At Rehamed Therapy, our specialists’ expertise and training covers a wide range of body parts and their injuries (from sports injuries to chronic pain), meaning that we are well-equipped to treat and rehabilitate your ailments. So, you are in pain?
Our team has experience in the following areas:
- Back and Neck
- Knee and Ankle Joint Injures
- Muscular Strains
- Shoulder and Elbow Injuries
- Lower-Back Pain
- Sports Injury
- Orthopaedic, Cardiothoracic and Stroke-related Conditions
We are confident that we can provide you the treatment and/or recovery you need and return to your daily routine and sporting activities. Remember, you are not ill, you are injured and we will help!
How are You Treated?
Each body part, every injury and every person is different. Therefore, each and indeed all injuries need to be treated based on individual, tailor-made rehabilitation. To ensure this, our process of a complete assessment allows us to understand your body’s strengths, weaknesses and focus our programs to take these into account. Our specialisations in different body parts will allow sports injuries, chronic pain and each person to recover in the optimal way.
One of the primary areas of injuries that most people have at least once in their lives is in the back, and in particular Lower Back pain. This ailment is so prevalent due to its many potential sources, including poor posture, incorrect sleeping position, prolonged sitting and general inactivity, poor working environments or over-exertion during sporting activities.
In particular, Low back pain is defined as pain and discomfort that is localized below the costal margin and above the inferior gluteal folds. Low back pain is an extremely complicated case as not only the muscles are affected but potentially also the entire back including spine, discs and nerves. In the case of pain that persists for 12 weeks or longer, even after an initial injury or the underlying cause of acute pain has been treated, Chronic-pain Lower Back injury can cause mobility impairment as well as movement and coordination difficulties.
When treating patients with such injuries, we first ensure that any serious problems the patient may have suffered contributing to the lower back pain such as fractures, disc herniations, cancer or infection, osteoporosis, spondylitis or scoliosis are accounted/planned for and will not interfere with their rehabilitation. Following this, we apply a holistic approach to remove the pain and recover the strength in the lower back by:
- Applying heat and massage treatment, loosening the muscles in the affected area
- Stretching and spine mobilisation to reduce the stiffness on the joint(s)
- Stochastic resonance therapy for further spinal mobilisation
- Electrotherapeutic modalities such as ultrasound, TENS or IFT
- Tailormade Exercise Program for your needs
- And finally also provide home programmes for further recovery.
With this approach (that is, of course, tailored to the unique body composition and injury/pain of each individual) our aim is to provide pain-free back strength that positively affects all of your activities and quality of life as a whole.
Another common workplace injury is in the Neck area, which can be caused in particular by poor ergonomics of the working or living environment, incorrect sleeping positions and posture as well as a number of different injuries from physical activity. This is a particular area of inconvenience due to the high (need of) mobility of the head and neck.
Although there are a wide range of different neck injuries that we treat at Rehamed Therapy, we can categorise these into three main areas of (sports) injuries or chronic pain:
- Whiplash causes damage to the surrounding neck muscles, ligaments, and nerves that lead to a variety of symptoms such as neck pain, stiffness, headaches, and dizziness.
- Repetitive strain injury occurs due to overuse of the neck muscles and tendons in the cervical region primarily due to poor posture or poor ergonomics.
- Cervical Injury (radiculopathy, disc herniation, spinal cord damage) covers a range of injuries focused on the vertebrae in the neck and can have different symptoms and effects.
Clearly this is a very important part of the body to manage and rehabilitate, therefore requiring expert care of our physiotherapists. Primarily, we will focus on treating your neck injuries with:
- Pain management – through thermal and light therapies, soft tissue manipulation, ultrasound and cervical traction.
- Range of motion exercises – providing joint mobilization, neck and pectoralis stretching
- Mobility exercises – through thoracic extension with foam roll/towel and scapular retraction and protraction exercises
- Strengthening exercises – including isometric neck exercises, neck exercises with resistance band, internal/external rotation of the shoulder and strengthening of the arm
Following this additional information and guidance will be provided to improve your every day ergonomics and posture to help prevent future injuries to the neck.
One of the most common areas of injuries, during both daily- and sports-activities alike, is in the knee joint. This is one of the most important joints in the body, carrying the majority of a person’s body weight and key to their overall mobility. There are a variety of culprits when it comes to varying grades of knee injuries for which physiotherapy and/or rehabilitation might be required:
- Ligaments (posterior, anterior, medial, lateral)
- Patella and ilio-tibial band (ITB)
and can sometimes result in the need for a total knee replacement (TKR) also. Depending on the severity of the injury, surgery and therefore post-surgery therapy may be required.
At Rehamed Therapy, we provide physiotherapy and sports therapy management for both operative and non-operative patients. The recovery management is focused primarily on safe mobilisation and re-strengthening of the join following injury, through the following phases:
- Passive mobilisation – Extension of the knee to the flexion as well as isometric quadricep activation and hamstring/calf stretching.
- Active mobilisation – Multidirectional mobilizations of the patella and strengthening exercises for the calf muscle, hamstring and quadriceps can be performed.
- Functional exercise – Stimulate coordination and control through proprioceptive exercises and variation in visible input, surface stability, speed of exercise performance, complexity of the tasks.
- Neuromuscular optimisation – with plyometric exercises and adding sport-specific exercises including acceleration and deceleration, variations in running and turning and cutting manoeuvers to improve arthrokinetic reflexes.
Of course, the combinations of physiotherapy and sport therapy are optimised for your injury, whether sports injuries or chronic pain, recovery targets and individual needs to ensure that rehabilitation is perfectly tuned to your body.
A common area of injury, both in daily life and due to sporting activities, is in the ankle. Typically, an Ankle sprain is where one or more of the ligaments of the ankle are partially or completely torn. The lateral ankle ligament complex most frequently damaged whereas the medial side can be injured with forceful pronation and rotation movements of the hindfoot.
The symptoms and signs of an ankle sprain are presented by tenderness, swelling and bruising occurring on either side of the injured ankle, typically characterised by three grades of severity:
- Grade I (Mild) – Represents a microscopic injury without stretching of the ligament on a macroscopic level, with little impact on function.
- Grade II (Moderate) – Has macroscopic stretching, but the ligament remains intact or is only partially torn, resulting in reduced proprioception, range of motion and some instability
- Grade III (Severe) – Complete rupture of the ligament and will have large swelling, high tenderness, loss of function and instability.
While we provide physiotherapy and rehabilitation for all three grades of ankle injuries, in particular for severe injuries we follow a three-stage approach to recovery:
- Inflammatory Phase – The aim is the reduction of pain and swelling, and improvement of circulation. PRICE protocol (Protect, Rest, Ice, Compression, Elevation) is applied.
- Proliferative Phase – Gradual increase in activity level, range of motion exercises, active stability and motor coordination. In this phase we start with Sports Therapy rehabilitation programme.
- Remodelling and Rehabilitation – Improve muscle strength, active stability, motion of foot/ankle, mobility and gait in walking, climb up/down stairs, running. Provide information about possible preventive measures and advice regarding appropriate shoes to wear during sport activities.
All in conjunction with Sports Therapy rehabilitation. Our programmes are designed to return full function and strength to your ankle and of course also to prevent further sports injuries or chronic pain.
As far as Muscular injuries are concerned, these can obviously appear in a variety of body parts, particularly those under great stress during heavy lifting and sporting exercises, such as the hamstring, quadriceps, groin, and also shoulder and back muscles. The physiotherapeutic goals in muscular recovery are the return to strength of the muscle and overall mobility and stability of the body area.
Recovery time depends on the severity of the injury. Muscle strain, muscle pull or tear, refers to damage to a muscle or its attaching tendons, characterised by three grades:
- Grade I – Mild damage to individual muscle fibers causing minimal reduction in strength and motion.
- Grade II – More extensive damage with more muscle fibers affected, this injury presents with loss of strength and motion.
- Grade III – Complete rupture of a muscle or tendon. These injuries sometimes require surgery to reattach the damaged muscle and tendon.
During rehabilitation and therapy for muscular injuries (whether sports injuries or chronic pain treatment), we focus on both physio- and sports-therapy techniques to recover the muscle. These involve:
- Electrotherapeutic modalities such as ultrasound or TENS
- Gentle range of motion exercises and stretching (manual or active)
- Deep stripping massage of the muscle
- Progressive strengthening exercises in cooperation with Sports therapy rehabilitation
- Finally, additional patient education about your condition, which precautions to observe, any modifications to activity or work recommended and injury prevention
In addition, home programmes can be provided to help you accelerate you results as well as continue to strengthen and prevent further injury following completion of our therapy.
Shoulder injuries are amongst the most complex to treat and rehabilitate. The shoulder is a ball and socket joint and dislocation occurs when the ball is wrenched out of its socket. The force required to do this can also tear or partially tear the muscles, ligaments and shoulder capsule surrounding the joint. Treatment for joint dislocation is usually by closed reduction; this is skilled manipulation to return the bones to their normal position.
At Rehamed Therapy, we primarily focus on Anterior and Posterior shoulder dislocations. Anterior dislocation is the more common and is caused by the arm being positioned in an excessive amount of abduction and external rotation. Posterior dislocation is caused by an external blow to the front of the shoulder and there is an indirect force applied to the humerus that combines flexion, adduction and internal rotation.
Although the treatments for these of course differ in detail, we follow a three-phase approach to returning the shoulder back to full physical activity:
- Stability Phase – This will focus on immobilization for the shoulder joint and active range of motion of the elbow, wrist and hand, helping with pain reduction.
- Motion and Rotation Phase – Here, we undertake active assisted mobility to achieve full range of motion, passive stretching of the joint capsule through joint mobilizations or self-stretching and muscle activation surround the shoulder joint.
- Return to Activities Phase – Primarily focusing on strengthening exercises and functional exercises including proprioceptive training.
Our therapists are skilled in taking you through these phases with a hands-on approach in order to ensure this complex joint is brought back to full mobility.
In particular for golf and tennis players, but of course also other physical and sporting activities, the elbow is important joint that unfortunately can injure often and quite painfully. Let’s look at the two most common types of elbow injury.
Tennis Elbow, also known as lateral epicondylitis, is characterised by swelling of the tendons in the elbow and arm. This is usually caused by overusing the muscles and tendons attached to your elbow and used to straighten your wrist, leaving tiny tears and inflammation on the outside of the elbow. Despite the name, tennis elbow is often caused by other activities that place repeated stress on the elbow joint such as decorating or playing violin, racquetball, squash, fencing, weightlifting.
Golfer’s Elbow, also known as medial epicondylitis, is characterised by inflammation in the tendons that connect the forearm to the elbow. It is caused by overusing the muscles in the forearm that allow you to grip, rotate your arm, and flex your wrist, creating tiny tears in the tendons. Other racquet sports, throwing sports, weight training, repetitive occupational movements such as construction, plumbing and carpentry can also cause golfer’s elbow.
Our Physiotherapy rehabilitation approach is focused on:
- Reducing the pain and inflammation and advising the patient on protecting the injured tendon from further strain
- Performing massage and manipulating the elbow surrounding tissue to help relieve the pain and stiffness
- Range of motion exercises to further reduce stiffness and increase flexibility
- Progressive stretching and strengthening exercises to bring elbow back to fitness
all in-line with your Rehabilitation plan conceived from a Sports Therapy perspective. While the above focuses on sports injuries, chronic pain treatment is also important and our programmes are designed to return full function and strength to your ankle and of course also to prevent further injury.
Orthopaedic surgery is the branch of surgery that involves the musculoskeletal system (bones, muscle, ligaments, tendons and joints) and can be rather common especially amongst athletes and active sports people. It is important in both sports injuries and chronic pain treatment. After surgery, the affected area will immediately go into healing, meaning that the body will start to repair the damages from the surgery. Physiotherapy is crucial here through individualised programmes to ensure the optimal healing and return to activity for the injured body part. We provide rehabilitation services for a number of common orthopaedic surgery procedures:
- Joint replacement procedure (Arthroplasty) – to restore function of the damaged joint
- Revision joint surgery – If, for example, an existing implant failed
- Debriment – Shaving of dead/damaged tissues before healing takes places
- Spinal fusion – Joining the vertebrae together to repair or provide more stability to the spine
- Bone fusion – Improve bone healing by grafting
- Soft tissue repair – focusing on torn ligaments, tendons or meniscus to enhance proper healing
- Internal fixation of bones – procedure that places fractured fragments of the bone together and keeps them in places with rods, screws, plates, wires, and pins.
Through our team and facilities, we provide a combination of Physiotherapy and Sports Therapy (we have specialists in each area and also S&C) to provide:
- Early phase of Physiotherapy – Starting as soon as the patient is discharged from surgery, this focuses on pain relief and reduced swelling, restoration of motion and muscle activation non-disruptive to the healing process.
- Physiotherapy and Rehabilitation – Once the post-operative pain and swelling subsides, our focus will be on returning to normal range of motion, body biomechanics and strength through joint mobilization, manual therapy to release muscle tightness and balance/proprioception exercises.
- Physiotherapy and Sports Therapy Rehabilitation – Our sports therapists work on your return to daily activities and sport through advanced and complex balance and proprioception exercises, progression on strength and the return to sport program.
While orthopaedics is a major area of focus, we also provide physiotherapy and rehabilitation for non-orthopaedic ailments and surgeries, such as in the Cardiothoracic area. Cardiothoracic surgeries are typified by surgical treatment of organs within the thoracic area (the chest), generally focusing on the treatment of conditions of the heart and lungs. More specifically, cardiac surgery refers to procedures involving the heart, major arteries and great vessels, whereas general thoracic surgery involves the lungs, oesophagus and thymus, amongst others.
At our Centre, we focus on post-surgical rehabilitation for a variety of Cardiothoracic treatments, including:
- Cardiac – Open heart surgery, Bypass surgery, Angiogram, Angioplasty
- Thoracic – Lung volume reduction, Lobectomy, Sublobar / Bronchoplastic resection, Esophagectomy
These are, of course, extremely serious procedures to some of the most vital organs of the body and therefore both the treatment and rehabilitation should be given the highest priority and quality. Due to this, it is important to note that we only accept patients after having been discharged and received full clearance to exercise from their attending doctor or treating physician. Once a patient has obtained this clearance, our specialists will help provide the after-care through:
- Breathing exercises & Ventilatory training – Prevention and comprehensive management of impairment through diaphragmatic breathing, segmental breathing, inspiratory resistance training, and breathing techniques to help relief of dyspnea during exertion
- Postural drainage – Mobilisation of the chest sputum and ultimately coughing and huffing method to spit the sputum
Our goal is to ensure you the most comfort following these highly sensitive surgical treatments and bring the cardiothoracic functions back to their best possible health.
Another non-orthopaedic trauma area that we focus on at is physiotherapy and rehabilitation for stroke patients. A stroke (neuro trauma) occurs when blood vessels carrying oxygen and nutrients to the brain are either blocked by a clot or have ruptured. When that happens, part of the brain is not getting the blood and oxygen it needs and therefore the cells begin to die. Some examples of strokes are ischemic stroke, haemorrhagic stroke, and transient ischemic attack or mild stroke that caused by a temporary clot.
Our Stroke Rehabilitation programmes depend on the part of the body or type of ability/function that has been affected by the stroke. In particular, we focus on:
- Physical activities
- Motor skills exercises – helping improve muscle strength, coordination and joint proprioception
- Mobility training – learn to use mobility aids such as walkers, canes or a wheelchair with the aim to slowly become less reliant on these aids.
- Constraint induced therapy – re-training the affected side of the body in its standard functions
- Range of motion therapy – by easing the muscle tension (spasticity)
- Technology assisted physical activities
- Functional electrical stimulation – where electricity is applied to weakened muscle, causing them to contract which helps to re-educate the muscle
Of course, we will always say the stroke rehabilitation should begin as soon as possible. However, we will always look for the appropriate physician clearance first (as with cardiothoracic surgery patients) before accepting a patient.