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Aerobic Exercise - The American College of Sports Medicine (ACSM) defines aerobic exercise as "any activity that uses large muscle groups, can be maintained continuously, and is rhythmic in nature." Aerobic means in the presence of oxygen. In other words, your body is burning its fuel (glucose) in the presence of oxygen. It is performed at less than 85% of your maximum heart rate. An aerobically fit individual can work longer, more vigorously and achieve a quicker recovery at the end of the aerobic session. Jogging, cycling, swimming, aerobics classes, and rowing are examples of aerobic exercise.
Active Range of Motion (AROM)
Active Assistive Range of Motion (AAROM)
Cryotherapy or Cold Therapy
Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.
The trunk and its associated muscles make up the core. The extremities are the arms, forearms, hands, thighs, legs, ankles/feet. Strong core muscles provide a foundation for the extremities to attach to and work more efficiently. It is hypothesized that a weak core can cause excessive stress on the extremity muscles, tendons, ligaments and joints.
Core strengthening is a multi-joint exercise, involving larger muscle groups such as the chest, back, abdominals, back, hip/thigh, and shoulder blade muscles.
Core strengthening is often incorporated as part of a low back or neck rehabilitation program. Because recovery or enhancement of core strength provides a stable base for the extremities, it is also commonly part of an arm, forearm, thigh, leg or ankle program.
Electrical Stimulation (EMS)
The application of electrical stimulation to aid in improving strength (e.g., the quadriceps muscle after knee surgery or injury). Neuromuscular Electrical Stimulation (NMES) is also used to decrease pain and swelling and to relieve muscle spasm.
Gait or Walking Training
The analysis of walking problems by visually examining the interaction of the low back and the joints of the thighs, legs, and feet during the various stages of walking, including, initial contact, loading response, mid stance, terminal stance, pre swing, mid swing, and terminal swing. Many back, thigh, leg, ankle, and foot problems may be caused by or manifest themselves in subtle gait abnormalities.
Heat is recommended to decrease chronic pain, relax muscles, and for pain relief. It should not be used with an acute or "new" injury.
An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.
Muscle(s) contracting through the range of motion (ROM) with resistance. This is usually prescribed for strengthening.
Medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.
The application of ice directly to the skin's surface to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue.
Hands-on therapeutic procedures intended to increase soft tissue or joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.
A gentle longitudinal/axial pull on the neck, either manual or mechanical, intermittent or continuous for relief of neck pain, to decrease muscle spasm, and facilitate unloading of the spine.
Proprioceptive Neuromuscular Facilitation (PNF)
PNF is a system of manually-resisted exercises performed in diagonal patterns that mimic functional movements. Initially this technique was used in developmentally and neurologically impaired patients. Today, PNF (or a variation of it)is commonly used for almost every aspect of neuromuscular retraining. It can be used on the professional athlete or someone in a nursing home.
Instruction in the correct biomechanical alignment of the body to reduce undue strain on muscles, joints, ligaments, discs, and other soft tissues. There is an ideal posture but most do not have it. Therapists educate patients about the importance of improving posture and body mechanics with daily activities. Stretching and strengthening exercises may be prescribed to facilitate postural improvement and to prevent further disability and future recurrences of problems.
Progressive Resistive Exercises (PRE)
Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.
Passive Range of Motion (PROM)
The patient or therapist moves the body part through a range of motion without the use of the muscles that "actively" move the joint(s).
The longitudinal/axial pull on the lumbar spine, either manual or mechanical, intermittent or continuous. Pelvic traction may be helpful for the relief of low back pain and muscle spasm.
Proprioception is the body's ability to sense where it is in space. For example, close your eyes and touch your nose. How were you able to move your finger to your nose without seeing it? Proprioception exercises are used to help retrain your sensory system after the nerves have been damaged during a musculoskeletal injury. Your body uses its sensory system in the joints and muscles to know how they are moving. Balance and coordination both depend on your body's proprioceptive skills.
Exercises characterized by the application of a quick muscle stretch followed by rapid muscle shortening enabling muscle(s) to achieve maximal rates of force development. They are intended to improve reactive/explosive muscle performance.
Here is a partial list of physical agents used for treatment.
With or without resistance. This is usually prescribed for improving the strength and/or range of motion of the back or lower extremities as well as cardio-vascular endurance.
Soft Tissue Mobilization
Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesion, and for pain relief.
Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.
Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is a relatively low voltage applied over painful areas through small self-adhesive electrodes. The electrical stimulation "disguises" or "overrides" the sensation of pain. It is a small, portable unit, used in intervals, to control pain and reduce dependence on drugs. It is usually prescribed for relief of pain.
Therapeutic Ball Exercise
A therapeutic ball a large rubber ball 55 to 85+ centimeters in diameter used for strength, balance, and flexibility exercise. AKA therapy ball or Swiss ball. The ball provides a fulcrum or pivot point around which exercises are performed. The ball also is subject to rolling which requires additional stabilization and concentration to perform a given exercise.
Ultrasound uses a high frequency sound wave emitted from the sound head when electricity is passed through a quartz crystal. The sound waves cause the vibration of water molecules deep within tissue causing a heating effect. When the sound waves are pulsed, they cause a vibration of the tissue rather than heating. The stream of sound waves helps with nutrition exchange at the cellular level and healing. Studies have shown that ultrasound is helpful for ligament healing and clinically, for carpal tunnel syndrome, and muscle spasm.
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