Physical therapy for the musculoskeletal system is the subspecialty of physical therapy with which most people are familiar.

1. MUSCULOSKELETAL PT: GET TO THE ROOT OF THE PROBLEM?
TH E MAN Y FACES OF MU S CU LOS KELETAL PH YS ICAL TH ERAPY
Physical therapy for the musculoskeletal
system is the subspecialty of physical
therapy with which most people are
familiar. The term physical therapist often
conjures up images of clients doing back
strengthening exercises, athletes
working on their shoulders and older
adults rehabbing a total knee
replacement. These are all examples of
physical therapy for the musculoskeletal
system and many PT professionals will
dedicate their careers to mastering the
assessment and treatment of the bones,
joints, tendons, fascia, ligaments and soft
tissue, the structures that make up the
musculoskeletal system. Let’s take a
further look into how physical therapists
work with the musculoskeletal system.
WH AT KIN DS OF MU S CU LOS KELETAL CON DITION S DO PH YS ICAL
TH ERAPIS TS TREAT?
A wide range of conditions and injuries affect the musculoskeletal system. In general,
we can think about musculoskeletal physical therapy as addressing four primary
categories of musculoskeletal concerns.
Acute injuries: Acute injuries are those that have recently occurred, typically within the
last few weeks (subacute injuries are included here). Symptoms of an acute injury to
the musculoskeletal system include:
• Pain
• Swelling and inflammation
• Muscle or joint stiffness
• Muscle weakness
• Redness and warmth
• Local deformity
• Difficulty moving or bearing weight through the area
Chronic injuries and issues: Chronic injuries are those that are more than a few weeks
old, have (optimally) entered a more chronic phase of healing wherein things like pain
and inflammation have significantly decreased. An example of this type of chronic injury
is a person seeking PT four weeks after an acute ankle sprain. This can also include
chronic irritation or pain that is ongoing or intermittent and may or may not be easily
attributed to a particular incident. For example, someone who experiences knee pain
whenever they run.
Pre- and post-surgical rehab: Surgeries are performed to address a wide range of
medical conditions and injuries. Any surgery, no matter how small, disrupts tissues in
the body and can lead to impairments in tissue mobility, scarring, pain, stiffness,
muscle weakness and alterations in movement. Musculoskeletal physical therapy aims
to address all of these concerns to help restore optimal functioning of the affected
JANUARY 6, 2023
MSK PHYSICAL THERAPY SERVICES
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2. area. The goal of pre-surgical rehab is to prepare the body for surgery and to help
optimize the post-surgical recovery and outcome.
Injury Prevention: Sometimes the goal of musculoskeletal physical therapy is to identify
risk factors for injury and intervene to address them before the injury occurs. This is
often done in the context of athletes who are preparing for an upcoming season or a
new training block. In this case therapists combine their knowledge of the
musculoskeletal system and their familiarity with the demands of a particular sport or
activity to identify areas of movement and performance that may predispose the
individual to injury in the future. After a thorough assessment, treatment and exercises
are prescribed as necessary to optimize performance and lower the risk of injury.
Another area of musculoskeletal physical therapy centered on injury prevention is PT
for pre-partum women.
As you can see, musculoskeletal physical therapy can address a wide range of
conditions affecting the body. Here is a list, though far from comprehensive, of
conditions that musculoskeletal physical therapists treat
• TMJ disorders
• Back pain and neck pain
• Other joint pain (knee, ankle, foot, hip, shoulder, elbow, wrist, hand)
• Arthritis
• Post-surgery (examples: ACL repair, bunion repair, hip or knee replacement, carpal
tunnel surgery, spinal fusion, and many, many more)
• Fracture recovery
• Rotator cuff injury
• Muscle strain
• Ligament sprains
• Muscle contusions
• Joint replacement recovery (knee, shoulder, hips, etc.)
• Headaches
• Muscle stiffness and tightness
• Pain with activity
• Pre- and post-partum
WH AT DOES MU S CU LOS KELETAL PH YS ICAL TH ERAPY LOOK LIKE?
As with all physical therapy, musculoskeletal physical therapy should be individualized
to meet your specific needs. After interviewing you about your symptoms and
performing a physical exam, your physical therapist can discuss with you the plan of
care. Typically you will work with your physical therapist between 1 and 3 times a week
for a number of weeks, tapering off as you make improvements and near your
discharge date. The main goals of this type of physical therapy is to help you return to
the functional activities you need and love to do with as few symptoms as possible and
to give you strategies to maintain the improvements you made during therapy to
prevent recurrence of the problem in the future.
S OME OF TH E PRIMARY GOALS OF MU S CU LOS KELETAL PH YS ICAL TH ERAPY
ARE AS FOLLOWS :
Reduce pain, inflammation and irritation: While completely eliminating your symptoms
may take time, making you more comfortable in the meantime is an important first step
in your rehabilitation. Applying ice or heat, ultrasound or electrical stimulation to the
affected area can often give you some relief. Soft tissue mobilization or gentle joint
mobilization may also be employed by your physical therapist to reduce tissue irritation.
Improve flexibility: Your PT program may include stretching, myofascial release
techniques, joint mobilization and mobility exercises to improve flexibility and range of
motion.
Build up your strength: You will learn exercises to help strengthen the muscles around
the injured area and other connected areas of the body. Having good strength
throughout the body allows stress to be distributed across multiple joints and helps to
prevent injury and irritation in the future.
Optimize your movement: Learning proper biomechanics and enhancing the
neuromuscular control of joints and muscles is an essential component of healing and
preventing injuries. Physical therapists are movement experts and through analyzing
your movements, can guide you in improving how you move and train your muscles to
perform those movements in the safest and most effective way possible.
RES T IS N OT ALWAYS BES T
Many of us are in the habit of resting and cutting back our activities whenever we feel
pain or experience injury but active recovery is often the best strategy. The important
thing, however, is to do it in a way that enhances the resiliency of the injured or
irritated tissues and doesn’t injure it further. This is where the knowledge and expertise
of a licensed physical therapist comes in handy. Even if the injured area must be
immobilized and rested for a period of time, finding appropriate ways to exercise
adjacent areas and promote movement will help with healing and recovery.
So if you are struggling with a new injury, planning on having surgery, looking to
prevent a future injury or are tired of dealing with some chronic irritation, don’t play the
wait-and-see game. Call Evolve PT today and let our skilled team of providers guide you
to long lasting recovery and improvements.

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