells. The only difference here is we are using "light waves" instead of "sound waves" that are used with ultrasound. Infrared is a nice modality to have when an injury is in a "bony" area. Using ultrasound you must be careful not to burn the lining on the bone(periosteum) if you are in a very superficial area (wrist, ankle, ribs, etc). This is when Infrared can be a nice option. In recent years more research has been dedicated to the healing effects of light therapy and thus it is being used more often.
Ice and heat have long since been used as a standard first line approach at modulating the physiological response of inflammation that occurs when an injury takes place. Ice generally causes vasoconstriction (narrowing) of the blood vessels, while heat generally causes vasodilation (opening) of the blood vessels. When an area has excess fluid (Edema) this causes pain. We can use ice/heat for two reasons. First is pain control. Ice or heat will cause some reduced pain sensation of the nerve endings in the area applied. Ice does a better job of this as it will eventually numb the area. Ice also does a better job at reducing the swelling quickly. Secondly contrast therapy is used commonly to reduce the swelling (Edema) in the area. This is done by alternating hot and cold causing a widening and narrowing of the blood vessels that acts as a "pump" to get the swelling off the injured area and thus reduce the pressure and irritation to the nerve endings. So to summarize nerve endings can be irritated by mechanical pressure from swelling or damaged tissue but also by chemical irritation from the effects of the inflammatory process. This process is needed for healing to occur but does require some modulating in phases of acute injury.
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