Physiotherapy Services

Physiotherapy Services

Osteopathy

Osteopathy

Massage therapy.

Massage therapy is one of the oldest known physical therapy treatments. It involves a combination of various maneuvers, based on movement and pressure, applied to the body with therapeutic objectives.

When applying the massage we can do it at 3 levels of depth:

  • Superficial: performed with minimal intensity, acting on the skin and subcutaneous tissue.
  • Medium: This applies a higher intensity, targeting the superficial and middle muscles. This is the most commonly used.
  • Deep: maximum intensity to reach the deepest muscles. This is often used in sports.

  • Rubbing: This is a superficial movement of the skin performed with the palm of the hand or the pads of the fingers. This gentle maneuver is often used at the beginning of a massage to prepare the area. It has a soothing and draining effect.
  • Friction: This is deeper than the previous technique and involves moving the skin over the muscles. It is performed with the pads of the fingers. It is often used for keloids.
  • Pressure: This involves compressing an area with both hands or between the thumb and fingers. It can be performed with movement or statically. It has a sedative effect and improves circulation.
  • Kneading: This is done with the thumb and index finger of both hands, using a series of twists and turns to traction in the muscle core. It has an analgesic effect, improves circulation, eliminates toxins, and relaxes muscles.
  • Vibrations: These are contractions performed with the forearm and transmitted to the physiotherapist’s hand, which is in contact with the patient’s skin. Sedative effect

  • Relieves and calms pain.
  • Promotes relaxation.
  • Release adhesions.
  • Improves circulation.
  • Reduces edema.

  • Wounds.
  • Thrombophlebitis.
  • Recent fractures.
  • First three months of pregnancy.
  • Fever.
  • Lithiasis.

Every physiotherapist must start with massage therapy to initiate any treatment and, depending on the patient and the reason for the consultation, apply and combine it with other appropriate techniques.

TENS .

TENS (Transcutaneous Electrical Nerve Stimulation) is a device commonly used in physiotherapy, which works on the pathways that transmit pain, producing an analgesic effect or a modulation of the affected sensitivity.

The physiological basis on which TENS is based is the “pain gate system.“ This basis assumes that the brain can control pain by closing or opening the pathways through which it is transmitted. This is done unconsciously, but with TENS, an external way to control this pain transmission has been found.

In addition, TENS takes into account the brain’s ability to accommodate, so in the same session it produces variations in intensity and frequency that constantly stimulate the brain to relieve pain.

TENS is easy to apply and can be used on almost any area of ​​the body and for virtually all conditions, whether acute or chronic. We can say that it’s a complementary and essential technique in every physical therapy consultation.

The current is transmitted through electrodes that adhere perfectly to the skin and are placed around the affected area so that the TENS blocks the nociceptive pathways that reach the brain.

This placement of the electrodes can be:

  • Parallel to the area of ​​pain
  • Perpendicular to the area of ​​pain
  • On a trigger point or acupuncture point
  • About dermatomes
  • At the segmental level of the spinal cord

During the session, we work on different parameters such as frequency and duration of the impulse to generate relief and prevent nervous tissue from accommodating.

Although it is a machine with great application for many pathologies, we must take into account some considerations since it is still an electrostimulation, therefore we should not use it in:

  • People with pacemakers or heart disease
  • Pregnant women.
  • Do not place the electrodes directly on the carotid sinus.
  • Damaged skin (wounds, scratches, etc.) because passing the current can cause a burn.

The use of electrostimulation in physiotherapy is a complement to improving treatment performance and patient recovery.

Radiofrequency R-200.

Physiotherapy treatment accompanied by professional healthcare radiofrequency, in our case R-200 (also known as diathermy), consists of the emission of electromagnetic radiation that reaches the innermost tissues, producing an increase in their temperature.

This temperature increase is between 3º and 4ºC and is not produced by the machine, but by the body itself, in response to the movement of the electrical charges of the current that reaches the interior of the cells.

  • Increases the production of elastin and collagen.
  • It releases endorphins and this contributes to analgesia.
  • Anti-inflammatory effect due to vasodilation. By increasing blood flow, it facilitates the elimination of toxins and waste, as well as cell regeneration.
  • Regula el PH.
  • Mejora el sistema inmunitario.
  • Activación del sistema nervioso vegetativo.
  • Autorregulación térmica.
  • Hiperemia y vasodilatación.
  • Renovación del líquido intersticial.
  • Eliminación de residuos metabólicos.
  • Mejora el nivel de polarización celular.
  • Analgesia de dolores de origen bioquímico (también en mecánicos y neurálgicos de forma indirecta).
  • Relajación muscular.
  • Eliminación de edemas por vía linfática y sanguínea.
  • Diapédesis de elementos de defensa en la zona afectada.

Por todo lo anteriormente descrito podemos concluir que la radiofrecuencia de uso terapéutico y médico puede ser usada en multitud de patologías, ya sean agudas (roturas musculares, esguinces, epicondilitis…) o crónicas (artrosis, artritis…)

La afección más habitual en consulta suele ser la sobrecarga tanto cervical como lumbar y como hemos comprobado con numerosos pacientes, esta hipertermia profunda que se genera gracias a la radiofrecuencia, realmente genera un alivio en el paciente de manera rápida y con una sensación de calor muy agradable durante la sesión.

A pesar de ser una técnica respetuosa y nada invasiva para el paciente, presenta algunas contraindicaciones, como:

  • Mujeres embarazadas o lactantes.
  • Enfermedades cutáneas, heridas, arañazos…
  • Prótesis metálicas.
  • Marcapasos.

El uso de técnicas complementarias específicas en cualquier tratamiento de fisioterapia nos garantiza, en mayor medida, una mayor y óptima recuperación.

Kinesitherapy.

Kinesitherapy is a physiotherapy technique that uses movement as a form of rehabilitation for a muscular or joint injury or pathology.

This exercise produces different effects on the areas involved, such as:

  • Improves circulation, venous and lymphatic return.
  • Increased muscle tone and power, especially during resistance exercises.
  • It helps loosen joints and improve mobility. This helps prevent stiffness and adhesions.
  • Improves coordination, balance and proprioception.

These are all techniques aimed at restoring mobility in the affected area, but without any patient involvement. They are all performed by the physiotherapist. Thus, we help restore joint range of motion and, above all, prevent adhesions.

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Dry Needling.

Dry needling is a physiotherapy technique based on the use of a needle to stimulate trigger point receptors or muscle contractures. This relaxes the muscle and increases its elasticity.

All muscles have a series of trigger points that are usually inactive, but on certain occasions, due to various circumstances, they become activated and produce local or radiated pain.

We can differentiate a trigger point from a contracture by the type of pain. A contracture generally presents with localized pain, while a trigger point typically presents with radiating pain. A typical example is pain that radiates from the neck to the head.

There are many causes that can activate these points or develop contractures: overload, repetitive movements in daily life, lack of laxity and elasticity, a sudden fall or blow, poor posture…

During dry needling treatment, the physiotherapist manipulates the needle several times, depending on the condition and response of the muscles, until relaxation is achieved.

  • Superficial puncture: The needle is inserted a maximum of 1 cm deep, without reaching deep into the muscle. This is followed by manual techniques or complementary equipment.
  • Deep puncture: Longer needles are used, depending on the muscle, as we aim to reach deeper. We also use complementary treatment afterward.

After performing the technique, the patient may feel “soreness” for the first 24-48 hours.

Success will depend on proper execution of the technique by a specialized physical therapist, good postural habits, and stretching to keep the muscles relaxed. Request your appointment here.

Electroneuroacupuncture.

Electroneuroacupuncture (ENA) is a recently developed technique in the physiotherapy field that integrates the concepts of acupuncture/Chinese medicine with neuromodulation.

We provide an anatomical and clinical view of the meridians that run through the body and their most prominent acupuncture points. This holistic view of pathology teaches us to visualize the whole and not focus on a single point or affected area. Thanks to this, we can treat all types of pathologies, whether chronic, acute, physical, or emotional.

By combining these two well-known techniques in physiotherapy, we find the perfect union of an invasive therapy based on nerve innervation and anatomical points (neuromodulation) that integrates perfectly with traditional Chinese medicine and its points on the meridians that run through our body (acupuncture).

To perform this technique, we use acupuncture needles, which vary in length depending on the area being treated. We locate the nerve that supplies the affected area and look for the altered points. To complement this, we look for the points on the related meridian, which will provide additional support to complement the treatment and achieve greater effectiveness.

The fact that we can treat a pathology with points distal to it allows us to multiply the effects and therefore the benefits of the treatment. Once the points have been located, as explained above, a current is applied to the needles to stimulate the nerve and generate endorphins that will act by reducing the pain and relaxing the area. We can also apply moxa to these points so that relaxation is achieved through the heat that passes through the needle.

This technique teaches us to look at the body as a whole, which is why it is especially beneficial for pain that radiates across a wide area such as the arm or leg, as it allows us to work along the entire nerve pathway, as well as for people who suffer from generalized pain.

On an emotional level, with Electroneuroacupuncture (ENA) we can improve anxiety, sleep quality and overall relaxation of the patient with the stimulation of certain acupuncture points and the peripheral nervous system.

Kinesiotaping .

Functional bandaging is a type of physiotherapy technique that consists of limiting or inhibiting a movement that causes pain, leaving the rest of the movements free. In this way, only the damaged structures remain at rest, and we avoid the disadvantages of complete immobilization (loss of muscle mass, risk of loss of bone density in the immobilized region, circulatory problems, thromboembolism, and other unwanted effects). Functional bandages can be preventive or therapeutic.

Necessary material:

  • Foam (Protection plates)
  • Pre-bandage
  • Adhesive spray
  • Elastic bandages
  • Tape
  • Scissors

  • Elastic technique: used to limit movement that causes pain; adhesive or cohesive elastic bandages are used for its application.
  • Inelastic technique: This technique eliminates the movement that causes pain. It is used with a non-elastic adhesive tape.
  • Mixed or Combined Technique: When we combine the two previous materials, we use elastic bandages and reinforce them with strips of tape.

When applying a bandage, avoid wrinkles on the sole of the foot, compressions in the popliteal fossa, compressions in the Achilles tendon, bony edges, flexion-extension regions and seek the comfort of the patient.

  • First or second degree ligamentous strains.
  • Prevention of ligament laxity.
  • Muscle fiber tears.
  • Muscle strains and elongations.
  • Long bone fractures.
  • Rib fractures.
  • Discharge tendinopathies.
  • Download plantar fasciitis.
  • After the cast is removed, to begin the rehabilitation period.

  • Tendon, ligament and muscle tears.
  • Fractures.
  • Edema.
  • Varicose veins.
  • Serious injuries.
  • Allergies to applied materials.

Within a physical therapy treatment, the appropriate set of techniques must be applied for each patient, in each case. Therefore, evaluation is the first step toward optimal recovery.

Functional Bandage.

Functional bandaging is a type of physiotherapy technique that consists of limiting or inhibiting a movement that causes pain, leaving the rest of the movements free. In this way, only the damaged structures remain at rest and we avoid the disadvantages of complete immobilization (loss of muscle mass, risk of loss of bone density in the immobilized region, circulatory problems, thromboembolism and other unwanted effects). Functional bandages can be preventive or therapeutic. Necessary material:

  • Foam (Protection plates)
  • Pre-bandage
  • Adhesive spray
  • Elastic bandages
  • Tape
  • Scissors

  • Elastic technique: used to limit movement that causes pain; adhesive or cohesive elastic bandages are used for its application.
  • Inelastic technique: This technique eliminates the movement that causes pain. It is used with a non-elastic adhesive tape.
  • Mixed or Combined Technique: When we combine the two previous materials, we use elastic bandages and reinforce them with strips of tape.

When applying a bandage, avoid wrinkles on the sole of the foot, compressions in the popliteal fossa, compressions in the Achilles tendon, bony edges, flexion-extension regions and seek the comfort of the patient.

  • First or second degree ligamentous strains.
  • Prevention of ligament laxity.
  • Muscle fiber tears.
  • Muscle strains and elongations.
  • Long bone fractures.
  • Rib fractures.
  • Discharge tendinopathies.
  • Download plantar fasciitis.
  • After the cast is removed, to begin the rehabilitation period.
  •  

  • Tendon, ligament and muscle tears.
  • Fractures.
  • Edema.
  • Varicose veins.
  • Serious injuries.
  • Allergies to applied materials.

Within a physical therapy treatment, the appropriate set of techniques must be applied for each patient, in each case. Therefore, evaluation is the first step toward optimal recovery.

Auriculotherapy.

Auriculotherapy is a technique within the field of painless alternative medicine. It was initially created to treat stress and anxiety, but its study has now advanced and includes the treatment of dozens of pathologies, and is currently a widely used technique within physiotherapy.

  • This alternative therapy arises from traditional Chinese medicine, but it was in France where Dr. Nogier verified its effectiveness. It was shown that the ear is a micromap of our entire body, it appears as if it were in the shape of a fetus in the womb; therefore, each part of our body is represented by a specific point on the ear. By stimulating a point on the ear, we simultaneously stimulate various nerve endings that have an effect on the organ related to that point. Therefore, auriculotherapy is not only used to treat but also helps us diagnose, since by pressing the points depending on whether they are painful or not, they will inform us if there is dysfunction.

  • First, we’ll assess the symptoms and identify the affected areas, identifying the most appropriate points. To begin the new treatment, we’ll apply pressure to the points using:
    • Filiform needles: applied to the points for 10-30 min.
    • Intradermal needles: These are placed under the skin for approximately 7 days.
    • Seed patches: These are stuck to the skin for 5 days.

It can be applied when the following cases occur:

  • Muscle pain, sprains or fractures.
  • Sciatica.
  • Joint pain.
  • Digestive problems.
  • Vertigo.
  • Facial paralysis.
  • Emotional problems: stress, anxiety and/or depression.

It cannot be applied when the skin of the ear is red or irritated and during pregnancy.

Auriculotherapy is a noninvasive, safe technique with no side effects. Request your appointment.

Suction cups.

The cupping technique, better known in the field of physiotherapy as the cupping technique, despite having been used for thousands of years by traditional Chinese medicine, has been little popular until 2016, at the Rio de Janeiro Olympic Games, where the technique became very well known and used, following the sighting on television of some athletes with “marks” on their backs as a result of having been treated with this cupping technique.

 
Physiotherapy treatment with this technique consists of applying it to certain parts of the body, with which the skin and part of the muscle are suctioned, creating a vacuum, so that the pores open and thus promote blood and lymphatic circulation.

The original method used, although it is still used today, consists of the use of glass suction cups, where a cotton ball with alcohol is attached with tweezers, lit, and the combustion of oxygen creates the vacuum and suctions the skin.

For the treatment of the affected area we can use two techniques:

Massage: We apply oil to facilitate movement, place the suction cups, and once the suction is complete, we move them over the entire area to be treated. This technique improves the lymphatic and blood systems and eliminates toxins, among other things.

Fixed suction cup: we place 6-10 suction cups on the area of ​​interest, leaving them for 10 minutes, causing a violet color on the skin (hyperemia) and after this time we remove them.

Benefits:

  • Eliminates muscle contractures and trigger points.
  • Increases blood circulation.
  • Eliminates toxins.
  • Strengthen tendons.
  • Lymphatic drainage

CONTRAINDICATIONS:

  • Thrombosis, thrombophlebitis.
  • Varicose veins.
  • Wounds.
  • Fever.

As with other physical therapy treatments, the most important aspect of treatment is the combination of appropriate techniques for each case, tailoring the treatment to each patient.

Moxibustion.

Moxibustion is a therapeutic method imported from traditional Chinese medicine. It is based on the application of heat to specific points on the body (usually acupuncture points) to activate blood circulation and oxygenate the treated area. The use of Moxibustion for physiotherapeutic purposes follows the principles of the “channel theory.” This theory tells us that the body functions as a network system where blood and energy related to each part of the body flow. Sometimes these energies become unbalanced, causing illness and pain. This therapy aims to reestablish this energetic balance.

For optimal treatment, use the Artemisia plant. It can be used in several ways:

  • Direct application: It is used with moxa (the mugwort plant ground into a powder for burning) applied to specific acupuncture points. Burning is not possible because when using moxa, only three-quarters of the material is burned before being removed.
  • Indirect application: This application uses mugwort leaves rolled into a cigar shape. Light the cigar and pass it over the areas you want to treat, keeping a minimum distance between the skin and the cigar.
  • Needle moxibustion: Acupuncture needles are inserted into the treatment points, and a mugwort pellet is placed at the base of the needle. This allows heat to pass through the needle to the body.

  • Rheumatic pain, osteoarthritis, lumbago
  • Respiratory problems: asthma, bronchitis, etc.
  • Fluid retention, edema
  • It is especially indicated in chronic diseases.

Contraindications:

  • When the patient’s fever reverses.
  • Skin infections in the area to be treated.

Moxibustion is generally used as a complement to acupuncture and physiotherapy treatments when treating the patient as a whole.

Myofascial Release.

Myofascial induction or myofascial release is a physiotherapy technique used to evaluate and treat the myofascial system. The fascial system is a set of fascia that runs throughout the body, enveloping anatomical structures and viscera; and thus relating them to each other. Fascia is a connective tissue, containing a lot of collagen, which is found under the skin and envelops bones, muscles and joints, nervous and vascular structures. It is responsible for protecting and holding the different structures of the body together. For various reasons such as: poor posture, stress, trauma or prolonged immobilization, among others, the fascia can harden and shorten, causing pain and limited mobility. The fascia runs throughout the body continuously, so if it is injured in one part of the body, other more distant areas can also be affected.
For all these reasons, the objective of the myofascial induction technique or myofascial release is to release these myofascial restrictions. This achieves a reduction in pain, restoring musculoskeletal balance, and increasing joint movement. Superficial or deep techniques can be used for its application. First, the physiotherapist will position the affected area at the extreme end of the movement barrier or the most comfortable area. The patient is then allowed to breathe calmly while the physiotherapist palpates the tissues, looking for a sensation that indicates that the tissue is “ready to relax.” It is at this point that the tissue is helped to follow the spontaneous movement pattern. The process is repeated in several sessions until complete release is achieved.

  • Aneurysms
  • Fractures
  • Fever
  • Tumors
  • Infectious diseases
  • Women during the first three months of pregnancy
  • Advanced phlegm

Myofascial induction assesses and treats the patient from a holistic perspective, seeking a balanced and symmetrical body. Request your appointment here.

Lymphatic drainage.

Manual lymphatic drainage is a massage therapy technique in physiotherapy involving very gentle, slow, and repetitive movements on the skin, which should be performed in the correct direction to help improve the lymphatic system.

The lymphatic system consists of a series of capillaries, or ducts, that collect and transport waste products from other tissues to the circulatory system, so that the body can get rid of them. When the lymphatic system is unable to eliminate these waste products, edema or retention occurs. Lymph nodes, which are responsible for purifying pathogens, are found along the path of the lymphatic system. These become swollen because they cannot purify their tissues when the lymphatic system is affected.

  • It is applied to treat lymph nodes and vessels.
  • No cream or oil is used in its execution.
  • We work from proximal to distal, and in segments from distal to proximal (to drain the areas closest to the lymph nodes and make room for the lymph that will come from more distant areas).
  • Very gentle pressure is applied, like a caress.
  • A very slow rhythm of movements is applied, always following the rhythm of the lymphatic vessels.
  • In each area several sequences are performed, which are repeated at least three times.
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INDICATIONS:

  • Mainly for the treatment of lymphedema, traumatic or post-surgical edema.
  • Rheumatic conditions.
  • Tired or swollen legs.
  • Algodystrophy (Sudeck).
  • Hematomas.
  • Nervous pathology: headaches, vertigo.
  • Mastectomies.
  • Stress and anxiety.
  • Digestive system disorders.

CONTRAINDICATIONS:

  • Infections
  • Phlebitis
  • Fever
  • Hypotension
  • Asthma

Request your first appointment here.

Ultrasound.

Ultrasound physiotherapy consists of a treatment based on the mechanical vibrations of a longitudinal wave that produces compression in the tissue. Ultrasound requires a special medium for its application, through which the waves can be transmitted. This medium is commonly referred to as “ultrasound conductive gel.”

The frequency at which we will use ultrasound will depend on the pathology:

  • High frequencies: 3Mhz, for superficial pathologies.
  • Low frequencies: 1Mhz, for deeper pathologies.

The tissues that respond best to this type of waves are those with a high amount of collagen and absorption: tendons, ligaments, joint capsules, and fascia.

It is therefore a therapy that can be used in both acute and chronic cases, depending solely on the parameters used. Furthermore, since it is a painless therapy, it is very pleasant for the patient.

The effects of ultrasound at the cellular level are:

  • Muscle relaxation.
  • Increased cell permeability.
  • Improves tissue regeneration.
  • It acts at the level of the peripheral nerves.
  • Analgesia.
  • Anti-inflammatory.

The application forms can be:

  • Direct application: The ultrasound head is applied directly to the skin using the gel. We take into account the angle of the head relative to the skin so that the waves penetrate as far longitudinally as possible. This angle is typically around 30° (depending on the area and the individual).
  • Underwater application: This involves using an aqueous medium to aid in the propagation of the waves. This is used in cases of very irregular (knee) and/or painful areas. To do this, place the affected area in a bucket of water and place the ultrasound head at a distance of 3 cm. The water temperature should be between 36º and 37º and you should never put your hand in the water while the waves are acting. If a bucket cannot be used, you can use a latex balloon filled with water.
  • Mixed application: here we will make a variation of the two previous ones.

In our clinic, we often combine ultrasound with other physiotherapy techniques to optimize and improve results.