Patient Services

Soft tissue refers to muscles, nerves, ligaments and tendons.  They range from soft to tough but remain pliable to allow for stability and motion.  We are mobile creatures designed to stay active.  Lack of activity, repetitive injury, sustained movements or scarring  can lead to stiffness, over activation of the wrong muscles and various symptoms related to soft tissue.  In fact, soft tissue can refer symptoms that mimic headaches or pinched nerves.  Soft tissue treatment uses a variety techniques to improve pain-free motion.  

Neural Mobilization

Nerve fibers, like muscle fibers, are composed of soft elastic tissue. By gently stretching painful nerves, micro scarring is released and nerves adapt to their environment and so reduce pain associated with nerve irritation.

Myofascial Release

Scars develop everywhere in the in the body, even inside. When scars develop in a haphazard fashion that interferes with normal motion they can cause pain.   Myofascial release treats painful adhesions in muscle, tendon, and ligament fibers (soft tissue) as well as overlying fascia to facilitate pain-free motion.

Post Isometric Relaxation

Some muscles become facilitated “turned on” due to (1) direct injury, (2) to compensate for injury elsewhere or (3) when we engage in faulty movement patterns that perpetuate injury.  This strategy  for stubborn muscles  combines stretching with sustained muscular contraction to increase relaxation and pain-free motion.

Active Release Technique

Combines petrissage with specific muscle movement to relieve painful muscles, release trigger points and break up painful adhesions.

Muscle Activation

Some muscles become inhibited “turned off” due to (1) direct injury, (2) to compensate for injury elsewhere or (3) when we engage in faulty movement patterns that perpetuate injury.  This strategy “awakens” muscles so they can do there job and you move without discomfort.

Active exercise or active care means the patient participates is his treatment as opposed to being an uninvolved recipient called passive care.  For example, a therapist stretches you versus you stretching for your self.  Research tells us that patients involved in their treatment will (1) have better short term and long term response to care, (2) quicker recovery times and (3) decreased pain.  The next question that comes to mind is, “why see someone for something I can do myself?”  The answer is guidance.  Its like working out alone versus using a personal trainer.  A good doctor will know when to push more or scale back.  Furthermore, a good doctor will not foster dependence on his service.   On the contrary, he should try to help you–empower you–to manage small flares up on your own.  He will always be available to provide care when you need help.   Stretching exercises This is pretty straight forward.  Most people now basic stretches.  These are important because flexibility prevents injury.  That’s why baby’s don’t often break bones or pull muscles, why drunk drivers rarely get injured or why coaches stress their players about warming up.  Sometimes, your body needs extra help relaxing tense (facilitated) muscles.  Fortunately, there are a variety of strategies for accomplishing this goal and targeting specific muscles with unique stretches. Stabilization exercises Strengthen key muscles that protect the spine during activity.  If you think of the spine as those building blocks we played with as children you can imagine that stacking blocks on top of one another does not provide the most stable structure.  Muscles play a key role in holding those “blocks” steady while we work and play like guide wires on a tent or mast.  Your vertebra–back bones–have about seven small stabilizing muscles on each side.  If these do not work properly, then your spine will be unsteady.  This muscular instability can cause back pain and related symptoms. Sensorimotor training  Re-establishes a healthy and appropriate muscle response by stimulating sensory input and reinforcing important neural pathways that keep us moving injury free even when we are not paying attention.  These type of exercises ensure an adequate and appropriate response to external, physical stress.  One way to think of this is to imagine someone throwing something at you and you see it, but don’t move.  There is disconnect between what you see (sensory input) and what you do (motor response).  Another example.  If you stumble and your muscles do not engage at the right time to protect your spine you may experience an injury.

Doctors use several tests to evaluate neurological function and help diagnose neurological conditions.  The most frequently used are Nerve Conduction Studies(NCS) and ElectroMyoGraphy (EMG).  NCS and nEMG tests are done in order to evaluate the condition of nerves and muscles. NCS utilizes mild electrical stimulation applied to the extremities.  nEMG uses a very thin needle—similar to acupuncture– inserted into specific muscles to observe and listen to its reaction.  An electrodiagnostic evaluation employs highly sophisticated equipment to calculate the functionality of major nerves in the extremities; it assesses whether muscles have had interruption in their nerve supply, or whether muscle damage exists. Clinical evaluation is irreplaceable.  However, these tests give doctors specific details regarding the stage of disease by providing quantitative and qualitative information about peripheral myelin, axons and muscles.  This information enables the doctor to provide the best therapeutic options to the patient.   Electrodiagnostic evaluation is best suited for those patients with persistent complaints of skin disturbances, muscle weakness or cramping, radiating pain or limb pain, or spinal pain that have had minimal to no response with conservative treatment. For more information, visit www.teleEMG.com

My treatment strategies aim to relieve and control pain. However, treatment alone cannot undo bad habits that contribute to patient complaints.  These bad habits can perpetuate symptoms and  provide a continual source of stress.  For example, the way we sit, the way we play, the way we eat and whether we smoke can contribute the long list common complaints affecting your daily life.   I strive to empower the patient with tools to adapt their workplace and lifestyle habits. This will help them cope with their day-to-day symptoms so they do not feel powerless when faced with a flare up or exacerbation. Doctors should empower people to help themselves and not depend on medical intervention whether it be alternative or traditional.