While we are able to treat patients with all physical therapy related diagnoses, our physical therapists specialize in and encourage patients to be treated at S.O.A.R. Physical Therapy when they have orthopedic diagnoses such as:
If you are not clear whether your problem is appropriate for our care, please call or e-mail us with your questions. We will get back to you with answers to your questions as soon as one of our therapists is available.
A listing of some of our unique and specialized programs follows:
Orthopedic rehabilitation encompasses a wide range of injuries and problems involving the joints, muscles, tendons, ligaments, bones and peripheral nerves. In physical therapy we work to resolve pain, limited motion, gait problems, weakness, dizziness and instability, loss of function, and to prevent recurrence. While trained in all areas of physical therapy, each of the therapists at S.O.A.R. specialize their practice in the area of orthopedic rehabilitation.
Athletic injuries are essentially orthopedic injuries which have a sport specific component. Because the function of athletes requires more strength and speed for more elite motor control, it can be more difficult to identify problems early and requires higher training levels to fully restore sport activities. Screening and diagnosis can be less obvious than with non-athletes because complaints only appear with high level function. So our examination methods of your injury must be as reliable and valid as possible. With athletes, and all of our patients, we employ examination and treatment methods that are based on the best evidence available in our professional literature. The higher level training of S.O.A.R. physical therapists provides us with these additional skills. Our programs are uncommonly effective at returning athletes to their sport quickly and preventing re-injuries.
Throughout the year, S.O.A.R. Physical Therapy provides free community education seminars on topics of:
- Falls Prevention
- Hip and Knee Joint Replacements
- Shoulder Injuries & Rehabilitation
- Spine Pain - Causes, Correction and Prevention
These programs are routinely done on Saturdays at our Sea Girt location. At your request, they can also be done at different times at your location. Please call us if you are interested in sponsoring one of our seminars.
For people that have completed a physical therapy program at S.O.A.R., we offer two options to assist you in staying well. Neither is physical therapy, skilled care or therapeutic care. They are not substitutes for physical therapy, skilled care or therapeutic care. Therefore, neither is covered by health insurance. The client goal of participation in them is to minimize the likelihood of regression or recurrent injuries. They are both forms of a maintenance program.
An After-Care Program (ACP) is available when your therapist feels that continued success is only dependent on you performing continued exercises. The ACP is a self directed exercise program at S.O.A.R. instead of or in addition to what you can do at home. It provides you with an opportunity to continue the program that was established by your physical therapist on a maintenance level in the environment and with the equipment that you are already familiar.
For people that need to maintain joint and/or soft tissue mobility, we also offer The Manual Therapy Maintenance Program (MTMP) where your therapist can continue some of the manual techniques they were performing while you were receiving physical therapy. It is an adjunct to your home exercise maintenance program after you have completed the goals of your physical therapy program. Participation allows you to receive hands-on assistance in avoiding or preventing a decline in mobility.
For further information about either maintenance program, speak with your physical therapist when you are near completion of your physical therapy program.
Spinal rehabilitation refers to correcting problems with your neck or back. It is a subspecialty of orthopedics. Because of the unique structure of the spine and special problems related to this area, specialized training is necessary to ensure appropriate treatment.
Because the majority of spinal problems are mechanical, relating to specific activities, postures, and habits of the patient's lifestyle, a mechanical solution is necessary. A thorough evaluation will be performed to identify movements, positions, and activities that both aggravate and relieve the condition.
Eighty percent of people have one or more significant episodes of neck or back pain at some time in their lives, many have several. The majority of spinal pain can be placed in one of three syndromes described by the McKenzie approach to spinal care. Each has a different method of resolution. The emphases of the program are:
- Spend the necessary time to identify which of the syndromes apply to your type of spinal pain.
- Teach the patient what they need to know to stop aggravating and start resolving their pain.
- Emphasize the necessary self-treatment techniques for the prevention of future episodes of pain.
Postural Syndrome - The simplest of McKenzie's syndromes, this is caused by slouched postures that place stress on and cause pain to spinal ligaments and soft tissues. It usually occurs in children and treatment includes only one or two sessions that identify the syndrome and teach the patient its cause and how they will resolve it.
Dysfunction Syndrome - This occurs in patients with a long history of poor postures and body mechanics that have allowed them to develop stiffness in one or more directions of movement. Very often, occupations or recreational activities emphasize forward moving spinal movements but very little backward moving. So they become susceptible. Likewise, dysfunction syndrome can occur in any direction of movement avoidance, even beyond the spine. Since we keep what we use and lose what we don't, over the years we develop stiffness that eventually causes increased joint pressures and then pain. Our therapists determine the direction(s) of stiffness and teach the specific exercises necessary to restore normal movement and pressures. When needed, we also use special techniques to mobilize the necessary joint segments or stretch the shortened soft tissues with our hands.
Derangement Syndrome - Spinal derangement syndrome involves some level of damage to the discs of the spine. When therapy is begun early, there is usually no need for surgery. When there is pain below the elbow (neck injuries) or knee (low back injuries), particularly if it becomes constant, it is more serious and coming closer to requiring a surgical correction. The early warning signs are the inability to bring the head or back to an upright position, one-sided neck/arm pain or low back/leg pain. These injuries can be treated with specific positioning and special exercises taught by our therapists to restore the disc to its correct position. The patient is then limited in activities and postural movements for several days until the disc begins to heal in its corrected position. When appropriate, the therapist progresses the patient with other exercises that further strengthen the disc stability and muscular control of healthy spine postures. Patients are thrilled when they have learned how to control their pain instead of it controlling them, and are then able to prevent future episodes.
Recently principles of LSVT LOUD® were applied to limb movement in people with Parkinson disease (LSVT BIG®) and have been documented to be effective in the short term. Specifically, training increased amplitude of limb and body movement (Bigness) in people with Parkinson disease has documented improvements in amplitude (trunk rotation/gait) that generalized to improved speed (upper/lower limbs), balance, and quality of life. In addition, people were able to maintain these improvements when challenged with a dual task.LSVT BIG can be delivered by a physical or occupational therapist. Treatment is administered in 16 sessions over a single month (four individual 60 minute sessions per week). This protocol was developed specifically to address the unique movement impairments for people with Parkinson disease. The protocol is both intensive and complex, with many repetitions of core movements that are used in daily living. This type of practice is necessary to optimize learning and carryover of your better movement into everyday life!
Start exercising NOW – as soon as possible. Physicians rarely refer their patients to health and fitness programs at diagnosis because medications are very effective early on at alleviating most of the symptoms, and patients experience little change in function. Yet, according to a recent survey it is at the time of diagnosis that patients often begin to consider lifestyle changes and seek education about conventional and complementary/alternative treatment options. Thus referrals to exercise, wellness programs and physical/occupational therapy would be best initiated at diagnosis, when it may have the most impact on quality of life.
When people experience dizziness due to Benign Paroxysmal Positional Vertigo (BPPV), it can be treated by physical therapists with this area of expertise with good success. The cause is from calcium carbonate crystals that create an imbalance of flow of the normal inner ear fluid that sends signals to our brain to maintain normal balance.
- Feeling of disorientation.
- Sensations where the room appears to "spin" or "waver".
- Examination to confirm that BPPV is the cause of your symptoms.
- Same day repositioning of the crystals with an "Epley Maneuver".
- Education on subsequent head movements and positioning that can influence a recurrence.
- Education on indications that you would need follow-up treatments.
The National Center for Injury Prevention and Control reports that 25-35% of people over age 65 falls once or more each year and 1 in 20 experience a fracture or other serious injury. The cause of falling will be assessed by one of our physical therapists to determine the appropriate treatment to reduce your risk. People appropriate for this program are those that have fallen once or more in the last 6 months.
- Experience one or more falls in the last 6 months
- Contributing history of any of:
- Osteoarthritis - Rheumatoid Arthritis - Muscle Weakness - Muscle or Joint Stiffness -Neuropathy - Vertigo - Vestibular Ocular Reflex Disorder - Parkinson's Disease - Stroke - Other Norological Deficits
- Physical Therapy examination of:
- Proprioceptive/Somatosensory Pathways - Vestibular System - Musculoskeletal System - Neurological System - Cardiovascular System
- Perform validated baseline tests (for follow-up improvement assessment) of:
- Berg Balance Scale - Dynamic Gait Index - Tinetti Balance Scale - Timed Up and Go Test - Functional Reach Test - Six-minute Walk Test - Dix-Hallpike Maneuver
- Physical Therapy program focused on addressing the deficits identified above.
Fibromyalgia includes elusive symptoms such as poor sleep patterns, widespread muscle aches and pains, fatigue and decreased activity levels. Others may experience chronic headaches, cold hands and feet, irritable bowel syndrome or depression.
- Difficulty sleeping
- Muscular pain
- Sometimes a history of bacterial infections, systemic lupus erythematosus, hypothyroidism or rheumatoid arthritis
There is no cure but it can be managed with:
- Sleep medications from your doctor
- Stress reduction techniques
- Low level aerobic exercises
- Pain management treatments
- Posture improvement and body mechanics instruction
- Massage that often includes myofascial release techniques
- Gentle stretching exercises
Golf is a full body sport. Limited mobility or strength anywhere through the chain of your arms, spine and legs can change the direction of your swing, your clubs impact on the ball and the stress on your body. This program identifies those limitations, designs an exercise program to correct them, and results in better bodies and golf performance.
- Stiffness in your body, especially the largest contributors to golf performance (spine, shoulders & hips)
- Increased complaints in these stiff areas during or after playing golf
- Difficulty correcting your golf performance despite instruction and attempted stroke correction
- Physical Therapy examination of the spine, arms & legs with an emphasis on full-body flexibility and strength
- Instruction in exercises to correct the identified problems
- Hands-on work by your physical therapist to help you restore lost mobility
Headaches are one of the most frequent complaints to doctors. There are many reasons for headaches, including serious medical conditions that are best treated by your physician. However, one of the most common causes is years of improper neck posture that permits the muscles in the back of the upper neck to become very tight. Nerves that exit the spine just below the scull and travel to the sides of the head become entrapped. Pressure on these nerves from tight tissues causes pain to the area of their destination - the head.
- Pain may be one or two-sided but is located in the back of the upper neck
- Pain is worse with morning or late-day stiffness
- Pain accompanies large volumes of eye-to-hand related tasks
- Pain is usually relieved with massage or rubbing of the neck
- Stretches of the muscles at the base of the skull and top of the neck
- Strengthening of the postural muscles
- Training in the maintenance of postural corrections
Osteoporosis is a specific form of generalized osteopenia (a bone mass reduction below what is normal for your age). Throughout adulthood bone is constantly remodeled, forming new bone and resorbing old bone. Osteoporosis begins in the early 40s when bone resorption begins to exceed the rate of bone growth. It is magnified by hormonal changes, malnutrition, alcoholism and chronic diseases that prohibit normal functions like standing and walking.
- Hormonal changes after menopause or hysterectomy
- Prolonged use of anticonvulsants or corticosteroids
- Diabetic history
- Higher incidence in asian or Caucasian women with a family history of fair skin or small frame/stature
Osteoporosis occurs in both women and men but is six times more likely in women before age 70. They are equally at risk thereafter.
- Proper calcium intake/supplements or hormone replacement per your doctor
- Gentle weight training exercises for the arms, legs and spine
- Exercise modifications for any history of arthritis, fractures, cardiac or respiratory problems
- Falling risk assessment with recommendations for changes in walking pattern, shoes worn, household hazards
Patellofemoral syndrome is a condition of usually diffuse pain in the front of the knee brought about by activities that cause high joint pressure between the knee cap and the rest of the knee. Literally, chondromalacia refers to a softening of the cartilage on the under surface of the knee cap. The softening occurs from poor alignment of the knee cap that results in an uneven distribution of pressures. As the cartilage wears away, joint pressure results in pain at the joint nerve endings.
- Pain in front of the knee - no specific location
- Pain aggravated by jumping, squatting or stair climbing
- Pain worse by simply standing up; sometimes better after moving about
- Flexibility exercises of certain hip, thigh or knee muscles
- Special low-compressive knee strengthening exercises
- Electromyography (EMG) to restore balance in strength of thigh muscles
Some people also have complex factors of the foot and lower leg or hip joints causing torsion or twisting at the knee joint that stresses the patella. Our physical therapists and your physician determine how much each of these factors contributes to your knee pain. Most of the problems of muscle tightness and weakness can be addressed with special exercises. Dramatic improvements can be obtained using an EMG monitor (something similar to how your doctor monitors the function of your heart muscle) and special taping to correct the movement and alignment of your knee cap. If you have one of the more extreme cases that your doctor feels may require a surgical correction, these same rehabilitation issues often still apply to optimize your rehabilitation after surgery. Our therapists use this advanced technology combined with our biomechanical analysis of your entire leg to provide you with a comprehensive approach to resolving your knee pain once and for all.
Shoulder impingements refer to the entrapment of the rotator cuff tendons as they travel between the ball and socket components of the shoulder. The cuff is actually the site where several small muscle tendons merge into one larger tendon. Originally it may present as a shoulder tendonitis or bursitis. As the problem gets worse, minor, and then major, tears of the rotator cuff tendon can occur.
- Pain in the front of the shoulder or radiating to the outer upper arm
- Pain aggravated by:
- Repeated use of arms overhead - Throwing, distance swimming or weight lifting
- Limited inward rotation motion of the shoulder
- Clicking or "catching" in the shoulder when lowering the arm
- Restore normal flexibility of the shoulder joints and muscles
- Strengthen the rotator cuff and other shoulder muscles
- Train the scapular muscles in maintaining an opening for the rotator cuff through better scapular alignment
The biomechanics of the shoulder are more complex than any other joint of the body. Proper shoulder function requires a sophisticated coordination of flexibility, strength and postural control of several shoulder region joints and the scapula (shoulder blade). Our therapists are experts at identifying and correcting muscle and joint tightness. We then train the muscles in proper recruitment, or sequencing of contraction, to control these problems. This may require special techniques of stretching the capsule of your shoulder, "hands-on" exercise techniques to facilitate recruitment training of muscles or the use of an EMG monitor to train you to control of your shoulder muscle function better. When the mobility is corrected to allow space for the rotator cuff tendons and the movement of the scapula is corrected to keep the space open during overhead movements, there is less pressure on the tendons, you remain pain-free and your rotator cuff stays healthy.
Definition of TMJ Syndrome:
The temporomandibular joints (TMJ) connect the jaw bone to each side of the face. They are located immediately in front of each ear. Like all joints, they are subject to wear and tear injuries. Injury or extreme amounts of talking or chewing can place enormous amounts of pressure on the joint surfaces and cause them to degenerate over time. Similar to the knee, the TMJ also has a "cartilage" in it that can be damaged and block normal movement.
- Blocked movement of the jaw
- Jaw moves crookedly when opening or closing
- Painful TMJ - especially with talking and chewing
- Frequent headaches
- Ringing of ears
- Tenderness in front of or within the ears
- Restore motion to TMJ and/or neck joints
- Postural correction training
- Train mouth and facial muscles in proper control of jaw movement
There is a direct relationship between neck posture and mobility to TMJ, head and facial pain. This area of orthopedics is often overlooked. Physical therapists with this area of expertise understand how the simple tasks of breathing, speaking and chewing are not so simple to persons with poorly functioning TMJs. We use our skills to restore normal joint motion and develop proper jaw muscle strength and control. Many dentists are knowledgeable in this area and often refer patients to physical therapy as part of their total treatment program.