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Physiotherapy Services
Physiotherapy helps patients with functional mobility issues caused by injuries, illnesses, or surgeries. Physiotherapists identify patients’ functional needs, and develop plans to relieve pain, restore maximum body function, improve independence with everyday tasks (such as sports and exercise, recreational activities, work duties, etc.), and decrease risk of injuries during performing these day-to-day activities.
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About Physiotherapy Services
Physiotherapy helps patients with functional mobility issues caused by injuries, illnesses, or surgeries. Physiotherapists identify patients’ functional needs, and develop plans to relieve pain, restore maximum body function, improve independence with everyday tasks (such as sports and exercise, recreational activities, work duties, etc.), and decrease risk of injuries during performing these day-to-day activities.
About Health

What is physiotherapy?

Physiotherapy helps people recover from stiffness, weakness, pain and other movement-related problems caused by injuries, illnesses, or surgeries. Physiotherapists usually start by examining the patient’s complete medical history and conducting a thorough biomechanical assessment to identify the patient’s specific functional needs. Based on the assessment results, they then develop the best treatment plan to speed up recovery, improve mobility, and restore maximum physical function.

When should I see a physiotherapist?

It is highly recommended to see a physiotherapist if you:
• Have an injury, swelling, bruising, or deformity in any part of the body
• Are experiencing stiffness or pain in your joints (particularly if symptoms have continued for more than 3 days)
• Are suffering from numbness or tingling (“pins and needles”)
• See your limbs give out occasionally, and you need advice on improving your body’s strength, flexibility,
balance, or fitness
• Have postural problems
• Need advice on injury prevention or other aspects of musculoskeletal health
• Wish to improve your physical performance for sports, or are planning to return to sport or physical activity following a prolonged period of inactivity

How can physiotherapy help me with my injury?

To identify the treatment techniques that work best for you, we must first assess and diagnose your injury thoroughly and accurately. We can then develop a personalized treatment plan tailored to your specific needs and treatment goals.
Physiotherapy treatments can significantly speed up your return to sports or physical activity, while reducing the likelihood of injury recurrence by addressing the root cause of the problem. Physiotherapists will advise patients on the activities they should embrace or avoid to ensure optimal mobility and long-term recovery.

What conditions do physiotherapists treat?

Physiotherapists treat a broad range of conditions related to the musculoskeletal system, including:
• Sports injuries
• Post-surgical concerns (i.e. after joint replacements, ligament reconstructions, disc surgeries, bone fixations)
• Back and neck ache originating from disc problems, which may radiate down to the arms and/or legs causing pain, numbness, and tingling
• Myofascial pain - pain that occurs in the musculoskeletal system without any obvious cause
• Arthritis-related pain
• Whiplash and other injuries caused by MVA (Motor Vehicle Accidents)
• Work-related injuries, i.e. the strain of desk/computer work
• Headaches – physiotherapy helps determine if the problem is myofascial (related to the musculoskeletal system), or cervicogenic (related to neck dysfunction).

What techniques do physiotherapists use to treat injuries?

Most of our physiotherapy services are mainly based on manual therapy. In these hands-on techniques, our licensed physiotherapists use their own hands to treat the affected area by manipulating the surrounding bones, joints and muscles through the use of certain movements of different type, strength and speed. These movements help restore the function of the affected area by stretching tight muscles/nerves or mobilizing stiff joints - based on the purpose of treatment.

Adjunct treatments may include:
• Individual and group exercise programs (e.g., back pain courses and Pilates)
• Acupuncture: a needling-based technique for acute and chronic pain
• Dry Needling: a needling-based technique for chronic tight muscle bands
• Taping: use of specialized tape to hold and maintain muscles and joints in correct positions
• Mechanical Cervical & Lumbar Traction: a machine is used to provide a gentle and consistent stretch to the neck or back joints to help alleviate disc and nerve pain caused by a disc bulge or joint compression
• Electrical Modalities: This technique is only useful with acute injuries. It involves the use of machines such as ultrasound, electrical current, and laser stimulate circulation.

How many sessions should I expect to receive before I experience a change?

Your physiotherapy treatment is tailored to your individual needs, so it is not possible to determine in advance how many sessions will be required. At the first appointment, your physiotherapist will suggest the number of treatments you will require based on your assessment results. In general, however, you should feel a change within 6-8 sessions of physiotherapy in conjunction with posture and position modification and exercise.

What will happen on the first session?

The therapist will discuss the following:
• Your medical history
• Your current problems and complaints
• Pain intensity; what aggravates and eases the problem
• How this is impacting your daily activities or your functional limitations
• Your goals for physical therapy
• Medications, tests, and procedures related to your health

The therapist will then perform an objective evaluation which may include some of the following:
• Palpation - touching around the area of the pain or problem, to check for the presence of tenderness, swelling, soft tissue integrity, tissue temperature, inflammation, etc.
• Range of Motion (ROM) - the therapist will move the joint(s) to check for the quality of movement and any restrictions.
• Muscle Testing - the therapist may check for pain, weakness and quality of the muscle contraction. Often, the muscle strength is graded as part of a neurological screening.
• Neurological Screening - the therapist may check to see how the nerves are communicating with the muscles, sensing touch, pain, vibration, or temperature. Reflexes may be assessed as well.
• Special Tests - the therapist may perform special tests to confirm or rule out the presence of additional problems.
• Posture Assessment - the positions of joints relative to the ideal state and to each other may be assessed.

The therapist will then formulate a list of your problems, and ascertain how to treat them. A plan is subsequently developed based on the patient's specific needs. This usually includes frequency and duration of treatment, home programs, patient education, short and long-term goals, and what is expected after discharge from therapy.

How long does each treatment session last?

Initial assessments usually last for one hour with subsequent sessions of 30 minutes. However, your therapist may request subsequent one-hour sessions if your condition is more complicated or requires more time for a specific treatment to be implemented.

Do I need to bring anything?

On your first visit, please bring along your referral, if you have one, as well as any important insurance information, any hospital reports related to your condition, and a list of any medication you are taking. Also, please make sure to wear comfortable clothing that allows visual assessment of the problematic area ـــ such as shorts if it is a leg problem, or a tank top for women if it is a neck or shoulder problem. In case you forget, there will be clean shirts and shorts available at the clinic for you to use. If you are not comfortable with exposing the area to be assessed, this can be accommodated by your therapist.

Do I need a referral to start physiotherapy?

No, you do not need a referral to start physiotherapy. You can just call our clinic to arrange an appointment for an initial assessment with one of our physiotherapists.

Do you do home visits?

Special arrangements can be made to provide treatment at home for patients with certain conditions or physical disabilities that prevent them from seeking treatment at the clinic. Please contact our clinic for more information.

Can physiotherapy reduce headaches?

Many headaches have a mechanical component to them that is often related to the neck. These types of headaches, which are called cervicogenic headaches, can mimic or trigger migraines in people who suffer from neck problems, and can develop into a condition called chronic daily headache. Treating the neck, upper back, and shoulders can significantly reduce the frequency and intensity of neck headaches that may be mimicking or triggering the migraines. Manual therapists have the tools to assess and treat the various factors that can contribute to headaches.

What is respiratory physiotherapy?

The aim of the respiratory physiotherapy is to increase endurance and improve the quality of life in patients with lung conditions. There are many treatments that can be administered in such cases, including:
• Coping strategies for breathlessness
• Chest clearance techniques
• Exercise
• Relaxation
• Breathing retraining
• Lifestyle management
• Postural draining

What is pediatric physiotherapy?

Pediatric physiotherapy involves treatment for any child with developmental delays, congenital problems, or childhood diseases such as cerebral palsy, spina bifida, muscular dystrophy, arthrogryposis, and spinal cord injuries.

Our specialist pediatric physiotherapist can offer advice, support, and guidance for parents. Following a detailed assessment, specific treatment plans will be developed based on your child's specific needs. These may include:
• Stretching and strengthening programs
• Education of normal movement patterns
• Gait training/retraining
• Milestone development
• Fine or gross motor skill practice

For an appointment with our Pediatric Physiotherapist, please contact our specialized pediatric team at FSRI’s Children’s Evaluation and Rehabilitation Center (CERC) at: 22257238.

What is acupuncture?

With its roots in Chinese traditional medicine, acupuncture is a 2500-year old therapeutic technique of natural healing. It has proved to be a safe and effective method to speed up recovery, reduce or relieve pain, and improve function of the body’s affected areas. Acupuncture involves the insertion of very fine needles through the skin and tissues at specific acupuncture points on the body. Many times, acupuncture is used as an alternative to medications. In certain conditions, electrical stimulation can be added to the acupuncture needles for more effectiveness. In fact, acupuncture has been around longer than Western medicine and is now a very common and effective tool used in physiotherapy practice to treat conditions varying from headaches to back, nerve and jaw pain (TMJ region).

How does acupuncture work?

Chinese Eastern Medicine Theory
The Chinese theorized that the body had an energy force, known as Qi (pronounced “Chi”) running throughout it. The Qi consists of all essential life activities, including the spiritual, emotional, mental, and physical aspects of life. A person’s health is influenced by the efficiency of Qi flow in the body. If the flow of Qi is insufficient, unbalanced, or interrupted, the body’ balance and circulation are affected and illness may occur. Qi travels throughout the body along “meridians” (or channels). These meridians are the same on both sides of the body (paired). The acupuncture points are specific locations where the meridians come in touch with the surface of the skin, and are easily accessible by “needling” or acupressure. The connections between them ensure that there is an even circulation of Qi throughout the body, meaning energy constantly flows up and down these pathways smoothy, freely, and uninterrupted. Acupuncture is said to restore the balance of Qi.

Western Medicine Theory
In the last 30 years, many attempts have been made by scientists to explain some of the pain-relieving effects of acupuncture in Western terms. Western medicine believes that acupuncture stimulates the body to produce its own pain relieving chemicals called “endorphins". These endorphins help to block the pathways that relay pain messages from the body to the brain, resulting in relief of pain, overall relaxation, and biochemical restoration of the body's own regulation systems. The improved energy and biochemical balance produced by acupuncture stimulates the body's natural healing abilities, leading to reduced inflammation and improved physical and emotional well-being.

What does acupuncture feel like and - how will I feel?

People experience different sensations with acupuncture. Most patients feel only minimal discomfort as the needles are inserted, while some feel no pain at all. Once the needles are in place, there should be no significant discomfort. Acupuncture needles are extremely fine and are made from stainless steel, therefore they are much thinner than the needles used in injections. The most common sensations felt during treatment can be described as an electrical achy sensation, feeling of heaviness and numbness, or a flowing sensation in the area being needled. Think of the meridian system as a plumbing system. When there is a problem in the body, our bodies’ “plumbing system” (or “the energy flow” according to the Chinese) is blocked. When you feel the above-described sensations, it means that the “clog” blocking the “plumbing system” has been opened, and the flow of energy and blood to the affected tissues can be properly restored.

Is acupuncture safe?

One of the most striking aspects of acupuncture is the almost complete absence of adverse effects and complications when performed by a qualified professional (such as a well-trained physiotherapist). Most patients feel minimal discomfort and find the treatment relaxing. At our clinic, we only use sterile disposable needles to eliminate risk of infection.
The most common effect that can occur is the development of a small bruise, with a small amount of bleeding at the needle site. Other treatment effects that some people may experience include: slight fatigue, dizziness, nausea, fainting, and mild pain while the needle is in place or after it is removed. Generally, infection is a small possibility with any invasive technique, and the use of clean, sterile, single-use needles almost eliminates the chances of an infection ever happening.
People with pacemakers can still be treated, but such cases should be brought forward to the therapist so that no electrical stimulation is used.

How many acupuncture sessions will be required?

The number of sessions will vary depending on the type and severity of the condition being treated. For acute problems, only a few sessions may be required. Some people can notice improvement right away, whilst others may need more sessions to give a cumulative effect before a benefit is noticed. Generally, at least 5-6 treatment sessions are recommended to see if acupuncture has any benefit for you.
For chronic, complex, or longstanding conditions, 1 to 3 sessions a week for a period of several weeks may be recommended, with less frequent sessions as improvement occurs. Treatment sessions usually last between 15 to 30 minutes. Relief may be felt immediately or within a few hours or days. In some cases, however, improvement can be felt only after receiving a few sessions. Acupuncture’s main goal is to regain the natural balance of the body; therefore some people may experience an increase of their symptoms for a few hours or for a day or two before they start to feel some relief; this is a normal side effect for some patients. An escalation or an immediate decrease of symptoms are both good signs showing that your body is positively responding to the treatment.
Acupuncture can be used alone or combined with other forms of medical or physical therapy to achieve optimal results .

Is there any special advice to follow before an acupuncture treatment?

Acupuncture treatment can be done at any time. However, patients are advised not to eat unusually large meals before or after treatment. It is best to avoid alcohol or sedatives for four hours prior to treatment. Pain medications may be taken as required.
Acupuncture is a very effective method to treat a broad range of body ailments. It is a safe, effective, and natural alternative medicine to treat pain and dysfunction.

What is the difference between acupuncture and dry needling?

Contrary to popular belief, acupuncture and dry needling are not the same. Although both treatments are carried out using the same type of needles (sterile, single-use, stainless steel needles which contain no medicine), the treatment styles and objectives of these modalities are vastly different. Whereas acupuncture is based on the principles of ancient Chinese medicine and the theory of energy flow, dry needling, on the other hand, works to reverse physiological adaptations which muscles undergo in response to stress, overuse and pain. A common effect of both treatments is the release of the body’s natural painkilling chemicals which reduce propagation of pain signals through the nerves of the body. These chemicals can effectively “turn down the volume” of your pain.

Acupuncture
This ancient treatment (referred to as “De Chi” in Chinese Medicine) involves the insertion of needles into the muscles to treat imbalances in the body’s energy. Acupuncturists manipulate the body’s energy flow by stimulating distinct points in the body. These points are mapped out on the meridians (or the network of lines and pathways through which energy moves within the body). This helps regain the natural flow of energy in the body and thus improve overall health and wellness. Acupuncture can help with a wide range of disorders and conditions -from musculoskeletal pain and dysfunction to migraines, fibromyalgia, menstrual cramps, addiction, infertility, nausea, insomnia, depression, and anxiety.

Dry Needling (DN)
When a muscle is put under repeated or elevated strain, it allows continuous contraction at some points along its length (to increase its tension and respond properly to the increased physical demands). These tight points, however, tend to cause pain and reduce the muscle’s ability to work, as a continuously-contracted muscle will have a limited capacity left to contract and relax. Dry needling relaxes these tight areas by restoring the natural chemical balance and reducing inflammation and strain within the dysfunctional muscle. This helps the muscle restore its ability to assume its role within the body. Dry needling is useful for all chronic musculoskeletal dysfunction and pain. The safety precautions, treatment-related sensations and effects, and the number of sessions required follow the same principles as for acupuncture.
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