Orthopedic & Total Joint Replacement Rehabilitation

Protocols following any orthopedic surgery vary physician to physician. To have continuity of care with the same therapist proving treatment visit after visit ensures not only these protocols are followed, but allows us the ability to accurately assess the patients progress and report back to the surgeon should follow up care be required.

From physical manipulation to the use of ultrasound, heat, cold, or electronic muscle stimulation we are able to follow a specific treatment protocol prescribed by a physician or develop a specific treatment plan under their supervision or consultation.

One component that is often ignored my many treatment facilities is scar massage. If the orthopedic repair is successful but the incision or scar adheres to the structures below the patient outcome can be adversely affected. At Pullano Physical Therapy this is consistently included as part of every orthopedic rehabilitation protocol.

Shoulder Impingement Therapy

Spinal Decompression Therapy

Shoulder Impingement is the most common shoulder injury treated in physical therapy practices.

It results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted.

The rotator cuff is a tendon linking four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. These muscles cover the "ball" of the shoulder (head of the humerus). The muscles work together to lift and rotate the shoulder.

The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs, or "impinges" on, the surface of the rotator cuff. This causes pain and limits movement.

Shoulder Impingement is typically related to one’s posture. We are all affected by today’s technology and as technology improves and media devices get smaller, the posture of the head, neck and shoulders are less anatomical correct and create an underlying impingement.

Treatment includes working with the patient to improvement their posture, identifying their underlying causes and offering them corrective solution.

Myofascial Release

Wrapping each and every muscle in the body is fascia, a thin membrane like coating which act to hold the muscle together into a functional unit. In a healthy patient the muscle contracts and relaxes below this fascia. Following an injury swelling and inflammation often occur and the muscle can then adhere to the fascia creating a feeling of tightness, decrease range of motion and pain.

Myofascial release is a gentle technique used to release the fascia from the underlying muscle. This light manipulation of this skin and superficial muscle degrades the adhesions and promotes the body’s natural healing process.

At Pullano Physical therapy myofascial release is used in almost every treatment protocol.

Spinal Decompression Therapy

Spinal Decompression Therapy

Very few offices specialize in spinal decompression like we do. At Pullano Physical Therapy, we have the staff, experience and equipment to treat patients needing spinal decompression.

Spinal decompression is used for relieving pressure on the vertebrae and nerve structures by manipulating the supporting structures of the spinal column. This treatment offers patients improved range of motion, pain reduction, and often eliminates issues within arms or legs affected by the compression within the spinal column.

Spinal decompression may be accomplished by manual decompression or the use of adjunct equipment such as spinal decompression tables.

Manual decompression is often used on the cervical spine as the muscular structures are not as strong as other regions of the spine. This hands on treatment allows instantaneous feedback top the provider through their sense of touch as they can feel release of tension and immediately adjust their pressure or technique being used.

In addition the manual techniques we also offer two sate of the art, computerized decompression tables which are used for cervical and lumbar decompression protocols. The use of these tables is included in the many treatment protocols used at our practice. Within 8-12 treatments with these tables are patients have seen significant, lasting improvement.

Sports Rehabilitation

The treatment of an athlete’s injury is one that often requires a more immediate approach. At Pullano Physical Therapy we understand that often the pain of watching ones team or event occur without their participation is can be more painful than the original injury. We do our very best to accommodate these athletes (professional or amateur) into our busy schedule as soon as possible.

Athlete’s injuries can be simple from a minor twist or sprain to more complex as a significant dislocation or injury requiring an extensive surgical repair.

All of our therapists have experience in a variety of sports and continue to participate in a variety of sporting activities on a regular basis. This experience allows them to understand not only the injury from their formal training perspective, but also the originating mechanism which allow them to better develop a specific treatment plan or protocol.

Understanding a specific injury is important to developing and treating an injury and helping them getting them back in the game.

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Water Sports Therapy

Water sports rehab is specialized care directed at the water skiing community that is plagued with significant ankle injuries. As a competitive water skier, Matt Pullano is a member of this community and quickly realized that therapy in this area was lacking.

Many therapy protocols for ankles have used traditional manipulation and strength training exercises. At Pullano Physical Therapy, we take this to the next level. In addition to the traditional treatment modalities we also include a unique stretching program and ski rehabilitation aimed at not only promoting our patient's healing but also returning the skiers to the water quickly and ultimately improving their performance.

Water Sports Therapy

Vertigo

Vertigo

While there are many other type of vertigo and balance disorders, the most common cause of room spinning disorders is Bengin Proximal Positional Vertigo (BPPV).

BPPV is a condition in which you have brief, but intense, episodes of dizziness that occur when you move your head. Vertigo usually comes from a problem with the part of the inner ear responsible for balance (vestibular labyrinth). BPPV occurs when tiny particles called otoconia in one part of your inner ear break loose and fall into the canals of your inner ear. Canalith repositioning can cure this specific type of vertigo (BPPV) in just one treatment.

This treatment is not a common offering at most physical therapy officers. At Pullono Physical Therapy we are proud to offer this treatment and have had numerous life changing success stories over our ten years plus of offering this specialized treatment.

Gait Training

Gait Training

A person's gait is a pattern of stepping or walking that is specific to that individual. Gait training is needed to help a specific patient gain proficient and safe ambulation within and outside the home with or without an assistive device. Patients usually require gait training if there is some lower trunk or lower limb dysfunction. This dysfunction is often associated with neurological or orthopedic impairment. Complications that may require gait training include:

  • muscle weakness
  • deformity
  • spasticity (the presence of abnormal involuntary muscular contractions)
  • loss of sensation due to injury or disease that results in inaccurate sensory information and unsafe or inefficient motion
  • pain in the weight-bearing joints of the lower extremities, which causes distortion of normal gait

This service is aimed towards increasing their stability, balance and ability to safely walk both on flat surfaces as well as negotiating obstacles and uneven surfaces.

Gait training involves strength training, balance and coordination exercises and guided individual exercise.