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Physical Rehabilitation

Premiere Spine & Sport offers specialized rehabilitation services for patients suffering general orthopedic problems and sports injuries.  Our philosophy is to assist (rather than interfere with) the body’s natural healing abilities in order to restore the functional movements our human body was designed to perform.  The primary goal is to expedite recovery and to restore range of motion, muscular strength, endurance, neuromuscular control, and cardiorespiratory endurance by reducing inflammation and enhancing the repair processes.  Special consideration is given to prevent the recurrence of injury and tissue overload by incorporating individualized home-program instructions and sport-specific exercises.

The clinicians and therapists in the office often incorporate one or more of the following therapies into your treatment plan: soft tissue mobilization; PNF muscle stretching; corrective exercise; and functional movement assessments.  While effective individually, these therapies also work symbiotically, enhancing treatment effectiveness and significantly reducing recovery time.

Soft Tissue Mobilization

Soft tissues include muscles, tendons, ligaments, bursae, fascia, and nerves.  The treatment of these structures is called soft tissue mobilization.  When trauma occurs, whether from a single traumatic event or repeated microtrauma, inflammation follows.  The inflammation leads to scar tissue formation, decreasing the ability of the muscle to lengthen and contract normally, which negatively impacts range of motion.  The effect can be very specific within a muscle or can affect entire muscle groups leading to faulty biomechanics.  The scar tissue can also cause pain and predispose you to re-injury. 
The purpose of soft tissue mobilization is to restore normal texture, tightness, flexibility and function to the affected tissue.  We utilize several techniques such as Active Release Technique (ART®), Graston Technique®, Myofascial Release, and HansON Muscle Technique.
Active Release Technique (ART®) – involves placing tension on the affected tissue and then instructing the patient to move through a range of motion in order to lengthen the tissue and remove microscopic scar tissue.
Graston Technique® – is an instrument-assisted technique designed to detect and treat adhesions, scar tissue and other restrictions.  The clinician uses the instruments to break up cross-fiber scar tissue links, splay these fibers and increase fascial mobility.  
Myofascial Release – focuses on removing fascial adhesions by using gentle sustained pressure applied in a specific direction.  Fascia is the tough connective tissue that surrounds most structures in the body providing support, protection, and improved shock absorption.  Myofascial release is beneficial for treatment of chronic pain, peripheral nerve entrapments, and various other injuries.
HansON Muscle Technique – involves identifying the primary muscles with the most accumulated tension causing pain.  Once a primary reflex point has been localized, it is released of its excess tension with deep friction massage.  Deep friction massage uses deep pressure with specifically directed movement in order to remodel adhesions, allowing the soft tissue to become more flexible, pliable and functional.

PNF Muscle Stretching

Proprioceptive Neuromuscular Facilitation (PNF) muscle stretching is an advanced form of stretching technique that requires assistance to perform.  PNF involves stretching a muscle or group of muscles to its end range, followed by contracting the same muscle isometrically for at least six to ten seconds, and then stretching it further to its new end range.

Aside from being safe it is considered to be the fastest and most effective way to increase range of motion.  PNF is commonly used to enhance both active and passive range of motion in order to improve muscular strength and coordination.

Corrective Exercise

Corrective Exercises are designed to make positive changes in the way you move and focus on the underlying cause of dysfunction by targeting and correcting muscle imbalances caused by weakness.  These exercises do not focus on building bulky, superficial muscles (e.g. six-pack abs).  Instead, they focus on strengthening the core, stabilizing muscles of the body.  Strengthening the stabilizer muscles will reinforce the joints, creating a stronger, more balanced body.  Corrective exercises look very different from the typical gym exercises.  Many of them involve small movements with little to no equipment and can be easily adapted for a home program.

For athletes we also design integrated sports-specific programs that will help them accomplish their sports performance goals and reduce their risk of injury. These programs may include flexibility training, cardiorespiratory training, core training, balance training, and integrated multiplanar resistance training. 

Functional Movement Assessment

Functional movement is based on real-world situational biomechanics and is defined by the ability to move the body with proper muscle and joint function for efficient, pain-free movement. Functional movements take place in multi-planes of motion with the use of multiple joints which place demand on the body’s core musculature and innervation.  These movements require the firing of multiple muscle groups in various positions, ranges of motion and varying intensity to achieve a common goal.

The Functional Movement Screen (FMS) is an innovative system developed to evaluate movement pattern quality in healthy individuals.  The FMS is comprised of seven movement tests that require a balance of mobility and stability and will quickly demonstrate limitations and asymmetries in basic movement patterns.  Muscle tightness/weakness, previous injuries, or bad posture are examples of factors contributing to dysfunctional movement, which increases an individual’s risk of injury and impairs his or her ability to perform.  We use the FMS not just to identify but also correct functional limitations by improving durability, flexibility, physical capacity and movement competency.

If musculoskeletal pain is present, we utilize the Selective Functional Movement Assessment (SFMA) to further identify and assess impairments contributing to the disability. Pain is typically a symptom of dysfunctions elsewhere in the kinetic chain. Therefore the goal of the SFMA is to identify the most dysfunctional movement pattern and break the pattern down to identify the underlying cause of the dysfunction.