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Physiotherapy of the Spinal Cord

 

 

Orthopaedic and spinal physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system including rehabilitation after orthopaedic and spinal surgery. This specialty of physical therapy is most often found in the out-patient clinical setting. 
Orthopaedic and spinal therapists are trained in the treatment of post-operative orthopedic procedures, fractures, acute sports injuries, arthritis, sprains, strains, back and neck pain, spinal conditions and amputations. Joint and spine mobilization/manipulation, therapeutic exercise, neuromuscular re-education, hot/cold packs, and electrical stimulation (e.g., cryotherapy, iontophoresis, electrotherapy) are modalities often used to expedite recovery in the orthopaedic setting.

Additionally, an emerging adjunct to diagnosis and treatment is the use of sonography (ultrasound) for diagnosis and to guide treatments such as muscle retraining. Those who have suffered injury or disease affecting the muscles, bones, ligaments, or tendons of the limbs or spine will often benefit from assessment by a physical therapist specialized in orthopaedics and spines.

 

Exercise benefits

 

Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system.

Exercise also reduces levels of cortisol, thereby benefiting health. Cortisol is a stress hormone that builds fat in the abdominal region, making weight loss difficult. Cortisol causes many health problems, both physical and mental.

 

There are different categories of physical exercise including aerobic exercise, anaerobic exercise, strength training, and agility training

 

Sometimes the terms 'dynamic' and 'static' are used. 'Dynamic' exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly (during the exercise).

Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression. Strength training appears to have continuous energy-burning effects that persist for about 24 hours after the training, though they do not offer the same cardiovascular benefits as aerobic exercises do.
Both aerobic and anaerobic exercise also work to increase the mechanical efficiency of the heart by increasing cardiac volume (aerobic exercise), or myocardial thickness (strength training). Such changes are generally beneficial and healthy if they occur in response to exercise.
Not everyone benefits equally from exercise. There is tremendous variation in individual response to training: where most people will see a moderate increase in endurance from aerobic exercise, some individuals will as much as double their oxygen uptake, while others will never get any benefit at all from the exercise. Similarly, only a minority of people will show significant muscle growth after prolonged weight training, while a larger fraction experience improvements in strength. This genetic variation in improvement from training is one of the key physiological differences between elite athletes and the larger population. Studies have shown that exercising in middle age leads to better physical ability later in life.

 

Common misconceptions

 

Many myths have arisen surrounding exercise, some of which have a basis in reality, and some which are completely false. Myths include:

  • That excessive exercise can cause immediate death. Death by exercise has some small basis in fact in the same way that walking in front of a bus is likely to get you killed ie use a bit of common sense. Water intoxication can result from prolific sweating (producing electrolyte losses) treated with consumption of large amounts of plain water (and therefore insufficient replenishment of electrolytes, especially salt and potassium). It is also possible to die from a heart attack or similar affliction if overly intense exercise is performed by someone who is not at an appropriate level of fitness for that particular activity. A doctor should always be consulted before any radical changes are made to a person's current exercise routine. Rhabdomyolysis (breakdown of skeletal muscle) is also a risk. Other common dangers may occur from extreme overheating or aggravation of a physical defect, such as a thrombosis or aneurysm.
  • That weightlifting makes you short or stops growth. One highly debated caveat is that heavy weight training in adolescents can damage the epiphyseal plate of long bones.
  • One misconception is that muscle tissue will turn into fat tissue once a person stops exercising. This is not literally true as fat tissue and muscle tissue are fundamentally different. But the common expression that "muscle will turn to fat" is truthful in the sense that a combination of muscle wasting due to lack of exercise and increased fat storage in the same body part, will cause the misconception to appear true. Another element of increased fatty deposits is that of diet, as most people will not significantly reduce their diet in order to compensate for the lack of exercise/activity.
  • Spot reduction is a myth that consists of believing that exercising and training a particular body part will preferentially shed the fat on that part. For example, doing sit-ups is not the best way to reduce subcutaneous belly fat. One cannot reduce fat from one area of the body to the exclusion of others. Sit-ups may improve the size and shape of abdominal muscles but will not specifically target belly fat for loss. Such exercise might help reduce overall body fat and shrink the size of fat cells.

 

Nutrition and recovery

 

Proper nutrition is at least as important to health as exercise. When exercising, it becomes even more important to have a good diet to ensure that the body has the correct ratio of macronutrients whilst providing ample micronutrients, in order to aid the body with the recovery process following strenuous exercise.

This can be compromised by psychological compulsions (eating disorders such as exercise bulimia, anorexia, and other bulimias), misinformation, a lack of organization, or a lack of motivation. These all lead to a decreased state of health.

Delayed onset muscle soreness can occur after any kind of exercise, particularly if the body is in an unconditioned state relative to that exercise