The ability to maintain an upright posture and to move your arms and legs to perform all sorts of tasks and activities is an important component of your health. Most of us can learn to live with the various medical conditions that we may develop, but only if we are able to continue at our jobs, take care of our families, and enjoy important occasions with family and friends. All of these activities require the ability to move without difficulty or pain.

Because physical therapists are experts in movement and function, they do not confine their talents to treating people who are ill. A large part of a physical therapist's program is directed at preventing injury, loss of movement, and even surgery. Physical therapists work as consultants in industrial settings to improve the design of the workplace and reduce the risk of workers overusing certain muscles or developing low back pain. They also provide services to athletes at all levels to screen for potential problems and institute preventive exercise programs. With the boom in the golf and fitness industries, a number of physical therapists are engaged in consulting with recreational golfers and fitness clubs to develop workouts that are safe and effective, especially for people who already know that they have a problem with their joints or their backs.

The cornerstones of physical therapy treatment are therapeutic exercise and functional training. In addition to "hands-on" care, physical therapists also educate patients to take care of themselves and to perform certain exercises on their own. Depending on the particular needs of a patient, physical therapists may also "mobilize" a joint (that is, perform certain types of movements at the end of your range of motion) or massage a muscle to promote proper movement and function. Physical therapists also use methods such as ultrasound (which uses high frequency waves to produce heat), hot packs, and ice. Although other kinds of practitioners will offer some of these treatments as "physical therapy," it's important for you to know that physical therapy can only be provided by qualified physical therapists or by physical therapist assistants, who must complete a 2-year education program and who work only under the direction and supervision of physical therapists.

Most forms of physical therapy treatment are covered by your insurance, but the coverage will vary with each plan. Most states do not legally require patients to see their physicians before seeing a physical therapist. Most of the time all you have to do is ask your doctor if physical therapy is right for you.

Physical therapists and occupational therapists are specialists in movement and functional activities, as well as in the treatment of neuro-musculoskeletal disorders. Pain often accompanies a movement disorder, and therapists can help correct the disorder and relieve the pain.

• Orthopedic Physical Therapy – The American board of Physical Therapy Specialties certifies individuals who have demonstrated advanced clinical knowledge and skills in physical therapy specialty areas. Probably the most common physical therapy specialist is the orthopedic specialist. These specialists care for post-surgical patients, arthritis, tendinitis/tendinosus, fracture rehabilitation, muscle sprains and strains, neck and back pain, hip and knee problems, shoulder, elbow, and wrist conditions. Concord Hospital has a number of staff who are nationally board certified Orthopedic Specialists (OCS).
• Manual Therapy - Manual therapy is a broad term that describes a variety of hands-on treatment techniques that are applied to movement dysfunctions. Various joint mobilization techniques, soft tissue manual techniques to include myofascial release with and without movement, neural mobilization, craniosacral therapy, strain/counter strain, etc. These are some of the more popular manual therapy techniques. Our therapists incorporate manual therapy techniques as a part of a complete treatment plan.
• Hand Therapy - Occupational therapists are well trained to treat hand and wrist conditions. Some of our occupational therapists have taken additional courses and training and have passed a hand therapy certification examination. These therapists are called Certified Hand Therapists (CHTs).
• Women's/Men’s Health - Some therapists specialize in women's/men’s issues such as pelvic pain, incontinence, post-surgical issues. Special treatment is also available for pre and post pregnancy. Many that suffer from incontinence do so needlessly. A physical therapist may be able to help.
• Industrial Rehabilitation - Specialists in industrial rehabilitation help with those that have suffered on-the-job injuries. Moreover, they will evaluate work tasks, fabricate assistive devices, evaluate and help redesign work flow/tasks to decrease the incidence of injury. Often, industrial rehabilitation specialists will evaluate your ability to perform certain job tasks with an exam called a Functional Capacity Evaluation (FCE).
• Concussion Assessment and Management Program (CAMP)
The program components are:
• Community Education - We offer Community Education programs and educational information to increase awareness about prevention and recognition of concussion to schools, parents, and other community members.
• Impact ® - We offer Baseline Screenings utilizing ImPACT ® as part of the community program offerings. Pre-screening is designed to capture a baseline level of brain function before an individual sustains an injury.
• Post Concussion Services - Rehabilitation Services physical and occupational therapists offer Post Concussion Treatment that will provide objective data to assist in the management of patients with concussion. Services include an evaluation of neurocognitive deficits (via the ImPACT® Test), as well as assessments of balance, vestibular function, associated musculoskeletal injuries (neck, face, shoulder, spine) and cognitive function.
  After testing is completed, the athlete or individual will complete a post-concussion rehabilitation program which includes a progression through evidence based protocols for post concussion exercise programs and cognitive training.
• Fall Prevention Program - Our Physical Therapists specialize in fall risk assessments which include completing a thorough physical assessment, review of your medical history, and perform special tests to determine your fall risk factor.
  Based on your risk level, your physical therapist will develop a treatment plan tailored to your needs to help reduce the risk of future falls. Your individualized plan will include exercise to improve strength, mobility, and balance, home safety tips, proper instruction with assistive devices, and access to valuable resources. You also may have the opportunity to work on our new state of the art piece of equipment called The Active-step. The Active Step is a treadmill-based fall simulator that can retrain the body’s natural ability to respond to a postural perturbation (e.g. a trip or slip) by changing the biomechanics of your step recovery.
• Fitness and Wellness
- Physical therapists are well trained to help with your fitness needs and wellness programs. If you need an exercise program, have trouble with your weight, are concerned about osteoporosis, have an issue with diabetes, or you would like to learn how to prevent falls, our therapists can help. The previous examples are just a few of the many programs physical therapists offer.
• Aquatic Therapy - Aquatic therapy takes advantage of the physical properties of water to assist with the rehabilitative process. Buoyancy, turbulence, hydrostatic pressure, and thermal properties of water can assist with the rehabilitation of a patient. Those suffering from chronic pain, osteoarthritis, fibromyalgia, rheumatoid arthritis, lumbar fusion surgery, or with a limited weight-bearing status are just a few of the many different patient populations that can benefit from aquatic therapy.
• Balance, Dizziness, and Vertigo Rehabilitation - Many suffer from dizziness or vertigo. (Often referred to as: BPPV (benign paroxysmal positional vertigo). Our clinics specialize in the rehabilitation of patients with vertigo. Patient education, strengthening, safety awareness, posture and balance exercise, and special techniques that affect sensory and balance centers of the brain and limbs are all important components of a rehabilitation program.
• Lymphedema Rehabilitation - We take it for granted but a special component of the circulatory system, the lymph system, helps filter and drain fluid from our arms and legs. When this drainage system is damaged, painful swelling can result. We have therapists who specialize or are certified in the treatment of lymphedema. Special massage and bandaging techniques and education are utilized by the lymphedema specialist.

1. Your medical history;
2. Your current problems/complaints;
3. Pain intensity, what aggravates and eases the problem;
4. How this is impacting your daily activities or your functional limitations;
5. Your goals for therapy;
6. Medications, tests, and procedures related to your health.

• The therapist will then perform the objective evaluation which may include some of the following:

1. Palpation – the therapist may touch around the area of the pain/problem to check for the presence of tenderness, swelling, muscle/tissue density, tissue temperature, inflammation, etc;
2. Range of Motion (ROM) - the therapist may move the joint(s) to check for the quality of movement and any restrictions.
3. Muscle Testing - the therapist may check for strength and the quality of the muscle contraction. Pain and weakness may be noted. Often the muscle strength is graded. This is also part of a neurological screening.
4. Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
5. Special Tests - the therapist may perform special tests to confirm/rule out the presence of additional problems.
6. Posture Assessment - the therapist may evaluate a patient's positioning of his or her body and limbs to determine directly observable physical abnormalities.
The therapist will then formulate a list of problems you are having, and how to treat those problems. Together we will develop a treatment plan specifically for you. This includes how many times you should see the therapist per week, how many weeks you will need therapy, home programs, patient education, short-term/long-term goals, and what is expected after discharge from therapy. This plan is created with input from you, your therapist, and any information we’ve received from your provider.