Exercise is anything you do in addition to your regular daily activity that will improve your flexibility, strength, coordination, or endurance. It even includes changing how you do your regular activities to give you some health benefits. For example, if you park a little farther away from the door of the grocery store, the extra distance you walk is exercise. Also, exercise can include stretching to reduce stress on joints, core stability exercises to strengthen the muscles of your trunk (your back and abdomen) and hips, lifting weights to strengthen muscles, walking, doing water aerobics, and many other forms of activity. Your physical therapist is likely to teach you how to do an exercise program on your own at home so you can continue to work toward your fitness goals and prevent future problems.
Manual therapy (sometimes called bodywork) is a general term for treatment performed mostly with the hands. The goals of manual therapy include relaxation, decreased pain, and increased flexibility.
Manual therapy can include:
- Massage. Pressure is applied to the soft tissues of the body, such as the muscles. Massage can help relax muscles, increase circulation, and ease pain in the soft tissues.
- Mobilization. Slow, measured movements are used to twist, pull, or push bones and joints into position. This can help loosen tight tissues around a joint and help with flexibility and alignment.
- Manipulation. Pressure is applied to a joint. It can be done with the hands or a special device. The careful, controlled force used on the joint can range from gentle to strong and from slow to rapid.
Physical therapy almost always includes education and training in areas such as:
- Performing your daily tasks safely.
- Protecting your joints and avoiding reinjury.
- Using assistive devices such as crutches or wheelchairs.
- Doing home exercises designed to help with your injury or condition.
- Making your home safe for you if you have strength, balance, or vision problems.
In some locations, physical therapists are specially trained to be involved in other types of treatment, including:
- Vestibular rehabilitation, which helps your inner ear respond to changes in your body position. This is helpful if you have problems with vertigo, or a feeling that you or your surroundings are spinning or tilting when there is actually no movement. Rehabilitation (rehab) can help you get used to the problem so you know when to expect it. And rehab can train your body to know how to react.
- Wound care. Wounds that are very severe or don't heal well, often because of poor blood flow to the area, can require extensive care. This may include special cleaning and bandaging on a regular and long-term basis. Sometimes oxygen treatment or electrical stimulation is part of the treatment.
- Pelvic health. Physical therapists can provide instruction in exercises to help control urinary incontinence or to relieve pelvic pain.
- Oncology (cancer care), to help if cancer or treatment for cancer causes you to have problems with movement.
- Decongestive lymphatic drainage, which is a special form of massage to help reduce swelling when the lymphatic system is not properly draining fluids from your tissues.
Other treatments include:
- Cold and ice, to relieve pain, swelling, and inflammation from injuries and other conditions such as arthritis. Ice can be used for up to 20 minutes at a time. In some cases, ice may be used several times a day. Some therapists also use cooling lotions or sprays.
- Heat, to help relax and heal your muscles and soft tissues by increasing blood circulation. This can be especially helpful if a joint is stiff from osteoarthritis or from being immobilized. Heat can also relax the muscles before exercise. But heat can also increase swelling in an injured area if it is used too soon.
- Ultrasound therapy, which uses high-pitched sound waves to ease muscle spasms and relax and warm muscles before exercise, to help relieve pain and inflammation, and to promote healing.
- Electrical stimulation. In general, this is the use of electrical current to create an effect in the body. Electrical stimulation is sometimes used at low levels to reduce the feeling of pain. It can also be used to cause muscles to contract (tense). And it is being studied as a way to help with healing of wounds and broken bones.
- Hydrotherapy (water therapy), which is a term from the past that means the use of water to treat a disease or to maintain health. The most common hydrotherapy now is water exercise.