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Physical Therapy Programs


CNMR’s physical therapy programs start with an initial evaluation. Here, we listen to the history of your injuries, investigate the involved areas, and develop a plan of care that precisely reflects your needs. The plan involves feedback from the patient at every turn; after all, it is your body. We will discuss the need for different methods of treatment, many of which are described below.Torn ACL

Methods of treatment:

Rehabilitative Exercise: we use targeted exercise in order to affect tissue changes in the body. This is always closely monitored by your therapist directly to correct deviations in movement and to improve strength and flexibility. The number of repetitions, the direction of motion, and type of resistance may vary according to the need of the patient, and what activities are restricted. When stretching we may change the duration of the stretch and the angle to allow for effective lengthening of shortened tissues.

Neuromuscular Re-Education: sometimes a muscle just does not function properly. This is often seen in rotator cuff tendonitis, or a lower back spasm. In these cases, we have to ‘teach’ the muscle how to remember its role. This is done by breaking down the movement pattern into simple components until they are mastered, then reintegrating them into effective motion. Coordination drills also are a part of this method of treatment, as are balance activities. If you are familiar with PNF or AIS, these too are neuromuscular techniques- using a muscular contraction to facilitate reflexive inhibition and reduce resistance to motion.

Manual Therapy: the oldest art of healing, manual therapy includes a vast assortment of treatment techniques where the therapist will, by definition, lay on hands. From increasing the mobility of the spine with targeted and directed force, to stretching tightened ligaments in a frozen shoulder, manual therapy is one of the most versatile and effective means to improve a patient's outcome. By creating external forces upon the joint, bone, and muscle structures, your therapist can improve your condition in a way that exercise and stretching cannot. This mode of treatment also includes medical massage. See that tab for more information.

Postural and Ergonomic Assessment: Oftentimes clients are unaware of their own postural and ergonomic problems. Washington DC is notorious for overworked people, and the way that their desks and offices are set up may not reflect the individual needs of the client. During your initial evaluation, specific recommendations will be made according to your body's dimensions. Bringing in pictures of your work setup can allow us to make very specific, and often highly effective suggestions to improve your ergonomics. We can also give your employer a write up of our evaluation if new office equipment is needed. If that is not enough to set your body straight, a physical therapist can come to your workplace to perform an ergonomic assessment, and really get to know your specific stressors.

Gait and Movement Retraining: watching how a person moves gives us clues as to what causes injury. Frequently the secret is finding the restricted motion, weakness, or alignment issue in the midst of normal activity. Seeing how a person walks, bends, lifts, twists, and so on gives us actionable insight and leads to an effective plan of care. We then isolate the faulty structures, retrain them in a functional manner, and then reintegrate the motion into the whole.

For specifics, please also see the Sports Physical Therapy tab for more information.

With our physical therapy programs, we diagnose these common problems:

If you strained your neck or back, we can...
  • Neck pain stretchBalance strength and length of muscles to stabilize the neck and back
  • Perform soft tissue release to decrease painful knots and trigger points
  • Retrain work and exercise patterns to improve muscular efficiency
  • Work on postural corrections to decrease the recurrence of neck or back pain
  • Address ergonomic needs in the car, on the metro, or while at work

If you strained or tore your rotator cuff:
Rotator cuff
  • Relearn patterns of shoulder motion to reduce strain on rotator cuff
  • Improve muscle force production of synergistic muscle groups to improve the integrity of motion
  • Demonstrate how to avoid dangerous movements so as to avoid further aggravation
  • Retrain and rehabilitate injured rotator cuff muscles
  • Reduce inflammation to allow proper rotator cuff function

If you have chronic pain or Fibromyalgia:
Chronic Pain
  • Gently coax spasmed muscles to relax through massage, myofascial release, or neuromuscular re-education to decrease pain and tension
  • Usher the client toward proper movement retraining to improve muscular performance
  • Coach the client to alter dangerous patterns of overexertion
  • Incorporate craniosacral therapy to aid in decreasing central state over-activity

If you strained or ruptured your ACL:
ACL Sprain or Strain
  • Incrementally and safely improve knee muscle strength
  • Progress patient through all manners of sports-specific exercise
  • Retrain power, speed, and endurance of quad, hamstring, abductor, and adductor muscle groups
  • Return the client to safe activities of choice
  • Regain flexibility of the quads and hamstrings to allow for smooth and efficient motion

If you have chronic headaches or TMJ dysfunction:
Headaches and TMJ
  • Decrease tone into upper neck and shoulders via massage
  • Retrain home, sleep, driving, and work posture to eliminate aggravating factors
  • Incorporate manual techniques to relax sore muscles in the affected areas
  • Consult with dentists, prosthodontists, and periodontists to maximize your benefit
  • Treat any underlying TMJ problems with targeted stretching and manual therapy to the jaw and temples

If you suffer from hip pain (bursitis piriformis syndrome, ITB syndrome, or labral tears):
Hip pain
  • Examine faulty structures with effective testing
  • Decompress impinged joint structures through local mobilization and traction
  • Reduce inflammation local to the muscle tissue through manual therapy and ultrasound
  • Promote more fluid function of the abductors, and decrease tightness of the Iliotibial band (ITB)
  • Coax greater strength and stability from the joint by working synergistic muscles

If you suffer from plantar fasciitis:
Plantar Fasciitis
  • Cast the feet for custom orthotics in order to allow for greater foot support, improved mechanics, and reduction of pain
  • Change footwear habits and address provocative factors while at home and work
  • Progressively and gently elongate the fascia through slow stretching
  • Release the fascia with manual therapy to decrease local inflammation
  • Increase the strength of supportive muscles to allow for better support
  • Consult and collaborate with local podiatrists as needed

If you suffer from balance or coordination deficits:
Balance training
  • Ascertain which kinesthetic systems are involved: vestibular, visual, or proprioceptive
  • Retrain each system using soft or hard terrain
  • Use amplified or diminished visual cues to force greater use of lacking systems
  • Employ tai-chi to help relearn balance strategies

 

Call us at 202-257-1363 to start a comprehensive treatment program to reduce or eliminate your body's physical dysfunctions. We are conveniently located in Washington DC near the Farragut West and Farragut North metro stations.
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