MSK Physical Therapy Services
Musculoskeletal PT: Get to the Root of the Problem?
The Many Faces of Musculoskeletal Physical Therapy
Physical therapy for the musculoskeletal system is the subspecialty of physical therapy with which most people are familiar. The term physical therapist often conjures up images of clients doing back strengthening exercises, athletes working on their shoulders and older adults rehabbing a total knee replacement. These are all examples of physical therapy for the musculoskeletal system and many PT professionals will dedicate their careers to mastering the assessment and treatment of the bones, joints, tendons, fascia, ligaments and soft tissue, the structures that make up the musculoskeletal system. Let’s take a further look into how physical therapists work with the musculoskeletal system.
WHAT KINDS OF MUSCULOSKELETAL CONDITIONS DO PHYSICAL THERAPISTS TREAT?
A wide range of conditions and injuries affect the musculoskeletal system. In general, we can think about musculoskeletal physical therapy as addressing four primary categories of musculoskeletal concerns.
Acute injuries: Acute injuries are those that have recently occurred, typically within the last few weeks (subacute injuries are included here). Symptoms of an acute injury to the musculoskeletal system include:
Pain
Swelling and inflammation
Muscle or joint stiffness
Redness and warmth
Local deformity
Difficulty moving or bearing weight through the area
Chronic injuries and issues: Chronic injuries are those that are more than a few weeks old, have (optimally) entered a more chronic phase of healing wherein things like pain and inflammation have significantly decreased. An example of this type of chronic injury is a person seeking PT four weeks after an acute ankle sprain. This can also include chronic irritation or pain that is ongoing or intermittent and may or may not be easily attributed to a particular incident. For example, someone who experiences knee pain whenever they run.
Pre- and post-surgical rehab: Surgeries are performed to address a wide range of medical conditions and injuries. Any surgery, no matter how small, disrupts tissues in the body and can lead to impairments in tissue mobility, scarring, pain, stiffness, muscle weakness and alterations in movement. Musculoskeletal physical therapy aims to address all of these concerns to help restore optimal functioning of the affected area. The goal of pre-surgical rehab is to prepare the body for surgery and to help optimize the post-surgical recovery and outcome.
Injury Prevention: Sometimes the goal of musculoskeletal physical therapy is to identify risk factors for injury and intervene to address them before the injury occurs. This is often done in the context of athletes who are preparing for an upcoming season or a new training block. In this case therapists combine their knowledge of the musculoskeletal system and their familiarity with the demands of a particular sport or activity to identify areas of movement and performance that may predispose the individual to injury in the future. After a thorough assessment, treatment and exercises are prescribed as necessary to optimize performance and lower the risk of injury. Another area of musculoskeletal physical therapy centered on injury prevention is PT for pre-partum women.
As you can see, musculoskeletal physical therapy can address a wide range of conditions affecting the body. Here is a list, though far from comprehensive, of conditions that musculoskeletal physical therapists treat
Back pain and neck pain
Other joint pain (knee, ankle, foot, hip, shoulder, elbow, wrist, hand)
Post-surgery (examples: ACL repair, bunion repair, hip or knee replacement, carpal tunnel surgery, spinal fusion, and many, many more)
Muscle contusions
Joint replacement recovery (knee, shoulder, hips, etc.)
Headaches
Muscle stiffness and tightness
Pain with activity
Pre- and post-partum
WHAT DOES MUSCULOSKELETAL PHYSICAL THERAPY LOOK LIKE?
As with all physical therapy, musculoskeletal physical therapy should be individualized to meet your specific needs. After interviewing you about your symptoms and performing a physical exam, your physical therapist can discuss with you the plan of care. Typically you will work with your physical therapist between 1 and 3 times a week for a number of weeks, tapering off as you make improvements and near your discharge date. The main goals of this type of physical therapy is to help you return to the functional activities you need and love to do with as few symptoms as possible and to give you strategies to maintain the improvements you made during therapy to prevent recurrence of the problem in the future.
Some of the primary goals of musculoskeletal physical therapy are as follows:
Reduce pain, inflammation and irritation: While completely eliminating your symptoms may take time, making you more comfortable in the meantime is an important first step in your rehabilitation. Applying ice or heat, ultrasound or electrical stimulation to the affected area can often give you some relief. Soft tissue mobilization or gentle joint mobilization may also be employed by your physical therapist to reduce tissue irritation.
Improve flexibility: Your PT program may include stretching, myofascial release techniques, joint mobilization and mobility exercises to improve flexibility and range of motion.
Build up your strength: You will learn exercises to help strengthen the muscles around the injured area and other connected areas of the body. Having good strength throughout the body allows stress to be distributed across multiple joints and helps to prevent injury and irritation in the future.
Optimize your movement: Learning proper biomechanics and enhancing the neuromuscular control of joints and muscles is an essential component of healing and preventing injuries. Physical therapists are movement experts and through analyzing your movements, can guide you in improving how you move and train your muscles to perform those movements in the safest and most effective way possible.
REST IS NOT ALWAYS BEST
Many of us are in the habit of resting and cutting back our activities whenever we feel pain or experience injury but active recovery is often the best strategy. The important thing, however, is to do it in a way that enhances the resiliency of the injured or irritated tissues and doesn’t injure it further. This is where the knowledge and expertise of a licensed physical therapist comes in handy. Even if the injured area must be immobilized and rested for a period of time, finding appropriate ways to exercise adjacent areas and promote movement will help with healing and recovery.
So if you are struggling with a new injury, planning on having surgery, looking to prevent a future injury or are tired of dealing with some chronic irritation, don’t play the wait-and-see game. Call Evolve PT today and let our skilled team of providers guide you to long lasting recovery and improvements.
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First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.
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