Treatments

Below you will find a list of possible treatment modalities and techniques used by Stephen Klatt. This list is to help you get a better understanding of what treatments are available. It is important to know that although there are many options on the list, a thorough assessment helps to narrow down which treatment options are best suited to you as an individual and best suited to your current condition and stage of healing.

Acupuncture

Acupuncture is the use of very small needles to puncture the skin. A physiotherapist will use acupuncture as a treatment to target, myofascial restriction, swelling, decreased blood flow, and help with pain management and stimulating the nervous system. Acupuncture can even help to improve healing times by stimulating the body’s natural healing response.

Cupping

Cupping is an effective treatment for myofascial restriction in the body. When the cups are placed on the skin, we are able to get microstretching of the tissue between the cups, and we are also able to get a deeper stretch by taking the joints through smaller range of motion. This is especially beneficial when used to treat arthritic joints that already have limited range of motion.

Exercise Prescription

An important part of recovery from any injury is a well planned gradual return to exercise. Physiotherapists are highly trained in exercise planning from beginning to advanced stages of recovery. Each exercise serves a purpose, and I always take time to ensure you understand why you are doing each exercise. Knowledge is power, and I hope to empower you on your road to recovery. I ensure that every exercise you are doing serves a purpose in your rehabilitation.

Heat or Ice

To heat or to ice, this is a common question I get in the clinic.

Ice: Most commonly applied to an injury that happened recently. Ice is best used to help manage pain in a recent injury and may help to decrease swelling. Recent research has changed our understanding of how we apply ice. We now know that using too much actually slows the healing process. It’s best to give the body what it doesn’t have, so if the injured area is feeling hot, we want to bring it back to room temperature, not freeze it completely.

Heat: Best used on an injury that has been there for more than 1-2 weeks. This ensures that there is less active swelling or inflammation in the area. Note: the swelling may last longer depending on how bad the injury. Heat is most effective on tight achy muscles to help them relax.

Joint Mobilizations

Joint stiffness can cause limited mobility, but can also be a symptom of a nearby injury. When joints in the body stiffen up, they follow the “use it or lose it” principle. Sometimes the stiffness in a joint requires hands on attention to restore function back to normal. There are 2 types of mobilizations that I prefer to use in the clinic:

Grade 4 Mobilizations: Also known as “small amplitute, rhythmic oscillations”. This type of joint mobilization is used to help decrease pain caused by stiffness in the joint and also works to slowly release the stiffness in the joint.

Muscle Energy Techniques: This technique is used to help the muscles pull the joint back into a natural resting position. It works wonders on stiff ribs, upper back, sacroiliac joints (SI joints) and the neck. The technique involves the therapist creating resistance on the body while you push against the resistance. The reason it is so effective is because we are activating “reciprocal inhibition” in the joint. This allows the muscles on one side of the joint to relax while the others are contracting. The relaxation this creates in the joint is what allows the joint to return to its neutral resting position.

Laser

Laser, also known as “Cold Laser Therapy” is the use of a low-level laser to help reduce inflammation and relieve pain. The laser works at the cellular level to stimulate the natural healing response of the body.

Myofascial Release

Myofascial release can be done in many ways including cupping, massage, acupuncture, myofascial stretching, and skin rolling. The technique that is used depends on the area affected and the tissue that is restricted. It is normal to feel relief immediately with a myofascial release, but it is also normal to have some soreness that lasts for 24 hours after the treatment session. If the injury was too recent, we may need to wait for more healing to occur until myofascial release becomes an appropriate treatment option.

Pain Education

It is important to understand that pain is a protective mechanism in the body. It helps to let us know that we are in danger. But, it is also important to know that this protective system can be over active.

Just like we learn how to do tasks with many repetitions and a lot of practice(ie. Riding a bike, learning to read, learning to walk etc.) our nervous system can also get “good” at experiencing pain. The more often that a pain pathway is triggered in the body, the easier it will be to trigger it in the future.

This leads to a new way of looking at treating pain, especially when it has become chronic. (See chronic pain for more information and watch the short video explaining why we feel pain)

Stretching (Assisted)

When muscles get tight, they can pull the body out of alignment. Stretching can be an effective way to help restore the normal resting length of muscles and relieve tension on the joints. A physiotherapist is able to help with an assisted stretch in the clinic to stretch the muscles in directions that are difficult to do on your own. Stretching in the clinic is always followed-up with stretches that you can do at home to maintain the gains that we achieved together.

TENS (Transcutaneous Electrical Nerve Stimulation)

Using low-voltage electric currents, we are able to treat pain and decrease muscle tension. There are different ways to apply TENS, but the most common is with pads on the skin that allow the electricity to pass through layers of tissue directly to the affected muscle. Using the “gate-control theory” TENS helps to block the pain. This can be useful in conjunction with gentle exercise and stretching to help return function to the body.

Traction

Traction is a treatment that allows us to decompress the joints in the body. Often used for the spine, it can be applied at nearly every joint in the body. In the clinic, I perform traction manually (with my hands, or with the use of a strap for assistance) to relieve pressure in the joints that are stiff and tight. Traction can be useful for:

• Relieving the tension of a migraine or headache
• Releasing tension in the low back helping to lessen sciatica symptoms
• Releasing stiffness in joints after a fracture, especially after the removal of a cast

Ultrasound

Ultrasound, also known as “therapeutic ultrasound” is the use of a device that sends high frequency sound waves through the tissue. These sound waves vibrate the tissue in a way that causes increased blood flow, and can also cause deep tissue heating depending on the setting used. The vibrations created by the sound waves create air pockets in the tissue called “cavitations”. This is what makes ultrasound an effective treatment for joint stiffness, tendon strains and ligament sprains. Similar to laser, the goal of ultrasound is to help speed up healing at a cellular level.