Physical therapy is a process of using knowledge of anatomy and physiology with exercises, soft tissue healing, posture and body mechanics and applying these principles of healing specific tissues following injury. Physical therapy conditions focuses on the spine and its joint structure including spinal segments, muscles, tendons, and ligaments.
Major goals of physical therapy with respect to neck injuries are:
· Correct spinal positional faults or limitations of spinal motions.
· Appropriate stretching and strengthening through cervical spine.
· Educate patients on proper posture and ergonomics.
· Accelerate the stages of healing by reducing pain and reducing the inflammatory cycle.
· Activity modification to reduce or eliminate future occurrences.
· Manage exacerbations.
A physical therapist can make sure you are practicing optimal exercises for your condition, and can modify the exercise as you progress. Many patients do NOT require referral from a physician to be seen by a physical therapist. You can check with your insurance company to see if a physician’s referral is required. If a referral is not required you may be seen directly by one of our Physical Therapists.
We use techniques including traction, joint mobilizations, soft tissue mobilizations, muscle energy techniques and stretching to assist in aligning the cervical spinal segment. Once aligned, the cervical spine will be allowed to move as needed to restore normal joint mechanics. Eliminating impingement of nerves, physical blocks in the spine or facet joints.
Appropriate stretching and strengthening through cervical spine.
Classically we “stretched then strengthened”. In truth both are needed to restore normal function. The Cervical spine has three planes of movement. Flexion motion is like nodding, rotation is like shaking your head “No”, and side bending is bringing your ear to your ear to your shoulder. Stretches generally begin in each plane and then become more advanced to use motions from multiple planes.
Strengthening begins with extension strengthening and achieving neutral spinal position. Scapular strengthening and postural exercises are included early in cervical programs. Then typically exercises in the other two planes are included. We finish cervical strengthening with compound motions of the neck and UE strengthening. The therapist will use their clinical judgment as to when to bring in each level of stretching and strengthening.
Educate patients on proper posture and ergonomics.
Good posture is imperative in recovering from neck injuries. Pain is your body telling you that something is wrong with your alignment and soft tissue is being stressed in some way. Changing posture can alleviate the stress and eliminate the pain. Sit up straight! It feels better and puts the least amount of strain on your spine! If you sit or bend too often or for too long a period of time, bend in the opposite direction to balance the stresses out and relieve muscle tension. Thinking of military type posture with shoulders squeezed and chest out, chin in, stomach tight with standing, walking, lifting and bending. Ergonomics for each situation can be evaluated and corrected by a physical therapist.
Accelerate the stages of healing by reducing pain and reducing the inflammatory cycle.
We use soft tissue mobilization, massage, relaxation techniques and modality treatments to assist in pain and inflammation reduction. This coupled with improved muscle balance with respect to flexibility and strength, proper posture and body mechanics is a significant help the therapy process.
Activity modification to reduce or eliminate future occurrences.
“Time waits for no one”! Unfortunately with injuries our life doesn’t stop. Modifying how we go about daily activities may also assist in our speed of healing. This includes body mechanics but also eliminating activities that are exacerbating our injury or limiting how much time we spend performing each activity. For example: taking breaks each hour from computer work to walk around or stretch or carrying less groceries in with each trip from the car. Careful progressions in overall activity can be helpful in recovering.
As hard as we may try it is likely that some situation will occur that will flare up our symptoms or we will have a lapse in judgment of what our injury will tolerate. When these exacerbations occur quick management is important to limit the duration and intensity from what may be weeks to months to only a few days. Quick attention with your therapist or using the principles that have been learned from your sessions in therapy will limit exacerbations.