We are unique in our approach and provide a highly skilled hands-on experience offering advanced specialized techniques of orthopedic manual physical therapy and dry needling in conjunction with prescribed therapeutic exercise that you will not find in standard exercise based physical therapy clinics. Physical therapy and exercise are not synonymous, doing exercise alone is not physical therapy. Physical therapist at NNPT have a multi-faceted skill set. We believe evidence-based high level advanced manual physical therapy is the foundation and key to unlocking your potential making exercise more effective for significantly enhanced physical therapy experience and unsurpassed outcomes.
What is Manual Physical Therapy
Manual physical therapy is the highly skilled scientific evidence-based art of hands-on treatment involving soft tissue mobilization, neural mobilization and joint mobilization. These techniques require the therapist to have a fluent knowledge of anatomical structure and biomechanics combined with highly skilled techniques applied through their hands to maneuver and mobilize soft tissue, joints and nerves. This approach entails a thorough specialized examination through a comprehensive hands-on assessment process identifying involved tissue and body structures to determine the many factors that can cause pain, inflammation, limited mobility and decreased function. Your orthopedic manual physical therapists at NNPT identifies these structures involved through special orthopedic and neurological tests, specific measurable mobility testing and skilled palpation. Based on the assessment, techniques are applied using hands-on specialized soft tissue mobilization, joint mobilization and specific neural glides which may include; end range physiologic mobilizations, oscillatory techniques and sustained passive joint mobilizations in conjunction with active movements from the patient. Dry needling is also a manual skill that becomes more refined in the hands of a highly trained manual therapist.
Why is NNPT Manual Physical Therapy the Choice
Many patients have done exercise either with a physical therapist or assistant, a trainer or on their own without improvement and frequently worsening of their condition. Logically to provide more exercise is not the solution without resolution of the underlying problems. Inflamed tissue "itis's", shortened tissue, adhered tissue, scar adhesion, nerve compression, joint stiffness or mal-positioned joints will not respond to exercise (alone) and often get worse becoming chronic which may lead to further degenerative process potentially requiring avoidable pharmaceutical or surgical interventions. Skilled manual Physical Therapy and Dry Needling provided by a trained orthopedic manual physical therapist at NNPT can resolve these issues through highly skilled precise manipulative soft tissue, scar, joint and nerve mobilizations allowing the patient to successfully progress with effective strengthening, stretching and mobilization exercise and return to pain free function.
Case Spotlight
Unremitting Chest Pain 5 Months After Open Heart Surgery
Mr. S, was a 68 year-old male status post open heart surgery. He had a successful surgery but was left with significant anterior chest pain with difficulty taking deep breaths and constant pain for 5 months after the procedure. He had several injections that did not relieve his pain and was told there was nothing more that could be done. Mr. S was referred to NNPT, was assessed including palpation of soft tissue, spine and ribs and it was determined that he had a rib that was not moving properly in the anterior rib joint (costochondral). Mr. S was skillfully mobilized through his spine and ribs and had instant relief after 1 treatment with no follow-up needed.
Patient Snapshot:
Mr. S, 68, persistent anterior chest pain and painful deep breathing 5 months post-op; injections failed to help.
Assessment:
Manual exam revealed costochondral/rib mobility dysfunction with thoracic involvement.
Manual & Rehab Approach:
Skilled rib and thoracic mobilization with targeted manual techniques.
Outcome:
Immediate relief after one treatment; no follow-up required.
70 Years of Elbow Contracture and Pain After Childhood Fracture
Mr. C. a 75 year-old male presented to NNPT for treatment of his left shoulder secondary to a rotator cuff tear. During his thorough assessment it was noted that his other elbow was in a bent position and was asked what had happened to his right arm. He stated he had ridden his tricycle down the stairs at 5 years old and broke his elbow. He was casted at that time and has since had limited mobility and elbow pain. He asked if therapy may help. It was suggested that since he had not had success with any prior treatment that manual therapy could possibly benefit him. He was told by an orthopedist that there was nothing that could be done. He was also told that an elbow replacement was not an option secondary to the contracture of his elbow and likelihood of a poor outcome. Upon a second opinion he was told he could try PT but it would not likely help. After a comprehensive assessment it was determined he was lacking 20 degrees of elbow extension, had 6.5 cm gap from his right fingertips to his right shoulder when reaching to his shoulder, significant end range pain with bending and straightening his arm and only 25 pounds of right-hand grip strength. Functionally he had limited use of his arm and had to carefully position his arm at night to be able to sleep. Manual therapy was initiated including specific skilled joint mobilizations. After his initial session he was able to get his fingertips to his chest and shoulder, his arm could lay flat in bed, and he had a significant reduction in pain. After seven sessions he continued to have improvement and grip strength improved from 25 pounds to 70 pounds. He continued to have mild discomfort but had a significant improvement in right arm function, was able to lay in bed with his arm extended without pain and reported improvement in quality of life.
Patient Snapshot:
Mr. C, 75, lifelong right-elbow stiffness/pain (fracture at age 5); told surgery unlikely to help and PT unlikely to change it.
Assessment:
20° extension, 6.5 cm fingertip-to-shoulder gap in flexion, 25 lb grip; significant end-range pain and disrupted sleep positioning.
Manual & Rehab Approach:
Specific elbow joint mobilizations and graded home program.
Outcome:
After first session: fingertips to chest/shoulder, arm lies flat in bed, pain markedly reduced. After seven sessions: grip 25 → 70 lb, better function, sleeping without pain; mild residual discomfort only.