Manual Physical Therapy

This is just another way of saying Hands on Therapy. In many cases, therapists have their hands on the patients for 10 minutes/session—sometimes, even less.

In my office, we will be doing hands on therapy during the entire session. Years ago, ALL physical therapy was hands on manipulation, but over the years, the insurance companies have started to drive care. This is the reason why most therapists are juggling two and three patients at once, and often passing patients on to the aides and rehab techs. Brian Tenenhaus strives to spend each and every session in a one-on-one environment for the best possible care to each patient that he treats.

Dry Needling

This is a technique that has been used for hundreds of years, all over the world. Just like many other types of medicine, it took a while until it was practiced here in the United States. Numerous studies have found that muscle fibers that are taut, painful, and in spasm, can cause significant pain, and also create what’s called referred pain. Myofascial Trigger Points have amazing referral pain patterns. Below are a few different examples as to how and why this is such an important technique to utilize as an adjunct of care.

Neck muscles can refer pain to the front of the face, surrounding the TMJ/ear and also around the eye socket. It happens all the time where somebody has continual pain in the front of the eye that gets misdiagnosed as a sinus infection. Not one, not two, but sometimes 3 bouts of antibiotics later, and somebody finally gives up on their primary care physician to take their care in a different direction.

Here’s another example, the subscapularis, (the muscle on the under surface of your shoulder blade) can refer pain down to the wrist, or the pectoralis muscles often refer pain down to the 3^rd, 4^th and 5^th fingers and to the elbow. Who would have thought that wrist pain could have been coming from the muscle on the shoulder blade? These areas MUST be addressed, because many Doctors automatically assume you have Carpal Tunnel Syndrome.

How about tennis elbow? That is almost always explained as being a tight, overused muscle in the forearm, but it could be a trigger point coming from the triceps, the pectoralis major, or even the rhomboid muscle.

If the patient agrees to it, Dry Needling is often integrated into the Physical Therapy sessions, as needed. However, Dry Needling is ALSO available as an “A la Carte” service. Those who sit at a desk all day, cyclists, runners, and other athletes have all found it to be incredibly helpful.

Each session lasts approximately 30 minutes at $68.00 (can be billed through insurance as an OUT of Network physical therapy session)

Comprehensive Run Analysis

Run Analysis: Did you know that most runners have or will have some sort of injury or pain, that hinders their training? Have you ever watched yourself run? This physical therapist is not just a movement analyst, but he has just recently finished his first Ironman. (That’s 2.4 miles of swimming, 112 miles on the bike and a marathon to round out the day). He’s experienced plantar fasciitis, Achilles tendonitis, and shin splints first hand. Come get your run looked at and see what could be holding you back from your next PR!

On Court Tennis Analysis

Have you ever had a physical therapist come to your tennis lesson or match to analyze your swing, your serve, your court movement. This physical therapist not only played Division 1 tennis, but he also has taught over 12 years of tennis locally and in Northern Virginia as well.

Experience a “one of a kind” tennis analysis session that starts with your PT observing you on the court in a tennis lesson for 1 hour followed by a 45 minute integration of video motion analysis. After that, take it into the treatment room and get your dysfunction treated so that it comes full circle and improves your tennis skill set, the next time you get on the court.

Custom Orthotics

Your feet are the first thing to hit the ground, with every step that you take. If your feet are not supporting your frame, than that is setting you up for failure. Orthotics are molded to your feet, to create a more efficient support of your arch.  If you asked me “do you like orthotics?” My answer would be simple.

“For some people, where they are at in their life, orthotics will make a significant difference in reducing their pain, and ultimately, changing their life. Orthotics will help take pressure off of your back, hips, knees and even your neck. They will also help to put you in a proper alignment, starting at the heel bone, and working its way up the chain.”

However, they are not for everybody. Some people will not do well with orthotics, and Brian will deal with each case accordingly.  Oftentimes, the orthotics will not be something that you have to use for the rest of your life, but rather, a supplement to your physical therapy. They can be used to bridge the gap, and to help get you out of that pain cycle.

Ideally, you will be given exercises that are used in conjunction with manual therapy, to restore your arch and create the most efficient foot posture and alignment. At this point, if your alignment is still inefficient, or you still have too much pain with running, walking, or during your every day activities, the orthotics can be an excellent adjunct.