Desensitization of the Central Nervous System by providing safe sensory input through heat, music and a variety of calm touches to comfort each of the five senses – this makes the brain learn to turn “off” the “flight or fight” response and turn “on” the “rest and digest” response. Each patient will receive an individualized self-care program in order to keep their nervous system in the “rest and digest” mode on their own after treatment. The Associative Awareness Technique (AAT) reduces anxiety and depression related muscle tension and pain, improves insomnia and digestive issues, and restores emotional balance and mental clarity. Who would benefit from the Associative Awareness Technique? People experiencing… • Chronic Pain • Stress • Anxiety • PTSD • Insomnia • Some cases of depression • Post-Partum Depression • Panic Attacks

Proprioceptive Balance Training involves stressing your balance and proprioception system at particular progressive levels to restore balance and joint stability. Propriopceptors are sensors that tell your brain where your body is in space. Think about closing your eyes… but, you still know where your hand is – that sense is proprioception. Ligament and joint injury can shut down or interrupt proprioceptors from doing their job. This leads to easily re-injuring the effected joint. Have you ever noticed that the ankle you sprained in soccer at 10 years old, is the same ankle you roll at 35 on a weekend hike? That’s because the proprioceptors are still somewhat shut down and are not telling your brain where your ankle is in space, as quickly as it needs to know. Proprioceptive Training involves stressing your balance and proprioception system at particular progressive levels to restore balance and joint stability. Who Would Benefit? People experiencing… • Difficulty balancing • Chronic ankle or knee sprain • Any post-surgical condition

Blood Flow Restriction Training (BFRT) is a new and innovative way to safely and quickly improve your strength and muscle size. During Blood Flow Restriction, a tourniquet cuff is placed around the arm or leg in order to partially (up to 80%) occlude the blood flow to the limb. BENEFITS OF BFR: Increased muscle strength (3-4 wks) Increased muscle size (2 wks) (w/o BFR - greater than 14-16 wks). Increase cardiovascular function (Increase VO2 w/in 2 wks) - not covered in this inservice. Helpful in rehab, elderly, in-season training, supplement to existing ex. Program. Lighter loads used than traditional wt training. Little to no muscle damage (if you don’t go to failure). Overall, faster results!

When your body perceives a risk to injury, it creates a soft tissue spasm that limits ROM and causes pain that makes it difficult to move (dysfunction). However, much like the excessive amount of swelling one experiences after an ankle sprain, our bodies tend to overreact and create more muscle spasms then necessary or keep the muscle spasms active for longer than necessary. Counterstrain is an advanced manual therapy technique that relies on practitioner skill to position the body and gently manipulate the fascia to address this overreaction. Through new research and science, we’ve discovered that dysfunction can happen in any system of the body. What makes Counterstrain special is the assessment of all those systems as a source for your pain. Our Physical Therapists will not only scan your musculoskeletal system for dysfunction, but also have the capabilities to assess your visceral, venous and lymphatic, arterial, and nervous systems. Each patients’ symptoms are multi-factorial, meaning dysfunction in multiple systems needs to be address for you to experience complete and long lasting relief. Counterstrain Rationale: Fascia is a dense connective tissue that envelops all our muscles, internal organs, vessels and nerves and is the largest sensory organ in the body. Therefore, it is necessary to treat not only the muscle fascia (myofascia), but all the fascia of the body. This tissue contracts, has a rich vascular and nerve supply, and contains specialized Type III and Type IV peripheral neurons that sense movement and pain. When stimulated, theses receptors can trigger nocifensive and nociautonomic reflexes. Nocifensive Reflex: A skeletal muscle contraction, activated through a reflex, that the body uses to protect inflamed or damaged tissue Nociautonomic Reflex: An autonomic response, activated through a reflex, that results in neural, vascular, respiratory, and digestive problems Although originally protective in nature, these reflexes can cause long term problems if they don’t turn off. During a Counterstrain treatment, our skilled and gentle technique normalizes the inappropriate protective reflexes by mechanically decompressing the tissue and draining inflammation and chemical irritation off the pain receptors, thus decreasing pain. Causes of dysfunction include but are not limited to: • Trauma: physical and emotional • Poor posture causing postural strain • Repetitive strain causing overuse injuries • Structural strain like leg length differences and foot abnormalities • Inflammatory diseases like Lyme and Crohn’s disease • Food sensitivities that lead to chronic pains What is a Counterstrain treatment like? Areas of dysfunctions are identified with our hands using a Cranial Scan to narrow the focus on the biggest problem. Once a specific system and area of the body has been identified, diagnostic tender points identify the presence of dysfunction and tell us how successful our treatment is. During a treatment session, a dysfunctional anatomical structure is identified via its correlating tender point. The clinician then decompresses the involved tissue through a position or fascial glide, and holds this pain free position for 45 – 90 seconds. Once the tender point has been diminished, the clinician moves on to the next worst dysfunction and repeats… decreasing tension throughout the body and restoring pain free movement. Benefits of Counterstrain: • Decrease pain • Drains inflammation • Normalizes inappropriate reflexes • Increases mobility • Improves proprioception • Eliminates inhibition which improves strength • Improves function of the immune system • Creates an ideal healing environment Counterstrain is a Soft Tissue Mobilization technique in Manual Therapy , meaning the clinician uses only their hands to find and fix muscle spasm and joint dysfunction. It is a comfortable indirect treatment that relaxes muscles without pain or pressure. By passively moving the spasmed muscles and dysfunctional joints toward positions of comfort that shorten the muscle and take the tension out of the muscle spindles, Counterstrain allows the muscle spindles to “reset” themselves. Once “reset” the muscle spindles stop sending a message to the muscle to contract. The muscle then relaxes, and the misaligned joint often returns to its normal position spontaneously. This allows the joints influenced by the now relaxed muscle to be able to move, increasing the range of motion and easing muscle pain. Who would benefit from Strain-Counterstrain? People experiencing… • Muscle, Joint or Nerve Pain • Pain that has been difficult to diagnose • Pain that returns after traditional treatments

Dry Needling at Coal Creek Physical Therapy in Louisville, Colorado is an extremely effective technique that uses a very fine needle to “deactivate” or “shut down” painful or knotted areas in your muscles. Many of us have areas in our body that feel tense all the time or feel like a hard ball in the muscle. By inserting fine dry needles into these tight areas a “twitch response” or a brief contraction is elicited, followed by an immediate and long lasting relaxation. Because the needle can treat very deep parts of the muscle, the technique can achieve amazing pain relief that you never thought was possible. Trigger point dry needling is extremely effective treatment for chronic strain due to overuse, spasm due to muscle guarding, and deep muscle pain that cannot be reached by the therapist’s hands. We have many physical therapists with certifications in Trigger Point Dry Needling: Erin Jensen MST Chantal McDonald PT, MSPT, OCS, MTC Julie Byrt MSPT, CMMT Who would benefit from Trigger Point Dry Needling? People experiencing… • Muscle, joint, or nerve pain • Headaches • Limited flexibility • Muscle tightness • Muscle weakness

Electrical Stimulation (e-stem) is a modality that delivers comfortable electrical currents to vibrate soft tissues to increase blood flow, reduce inflammation and decrease pain. Therapeutic Modalities such as e-stem, stimulate tissue to decrease pain and inflammation and increase healthy blood flow. Who would benefit from Electrical Stimulation (e-stem)? People experiencing… • Inflammation

Benign Paroxsysmol Positional Vertigo is a displacement of crystals in the inner ear which causes the experience of spinning with bending over and laying down. If you have this, you need The Epley’s Maneuver performed by a skilled physical therapist to rid you of your dizziness. The Epley’s Maneuver puts the crystals back where they belong and reduces the spinning completely in 1 to 3 treatments. The procedure takes 5 minutes and is comfortable, safe and the true fix for BBPV. Who Would Benefit from Epley’s Maneuver? People experiencing… • BPPV (dizziness due to the crystals in the ear being out of place)

Graston Technique® (GT) is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes. Graston Technique uses specially designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The use of Graston Technique instruments, when combined with appropriate therapeutic exercise, leads to the restoration of pain-free movement and function. The instruments also are used diagnostically to assess the kinetic chain, in an efficient manner using the principles of regional interdependence. Soft tissue injuries can be debilitating and frustrating. Graston Technique® (GT) therapy is successful in effectively treating all soft tissue conditions, whether they are chronic, acute or post-surgical. GT therapy can help you enjoy life again. Our unique technique and instruments enable the treatment of scar tissue and fascial restrictions during rehabilitation that allows for faster rehabilitation and with greater success when the goal is restoring range of motion, eliminating pain, and restoring normal function. Here is list of some of the most common conditions treated with Graston Technique® therapy: Ankle Pain (Achilles Tendinosis/itis) Wrist Pain (Carpal Tunnel Syndrome) Neck Pain (Cervical Sprain/Strain) Fibromyalgia Hamstring Injuries Hip Pain IT Band (Iliotibial Band) Tennis Elbow (Lateral Epicondylosis/itis) Back Pain (Lumbar Sprain/Strain) Golfer's Elbow (Medial Epicondylosis/itis) Knee Pain (Patellofemoral Disorders) Heel Pain (Plantar Fasciitis) Shoulder Pain (Rotator Cuff Tendinosis/itis) Scar Tissue Shin Splints Trigger Finger Women's Health (Post-Mastectomy and Caesarean Scarring)

Iontophoresis is a modality that is the strongest anti-inflammatory agent that physical therapy has to offer. Therapeutic Modalities such as Iontophoresis, stimulate tissue to decrease pain and inflammation and increase healthy blood flow. It’s delivery of Dexamethazone, a cortoco-steroid medication (liquid form), into tissue with electrical charge. Coal Creek Physical Therapy uses a battery operated patch that delivers the Dexamethazone into your inflamed tissue over a 6 hour time period while you are on the go, commonly used to treat tendinitis & plantar faciitis. Who would benefit from Iontophoresis? People experiencing… • Inflammation

Joint Manipulation is a Manual Therapy technique that is a skilled, hands-on treatment which moves joints at high speed in safe and small increments to reduce joint pain, muscle spasm and increases overall mobility – usually recognized as “popping” of joints. This is the fastest and most effective way of restoring motion and decreasing pain in acute injuries. Who would benefit from Joint Manipulation? People experiencing … • Neck, mid-back, rib and low back pain • Muscle Pain • Muscle Tightness • Joint Restriction or Stiffness

Joint Mobilization is a Manual Therapytechnique that is a comfortable and specific hands on treatment which moves and stretches joints to reduce pain and increase mobility. This is commonly used post-surgically to regain range in extremities. Joint Mobilization is an important factor when treating low back and neck pain as it reduces spinal restrictions and decreases pain. Who would benefit fro Joint Mobilization? People experiencing… • Muscle Pain • Muscle Tightness

Manual Therapy is a specialized form of physical therapy delivered by the hands, as opposed to a device or machine. In Manual Therapy, physical therapist’s use their hands to apply skilled and comfortable pressure on muscle, joint and nerve tissue to decrease pain and improve movement. Manual Therapy includes: • Joint Mobilization • Joint Manipulation • Soft Tissue Mobilization: Mayofascial Release, Trigger Point Release, Transverse Friction Massage, Deep Tissue Therapeutic Massage, Strain-Countertrain Who Would Benefit from Manual Therapy? People experiencing… • Muscle, Joint and Nerve Pain • Chronic Pain • Headaches • Restricted Movement • Inability to tolerate exercise

Myofascial Release is a Manual Therapy technique in Soft Tissue Mobilization that is specific deep strokes that combine compression rotation and elongation to improve mobility and decrease pain in muscle tissue, comfortably. This is effective in both acute and chronic conditions. Who would benefit from Myofascial Release ? People experiencing… • Muscle Pain • Muscle Tightness

Neural Mobilization is moving of the nervous system including the spinal cord and peripheral nerves in the body to reduce nerve pain and improve motion of the affected body part. This can be done passively by your physical therapist to the patient or actively by the patient for themselves after instruction by physical therapist. Who would benefit from Neural Mobilization? People experiencing… • Nerve Pain • Limited Flexibility • Pain that’s been difficult diagnose

Orthotics are custom molded arch lifts that support your foot and place your ankle joint in neutral with every step so your ankles, knees , hips and low back can be stress and strain free when you are on your feet during walking , running and hiking activities. Our physical therapists will mold the Orthotic insert right to your foot in the clinic, and you can take them home the same day. Who would benefit from Orthotics? People experiencing… • Foot, Knee, Back or Hip Pain, when on their feet • Flat Feet (pronation) • High Arch (supanation)

Soft Tissue Mobilization includes different hands on techniques that reduce muscle tension, spasm, tightness and pain. It is a generalized term that includes the specific massage techniques of Myofascial Release, Transverse Friction Massage, Trigger Point Release, Strain-Counterstrain and soft and deep tissue Therapeutic Massage. We use this in addition to joint mobilization and joint manipulation to get you back to pain-free movement as soon as possible. Who would benefit from Soft Tissue Mobilization? People experiencing… • Muscle Pain • Muscle Tightness

Patient Education includes detailed explanation about the specifics of your pain or injury. Learn what’s causing it, what’s contributing to it, and how treatment will solve it. Our goal for you is to fully understand your condition to participate in your recovery and keep yourself healthy after discharge from our care. Patient Education also includes individualized instruction on self-care techniques, posture, and ergonomics to help you feel better faster and help prevent pain from returning. Who would benefit from Patient Education? • Everyone! Your power to heal comes from knowledge and understanding of your condition

Pelvic Floor Rehab at Coal Creek Physical Therapy includes treatment for men and women with urinary or fecal incontinence, urgency/frequency of urination, and/or pain in the pelvic region. This includes: pain in the abdominals, buttocks, pelvic floor, tailbone, vagina, rectum, penis or testicles. The pelvic floor muscles may become weak, tight or spastic as a result of disuse, surgery or trauma, Pelvic Floor Rehabilitation reeducates these muscles and reduces pain and inflammation. Who would benefit from Pelvic Floor Rehab? People experiencing… • Incontinence • Pelvic Pain • Chronic Back Pain • Pain with Sex (Dysperenia) Or women needing: • Post-Partum Wellness Care

Therapeutic Bracing is meant to protect joints from movement to help healing. Some joint sprains are best rehabilitated with early immobilization. Coal Creek Physical Therapy can prescribe a comfortable, functional brace that will protect your joint from movement and strain to help you heal. The most common are wrist, thumb, knee and ankle. Who would benefit from Therapeutic Bracing? People experiencing… • Acute sprains and strains • Chronic dislocation of any joint

Therapeutic Exercise is needed in order to correct movement patterns and increase mobility. Over time with repetitive work, sleep and athletic activities, there is a constant force of gravity pulling on our bodies, some muscles get stronger and tighter while others get weak and looser. The joints in our bodies can stay ” in neutral” and remain pain free if our muscles are equally strong and flexible. If the muscles around a joint are tight on one side and weak and loose on the other, it can create joint and muscle pain. Therapeutic Exercise corrects these imbalances so your joint and muscle pain goes away and stays away so you can do all your favorite activities pain free.There are two types of Therapeutic Exercise: one is very specific movements and actions that target a particular muscles to strengthen or stretch them in order to optimize muscle balance and reduce pain. The other therapeutic exercises are very particular actions that when practiced in many repetitions create a new improved pattern of movement that no longer stresses the previously painful area. The Therapeutic Exercise Prescription is generally given at 3-5 exercises requiring 5-10 minutes once or twice a day to achieve goals. Who would benefit from Therapeutic Exercise? People experiencing… • Muscle, joint or nerve pain – in all muscle and joint pain, something hurts because an non- optimal movement pattern is stressing it, all muscle and joint pain needs correction of this pattern in order to recover long term.

Therapeutic Massage uses a variety of hands on Soft Tissue Mobilization Techniques to reduce muscle pain and improve muscle flexibility – specific techniques include: Myofascial Release, Transverse Friction Massage, Strain-Counterstrain, and Trigger Point Release. Who would benefit from Therapeutic Massage? People experiencing… • Muscle Pain • Muscle Tightness

Therapeutic Taping is the use of tape on the body to correct posture, reduce muscle tension, pain and inflammation and to teach correct movement patterns all day even when you are not in physical therapy. The use of Therapeutic Taping Kinesio Tape, McConnel Tape, and/or Athletic Tape on the foot and ankle, knee, low back and shoulder can speed up your road to recovery significantly! Who would benefit from Therapeutic Taping ? People experiencing… • Pain with particular movements • Non-optimal movement patterns (i.e poor posture, bending at the back instead of at the hips, knees that roll in, or flat feet or excessive arches) • Inflammation

Transverse Friction Massage is a Manual Therapy technique in Soft Tissue Mobilization that is short, deep strokes across tendons and ligaments to reduce inflammation and increase scar tissue mobility. Who would benefit from Transverse Friction Massage? People experiencing… • Tendinitis

Soft Tissue Mobilization includes different hands on techniques that reduce muscle tension, spasm, tightness and pain. Many people suffer from sensitive spots in muscle, often called trigger points or muscle knots. Trigger Point Release is a soft tissue mobilization technique that includes pressure combined with breathing and visualization techniques to relax muscle tension. Who would benefit from Trigger Point Release? People experiencing… • Muscle Pain • Muscle Tightness

Ultrasound is a modality that delivers sound waves to muscle, tendon or ligament tissues up to 3 cm deep. Therapeutic Modalities stimulate tissue to decrease pain and inflammation and increase healthy blood flow. Sound waves from Ultrasound vibrate the tissue at the cellular level to increase temperature, increase blood flow, decrease inflammation and decrease pain. Ultrasound is commonly used to reduce tendinitis and speed recovery of ligament sprains. Who would benefit from Ultrasound? People experiencing… • Inflammation

Vestibular Rehab begins with an evaluation to determine which system and which reflexes are not working properly. The Vestibular System is a structure of fluid-filled canals in your inner ear that assist in your body’s ability to balance. The Vestibular System interacts with your Visual (Oculomotor) System and Proprioceptive System reflexively to maximize balance. Vestibular Rehab consists of specific and progressive balance exercises that appropriately stress the Vestibular System, Oculomotor System, and Proprioceptive system to reach the goal of optimal balance. *This rehabilitation is most commonly used to help with dizziness (Vertigo). Vestibular Rehab is used in conjunction with other treatments including: AAT, Epply’s Manuever, Joint Mobilization and Soft Tissue Mobilization to completely rid you of dizziness. Click to read more. Who Would Benefit? People experiencing… • Dizziness • Vertigo • Loss of Balance