At Cornerstone Physical Therapy we treat a variety of conditions from plantar fasciitis to headaches and TMJ or Temporomandibular Disorders. We have successfully treated pelvic issues post-delivery after a pregnancy and helped many athletes achieve full function and ROM after a knee surgery. Our staff has received sports medicine, manual therapy and craniofacial certifications. Manual therapy is the hands-on assessment and evaluation of musculoskeletal injuries of the entire body. A Cranio-facial certification is specific to problems of the head, neck, face and jaw. There are only a handful of Cranio-facial Certified Physical Therapists in the country. As you read further here is some information on some of the specialty problems we treat and approaches we use.
Trigger point dry needling (TPDN) is a treatment for muscular tightness and “spasm”, or "knots". These areas of tightness are commonly referred to as trigger points. Trigger points are defined as the presence of exquisite tenderness in a nodule of a taut band of muscle, and may elicit a twitch in response to pressure. Trigger points can develop from injuries, poor posture, or a disease process.
The muscular tightness or spasm that develops from an injury or disease process can cause compression and irritation of the nerves exiting the spine and anywhere along their pathway. When the nerves are irritated they can cause a protective “spasm” to any of the muscles along their pathway. Care must be directed both centrally to take care of the origin of the pain and peripherally to reduce symptoms from the central compression.
The technique uses small, thin, solid core filaments that get inserted into the muscles at the trigger points causing a replication of the pain or referral pattern. The muscles then contract and release. This contracting and releasing improves muscle flexibility, removes the source of irritation, promotes healing, and decreases the spontaneous electrical activity at the trigger points.
Cornerstone Physical Therapy has increased the level of knowledge of TPDN through the use of 3-Dimensional Cat Scans of the head, face and neck. Because of our interest and specialty focus our approach with TPDN is very in depth. The addition of diagnostic ultrasound to assess or "see" into the human body allows us a greater level of safety with TPDN. The Treatment for tinnitus patients as well as loss of speech and swallowing are some of the problems our clinic has been able to help, with the assistance of TPDN.
In the State of Colorado the requirements to practice TPDN are two weekend courses after 2 years of clinical experience. As the popularity of this technique grows more and more clinics are offering this treatment. Protect yourself by finding out how much training your Physical Therapist has undergone and how long they have been practicing. As with any treatment this should not be the only intervention that you receive by your Physical Therapist. TPDN can be a very safe technique in skilled hands.
If you are interested in this form of treatment and want to know more please call us at 719-596-5000.
Cornerstone Physical Therapy sets itself apart by being a completely hands-on clinic. This is what manual therapy means, to diagnose and treat through the assessment of touch. This includes thrust manipulation to restore a “stuck” joint in your spine, to facilitating or helping a muscle work after a stroke. There are many different philosophies of manual therapy across the globe. At Cornerstone Physical Therapy we have been trained in many different treatment approaches. This allows us to have more “tools in our tool belt”. Because of our passion in our learning and our desire to excel in what we do we have continued to progress in manual therapy by certifying. A certification in manual therapy means that oral, practical and written tests were passed to achieve a higher level of practice. Many Physical Therapists practice some form of manual therapy, few specialize. When choosing a physical therapist, check their credentials. A specialist in a specific area can more effectively treat your condition.
How can Physical Therapy help with headaches? Pain in the head, frequently called “Migraines”, can occur from many sources. The muscles of the jaw, neck and shoulders can refer pain into the head. The joints of the upper neck can also cause pain in the head. Issues with vision and even the vestibular or balance system can be a contributing factor. Diagnosing your headache can be difficult. If your headaches start in the base of the skull, are more one sided, occur frequently or even daily your headaches may be Tension Type or Cervicogenic Headaches. This means that the pain in your head is coming from tense muscles and/or stiff neck joints.
Physical Therapists specializing in treatment of the neck can determine if your headache is related. This can be treated with manual therapy, restoring joint motion and reducing muscle tension. Joel Rauser has lectured extensively on the role of headaches stemming from the neck and the successful treatment with manual therapy. Other aspects that we assess are posture as well as work site analysis. A new form of vision therapy through restoring eye muscle balance is available at CornerStone Physical Therapy. We have treated people from all age groups, including children. Contact us if you have questions about whether your headaches are treatable with Physical Therapy.
Temporomandibular Joint (TMJ) Disorders or TMD means that you have a problem with the hinge joints of the jaw. Diagnosis of a TMJ problem is difficult and books about the classification of TMJ disorders are usually fairly thick. TMJ issues can present with headaches, pain in the face, ear, neck and throat. They can feel like a pressure in your ear without any observable ear issues from your doctor. Patient’s will occasionally hear their pulse in their ear as well as ringing, called tinnitus. Balance issues and dizziness are common symptoms as well. Clicking in the jaw or noises in your ear with chewing or jaw motion are common but do not necessarily mean you have a problem needing treatment.
There are many forms of treatments for TMJ issues such as the use of a dental splint or appliance from your dentist. This is like putting on an ankle brace for an ankle sprain. A dental splint will change how your teeth together and hopefully reduce some of the stress of your jaw. Dental splints can also make your problem worse as well if not fitted appropriately or if there has not been a clear diagnosis made before the dental splint. A properly fitted dental splint requires a dentist to fabricate this for you. Over the counter splints rarely work. Other treatments are oral surgery. This is rare and should be used as a last resort.
The most cost effective and conservative treatment is through a Physical Therapist that specializes in the treatment of TMJ disorders. Physical Therapy training during school is very limited in the amount and quality of the information that we graduate with. Finding a Physical Therapist with a certification in TMJ Disorders is very important in your road to recovery. The University of St. Augustine and the American Academy of Orofacial Pain are the only schools that offer a certification to Physical Therapists regarding TMJ Disorders and the neck in the United States.
TMJ treatment is a multi-disciplinary approach and can include your doctor, pain specialists, dentists, pain psychologists, chiropractors and Physical Therapy.
If your shoulder hurts, makes joint sounds when you move it, if you have limited your activities or even have pain while sleeping on your shoulder, you need to understand why. First, check to see if your shoulder moves like the other. Second, a common problem is a shoulder joint capsular restriction, rotator cuff trigger points, and rib pain with muscle tension
Have you ever had an alignment issue of your car? You know there is a problem when your car vibrates at higher speeds, your steering wheel pulls to the side, and you have tread wear. A chronic shoulder problem is like a car alignment issue. This post is on how to screen for a shoulder problem and best treatment.
Dizziness or vertigo can be caused by a neck problem. Here are a few tips when assessing the neck. The head is not on straight. History of self-manipulation or stretching means that there is a neck problem. Pain and loss of upper neck motion with testing.
One way to find success in treatment is to know what not to do for your vertigo. Certain treatments say they work on treating vertigo but do not follow our understanding and knowledge of how our vestibular system works. You will be able to evaluate and treat a vertigo patient by the end of this post and know what NOT to do.
There are 3 systems that can cause dizziness. Our vision or eyes, our inner ear or vestibular system, and our upper neck. This post is the beginning of a 3 part series in assessing and treating dizziness successfully.
The problem with core exercise programs is that they typically do not work. Assessing your core and related issues that can affect your core function is the first step. Second, effective training that is unique to each person is important.
Getting our patients to follow through with a home program can be frustrating and difficult. The frustration is shared, for us and for our patients. How can we improve our success rate with our clients and also for ourselves as we try to get BETTER?
Sinus pain that persists may be coming from the neck. Here are two cases with sinus pressure and pain. Antibiotics did not resolve their symptoms. Cone beam CT is a lower radiation imaging technology that was used to assist with the diagnosis.
Sinus pain and pressure that does not respond to antibiotics may have a cause that has nothing to do with your sinuses. Yes, thats right! Sinus pain that is not an infection or disease? Here is a test that can help us determine if there is an infection or if it is something else.
At Cornerstone we care about YOU. You are the reason we train, innovate, and work together to provide the best possible care. These videos share information about your first visit with us. We look forward to figuring out your problem together and returning you to life so that you can LIVE IT.
How do you know if your vertigo treatment is helping? Your vertigo gets better fast! If your dizziness responds slowly to vertigo treatments then it is either not helping and the side or canal has not been identified. OR your symptoms are coming from a vision and/or neck problem.
Core training and exercises are commonly used to treat a weak core. But why is your core weak to begin with? If you have chronic back tension, are pregnant or have just had your baby, or just want to improve your core the COR Strength Project is for you.
This is Part 3 of our COR Strength Screen. Using diagnostic ultrasound we test different activities that should engage your core normally. We are looking for involuntary activation of your core. We will also look at voluntary core activation or tightening your core on demand.
Abdominal bracing for core activation is the foundation for all our future exercises. While it is not the only activity we will be using to get your core to engage it is a good place to start. To determine its effectiveness we use diagnostic ultrasound for Targeted Core Training.
Knee pain to the front or side of the knee is very common. Dry needling can be an effective way to reduce tension and pain to the knee. This video shows me dry needling the outside of my knee with two different techniques. Don’t try this at home!
This is part 1 of our screening process for core strength and function. Posture, breathing, and back and pelvic issues are what we look for as part of our screen. Determining a cause for a weak core is an important part of the process.
Part 2 of our core screening process is about how we use diagnostic ultrasound to assess core function. When the core muscles thicken they are contracting. Through different actions we test to see if the core is activating.
Following a ruptured appendix, abdominal surgery and an infection my core was not working. This limited my ability to hike and run with tension and pain to my trunk. Targeted Core Training has improved my core and my ability to live my life again. Seeing my core function in real time allowed me to start engaging my core, reducing my pain and tension, and push beyond my limits. This is my COR Strength Story.
SEE IT, TRAIN IT, LIVE IT!
Targeted Core Training is using diagnostic ultrasound to see core function. When strengthening your core muscles or abdomen seeing how your muscles engage in real time enhances any program and speeds up core activation, strengthening and recovery.
This video is on dry needling for knee pain. It includes a follow up on a return to hiking and running hours after treatment. Pain and tension had reduced and the treated knee felt better than the right! Following dry needling it is safe to exercise. Immediate pain relief can occur after a dry needling treatment.
Only 50% or half of ear pain symptoms are from the ear. Otalgia or ear pain needs to be evaluated by your family doctor or Ear, Nose and Throat specialist. Dr. Jim Yohanan, an ENT physician, shares his expertise on diagnosing ear pain.
Physical therapists spend a lot of time dealing with pain. One of the many influences of pain is linked to testosterone. Robert Dill PAC of Apollo Medical Associates shares his expertise on the symptoms of low testosterone and the importance this hormone plays in men and women.
Testing testosterone is recommended through your family practice healthcare professional or through a specialist in hormone replacement therapy. This post shares some information on testing and what to look for when checking for low testosterone.
Dry needling for headache pain can be very effective in reducing muscle tension to the neck and base of the skull. While this does not deal with the underlying problem of why the neck muscles are painful it can be very helpful as a treatment.
Following any dry needling treatment it is important to keep the muscles and area moving. Self massage can be helpful to the area. Soreness can occur but should not last more than a few hours. Contact your practitioner if your soreness lasts more than 12 hours.
Ever have eye strain and fatigue? Headache pain that feels like this is from your eyes? Here is a video that shows how your eye muscles and nerves can be affected and causing headache pain and even dizziness.
This post shows us how we test to see if there is an ocular or eye muscle problem using convergence or 'crossing our eyes'. Both eyes need to work together and this test will tell us if this is happening or if there is a problem.
This session talks about how we test the eye muscles for trigger points or knots and the nerves that work the muscles of the eye. Headache and eye pain can be related to this finding and testing the eye muscles is important in determining the cause of headaches.
A forward head posture is common with headache pain. A great exercise to help reduce tension and muscle guarding is nodding. This post includes a video on 'how to' treat headache pain through daily exercise.
Dry needling can be a very safe treatment option in the hands of a skilled practitioner. While complications are rare lung punctures and other injuries do occur. Here is a video of a real patient and dry needling treatment using imaging to improve safety.
Have you ever been diagnosed with Ocular Migraines? What if there was a reason for the headaches and visual disturbances and treatment was possible? Here is a young woman's story and her years of headache pain.
This is how we test the neck when looking for a cause of headache pain. The upper portion of the neck, or the upper cervical spine, is a common source of headache pain. Testing the atlas and axis and how it moves not only gives us information on movement and pain but also a guide for treatment success.
Chronic ear pressure, plugging and even pain can come from a Eustachian Tube Dysfunction. This condition is most common with a neck or cervical problem. Other symptoms include tinnitus or ringing, headaches, and neck pain and stiffness. Here are two people sharing their story.
What is the cause of ear pressure, plugging and pain? This video explains an Eustachian Tube Dysfunction and the causes. Most ear pressure issues that are persistent are because of muscle tension to the neck and throat.
If you are suffering from vertigo or dizziness one type of vertigo can be related to the movement of crystals in our inner ear. This is called Benign Paroxysmal Positional Vertigo or BPPV. This type of dizziness feels like the room is spinning.
What if what you thought were migraines had a treatable cause? What we commonly describe as migraine pain may have a source. It is through finding the source of your head pain that treatment options become a reality. Here is a story of a young woman's journey with constant headache pain and ocular migraines.
This video is about the process in picking the right pillow for you. For side sleeping remember to 'fill the holes' and keep the spine straight with enough support. If you have tried 2 or 3 pillows and your neck pain or headache pain continues then the problem is not your pillow but your neck.
Shoulder pain that is chronic or gets worse with activity is usually the result of changes in how the shoulder moves or a biomechanical problem. Impingement Syndrome or rotator cuff strain are common diagnoses. Restoring normal joint mechanics is the goal of treatment before exercising.
One form of dizziness is vertigo. This is usually associated with our inner ear or vestibular system and is called Benign Paroxysmal Positional Vertigo or BPPV. BPPV is an inner ear problem related to loos crystals (Otolith) that are not where they should be.
Matt is a sportsman with great future. Watch his story.