Therapeutic ExerciseTherapeutic exercise refers to a range of physical activities that helps restore and build physical strength, endurance, flexibility, balance, and stability. The goal of therapeutic exercise is returning an injured person to a pain-free, fully functioning state. Therapeutic exercise is managed by the chiropractor. We will begin the therapeutic exercise by taking a medical history and evaluating a patient’s physical condition and capabilities. Based on an initial assessment, the care provider will determine a treatment plan that includes an exercise program tailored to the patient’s needs. Therapeutic exercise programs are carefully monitored and emphasize slow progression. A provider may assist the patient with some physical movements, if warranted, and will continuously modify the treatment plan according to the patient’s progress. The first goal of any therapeutic exercise plan is to reduce pain and inflammation. Next, the goal may shift to regaining range of motion, rebuilding muscle strength, and developing endurance. Therapeutic exercise programs may include:
Strengthening exercises: To develop strength, the emphasis is on heavy resistance and a limited number of repetitions.
Endurance exercises: To develop endurance, large muscle groups are engaged for a longer period of time.
Flexibility exercises: To develop flexibility, stretching and movement are emphasized.
Balance and coordination exercises: To develop balance and coordination, the emphasis is on center of gravity.
Neuromuscular Reeducation Therapy The American Medical Association defines neuromuscular reeducation as the use of therapeutic exercise techniques to improve impaired movement, balance, coordination, decreased kinesthetic sense, and impaired proprioception (sense of one’s location in space). The key approach for neuromuscular reeducation therapy is proprioceptive neuromuscular facilitation (PNF). Proprioceptive Neuromuscular Facilitation (PNF) retrains the nervous system in two ways. First, it stimulates proprioceptors, which are receptors in joints that relay information about the body’s position through the nervous system to the brain. Second, it uses a particular pattern of stretching to help increase movement. PNF can be a particularly effective treatment modality. Patients who are in pain are often unaware of the various ways that their bodies compensate for that pain, and these unconscious adaptations can introduce new sources of pain. The stretching patterns and sense of body positioning can help make patients aware of the unhealthy, painful postures and promote greater strength and flexibility.