Physiotherapy

Physiotherapy (or remedial exercise) is used across all areas of medicine. It combines both passive and active elements. Acute pain is relieved, weakened structures are strengthened, and blockages and misalignments of the musculoskeletal system are resolved. Advice on posture and movement is also part of the work.

In modern medicine, physiotherapists are an indispensable part of rehabilitation medicine — above all in orthopaedics (e.g. for back problems) and in neurology (e.g. after a stroke). But it also appears as respiratory therapy in internal medicine, as postural exercise for children, or during the postnatal period.

The complexity of the field demands broad knowledge that must be continually adapted to medical progress.

Manual therapy is an examination and treatment technique concerned with finding and treating functional disorders of the musculoskeletal system. The examination follows the clinical diagnosis and aims to identify the affected tissue structures, determine how acute the lesion is via tissue irritation, and locate the cause of the complaints.

The cause of the complaints often lies in a mismatch between capacity and load. Treatment therefore aims to correct this mismatch and restore the physiological interplay between joints, muscles and neural structures.

Both passive, mobilising techniques applied by the therapists and active exercises by the patients — for strengthening, stabilisation or self-mobilisation — are used. Patients also receive instructions for exercises to do at home, which support the work of the manual therapist.

Lymphatic drainage is a relatively young therapy. In Germany it was only in 1973 that Dr Asdonk founded the first lymphology clinic and scientifically proved the effectiveness of lymphatic drainage, so that the therapy became recognised by the health insurers.

The goal of manual lymphatic drainage is to move congested tissue fluid onward through the lymphatic system. A specific hand technique is essential: with flat fingers or hands and finely dosed pressure, a suction is created in the lymph vessels that draws the excess lymph fluid out of the tissue. Only in deep abdominal drainage is deeper work done; otherwise the work is largely superficial.

For support, the area can be bandaged after treatment, or compression stockings can be applied. The therapy is especially important in the aftercare of surgery in which lymph nodes were removed, e.g. for breast cancer. Lymphatic drainage is also used for:

• lymphoedema
• oedema after injuries
• Sudeck’s disease / CRPS
• artificial and ischaemic oedema
• rheumatic oedema
• chronic inflammatory oedema
• inactivity oedema (with paralysis)
• cardiac oedema

The Bobath concept is one of the most widespread therapy concepts for treating people with neurological disorders. It rests on a neurophysiological foundation but takes a holistic approach — that is, it involves the person in their whole personality.

This requires close cooperation, both among the specialist disciplines involved and with relatives and the affected people themselves. The Bobath concept is continually developed through experience gained in therapeutic work, new findings from the neurosciences, and input from neighbouring fields.

Who is treated?

• Children, adolescents and adults with developmental disorders or congenital brain damage (disorders of the central nervous system, sensorimotor abnormalities, cognitive impairments, etc.)
• Adults with acquired brain damage (stroke, MS, traumatic brain injury, etc.)

Bobath is a globally recognised therapy concept whose effectiveness is confirmed by today’s findings in brain research. It is continually developed further.

The approach views the child holistically: observing motor development and fostering all the senses, social and emotional abilities and cognitive development. The concept was originally developed for children with neurological problems, but we now know it is also excellent for children with developmental delays and minor abnormalities. We use Bobath therapy for premature and newborn babies with:

• regulation disorders
• asymmetries
• muscle-tone abnormalities
• to improve balance and coordination in children of any age

In everyday situations such as playing, dressing and eating, we want to offer support in order to broaden and strengthen the child’s abilities. This can be done with our hands, by shaping the child’s environment, or with aids. It is important that the child has a sense of success — only then can it learn and keep taking joy in its development.

You as parents matter greatly to us too! We show you how best to lift, carry and feed your child, so that your daily handling is easier and you can support your child.

The Castillo Morales® concept was developed by Dr Rodolfo Castillo Morales, an Argentine rehabilitation physician who led the rehabilitation centre in Córdoba, Argentina. He engaged intensively with the anthropology of Latin America and let those experiences of the indigenous way of life fundamentally shape his therapy concept. The treatment is therefore based on respect for the other person, trust in their abilities and support for their strengths. It focuses on the needs of everyday life.

Goals of the treatment:

• broadening non-verbal and verbal communication
• perceptual development (e.g. feeling, seeing, hearing)
• improving active uprighting and movement
• activating and regulating orofacial functions (sucking, swallowing, saliva control, chewing, facial expression, articulation)
• fostering initiative and independence (e.g. in communication, eating, drinking, moving about)
• supporting parental competence
• preventing secondary pathologies

Who is treated? Premature babies, infants, children and adults with:

• muscle hypotonia, e.g. with Down syndrome, Prader-Willi syndrome or other syndromes
• orofacial disorders, e.g. with neurological conditions, facial palsy, Möbius syndrome, Pierre-Robin sequence or cleft lip and palate
• central motor disorders and multiple disabilities, e.g. with cerebral palsy or traumatic brain injury
• peripheral palsies, e.g. plexus palsies or myelomeningocele
• neuromuscular diseases

In sling-table therapy, parts of the body or even the whole body are suspended in slings. This suspends gravity and relieves the spine and joints. Movements that would normally be restricted or painful can then be carried out much more easily and painlessly in this state of weightlessness.

Sling-table treatment is used for:

• pain (especially spinal complaints such as herniated discs, cervical-spine problems, shoulder pain and hip-joint problems)
• paralysis
• contractures

Every physical and psychological discomfort leads, over time, to muscle tension and thus to pain, which in turn intensifies the discomfort. Targeted, professional techniques can break this vicious circle: circulation is stimulated, so that waste substances are removed more effectively. Loosening the muscles clears the way for normal movement.

Alongside classic massage, with its mainly local effect, there are many specialised massages such as connective-tissue massage and foot-reflex massage — both with an effect reaching into the autonomic nervous system and the internal organs.

Treatment with red-light heat, a hot roll or a fango pack prepares the body. Circulation is stimulated, the lymphatic system is activated and tension is loosened — now “trouble particles” can be removed more effectively. Further therapies can then work in a more targeted and deeper way.

Applying ice likewise stimulates circulation. Swelling recedes and pain sensitivity decreases. The way is then clear for further therapeutic measures.

Foot-reflexology therapy is a form of treatment that, over many years, has developed from old folk knowledge into a precisely worked-out specialist therapy. Although it starts at the foot, it is more than an ordinary foot massage: besides intense local circulation, it can bring about the healing or improvement of disturbed organs and tissue functions throughout the body.

How the method works: In the foot, all areas of the person have their assigned places — the reflex zones — which reflect their momentary condition in miniature, like a screen. We therapists work with targeted grips, in the truest sense a “treatment by hand”, without any devices or other aids, in order to bring the disturbed energy flows into order and harmony, as far as possible.

The pain triggered by reflexology usually occurs only under targeted, point-specific treatment and almost always subsides over the course of a treatment series. Experience gathered over decades shows that complaints in the weakened or diseased organs subside to the same degree as the oversensitive reflex zones normalise.

When people are bedridden or unable to come to a practice for other reasons, the doctor can prescribe a home visit in addition to the desired type of therapy. Our therapists then come to the home and treat the patient there.

A broad range of treatments is possible this way. For example, respiratory therapy can be given to a bedridden patient to prevent pneumonia; transferring from bed to wheelchair, or climbing stairs, can be practised.

Our therapists look for solutions to make independent living at home possible. They advise on which aids (grab rails, bath lifts, raised toilet seats, etc.) would be useful.