Physical Therapy Services In Oconomowoc
At Oconomowoc Physical Therapy, Dr. Carla Colella, DPT, OCS, offers a wide range of services designed to best meet your needs. These include:
House calls will resume December 2019 (after the birth of Baby Colella #2).
Sometimes we blame our life responsibilities for getting in the way of taking care of ourselves. If you feel that it is hard to get away from the house, OPT will come to you. Get the same hig-quality care when:
-the kids are doing homework or napping
-you work from home & have to toggle your mouse every now & again
-it is January, and you're not going outside if you don't have to
* House calls provided at an additional fee. OPT requires your walkway to be maintained/not icey in the winter months. A minimum of a 6x7ft space is required to set up the treatment table.
** House calls are different than "Home health PT." "Home health" is for those who are medically homebound whereas house calls are a concierge service for those who are medically able to leave the home.
Manual therapy is a broad term to describe thousands of techniques to improve the mobility of your joints, muscles, ligaments & even your nerves. Depending on the technique used, the result can be improved flexibility, or decreased pain, but my favorite benefit is for improved efficiency in body mechanics which reduces your body’s need to compensate around an injury.
Some forms of manual therapy I use include spine and extremity joint mobilization, muscle energy techniques, instrument assisted soft tissue mobilizations (IASTM), and myofascial release (MFR).
Dry needling has a very Western/anatomic theory behind it and it is thus, different from Chinese acupuncture. From a layperson looking on, it may look similar as very thin (.3 mm) needles are inserted into the body, although they do not stay in nearly as long.
I have seen many patients who have had dry needling elsewhere and not had as effective results. I think this is because we tend to think that our “tight” muscles are the problem, and other therapists (who perhaps had different instruction) use the over-simplified approach of “Muscle tight? I will put needle in tight muscle, fix muscle.” This ignores the fact that the body is super complex and intricate. When this approach does work it is because the needles are directed at the myofascial trigger points that cause and refer pain throughout the body. High concentrations of chemicals (lower pH, inflammatory markers, etc.) that cause pain can be found in these trigger points. When the needle is inserted, it helps to normalize these chemical levels and decrease muscle tension and pain.
Often times we have “tight” muscles that are trying their best to be protective; they have a job to do. If you take a vacation, do you have less work to do? Typically not, it just builds until you get back. This is why if you just treat the impaired muscle and it goes right back to the way it felt after a few days (or after you run again, or whatever your aggravating factor is)- that wasn’t the problem, it was a symptom. At OPT, we take it a step further: what is it working to protect? What is the underlying dysfunction there? Often times, there is a functional instability, which is why that detailed and comprehensive evaluation is so important, as those instabilities are more a problem of HOW you move, and are not likely to show up on any static imaging (radiographs or MRIs). This is where dry needling really helps. I’ve also written a blog on this topic. By leaving the needle in a very deep spinal stabilizer muscle (which are very difficult to touch through the often times big, ropey muscles in the back) and hooking it up to electrical stimulation, we can re-facilitate the function to stabilize an independent spinal level. After disuse (from being in pain for a long time), the muscle can change what types of cells are there, and it can get fatty infiltrates (even if you are a thin person). While some claim re-facilitation can be done with exercise alone, I would argue that yes, it is possible for some who take the time to learn body awareness, but with dry needling, you can be instantaneously better at performing your core stability exercises/ perform better on your functional stability tests! (This is huge.)
What to expect? I tell my patients to expect a deep, crampy, achy sensation. This may be as brief as a few seconds but for a few people (~20%) it may last longer, up to a day or 2. However, it is a different sensation from your symptom pain (which is typically worse).
Dry Needling can also help acute (woke up & can’t turn my head) or chronic pain, in nearly any area of the body: headaches, migraines, temporomandibular joint pain (TMD), neck pain, back pain with or without sciatica, fibromyalgia, thumb pain, plantar fasciitis, carpal tunnel, rotator cuff weakness or pain to name a few.
At Oconomowoc Physical Therapy I treat high school, college, recreational and competitive athletes who have sustained sports injuries.
My goal is to determine the cause of your injury and aid in the healing process to get you back as soon as you can. I also strive to educate the athlete to help prevent recurring injuries. I specialize in mechanical efficiency; so while you may come in thinking you have “patellafemoral syndrome” what you may really have is an inefficient landing strategy (does the floor shake when you land?), which is very trainable.
Sports injuries I commonly treat include post-concussion syndrome (see CST section), running injuries, golfing injuries, rowing/paddling injuries, and overall strains, sprains, as well as “post-boot syndrome” for when you have a hard time returning to sport after being immobilized in a walking boot.
Not injured? That’s great, you still may benefit from PT. Has your speed hit a plateau? Does your coach keep giving you the same cues that your body just can’t figure out? Have you “graduated” from PT elsewhere, but are still lacking the confidence to go at it 100%?
I don’t care how many times I’ve seen it; I’m still amazed at how poorly some seasoned athletes who train regularly perform at basic movement patterns & stability drills. I know you are strong, but you just may not be strong in the right sequence to do your sport the best you can.
These types of clients typically need: a thorough assessment, movement pattern retraining (think: reorganizing your muscle memory) and a series of exercises (most of which I will guarantee you’ve never seen) to help you apply that new movement pattern to your sport.
These patients also begin with a FREE 20 min screen to determine if your deficit is, in fact, a motor control problem, or if you just need to train more, in which case, I can refer you to some great personal trainers.
Back & Neck Pain; Acute & Chronic Pain
Some pain is short-term, or acute. If you are in your first episode of it, feel free to give it a few days to work itself out on its own. However, if you don’t have a few days, call to set up a Free 20 min consult for some pointers and know bed rest is generally NOT indicated. If you tend to have a few acute flare ups every year or so, you may also want to schedule a consult, as these can be preventable.
Some pain is sub-acute. It is not a far stretch to think that if we were to step on a nail every day, we would have foot pain, yet we tend to lose that logic when the “nail” is something small and cumulative. “Tech neck” is an example of this. When you work a long time your neck gets sore, when you do other work (yard work for example) it is fine, even if you’ve had the problem off & on for a year.
Chronic pain is a whole different animal. We take comfort in the mechanical model. If something hurts, there has to be a structure that is injured causing me to feel that way. Unfortunately, that is not the case, tissue damage is not correlated with pain. If you have pain in 10 different body parts, it is rare that you have 10 separate problems. Often times, primary care providers do not know how to treat these patients, and they are left angry & confused thinking “maybe it’s all in my head.” There has been a lot of research over the past few years about how chronic pain changes perceptions & experiences & how that changes how the body functions. Since it has such a different pathology, it must be treated vastly different. Did you know people with non-specific chronic low back pain are not able to tell (with a specific degree of certainty) where they feel a light touch when applied with their eyes closed? Chronic pain can be debilitating, but like anything there is a plan of care, with a series of progressions. We may need to start with visualizing movement in a painful limb, or sensory integration You may have some acute on top of chronic problems that would be treated the same way any acute “road block” would be. If stress from trauma is a factor in your pain, or you really don’t tolerate touch too well, my gentle alternative therapies of visceral manipulation & CranioSacral therapy may be effective. My point being: there’s always a starting point…that doesn’t involve medication, and we always celebrate the small steps. I believe getting you a good night’s sleep is a top priority, and setting small, achievable goals is paramount to your success. Whereas the insurance-based model will likely cut you off for “plateauing,” you can continue on with OPT with a maintenance program to keep achieving your small steps & make it to the top!
Whether you had a Cesarean Section or vaginal birth, there is some birth trauma. While traditional Kegels are an okay place to start, they are not the be all, end all of pelvic recovery.
While I do not offer internal, biofeedback training, I do offer manual therapy/bodywork for coccyx mobilizations, sacral decompression, and an array of visceral manipulation techniques to decrease strain on your bladder ligaments, aid in restoring your breathing pattern, and help close your diastasis recti (in 1-2 sessions).
I also offer a step-wise return to sport program, because that "do nothing for 6 weeks and then go ahead and ruin” advice most women get from their physicians leaves a large gap that you shouldn’t have to feel and for not intuitively knowing how to fill.
Put "Momstrong" in the subject from the Contact Me section. I give away one free wellness visit per month to a mom, just because what you do is hard. As moms we give and give and tend to neglect ourselves. This is my way to let you know what you do is appreciated. Moms with children of all ages are eligible.
Visceral Manipulation and CranioSacral Therapy
These treatments can be especially effective in treating the root cause of pain. When we look at our fascial system, it is one continuous network that also surrounds our internal organs as well as our brain and spinal cord, so it can be thought of as a very specialized facial manipulation that works with the body’s inherent movement and rhythms. It can feel subtle at the time and almost “too” gentle and yet have a profound impact on patients.
It is effective for people who have been involved in a motor vehicle accident, sustained a head injury/concussion, after any kind of pelvic, abdominal, or dental surgery, and for patients who have an anxiety or stress-related component to their pain, and are especially good candidates when they have not responded well to verbal-based treatment…some people are just more tactile.
These are also effective for the seemingly orthopedic patient. If I can’t put my leg far behind me when I run, and multiple people have told me I “have tight hip flexors” then I think my hip flexor muscle is the problem. I would never think that it is my inability for my hip flexor and colon to slide along each other in my body. Afterall, I don’t have any digestive issues – but that may just be the case. Again, you never know until you’re assessed.
This is easily one of the most important, but least “sexy” things to work on in PT. Lifting, pushing, pulling and rotating comprise most of our active movements. We need to do it properly every time (not just one time in the clinic so our PT can check if off a list). Why are you not lifting properly? Is it just because your legs fatigue, so you begin to compensate in your back? Are you avoiding putting weight through one knee? When you shovel snow, are you carrying to much of a load outside of your base of support? You never know until you have an expert analyze these tasks for you. I help people first become aware, and then learn how we make big muscles do big work, and small muscles to do small work…I never said this was rocket science, but even rocket scientists might have a hard time learning it; it takes help and it takes repetition, but the response from people who really follow through with it is often, “I never knew I could feel this good.”
Kinetic Chain Coordination, Mechanics Proprioception Training and Prescriptive Exercises
Many of my patients are already strong when they visit our clinic, but they lack the neurological control to piece it all together to make their motions even more efficient.
I work individually with each patient to assist with core integration and coaching people how to move after the manual therapy alleviate the restriction preventing them from moving.
I believe that the key to exercise success in physical therapy is providing customized, specific programs that help each patient progress to bridge the gap from where they are now to where they want to be.
Instrument Assisted Soft Tissue Mobilization (IASTM)
Instrument Assisted Soft Tissue Mobilization (IASTM) is basically a type of massage with a tool. With this stainless-steel tool, I can detect and treat fascial restrictions with more rapid localization, and effectively treat areas exhibiting soft tissue fibrosis or degeneration. Supplemented with exercises and other kinds of physical therapy, it works to effectively improve mobility between layers of soft tissue including scars.