Physiotherapists in Columbus, GA

http://www.smartstretch.com/

Abigail, I have some ideas, but my background includes years of experience as a certified personal trainer, AIS therapist, and corrective exercise specialist. So if I suggest something that you don't quite understand, please ask for clarification. Regardless of what I suggest, run it by your client's PT(s) before you implement it. The following thoughts are based on my own practice experience, and may not reflect the most recent research literature or the practice experiences of other therapists. They are not thoroughly thought out ideas, but rather some concepts that may be fairly simple to adapt to your own needs. There are a few things I have found helpful when working with clients that seem to have some form of muscle inhibition or even sensory motor amnesia. For one, direct manual stimulation of the target area to provide a flood of sensory input prior to PIR or other active work may make it easier for the client's CNS to "remember" how to innervate those tissues. Since different mechanoreceptors respond to different stimuli (i.e. light touch, deep pressure, vibration, hot, cold, skin stretch, etc.), it might be helpful to use multiple forms of stimulation. This can be done in a few moments, with some quick light strokes, a few compressions, and a bit of tapping. Don't overthink it. Repeat throughout the session while working with the target area(s). Sometimes I am tapping or rubbing the area between/during each repetition of a movement/contraction. When working with areas that are weak/inhibited, I don't want to stretch them. Instead, I usually hope to see them contract more efficiently/forcefully. In many cases, weak/inhibited areas seem to have difficulty with concentric contraction. I am not certain why this is. I have had more success with eccentric contraction of the target area(s). In corrective exercise/rehab work, I typically see faster improvements in tissue innervation and functional strength when using movements that emphasize resisting motion. For example, a person who is too weak to do unassisted squats will usually improve faster by practicing slowly squatting down onto a chair/bench. It usually doesn't take long for their strength to improve enough to stand up again without help, and eventually to squat without a bench/chair behind them. You said that this client is already able to contract his rectus femoris and sartorius. That leaves the vastus lateralis, vastus intermedius, and vastus medialis. None of those cross the hip joint, so focus on flexing/extending the knee. Here's an example of a simple eccentric exercise: The client is supine with a large bolster under the knee of the target leg. When at rest, the knee is bent. The heel of the foot and the hip rest on the table. Use some light strokes, firmer compressions, and tapping/vibration to stimulate the target area(s). Assist the client in straightening the knee without changing the angle of the hip (this isn't a leg raise). Ask the client to keep the knee extended without your assistance for 1-10 seconds (depending on how weak they are), and then have them slowly permit the knee to bend until back in the starting position. Repeat 3-10 repetitions depending on the client's level of ability. Repeat the stimulation as often as desired. Depending on the client's tolerance for the activity, I might ask them to perform 1-3 sets of 3-10 repetitions. The work should never be painful, and (and first) it shouldn't feel terribly strenuous even if they fatigue. To increase the level of difficulty, use your hand to apply gentle, progressive downward pressure for your client to resist. To increase challenge to the vastus medialis, laterally rotate your client's foot as the knee bends, while having them continue to resist the downward force. Rotate their foot medially to increase challenge to the vastus lateralis. Vastus intermedius is challenged when the knee and foot are aligned, but so is rectus femoris. It may take more resistance to trigger cocontraction of vastus intermedius. Again, we are still focusing on simple single-joint movement. If you are not certified as a trainer, it would be inappropriate for you to progress this client into more complex strengthening work such as squats, lunges, etcetera. It would be more appropriate for this client to perform such exercises with the PT and/or with a personal trainer well versed in corrective exercises (and ideally with prior experience training clients with similar issues). There are far too many permutations of possible modifications, variations, progressions, and programing of such movements for discussion here. That's another reason why a competent fitness professional should assume that portion of the strengthening work. If you don't have such a person you can refer to as needed, it's time to start looking. I hope that gives you some useful ideas to think about. For a quick review of the quadriceps muscles, here's a handy link: http://www.wheelessonline.com/ortho/quadriceps_muscle

Jason Erickson may have some other ideas.

Let me start by saying my information came from Aaron mattes he is a long-term approved provider. Whether you can isolate or not is not the issue all clients I am currently treating that had atrophied problems as you speak of gotten better with errands work. The day I no longer strengthen patients will be the day I quit massage therapy. Go to stretching USA.com. Active isolated stretching will help you. I have more physical therapist sending me patients for strengthening and stretching then I can shake a stick app they send more than chiropractors or medical doctors. You might order Aaron's book specific strengthening for everyone take the course when you can.

We just had this conversation on another thread with Tyler Krausert about confusion of what pt's actually do...

I remember that too. But I forget the topic subject. Beret can you recommend some keywords to search. Was it this thread or a different one? https://www.facebook.com/groups/611431842200765/permalink/893651670645446/

Select Physical Therapy Ask to see Jorge, but anyone is good there. 3624 Edgewood Rd Columbus, GA 31907 (706) 565-3427

Marilyn Jones at the Columbus Clinic. I saw her for months for lower back pain and she is wonderful!

Columbus Regional medical center offers Rehab therapy call 706 571 1000 and ask for outpatient rehab

Try St. Francis. Also check with P.C. Spine and Joint Center. Dr. Cooper is excellent and I believe he takes Tricare.