The most common prescribed medication for musculoskeletal problems or post surgical protocols are anti-inflammatory medications or NSAIDs. In a recent study it has come to the attention of researchers at the University of North Carolina in Chapel Hill that some of these medications can reduce the ability of tissues to handle an appropriate load force. Read the full story

The Spotlight section of our website is designed to collect a grouping of articles and posts that deal with a specific pathological condition or an area of focus in the field of Physical Therapy. Read the full story

This is the third installment of a three part series dealing with the 3 phases of healing during soft tissue lesions. The first installment focused on guidelines for the acute phase of healing followed by a second installment focusing on the guidelines for the subacute stage of healing.

The Chronic stage of healing is the last step toward a completely healed scar over the area of the lesion and it is the stage where the scar begins to add tensile strength.

The Chronic Stage (maturation and remodeling) demonstrates no signs of an inflammatory response. Contractures may be present as well as possible areas of adhesion left over as a residual effect from the acute response. Muscle weakness may continue to exist in this stage which can limit function

Since the tissue is beginning to remodel it needs the appropriate stimulus to ensure it aligns properly with the line of force. Realignment and stimulus along with strengthening is the basis for the interventions during this phase of healing. Read the full story

We begin this post by defining the subacute stage of healing for soft tissue injuries. This is the second part of a three part series on soft tissue lesion management. The first post entitled Guidelines for Acute Stage Interventions dealt with days 4-6 of initial injury.

The Subacute Stage (healing and repair) the symptoms of pain, swelling and redness will be much less and will eventually be absent. The patient’s ROM will be very specific to end range tissue tension. Meaning the patient will have little to no pain during most of the range until tension is applied at the end of a movement to the tissue.

The subacute stage occurs in the first 10-17 days but it can last from 14-21 depending on the type of tissue that is injured. Read the full story

How many times has this scenario been repeated in out patient clinics. A patient comes in with the goal to improve the ability to go from sitting to standing. Immediately the therapist begins to use open chain exercises such as short or long arc quad sets to strengthen the knee. The entire session proceeds and the act of going from sitting to standing is never performed.

This is just one example among many that takes place in clinics each and every day. I agree that sometimes muscle setting exercises are important to maintain the osteokinematics of the joint however it should not be the primary focus of treatment. PT’s need focus on functional goals and use those as a basis for strengthening. Read the full story

I recently had a discussion with a friend of mine about his recent workouts. He is currently training in order to pass the standards for the North Carolina State Troopers.

New applicants must pass rigorous physical and mental testing. Basically new applicants must perform pull ups, push ups and sit ups repetitions all in a time period of about a minute. The amount of repetitions determines your score along with the written exam and run time. The run distance is about 1.5 miles. Applicants must also be under 13% body fat (men).

I was really excited for him and began to ask him how the training was coming along. He began to describe how he worked legs one day, then back another day, then biceps another day and finished up the week with a couple of spin classes.

This statement really surprised me. He was performing a low repetition workout with isolated body part training with only two small cardiovascular sessions each week, however his test is based on high endurance repetitions with a strong emphasis on cardiovascular fitness.

He then proceeded to ask me what I would do. I told him that if I were him my workout would consist of time based push ups, pull ups and sit ups followed by a 1.5 mile run. He laughed and said that I was just doing the fitness test.

He really thought that in order to pass this fitness exam he must gain a large amount of muscle for strength and train like a bodybuilder in order to lose the body fat. I have found that this is a common problem.

When I worked as a personal trainer many women would refuse to perform weighted exercises because they didn’t want to bulk up.

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