Services
Conditions
• Back Pain
• Herniated Disc
• Low Back Pain
• Neck Pain
• Non-Surgical Approach to Back Pain
• Spine Care
• Spine Disorder
• Spine Pain
• Spine Rehabilitation
• Spinal Stenosis
• Other Spine-Related Issues
Effective spine care requires a holistic approach with an appreciation for the specific condition and the interaction of neighboring body regions and the patient’s emotional makeup and lifestyle. Ongoing communication with you and your healthcare team is essential to thoughtful care. Collaboration and communication with medical and fitness providers have been a hallmark of the physical therapy care provided by Dr. Evan Johnson throughout his career.
Treatment
Evaluation
Dr. Evan Johnson performs an individualized assessment to evaluate an individual's physical abilities, limitations, and impairments to create a personalized treatment plan. The assessment typically begins before the patient arrives with a thorough medical history review, including any current or past spinal conditions, injuries, surgeries, and medications. This is followed by a physical examination, which typically includes:
Biomechanical analysis: Dr. Johnson will evaluate your spinal alignment, limb and spine range of motion, flexibility, and stability. This involves testing for core strength, muscle imbalances, joint restrictions, and movement dysfunction.
Posture analysis: Dr. Johnson assesses your standing, sitting, and dynamic postures to identify any imbalances, asymmetries, or compensations that may be contributing to spinal pain or dysfunction.
Functional movement analysis: Dr. Johnson will evaluate your ability to perform specific movements related to everyday activities that may contribute to your condition or related disorders. This may include simple motions like rising from a chair, squatting, walking, balancing on one leg, or using your mobile device.
Athletic performance assessment: If the patient is an athlete, golfer, dancer, yoga, or Pilates practitioner, Dr. Johnson will work with you to break down task-specific skills to better understand how these activities might affect your overall condition and help you optimize your performance.
Integrative Therapeutic Approaches
Physical therapy treatment for spine conditions typically involves a combination of manual therapy, exercise, and patient education. Treatments are intended to reduce pain, improve range of motion, and restore normal function and mobility. Treatment involves identifying your goals and specific needs. Working with you to achieve your personal goals safely, effectively, and in an individualized manner is always the focus of Dr. Johnson’s physical therapy care.
Dr. Johnson will work closely with you to develop a personalized home exercise program and provide education on managing symptoms and preventing future spinal injuries.
Common physical therapy treatments for spine conditions:
1. Manual Therapy
Manual Therapy involves hands-on techniques to mobilize and manipulate the spine and surrounding tissues. Manual therapy may include joint mobilization, soft tissue mobilization, and muscle energy techniques.
Dr. Johnson is certified in the use of manual therapy techniques and has taught these techniques to doctoral physical therapy students and other doctors for over 2 decades. Manual therapy for the spine may include techniques such as:
Mobilization: This technique involves gentle movements of the spine and joints to increase the range of motion and decrease pain.
Manipulation: This technique involves a high-velocity, low-amplitude thrust applied to a specific joint to improve joint mobility and reduce pain.
Soft tissue mobilization: This technique involves applying pressure to soft tissues, such as muscles, tendons, and ligaments, to reduce muscle tension and improve flexibility.
Muscle energy is a manual therapy technique involving active muscle contractions to improve joint mobility and reduce pain. Muscle energy technique works by activating the body's natural healing mechanisms to promote relaxation and increased mobility of the affected area. It can be particularly effective for conditions such as low and mid-back pain, neck pain, pelvic/ sacroiliac joint pain, and joint stiffness.
Strain counterstrain is a manual therapy technique that is used to treat musculoskeletal conditions such as muscle spasms, trigger points, and joint pain. It involves positioning the affected area in a position of comfort, which helps to reduce pain and tension in the affected muscles and joints. The goal of strain counterstrain is to reduce tension and pain in the affected muscles and joints by promoting relaxation and improved blood flow to the area. This technique is often used in conjunction with other manual therapy techniques and therapeutic exercises to provide a comprehensive approach to pain management.
Myofascial release: This technique involves stretching and applying pressure to the fascia, the connective tissue surrounding muscles and organs, to reduce tension and improve mobility.
Manual therapy for the spine can be an effective treatment for many musculoskeletal conditions of the spine, particularly when combined with other treatments such as therapeutic exercise, stretching, and education about proper posture and body mechanics. However, it's important to consult with a licensed healthcare professional before beginning any new treatment, as manual therapy may not be suitable for everyone, depending on their specific condition and medical history.
2. Therapeutic Exercise
Therapeutic Exercise includes exercises designed to improve strength, coordination, flexibility, and range of motion in the spine and surrounding areas. Dr. Johnson may prescribe exercises to target specific muscles or movement patterns. Therapeutic exercise is a type of prescriptive physical therapy exercise involving specific exercises to treat or prevent injuries, improve physical function, and promote overall health and wellness. Therapeutic exercise requires a thorough understanding of the medical and biomechanical roots of a patient’s condition. Therapeutic exercise promotes well-being and healing through the application of the SAID principle. The SAID principle, or Specific Adaptation to Imposed Demands principle, states that the body will adapt specifically to the demands placed upon it. Knowledge of tissue healing allows for the application of the SAID principle to encourage healthy tissue remodeling by placing focused demands on healing tissues. The tissue reorganization process is critical for restoring normal function and preventing future injury. By laying down new collagen fibers and other structural elements, the body is able to restore strength and stability to the injured area. This can be further supported by manual therapy and exercise, which can help to stimulate tissue remodeling and promote the development of new blood vessels, nerves, and other tissues. A well-rounded exercise program should include a variety of exercises and activities that challenge the body in different ways to promote overall health and fitness.
Range of motion exercises: These exercises are designed to improve joint mobility and flexibility, often focusing on a specific joint or series of joints.
Strengthening exercises: These exercises are designed to improve muscle strength and endurance, often focusing on a specific muscle group or groups.
Balance and coordination exercises: These exercises are designed to improve balance and coordination, often using a combination of static and dynamic movements.
Cardiovascular exercises: These exercises are designed to improve cardiovascular health, often involving activities such as walking, cycling, or swimming.
Functional exercises: These exercises are designed to improve the ability to perform everyday activities, such as walking, lifting, and reaching.
Therapeutic exercise can treat a wide range of conditions, including musculoskeletal injuries, neurological disorders, and chronic diseases. The prescribed exercises will depend on the patient's condition, goals, and overall health status.
It's important to consult with a licensed healthcare professional before beginning any new exercise program, including therapeutic exercise. Your healthcare provider can evaluate your condition and develop a treatment plan tailored to your needs.
3. Neuromuscular Reeducation
The Neuromuscular Reeducation technique is used by physical therapists and other healthcare professionals to help patients improve their movement patterns and restore normal function after an injury, surgery, or other medical condition. This technique involves exercises and other interventions designed to improve communication between the nervous system and the muscles, leading to better coordination, strength, and control. Neuromuscular reeducation can be effective for various conditions, including sports injuries, stroke, spinal cord injuries, and other neurological or musculoskeletal disorders. It is often used in conjunction with other treatments, such as manual therapy and stretching, to provide a comprehensive approach to rehabilitation.
4. Spinal Stabilization
Spinal Stabilization exercises are a type of therapeutic exercise designed to strengthen the muscles that support the spine, including the abdominals, back extensors, and hip muscles. You may be taught to identify and maintain a neutral spine alignment while progressively applying more challenging exercises. Neutral spine is a term used in physical therapy and biomedical engineering to describe a specific position of the spine that is considered optimal for stability and function. Maintaining a neutral spine position during activities can help to distribute load and stress more evenly throughout the spine, reducing the risk of injury and improving overall spinal function.
The application of neutral spine stabilization exercises focuses on the importance of maintaining a neutral spine during activities that involve loading or stress on the spine, such as lifting weights, carrying heavy objects, or performing repetitive movements. This is accomplished by engaging your core abdominal and trunk muscles while maintaining the spine's natural curves. Spinal Stabilization treatment teaches you to use muscles like a brace or corset to hold your spine stable under many different conditions.
5. Exercises Used in the Prevention of Low Back Pain and Other Spinal Conditions
Posture training: Poor posture can contribute to spinal pain and dysfunction. Dr. Johnson provides education and training on proper posture and body mechanics to reduce strain on the spine.
Directional Preference may be identified using the McKenzie Technique. This method of assessment and treatment for musculoskeletal pain aims to identify and treat the underlying cause of the pain by identifying a patient's directional preference, which is the specific direction of movement that reduces or eliminates their pain. Once the directional preference is identified, the therapist will prescribe specific exercises and postures for you to perform at home. This can be used to facilitate fluid migration within an intervertebral disc away from the nerves of the spine that travel to the legs (sciatica) or arms (pinched nerve in neck).
Ergonomics: This is the study and design of work environments and tools that are safe, efficient, and comfortable without placing undue strain on the body. Good ergonomics can help prevent musculoskeletal injuries, reduce fatigue, and improve productivity.
Mechanical traction: Mechanical traction for the neck is a treatment modality that uses a mechanical device to gently stretch the neck and relieve pain for certain neck conditions. Mechanical traction works by reducing pressure on the structures in the neck, such as the discs, nerves, and joints. The gentle stretching of the neck can help increase blood flow and oxygenation to the affected area, promoting healing and reducing inflammation.
Mechanical traction may be recommended for patients with conditions such as herniated discs, degenerative disc disease, cervical radiculopathy, or neck pain caused by poor posture or muscle tension. It's important to note that mechanical traction may not suit all patients. Mechanical traction is often used in conjunction with other treatment modalities, such as manual therapy or exercise, to provide a comprehensive approach to neck pain management. Your healthcare professional can help determine if mechanical traction is right for you and develop a treatment plan tailored to your specific needs.
The specific treatment plan will depend on the patient's individual needs and the nature of their spine condition. Dr. Johnson will work closely with you to establish goals and monitor your progress throughout your treatment.