Our Rehab Approach

This month, I wanted to offer an inside look into our approach to rehab at Corpo Kinetic.  While most readers of this blog are most likely familiar with Pilates and the benefits it can offer to core strength as well as overall fitness and flexibility, you may not be as familiar with how a Pilates studio approaches injury rehabilitation.

Let’s start with the basics:  What is Rehab?

Rehab is a broad term which relates to treatments intended to aid in recovery.  For us, we’re talking more specifically about recovery from musculoskeletal injury.  Many professionals can help you recover from such an injury, including your medical doctor, a physical therapist, and a chiropractor.  Massage therapists and fitness professionals who have been trained in how to work with injuries can also be a part of your rehab team.

The musculoskeletal injury treatment team

When you have an acute injury (acute = just happened, as opposed to chronic = been with you awhile), a medical doctor is usually your first go-to.  Your doctor can diagnose your injury, which is helpful because diagnoses often come with a treatment plan.  You now have years of medical research at your side telling you what has and has not worked for other people with your condition!

Depending on the injury (and, getting real here, depending on your insurance plan…), a medical doctor may refer you to a physical therapist for treatment.  These days, recent physical therapist graduates have gone through a three-year program, and are doctors themselves.  While physical therapists will use the application of heat, cold, stem machines, and more to treat injury (there are some cool tools out there!), the majority of their treatment time is in manual therapy and exercise.  In many cases, a physical therapists will perform the manual therapy and assign exercises, which will be taught and/or supervised by a physical therapist aide (often a young student who’s hoping to be accepted to a physical therapist doctorate program).

If you’re more into the alternative health route, you may start by taking your injury to a chiropractor.  Chiropractors are also doctors and can diagnose injuries.  All chiropractors are trained in joint manipulation, and if your injury is caused by or exasperated by a joint being out of place, they can help.  Some chiropractors (and, IMHO, the best chiropractors) also treat muscles and other soft tissues (ligaments, tendons, and fascia – the stuff that connects stuff).  In my experience, treating muscles as well as bones works better because tightness in the soft tissues may be pulling the bones out of alignment, and just treating the bones may leave you with a tight muscular structure which will pull you back into your misalignment soon after you leave the chiropractic office.

And now we get to who we are at Corpo Kinetic: massage therapists and Pilates instructors who have been trained to work with injuries.  That is quite a mouthful!  The reason for it is that not all massage therapists or Pilates instructors have the training to specifically work in a rehabilitative manner.  Learning about rehab care in the massage and Pilates world is continuing education – it is additional to the basic training required in order to be certified.

The trainers who offer rehab services at Corpo Kinetic are unique in that we are BOTH massage therapists AND Pilates instructors, AND we have additional training in each field to work with injuries.

The tools we use at Corpo Kinetic in our rehab services are two-fold.  As certified massage therapists, we can use massage and manual therapy to release tension in the soft tissues (muscles, fascia, ligaments, and tendons), and as certified Pilates instructors we can help you strengthen areas which need strengthening as well.  This two-fold approach can be very powerful in getting past injury.

Why would you see us as opposed to a physical therapist or chiropractor?  Your health care team is ultimately up to you.  Pilates and massage, even when combined in a rehab setting, should not replace an evaluation from a trained medical professional such as your doctor, a physical therapist, or a chiropractor.  Depending on your injury, our rehab services may be a good fit for you either as your main source or rehabilitative care or as an addition to the care you are getting in a medical setting.  Here are some examples of the types of clients who see us for rehab:

  1. Physical therapy has helped!  But you’re still not back to your full functioning.  Unfortunately, many insurances will only pay for a certain amount of physical therapy per injury.  If you’re better but still not back to all the physical activities you’d like to do, you may just need more care.  We can help pick up where your physical therapy left off.
  2. You’re currently doing physical therapy, but you want more supervised movement.  If you’re lucky, you get to see your physical therapists twice a week, but often PT appointments are weekly or even less frequent.  To get past an injury, you need to be doing your physical therapy exercises more frequently, and for best results you want to make sure that you’re doing your exercises with the best form and alignment.  In these cases, our rehab trainers make a great addition to your team, helping you maintain good form and strengthen the appropriate muscles in between your physical therapy appointments.
  3. Your doctor has offered medical interventions such as steroids and surgery, but you’d like to try a more conservative approach first.  Because surgery has risk of complication, and is essentially another injury the body will have to recover from, many people would like to avoid surgery if possible, or delay it as long as possible.  Some people also believe that steroids do more to mask symptoms than treat the cause of injury.  Many people turn to Pilates when they are seeking to avoid back surgery, and adding manual therapy with our rehab services can be even more effective.  Even in cases of more advanced osteoarthritis, where eventually a joint may need to be replaced, I have seen our rehab services decrease pain, increase mobility, and push back a surgery date, adding years of healthy function.  Manual therapy and strengthening exercises can help make sure that the musculature around the joint isn’t pulling it out of alignment, which would increase the bone-on-bone rubbing which causes pain and lack of mobility.
  4. You’re seeing a chiropractor, and you both feel strengthening is the next step towards getting you back to full functioning. If you keep getting adjusted and the pain or injury keeps coming back, you may need to strengthen the musculature around the area.  Increased muscular support can help you resist the loads you’re placing on your body as you go about your daily life, helping you hold your adjustment for longer.
  5. You have a chronic injury you’d like to address.  Let’s go back to semantics: acute and chronic injuries raise different alarm bells in the treatment world.  For acute injuries, think:  this just happened!  lots of pain!  need help now!  Acute injuries are best initially evaluated by a medical doctor or chiropractor for diagnosis.  For chronic injuries, think of the old ankle sprain that keeps acting up, the “bad back” you’ve had ever since becoming a mom, your “weak knee,” or the old shoulder injury from playing football in high school.  These types of injuries often don’t require immediate medical attention: in many cases you’ve already gotten help from a medical professional back when the injury initially occurred.  However, as we age with injury, the scar tissue that originally helped stabilize the area can get “gummy,” restricting mobility and causing compensation patters.  The result can be unbalanced areas of weakness and restriction, which can be addressed very well with a combination of manual therapy to release the “gummy” areas and strengthening exercises to correct the years-old compensation patterns.

How do rehab services work at Corpo Kinetic?

When a new rehab client comes to our studio, we start with a 90 minute initial appointment.  This longer session allows us to do a thorough intake and assessment.  We’ll start with a conversation with you.  We want to know the history of the injury, what you’ve done so far to help it, what has helped, what hasn’t, and very importantly: your goals.  Are you looking for pain relief?  Are you looking to be able to return to your full athletic functioning?  Both?  Assessments might include evaluating your range of motion, a postural analysis, watching you move, and muscle testing to determine relative strength.  Then, depending on your injury, the session will proceed with a combination of manual therapy and Pilates strengthening exercises.

Follow up appointments are typically an hour.  We always do a quick intake and assessment to make sure things are progressing as expected, or allow us to change course if need be.  Often, as injuries improve, clients will find themselves receiving less manual therapy and doing more rehabilitative Pilates.  As appropriate for you and your injury, we may suggest some exercises to do at home, or even lifestyle changes if it seems like some simple changes could improve your progress.  (These changes are usually simple, such as changing shoes to addressing how or how much  you sit.)  If possible, we suggest rehab appointments be scheduled twice a week.  If scheduling only allows a weekly visit, we may be able work with that as well, but we will likely spend more time developing a home program and making sure you are confident with doing those exercises well on your own.  When exercising, frequency matters, and if you’re recovering from injury we want to be sure you get the benefit of adequate frequency.

That’s it for this month!  I hope you have a better idea of how our rehab services work, and how they can fit in with your current plan for injury recovery.  If you are wondering if we may be able to help you, please do not hesitate to give us a call at 510-463-1473 or email us at info@corpokinetic.com.