Treatment Modalities

  • Dry needling is a form of physical therapy used to treat musculoskeletal pain and dysfunction. It is an invasive form of myofascial release in which thin, flexible needles are inserted into the body. The places the needles are placed in the body are determined by accurate anatomical knowledge based on sound scientific reasoning within a biomedical paradigm.  This is different to acupuncture, which is a treatment technique related to Chinese Medicine, and takes a philosophical rather than empirical approach to the body.

    Dry needling can be used for:

    • Musculoskeletal conditions.  
    • Back and neck pain
    • Muscle strains
    • Tight and painful scars
    • Headaches
    • Shoulder pain

    How Does It Work?

    Dry needling works in at least 3 different ways depending on what you do with the needle.

    • The simple insertion of a needle and the subsequent stimulation of the needle give you a rush of natural painkillers called opioids, and a feel good hormone called serotonin.  These actively reduce your pain, and this enables you to exercise more effectively. 
    • Using a needle to stimulate a trigger point in a muscle frees the muscle up to work more efficiently by causing it to twitch and release.  This helps the local muscle to both contract and lengthens better, and will allow you to have more power and better flexibility in the muscle.  This also reduces local muscle pain.
    • Using a combination of needles in different parts of the biomechanical system, your therapist can help you align and balance out your movement patterns as a whole. 

    What are the Side Effects of Dry Needling?

    There are relatively few side effects, which is one of the great advantages of this effective therapy.  The more common ones include discomfort from the needling procedure, bruising, and occasionally a very small amount of bleeding.  Less commonly, patients may experience transient feelings of drowsiness, euphoria, tearfulness, sweating or chills. 

  • Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

    Originally developed by athletes, Graston Technique® is an interdisciplinary treatment used by more than 20,000 clinicians worldwide — including physical and occupational therapists, hand therapists, chiropractors, and athletic trainers.

    GT is utilized at some 2,200 outpatient facilities and 58 industrial sites, by more than 325 professional and amateur sports organizations, and is part of the curriculum at 59 respected colleges and universities.

    For the clinician:

    • Provides improved diagnostic treatment
    • Detects major and minor fibrotic changes
    • Reduces manual stress; provides hand and joint conservation
    • Increases patient satisfaction by achieving notably better outcomes
    • Expands business and revenue opportunities

    For the patient:

    • Decreases overall time of treatment
    • Fosters faster rehabilitation/recovery
    • Reduces need for anti-inflammatory medication
    • Resolves chronic conditions thought to be permanent

    For employers and the healthcare industry:

    • Allows patients to remain on the job
    • Reduces the need for splints, braces, and job-site modifications
    • Contributes to the reduction of labor and healthcare costs, direct and indirect
  • The basic principle of Interferential Therapy (IFT) is to utilise the significant physiological effects of low frequency (<250pps) electrical stimulation of nerves.

    Interferential therapy utilizes two medium frequency currents which pass through the tissues simultaneously. They are set up so that their paths cross; and in simple terms they interfere with each other. This interference gives rise to an interference or beat frequency, which has the characteristics of low-frequency stimulation

    The exact frequency of the resultant beat frequency can be controlled by the input frequencies. For example, if one current was at 4000 Hz and the other current at 3900 Hz, the resultant beat frequency would be at 100 Hz.

    The medium frequency currents penetrate the tissues with very little resistance, whereas the resulting interference current (low frequency) is in the range that allows effective stimulation of the biological tissues.

    The are 4 main clinical applications for which IFT appears to be used:

    Pain relief
    Muscle stimulation
    Increased local blood flow
    Reduction of oedema

  • The word massage is derived from either the Arabic “mass”, to touch, or the Greek “massein”, to knead.

    Massage therapy can be defined as a variety of manual techniques designed to relieve stress, promote relaxation and general wellness in someone who has no definable health problems or help to mobilize various structures, relieve pain and swelling, prevent deformity and promote functional independence in someone who has a specific health problem.

    The effects of massage are both physiological and psychological e.g:

    • Pain management/reduction
    • Improved circulation
    • Lymphatic improvements
    • Musculoskeletal improvements such as increased range of motion and decreasing spasms Improve respiratory function and increase the activity of the immune system.
    • Psychologically, massage can help reduce stress, depression, anxiety and give the client a feeling of well-being.
  • A subjective examination  will be done whereby information regarding the mechanism of injury is obtained

    The physiotherapist will conduct :

    • Any history of previous injuries or conditions
    • the patient’s occupation or hobbies that may aggravate or be affected by the condition

    A proper and thorough Physical(objective) examination will be done.

    The objective assessment is guided by the history and the findings of the subjective exam.

    The physiotherapist will observe:

    • Posture
    • Patterns of movement
    • Any swelling, deformity or asymmetry.
    • Highly developed skills of palpation will identify crepitus (noise within the joints or tendons)
    • Identify areas of heat, tenderness, or palpable deformity.
    • Tests will be used to determine the type of tissues involved, hypothesize a pathologic process, and guide the selection of exercise.
    • Therapists will use their clinical judgment with consideration of severity, irritability, acuity, and patient’s medical history when selecting tests.
    • Often the outcome of one test will be a crucial factor in the selection of additional assessment tools.

    You will be asked to rate your pain on a scale from 0 to 10, 0 being no pain, and 10 being severe pain. This is to determine quantitatively if your pain is getting better or worse.

    Please come prepared. This will save valuable time so that the therapist can start with treatment interventions.

    • Ultrasound therapy (US) is the use of sound waves above the range of human hearing to treat musculoskeletal problems Ultrasound is high-frequency sound waves, greater than 20,000 Hz.  Therapeutic ultrasound is in the frequency range of 0.9 – 3 MHz. There are many flavors of therapeutic ultrasound, using different intensities and frequencies of sound, but all share the basic principle of “stimulating” tissue with sound waves.

      It is estimated that thermal effects occur with the elevation of tissue temperature to 40–45°C for at least 5 min.

      Ultrasound is used to

      • break up scar tissue and adhesions
      • reduce inflammation, swelling, and calcium deposits
      • create a deep heat to a localized area to ease muscle spasms (much deeper than can be achieved with a hot pack – up to 5 cm) 
      • increase soft tissue extensibility prior to stretching and exercise
      • facilitate healing at the cellular level
      • speeds metabolism and improves blood flow
      • reduces nerve root irritation
      • at low intensities can speed bone healing
      • enhance transcutaneous drug delivery by phonophoresis

      The main piece of equipment is a high-frequency generator, which provides an electrical current through a cable to a transducer which contains a piezoelectric crystal. This crystal when exposed to the current will vibrate at a given frequency,  expanding and contracting, which produces the necessary compression wave.  By using a different frequency the therapist can target tissues at different depths for either healing or destruction,  or simply use the device to reduce pain. Although simple in principle, the use of ultrasound as a therapeutic modality requires a comprehensive understanding of its effects on the body tissues and of the physical mechanisms by which its effects are produced.  The lower the frequency used, the deeper is the penetration of the waves into the body. By varying the frequency from continuous to intermittent, the amount of heat applied can likewise be controlled by the physiotherapist.

    • Light Therapy works by energizing compromised cells and increasing blood flow using LED light
      of a highly beneficial wavelength. In this way, the process of cell death is reversed, leading to quicker healing and recovery following injury.

      This process has been optimized with the patented Photizo® light therapy device and numerous conditions are treatable at the push of a single button.
      Photizo® is safe and easy to use by people of all ages.

      During tissue damage, cellular integrity and function are compromised. Without a means to quickly and effectively reverse such damage on a cellular level, damaged cells will die (i.e. undergo necrosis).

      A major drawback of almost all other light therapy units currently available, whether laser or LED-based, is that they are large, expensive, fragile, and very complex to use. Accordingly, only skilled clinicians and specialists can use such devices and obtain successful results in clinical settings only. Some light therapy units currently available produce light having a wide range of non-beneficial wavelengths (from 440 nm to 3500 nm), which impairs their efficacy due to the fact that the truly beneficial wavelengths make up a very small proportion of the total light emitted. Photizo® only produces light of the most beneficial wavelength, hence the shorter treatment times experienced by our users. Some of the protocols take only a minute to administer, once a day, with healing results are seen within a day or two. This is not the case with other light therapy units, where healing is a slow process taking weeks or months. In addition, most currently available units have low power 10 to 40 milliwatt light diodes, while Photizo® has a 150mW diode. In certain applications, such as in a hospital or clinical setting, a 1200mW probe is available as an accessory to treat larger affected areas at a time. The use of such high-power probes means that less treatment time is required to ensure the same efficacy.

      There is, however, a limit to the amount of light therapy that can be administered in a treatment regimen before healing or tissue repair and Photizo® provides the optimal application of light therapy in each protocol for each wound type, for safe treatment once a day.

      Photizo® has been designed around the needs and feedback of our clients, who told us they needed a small, portable, easy to understand and simple-to-use light therapy unit, with a high-power diode for quick and simple treatments. Accordingly, Photizo® has been designed with the professional and the layman in mind and is easy enough for the whole family, even children, to use.

      Photizo® incorporates built-in treatment protocols for some of the most common conditions which have been proven to be treatable by light therapy in the fields of cosmetics, healing, and wound treatment. All the parameters necessary to treat, for example, a wound, have been incorporated in a single protocol button for such condition – merely by pressing the appropriate button, the whole protocol is run to treat the appropriate condition, taking a minute or two per application per day. This is a major advance over other systems that are currently available, as the device can be operated intuitively by unsophisticated users with a minimum of training. This allows clinicians and physiotherapists to quickly yet safely treat their patients before tissue decay sets in, while the layman and even children can treat themselves safely on a non-invasive basis. With no moving parts, Photizo® is and remains the leader in reliability and performance. Photizo® has worldwide patent applications to stop cheap imitations from causing damage to our customers and their patients.

      Photizo® makes use of a near-coherent light beam produced by a high-intensity LED array. The probe is robust enough to survive most conditions, while the operational unit has been designed to be resistant to accidental spills. This device has been designed to withstand conditions in rural areas, and is a major distinguishing factor between Photizo® and other light therapy devices, which tend to be fragile and break easily. In addition, the Photizo® device is assembled on an ISO 9000 assembly line and has extensive product back-up and warranty maintenance. While most other light therapy devices have light sources, which only last for 500 to 1000 hours, the

      Photizo® diode can perform for up to 50,000 hours without a significant loss of output

      A Step-by-Step Guide

      1. Photizo® stimulates the production of ATP in the mitochondria

      ATP is the major carrier of energy in the cells and is made by the cell’s power units, the mitochondria. Without ATP, all cellular functions cease, and an increase in ATP allows the cells to accept nutrients faster and to dispose of waste products by increasing the energy levels in the cell. ATP provides the chemical energy that drives the chemical reactions of the cell. ATP production is enhanced by light therapy, as light of a coherent, optimal wavelength energizes the cytochrome b structure, allowing it to donate electrons to the electron transport chain at a greater rate to increase ATP production. 

      2. Photizo® reverses cell death process and ensures cell repair

      Following injury, a cell quickly approaches a point of no return, after which cell death is a certainty. Photizo® light therapy, if administered immediately, can reverse most such cell death processes by increasing ATP production. 

      3. Cellular regeneration

      Once a cell has died, the body needs to make new cells to replace the compromised or damaged cells. Light therapy prevents the overproduction of scar tissue and ensures quicker (up to 250X) cellular regeneration. This is of major importance for accident victims to regain full functionality. This accelerated “replacement” effect is seen in all cell types. Once cells have been boosted with light therapy they can resume their normal functioning and make new blood vessels, nerve tissue, bone cells, cartilage, etc. Light therapy does not cause cellular overgrowth or cancer – cells are merely recharged to resume their normal functioning. 

      4. Clearing of inflammation and increased lymphatic activity

      Local inflammation, although necessary, chokes a cell. Photizo® lessens inflammation and ischemia, helping the cell to take up nutrients and oxygen from surrounding tissue and blood vessels. Light therapy relieves ischemia and stops cell “choking”. Edema has two components i.e. a liquid part, which can be evacuated by the blood system, and a proteinaceous component which is comprised of proteins that have to be evacuated by the lymphatic system. Research has shown that the lymph vessel diameter and the flow of the lymphatic system can be doubled with the use of light therapy. The venous and arterial diameters can also be increased. This means that both components of edema can be evacuated faster to reduce swelling. 

      5. Increased immune system activity

      Near-infrared light has been shown to increase immune system functioning. The exact mechanism by which this occurs has not been elucidated, but several studies have shown a systemic effect in subjects on whom light therapy was used. This means that local treatment of a wound with Photizo® has a general immune-enhancing effect. 

      6. Photizo® increases blood supply

      Increases blood supply to areas by stimulating the formation of new capillaries and blood vessels to replace damaged ones. This speeds up the healing process by providing more oxygen and nutrients needed for healing to the damaged cells. It also accelerates waste and debris removal from the site of injury. Light therapy has a vasodilatory effect. 

      7. Systemic effect and reduced excitability of nervous tissue

      Photizo® assists in reducing the excitability of nerve tissue, thereby relieving pain. There is also a sharp increase in endorphins and serotonin, providing a further systemic pain-relieving and calming effect. This is of importance in acute and chronic pain relief. 

      8. Photizo® regulates collagen production

      Collagen is the most essential protein building block used to repair damaged tissues and to replace old tissues. By increasing and regulating collagen production less scar tissue is formed. Photizo® does not result in an overproduction of collagen – rather, it helps the cell produce optimal levels necessary for healing. 

  • Orthopaedic Manual Physical Therapy (OMPT) is any “hands-on” treatment provided by the physical therapist.  Treatment may include moving joints in specific directions and at different speeds to regain movement (joint mobilization and manipulation), muscle stretching, passive movements of the affected body part, or having the patient move the body part against the therapist’s resistance to improve muscle activation and timing.  Specific soft tissue techniques may also be used to improve the mobility and function of tissue and muscles.

    Conditions that can be treated with OMT?

    Orthopedic manual physical therapists treat acute and chronic conditions in body regions including the head, neck, back, arms, and legs. When someone suffers from a neuro-musculoskeletal disorder, an exercise and movement re-education program may be all that is needed to restore full pain-free movement, function, and return to full activity.  However, in some cases, soft-tissue and joint restrictions are present, which might result in these same exercises or movements being painful or even making the condition worse. In these instances, an OMPT therapist can provide hands-on techniques to improve mobility, reduce pain, and restore normal function of the soft tissues and joints.  Following these interventions, the OMPT therapist can prescribe and implement the most effective individualized exercise and movement re-education program to maintain and improve health.

    The services of an orthopedic manual physical therapist are recommended if you have muscle, joint, or soft tissue conditions that affect movement, strength, posture, or cause pain.  This not only includes common disorders associated with trauma, post-operative recovery, poor posture, overuse, athletic injuries, obesity, arthritis, or congenital conditions, but also disability associated with conditions such as Parkinson’s disease, multiple sclerosis, cerebral palsy, spinal cord injury, diabetes, cancer, heart disease or balance disorders. Patients suffering from chronic conditions can benefit from skilled OMPT intervention with the goals of attaining optimal health, returning to optimal activity, and minimizing disability associated with disease progression.