WHAT TO EXPECT AT YOUR FIRST PHYSICAL THERAPY APPOINTMENT
Private One–On–One Functional Manual Therapy™ Sessions
If you're reading this page, that probably means you've booked your first appointment with us! Congratulations on taking the first step toward improving your health.
When you walk through the doors of Berman Physical Therapy, you can expect to be greeted by name with a smile by our awesome office staff! You've probably already spoken to one of our admins on the phone, but they're excited to meet you face-to-face and offer you coffee, water, and chocolate! You'll also get a chance to meet Yeti, our office therapy dog:
Once you've gotten comfortable, you'll begin your first session with a consultation with one of our specialists. After a quick chat about your unique situation, the physical therapist will gather important data about your body through special hands-on tests and measurements. Don't worry – we'll explain exactly what we're doing the entire time, and you can and should ask questions!
When We've Got A Pretty Good Idea About Where You Stand, We'll Be Ready To Begin The Treatment!
If you're visiting us for a free Discovery session, we'll discuss the treatment plan, including your diagnosis (what exactly is wrong), your goals (what we want to achieve by the time you "graduate" from physical therapy), and the plan (how we're going to get to the goals!). You'll also know exactly how long it will take – we'll NEVER tell you that we're going to "just wait and see!"
If you're visiting us for a full treatment appointment, we'll get down to business and put our hands on you. Make sure you wear loose – fitting clothing or workout clothes so you can move comfortably!
Using rare and effective Manual Therapy techniques, coupled with Functional Mobilization, one of our physical therapists will work to return your body to its efficient state through mobilization of joints, fascia and other soft tissues, neurodynamics, and even visceral (organs) mobilization. Every situation is different, so it's impossible to say exactly which techniques we'll utilize at your appointment, but here are a few of the treatments we commonly employ:
FUNCTIONAL MOBILIZATION / MANIPULATION
The ultimate goal of Functional Manual Therapy® is to provide the patient with the mechanical ability and the neuromuscular tools of strength and endurance and proprioceptive awareness to become self sufficient and more proficient in all areas of human performance. This training is reinforced with the utilization of unique Functional Test which demonstrates to the patient the importance of efficient mobility and proper alignment.
MUSCLE ENERGY TECHNIQUE (MET)
Popularly known simply as MET, muscle energy technique is a form of stretching commonly used by sports massage therapists, sports therapists, osteopaths and some physiotherapists, chiropractors and fitness professionals. There is no standardized definition of this technique, which involves the active contraction of a muscle by the client against a resistive force provided by a second party (i.e., the therapist). Originating as an osteopathic technique in the late 1950s and early 1960s, there are today numerous variations and applications of this method of stretching.
MET is believed to be particularly helpful in lengthening postural muscles, which are prone to shortening. Theoretically, the active contraction performed by the client against the resistance produced by the therapist is an isometric contraction and may therefore be helpful in strengthening muscles. Also, contraction of one muscle group decreases tone in the opposing muscle group, and MET may therefore be beneficial in helping to overcome cramping. There is some debate about the degree of force a client should use when contracting a muscle before it is stretched, although low levels of contraction are advocated, certainly no more than 25 percent of the client's maximum force capacity. This is especially important should the technique be used in early stages of rehabilitation after injury, when levels as low as 5 percent may be the most appropriate. MET is sometimes used with a pulsing motion (known as pulsed MET), which advocates claim helps reduces localized oedema.
MYOFASCIAL RELEASE (MFR)
Myofascial (my-o-FASH-e-ul) release is a manual therapy technique often used in massage. The technique focuses on pain believed to arise from myofascial tissues - the tough membranes that wrap, connect and support your muscles.
Theoretically, myofascial pain differs from other types of pain because it originates in "trigger points," which are related to stiff, anchored areas within the myofascial tissue. The pain that a trigger point causes is often difficult to localize, though.
During myofascial release therapy, the therapist locates myofascial areas that feel stiff and fixed instead of elastic and movable under light manual pressure. These areas, though not always near what feels like the source of pain, are thought to restrict muscle and joint movements, which contributes to widespread muscle pain.
The focused manual pressure and stretching used in myofascial release therapy loosen up restricted movement, leading indirectly to reduced pain.
FUNCTIONAL MOBILIZATION / MANIPULATION
What we know today as PNF began as "proprioceptive facilitation", a term developed by Dr. Herman Kabat in the early 1940's. In 1954, Dorothy Voss added the word "neuromuscular" to give us the now familiar Proprioceptive Neuromuscular Facilitation, (PNF).
Dr. Kabat's conceptual framework for PNF came from his experience as a neurophysiologist and physician. The works of Sister Elizabeth Kenney, an Australian nurse who treated polio patients with specific stretching and strengthening activities, was an early influence on Kabat. Kenney's work was seen as a departure from the normal treatment at the time, but lacked the grounding of sound neurophysiological rationale. Kabat integrated Sister Kenney's manual technique with Sherrington's discovery of successive induction, reciprocal innervation and inhibition, and the phenomenon of irradiation.
His goal was to develop a hands-on treatment approach that enabled clinicians to analyze and assess a patient's movement while at the same time facilitating more efficient strategies of functional movement. So it is important to recognize that PNF is not just a treatment approach, rather, it is a tool that allows for simultaneous assessment and treatment of neuromuscular dysfunction.
From its beginnings, PNF has successfully integrated many of the concepts of contemporary neurorehab interventions. The Philosophy and Basic Principles of PNF, together with the specific spiral and diagonal patterns, make up the cornerstone of PNF. PNF also includes mot or learning and functional retention of newly learned activities with the repetition of a specific demand; the use of the developmental progression of motor behavior that enables patients to create and re-create strategies of efficient functional movement; and the biomechanical and behavioral analysis of motor control. All activities within PNF intervention are directed towards a functional goal and are relative to the environment in which the goal is to be achieved.
SOFT TISSUE MOBILIZATION (STM)
Manual treatment of the soft tissues has existed since the beginning of recorded history in the form of massage and manipulation. The primary purpose of these approaches was to treat symptomatic soft tissues. The functional orthopaedics approach to soft tissue mobilization (STM) has been developed not only to evaluate and treat soft tissue dysfunctions that precipitate myofascial pain but also to evaluate and treat those dysfunctions that alter structure and function and produce mechanical strains on symptomatic structures. In addition, STM offers a functional approach for evaluating and improving the patient's capacity to achieve and maintain a balanced posture, which enhances the ability to learn and perform efficient body mechanics. This approach is integrated into a broader treatment strategy of joint mobilization and neuromuscular reeducation and is coupled with a specifi c training, conditioning, and fl exibility program.
STM is intended to be used as a component of a complete manual therapy program that includes evaluation and treatment of articular, neurovascular, and neuromuscular dysfunctions. The approach encompasses evaluation of the soft tissue system and application of specifi cally directed manual therapy techniques to facilitate normalization of soft tissue dysfunctions. This integrated treatment approach has been termed functional mobilization.
And here are some conditions we commonly treat:
At the end of your first Physical Therapy Appointment...
At the end of the session, we'll evaluate the improvements in functionality gained from therapy by repeating the special testing process from the beginning of the appointment. Over 99% of patients experience IMMEDIATE change in muscle function after just ONE session!
Finally, we'll finish by showing you how to retain the improvements you achieved! We'll give you between one and three specific exercise instructions you can perform at home.
We make it really easy – we can even take a video of you doing the exercises so that you remember exactly how to do them when you're on your own!
And that's all there is to it!
Oh – don't forget to take some chocolate for the road as you head out after your first session. You deserve a treat for taking the first steps toward healthier living and a pain – free lifestyle!!