On the first visit, the PT gathers subjective information from the patient regarding the history and nature of their pain and symptoms, past medical history and treatments, physical activities and work background, as well as goals. Objective measurements are gathered which includes (and is not limited to) range of motion, strength, palpation, movement and postural assessment, breathing, as well neurological and special tests. Based on this information, the PT assesses what they believe to be the problem and a plan of care is developed outlining timeline and future treatments.

Hands-on work by the PT focusing on (1) soft tissue and/or (2) joints in order to increase mobility around the structure.

• Soft tissue work: Includes and is not limited to myofascial trigger point release, massage, manual stretching and resistance. “Trigger points” are palpable nodules in taut band of muscle fibers and could cause referred pain, stiffness, and decreased ROM (more on this here).

• Joint mobilization: utilized to help decrease stiffness in the joint and facilitate lubrication and gliding in the bones. This is done with repetitive manual pressure in a specific direction and grade of intensity. Manual traction, approximation, and/or manipulation could also be utilized depending on what’s needed.

The PT is hands-on during exercise to help maintain proper joint positions and activation of the right muscles. Various equipment is also available for use — a functional trainer cable machine, Pilates Reformer, mounted wall stall bars, and various resistance equipment including bands and weights. Wall mirrors are also available to assist with form.

• Therapeutic Exercise: includes various stretching and strengthening exercises and a focus on posture, trunk stabilization and breathing.

• Neuromuscular Re-education: restores normal movement, coordination, and muscle activation/relaxation. Oftentimes compensatory and faulty movement patterns are developed after injuries and/or surgeries and needs to be corrected.

• Dynamic Neuromuscular Stabilization (DNS) is an approach that helps restore “ideal” positions and movements, utilizing developmental positions that are innate to every person (more on this here).