Physiotherapy is mostly about restoring musculoskeletal functions. In the rehabilitation of an articular (arthrosis, sprain, fractures) or a muscular (increased muscle tone, rupture, dysbalance) problem, physiotherapy plays a big role but also can be used as an accessory therapy in some other medical areas like Pulmonology, Cardiology, Psychiatry etc.
The main goal during the musculoskeletal rehabilition is to increase the range of movement of the joint, to strenghten the muscles and in the same time to decrease the pain. Since the physiotherapists have a lot of skills how to handle long standing issues as well, it is never too late to turn to them.
Many people think that physiotherapy is only useful for the elderly population but this idea is wrong. Everyone who’s already suffered an injury and got a fracture or sprain, or had a musculoskeletal surgery, physiotherapy is important and needed. If a life situation gets someone out of the everyday routine due to an injury, physiotherapy can help this person to get back and continue their life and also teaches them how to prevent another injury by giving proper advices about ergonomy. We should not forget about the results of pyhsiotherapy in sport pre – and rehabilitation, which improves the athletes’ skills to perform better, to get more successful in their sports and avoid injuries or if they already suffered and injury therapy is essential to help the athletes go through the way back to their sport.
Functional Training is a type of a muscle strengthening system which lays emphasis on stabilizing the centre of the body (pelvis and lumbar spine) to create a well-working, statically proper musculoskeletal system using unstable equipments and elastic resistances. It works with the muscle chains of the body so the aim is not to isolate the muscles but making them work together during a movement. In sport rehabilitation functional training is combined with proprioception and sport specific excersises.
Sport Rehabilitation: treating hobby and professional athletes with chronic pain or post-injury, surgery or only correction training, increase of performance. After a trauma or surgery the rehabilitation starts with rebuilding the muscle strenght from zero and our aim is to start the recovery and regeneration as soon as possible so the athletes can go back to their sport as fast as possible. For that we use a lot of tools to help to improve muscle strenght, stability, stamina, coordination and also sport specific movements.
Body Roller: Stimulates the muscles with pressure thereby it increases blood circulation, decreases pain and relaxes muscles. With this tool we can almost relax all the muscles in our body except for abdominal muscles. It can be well used for pain due to muscle dysbalance, increased muscle tone, as a warm up before and after training and to treat trigger spots. It can replace stretching excersises as well, it has the same outcome without causing any neurological issue. It is an accessory treatment.
Lumbar Segmental Stabilization: Stabilization excersise programm for improving stability of deep muscles in the lower back. According to researches 20-30% of low back pain is connected to lumbar (segmental) instability due to a weakened, inappropriate, asymmetric function of low back deep muscles. Inappropriate curvature, mobility or increased muscle tone of the lumbar spine can be a sign for instability. We can rebuild the proper muscle control and the endurance of the deep muscles with special stabilizing excersises which will help the patients hold their harmonic lumbar curvature during daily activities and sports.
Kinesio Tape: A complementary treatment which can help in joint stabilization and correction, relaxation or facilitation of muscles and facilitation lymphatic drainage. By improving the blood circulation it alleviates pain. Kinesio Tape doesn’t contain any analgesic or anti-inflammatory drugs so the affect of it depends on application. It is effective during the rehabilitative and chronic phases on an injury as well as being used for preventative measures.
- Maitland Concept: A treatment of functional disorders in the joint, muscle and nervous system. Maitland Concept takes the International Classification of Functioning, Disability and Health into account. It is about joint mobilisation, manipulation of the extremities and spine, it also uses neurodynamic techniques, muscle stretching, and stabilising excersises.
- Mulligan Concept: It is a mobilization with movement manual therapy techniques for decreased range of movement, painful movements and referred pain.
- FRSB (Fascia Release for a Structural Balance): combines manual therapy skills with structural therapy to treat muscles and fascial tissues. Fascia is our biological fabric, plays a big role in support posture and stability. We can treat chronic muscle contractures or elongations. By increasing the blood circulation of the muscles they can work more efficient, and the optimised muscle usage leads to better performance.
- Trigger Therapy: Every muscle in the muskuloskeltal system has hyperirritable spots, these are called trigger points (TrP). They localised mostly at the origin and insertion of the muscles but also in the muscle belly. The blood and lymph circulation of these spots is inappropiate thereby the function of these muscles are less efficient. We can see a big variety of pain what trigger point can cause. From a slight, localised pain to a sharp or reffered pain they can also generate some odd sensations. We treat these sensitive spots with pressure and stretching.
- The McKenzie Method (MDT-Mechanical Diagnosis and Therapy): Robin McKenzie (PT) developed this method, it consists two components: assessment and intervention to treat musculoskeletal conditions mostly protrusion and herniation of a disc. This method uses repeated movements in a single direction to elicit centralisation of the pain. If we find the preferred direction which centralises the pain, and we also combine it with deep muscle strengthening we may prevent our patient from surgery, we can help them to be free to move again or even get back to their sports.
- Peripheral Nerve Mobilization: Neuro mobilization is a method of conservative treatment of disorders of neural tissue. A peripheral nerve pain can be caused by vertebras if their position is inappropriate due to herniation, trauma, degeneration etc.
Schroth Method is a nonsurgical correction therapy for scoliosis which’s goal is to elongate, de-rotate and stabilize the spine in a three-dimensional plane using a special breathing technique called rotational angular breathing. This therapy was developed by Katharina Schroth and further popularized by her daughter Christa. Katharina was born in Germany in late 1800s and had scoliosis what was unsuccesfully treated with bracing. She has experienced the pain of scoliosis physically and mentally as well and did not want to acquiesce in bracing. She has discovered that with proper positions and muscle contractions completed with controlled breathing she was able to correct her scoliotic posture. She and her daughter opened a clinic and treated many patients. This therapy focuses on restoring muscular symmetry and alignment of posture, breathing into the concave side of the body and it helps the patient to learn how to manage their own posture in everyday life. It’s no doubt that nowadays Schroth Method is considered the most effective therapy of treating postural problems, scoliosis and Scheuermann’s disease.
There is a high risk for deterioration of scoliosis in early age so it is very important to recognize this condition in time and start treating it before the end of bone maturation
bracing: The degree of the spinal curvature (scoliosis) is measured with Cobb angle. Cobb angle of 20 degrees with bad pregression (more than 5 degrees of deterioration per six month) usually requires bracing besides the physical therapy. Since every scoliosis patient’s body and curve is unique, the brace must be specially made. An X-ray film is needed to be taken and the orthotist can make the proper brace. It has to be worn at least 23 hours per day and it’s important to continue the treatment till the end of growth. Regular medical checkup is needed in every 3-4 month.
Nowadays the most commonly used brace in Europe is Chêneau brace.