Services

Orthopedics

Services

General Orthopedics

Sports injuries, joint pain, spinal disorders, work injuries, and more

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Treatable Conditions (including but not limited to):

  • Post-Operative Rehabilitation
  • Joint Replacement
  • Sports Injuries
  • Arthritis
  • Back and Neck Pain
  • Knee Pain
  • Ankle and Foot Pain
  • Frozen Shoulder
  • Muscle Weakness

Generally, any musculoskeletal-related pain issue affecting your everyday function can be treated by a physical therapist.

Physical Therapists are able to diagnose, manage and treat disorders and injuries of the musculoskeletal system as well as rehabilitate patients post orthopedic surgery.

Our therapists utilize joint mobilization/manipulation, strength training, and core stabilization routines as well as various modalities (electric stimulation, ultrasound, dry needling, hot packs and cold packs) to expedite recovery and improve overall well-being.

All of our physical therapy treatments are geared toward improving overall functional mobility and improving our patients' quality of life.

Crossfit/Lifting Injuries

Services

Crossfit/Lifting Injuries

Do you ever experience shoulder pain with snatches/jerks/overhead squats, back pain after doing deadlifts, knee pain during or after squatting, and or limited mobility with gymnastic drills?

If any of these sounds familiar to you or maybe you have a different concern, one of our certified lifting specialists can help you.  Seth, Jessica T.  and Caroline are level 1 USA Weightlifting Certified instructors

 

At Cornerstone Physical Therapy, our therapists have been trained in evaluating, diagnosing, and rehabilitating a wide array of injuries that can occur from participating in CrossFit and other weightlifting activities.

We offer one-on-one sessions with one of our lifting specialists to work with you to develop a plan of care based on your specific needs

Common  injuries treated:

  • Shoulder pain
  • Low back pain
  • Muscular Strains
  • Neck pain
  • Knee pain

Any of there injuries can limit your ability to perform at optimal levels of performance. If you are not experiencing any pain but would have concerns regarding your form and technique with lifting see our Lifting Assessment tab on the Homepage under services offered in our Woodfin clinic.

Lifting Assessment

Services

Lifting Assessment

At Cornerstone Physical Therapy, our lifting specialists will perform a lifting assessment on you to evaluate your form and technique with feedback on how to improve your form and efficiency.

We offer one-on-one 60-minute sessions with one of our certified lifting specialists. Our clinic offers a Crossfit rig, drop mat, and lifting equipment up to 300 pounds to allow for a wide variety of assessments.

One session: $100

Three sessions: $250

If significant issues are found that cannot be resolved within three sessions, we will discuss physical therapy and how it could benefit you. Many insurance policies will cover physical therapy.

Orofacial/TMJ Disorder

Services

Orofacial/TMJ Disorder

In a study of over 45,000 American households, almost 22% experienced orofacial pain in the past six months. Nearly 40 million adult Americans experience orofacial pain on a regular basis. In addition, many children experience pain in their face, jaw (TMJ pain), and suffer from daily headaches.

Do you have TMD? Use this quick TMD Pain Screener to see if you could benefit from a consultation.

Treatable Conditions (including but not limited to):

  • Chronic Headaches/Migraines
  • TMJ Disorders
  • Trigeminal Neuralgia
  • Bell's Palsy
  • Post Surgical Orofacial Procedures (i.e. orthognathic surgery and mandibular fracture)
  • Cervical Spine Disorders
  • Asymmetric Mandibular Movements

South Asheville Location

East Asheville Location

Signs and Symptoms

Craniomandibular disorders (CMD) are characterized by a combination of symptoms that may include pain, tenderness and dysfunction of the temporomandibular joint (TMJ), the mouth and the occlusal contacts (how the teeth touch with closing), the cervical spine, and the muscles of chewing. Temporomandibular disorders (TMD) are usually treated by both a dentist who specializes in TMJ dysfunction and a physical therapist.

  • Headaches that begin in the back of the neck or the sides of the head
  • Popping or clicking in one or both sides of the jaw
  • Loss of jaw motion (normal movement is 44 mm)
  • Facial Pain
  • Difficulty biting or chewing
Orofacial
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How can Orofacial Physical Therapy Help?

Our Orofacial Physical Therapy approach includes an extensive examination of the jaw, mouth, neck and spine.

Following the initial physical therapy examination, the therapist develops a comprehensive treatment plan, which forms the basis of the physical therapy program.

 

Can any Physical Therapist Treat TMJ?

Yes. By State Regulations, any licensed Physical Therapist can treat TMJ dysfunction, but there is minimal training given for this complex problem in physical therapy school.

There are multiple continuing education courses that train a therapist to specialize in this area which goes beyond the basics. Before scheduling an appointment with any physical therapist regarding your TMJ issue, you should ask if the therapist has taken any continuing education classes specifically dealing with TMJ dysfunction as well as how often they are seeing TMD patients.

At Cornerstone Physical Therapy, our orofacial pain specialist, Seth J. Fibraio, is the only physical therapist in the Asheville area with advanced training in orofacial physical therapy.

Seth Fibraio has completed advanced coursework with Dr. Mariano Rocabado, one of the world's leaders in this field. Seth also received his Clinical Doctorate in Physical Therapy with a concentration in craniomandibular disorders.

Please call our office with any questions or to schedule an appointment.

Pelvic Health

Services

General Pelvic Support

It is our mission at Cornerstone Physical Therapy to improve awareness and availability of resources for pelvic conditions in our community.

We know that most people have had little experience with physical therapy and many people are not aware that physical therapy is a conservative and successful treatment for many pelvic conditions.

Pelvic physical therapy has been an area of specialization for more than 30 years and has been the topic of numerous research studies, which have demonstrated its effectiveness for a wide variety of conditions in both men and women. There are few contraindications for physical therapy treatment and virtually no side effects.

PELVICwide

Treatable Conditions:

  • Post-Hysterectomy/Post-Surgical Pain
  • Stress, Urge and Mixed Urinary Incontinence
  • Urinary Urgency
  • Overactive Bladder
  • Coccyx Pain
  • Fecal Incontinence
  • Pelvic Pain
  • Pelvic Organ Prolapse Management
  • Dysapareunia (pain with intercourse)
  • Vulvodynia and Vulvar Vestibulodynia Syndrome
  • Painful Bladder Syndrome/Interstitial Cystitis
  • Post-Partum Pain
  • Pregnancy-related Pain: hip, back, pelvic, etc.
  • Constipation
  • Abdominal Pain
  • Genital Pain in Males and Females
  • Post-Prostate Surgery Pain/Incontinence

What You May Expect During Your Physical Therapy Session:

A pelvic floor physical therapy evaluation is very different from the evaluation you receive from your doctor. Physical therapists are experts in assessing muscular tone, strength, flexibility, and endurance, as well as the general health of the musculoskeletal system.

Our evaluation of your pelvic floor is very detailed and comprehensive, and the exam often includes an assessment of your back, hips, and any other region of your body that may be involved.

 

Why Choose Cornerstone Physical Therapy:

  • Skilled services in a safe, comfortable and private environment
  • Excellent communication with your health care providers
  • Sound and knowledgeable advice and education about your condition
  • A comprehensive assessment and an individualized rehabilitation program
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Some Pelvic Health Facts and Resources

Urinary Incontinence (UI), Urgency and Frequency

    • Affects over 200 million people worldwide, with 1 in 4 adult women experiecing UI of varying degrees
    • Approximately 20% of men will experience urinary urgency and frequency during their lifetime
    • UI is often associated with aging, but it is NOT a normal/natural consequence of aging
    • According to the International Continence Society, pelvic physical therapy should be the first treatment option for urinary incontinence.
    • Pelvic physical therapy has been shown to produce a improvement in symptoms in over 85% of cases

Sources: (1) M.R. Knorst et al. 2013;17(5):442-449. doi: 10.1590/S1413-35552012005000117     (2) A.P. Kruger et al. 2011;15(5):351-356. Rev Bras Fisioter.

Pelvic Pain

    • Myofascial pelvic pain (MFPP) is frequently unrecognized and untreated component of chronic pelvic pain.
    • As high as 85% of women with chronic pelvic pain have musculoskeletal dysfunction and postural changes that contribute to their pain
    • Myofascial pelvic pain can be effectively treated with a variety of phyiscal therapy techniques

Source: E.A Pastore and W.B. Katzman. 2012;41(5):680-691. doi.10.1111/j.1552-6909.2012.01404.x

Pelvic Organ Prolapse (POP)

    • It is estimated that up to 50% of women will experience differing degrees of pelvic organ prolapse (POP)
    • Women with POP have reduced strength in their pelvic floor muscles
    • Guided pelvic floor muscle training has been shown to significantly improve prolapse symptoms with no adverse side effects

Source: I.H. Braekken, PhD, PT, et al. 2010;203:170e1-7. doi:10.1016/j.ajog.2010.02.037

What are Kegels?

  • Kegel is a contraction of your pelvic floor muscles and is more accurately called a “pelvic muscle contraction” or a “pelvic muscle exercise”
  • Over 50% of women do not perform the Kegel exercises correctly and up to 25% of women perform them in a way that PROMOTES incontinence
  • When performed properly, Kegel exercises will help you stay active and in control of your bladder and bowel. They will improve your pelvic support, which is especially important with prolapse, after gynecological surgery and childbearing.

Constipation/Dyssynergic Defecation

    • Dyssynergic defecation is defined as the inability of patients to relax the muscles required for successful defecation.
    • Biofeedback, as a part of pelvic physical therapy treatment, has been shown to be effective in treating this and many other conditions

Source: M.Sherburn et al. 2011;30:317-324. doi:10.1002/nau.20968

For more information on pelvic health physical therapy, check out www.womenshealthapta.org.

If you have any questions, comments or concerns, please don't hesitate to contact us. You are more than welcome to speak with one of our specially trained therapists at both locations.

Lymphedema/Post Oncological

Services

Lymphedema/Post Oncological

Following participation in treatment for cancer, secondary conditions may arise that contribute to pain and difficulty with returning to normal daily activities.  Common diagnoses include, but are not limited to, lymphedema, axillary cording, myofascial pain syndrome post mastectomy or lumpectomy, postural syndrome, balance disorder associated with peripheral neuropathy following chemotherapy, scar tissue restriction, as well as tension headaches.

Our therapists utilize a hands-on approach with one on one treatments sessions in order to provide individualized treatment sessions and assist with regaining normal mobility.  Once the cancer is treated, let us help you get back to the activities you enjoy with the least restriction possible.

What Is Lymphedema?

Lymphedema is an accumulation of fluids and protein in the tissue that develops as a result of a malfunction of the lymphatic system. Lymphedema is a chronic condition that causes painful swelling in the legs, arms, face, or trunk.

How Lymphedema Therapy Can Help

Lymphedema therapy can help provide relief from swelling as well as training to help manage symptoms in everyday life. We use a combination of treatment methods, including:

Complete Decongestive Therapy:

Phase one includes

  • Manual lymph drainage - a gentle technique that stimulates the lymphatic vessels in order to improve the vessel activity and assist with moving fluid out of the congested limb.
  • Compression wrapping - utilizing specific bandages to provide graded compression to decongest the limb. The wrapping will stay on consistently until the patient's next visit when they will be re-wrapped. This phase of treatment must be consistent in order to reduce the size of the limb, not make it smaller.
  • Exercises - designed to help the muscular system pump lymph fluid away from the affected area;
  • Training in a home management program.

Phase two includes

  • Transition to independent maintenance program
    • Includes recommendation on type of compression garment in order to maintain size of decongested limb
      • May include daytime and/ or nighttime compression garments
  • Transition to independence with self-manual lymph drainage
  • Transition to independence with home exercise program

What You May Expect During Your Lymphedema Therapy Session:

Lymphedema treatment utilizes Complete Decongestive Therapy (CDT), a combination treatment that includes:

  • Evaluation:
    • A comprehensive evaluation will be performed to collect objective information on the current status of the patient. This includes but is not limited to:
      • Range of motion measurements
      • Circumferential measurements of the involved and uninvolved limbs in order to objectively gain an understanding of the amount of fluid accumulation
      • Strength measurements
      • Functional movement analysis
      • Skin integrity check
      • Postural assessment
    • After the evaluation is completed the plan of care will be discussed with the patient based on the findings from the evaluation.
      • If it is decided that the patient will benefit from complete decongestive therapy, then there will be a list of supplies provided to the patient that they will need to purchase in order to participate in the compression bandaging portion of the treatment.
      • If compression bandaging is not necessary the patient may be recommended to participate in a less aggressive program that utilizes only manual lymph drainage, potential use of kinesiotaping, use of compression garment and exercise.

Meet Our Lymphedema Specialist, Dr. Jessica Grochowsky, PT, DPT, MTC, CLT

Jessica graduated from Stetson University with her Bachelor's in Rehabilitative Studies in 2006 and completed her graduate work at the University of St. Augustine and earned a doctorate of Physical Therapy in 2010.

Her continued education includes advanced certification in Manual Therapy through the University of ST. Augustine in 2012, she then became a Certified Lymphedema Therapist through the Academy of Lymphatic Studies in 2014, and in 2017 finished her certification in Dry Needling through Myopain Seminars. Additionally, she has taken continuing education courses in the treatment of vestibular disorders, spine-related dysfunction, sacroiliac join dysfunction and extremity dysfunction.

Lymphedema Resources

For more information on lymphedema physical therapy, check out www.moveforwardpt.com.

If you have any questions, comments or concerns, please don't hesitate to contact us.

Massage

Services

Massage

At Cornerstone Physical Therapy, we offer a variety of massage options for you to choose from whether you are looking to relax and de-stress or looking to find relief from pain.  Our licensed massage and bodywork therapist, Ashley, will customize your treatment based on your individual needs.  We also work with companies who would like to offer our massage services in house to their employees.

Massage Services:

Swedish:

  • Enjoy a flowing style that promotes relaxation while improving circulation, range of motion and releasing muscle tension.

45min/60min/90min for $45/$60/$90

 

Deep Tissue/Structural Bodywork:

  • This type of bodywork specifically focuses on reducing pain and tightness within the soft tissue layers by achieving balance in the body.

45min/60min/90min for $55/$70/$100

 

Customized Integrated Massage:

  • A massage designed according to your specific needs to include a combination of Swedish, Deep Tissue, Trigger Point therapy and other modalities.

45min/60min/90min for $60/$75/$105

 

Head, Neck & Shoulders:

  • Relax with specific techniques on your face, scalp, neck and upper back to help relieve tension headaches.

45min for $50

 

Lower Body Focus:

  • Relax with specific techniques focused on your lower back, pelvis, hips, and legs to help release tension and tight muscles in your lower body.

45min for $50

At South Asheville

Scheduling & Package Pricing:

 

We offer a variety of customized package deals for our massage therapy services as well as our other wellness services.

Please contact our office for specific package pricing.

**Monthly massage specials must be used within 30 days of purchase.**

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Running Assessment

Services

Running Assessments

At Cornerstone Physical Therapy, our running specialists focus on running analysis, run-specific training, and strengthening to help you achieve your goals.  We offer one-on-one sessions with a running specialist and work with you to develop a personalized home exercise program based on your specific needs.

One session $100
Three sessions $250

If significant issues are found that cannot be resolved within these sessions, we will discuss physical therapy and how it could benefit you. Many insurance policies do cover physical therapy treatment.

What We Offer:

  • Running analysis
  • Gait modifications, strengthening, and mobility work to improve your running speed and efficiency
  • Education on how to prevent and treat running injuries
  • Education on the proper warm up and cool down
  • Guidance on safe return to running

Specific Conditions Commonly Treated:

  • Achilles Tendonitis/Tendinopathy
  • Plantar Fascitis
  • Patellar Tendonitis/Tendinopathy
  • IT band syndrome
  • Patellofemoral Pain Syndrome
  • Hip pain

 

Meet Your Running Specialists

Doug Daniel, DPT, has a passion for trail and road running and enjoys competing in and studying both. Doug has completed post-graduate coursework in running mechanics, running injury rehabilitation, and dry needling. He specializes in the management of lower extremity tendinopathy, including problems with the Achilles, hamstring, and patellar tendons.

Jessica Tripp, DPT, began her running career while in physical therapy school and she has now completed 5 half marathons along with a handful of local races. Jessica has completed 54 hours of dry needling courses and is set to complete a specialized running and sports certification through the North American Sports Medicine Institute.

 

Kid's Clinic Warm-Up Handout

Click here to access the full version of our Kid's Clinic/Girl's On the Run warm-up designed by one of our therapists to help your kids become healthy, happy and motivated runners.

Research:

Stride Rate

"Subtle increases in step rate can substantially reduce the loading to the hip and knee joints during running and may prove beneficial in the prevention and treatment of common running-related injuries."

Heuderscheit BC et al: Effects of step rate manipulation on joint mechanics during running. 2011

Patellar Tendinopathy

"(in a randomized control trial comparing specific exercise to cortisone injections for patellar tendinopathy) The main findings of the present study were that the different treatment regimes had similar short-term clinical effects and clinical patient satisfaction, but these parameters differed on a kong-term basis. Specifically, ECC (Eccentric Exercise) and HSR (Heavy Slow Resistance exercise) maintained their clinical improvements whereas they deteriorated in CORT at the half-year follow-up.

Kongsgaard, M., Kovanen, V., Aagaard, P., Doessing, S., Hansen, P., Laursen , A. H., Kaldau, N. C., Kjaer, M. and Magnusson, S. P. (2009), Corticosteriod injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scandinavian Journal of Medicine & Science in Sports, 19: 790-802. doi:10.1111/j.1600-0838.2009.00949.x

Plantar Fasciitis

"The aim of this study was to investigate the effectiveness of shoe inserts and plantar fascia-specific stretching vs shoe inserts and high-load strength training in patients with plantar fasciitis. Forty-eight patients with ultrasonography-verified plantar fasciitis were randomized to shoe inserts and daily plantar-specific stretching (the stretch group) or shoe inserts and high-load progressive strength training (the strength group) performed every second day... A simple progressive exercise protocol, performed every second day, resulted in superior self-reported outcome after 3 months compared with plantar-specific stretching. High-load strength training may aid in quicker reduction in pain and improvements in function."

Rathleff, M. S., Mølgaard, C.M., Fredberg, U., Kaalund, S., Andersen, K. B., Jensen, T. T., Aaskov, S. and Olesen, J. L. (2015), High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scan J Med Sci Sports, 25: e292-e300. doi:10.1111/sms.12313

Vestibular Rehabilitation

Services

Vestibular Rehabilitation

Greater than 30% of people over the age of 60 have or will have dizziness.2 Not only is dizziness an unsettling feeling that can make one nauseated, it places a person at significant risk. Falls are the leading cause of accidental death in persons over 65 years.2 When a person has dizziness or vertigo, there is a 1.14 fold (114%) increase in the incidence of fractures with falling.3

Dizziness can also be very disabling for a person. As seen in the graphs below, dizziness is one of the leading causes of disability for persons above the age of 65.4 Dizziness can also contribute to other diseases. People who are dizzy are typically more fearful of falling. A person fearful of falling is more likely to reduce their mobility, staying in a chair or in bed. This results in deconditioning, frailty, and immobility, further increasing the risk of physical and mental illness.

Percentage of disability attributed to dizziness

 

At South Asheville

At East Asheville

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Mueller et al.

BPPV (Benign Paroxysmal Positional Vertigo)

  • Most common cause of vertigo (63% people over 65 years with dizziness)1
  • Makes you feel like the world is spinning around you or your head is spinning
  • Most commonly occurs with laying down, rolling over in bed, and bending over
  • Duration most commonly between 0-60 seconds, but can last up to 1-2 minutes
  • For more information on BPPV and its treatment, please follow this link BPPV link

Vestibular Disorders

  • Caused by:
    • Infection
    • Inflammation
    • Disease
    • Trauma
    • Medication
  • Severe vertigo that lasts for 24 hours to a few days
  • Residual imbalance and dizziness
  • Difficulty keeping balance in a dark room, on uneven surfaces, or when turning head quickly

Vestibular disorders can be treated with:

  • Gaze stabilization exercises: eye and head/neck coordination exercises
  • Habituation exercises: gradual exposure to movements
  • Balance and gait training

Cervicogenic dizziness

  • Dizziness can be a result of dysfunction of the neck. 83% of whiplash patients reported that dizziness began immediately after or within one week of their accident.5 Patients often complain of disequilibrium, lightheadedness, or “wobbly head.” Typically have neck pain and limited or excessive range of motion.
  • This can be treated through manual therapy, strengthening, and proprioceptive training.

Concussions

  • No two concussions are alike in presentation or recovery. Concussions can cause dizziness due to the central injury to the brain, injury to the vestibular organs, and/or injury to the neck. Each of these alone may cause dizziness symptoms, but with a concussion, all factors may be present.
  • Concussions can be treated through vestibular rehabilitation, manual therapy, strengthening, proprioceptive training, and metabolic conditioning.

 

 

  1. Chau AT, Menant JC, Hübner PP, Lord SR, Migliaccio AA. Prevalence of Vestibular Disorder in Older People Who Experience Dizziness. Front Neurol. 2015;6.
    doi:10.3389/fneur.2015.00268.
  1. Fernández L, Breinbauer HA, Delano PH. Vertigo and Dizziness in the Elderly.  Front Neurol. 2015;6. doi:10.3389/fneur.2015.00144.
  1. Liao W-L, Chang T-P, Chen H-J, Kao C-H. Benign Paroxysmal Positional Vertigo Is Associated With an Increased Risk of Fracture: A Population-Based CohortStudy. J Orthop Sports Phys Ther. 2015;45(5):406-412.
    doi:10.2519/jospt.2015.5707.
  2. Mueller M, Strobl R, Jahn K, Linkohr B, Peters A, Grill E. Burden of disability attributable to vertigo and dizziness in the aged: results from the KORA-Age study. Eur J Public Health. 2014;24(5):802-807. doi:10.1093/eurpub/ckt171
  3. Treleaven J, Jull G, Sterling M. Dizziness and unsteadiness following whiplash injury: characteristic features and relationship with cervical joint position error. J. Rehabil. Med. 2003;35(1): 36-43.

Treatment Modalities

Services

Treatment Modalities

Dry Needling

What is Dry Needling?  Dry needling is the use of a solid filament needle to target myofascial trigger points. A myofascial trigger point consists of multiple muscle contracture knots, which are related to the production and maintenance of the pain cycle.

How Does Dry Needling Work?  Inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit so-called "local twitch responses."

What Can Dry Needling Treat?  Dry needling can be used for a variety of musculoskeletal conditions. These include (but are no limited to) neck, back, and shoulder pain, arm pain, headaches including migraines and tension-type headaches, jaw pain and leg pain.

Is the Procedure Painful?  Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief painful response. Some patients describe this as a little electrical shock; others feel more of a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.

What are the Side Effects?  Most patients report soreness after the procedure, best described as muscle soreness over the area treated and into the areas of referred symptoms. Typically the soreness lasts between a few hours to a couple of days. Patients may also experience localized bruising.

What Should I Do After Having Dry Needling?  Our recommendations vary depending on the amount of soreness you have and on the individual response to treatment. Recommendations may include applying heat, gentle stretches and modification of activities.

How Long Does it Take to Start Working?  Typically it takes several visits for a positive reaction to take place. We are trying to cause mechanical and biochemical changes without any medications.

 

Joint Manipulation

Joint manipulation is the passive mobilization of synovial joints in an effort to achieve a therapeutic effect. Effects include temporary relaxation of surrounding muscle and intra-joint pressure. This consequently can increase passive range of motion of the targeted synovial joints. With a high-velocity low-amplitude force, the capsule of a joint (containing synovial fluid) can be deformed causing a change in pressure within the joint space. The effects are temporary though positive and can allow for freer less painful motion during therapeutic exercise.

https://www.apta.org/StateIssues/Manipulation/

Myofascial Release

Myofascial release is an effort to alter connective structures by stretching, or mobilizing adhesive tissues. The therapist moves slowly through the layers of the fascia causing a change to the fibers within. This is done either by hand or with the use of special therapeutic tools.

Instrument Assisted Soft Tissue Mobilization (IASTM) has gained popularity of late due to its low impact and effort for the relief of myofascial pain. It is often performed during motion and may even be used during a painful but tolerable motion to cause an effect during active stretch and relaxation of tissue.

Neuromuscular Re-education

Muscle movement patterns can be affected when nerves or muscles experience injury or have a painful stimulus of any sort. Neuromuscular re-education is a technique used to restore movement patterns through the repetive motion to retrain control centers of the brain and reflexive actions of the spinal cord to perform in accordance with what is intended.

The strength of a muscle is dependent on many factors:

    • anatomic and physiological status of the muscle fibers at the time of contraction
    • number and synchrony of the contracting fibers
    • number and frequency of nerve impulses reaching the muscle fibers
    • functional status of the neuromuscular junctions
    • structural and functional condition of the tissues surrounding the muscle fibers, such as blood vessels and connective tissue


O. Leonard Huddleston, M.D., Ph.D. 1954;156(15):1396-1398. doi:10.1001/jama.1954.02950150018005.

The effectiveness of a treatment may address any or all of the above elements to elicit a more powerful, safe muscle contraction.

Therapeutic Exercise

Directed guidance through exercise designed specifically to address patients' dysfunctions such as a movement disorder, muscle weakness, lack of balance or reduced endurance. Each patient will have their own set of exercises to challenge their neuromuscular system specifically.

Taping

Our therapists utilize three different types of tape: DynamicKinesiotape, and rigid types such as the Leuko brand. The various tapes may be used to stabilize a joint, restrict excessive joint motion or increase proprioception of taped area. This technique can be surprisingly effective to increase pain-free ROM. Its effectiveness is reduced after 3-5 days of use but can be worn in the shower, during exercise or any other daily activities.