Performance Therapy Services
Corrective Exercise
What is a corrective exercise?
​A corrective exercise is an exercise designed to remedy the cumulative results of stresses placed on the body, helping to restore and maintain joint posture, balance, mobility, and stability. This allows the body to move freely and without pain. Exercises will be prescribed based on the results of your initial evaluation.
Manual Therapy
What is orthopaedic manual therapy?
​Orthopaedic Manual Physical Therapy is a specialized area of physiotherapy / physical therapy for the management of neuro-musculoskeletal conditions, based on clinical reasoning, and utilizes highly specific treatment approaches including manual techniques and therapeutic exercises. Manual therapy treats musculoskeletal pain and disability that includes joint and/or soft tissue mobilization and manipulation.
Trigger Point Dry Needling
What is a trigger point?
A trigger point is a taught band of skeletal muscle located within a larger muscle group. They are locally painful to the touch and palpation can elicit referred pain to other areas of the body. They occur when the muscle undergoes a stress it is unaccustomed to. This can be something obvious like a fall or miss-step, or commonly, a low load stress on the muscle over a long duration of time (forward head posture while sitting behind a computer for work).
What is trigger point dry needling?
Trigger point dry needling (TDN) is an invasive procedure that involves placing a solid thin filiform needle into the skin and muscle at the level of the trigger point. TDN results in reduced pain, an anti-inflammatory immune reaction, and improved range of motion and muscular performance.
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How does it work?
The exact mechanism to TDN is unknown; however, increasing research suggests that inserting a needle into a trigger point causes favorable biochemical changes after a twitch response that essentially "control, alt, deletes" the muscle, improving it's performance, and breaking the pain cycle.
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Is it the same as Acupuncture?
Dry needling is not acupuncture, a practice based on traditional Chinese medicine and performed by acupuncturists. Some acupuncturists perform TDN as well, so it can be confusing. The main differences include the following: TDN involves the needling going into muscle tissue, not only the skin, and clams local versus systemic effects.
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Is it painful?
The needle is very thin, so many don't even feel the needle entering the skin. As the needle comes in contact with a trigger point, a twitch response is elicited, which feels like a deep, crampy, ache. It is normal to have this ache radiate into other parts of the body, and consistent pain patterns have been identified for specific muscles. Learn more here.
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How long does it take?
Treating one trigger point takes around 4-5 seconds; however, the duration of treatment is determined based on the size of the area being treated, the number of trigger points, and patient tolerance.
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What should I do after?
Typically after needling, soft tissue massage and exercise are indicated to increase blood flow and retrain the treated muscle.
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How many treatments does it take?
If there was an incident, like a fall, that caused the trigger point, 1-3 treatments is usually all it takes. If something is causing the trigger point to reoccur, or there are multiple within the area, a few more treatments may be required. Individuals whom are very active, perform manual labor, have sustained a significant injury, or are in chronic pain may do routine needling for maintenance/pain management.
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What are the risks?
The most serious risk associated with TDN is accidental puncture of a lung (pneumothorax) in muscles on the thorax. This is a rare complication, and in skilled hands should not be a concern. If this were to occur, it may likely only require a chest x-ray and no further treatment as it can resolve on its own. The symptoms are pain and shortness of breath. A more severe lung puncture can require hospitalization and re-inflation of the lung. If you feel any related symptoms, immediately contact your therapist and seek medical attention from your physician, or if necessary, go to the emergency room.
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Are there any side effects?
It is common to feel very relaxed, tired, or energized, after the treatment. Other reactions that are not worrisome include: local bruising, soreness, and ache/discomfort over the treated area. As the needles are very small and do not have a cutting edge, the likelihood of any significant tissue trauma from TDN is unlikely. Possible, but rare, side effects include feeling faint/dizzy, nauseous, and sweating. These are normal reactions that may be present due to changes in blood pressure (high or low), mainly associated with the patient’s first experience with needling.
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Can everyone be needled?
No. There are a few conditions and instances where needling is contraindicated. Please notify your provider if you have a fear of needles, are pregnant, have any implants, are on anticoagulant (blood thinners), or have any conditions that can be transferred by blood. Your practitioner will review your medical history and ensure needling is safe and appropriate for you.
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Please consult with your practitioner if you have any questions regarding the treatment above.
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References:
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2.) Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. journal of orthopaedic & sports physical therapy, 43(9), 620-634.
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Blood Flow Restriction
What is blood flow restriction (BFR)?
Blood flow restricted (BFR) rehabilitation is the brief and intermittent occlusion of venous (vein) blood flow using a tourniquet while exercising. Using this technique, you can exercise with significantly lighter weights to create the hypertrophic (growth) and stretch response that would traditionally require lifting at higher loads.
Instrument Tissue Mobilization
What is instrument assisted soft tissue mobilization (IASTM)?
IASTM is a process in which the clinician uses a set of handheld instruments to break down the scar tissue and fascial restrictions in soft tissues (e.g. muscles, fascia, ligaments, tendons).
Dry Cupping
What is cupping?
Cupping has been around since 3000BC and its exact origin is unknown. It involves placing cups on the skin to create suction. Sometimes the cups remain in place, sometimes they are moved. The suction may facilitate healing with blood flow, and the compression around the edge of the cup encourages soft tissue remodeling, similar to that of foam rolling or massage.
Video Movement Analysis
What is it?
Video analysis is a technique that allows us to analyze movement from various speeds and planes. It is most impactful in movements we do repeatedly, such as walking, running, throwing, as small deviations in movement overtime can create a large impact on the body.
Ergonomic Assessment
What does ergonomics mean?
Ergonomics is the assessment of the efficiency in ones work environment.
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Why do we assess it?
Posture matters when it's sustained for long periods of time, such as when working or driving. We can help measure and alter the risk factors in your work environment that may lead to musculoskeletal disorders, pain, or injury from your work/car set up.