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Understanding Back Pain

Understanding  Back  Pain
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People who suffer from lower back pain are encouraged to help themselves with exercises and being active and getting skilled physical therapy.  Lot of times patients are not explained in detail what is causing their pain and how to manage them so they can get better faster.

As back pain is very common and most of us experience in our lifetime.  Best way to avoid surgery or get better faster is to perform skilled exercises with help of physical therapist who can tailor exercises depends on type of back pain patient has.

Understanding back pain

There are several structures in the back that can cause and/or contribute to low back pain.

  • Intervertebral Discs

Although the intervertebral disc is a remarkably versatile and strong structure, essentially acting as a shock absorber during everyday activities, sometimes the disc fails when there is a sudden, unexpected force (such as a fall, lifting, or other trauma), or due to ordinary wear and tear over time. And when the disc does get injured it repair itself with fibrous tissue which can also cause pain and patient could hae recurrent back pain.

Activity is also needed to maintain the exchange of fluids in spinal structures and reduce swelling that naturally occurs in the tissues surrounding an injured disc. This swelling can further irritate nerves that are already affected by herniated disc material.  It can be achieved by particular exercises and physical therapy modalities.

These patients are normally complain of radiating, numbness, heaviness kind of pain and also complains of weakness in some leg muscles at times.

  • Spinal Muscles, Ligaments, and Tendons

The collective soft tissues around the spine – the muscles, ligaments and tendons – are also very important in maintaining proper spinal balance and strength. With decreased activity, the connective fibers of ligaments and tendons can begin to adhere to each other and lose resilience and may tear when sudden overload occurs. Unlike discs or connective tissue, however, when soft tissues are injured, they can quickly repair themselves.

Since muscles are in constant communication with the central nervous system, anger or anxiety can tense the muscles and cause muscle spasms. Ongoing tension inhibits normal muscle function and leads to muscle wasting and further stability problems, which in turn can lead to chronic lower back pain.

In this cases normally patient is complain of localized pain.

  • Spinal Nerves

When nerves are cut, pinched, or otherwise irritated, the muscles that the nerves control cannot work or reduce function of muscles. For example, when a herniated or bulging disc presses on the L4-L5 nerve root, it may inhibit the nerve’s ability to make the muscles it controls in the ankle and foot work properly, causing what is known as foot drop – the ability to raise the foot or stand on one’s tiptoes.

Most of these patients are complain of radiation, numbness, burning pain along with weakness in muscles or unable to move muscle.

Above mentioned are few reasons person can have lower back pain or leg pain with or without back pain.  In any case, Patient should consult orthopedic or neurologist if pain is really worst. In other circumstances patient can have consult with physical therapist and see if they can help them.

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Chronic Pain and Role of Physical Therapy

Chronic Pain and Role of Physical Therapy
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The amount of people having chronic pain is increasing now a days. A recent NIH study has showed those numbers.  The growing number of people experiencing pain has resulted in an unprecedented growth in prescriptions of diploids and anti-anxiety medications. And, deaths from abuse of these drugs is at an all-time high. By identifying patients at risk of opined and Benzedrine abuse more quickly, and getting them the right care, we can improve the quality of life for millions of people, and, in some cases, save lives. Lot of times going conservative and modifying life style can improve patient’s pain and quality of life.

Chronic Pain

There are many definitions of chronic pain, but one of the most widely accepted is any pain lasting longer than 12 weeks. Having pain for longer than 12 weeks is simply not normal. In contrast, acute pain, that is, pain lasting for a shorter period of time.  Sub-acute pain is when pain is closer to acute but not chronic yet.

Think about the differences between the acute pain and chronic pain, you experience pain while playing soccer twisting your ankle or knee, initial pain is acute pain. Patient now sees doctor who stabilize his/her injury and give necessary prescriptions. In subacute phase patient might be referred to physical therapy to control pain, decrease swelling, and promote healing strengthening and getting back player back in sports.  Now same scenario happens with somebody twisting ankle walking down street and didn’t take care of it thinking it will be better but patient still have lingering pain after three months that is chronic pain.

Certain pain starts suddenly (acutely) and get resolved with time. Unresolved pain can turn into chronic pain.   Over period of time if chronic pain is not taken care of can lead to arthritic changes in that join or can lead to complete disability.  That in turn led to depression other complications.

Patient who has chronic pain tend to get addicted to pain killers. The CDC reports: “Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.”

Every year people going to emergency and dying from strong pain killers like OxyContin, Percocet and heroin are increasing and it’s alarming.

Patient should be treated more conservative with physical therapy, psychological counselling and modifying life style which can reduce opioids related deaths from overdose.



Understanding Physical Therapy Method

From any aches, pain, joint stiffness or other musculo skeletal problem physical therapist has knack to assess and treat them.  Physical therapist can really understand bio mechanics of your joints and muscles.  You can always see a physical therapist for any of your needs with aches and pain.

First Step— The Assessment

The first step in physical therapy treatment is assessment.  Patient has to be evaluated in detail to understand their problem and underlying causes.  It is very important that they go the root of the problem to treat patient effectively.

Second Step- The treatment Plan

Although patient may come to see physical therapist for many different reason.  It could be neck pain, back pain, shoulder pain, knee pain, ankle pain, therapist has to lay out a treatment plan.  Most of the treatment plans may include Ice, Heat, Electrical stimulation, Ultrasound, Manual therapy, Therapeutic exercises.   Manual therapy is very important part of physical therapy it could be stretching, Soft tissue manipulations, neural mobilization, and joint mobilization.

Third Step- The treatment


It helps to reduce swelling and temporary relief from pain.  Ice usually applied first 48-72 hours of injury or in some cases even after if it inflammatory condition and swelling is on/off.  Ice helps decreasing swelling by constricting blood vessels.  Therapist will decide whether ice is good for your condition or not after the evaluation.


It helps to relieve muscular spasms, tightness and joint stiffness.  Heat helps to reduce pain, spasm and stiffness by dilating blood vessels.  Therapist may use heat to aid other treatment like stretching, joint mobilization.

Electrical Stimulation

There are different kind of current therapist used to treat patient’s pain.  Electrical stimulation helps to relieve pain temporary.  It can be used along with hot/cold packs.  It blocks pain at spinal level by releasing endorphin and encephalin.


It helps in promoting healing, increase metabolism and improve microcirculation in the area which is being treated.  It is kind of deep heat which penetrates deeper then conventional hot packs and it is very useful modalities for localized pain in conditions like tendinitis, sprains.

Manual Therapy

Working hands on patient cannot be emphasized enough in patient’s physical therapy treatment.  Any orthopedic conditions for which patient is going for physical therapy needs manual physical therapy.  Manual therapy may include stretching, neural mobilization, joint mobilization, joint traction, soft tissue manipulations.  Manual therapy should be part and backbone of any physical therapy treatment.

Therapeutic Exercise

It is very important in any rehabilitation that patient goes through series of exercises to reach their goal.  Range of motion exercises are to restore full range.  Flexibility exercise will be to keep flexibility across particular muscle.  Patient will be given particular exercise to regain strength and it will be tailored to targeted muscle and it will be part of patient’s recovery.


Knee Problems and Physical Therapy

Knee Problems and Physical Therapy
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Are you in knee pain?  Suffering for stiffness and has trouble getting around?  Unsure what exercises to do?

If any of your above asked question is yes then you need to see physical therapist.

Physical Therapist can evaluate your condition and plan your physical therapy program which can help you to reduce pain, stiffness and strengthen muscles.

Most of the patients who is suffering from pain, stiffness and weakness can benefit from skilled physical therapy.  Patient who did surgery also need post-surgical knee rehabilitation to reduce pain, swelling, increase ROM and improve strength.  With appropriate exercises and treatment program physical therapist can bring patient close to prior functional level.

For minor knee pain and sprains patient should expect 3-4 weeks of physical therapy.

If patient underwent knee arthroscopic surgery should expect about 6 weeks of physical therapy.

Patient who did knee replacement or did ACL repair should expect rehabilitation for about 12 weeks.

Above mentioned time frames are average time frame.  If you already has done about that much time of physical therapy and has not improved or are getting worst you should immediately see your doctor and find out cause.

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Resistance Training Among Young Athletes: Safety, Efficiency, and Injury Prevention Effects

Resistance Training Among Young Athletes:  Safety, Efficiency, and Injury Prevention Effects
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Resistance training is used by many athletes but does they know how safely they are doing. How efficient they are doing it? Many people question resistance training vs. power-lifting and research has shown more injuries have occurred in young power lifting athletes. I believe that young athletes are prone to injuring themselves because they are hard headed and don’t learn the right way to do it. Resistance training however is a great way to start building strength and eventually move up to power lifting. This topic is important to sports medicine because it is experimenting on if resistance training is safe, efficient, and causes injury prevention. It is also important to physical activity because it also strengthens the body at such a young age so that athlete could have an advantage over their peers.

At such a young age athletes are new to working out different muscles so they would commonly ignore form and just lift the weight. This would present negative effect to their ability and gain because they are doing it incorrectly. Young lifters have poor technique and inappropriate methods because they are not taught the correct way or they are just guessing on what exercises to do. Young lifters should be observed initially by personal trainer or qualified person to make sure about their technique. Evidence in this article provided that the youth who participate in regularly in resistance training programs show a significant amount of strength, injury prevention, and efficiency. It is also said that public health are aiming to increase the availability of resistance training program for the young athletes.

Performing resistance training provides a wide range of resistive loads, different movements, muscles, and speeds. These resistance exercises may include weight machines, elastic bands, medicine balls, and plyometrics. Compared to strength and power lifting exercises the resistance training reduces the risk of injury greatly. However, that does not mean one cannot get injured from performing resistance exercises such as poor conditioning, muscle imbalances, poor exercise technique. To prevent these injuries it is recommended that the young athlete training should be mature enough to follow instructions. Technique is key to the success of their positive gains because there is not point of doing the exercise if you are not activating the correct muscles. Another way to prevent injuries is to focus on all major muscle groups to keep your body strong and balanced. Also it’s very important that these athletes have flexibility and stretching exercises incorporated with their strength training.

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What to Look in Your Physical Therapist

At some point in your life – maybe after an injury or surgery, or just after you reach a certain age—there’s a good chance you will find yourself going to physical therapist’s office. And as you look around at the balance balls, ultrasound machines, and other contraptions, and as your body is pushed and pulled in a variety of odd and sometimes even painful ways, you may ask yourself: Does any of this stuff really help?


At New Age Physical Therapy our therapist will identify your problem and treatment as part of their evaluations, which are backed by solid scientific evidence.   Some of therapy may include:

1. Heat and cold

A hot pack sure feels good on an aching any part of your body. Same for the heat from an ultrasound machine, which can warm tissue deep in your body. And a cold pack on a swollen joint can also feel nice. But none of it will help you recover faster. It makes patients feel good, but it’s not very helpful, but using those things aide in recovery along with other therapeutic exercises and it helps psychologically.

2. Electrical stimulation and ultrasound.

Electrical stimulation and ultrasound could be part of your treatment depends on your diagnosis which helps to relieve pain.

3. Exercise machines after surgery

When patient goes to physical therapy after any surgery they should not be looking place where they have lot of equipment like gym, because after most of the surgery initial goal of therapist is to gain normal movement without any pain or discomfort.  Lot of the times those can be done with simple exercises and precautions.  Patient should look for therapist skill and dedication to their condition and treatment.

4. Changing exercise program

In any physical therapy care therapist needs to change patient’s exercise protocol depends on their needs and it has to be done as frequent as needed.  If you are stuck with same routine you might want to ask your therapist more questions or look for some other place.

5. Manual therapy

It’s very important that wherever you are going for physical therapy they are explaining your problem in detail and plan of treatment.   It is also important that they are using their manual skill to get you better and you are not just using machines.  Manual therapy like stretching, soft tissue massage, neural mobilization, joint mobilization.

6.  Seeing one therapist

It is important that you always seeing one physical therapist so they can track your treatment and modify as needed.

If you have any other question of wants to speak to one of our physical therapist please feel free to call at 718-224-3818.