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By Coleen Torres


Injuries to the muscles and other soft tissues of the body often require a course of physical therapy in order for the patient to regain normal body movement. Therapeutic exercise is an important component in most physical therapy regimens and it can effectively aid in not only easing pain, but also restoring range of motion, balance, strength, and flexibility.

The patient's movement abilities will be assessed and his or her medical history will be taken by the physical therapist. Based on this information, a personalized training plan of specific exercises will be devised to present the patient with increasing physical challenges that will promote healing. The first step is to overcome pain, and then continuing on to regain bodily endurance, flexibility, and strength.

A combination of different exercises are implemented in a physical therapy program, these are classified by the nature of the movement and how it affects the body. With passive exercise, the muscles don't have to do any work, manual or mechanical force is applied externally, which helps restore normal movement to the joints. Whereas with active exercises, the cooperation of the muscles is needed, either alone or with assistance, this not only improves motion of joints, but also strengthens neuromuscular control.

There are other type of activities designed to build endurance and strength in damaged muscles. Once the patient has progressed to the point where he or she can safely carry out range-of-motion and flexibility exercises, it's time to begin strength and endurance training. Gradually increasing resistance is added steadily so the body can respond by naturally gaining strength in the tendon, ligaments, muscles, and bones.

Exercises for regaining strength are generally grouped as either static or dynamic. The former are those which do not involve joint movement, with the length of the muscle fibers remaining the same since the resistance and tension are equal, rather it is the angle they are performed at which makes the difference and helps the patient increase strength, so using varied angles in practice and holding each movement for several seconds is recommended.

Dynamic exercises require muscle and joint involvement and can be sub-grouped as isotonic, isokinetic, variable-resistance, and manual movements. What each of these has is common is that it results in concentric and eccentric muscle action, which is the lengthening and shortening of fibers, generating force. This repetitive stretching of muscle-tendon bundles eventually boosts tensile strength.

An isotonic movement is one that applies an external force to the muscle which alters the angle of the joint, lengthening the muscular fibers. Some common examples of this are many weight machines, free weights, and ankle weights. Training equipment for variable-resistance movements are built to impose correct joint alignment and apply resistance relative to force, or the therapist may do this manually as well, deliberately placing the muscles in range-of-motion extremes that will limit the force produced.

With isokinetic exercises, the resistance and muscle force are equal, and they are performed with a fixed speed. Specially designed fitness machines provide a level of force commensurate with the user's muscle resistance, and the balance of concentric/eccentric action and velocity can normally be adjusted as well.




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