History of Physical Therapy

Physical therapy, also referred to as physiotherapy, is a branch of medical science that deals with the treatment of injury and/or disorder by using physical methods. It is performed under the guidance of a physical therapist (PT) or an assistant (PTA). During a physiotherapy session, a therapist may use heat, cold, exercise, and at times, electricity. Like other medical fields, physical therapy has evolved tremendously. Let's take a look about the brief history of physical therapy.

History of Physical Therapy

The practice of physical therapy can be traced back to about 460 BC, when physicians Hippocrates and Hector used massage therapy and hydrotherapy (water therapy) to treat their patients. Massage therapy is a technique of physiotherapy, whereby basic hand movements are used to reduce stress, relieve pain and stimulate healing.

The earliest documented record of the founding of a professional group for physical therapy, was the Chartered Society of Physiotherapy, in England, in 1894. It was a group formed by trained nurses with the aim to provide physiotherapy services to the general public. Following this, several institutes started training programs for physiotherapy, for example in 1913, the University of Otago, New Zealand, established the School of Physiotherapy.

However, it was during the World War I (1917-1918) that physiotherapy was performed widely as a rehabilitation therapy for people who were injured in the war. People employed for such rehabilitative work were known as reconstruction aides and they were trained nurses having background of physical education and massage therapy.

Shortly after this, in 1921, Mary McMillan (the first physical therapy aide) founded the American Women's Physical Therapeutic Association, which was later changed to the American Physical Therapy Association (APTA). She contributed a lot to the reconstruction aide services and came to be known as "The Mother of Physical Therapy". It was in the same year, that the first research paper on physical therapy was published in the US. The year 1921, was regarded as a landmark, in the field of physical therapy, as national accreditation of physiotherapy programs was introduced.

In the subsequent years, more research studies were conducted and papers were published on physical therapy. In 1924, the Georgia Warm Springs Foundation was established to fight the polio epidemic. Till the 1940s, common physiotherapy practices included massage, exercise and traction. It was only in the early 1950s that manipulative therapy for the spine and joint pain was introduced in the British Commonwealth countries. It is to be noted that until this time, physiotherapy was practiced only in hospitals.

In 1956, physical therapists, APTA and medical researchers jointly worked and cooperated on the Salk vaccine (first polio vaccine developed by Dr.Jonas Salk) trials, which led to the development of a polio vaccine. By this time, physiotherapy was being practiced as a common health care profession in the US. In 1974, clinical specializations in physical therapy was made possible, with the foundation of Orthopedic Section by APTA.

With the development of computer and technology in the 1980s, more advancement was observed in the field of physiotherapy techniques. For example, electrical stimulators and iontophoresis devices were introduced for practicing physiotherapy.

Nowadays, from a layman having back pain to a sportsperson suffering from a sports injury, physical therapy has become a common procedure for treatment of musculoskeletal injury and disorder.

Physical Therapy for Cerebral Palsy

Cerebral palsy is a neurological disorder that appears in early childhood. It is a result of damage caused to the brain that impairs muscle coordination and body movement. Though not progressive, the damage can't be reversed. Although congenital in most cases, cerebral palsy is not detected until a child is a few months or a year old. Early symptoms of cerebral palsy surface before a child turns three. However, cerebral palsy can be caused after birth as a result of head injury due to accidents or brain infections, like bacterial meningitis or viral encephalitis.

Treatment for Cerebral Palsy

Cerebral palsy can't be completely cured. However, there are a number of cerebral palsy treatments that can help a child overcome the disabilities associated with this disorder. Physical therapy, occupational therapy and speech therapy often prove useful for children suffering from cerebral palsy. Certain drugs can also be prescribed to control seizures, muscle spasms and relieve pain. Sometimes surgery is used to remove physical abnormalities or relax tight muscles.

Physical Therapy for Cerebral Palsy

Cerebral palsy seriously impairs a child's ability to move around. The freedom and fun that every child is entitled to can be restored with the help of physical therapy. A physical therapist is a professional who is trained to improve muscle coordination and movement, through exercise and other devices. A physical therapist goes through the medical history of patients, and then designs a treatment schedule depending upon the requirements. Physical therapy for cerebral palsy involves stretching, strengthening and repositioning of the muscles. This neurological disorder causes the muscles to become tight. Hence stretching them daily to increase flexibility, is an important component of treatment through physical therapy. Muscles are stretched by moving the limbs in such a way that it causes a slow a steady pull on the muscles. A physical therapist helps his patients to carry out exercises that would strengthen specific muscles for better support and movement. Positioning is done to reduce unwanted tone and to attain long stretches. For this purpose, a number of devices like braces, knee mobilizers, pillows, casts or splints may be used.

In his treatment a physical therapist may use the 'bobath' technique and 'patterning'. Sometimes due to cerebral palsy a child tends to retain some of the primitive reflexes. Using the bobath technique, a physical therapist relieves the primitive reflexes by repeated positioning of the limb in opposing movement. For example, if the limb of a child remains normally flexed, a physical therapist using this technique would extend it repeatedly. Through 'patterning' a physical therapist encourages a child to attain movements that develop along the normal path of motor development. For example, a child would first be taught to crawl and stand and then walk. Although certain therapists have reservations regarding 'patterning' due to lack of documented evidence of its value, nonetheless, it has proved to bear results.

Role of Family

Although physical therapy sessions are mostly done at hospitals, or at the clinic of the physical therapist, the role of parents and family is also important. It is often seen that cerebral palsy patients respond better to treatment in the comfortable surroundings of their home. Most of the physical therapy activities are simple. Parents can easily learn them and help their children with these exercises at home. Also, presence of parents provide a positive reinforcement to the child, that helps him respond better to physical therapy treatments. In fact physical therapy often includes interactive play. Playing with family members and with other children of the same age is encouraged.

The module of physical therapy for cerebral palsy changes over time, as a child may not retain the same disabilities, he did during infancy. The treatment program needs to be adapted continuously according to the needs of the child.

Restricted physical movement can often dent a child's confidence. During his struggle to overcome locomotive barriers, a child lays his deepest insecurities and frustrations bare in front of his physical therapist. Hence, a physical therapist needs to be more than a trained professional, who can help a child overcome his physical disabilities. He has to act like a patient guide and friend who would encourage the child every time he fails to stand up on his feet.

Animal Physical Therapy

People suffering from various injuries are often advised to visit a physical therapist. For years it has been common knowledge, that physical therapy is helpful in decreasing the discomfort associated with injuries. The same is applicable to animals, especially to dogs, horses and cats. Injured animals require a number of treatment plans, one of which is animal physical therapy.

Animal physical therapy is a developing field and an integral part of animal health care. It helps improve the lives of animals. As we all know, physical therapy has been extremely beneficial for humans. Recently, veterinarians found that physical therapy can also help animals recover from injuries. This was a major breakthrough in health care for animals. Even conditions like arthritis, chronic pain or even neurological symptoms observed in animals, can be effectively treated using physical therapy. Obese and overweight animals are often treated with physical therapy to assist in weight loss.

Animal physical therapy plays an important role in accelerating the healing process. Performing a surgery on an injured animal and discharging the patient without any physical therapy is an outdated approach. The main advantage of performing animal physical therapy, is that it speeds up the recovery. Animal physical therapy is an important part of veterinary care which simply cannot be ignored.

Benefits of Animal Physical Therapy

A physical therapy program can increase the success rate of any surgery. Post surgical management with physical therapy can expedite a successful recovery of the patient. The most important benefit of animal physical therapy is its ability to decrease pain in the injured parts. It also facilitates healing of inflamed tissues. If the joints are affected, then physical therapy will help maintain normal movements of the injured tissue. In some cases, limbs become paralyzed due to a severe injury. Physical therapy done on paralyzed or weak limbs, effectively prevents soft tissue contracture. Animal physical therapy plays a crucial role in strengthening weak or injured limbs. It also improves the function of the affected limbs. A neurologic or orthopedic injury, often limits the mobility of the patient. This can be overcome by using animal physical therapy. If you want your pet to undergo animal physical therapy, make sure it is performed by a licensed physical therapist who is specialized in the treatment of animals. You must verify the credentials and experience of the therapist, before hiring him for the job.

Animal Physical Therapy School

This is the place where veterinarians and even pet owners can learn various procedures and modalities involved in animal physical therapy. Some of the physically therapeutic modalities that are taught in these schools are as follows:

    * Massage therapy
    * Acupressure
    * Acupuncture
    * Ultrasound therapy
    * Hydrotherapy
    * Hot or cold therapy
    * Strengthening Exercises

Some of these techniques are taught in various veterinary colleges. Others are performed only by trained therapists. Animals respond quite well to these treatments. The main goal of animal physical therapy is to augment the quality of life, by effectively managing chronic and acute pain. So if your pet has sustained injuries during an accident, physical therapy will certainly help improve your pet's condition.

Knee Strengthening Physical Therapy

Do we realize the exact amount of dependency that we place on our knees in our daily lives? Hardly ever. We carry on with our walking and running and even the most mundane actions like bending or stretching with the greatest ease. It is only when the knees are affected and their actions limited that we understand just how much we use them. The knees are some of the most widely used parts of the human body. Most actions that have to do with the legs are carried out with the help of the knees. When a body part is used so much, one can pretty well decipher that it also runs the risk of being prone to injuries and that is what happens with the knees as a result. Athletes, sports people and those who are into heavy duty fitness sessions are some of those who are at the greatest risk of developing knee injuries. People who are obese are also at a higher risk of the same, because of the added pressure that is put on their knees. Other than that, a fall, injury or trauma to the knees are some of the most common causes of knee injuries.

Sometimes a knee injury is so severe that a knee surgery becomes important. And it is for the recuperation of the weakened muscles that support the knees, that a knee strengthening physical therapy has to be brought into action. To further the effects of the surgery, certain knee strengthening exercises are recommended by specialists. This physical therapy focuses primarily on strengthening the muscles that support the knees and thereby helps to reduce the pressure that is placed on the knee joints. It leads to faster recovery and prevents similar injuries from making way as often.

In the following section, we shall concentrate on the kind of exercises that knee strengthening physical therapy includes. These will showcase how to strengthen knees effectively well.

Knee Strengthening Physical Therapy Exercises

When undertaking knee strengthening exercises, maximum focus is placed on strengthening the hamstring and quadriceps because these are the muscle groups that support the knees maximally. Let us review some of these exercises in the following section.

Thigh Tensing

   1. Sit on a chair so that your soles are flat against the ground and the legs are bent at the knees in a 90 degree angle.
   2. Tense your right thigh so that you feel a tightness in it.
   3. Hold this position for 5-8 seconds and release.
   4. Repeat on the left leg.
   5. Alternate this exercise between both legs and do about 10 of each.

Leg Raises

   1. Lie on your back and bend the leg that is not affected. Place the sole of that feet flat against the bed.
   2. Now straighten the leg that is affected as much as possible.
   3. With the other leg bent, raise the straightened leg 3-5 inches off the ground.
   4. Maintain this position for 5-8 seconds before bringing it down. (Bring it down immediately if you feel any stress.)
   5. Try and do 8-10 repetitions. If you can't manage that, start out with 5.

Thigh Contractions

   1. Lie flat on your back and straighten both legs.
   2. Roll a towel and place it under the ankle of the affected foot.
   3. This will automatically straighten the knees.
   4. Press into the towel with your ankle and you'll see that the knee gets straightened further.
   5. Hold this position for 5-10 seconds.
   6. Release, relax and repeat. Do 10 more of the same.

Mini Squats

   1. Do this exercise when your knees have gained a little more strength.
   2. Stand on both feet, making sure that the toes and knees are pointed in the front.
   3. Bend your legs ever so slightly.
   4. Now try and balance on one leg and at the same time, try and do a mini squat by bending at the knees and lowering yourself.
   5. Stop, if there is any excess pressure felt.
   6. Repeat 10 times on the affected side.

Knee Circles

   1. Stand on a firm ground and bend your knees slightly.
   2. Place your hands over both knee caps.
   3. Make small circles with your knees with your hands guiding them.
   4. The circles have to be done with deliberate action, making sure that your feet are not lifted off the ground. If they are, it means that you are adding too much pressure.
   5. Form these circles on both the right and left sides. Do about 10 on each side.

P.S. - It has to be noted that the kind of knee exercises recommended will be different for different patients depending on the severity of their condition. Do not start out on them without consulting a specialist.

Other than these specialized knee strengthening physical therapy exercises, other simple knee exercises after surgery like walking, swimming and cycling are also recommended as a part of the treatment. These further the overall recovery by making the knee joints and surrounding muscles stronger. The recovery from a knee injury or surgery depends from one person to the other, but with these exercises being brought into the picture, it definitely helps to speed the process.

Physical Therapy for Shoulder Bursitis

Shoulder Bursitis is a condition that is caused when there is a swelling and inflammation of the bursa. The bursa is a small pouch that is filled with liquid, which surrounds the tendons and bones in order to protect them (Present all over the body). In the confines of this sac, the tendons and bones are protected, as well as allowed a medium which brings about a smooth range of motion. The bursa therefore facilitates the motion of the joints. Yet there are times when the bursa around the shoulders can get affected and thereby lead to swelling and inflammation. This condition is known as shoulder bursitis. With it, it brings about a lot of pain, sensitivity and trauma. There emerges a need to undertake several exercises for shoulder bursitis as well so that the shoulder pain can be dealt with and the functioning of the shoulders restored to normal.

There are several stages of physical therapy for shoulder pain that are undertaken in order to treat this condition and restore normalcy. In the following sections we will look through the varied stages of physical therapy for shoulder bursitis.

Physical Therapy for Shoulder Bursitis - Shoulder Bursitis Treatment

Physical therapy aims at increasing the efficiency of the affected part in order to bring about normal functioning of the same. This then involves several stages that target the problem from different angles and hope to bring about positive results.

Before getting to the varied exercises that are involved in strengthening the shoulders and treating the shoulder pain and inflammation, there are several other factors that are brought into the picture as well. What do these involve?

    * Rest - Avoiding any action that could aggravate the pain and lead to the worsening of the condition.
    * Medication - Pain killers and muscle relaxers are administered such that they can lower the pain that is caused and help a person deal with the situation better.
    * Packs - Ice or heat packs are administered to lower the swelling and inflammation.

Along with these factors, a physical therapist will also administer certain other techniques that will lead to the treatment:

    * Change in Lifestyle - A change in one's lifestyle becomes important so that the possibility of a relapse, or an aggravation of the condition does not come about. This then involves understanding the kind of actions that have to be avoided as well as those that can lead to a strain of the area.
    * Posture Correction - A wrong posture normally leads to the emergence of this condition. Special correction exercise are administered for the same in this order.

While these factors are important for curbing the aggravation of this condition and bringing it under control, the most important section of the physical therapy are the exercises that are administered which help in restoring the strength and the functionality of the shoulder. In the following section, we will take a brief look at some of these exercises as a part of the shoulder bursitis treatment.

Physical Therapy Exercises for Shoulder Bursitis

Here are some of the shoulder bursitis exercise that are undertaken as a part of this therapy.

Shoulder Extension

   1. Lie on your back and keep your arms by your side.
   2. Join them above your chest and then extend them over your head.
   3. Ensure that the arms are not bent even when above the head.
   4. Count till 5 and bring to the original position. Repeat 10 times and do 3 sets during the day.
   5. This exercise can also be done while sitting by keeping the hands straight and then extending them above the head.

Shoulder Push Back

   1. Stand against a wall with your arms at the sides.
   2. Take the right arm and push it into the wall. Hold for 5 seconds and bring back to the original hand.
   3. Then take the left hand and repeat the same.
   4. Repeat 10 times on both sides.
   5. Do this exercise thrice in a day.

Shoulder Crawling

   1. Stand facing a door or a wall and then using your left hand fingers, start crawling up the door and go as far as you can manage.
   2. Keep the hand at the highest point for 10 seconds and then bring to the original position.
   3. Repeat the same on the other side.
   4. Bring in 3 sets in total during the day.

These are the varied factors that the physical therapy for shoulder bursitis will involve. Here's hoping you've got the required information to carry forth the treatment for the same.

Physical Therapy Exercises for Torn Meniscus

The cartilage that is placed on top of the tibia and in between the femur bone and the tibia is the meniscus. It is this cartilage which enables the gliding movement of the knee joint. Torn meniscus is a common knee injury. A person can suffer either from medial or lateral torn meniscus. This injury is often caused due to forceful twisting of the knee joint, which causes the femur to grind into the head of the tibia. It can either only pinch the tibia or it can tear the cartilage itself. It is seen, that this injury is often caused during athletic activities. Although it is one of the most common injuries, treating the injuries is not as difficult. Using the physical therapy exercises for torn meniscus accelerates the healing process.

Medical Exercises for a Torn Meniscus

When one talks about the rehab exercises for torn meniscus, one should not only concentrate on the knee joint. There should be exercises to work the muscles in the entire leg. It is important that the thigh muscles are strengthened, which in turn will help in healing the cartilage. The quadriceps and the hamstrings will help in increasing the mobility and flexibility of the knee joint, which in turn will help to repair the meniscus.

Exercise # 1
Tie ankle weights around the ankle, which has suffered torn meniscus. Make sure you initially start with lowest of the weight possible. Sit on a chair with your leg hanging. Do not touch the foot to the floor and hold the position for a few minutes. Slowly lower the leg and repeat the same on the other leg, as it will help in strengthening the other leg as well. Ideally this exercise should be repeated 2 to 3 times everyday.

Exercise # 2
The next of the knee strengthening exercises for torn meniscus are the leg lifts. Lie on your stomach with both the legs extended out straight. Gradually lift the affected leg up in the air and hold it there for a few seconds. Release and slowly lower the leg. Repeat the same on the other leg as well. This exercise should be repeated 5 to 7 times on both the legs.

Exercise # 3
This exercise is often a part of physical therapy for a torn meniscus after surgery. To do this exercise sit on a chair with another chair in front of you. Place a pillow on the other chair. Extend and place both the legs on the chair in front of you. In this position the knee will be at a raised angle. Gently try to push the knee towards the floor, however, make sure you are using only the muscles of the leg for the same. Hold this position for a few seconds before you release the position and repeat the exercise. Ideally the exercise has to be repeated 5 to 7 times about 2 to 3 times daily.

Exercise # 4
This exercise helps in strengthening the calf muscles, which in turn helps in healing the torn meniscus. Stand close to a chair for support. Make sure there is about 6 to 10 inches away from the chair. There should be hip width distance between your feet. Hold onto the back rest of the chair and slowly raise your heels off the floor and balance your weight on the balls of the feet. When you raise your heels make sure your knees are straight. Hold the position for a few seconds and then gradually release and repeat the exercise 3 to 5 times, twice daily.

Exercise # 5
The next of the exercise for torn meniscus is walking in waist deep water. It helps in rehabilitating the injured knee. Walking in water will cause no impact on the knee joint, but the resistance of water will help in strengthening the muscles of the leg. If the pain is not immense, you can try to run slowly in water as well.

These were some of the physical therapy exercises for torn meniscus. Before you practice any of the exercises, it is advisable to consult your physiotherapist about the same. When you are doing the exercises, if you notice any kind of pain, stop doing the exercise immediately and consult your physiotherapist about the same.