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Physical Therapy Services


Lymphedema is a condition of chronic swelling. Lymphedema occurs when there is damage to the lymph nodes or vessels. Lymphedema is diagnosed as either Primary or Secondary Lymphedema.

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Primary lymphedema is when the swelling happens without reason or congenitally at birth.

Secondary Lymphedema occurs when damage happens to the lymph system. This could be surgery,  radiation, damage from trauma, chronic inflammation from venous insufficiency or infection, cancer cells blocking the vessels, parasites (filariasis) or other foreign material that might be blocking the lymphatics.

Primary lymphedema is far more common in the legs than arms, and more common in women than men.

Causes of Swelling

Swelling can happen when you sprain your ankle, get a bug bite, break a bone or just get a bump or a bruise. This kind of swelling is called “lympho-dynamic edema” because the lymphatic system is still working.  Lymphedema happens when the lymph system is not able to properly move the body’s fluid.

The lymphatic system works to remove bacteria, viruses and initiates the immune response to fight invaders.

Lymphedema Therapy and Treatment

Lymphedema therapy is designed to help reduce the size of the affected body part and provide education on how to keep your lymphedema under control.

Lymphedema treatment consists of two phases: Active Phase: this includes manual techniques of Manual Lymphatic Drainage, and multi layer bandaging until girth is reduced to within normal limits of non affected limb and education on skin care.

Then the Maintenance Phase consists of compression garment fitting, exercises, and instruction on self MLD.

Cranio – Sacral Therapy

Cranio – Sacral Therapy is an alternative “energy” treatment that uses light touch to palpate the rhythmic motions of the cranial bones and sacrum that is created by cerebrospinal fluid pressure. Selective pressures are used to gently modify the craniosacral motion to achieve a therapeutic result.

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The Craniosacral system can be defined as a functioning physiological system. The craniosacral system is made up of following anatomical parts:

Meningeal Membranes

  • Osseous structures that the meningeal membranes attach
  • Non osseous connective tissue related to meningeal membranes

Cerebrospinal Fluid

All structures that assist in production, resorption and containment of the cerebrospinal fluid.

The Craniosacral system is related to, influences and is influenced by:

  • The nervous system, musculoskeletal system, vascular system, and the lymphatic system, the endocrine system, and the respiratory system.
  • Abnormalities of the craniosacral system, whether it be structural or functional, will affect the development or function of the nervous system including the brain.

When to use Cranial Sacral Therapy

Craniosacral therapy is a helpful treatment for chronic pain patients, fibromyalgia, anxiety, head injuries, and trauma (emotional or physical).


Myofascial Release

Myofascial Release is an alternative whole body “Manual” therapy that uses a hands on approach to evaluate and treat the human body. Myofascial Release is focused on restrictions and imbalances of the connective tissue in the body. Myofascial restrictions can be caused from physical trauma, infectious disease, inflammatory processes or structural imbalances.

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Myofascial Release is an alternative whole body “Manual” therapy that uses a hands on approach to evaluate and treat the human body. Myofascial Release is focused on restrictions and imbalances of the connective tissue in the body. Myofascial restrictions can be caused from physical trauma, infectious disease, inflammatory processes or structural imbalances. Myofascial Release uses sustained manual pressure on the connective tissue to release restrictions that can cause skeletal muscle immobility, movement dysfunction and pain. Myofascial Release promotes restoration of movement, eliminates pain and promotes wellness by improving blood and lymphatic circulation and inducing a stretch reflex in the muscles. All Myofascial release treatments use the John F. Barnes approach!

What is Fascia?

Fascia covers all our organs, muscles, bones, nerves, blood vessels and lymphatic vessels and cells. Restrictions in the fascia can cause pain, mal alignment, and movement dysfunction.
There are several conditions that create restrictions in the fascia; Trauma – physical or emotional, inflammation- can be from infection or trauma, repetitive stressors, poor posture, surgical adhesions, scar tissue.

Effectiveness of Myofascial Release

Myofascial Release is an effective form of manual therapy for several conditions including: Chronic or Acute pain, postural imbalances, pre and post surgery, scar adhesions/scar tissue, head trauma, headaches and migraines, Fibromyalgia, Range of motion restrictions in any joints, anxiety, emotional trauma, TMJ dysfunction, neurological conditions, neck and back pain.


Myofascial Release benefits are: Reduced or elimination of pain, Improved posture, Improved daily functioning, increased flexibility and ease of movement, higher energy levels and increased body awareness.

Myofascial Release

BioMedical Acupuncture – Dry Needling

Dry Needling is also referred to as “Trigger Point” dry needling. Dry needling is a treatment technique that uses ultra thin mono – filiments as an extension of manual trigger point therapy. Dry Needling restores physiological homeostasis, creates self healing, and treats the root cause of disease and symptoms. Dry Needling is an effective way to reduce and eliminate pain, avoid invasive interventions , and Improves functional range of motion.

Pelvic Floor Rehabilitation & Women’s Health

The pelvic floor is made up of muscles in the pelvis, lower abdomen and perineum. These muscles create a sling that supports the pelvic and abdominal organs as well as assist with bladder and bowel control. Pelvic floor dysfunction affects 1 out of every 5 Americans.

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Pelvic Floor Dysfunction

Pelvic floor dysfunction can be a wide range of symptoms that occur when the pelvic floor muscles fail to work properly. Symptoms may include the following:

  • Urinary Frequency and leakage
  •  Incomplete bowel movement or several bowel movements in a short period of time
  • Straining or Constipation
  • Pain during urination or intercourse
  • Pain in the low back, sacroiliac joints or coccyx
  • Bowel incontinence

Cause of Pelvic Floor Dysfunction

The exact cause of pelvic floor dysfunction, in many cases, is unknown but some common causes are:

  • Trauma
  • Childbirth
  • Low back of SI dysfunction
  • Postural or muscular imbalances
  • Aging process
  • Post surgical treatment

Teartments for Pelvic Floor Dysfunction

Common conditions treated are the following: 

  • Urinary Incontinence
  • Urinary Frequency and Urgency
  • Vulvodynia
  • Endometriosis
  • Interstitial Cystitis
  • Lymphedema
  • Menstrual Problems
  • Adhesions
  • Coccygeal Pain
  • Episiotomy Scars
  • Painful Intercourse
  • Infertility Problems
  • Problematic Breast Implant/Reduction Scars

Functional and Therapeutic Exercises

Functional therapeutic exercise allows patients to regain their pre- injury level of function through development and progression of an exercise program. Development of a functional exercise program requires a continuous process of decision making that requires:

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  • Knowledge of human anatomy, physiology, biomechanics and function.
  • An Understanding of tissue and osseous healing stages
  • An Understanding neuromuscular responses
  • Evaluation skills to determine structural impairments that affect function and restrict activity
  • Knowledge of diagnosis, surgical intervention and therapeutic exercise interventions, and precautions.

Early phases of rehabilitation focus on activation of specific muscles to develop a balance with strengthening and timing of contractions of opposing muscle groups. Proximal core stability is vital for coordination of the extremities, therefore stability and balance are included in the early phases of rehab.

As muscle strength, endurance and control of a specific involved area improve, focus is shifted to strengthening muscle groups in functional patterns. This may be in weight bearing or non weight bearing positions. As function improves, the exercises can be more specific to activity.

The cornerstone of functional therapeutic exercise is the involvement of task specific movement patterns that are superimposed on sufficient stability, balance and muscle function to meet the demands in a patient’s life.

Dry Needling

Neuromuscular Re-education – Post Stroke, Parkinsons, M.S.

Neuromuscular re-education is a technique used to restore normal body movement patterns with control. The nervous system controls all our body movements, so neuromuscular re-education technique is used frequently in outpatient physical therapy.

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Neuromuscular re-education is a technique used to restore normal body movement patterns with control. The nervous system controls all our body movements, so neuromuscular re-education technique is used frequently in outpatient physical therapy.

Neuromuscular re-education consists of manual therapy techniques, such as, PNF, instruction on segmental activation of certain muscle groups, activities for balance and core control and other exercises to produce normal movement patterns.

Neuromuscular re-education techniques are used for a variety of situations to establish normal kinesthetic sense and proprioceptive awareness. Neuromuscular re-education is used for pre and post surgical treatment, Parkinson’s disease, strokes, brain injuries, balance and falls, and other injuries or traumas.

Neural adaptation precedes a strength change in the form of hypertrophy or hyperplasia of the muscle cells. A patient will have increased strength in the first 3-4 weeks based on this neural adaptation. This is referred to as enhancement of “neural” communication. This helps to re-establish and re- educate the normal neural control that is needed for movement patterns without substitution patterns or other abnormalities.

If you have a joint that does not articulate through its full range of motion, there will be weakness and functional limitations that develop over a period of time. If not treated properly, an acute injury could lead to chronic injury, loss of use of the joint, and pain. Re-education of the nervous system must occur before enough strength and motion will occur to regain full function of the joint. The nervous system controls the musculoskeletal system and is absolutely necessary for proper rehabilitation.

Spine and Joint Rehabilitation

When conservative treatments options fail to provide effective relief for an injury or health condition, surgery may be suggested.
Common conditions that may require surgical intervention include but are not limited to the following:

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  • Full or partial knee replacements
  • Total hip replacements
  • Shoulder replacement
  • Rotator cuff tears
  • ACL, MCL, and /or meniscus repairs
  • Spinal Stenosis
  • Disc herniations

All of these surgeries can have an impact on your body. Most surgical procedures will induce pain, inflammation, mobility limitations, edema, and restrict mobility and function.

Physical therapy can assist in tissue healing and to avoid recurring dysfunction. Re-learning how to walk, squat, lift, transfer, dress, and move a joint or spine column is not uncommon in pre-post surgical rehabilitation. 

Post surgical rehab will not only minimize your pain but accelerate your healing process. It can eliminate post operative complications like infections,  muscle weakness, scar tissue development and decreased function that can negatively impact your long term health.

Vestibular Rehabilitation

The Vestibular system includes parts of the inner ear and brain that process sensory information involved with controlling balance and eye movements. Disease or injury can affect these processing areas, causing dizziness, and balance loss. Vestibular disorders can also result from or worsen with genetics or environmental conditions for unknown reasons.

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Vestibular disorders is an umbrella term used to classify many different types of conditions that affect the inner ear and the central nervous system involved in maintaining balance. 

With over twenty five known vestibular disorders, it is sometimes difficult to differentiate them because they all share common traits.

The most common vestibular disorders include:

  • Benign paroxysmal positional vertigo (BPPV)
  • Vestibular neuritis
  • Meniere’s disease
  • Vestibular Migraine
  • Age related dizziness and imbalance
  • Head injury concussion or TBI

Vestibular Dysfunction

 Vestibular dysfunction can also be complicated by the aging process, autoimmune disorders and allergies. 

Symptoms of a Vestibular Balance Disorder:

  • Dizziness
  • Feeling off – balance
  • Feeling of the world spinning around you
  • Blurred vision
  • Disorientation
  • Falling or stumbling


  • Vestibular Rehabilitation Therapy (VRT)

Vestibular Rehabilitation uses certain types of assessment skills to identify which ear the problem is coming from and which semicircular canal is affected. Vestibular Rehabilitation will include Repositioning Maneuvers for BPPV, habituation exercises, Education and exercises to address balance deficits.

Vestibular Rehabilitation will improve symptoms within 48 hours, and most can return to normal activities within 2 weeks. 

Postural Evaluation

Postural evaluations are the cornerstone for any form of physical therapy. Education and training on proper posture will prevent a multitude of injuries by setting you up for proper joint alignment and muscle function. Proper posture is vital to maintain healthy segmental movement patterns which will prevent overuse injuries, and repetitive use injuries, strains and sprains. 

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Knowing how to align and move your body is necessary for healthy muscle balance and function. Postural evaluations will always be a part of the evaluation process and can be an individualized treatment for prevention.

Muscular Re-education