Learn More About How We Treat Better!
At Kulp Physical therapy, we focus on ensuring that you get the highest quality of services available. Take a deep dive into the treatments that we offer, and feel free to contact us if you have any questions.
DEEP DIVE INTO KULP PHYSICAL THERAPY
Physical Therapy for Neck Pain
Neck pain can be related to multiple factors such as occupational, psychological, and traumatic influences. Occupations that are considered high risk for neck include computer data processors, mechanics, typists, musicians, doctors, dentists, hygenists and cooks. These individuals have to maintain static neck and body postures for prolonged periods of time. Psychological factors include work satisfaction, family, health and economic stressors. Traumatic factors include whiplash, falls, recreational injuries and work-related injuries.
Neck pain can be localized and can be referred down the back or out to the upper extremities and head. Neck pain can range from being occasional with nonlimiting symptoms to sharp annoying debilitating symptoms to chronic pain and annoying stiffness. 15% to 20% of the general population complain of neck related symptoms in the 12 month period time. Common diagnoses include tension neck syndrome, cervical spondylosis, cervical disc disorders and other disorders of the cervical spine. Neck pain and low back pain are often interrelated.
Physical Therapy for Low Back Pain
It has been stated that back pain is the most common cause of disability in adults under the age of 45. Older individuals also suffer chronic and sometimes function-altering back pain. Most workplace or medical service-designed programs have made little progress in reducing low back pain causes and consequences. Kulp Physical Therapy is uniquely suited in treating low back pain causes and consequences. We take an approach of evaluation and treatment, which looks at the whys, and hows that create low back pain. Back pain can be categorized into upper back pain and lower back pain.
This article will concentrate on lower back pain. Most medical practitioners agree that back pain can come from multiple sources. Some of the sources include lumbar discs, vertebral and facet joints, organs, nerves, and most importantly, the muscles. Most disc, joint, nerve and muscle disorders are influenced by posture; work, household, and recreational activities; nutritional and hormonal imbalances, as well as psychological factor(s). Kulp Physical Therapy and Massage will look at each of these factors in determining how they are influencing individuals' pain and how each factor overlaps with each other.
for Shoulder Tendinitis/ Impingement Syndrome
Shoulder impingement - occurs when there is excessive use of the arm over the head. (i.e. lifting boxes, weights above shoulder level, overhand throwing or falling on an outstretched arm). The supraspinatus, infraspinatus, teres minor muscles, and the subdeltoid bursa are primarily involved in the shoulder impingement syndrome. The subdeltoids bursa's function is to help cushion the tendon during arm elevation.
The bursa is prone to irritation and inflammation, especially with overhead arm usage. When the bursa or the tendons become inflamed with shoulder elevation the supraspinatus tendon will become compressed between the acromion in the humeral head. The resulting symptoms may include sharp pain with side arm movements (abduction) from the mid range to the end range of movement; pain radiating to the back of the shoulder; into the deltoid muscle and down the arm into the lateral elbow and into the back of the hand.
Physical Therapy for Hip Pain
The Big Three: Hip Osteoarthritis, Hip Bursitis, Pyriformis Muscle Syndrome
Your hip significantly affects your daily activities. Hip pain can affect your walking, sitting, and sleeping. For most people, this affects every aspect of their daily lives. The following will help the reader understand their hip pain, the mechanisms of why you have hip pain, and how Kulp Physical Therapy can help you with your hip symptom.
So how does your hip pain start? You are 60 years old, you've raised your children and you’re considering retirement and your activity level has changed from being an active mother or father, raising your children, doing your household and work activities. You used to be involved in house renovations, painting or fixing a door, and participated in recreational sports at work or at the club. Now you're more sedentary and you have periodically involved yourself in a walking program or a light exercise program, but that effort comes and goes and you find yourself 30 or 40 pounds heavier than you were.
Physical Therapy for Headaches
Most headaches have a muscular component and sometimes muscles can be the prime origin of the headache symptom. Both migraine headaches and chronic tension-type headaches will have a myofascial trigger point in the muscles. We will concentrate on how the myofascial trigger points are associated and can create headaches.
Most of us are familiar with the classic presentation of headaches. But there is little to distinguish a migraine headache without aura from a chronic tension-type headache, (CTTH). One-sided pain of the head, aggravation of the headache by routine physical activity, nausea and vomiting, photophobia, and phonophobia are described as symptoms of a migraine without aura and the CTTH. The chronic daily headache, (transformed migraine, CTTH, new daily persistent HA (NDPH), and hemicrania continua), pathogenesis is considered to include peripheral and central nervous system sensitization.
Masseter & Sernocleidomastoid
Physical Therapy for Lateral Epicondylitis
a.k.a. Tennis Elbow
Tennis elbow is an inflammation of the tendons of the gripping muscles that help to extend the wrist which attach to the elbow. Occupations that contribute to a tennis elbow, include repetitive wrist and gripping motions such as machine and construction work. Tennis elbow is a cumulative trauma disorder that is a potentially progressive condition if not taken care of in the early stages.
Symptoms include pain with gripping objects and lifting objects, decreased strength, and tenderness to touch outer aspects of the elbow. Self-treatments by the individual include ice, rest and anti-inflammatories (medication given by the physician). A brace, worn when performing a repetitive activities around the forearm, can help distribute the forces throughout the inflamed tendons and muscles.
Extensor Carpi Radialis Brevis
Extensor Carpi Radialis Longus
Physical Therapy for Knee Pain
When we think of knee pain most times, trauma and degeneration are at the forefront of reasons why a person’s knee might hurt. There are a number of factors that we need to think about when considering knee pain. The hip and feet significantly influence the mechanics of the knee. In addition, a person's posture will affect how the knee is moved. Please read the following article and learn how we as active individuals in our daily lives, can create our knee pain.
Consider this patient; a female in her 40’s with a 20 year history of working, taking care of children, being the center of the family. She may have gained weight and has been off and on exercising since she had children. Her idea was to shift focus onto herself and begin exercising. So she starts a walking or running program as part of a local shoe store’s promotion and/or from research she had done online. She did her homework about exercise and stretching, but about three weeks in her knees started hurting. This problem is no different for men or women and it is a consistent issue that we see regularly at Kulp Physical Therapy.
Physical Therapy for Carpal Tunnel Syndrome
The Nemesis of the Hand
Carpal Tunnel Syndrome symptoms usually occur without incident. Symptoms usually begin at night or in the early hours of the morning, waking up the individual with a funny sensation or burning in the hand. Symptoms may include numbness, tingling, and burning in the palm side of the thumb, second, third and part of the fourth fingers.
The individual may notice clumsiness of usage as well as reduced grip strength and a history of dropping objects. Occasionally, the patient may experience a change in color of the hand as well as muscle atrophy. These symptoms can start out vaguely and light in nature but can progress to a severely disabling condition where the individual cannot use their hand for any functional tasks.
Physical Therapy for Plantar Fasciitis
Plantar fasciitis, also known as plantar fibromatosis or jogger's heel, is a disorder that results in pain in the heel and bottom of the foot. The pain is usually most severe with the first steps of the day or following a period of rest. Pain is also frequently brought on by bending the foot and toes up towards the shin and may be worsened by a tight Achilles tendon. The condition typically comes on slowly. In about a third of people, both sides are affected.
When plantar fasciitis occurs, the pain is typically sharp and usually unilateral (70% of cases). Heel pain worsens by bearing weight on the heel after long periods of rest. Individuals with plantar fasciitis often report their symptoms are most intense during their first steps after getting out of bed or after prolonged periods of sitting. Improvement of symptoms is usually seen with continued walking. Rare, but reported symptoms include numbness, tingling, swelling, or radiating pain.
Physical Therapy for Vestibular Rehabilitation
In the US 35% or 69 million people have a vestibular disorder(1). Eighty percent of people 65 or older experience dizziness(2). BPPV is the most common vestibular disorder and accounts for 50% of dizziness in older people(3).
BPPV occurs when the otoconia (crystals) fall off the otolithic membrane (hairs) in the semi-circular canal. (Fig 1) Sometimes the crystals continue to float in the canals and other times the crystals will embed themselves to the walls of the canal.
For example sitting up, rolling in bed, and looking up will cause moderate to severe room spinning. BPPV symptoms can include nausea, especially with changes in position.
Physical Therapy for Thoracic Pain
“Sitting and the Heavy Shoulder Syndrome”
Thoracic pains have a muscular component with significant postural and mechanical consequences. Thoracic pain will have a myofascial trigger point in the muscles that are affected by the daily activities and repetitive positions we put ourselves into. Today we will concentrate on how one's physical size, conditioning, and positioning can give a real “pain in the back”.
There are five categories of impaired thoracic alignment: kyphosis, post trunk sway, flat back, rotation and scoliosis. Thoracic kyphosis is defined as an increase in the flexion curve in the thoracic region. It usually starts as a postural fault and becomes a structural impairment. Posterior trunk sway of the thoracic spine occurs when the upper back is shifted backward and hips are swayed forward so that the shoulders are posterior to the hip joints. The flat back posture is one in which the thoracic spine is straight or the degree of flexion is noticeably less than normal. When the thoracic spine is extended, structural changes are more likely. Rotation of the thoracic spine is almost always an acquired problem resulting from repeated movements in one direction which occurs with one-handed sports such as baseball and tennis. This also can occur when one is sitting at a desk and frequently rotates to one side to work on a computer or answer a phone. Scoliosis is present when the thoracic spine and rib cage are rotated. This can be localized to a few vertebrae or can involve the entire thoracic spine. It is most evident from
Physical Therapy for Degenerative Changes in the Cervical Spine & How to Correct Them.
We will focus on how degenerative changes occur through Movement System Impairment Syndromes, (MSIS). Kulp Physical Therapy uses a Kinesiopathological model for defining the MSIS and how the dysfunction occurs.
First, let’s define Kinesiopathological. Kinesiopathological refers to how movement that is excessive, imprecise, or insufficient contributes to the development of pathology.
The MSIS model believes that accessory motion greater than the physiological motion causes the impairment and that accessory motion hypermobility, is the underlying characteristic of degenerative joint disease.
MSIS is a progressive condition that is related to lifestyle that causes degenerative changes in the tissues. It is influenced by a variety of intrinsic, (genetics, sex, age), and extrinsic, (lack of, amount of, and type of fitness, work activity), factors.
Physical Therapy for TMD (TMJ)
Kulp Physical Therapy has been treating TMD (temporomandibular disorder also referred to as TMJ) for over 30+ years with a great deal of success. The purpose of this article is to help the patient understand their symptoms and how we can help.
Do you have symptoms including clicking of the jaw, locking of the jaw, clenching, or grinding behaviors? Do you have painful chewing, vertigo, dizziness, ear ringing, neck pain, or headaches? If you do, you may have TMD.
Myofascial Trigger Point and Treatment
What separates Kulp Physical Therapy from other physical therapy clinics is our unique treatment of the myofascial trigger point. The Myofascial trigger point can be defined as an abnormal muscle condition characterized by a taut band (a hardened strip of muscle) with a hyperirritable nodule (the trigger point).
It has three other characteristics in its definition,
It has a local or referred sensation,
This trigger point and its pain or abnormal sensation is recognized by the patient as part of their symptom,
and there is a restricted range of motion within the muscle.
These are the primary features of a myofascial trigger point. There are other major characteristics that may accompany a trigger point. These include a twitch response, (contraction of the muscle when stimulated), muscle weakness, muscle stiffness, a jump sign, abnormal peripheral and central nervous system sensitivity which include allodynia, (pain from a sensation that is not normally painful), hyperalgesia, (increased pain response to normal painful stimulus).
Specialized Spinal Therapists
Kulp Physical Therapy has two physical therapists that have completed the Community Spine Pathway Training Program. Douglas L. Kulp PT, CMTPT, and Leah Valvo PT, OCS are encouraging patients to utilize the direct access law that the State of New York approved in 2006 to begin physical therapy treatment for neck and back disorders as soon as your symptoms start.
What this means is the patient no longer is required to see their physician first to receive the most up-to-date, evidence-based medicine for neck and back disorders.
“I started seeing Doug Kulp and his staff back in February for an arm injury that I described as tendonitis; the pain was keeping me up at night...Through various techniques including trigger point, transverse massage and ultrasound, my pain today is nearly non-existent. The staff was friendly and professional, the treatment was effective and I'm trying to be diligent with the exercises they taught me. I'd definitely recommend Kulp Physical Therapy & Massage to my family and friends.”
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1331 East Victor Road
Victor, NY 14564-9395
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