Physiotherapy (and physiotherapy) is a form of therapy based on movement.
It has been scientifically proven that this method is useful in the treatment and prevention of musculoskeletal disorders.
Kinesitherapy is an essential part of rehabilitative medicine and is used to help bones and joints return to their original state after an accident or surgery.
The importance of this form of therapy becomes clear when you consider that nowadays no physiotherapy practice can be opened if it does not have a training room.
It is important to understand the difference between exercise as an end in itself and exercise therapy (physiokinesitherapy).
The prevention and treatment of musculoskeletal complaints is based on strengthening certain muscles and on adopting a correct posture, especially in the case of back and neck pain.
Working or straining an inflamed or painful muscle has NO healing effect, but worsens the situation.
An appropriate and effective rehabilitation program must be followed, because if the exercises are performed unstructured and on good luck, the following undesirable effects can have the following undesirable effects:
- Exacerbation of inflammation;
- resurgence of pain;
- in more severe cases, impairment of rehabilitation.
Physiokinesitherapy is used to restore the functioning of the body, which has been impaired due to the following events:
- traumatic events or orthopaedic diseases (osteoarthritis, fractures, muscle or tendon lesions, dislocations, sprains, scoliosis, inflammation, etc.);
- neurological complaints (stroke, multiple sclerosis, Guillain-Barré syndrome, infantile cerebral palsy, obstetric traumatic plexus palsy, neuromuscular diseases, etc.);
- rheumatological diseases (rheumatoid arthritis, ankylosing spondylitis, etc.);
- Cardiovascular problems (diseases of the coronary arteries);
- Respiratory diseases (reduced lung performance due to prolonged immobilization).
The therapy consists of a variety of techniques:
- passive mobilization by the physiotherapist or an apparatus (e.g. Kinetec),
- active mobilisation,
- assistive, active mobilization,
- strengthening and coordination exercises after operations or after accidents,
- posture training,
- Physiotherapy for the prevention of low back pain, neck pain and back pain.
- corrective gymnastics,
- vascular gymnastics,
- McKenzie method for back and neck pain,
In the field of orthopedic rehabilitation, the best results are achieved when traditional physiotherapy is combined with special techniques developed by experienced physiotherapists.
It is important to follow a program that is precisely tailored to the particular complaints, because if inflamed muscles are strained, the situation can worsen and the pain can increase.
After surgery, rehabilitation that is too fast or too slow can affect the rehabilitation outcome.
Other methods belonging to manual therapy have been developed and improved by Cyriax, Maitland and Kaltenborn; they consist of manipulations, fascia techniques, movement exercises and stretching.
At this point, taping and orthoses are not discussed further, because they are only movement-facilitating aids.
Patients who have suffered a fracture find themselves with stiff joints during plaster removal, have weak muscles and fear of relapses.
In order to accelerate and stimulate bone healing, the following therapeutic measures are recommended in addition to magnetotherapy:
- passive mobilization and stretching exercises to make the stiff joints more mobile;
- muscle strengthening in the gym;
- proprioceptive rehabilitation to regain the usual security in the exercise of everyday activities.
Exercise therapy is prescribed by all orthopedists because it plays a key role in successful rehabilitation.
The exercises make the joint capsule more mobile and thus allow a more extensive movement.
In my experience, in the case of problems with the spine, the best results can be achieved by extension. It is important to always consider the pain threshold.
In patellofemoral pain syndrome, in which the kneecap shifts outwards or inwards, the following therapeutic measures bring the best results:
- strengthening of the medial thigh muscle,
- stretching of the iliotibial ligament, ischiocrural muscles and external wing ligament;
- Kinesio taping for positioning the kneecap.
In the case of arthroscopic reconstruction of the cruciate ligament, the athlete should also perform movement exercises in the swimming pool (hydrokinesitherapy), because physiotherapy of 6 months is provided for the operated patients; in the water, the loss of muscle tone and muscle mass is reduced and the athlete remains in training.
For postoperative rehabilitation of the shoulder after reconstruction of the rotator cuff, orthopaedists generally recommend strengthening the stabilizing muscles; this means rotational exercises against the resistance of gymnastic bands, cable pulls (pulley) and pressing a rubber ball against the wall.
Osteoporosis is a typical sign of aging and means a decrease in bone density and a resulting higher susceptibility to fractures.
In order to slow down or stop the progression of osteoporosis, gymnastics is the best therapy because forces act on the bone that cause calcium to be deposited in the bone.
In neurological diseases, the methods of therapists Vojta, Kabat, Bobath, Castillo Morales, Perfetti, Doman can be used.
There is no right or wrong method, the treatment must be individually tailored to the diseases and symptoms of the patients.
Neurological diseases can have a wide variety of clinical pictures; a patient who has suffered a mild stroke, for example, after 3-6 months of targeted rehabilitation, can regain the lost functions or learn substitute functions that allow him to carry out everyday activities.
Anyone who has suffered severe damage may no longer be able to walk and is confined to the bed with great motor difficulties; in these cases, a year after ischemia, it is impossible to regain the lost abilities, doctors agree.
In severe cases, physiokinesitherapy consists of passive mobilization to avoid joint stiffness and other effects on muscles and skeleton caused by immobilization.
Children born with infantile cerebral palsy take longer to learn to crawl, sit, and walk, but after years of performing the exercises, unexpected results can be achieved.
Physiokinesitherapy is especially indicated for cardiovascular diseases, especially if the coronary arteries are affected.
If the disease situation has stabilized, cardiovascular strengthening gymnastics should be carried out regularly so that a positive effect can arise.
This means 60 minutes of gentle gymnastic exercises, which are initiated and completed by a warm-up phase.
The aim is to strengthen the heart, because in this way the heart rate can be reduced at rest and when carrying out everyday activities, which in turn reduces the risks of a heart attack.
In diseases of the respiratory system, physiokinesitherapy is particularly recommended for patients with smoker’s lung (chronic obstructive pulmonary disease).
Even if the damage is irreparable, the quality of life of patients can be significantly improved.
Those affected often have difficulty walking more than 200 m; the training improves the physical condition.
Pelvic floor rehabilitation
Another disease that can be treated well with this therapy is urinary incontinence in women.
It is caused by a weakening of the pelvic floor muscles (especially the lifting muscle of the anus), which can occur after childbirth or with age.
Pelvic floor rehabilitation is based on some exercises to strengthen the pelvic muscles and synergistic muscles: guides, hip spinning outward spins and glutes.