Clemson Sports Medicine - Descriptions of Services



Aquatic Therapy
By providing a reduced weight bearing environment, aquatic therapy allows patients to perform movements in the water with reduced stress on joints and provides resistance for strengthening, toning, and stabilization. We have trained therapists who design and implement programs to address impairments due to a variety of conditions including orthopedic injuries and post-surgical dysfunctions, joint replacements, back and neck pain, arthritic conditions, fibromyalgia, balance deficiencies, and neurological impairments. Aquatic therapy can increase strength and endurance, increase range of motion, decrease swelling, improve balance and coordination, improve circulation, and assist in stabilization around joints.
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Athletic Training
Our Certified Athletic Trainers serve local high schools by providing emergency first responder care at athletic practices and events as well as education on injury prevention and management. After they evaluate an injured athlete, they may refer the athlete to a physician for further assessment or they may choose to initiate a plan of care and protocol for rehabilitation. Acting as a liaison between the athlete, health care providers (i.e. physicians and therapists), coaches, school personnel, and parents, the athletic trainer is a key member of our health care team. In addition, the Certified Athletic Trainer assists in educating student trainers and provides recommendations to coaches and administrators regarding injury prevention and treatment. Some of our practicing physical therapists also have certification in athletic training which enhances their knowledge of sports medicine and appropriate assessment and treatment techniques. The formal training requires a minimum of a bachelor’s degree, with an emphasis in anatomy, physiology, kinesiology, psychology, and nutrition. In addition to this curriculum, 1500 hours of practical experience must be logged under the direct on-site supervision of a Certified Athletic Trainer or physician to develop skills in taping, padding, equipment fitting, emergency care, CPR, injury evaluation and rehabilitation techniques.
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Comprehensive Back / Neck Care
Back and neck problems can result from a variety of disorders including degenerative disc disease, herniated disc, spinal stenosis, spondylosis, and scoliosis to name only a few. In addition to these disorders, injury or trauma to the neck or back can lead to a combination of problems in the joints, muscles, ligaments, and discs of the spine and create difficulty completing work duties and everyday routine self-care.

Our therapists are trained in the anatomy of the spine and the intricate relationship between the tissues of the spine to provide an educated evaluation of a patient’s pain and functional limitations. The therapist determines the source(s) of the deficiencies and designs a treatment program which may include: manual therapy to the spine to restore joint mobility, reduce muscle spasm and guarding, and reduce pain; stabilization exercises and strengthening exercises; range of motion and flexibility exercises; postural education and back safety education; home exercise instruction including education in modifying work and daily routine activity; use of modalities including heat or ice therapy, ultrasound, and electrical stimulation.
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Balance and Fall Risk Assessment Program
For older adults, falls are one of the greatest causes of serious health problems. Our Hendersonville clinic offers a balance conditioning program and fall risk assessment with a doctor’s referral based on increased risk due to age, history, medication changes, muscle changes, degenerative joint disease, post arthroplasty or osteoporosis.

The patient participates in an assessment conducted by a licensed Physical Therapist to determine if he/she is “at risk” of falling. A series of tests will identify the factors causing the increased risk. The program may include Biodex Isokinetic Testing and Exercise to determine strength deficits, dynamic balance testing and training, and walking analysis to address speed and step length. The treatment consists of a conditioning program designed by the Physical Therapist to modify the factors causing the patient to be “at risk” and an educational program to assist the patient in modifying any environmental factors to eliminate hazards in the home. At the end of the four week program, a report is provided to the patient and referring physician summarizing the effect of the program.
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Balance Training & Vestibular Rehabilitation
Dizziness can be a prolonged life debilitating condition and can be a result of stroke, head injury, whiplash, Multiple Sclerosis, Parkinson’s Disease, or other neurological, orthopedic or muscular disorders. Dizziness or “vertigo” can be a symptom of a change in the vestibular system, which can lead to problems with balance and spatial orientation.

By combining traditional physical therapy techniques with the most advance methods in balance restoration, several of our clinics offer vestibular rehabilitation and/or balance retraining. The program focuses on achieving optimal outcomes by addressing patient problems with regard to their dizziness, postural instability, orthopedic disability, and/or risk for falls.

For example, our Balance, Mobility and Dizziness Center in Charleston, South Carolina treats individuals with inner ear, neurological, muscular, motor, sensory, or orthopedic problems. The Center features the state-of-the-art SMART Balance Master System which uses computerized bio-feedback technology to assess physical function, balance disorders, sensory deficits, and mobility problems. The sessions are supervised by the Physical Therapist, and the program provides exercises, visual feedback, and objective testing while reports are sent to the physician and/or insurance companies.
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Biodex Isokinetic Testing & Exercise
The Biodex Multi-Joint System is designed for neuromuscular testing and rehabilitation. This state-of-the-art equipment provides dynamic and static muscle loading and various programs for rehabilitation of the knee, ankle, and hip as well as the shoulder, elbow, and wrist.

The Biodex testing mode allows the physical therapist to obtain baseline objective measurements of the force output of muscles surrounding the joint being tested. The Biodex software analyzes the data and prints a comprehensive report which the therapist assesses and shares with the referring physician. After assessing the data and determining the deficits present, the therapist designs and implements a rehabilitation program to improve the muscle strength and stabilization at the joint. In the rehabilitation mode, the Biodex offers several modes of operation including isokinetic, isometric, eccentric and passive loading. These exercises can assist in improving range of motion, strength, and stabilization of the joint. The system software uses on-screen graphics to motivate patients during the session.
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Baltimore Therapeutic Equipment (BTE)
Our occupational therapists at the Corporate Clinic in Clemson South Carolina use this multifunctional unit for treatment and evaluation. The BTE Primus is applicable for patients of various conditions/diagnoses such as:
	musculoskeletal problems cumulative trauma disorders/repetitive strain injuries peripheral nerve-related diagnoses neurologic conditions and/or injury neuromuscular disorders burns amputations
Specific upper extremity uses include:
	manual dexterity and fine motor skills to address the coordination of the hand and wrist in performing purposeful motions handling, grasping range of motion strength assessed both statically and dynamically in isolated muscle groups by performing isolated joint motions and in combined muscle groups by performing specific tasks endurance neuromuscular coordination addressed by performance of tasks that produce purposeful, coordinated motions
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Custom Foot Orthotics Fabrication

Custom foot orthotics are shoe inserts that are specifically designed to fit the individual’s foot. Our orthotics are engineered to restore and control natural foot functions and create proper biomechanical alignment to treat walking imbalances. Poor foot function (i.e. excessively low or high arches, bunions, laxity) can cause common “biomechanical problems” such as heel pain, knee pain, and low back pain. Our custom foot orthotics realign the foot and ankle to a neutral position to restore the foot’s natural function and, therefore, help to eliminate discomfort to make standing, walking, and running more efficient. Additionally, the orthotics provide shock absorption by giving a more even weight distribution and alleviating pressure from sore areas such as the ball of the foot and bunions.

By controlling foot biomechanics, orthotics can help alleviate conditions such as heel pain, arch pain, shin pain, achilles tendon pain, and pain at joints of the back/hips/legs, thereby helping people participate in every day work and sporting activities.
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Fibromyalgia Program
Fibromyalgia is a disorder that causes pain in joints and muscles and may cause loss of sleep, headaches, and general stiffness and aches in joints. Exercise has been shown to lessen the aches and stiffness related to fibromyalgia. The fibromyalgia program at our Sports Plus clinic in Charleston, South Carolina provides an exercise regime appropriate to the individual’s condition to restore joint mobility and stabilization, functional gains in strength, and pain relief. The program includes stretching exercises and gentle, low impact activity combined with cardiovascular therapy such as walking or bicycling to help the individual return to work activities and hobbies.
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Functional Capacity Evaluations (FCE)
The purpose of a functional capacity evaluation (FCE) is to determine the patient’s ability to return to work, reducing the potential for re-injury. The evaluation can assist in determining tolerance for certain work duties, any restrictions or modifications that the patient should follow once returning to work, possibly a percentage of disability for the patient, and the need for continued rehabilitative services. The goal of the program is to provide the individual, physician, and the employer with objective information to develop a safe and appropriate return to work plan. By having the patient perform various activities that simulate on-the-job work, the program tests for maximum objective strength and work ability while removing fear of injury. Patients can be referred for an FCE by physicians, insurance companies, employers, families, self or rehabilitation specialists.
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Golf Exercise Program
As golfers are often looking for that extra edge to better their game, we provide that extra advantage through our golf program. Our Hendersonville clinic has access to two machines that no one else in the country can offer. Our MedX Lumbar Machine analyzes low back strength while another machine provides a computerized golf swing analysis. After the analysis, the participant begins a conditioning program designed to assist in improving club head velocity, decreasing the risk of injury, and ensuring that the body is ready to absorb the forces it experiences during a round of golf. The programs consist of one-on-one training to improve overall performance and home exercise instruction and equipment. We focus on core stability, flexibility, posture and exercises to increase optimal playing level and overall condition. By participating in this program, the golfer begins the road to driving the ball farther and decreasing the risk of injury.
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Manual Therapy
Manual therapy differs from the use of passive modalities (i.e. ultrasound, moist heat, cold pack) in that it requires the therapist to use his/her body to treat the patient. Manual therapy uses a “hands on” approach from the therapist and encompasses all forms of joint mobilization, soft tissue massage/mobilization, manipulation, muscle energy techniques, manual traction, and neural stretching. Benefits of manual therapy include increased range of motion and strength, restoration of joint mobility, increased circulation, decreased muscle spasm, decreased pain, restoration of proper joint mechanics and stability, increased flexibility, and increased awareness of proper posture and biomechanical alignment.


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MedX Lumbar Machine
In many instances, lower back pain results from an injury to the soft tissues of the lumbar spine, specifically the muscles that extend the lumbar spine. Since research has shown that more than ninety percent of all lower back problems do not require surgery, we focus our treatment on restoring strength in the lumbar spine by using our MedX Lumbar Machine. This unique piece of equipment provides totally isolated testing and rehabilitation for the muscles that extend the lumbar spine as these muscles provide structural strength for the lower back area.

We use the MedX Lumbar Machine as a totally isolated exercise to provide direct work for these extensor muscles, something that is not accomplished through conventional exercise. Both testing and exercise are conducted throughout a full range of possible motion or any desired part of a limited range of motion. Strengthening these important muscles in the lower back is certainly a step in the right direction for prevention of injury and successful rehabilitation.
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Modalities

*Ultrasound:*
Ultrasound is a passive modality that uses high frequency sound waves to provide deep heating of tissue. These sound waves penetrate deep into the area being treated (i.e. muscle) and cause soft tissues to vibrate, creating friction between the cells and generating heat. In turn, the heat induces dilation of the surrounding blood vessels which increase blood flow to the area. This increase in blood flow delivers oxygen and nutrients to the tissue and helps to remove cell wastes, thus allowing relief of pain and inflammation, reduction of muscle spasm, and accelerated healing.


*Phonophoresis:*
Phonophoresis uses ultrasound in conjunction with the application of a topical anti-inflammatory. This anti-inflammatory medication can be mixed with the ultrasound gel and applied to the affected area using the probe from the ultrasound machine. The sound waves from the ultrasound application force the medication to migrate into the tissues being treated, thus reducing inflammation.

*Hot Packs and Heat Therapy*
Heat therapy increases localized circulation, decreases stiffness, and helps reduce pain. The increased blood flow delivers needed oxygen and nutrients to the tissue and removes cell wastes. Furthermore, the heating effect decreases muscle spasms, relieves pain, helps release tension in muscles, and aids in increasing range of motion.

*Cold Packs and Cold Therapy (Cryotherapy)*
Cold therapy slows the speed of nerve impulses and reduces the temperature of tissue beneath the skin. In turn, the vasoconstriction, or slowing of blood flow, reduces inflammation, muscle spasm, and pain.

*Electrical Stimulation*
Through the use of electrodes placed on the skin, an electrical current runs from the equipment to the area being treated and emits a tingling sensation that stimulates the nerve and muscle cells. In turn, the stimulation enhances healing, alleviates inflammation, and helps to reduce pain.



*Iontophoresis*
By applying an electrical current to a solution of medication, iontophoresis provides an effective and painless method of delivering medication to a target tissue area. The medication is placed in a pad on an electrode which is applied to the skin. The application of a positively charged current over a positively charged drug molecule will force the positively charged drug molecules away from the electrode and into the target tissue. In a similar manner, the negatively charged current drives away the negatively charged ions of the medication into the target tissue.

For example, dexamethasone is a commonly used anti-inflammatory medication in the administration of iontophoresis. Dexamethasone is a negatively charged medication, thus the application of the negative current over the electrode containing dexamethasone will drive the medication away from the electrode and into the skin, resulting in an anti-inflammatory effect on the target tissue.
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Neurological Rehabilitation
Neurological rehabilitation involves evaluation and treatment of individuals who have experienced disorders of the nervous system. These disorders may include, but are not limited to:
	Vascular disorders - including stroke and transient ischemic attack (TIA) Infections Structural, Traumatic, or Neuromuscular Disorders – including brain, head, or spinal cord injury, Bell’s Palsy, peripheral neuropathy Functional Disorders – including headaches, dizziness, neuralgia Degenerative Disorders – including Parkinson’s Disease, Multiple Sclerosis, Alzheimer’s Disease, Amyotrophic Lateral Sclerosis (ALS)
The rehabilitation program helps the individual to return to the highest level of functional mobility to maximize independence and improve quality of life for the individual. The treatment includes, but is not limited to:
	activities to increase the individual’s skills with self-care activities an exercise program to restore strength, range of motion, and management of spasticity and pain stabilization activities to improve core control and muscle balance in the trunk, pelvis, and shoulder girdle gait and balance retraining to maximize safety and efficiency of movement education regarding the disease process and family/caregiver education
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Orthopedics
Orthopedics is the branch of Physical Therapy that deals with the prevention and/or correction of injuries or disorders of the musculoskeletal system. This complex system includes bones, joints, ligaments, tendons, muscles and nerves and allows the individual to make functional and purposeful movements.

Physical Therapists who practice in the orthopedic field provide rehabilitation services for conditions that include but are not limited to:
	Injury to bones, tendons, ligaments, muscles Post-surgical conditions Balance and gait deficiencies Soft-tissue disorders Body mechanics education Back/Neck rehabilitation Neuromuscular re-education Assistance with pain relief and management Therapeutic exercise programs to restore strength and range of motion Family/Caregiver education and training
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Osteoporosis Program
Sports Plus in Charleston, SC has developed a program called “Healthy Bones, Healthy Bodies” (HB2) for osteoporosis management and fracture prevention. The program is taught by a licensed Physical Therapist from Sports Plus and provides educational information and exercise instruction to help individuals reduce the risk of developing osteoporosis or cope with current symptoms of the disease. The program also educates the individual with strategies for reducing his/her risk of falls.
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Pediatrics
Pediatrics is a very specialized field of physical therapy. Evaluation of the child determines delayed areas of motor development and functional capabilities, and treatment focuses on functional postural education, addressing hyper/hypotonic muscle activity, neurodevelopmental therapy, gait and weight bearing activities, parental/caregiver education, and assessment of equipment needs. Our Sports Plus clinic in Charleston, South Carolina offers Pediatric Physical Therapy services.
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Pilates Exercise
Clemson Sports Medicine and Rehabilitation features Pilates Mat Classes. Pilates is a low-load exercise program developed by Joseph Pilates that improves joint mobility and overall body flexibility while focusing on core/trunk stability. It re-establishes the balance between muscle groups in the trunk through strengthening and also indirectly provides strength to muscles in the surrounding joints. By customizing the program toward each patient or client, individuals acquire a sense of accomplishment. As goals are reached, one remains motivated to achieve further progress. Moreover, it improves posture and balance secondary to the focus on the deep abdominals and midback musculature. The general principle of Pilates is to lengthen the body and has been used by dancers for years. The mantra of Pilates is that after 10 sessions you feel better, after 20 sessions you look better, and after 30 sessions you have a whole new body.
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Posture Education/Reeducation
One of the keys to preventing injury and re-injury to the spine is education regarding postural techniques and proper body mechanics. During physical therapy sessions, our therapists teach patients about techniques to achieve optimal postural alignment to help their specific conditions. These specialized techniques may include manual therapy and verbal cueing, visual feedback, postural taping, and education for self-recognition of proper positioning and use of core control to achieve stabilization for the spine. The therapist can offer techniques to use not only in standing and seated positions, but also effective ways to safely perform work duties, recreational activities, household chores, and proper sleeping positions. By learning safe body mechanics to perform lifting and bending activities and following the therapist’s precautions of positions to avoid, the patient can help prevent future or further injury to the back or neck and enhance participation in work and recreational activities.
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Pre-Prosthetic & Prosthetic Gait Training
A patient who has experienced a recent lower extremity amputation may be a candidate for a prosthetic leg and may require training in use and care of the prosthesis, care of the residual (amputated) limb, and safe techniques for transferring and walking with the prosthetic limb. If the patient is to obtain comfort and good prosthetic function, he/she will need to participate in therapeutic exercise to strengthen the residual limb and the sound limb and learn how to balance on the prosthetic limb for safe transfers (i.e. sitting to standing, getting out of bed to a chair) and walking. A Physical Therapist will determine deficits that need to be addressed with rehabilitation including strength, range of motion, skin care, education in use of the prosthesis, balance deficiencies, gait deviations, and safety education. The therapist will implement a program to address any deficits, advise the patient on assistive devices to use with ambulation if needed (i.e. walker, cane), educate the patient and family about safety measures in the home, and help the patient reach an optimal level of independence and function. Progress notes are sent to the referring physician and constant communication is maintained between the therapist, prosthetist, physician, patient, and family.
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Sports Medicine
Sports medicine is a branch of physical therapy that utilizes a comprehensive approach to evaluate and treat sport and exercise-related injuries, disorders, dysfunctions, and disease processes while also providing the individual with education for prevention of future injury. Our therapists design treatment programs to address functional gains in strength, range of motion, and joint stability to help the individual return to his/her sport, hobby, or everyday routine. Rehabilitation may also include dynamic balance activities, plyometrics (i.e jumping and muscle loading drills), proprioceptive retraining (i.e. restoring lower limb sense of position in space), sport-specific exercise, speed and agility drills, power fundamentals, and edema control and pain management. Many of our clinics also provide Athletic Training services to cover sports events in the community. Our Physical Therapists and Athletic Trainers often work together to provide a teamwork approach when rehabilitating athletes for return to their sport.
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TMJ Treatment
Problems at the temporomandibular joint (TMJ) often create symptoms that are common to other conditions. This joint is located in front of each ear where the jawbone (mandible) connects to the skull, therefore problems with the joint often result in symptoms experienced in the jawbone area or a surrounding area such as the head or neck. Symptoms of TMJ disorders include a dull, aching pain around the ears, headaches, ringing in the ears, dizziness, nausea, fatigue of the chewing muscles, unexplained toothaches, frequent stiffness in the neck, deviation of the jawbone when opening or closing the mouth, and clicking or popping sounds when the mouth opens or closes. Such problems can result from structural abnormalities of the joint, injury, or disease.

A Physical Therapist can advise the patient in precautions to follow with chewing and dietary adjustments and can educate the patient in facial relaxation exercises and stress reduction practices. Furthermore, the therapist can develop a treatment program appropriate for the individual including strengthening and stretching exercises, traction, electrical stimulation of the muscles, postural reeducation and training, proper sleeping positions, biofeedback, massage, and heat or ice therapy.
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Women’s Program and Neuro Core Kinetics
Sports Plus in Charleston, South Carolina has developed a program targeted specifically toward women to treat conditions including prenatal and post-partum issues, osteoporosis, fibromyalgia, and spine dysfunctions. Our therapists focus on core stabilization, therapeutic exercise, and education to help women manage these conditions and enhance their quality of life.

As part of the Women’s Program at Sports Plus in Charleston, several therapists participate in an osteoporosis program called “Healthy Bones, Healthy Bodies” (HB2) for osteoporosis management and fracture prevention. The program is taught by a licensed Physical Therapist in the clinic and provides educational information and exercise instruction to help individuals reduce the risk of developing osteoporosis or cope with current symptoms of the disease. The program also educates the individual with strategies for reducing his/her risk of falls.

One of the physical therapists in this clinic is a Certified Manual Therapist (CMT), using her skills to focus on treatment for spine dysfunctions and chronic pain management. Using a teamwork approach, two other therapists earned specialized training in Neuro Core Kinetics (NCK) which targets core stabilization and focuses on re-learning movement patterns to enhance the individual’s general health. Thus, faulty movement patterns can be corrected and carried over to specific skills, whether they are sport-specific for the elite athlete or task-specific for the post-partum female. These programs not only treat the spine, but also extend stability, strength, and pain management to peripheral areas of the body (i.e. the extremities). Teaching the patient to use core stability and training helps the individual refine his/her posture, manage pain and physiological tension, and improve performance of sports, work duties, or everyday routine activities.
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Work Conditioning
Work Conditioning involves a treatment program that is highly structured and individualized to meet the work needs of the individual. The program utilizes real as well as simulated work activities combined with physical conditioning tasks to enhance the patient’s physical function, further enabling him/her to safely return to work.


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Wound Care
Approximately five million Americans suffer from chronic open sores that can become seriously infected. The infection can be due to limited blood flow that can slow the body’s healing ability. Many patients seek professional help from Physical Therapists for wound treatment.

Treatable wounds may include:
diabetic skin ulcers pressure sores/ulcers vascular disease wounds (i.e. venous ulcers, arterial wounds) surgery wound infection spinal injury wounds chemical wounds burns

Proper wound care is dependent upon the type and severity of the wound. Wound treatment can include removal of unhealthy tissue, whirlpool, education in proper positioning, techniques for pressure relief, and dressing applications to promote healing and closure of the wound. The fastest healing alternative is achieved through wound treatment programs which may include:
advanced wound dressings conventional wound dressings whirlpool and other modalities to promote healing (i.e. electrical stimulation) nutritional counseling education on proper positioning and prevention of further tissue breakdown protective footwear

The use of modalities in wound care promotes healing and reduces the effects and chances of further infection. Specifically, whirlpool treatment provides:
vasodilitation, or increased blood flow, by use of warm water softening and loosening of necrotic (dead) tissue mechanical debridement to remove unhealthy tissue wound cleansing with use of topical agents exudate removal to reduce infection pain management
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