Orthopedic Physical Therapy

Orthopedic physical therapy is care for the muscles, bones, joints, tendons, and ligaments. It includes pain relief and improved strength, endurance, flexibility, and function.

Physical therapists from Saunders Therapy Centers, Inc are trained to use a variety of techniques, including soft tissue manipulation, dry needling (similar to acupuncture), and therapeutic modalities such as electrical muscle stimulation/TENS, traction, heat, and cold.

orthopedicPhysical Therapy

You’ve got two systems that keep you going day in and out — your cardiovascular system, which pumps blood through your veins, arteries, and lungs; and your musculoskeletal system, which comprises the bones, joints, muscles, tendons, and ligaments. When one of these gets injured, it can significantly impact your daily life. That’s where orthopedic physical therapy comes in.

An orthopedic physical therapist (PT) has specialized medical training that can help restore movement and reduce pain caused by sports injuries, surgery, or chronic conditions like arthritis. The PT will work with you to develop an exercise program to improve flexibility and strength and use therapeutic modalities to soothe painful tissues.

Orthopedic PTs also often have advanced training in techniques, such as blood flow restriction and dry needling, which uses needles similar to those used in acupuncture to penetrate muscle trigger points and reduce pain. Other PT techniques include ultrasound, electrical stimulation, traction, and heat or cold treatments.

Your PT may begin with an initial consultation, where you’ll discuss your specific condition and what to expect moving forward. They’ll then develop a comprehensive treatment plan.

Throughout the treatment process, your PT will work closely with you to establish measurable goals for your recovery and support you in reaching them. The goal is to get you back to the activities you enjoy as soon as possible. But the most important part of the equation is you — you’re the only one who can put in the effort to reach your full potential. That’s why it’s crucial to set a goal for yourself and to stick with it, even when it’s difficult. A few key tips can help you get the most out of your sessions.

Manual Therapy

During manual therapy, your physical therapist will apply skilled techniques to move joints and soft tissues in ways that they cannot move on their own. This can help reduce pain and improve motion, posture, and function. It also helps to loosen tight muscles and release muscle tension, which can help prevent chronic injuries and decrease re-injury.

Your physical therapist may also use joint mobilization (passive traction and/or gliding movements applied to a joint surface) to restore the normal rolling-sliding mechanics of a joint. They may use soft tissue manipulation (passive pressure on the muscle or fascia to break adhesions and optimize muscle function) as well as modalities (such as heat or ice), massage, stretching, and movement-based exercise progressions.

Other therapeutic interventions include passive stretching, active mobilization, manual resistance exercises, and muscle energy techniques (MET). MET involves contracting and releasing a muscle to activate the muscle fibers and promote movement. Your physical therapist might also utilize strain counter strain and dry needling (a technique similar to acupuncture that uses needles to stimulate trigger points to relieve pain).

Many patients see orthopedic physical therapists for back problems, hip issues, shoulder pain, and other conditions of the musculoskeletal system. It’s important to find a clinic with experienced therapists who will be able to diagnose and treat your condition properly. Ask your doctor for a referral to an orthopedic physical therapist, or consider getting a recommendation from a friend who has had a musculoskeletal injury or surgery. Also, be sure to visit the clinic and look for clean equipment, respectful therapists, and convenient scheduling options that work for you. Be sure to set clear, realistic goals with your physical therapist, and don’t be afraid to ask questions if you don’t understand any of the treatment recommendations or procedures.

Therapeutic Modalities

PT modalities, or physical agents, use thermal, mechanical, electromagnetic, and light energy to help reduce pain and swelling as well as strengthen injured areas. They are a key part of the toolkit your physical therapist brings to your treatment session.

Some of the most commonly used therapeutic modalities include electrical stimulation, therapeutic ultrasound, iontophoresis, and neuromuscular electrical stimulation (NMES). Electrical stimulation produces a comforting tingling or thumping feeling when applied to your skin. It can also stimulate certain nerve fibers to decrease pain sensitivity and release neurotransmitters that prolong the pain-relieving effects. It is effective for ligament sprains, muscle strains, and joint stiffness.

Therapeutic ultrasound uses high-frequency sound waves to provide deep tissue heating. It helps increase blood flow to the injured area and relaxes tight muscles. It is also effective for reducing inflammation, relieving pain and swelling, and speeding up the healing process of the injured tissues.

Iontophoresis uses an electrical current to deliver medication across the skin into inflamed tissues, most often a steroid to reduce inflammation like dexamethasone for shoulder calcific tendonitis. It can also break up calcium deposits, reduce pain and swelling of nerves, or treat several other conditions.

Neuromuscular electrical stimulation, or NMES, uses an electric current to stimulate and contract muscle fibers. This allows the muscle to be “trained” and strengthened, helping to regain strength and function as the injury heals. It is a highly effective technique for treating back and neck injuries, as well as other soft tissue and joint problems. The therapist places electrodes on your skin or in the vicinity of the injured area to direct the electricity. They can pinpoint the exact muscle fibers they want to stimulate.


In this era of medical specialization, orthopedic physical therapy is one of several fields that offer an extremely focused approach to treating musculoskeletal injuries–injuries to the bones, joints, muscles, tendons, and ligaments. A physical therapist who specializes in orthopedics can help patients regain strength, mobility, and pain relief while learning how to prevent future injury.

Traction is a technique that involves pulling forces in opposite directions to immobilize limbs, reduce muscle spasms, relieve pressure on nerves, especially spinal nerves, and prevent or reduce skeletal deformity or muscle contractures. The application of traction is a complex skill that requires specific instruction to ensure the correct execution of the technique. The force must be balanced, splints or slings must hang free and be secure, the line and magnitude of pull must be precise and consistent, and the traction should not cause skin compression or bone movement (flexion or extension).

Physical therapists typically use a combination of manual techniques with other therapeutic modalities to manage low back pain. However, many therapists are still uncertain about whether and when to use traction for lower back pain. The purpose of this study is to examine how PTs choose to use traction, the patient characteristics that influence their decision to administer traction and its delivery mode/parameters, and the supplemental interventions that they routinely use with traction.

The results of the survey indicated that a majority of Orthopaedic section members use traction. Their decisions to use traction for low back pain are guided by recommendations from a classification system that preliminarily identifies those patients for whom traction may provide benefit. However, respondents are highly variable in their selection of patients for whom they utilize traction and their preferred traction delivery modes/parameters.

Kinesiology Tape

Kinesiology tape is a flexible elastic tape used to support muscles and joints. Physical therapists use this tool to mitigate pain, improve posture, facilitate movement, and assist in recovery from injuries. It is designed to be worn for several days and can withstand showering, swimming, and exercise. The tape comes in a wide variety of colors and shapes and can be purchased online or at many sports goods stores. You may have noticed it on athletes at your local gym or on the television during a sporting event as they demonstrate their impressive gymnastic skills.

In contrast to standard athletic tape which restricts motion, kinesiology tape is applied in a specific way to allow for the normal flow of body fluids. It lifts the skin and soft tissue layers, which allows for lymphatic drainage (in case of swelling) as well as provides space for muscles to move freely. It is believed to have positive effects on muscle contraction as it can increase the range of motion and quality of the movement. It can also reduce the pressure of a muscle on bones, thereby decreasing joint swelling and improving the ability to move.

It is a great tool to treat tendonitis and can be placed on the affected tendon to decrease inflammation and allow for decreased stress on the muscle. It can also be placed on and around closed scars to improve skin tone, decrease pain, and improve the pliability of the scar. It is important to note that this technique can only be effective if the fundamental rules of taping are followed.

The first and most fundamental rule is that the tape should never be stretched more than 75 percent of its original length. This will avoid the risk of irritation to the skin and a loss of its adhesive properties. The second rule is to avoid taping open wounds or any area that could potentially bleed or become infected. It is also important not to place the tape over a blood clot because it can cause dislodgement and subsequent hemorrhage.

Victoria Grant