In past newsletters, we have addressed changes that have been forced on our profession by the proliferation of managed care. The intent of this article is not to focus again on these issues, but to focus on treatment aspects and services available to our patients.

We are most proud that the basic principles on which THE pt GROUP was founded back in 1978, are still the same. Those principles are to provide convenient, cost-effective care to our patients by competent physical therapists. All therapists at THE pt GROUP are continually challenged in their skills through continuing education programs.

WORKERS' COMPENSATION
Physical therapy is an important part of rehabilitation in the workers' compensation system. A very small percentage of injured workers are totally disabled today due to the emphasis on return to gainful employment through functional rehabilitation programs. To achieve these goals, THE pt GROUP has become proactive in offering services to employers to aid in the rehabilitation of their injured workers.

Successful management of work related injuries is a critical component of a quality physical therapy program. No matter how good the treatments we have provided to our clients have been, it lacks value to the injured individual and their employer if it doesn't aid in a safe return to work.

PHYSICAL THERAPY FOR WOMEN^SM
Over the last several years, women's health issues have come to the forefront. THE pt GROUP has recognized the importance of rehabilitation geared toward women and developed its women's health program in 1992. The women's health program started with emphasis on urinary incontinence and pre and post-partum musculoskeletal problems. It has expanded to include treatment of lymphedema, osteoporosis and rehabilitation of patients with various cancers.

INCONTINENCE
Imagine if every time you sneezed, coughed, laughed or tried to run you would leak urine. Physical therapy can help to control urinary and fecal incontinence by strengthening the muscles that surround the urethra, vagina and rectum. Typical treatments consist of bladder retraining, biofeedback training of the pelvic floor muscles and Kegel exercises. If you have a problem controlling your bladder, physical therapy can give you the ability to regain control in as little as 5-6 weeks.

LYMPHEDEMA
Lymphedema is defined as excessive uncontrolled swelling. It can commonly occur after surgery to remove lymph nodes or after radiation treatment for breast cancer. Physical therapists have been trained in a special technique called manual lymphatic drainage, which helps significantly decrease swelling that occurs with lymphedema. Therapists can teach their patients skin precautions, massage techniques, positioning and how to wrap their arms or legs in order to control swelling to prevent reoccurrences. Physical therapy is truly an essential part of effective treatment for lymphedema.

OSTEOPOROSIS
THE pt GROUP has long recognized that women have special orthopedic rehabilitation issues, such as osteoporosis. Osteoporosis is a condition that leads to a loss of bone mass. This change in mass can make the bone highly susceptible to pathologic fractures, which occur in bones weakened by a disease process. Physical therapy can provide education in a strengthening exercise program that can help stabilize the disease process on the bone. For those who have experienced a pathologic fracture, physical therapy treatment may provide pain relief as well as education concerning positions and activities that are beneficial or harmful.

There are several other specialty areas that involve physical therapy that are available at THE pt GROUP. This includes patients with head, neck and TMJ problems; foot and ankle problems; and balance disorders.

HEAD AND NECK
During routine dental screening, it is often found that patients experience symptoms of facial and neck pain. The dental examination frequently reveals tenderness in the muscles used for chewing and perhaps altered jaw movement with or without joint noises. Skilled physical therapy intervention can be helpful in educating patients on joint protection for the jaw, and neck regions. The physical therapist will educate the patient in tongue positioning, establishment of muscle tone that allows the jaw to close so that the teeth match and eliminate excessive muscle tone in the neck region. Physical therapy is a conservative treatment to complement the dentist in managing these patients.

FEET
Many times problems with our feet can lead to problems in the knees, hips and low back regions. Physical therapy is an integral component in the treatment of injuries and complaints of pain and dysfunction in the foot and ankle complex. Physical therapists instruct clients in body mechanics, gait sequencing, stretching and strengthening exercises. Our goals are to increase mobility of the foot and ankle along with allowing the client to return to pain-free function.

BALANCE

Physical therapists treat individuals with symptoms of loss of balance and dizziness. Depending on the nature of the structures involved, treatment may be directed at strengthening a weak vestibular system specific to the individual's problem. If permanent damage is suspected, the treatment strategy may be based on compensating for the loss of function through the remaining contributors to balance. Often, individuals are de-conditioned due to fearfulness to travel out of the house for fear of falling. Strengthening can be performed in our clinic, or through the establishment of an appropriate self-directed program. Physical therapy is an effective intervention for individuals experiencing these symptoms.

SUMMARY
In closing, we would like to remind everyone to choose your physical therapist as carefully as you choose any healthcare professional. You have the right to know all available facilities and therapists that participate with your health plan and should insist on being able to choose your therapist. We also encourage any person who needs physical therapy to call and ask questions to be sure that your physical therapist has the credentials and training to treat your particular diagnosis. In these times with fewer treatment visits being authorized, every visit is so important that you need to be sure you are receiving the best care available, so that you return to your highest level of function possible, which is our pledge to you at THE pt GROUP.