PHYSICAL THERAPY

Physical therapists utilize exercise and hands-on manual therapy skills, education and skills training, in addition to modalities such as spinal traction, ultrasound, and electrical stimulation to relieve pain and inflammation. Functioning as part of a multi-disciplinary team, they work with physicians, nurses, and other therapists as well as social workers, teachers, and employers to help patients reach their goals and maximum independence.

All Perham Health therapists have advanced training in treating musculoskeletal pain from head to toe, as well as years of experience treating patients with neurological conditions, falls, swelling after cancer treatment or from venous insufficiency, dizziness, and after orthopedic surgery such as knee replacement or rotator cuff repair. We help children with a wide variety of neurological, orthopedic, developmental and sensory disorders.

Specialized Services

Dry Needling

Dry needling is not acupuncture, though it does involve the same kinds of monofilament needles.

Here’s how it works. In dry needling, needles are inserted into trigger points in the muscles to relieve pain and help restore normal function. Among the many potential advantages, dry needling can be used to treat short-term and long-term pain without the use of medications or surgical procedures. No medication is injected through needles in dry needling. However, electricity may be applied to help better treat certain trigger points. The needles may be inserted for a few seconds or up to 30 minutes depending on the treatment.

Our skilled therapists will work with you to learn about your muscle pain and recommend a treatment plan tailored to your unique needs.

Graston Soft Tissue Mobilization

Graston Technique is a soft tissue mobilization procedure that is used to detect and minimize the presence of buildup of fibrous scar tissue. When an injury occurs in the body, the natural healing process is to create adhesions and scar issue in the soft tissue. This buildup of scar tissue in our muscles, tendons and ligaments may lead to decreases in range of motion, cause pain and dysfunction.

Our therapists use steel instruments to break down scar tissue and increase circulation to soft tissue structures to promote healing. The trained therapists glide steel instruments on patients’ skin to identify and treat fibrous tissue. Graston is often paired with exercise to re-align tissue fibers in a more normalized pattern to promote healthy tissue.

Graston Technique is often effective in treatment of tendonitis, carpal tunnel syndrome, cervical sprains and strains, lateral and medial epicondylitis, plantar fasciitis, rotator cuff tendonitis, scar tissue, and more.

Vertigo Treatment

Dizziness is a very unpleasant experience that can leave one feeling nauseous, fatigued, and fearful of falling. Many people suffer from vertigo, or dizziness, and are unaware that therapy can help them.

The physical therapists at Perham Health have advanced training in the treatment of vestibular disorders, including benign positional paroxysmal vertigo (BPPV). The use of infrared goggles – or video Frenzel lenses – help determine the type of dizziness and the correct treatment for it. Vertigo treatments are customized to the type of disorder, with special exercises tailored to help symptoms resolve. Balance activities are also commonly included to ensure patients can safely move around and reduce the risk of falling.

Manual Lymphatic Draining

Our body has an important function to circulate fluids throughout its structures and remove any impurities it finds in the circulatory system. The system responsible for this filtering is called the lymphatic system. When fluid becomes stagnant in the body’s tissues, it leads to swelling and increases the risk for bacteria and viruses to grow. Swelling can be classified into edema which is excess fluid trapped in your body’s tissues and lymphedema which is associated with malfunction in the lymphatic system and is characterized by excessive tissue proteins which can lead to fibrosis (hardening of the tissue). Lymphedema is progressive and if untreated can result in chronic disfigurement, infection, open wounds, and loss of function.

Our certified therapists provide a comprehensive evaluation and treatment program that is individualized to each person’s needs. Treatment may include manual lymphatic drainage massage, compression bandaging, compression garments and exercise programs. The objectives of treatment are to reduce the swelling and to assist in getting patients back to a manageable living and working environment. When therapists are actively trying to reduce the swelling with massage and compression, as well as teaching the patient how to exercise and manage the swelling on their own, patients may be seen for one and a half hours up to four days/week. That period typically lasts for a couple weeks.

BIG/LOUD Program for Parkinson's Disease

Parkinson’s disease is a chronic progressive disorder of the brain that affects people by inhibiting their ability to use their muscles normally. This leads to tremors, rigidity, slower walking with shortened steps and an increased fall risk, poor posture which is typically accompanied by aches and pains, and difficulty speaking with appropriate volume or enunciating words. Our team of physical, occupational and speech therapists have advanced training in treating patients with Parkinson’s disease utilizing the LSVT BIG & LOUD program.

The LSVT BIG program was developed to help people with Parkinson’s disease improve strength, balance, coordination, and energy. It is a well-researched, international program that has shown to be effective in many cases to slow the progression of Parkinson’s disease and improve quality of life through increased ability to walk, move, and return to favorite activities. People who participate in the BIG program will be provided with a list of daily home exercises, as well as guided through these exercises and other activities by a therapist in order to achieve their particular goals. If there is something in particular a patient would like to work on, the therapist will break down the activity and work through it with them to improve the patient’s ability to complete that activity.

Parkinson’s disease may affect a patient’s speech as well, causing difficulty speaking at normal volumes due to weakened muscles, difficulty finding the right words, and difficulty articulating speech clearly. The LSVT LOUD program is an effective speech treatment designed to stimulate the muscles of the voice box and speech mechanisms through a systematic hierarchy of exercises to maximize speech intelligibility. Treatments have been shown to improve vocal loudness, intonation, and voice quality, with improvements maintained for up to two years after treatment. It is not simply training people to shout or yell; treatment uses loudness training to bring the voice to an improved, healthy, vocal loudness without straining.

Participants in the program come to therapy four days a week for four weeks. Therapy sessions are typically 45-60 minutes in length. Once the four weeks are completed, the patient will continue the exercises at home. Parkinson’s disease causes progressive degeneration of the brain and thus limits a person more and more as they age. For this reason, patients return to therapy every 6-12 months for a “check-up,” and if the patient has declined, therapy can resume.

Myofascial Release

Myofascial Release is a specialized soft tissue stretching technique used to treat patients with a variety of problems by releasing the tightness in the fascia- a thin tissue that covers all the organs, bones, nerves, muscles and tissues in the body. When an injury occurs from trauma, overuse, or even positioning, the fascia becomes short and tight. This uneven stress can cause pressure, pain and misalignment of the body.

Perham Health therapists are trained in Myofascial Release and complete a full evaluation to determine where tightness is located in the body. Treatment includes a combination of deep tissue releases and light stretching to the tight area. The therapists waits for the tissue to relax and then increases the stretch. The stretch is guided by feedback the therapist feels from the patient’s body. This tells the therapist how much force to use, the direction of stretch and how long to stretch. The process is repeated until the tissues relax, and then the next area is stretched.

Myofascial Release is a holistic approach to treatment with the main objective to reduce pain, increase function and improve the patient’s quality of life.

Fall Prevention

Falls are a serious problem for the elderly, with 35-40 percent of the population over the age of 65 falling each year. Unintentional (accidental) injuries are the fifth leading cause of death in older adults, and falls are responsible for two-thirds of the deaths from unintentional injuries. In addition to physical injury and death, falls also commonly have psychological and social consequences, as patients develop a fear of falling and restrict their activities. Falls are a major reason for 40 percent of nursing home admissions.

There are multiple risk factors for falling, some of which are modifiable, and some which are not. These include:

Age
Arthritis
Cognitive impairment
Depression
Difficulty bathing, dressing, & feeding oneself
Difficulty walking
History of falls
Muscle weakness
Poor balance
Use of canes and/or walkers
Use of four or more medications
Visual difficulties

Physical therapy can help reduce some of these risk factors by treating your arthritis, teaching you to walk more safely and the proper use of canes and/or walkers, and improving your balance and strength. Environmental risk factors are also important to address and our therapists will provide a checklist to go through your home and address things like throw rugs and other tripping hazards, poor lighting, lack of bathroom safety equipment and improper footwear. We will also teach patients how to get up off the floor after a fall and how to fall properly to minimize the risk of serious injury.

Women's Health

Throughout her lifetime, a woman’s body undergoes unique changes and faces unique challenges that can cause problems men don’t experience. Having a therapy team with the skills and knowledge to handle these issues locally is something Perham Health is happy to possess. From the challenges of back pain before and after pregnancy, to the challenges of urinary incontinence and osteoporosis in later years, Perham Health’s physical and occupational therapy departments professionals have advanced training to help you overcome these challenges.

Pregnancy and post-partum pain

A woman’s body goes through many anatomical and physiological changes during and after pregnancy that can often lead to pain and discomfort. Studies have shown that anywhere from 20-72% of women will experience low back and pelvic girdle pain during pregnancy. This does not have to be the normal. At Perham Health, we have therapists who can help with:

Back and pelvic pain both during and after pregnancy
Weakness of core musculature (diastasis recti)
Offer recommendations on bracing and belts to provide support and alleviate pain during and after pregnancy
Provide education on body mechanics both while pregnant and while caring for your new baby
Provide advice on exercise and maintaining your health during and after your pregnancy
Improve swelling in your legs through gentle massage and/or providing recommendations on compression
Help with bladder control issues

Our therapists will provide an extensive evaluation to be able to tailor a program that is suited to your specific needs while using a gentle approach with hands-on treatment, education, and instruction.

Urinary incontinence

Urinary incontinence affects approximately 20 million people in the United States, including somewhere between 26-46% of women. It is a serious medical condition which can lead to rashes, pressure ulcers, and urinary tract infections, and is a serious psychological stressor, as a source of embarrassment and self-imposed social and physical activity restriction, impaired sexual relationships, impaired emotional and psychological well-being and quality of life.

There are three main types of urinary incontinence: stress urinary incontinence, which is involuntary leakage during exertion or effort, sneezing or coughing; urge urinary incontinence, which is involuntary leakage which occurs during or immediately after a sense of urgency; and finally a mixed type which has features of both.

Our therapists at Perham Health have received advanced training in how to assist patients with managing these conditions, through addressing underlying weakness in the pelvic floor muscles and reduced awareness of bladder irritants. The American College of Physicians now strongly recommends pelvic floor muscle training with bladder training as the first-line treatment for women with stress urinary incontinence and mixed type, with a weaker recommendation for women with urgency urinary incontinence. The therapy is more than Kegel’s; if you suffer from urinary incontinence, ask your medical provider for a referral.

Osteoporosis

According to the National Center for Disease Statistics, 16% of adults aged 65 and older have osteoporosis of the lumbar spine or hip, with women nearly five times as likely to have it as men. Unfortunately, one in two women, and one in four men, will fracture a bone some time in their lifetimes because of osteoporosis. Up to one in five people who fracture their hip die within a year, and one in four will require a long-term stay in a nursing home. Only one third of those suffering a hip fracture get back to their prior level of functioning.

There are treatments for osteoporosis, and hopefully patients pair with their doctor to use medications and diet, smoking cessation and limiting alcohol consumption to address bone density. However, often missing pieces in the management program are learning proper posture and safe ways of moving and lifting, instruction in safe exercises to improve bone density as well as in what exercises and activities to avoid, balance and fall prevention strategies, including a home safety checklist. Perham Health’s physical therapists can fill these gaps, and arm patients with the knowledge and skills to minimize their risk of fractures.

If you have been diagnosed with osteoporosis, talk to your medical provider about a referral.

Concussion Treatment

Physical therapy is able to help individuals who suffer from a concussion that has lead to symptoms and impairments which make functional movement and tasks difficult.

This includes treatment for: vestibular impairments resulting in disequilibrium, dizziness and decreased balance; neck pain and headaches; poor tolerance to exertion; difficulties with motor function which may include decreased coordination, decreased reaction time, and impairments with dual tasking.

The goal of physical therapy in concussion treatment is to help individuals recover, allowing them to return to daily activity, play and/or job duties without restriction.