Rehabilitation

What Does Rehabilitation Mean: A treatment or treatments designed to facilitate the process of recovery from injury, strains, sprains, overexertion, over usage, surgical injuries, illness, or disease to as normal a condition as possible.

 What Is The Purpose of Rehabilitation? To restore some or all of the patient’s physical, sensory, and mental capabilities that were lost due to injury, illness, or disease. Rehabilitation includes assisting the patient to compensate for deficits that cannot be reversed medically. It is prescribed after many types of injuries, surgical procedures, illness, or disease, including amputations, arthritis, cancers, cardiac disease, neurological problems, orthopedic injuries, spinal cord injuries, strokes, traumatic brain injuries and many others’.

 What Does Rehabilitation Entail? A proper and adequate rehabilitation program can help reverse many disabling conditions or can help patients cope with deficits that cannot be reversed by medical care. Rehabilitation addresses the patient’s physical, psychological, and environmental needs. Goal is to restore the patient’s physical functions of the muscles and sometimes may require modifying the patient’s emotional, and social environment.

Every rehabilitation patient I see is different; so each program is tailored /customized to the individual patient’s needs and can include one or more types of therapy, muscular techniques, exercises, position release, and stretching sequences.  Massotherapy and some Physical Therapy stretching helps the patient restore the use of muscle function. Several things can be used to help the restoration process; such as use of heat, cold, massage, exercises /stretching, and other techniques. It seeks to relieve pains, tensions and open falsest, improve strength and mobility, ROM and train muscles to “set;” which all benefits the patient to perform important everyday tasks.

Rehabilitation is normally prescribed to rehabilitate a patient after amputations, surgical procedure, arthritis, cancer, cardiac disease, cervical and lumbar dysfunction, neurological problems, orthopedic injuries, pulmonary disease, spinal cord injuries, stroke, traumatic brain injuries, and other injuries/illnesses. Depending on the patient’s condition, exercises may be performed by the patient alone or with the therapist’s help similar to physical therapy, or with the therapist moving the patient’s limbs. Therapists may ask for certain exercises and proper body mechanics to be done outside of therapy. Massage aids circulation, helps the patient relax, relieves pain and muscle spasms, and reduces swelling; as well as builds the tissues, restores function, mobility, flexibility and others’.

Dr. Hartman offers Kinesiology taping for all athletes, injuries, helping with faster recovery after surgeries etc. Taping has been shown to reduce swelling/inflammation, providing muscular and joint support, relieves pain etc.

Dr. Hartman has helped numerous people with Rehabilitation for:

• Systemic Lupus Erythematosus
• Cancer
• Cardiac
• Geriatric
• Total Joint Replacement Rehab (Several Hip & Knee)
• TMJ, Strokes, Facial Muscles
• Tendon injuries & Tendonitis
• Adductor Strains / Pulls & Injuries
• Coccyx Pain
• Hamstring / Quad pains /strains
• Anterior, Medical & Lateral Collateral Ligament Injuries
• Hip Flexor
• Meniscal Injuries
• Bursitis: Elbow, Knees, Prepatellar, Trochanteric, etc.
• Lliotibial & IT Band Syndromes
• Piriformis / Sciatic Nerve
• Plantar Fasciitis
• Anterior & Posterior Cruciate Ligament Injury
• Stress Fractures / Sprains
• Mechanical Low Back Pains
• Myofascial Pain
• Post-exercise Muscle Soreness
• Carpal Tunnel & Trigger Finger
• Rotator Cuff Injuries /Tears & Shoulder Impingements /Hemiplegia
• Fibromyalgia, MS, Cerebral Palsy, Neuropathy, ALS
• Spinal Disorders (building muscles up around areas)
• Gait Analysis / Dysfunction
• Neuromuscular Issues / Injuries
• Stretching and Exercises
• Surgeries –Pre & Post
• Reduction of Coagulated Fluids (Edema)
• And Many Others’

Some of the ways Dr. Hartman helps is by:

Active & Assisted Isolated Stretching –AIS: is the method of muscle lengthening and fascial release that provides effective, dynamic, facilitated stretching of major muscle groups, but more importantly, AIS provides functional and physiological restoration (muscle memory) of superficial and deep fascial planes. Active Isolated Stretching enhances ALL aspects of movements and flexibility, and is a uniquely effective exercise system developed by Aaron Mattes. It uses your own body to facilitate results. Stretches are held for short periods and completed in reps. It can play a major role in injury rehabilitation therapy aimed at restoring function that has been lost through physical trauma or other types of soft-tissue damage. Including, restored neuromuscular functioning. Dr. Hartman utilizes Aaron Mattes’ techniques when needed for all therapies whether you are an athlete, patient in rehab for an injury, post surgery, or a stay at home mother etc.

Cold laser therapy is a non-invasive Low level Laser Therapy (LLLT) that has been used in the treatment of a variety of medical conditions and has been shown to improve wound healing, reduce edema, and relieve acute pain; including reducing overall body circumference, measurements of specifically treated regions, including the hips, waist, thighs, and upper arms, with recent studies demonstrating the long-term effectiveness of results. Also, used to accelerate tissue repair, including wound healing, and for the alleviation of skin conditions such as acne, scarring, and wrinkles. The treatment is painless, and there has been no adverse events associated with LLLT.

The LLLT has been used in practices such as Chiropractic, Physical, Massage and Rehab therapy to reduce pain and inflammation; including in TCM, Oriental Medicine, Acupuncture & Auriculartherapy. Lasers at 635nm are the exact vibration of a healthy living cell. In acupuncture, lasers with a beam at 635nm are the equivalent to using a needle, and they have been used in acupuncture for years. Using a laser beam at this frequency heals the cells of the body and easily stimulates acupuncture points (Meridian Points). “Remarkably, LLLT can also reduce both acute and chronic pain. Although many of the reports of pain relief following exposure to LLLT are anecdotal, there have been a number of reports based on trials aimed at assessing LLLT as an analgesic modality”. (Excerpted from, Low Level Laser Therapy, Mary Dyson PhD, FCSP; Softlaser Guide: p.23, 2011)

There is no pain with laser treatment, and there are no known negative side effects. Many conditions, which have not responded to conventional treatment, respond favorably to the directed light energy and the healing frequency of the pulsed laser light.

Over 2000 studies have proven laser therapy is effective and safe. Examples:

• Reduces pain by causing the production of natural pain killer endorphins.

• Reduces inflammation by suppressing inflammatory enzymes that create swelling, redness, pain, and heat and it enhances the release of anti-inflammatory enzymes.

• Enhances lymphatic drainage, which increases circulation and speeds healing.

• Stimulates the release of several helpful healing enzymes.

• Releases tight muscles (both smooth and striated) that create chronic pain, join problems, and decreased mobility.

• Speeds bone repair by stimulating fibroblastic and osteoblastic proliferation.

LLLT (low level laser therapy): in the correct frequency appears to be antiviral, anti-fungal, and anti-herpetic. Primer: nm = nanometer, a measure of the size of the beam of light
Laser = light amplification stimulated by emission of radiation
Laser light is unlike regular light in that it is coherent i.e., the photons are well ordered and synchronized. Laser light is also monochromatic, meaning it is of one pure color. Laser irradiation of tissue cultures has shown units of light energy (photons) are absorbed by enzymes, which react to light within the cell. Visible red light is absorbed within the mitochondria and the infrared light is absorbed at the cell membrane. In a mammalian cell, this results in a change in membrane permeability, increased ATP levels, and increased DNA production. The photons picked up by the cell membrane result in improved membrane stability and increased activity of the ATP dependent Na/K pump. Because cell metabolism is influenced by Na/K movement across the membrane, increasing the gradient will affect the flow of ions and hence the overall metabolism of the cell. On a tissue level, shown to increase collagen and epithelial production and production of new capillaries and an increase in density of the capillary bed. Reduction of pain and inflammation results from this treatment; as does the stimulation of nerve regeneration, muscle relaxation and atonicity (lack of muscle tone). There is also an indication that laser light therapy helps to increase the immune system response, among numerous other healing modalities…

It has also been used in helping to block or impede and/ or correct to heal sensitivities to foods and substances with several techniques used to stimulate healthy cell regeneration; including on acupuncture points.

Kinesiology (Kinesio) taping: a form of rehabilitative taping designed to facilitate the body’s natural healing process, by providing support and stability to muscles and joints without restricting the body’s range of motion. Helps alleviate pain and helps lymphatic draining, while decreasing inflammation naturally.  Some examples of taping benefits are:

• Pain Relief
• Prevents /Relieves muscle cramping and/or spasms
• Reduces inflammation
• Quicker recovery from overused/worked muscles
• Helps decrease bruising
• Supports injured joints and muscles without restricting ROM
• Prevents muscles to become weakened, by helping to improve muscle activation
• Allows you to stay active while healing from your injury

Muscle Regeneration, Repair, and Rebuilding:  Dr. Hartman has worked with hundreds of people, including many athletes, throughout the years, with therapy, rehabilitation, muscle balancing, acupressure, nutritional coaching and much more. Through the years of working with a variety of people, one of the most common mistakes has been, most people will go to a physical therapist or chiropractor first instead of receiving muscular therapy. Being a physical therapist aide herself, Dr. Hartman understands why so many people think this way; but in all actuality, physical therapy is a localized therapy and will not address all muscles, tendons, ligaments, and tissues associated. Each case is different and physical therapy maybe needed in combination with muscular therapy and/or a chiropractor adjustment at times. However, if it’s muscular and we are not addressing the real problem, it will only be a shortened period of time before we are again hurting. In Dr. Hartman’s experience, Physical Therapy is very important and beneficial for those who have undergone surgeries, major injuries or accidents (in a recuperation phase), sometimes for crippling diseases; and in certain instances, some diseases or medical conditions that have impaired function. Although, receiving physical therapy and muscular therapy together will far more benefit patients and cut recovery time, in most cases, in half.  As for Chiropractic treatments it is beneficial in relieving pain in back neck pain, hips, ribs, whiplash, headache, and more; including helps with posture by keeping the spine aligned. However, both will ONLY work temporary until the muscles are set. These treatments are needed sometimes but muscles are what move the body and if they are not put back in place, it is only a matter of time before things will go back out again. After which, resting in-between therapies /treatments is a MUST. This allows muscles to set and repair, rebuild and heal. When we are continually overactive (daily with no real rest or break), this only sets us up for injuries and can cause prolonged recovery. Receiving muscular therapy first then physical therapy and/or a chiropractic adjustment actually makes the chiropractic adjustment and/or physical therapy much more beneficial.

Muscular Therapy: is an extremely important part of anyone’s wellbeing and health, especially for those with health challenges, athletes; and those who want to prevent problematic areas and injuries. As stated above, many people and athletes undergo physical therapy or rehabilitation when they get hurt, injured, or run into a problem. However, Dr. Hartman’s advanced medical deep muscular therapy helps to prevent many of these injuries by building muscle tissues and fibers, which enhance athletic performances. When muscles are worked on a regular bases, and allowed to heal, rest, set, rebuild and regenerate; injuries are less likely to happen, and muscles become stronger, and firmer. Although, you have to go to someone who knows how to create the right muscular techniques, exercises, stretches, etc. as Dr. Hartman does. Most therapist working are not trained in this area, unless they choose to be; which is rare a therapist would want this advanced muscular training unless they have many athletes and work with rehabilitative patients as Dr. Hartman works with.

Here’s why everyone should consider therapy, especially athletes: Muscles and their tendon attachments combine to form what are known as musculotendinous units. These musculotendinous units provide the force that is necessary for movement. Many sports require explosive movements, e.g., sprinting, jumping, running, and shooting etc. with large forces generated by muscles and tendons. It is easy to see why over a quarter of all injuries affect these structures. A muscle strain is damage caused by over-stretching or exertion of muscle tissue. It is thought to occur most frequently when movements such as sprinting, stretching for the ball, or kicking or throwing the ball are carried out in an uncoordinated manner. The muscle tissue becomes overloaded, overworked, and reaches a breaking point where a tear or partial tear occurs. The player will experience pain that will persist if he or she attempts to stretch or contract the muscle. This can also happen in workouts, daily activities, etc. Building up the muscles and keeping them in place prevents SO many things! For example:

There are 3 types of muscle strains:

• GRADE 1 STRAIN
There is damage to individual muscle fibers (less than 5% of fibers). This mild strain requires 2 to 3 weeks rest.
• GRADE 2 STRAIN
There is more damage that is extensive and more muscle fibers are involved, without the muscle completely being ruptured. The rest period required is usually between 3 and 6 weeks.
• GRADE 3 STRAIN
This is a complete rupture of a muscle. The person usually requires surgery to repair the muscle, rest, and therapy. The rehabilitation time is around 3 months or longer due to the extent of the injury.

All injuries, especially muscle strains should be well rested and allowed to heal in order to prevent further damage and injury. If the patient continues to play, the condition will worsen. If ignored, a grade one strain has the potential to become a grade two strain or even a complete rupture.

Dr. Hartman’s job is to work muscles by helping them heal quicker, rebuild, regenerate, and keep them in place (set) for muscles to become strong enough to prevent any more damage or lessen the chance of injuries occurring and/or reoccurring. However, she tells all athletes, they also have to have rest, even if it’s one day a week but especially after therapy and they need a good diet too. Most athletes do not want to rest or their coaches or parents will push them into having to workout everyday to “keep them strong.” The truth is they are ONLY hurting their muscles and there is a much higher risk for injuries, tears, and strains by NOT resting and allowing muscles to repair. In Dr. Hartman’s experience, resting after therapy helps set muscles, allows them to repair, rebuild, recondition, and regenerate themselves; as well as provides a lesser chance for injuries, tears, and strains. In fact, many of Dr. Hartman’s athletes she sees on a regular basis for therapy, who rest at least once a week, and do her nutritional plan; have reported they have beaten their PR (Personal Records), feel SO much better, do not get as sore and rundown; all of which they state is from her therapy, nutritional plan, and taking time to rest.  Dr. Hartman has worked with numerous injuries that could have been avoided by following the above.

Diet: is a very important thing to consider whether you are an athlete, have health challenges, etc. Our Western diet is extremely high in sugared carbohydrates, bad fats and an enormous about of animal proteins. More and more nutritional deficiencies are being discovered because of our Western diet and all the chemicals used on our soils. In fact, a recent study found many people have deficiencies in vitamin D, vitamin A, vitamin B, (some vitamin C) calcium, magnesium, omega 3’s, and iodine; with an increase in toxicity; due to our diets and nutrient depleted soils. Because our plants are depleted of many natural nutrients due to all the chemicals used; they have become not as nutritious as they once were, which can cause more toxins and toxic build up in the body. The recommended fiber intake is 12 grams a day but should be closer to 35 grams a day to help eliminate more of these toxins. Dr. Hartman also recommends doing a colon cleanse or whole body detox once every 3 or 6 months for 7 to 10 days (at most). Flushing and cleansing the colon and body helps to eliminate many toxins, and keeps us healthier. Juicing with organic veggies and fruits also provides healing on a cellular level but is not recommended with any other detoxification program. Dr. Hartman herself cleanses once every 3 to 6 months or when she starts to feel ran down. Toxic build up can make us sick, causes illness, and disease in our body. Eliminating them is essential for whole body health and ingesting certified organic foods helps prevent many of the toxins we are now experiencing and exposed to in our environment.  There are numerous detoxes out there, however, a person should seek professional advice first from a knowledgeable practitioner before starting any detox program. Moreover, no one should detox for a long period, this is very unhealthy and can cause loss of vital and essential nutrients, minerals, vitamins, etc…

Protein: Another to consider with common deficiencies found in all major food groups due to both the quality and the quantity of what is grown, we need to look at protein, one of the most underrated food groups. In general, most people do not get enough protein from their diet on a continuing basis. Understanding the amount of protein a person requires is complicated. Common equations for calculating the amount of protein a person needs are based on body weight and the amount of lean muscle. Protein supplies the amino acids necessary for healing and restoring the body. Muscle is built and maintained through ingestion of protein so to have a complete balance of nutrients we need to balance protein with the correct amount of complex carbohydrates and healthy fats. Plant proteins and other vegetables tend to be much lower in saturated fat and cholesterol and are much easier to digest and disburse in the body and healthier than animal proteins. Although, we do need some animal proteins in our diets if we are not supplementing essential amino acids, e.g. using Bragg’s Liquid Amino for example. Animal proteins are a complete source of proteins, however, you have to eat organic meats to avoid a multitude of chemicals/toxins, growth hormones, over use of antibiotics, steroids etc.

A simple formula for calculating the amount of protein a person requires is to take your ideal body weight and multiplying by .75. This gives the average person’s daily requirement for protein in grams. It is important to use a protein powder every day to supplement the amount of protein, whether you do one or two shakes or using it in baking etc. and especially after exercise for help with recovery. There are several choices of powdered proteins and include egg, hemp, rice, pea and whey proteins. These all vary in density and have different properties. Rice proteins are less dense, easy to digest and great for detoxification. Whey protein provides support for human muscles and provides a broad array of amino acids for the body to use in healing itself. There are many sources of whey available. They include the whey concentrate, whey protein and whey protein isolate. The isolate is the purest, the most expensive, and the best absorbed.However, don’t be fooled, not all protein is created equal. You need the right kind, in the right amount, at the right time…

Complex Carbs & Healthy Fats: carbs have got a bad rep for a while now, however, “Carb free diets” are unrealistic in the long term and very unhealthy. Complex carbs are the healthy carbs and much better for our bodies. There are numerous healthy fats, however, our Western diets use mostly the bad carbs (simple) and fats. Your body does not use all carbohydrates in the same way. In fact, there are four different types of carbohydrates: Monosaccharaides, disaccharides, oligosaccharides, and polysaccharides. Mono and disaccharides are often referred to as “simple” carbohydrates, while oligosaccharides are called “complex” carbohydrates.Monosaccharaides are simple natural carbohydrates like glucose and fructose. Disaccharides take the form of table sugar (sucrose) and milk sugar (lactose). Sugary cereals, soda, and desserts are all simple carbohydrates.You need complex carbohydrates (poly and oligosaccharides) to protect your vital organs, provide your cells with energy, and even to lose weight. Poly and oligosaccharides are found in plants and whole grains. Complex carbohydrates are full of dietary fiber; phytochemicals and vitamins that your body needs to stay healthy. Some good sources of complex carbohydrates include whole grain bread and pasta, fruit and vegetables, and brown rice.Carb free diets can put you at risk for developing health problems, especially if it’s for a prolonged amount of time. Read more at: http://www.boxingscene.com/weight-loss/20752.php And  http://www.bengreenfieldfitness.com/2011/08/the-hidden-dangers-of-a-low-carbohydrate-diet/

There are SO many wonder diets out there that “claim” to work but many are depleting the body of vital minerals, nutrients, and healthy fats, carbs, and proteins. Dr. Hartman has herself tried numerous diets over the years, as a young athlete. She only struggled with her weight after her first child and still to this day carefully watches her food intake. She has tried numerous “fad” diets, starved herself on several “athletic diets,” “No carbs,” “Low fats” and used protein shakes instead of food too often with appetite suppressants, etc. 13 years ago, Dr. Hartman had to change her diet due to her daughter’s sensitive system or she would breakout with numerous foods Dr. Hartman was eating or become reactive.

Dr. Hartman has a Bachelors in nutrition/natural health, which took 4 years to complete, and she has slowly changed her families Western diet to all whole foods, natural and organic the way God made them. Dr. Hartman also found out through her nutritional education and training, the fat diets actually hurt the body, mind, muscles, organs, and all systems; including deplete needed good fats. The low carbs are a good start but it we must have some healthy carbs, not the sugary carbs we’ve all grown up on and become accustomed too. Diets that consist of very high animal proteins also have their downfall and can cause the body to lose vital nutrition as well. Dr. Hartman has realized from 13 years of study, we need a good ratio of all healthy fats, proteins and carbs.

Many of Dr. Hartman’s athletes set their selves up for injuries by the mindset of pushing themselves to incredible limits with little resting in-between, and almost starving themselves by cutting out “fats” and stopping “carbs,” only focusing on mostly high animal protein. Dr. Akins was one who started this new revolution of low carbs and high proteins. 6 Week body makeover is very similar to the Akins diet. However, during training and/or before meets/competitions, athletes need some healthy fats, carbs, and a good source of proteins before and afterwards. As well as other essential nutrients, all of which are key to their success and performance, especially preventing injuries. Due to many factors, Dr. Hartman has helped to educate athletes in numerous areas to insure proper performance, nutritional essentials, and to help rebuild, repair, regenerate, and recondition muscles through rehabilitation, muscle confusion, stretching, massotherapy, and nutritional practices.

All Diets: should consist of: some protein, some carbohydrates, and a healthy fat. Yes, carbs! Carbs give you energy, and before and after your workout is the best time to consume them. Dietary protein ingestion during or immediately after exercise stimulates muscle protein synthesis, inhibits protein breakdown and, stimulates net muscle protein accretion following resistance as well as endurance type exercises. Protein facilitates the skeletal muscle adaptive response to each exercise session, resulting in more effective muscle tissue reconditioning.  Most of the time, Dr. Renee Hartman suggests 20 grams of protein, 20-30 grams of healthy slow digestion carbohydrates. Why slow-digesting carbs? They produce a slow increase in blood glucose, sustains energy, and a modest insulin release in response. In addition, no more than 5-10 grams of healthy fats should be consumed. Eating a balanced diet that includes proteins, healthy fats and complex carbohydrates is the best-balanced way to stay healthy.

For those who would like just AIS and not incorporated with medical massotherapy -please call Dr. Renee Hartman for pricing and time @ 765-860-2144