What is Therapy?

     Therapy is the use of natural means either manually or using instruments to assist and treat patients with physical ailments without the use of drugs or surgery. There are many forms of physiotherapy which can be categorized as passive therapy or active therapy. Passive therapy would be any form of treatment where the patient is at rest or not exerting any energy. Active therapy would involve exercises such as stability exercises, flexibility exercises, or strengthening exercises. Generally passive therapy should be incorporated to reduce pain and inflammation to then be increased to active therapy to restore normal movement in the joint.

     A great form of passive therapy is Low Level Laser Therapy (LLLT). LASER stands for Light Amplification of Stimulated Emission or Radiation. Low Level Laser Therapy is used in physiotherapy to assist with pain and promote healing. The LLLT may reduce pain and inflammation by facilitating the removal of exudate from the injured tissue by stimulation of cellular structures know as mitochondria. Mitochondria are the nuclear power plant of our cells constantly producing energy through the production of adenosine triphosphate or ATP. Energy is produced on an atomic level through the cleaving of one phosphate molecule from ATP thus producing ADP. The body can then use this energy for all of its physiological process such as cellular respiration. During cellular respiration there is an exchange of ions across the cell membrane between cytoplasm and interstitial fluid. It is through this process that the LLLT can influence cellular healing by encouraging further transfer of exudate through the cell membrane and into lymphatic and then blood circulation eventually finding its way out of the body thus removing edema and allowing for healing to occur.

      Another form of passive therapy is Neuromuscular Muscular Electrical Stimulation (NMES) aka Electrical Muscle Stimulation (EMS). This therapy consist of using therapeutic levels of electrical stimulation to promote healing in the body by placing electrodes over the skin thus creating micro-contractions in the muscle which then aid in reducing inflammation as well as strengthen the muscles. EMS also acts on the neurological level decreasing pain by blocking perception of pain to the nerves. This form of therapy is safe with most patients but is contraindicated with pacemaker, pregnancy, and metal implants.

      Ultrasound (US) is also a great form of passive therapy commonly used to aid in the healing process. Ultrasound therapy sends sound waves into the tissue thus agitating the interstitial fluid and cytoplasm therefore increasing cell membrane permeability allowing edema to be decreased by increasing the metabolism and blood flow. Ultrasound is contraindicated with cancer, pacemaker, over growth plates, pregnancy, and metallic implants.

      Therapeutic Exercises are specific exercises or body movements targeting injuries with the intent of promoting healing and preventing future injuries by hardening or conditioning of the injured area and surrounding structures. This can be accomplished through myo-fascial release techniques such as stretching. Also strengthening exercises can be employed to stabilize and protect any injured area thus speeding recovery. Stabilization exercises can be added as well promoting proprioceptive neuromuscular facilitation or body sensing exercises. A combination of therapeutic exercises will assist the body to reeducate the neuromuscular communication between the brain and the body.