Weight of Injury
Stephen Clark, PT, DPT, MHS, OCS, MBA

...continue from page 3

Massage increases circulation, which assists the healing process and reduces muscle to return to normal function.

Modalities are also useful. I prefer using iontophoresis with Dexamethazone, which chemically reduces local inflammation; ice packs for joint and muscular pain, and inflammation; ice packs for joint and muscular pain, and inflammation; and ice massage for small, superficial tendon inflammation.

Restore, promote or maintain normal flexibility. Normal physiological and accessory range of motion must exist so all joints and muscles work together. For Brian, who is inflexible, we emphasize stretching over strengthening. On the other hand, with Kris, who has a tendency to be hyper-flexible, we emphasize strengthening and stabilization, with minimal stretching.

Strengthen surrounding areas. To prevent re-injury, you should strengthen the joints above and below the injured area for two reasons. First, injuries usually occur at a joint that's overloaded because of weakness at an adjacent joint. Strengthening the noninvolved areas will protect the injured area. Second, you'll keep your patients active and motivated, since they'll be doing as much as possible without perpetuating the existing injury. The last thing an active patient wants to hear is "Stop all exercise."

Strengthen injured area. As the injury heals, add therapeutic exercise to the injured area. For people like Brian, use lower loads, higher reps and alternative exercises. This will reduce the load through the joints and muscles, as well as help him coordinate movement and work through a full range of motion.