Download Physical Therapy and Rehabilitation

Physical Therapy and Rehabilitation
Rehabilitation of the foot, and leg requires your doctor to carefully
guide you through a well-devised plan of care. Goals of this plan include
relieving pain, restoring as much function without discomfort and
monitoring the social, psychological, and vocational implications of the
treatment. Rehabilitation may be necessary following an injury, surgery,
acute or chronic disease, or a neurological deficit.
Physical medicine involves the use of electrical impulse, heat,
light, and water, as well as mechanical agents (exercise, gait training,
orthotics) to diagnose and treat disease. It can be used with, and in
addition to oral or injectable medication and surgery.
Your treatment may consist of one or more of the following
modalities.
Heat
Heat, when properly administered, is quite valuable in your
healing process. It can increase blood supply to the skin and other soft
tissues, which promotes healing. Elasticity and motion of the ligaments
and joint capsules is enhanced. This is particularly important following
long periods of immobilization. The body’s response to inflammation is
increased. Heat can be applied superficially or deep. Superficial methods
include hydrotherapy or whirlpool bath. This is not only helpful for
improving motion; it also cleans wounds and ulcers, and increases local
circulation. Compresses may be used, and consist of gel packs placed
over the affected region. Paraffin or wax baths involve submerging your
foot or ankle into liquid wax. After 20-30 minutes, the cooled wax is
easily removed. Deep heating is achieved utilizing a diathermy or
ultrasound. Heat is usually not used in acute injuries less than 88 hours
old. Additionally, impaired circulation and sensitivity may prevent this
form of therapy.
Ultrasound and Diathermy (Deep Heat)
Ultrasound is high frequency sound waves above the audible
range. It may be applied utilizing a transmitting gel or with the ankle or
foot under water. Diathermy produces microwaves. When either is
applied to the skin, deep heating is the primary effect. Diathermy
treatments are 15-20 minutes each and performed up to twice daily.
Ultrasound treatments are given for 5-7 minutes with the ultrasound
hand piece being moved continuously over that part of the foot or ankle,
which is being tested. Please inform your doctor of any internal metallic
substance close to the skin or if you wear a pacemaker.
Cold
Cold is effective in decreasing bleeding, swelling, and pain. It
produces an anti-inflammatory effect, local anesthesia, and helps
control spasticity by slowing or partially blocking neuromuscular
transmission. Cold is used following acute trauma, such as sprains or
strains of muscles, tendons, ligaments, and joints. Also acute burns,
infections, or chronic capsular and soft tissue inflammation may require
cold therapy.
Methods usually include ice packs, cooling pads, or immersion in
ice. You should notify your doctor if you have diabetes, systematic lupus,
scleroderma, rheumatoid arthritis, or ant circulation disorder prior to
cold therapy.
Massage
Everyone knows the relaxation achieved following massage.
However, massage also produces analgesia by causing the body tot
release its natural painkillers, endorphins, at the site of an injury.
Edema, or swelling is reduced by stimulating fluid movement in the
tissues. Muscular tension is reduced and circulation in the skin
increased. Massage is helpful with soft tissue injuries, joint pain, joint
stiffness and after immobilization (braces, casts, wheelchairs, bed rest).
Thickened scar tissue may be loosened with deeper massage. If you
have a clotting disorder, fracture, or infection, massage my not be
indicated.
Electrical Stimulation
This form of physical therapy is one of the most versatile. One or
more types of electric stimulation may be utilized for a variety of
problems. A few of the conditions, which warrant this therapy, are skin
disorders, arthritis, post trauma, after surgery, and circulation
disorders. Electrical stimulation is safe, effective and not invasive. Three
types are: galvanic stimulation, T.E.N.S., and low voltage muscle
stimulation.
Galvanic stimulation uses electricity to produce medical effects
without actually stimulating the muscles. Instead, medications can be
introduced to specific sites in the body using electricity as the transport
vehicle; not a needle. A wide variety of useful effects on the body tissues
can be obtained in a very controlled manner with no discomfort the
patient.
T.E.N.S. is an abbreviation for Transcutaneous Electrical Nerve
Stimulation. It utilizes a small, portable nine-volt battery-operated unit.
T.E.N.S. is extremely effective in controlling both acute and chronic pain.
It is operated by the patient and is portable.
Low Voltage Muscle Stimulation uses electricity to produce small
muscle contractions without active physical exertion. The same
chemical and physical responses as normal muscle work are produced.
Low Voltage muscle stimulation is used to increase circulation, decrease
swelling and pain, decrease stiffness, and re-educate muscles.
Electrical Stimulation is not used if you have a pacemaker,
irregular heat rhythm, or some types of malignancies.
Ultraviolet Radiation
Utilized for many years, ultraviolet radiation is both anti-bacterial
and anti-fungal. Most indications are dermatological and include
superficial infections, pressure ulcers, dermatitis, psoriasis, and eczema.
Application is performed with a hot quartz lamp, mercury vapor lamp,
sun lamp, or black light. If you are photosensitive or have systemic or
discoid lupus, please tell your podiatrist.
Therapeutic Exercise
Exercise can be very helpful in maintaining wellness as well as
treating illness and disease. Your doctor will recommend exercises to
help prevent contractures and fibrous adhesions following
immobilization after surgery or a traumatic injury. Exercise will restore
muscle tone and joint motion. It also helps prevent secondary effects of
inactivity such as depression and psychosocial implications. Disuse
syndromes can cause stiffness in joints, muscle atrophy, osteoporosis,
pressure ulcers, pain, and phlebitis. A program will be structured to
your needs. If you currently have severe heart disease or breathing
disorders, your exercise program may be restricted.
Intermittent Compression Pump
When walking, your leg muscles act as a pump to drain the feet
and lower legs of fluid. After an injury or surgery, swelling of the feet an
legs is common. Combined with immobilization, the swelling can be
substantial due to the lack of muscular function. The intermittent
compression pump is safe, easy to operate and painless. Large vinyl
boots are placed over the legs and intermittently air pressurized. The
pump performs a milking action to remove the fluid.
How Long Do I Need Therapy?
Treatment is most effective when performed on a regular basis, 23 times per week 4-6 weeks, with regular re-evaluation. The length of
time for treatment may very with your response to treatments and the
severity of your condition.