Advanced Solutions Rehab
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Services at ATS

Physical and Occupational services include, but are not limited to the following:


Multi-faceted intervention following evidence/research based guidelines for both pre- and post-operative orthopedic procedures. Areas of focus include all joints in both the upper and lower extremities as well as the cervical, thoracic, and lumbar spine.


Manual therapy of the upper and lower extremity joints, as well as for the spine is utilized to increase blood flow, provide proper anatomical alignment, nerve health, and to increase range of motion or flexibility by following evidence- and research-based guidelines.

The clinicians at Advanced Therapy Solutions have a unique approach, utilizing influences by Maitland, Cyriax, McKenzie and Mulligan. Manual therapy usually includes, but is not limited to:

  • Joint Mobilization/Manipulation – A direct mobilization technique of the affected and symptomatic joint to address pain and stiffness.
  • Soft Tissue Mobilization – These are techniques performed on the muscles, tendons, ligaments and capsules to eliminate spasm, trigger points, adhesions (scar tissue) to restore normal tissue length or to diminish pain and soft tissue restrictions.
  • Neurodynamics (Neural Mobilization) – Specialized mobilization techniques to restore normal gliding and flexibility of potentially irritable nerve tissue.


Most back pain is caused by muscle strain, awkward lifting of heavy objects, bad posture, weak core muscle strength and general poor overall conditioning. These factors can cause both sudden back pain and intermittent back pain that comes on slowly over time. (According to the Mayo Clinic and the Centers for Disease Control and Prevention)

Current evidence and research indicate that four out five people have had back pain at some point in their life. The direct cost of treatment for low back pain is upwards of $50 billion a year according to the Archives of Internal Medicine (February 2010).

The therapists at Advanced Therapy Solutions are experienced in the non-surgical treatment of bone and joint, tendon and muscle conditions. They can help patients recover using hands-on physical therapy and supervised, targeted exercise. In addition they also teach patients how to prevent injuries and how to manage ongoing musculoskeletal problems.

The Spine Care Philosophy at Advanced Therapy Solutions:
We help find solutions to easy or complex spine problems by working closely with your doctor. Regardless of whether you are a post-surgical or non-surgical spinal patient, our therapist will perform a comprehensive evaluation on your first visit and develop an individualized program based upon your needs and functional goals. The physical therapist will incorporate both manual therapy techniques as well as a therapeutic exercise progression into most treatment programs.

In the July 2006 issue of the Clinical Journal of Pain, researchers found that patients who were seen by a physical therapist within two days of injury or pain reported less pain after six months than patients who waited four weeks before receiving therapy. Bottom line: seeing a physical therapist quickly means less pain in the long run.

The Goals of Physical Therapy in Spine Care:

  • Reduce any postural shifts that a patient may display.
  • Down regulate the nervous system that might be “buzzing” at higher levels.
  • Eliminate or reduce radiating symptoms into the arms or legs.
  • Restore normal range of motion in the spine.
  • Increase muscle length, when needed, through a stretching program.
  • Increase the strength and endurance in local stabilizing musculature.
  • Functional strength and endurance training to help return you to daily activities, work and sport.

Which Spine Conditions do we treat?
Patients who have acute and chronic low-back, mid back and neck pain, muscle-tension headaches, pain radiating into arms or legs, general arthritic spine related pain complaints, lumbar spinal stenosis, and work-related spine pain may benefit from physical therapy at Advanced Therapy Solutions. In addition, post-surgery physical therapy is critical for successful and faster recovery from operations such as laminectomy and fusion procedures. Some more specific diagnosis that we treat include: spondylolisthesis, lumbar or cervical radiculopathies, facet joint dysfunction and sacroiliac pain.

Outcome or prognosis:
Multiple factors contribute to your prognosis for a full recovery. The extent of injury, whether this is an acute or chronic condition, the presence of additional health problems, co-morbidities, general activity and fitness level and patient motivation will all factor into your recovery. Although every patient is different, the therapists at ATS are dedicated to helping you return to your previous functional level.


Why a hand and upper extremity specialty?
Our hands are vital to our quality of life and daily activities. Any loss of function due to an injury, illness or degenerative process can devastate our lives. We offer you the assurance that the therapist treating you has achieved the highest level of competency in the profession and stay current in the field. Our Hand Therapy Team works one on one to develop and implement individualized treatment programs to help the patient adapt and excel to regain function while managing the pain.

Hand and Upper Extremity Services offered:

  • Arthritis program
  • Amputations and Prosthetic training
  • Brain Injury program
  • BTE Work Simulator
  • Comprehensive Upper Extremity Evaluation
  • Congenital disorders of the Upper Limb
  • Carpal-tunnel Syndrome
  • Custom Splinting
  • Fracture Treatment
  • Fluido-Therapy
  • Peripheral neuropathies
  • Repetitive motion disorders
  • Severe soft tissue injuries, including burn injuries
  • Tendon, nerve and ligament injuries
  • Work- and sport related injuries


Anyone who has difficulty moving on land may find it easier to move in water. In order to determine whether aquatic therapy might be right for you, your physical therapist will do an initial evaluation. Once it is assessed that a patient can benefit from aquatic therapy, treatment sessions will mostly take place in the water, with the occasional session on land. The ultimate goal of aquatic therapy is to gain function which can be transferred to a land based program.

The benefits of aquatic therapy lie in the properties of the aquatic environment: resistance, buoyancy, pressure and temperature.

Air resistance is less than water resistance which means more muscles are utilized during a therapy session in the water than on land which helps improve strength and balance.

This property makes the body feel lighter which relieves joint stress during exercises, benefiting patients with arthritis and high levels of pain.

When submerged in the water the hydrostatic pressure helps decrease swelling, improves blood flow, and relieves joint stress. This property also helps to improve body awareness in space.

Warm water can help to relax tight muscles, improve circulation and relieve pain.

Aquatic therapy can be used to treat many medical conditions, such as chronic pain, low back pain, joint pain, as well as neurological and orthopedic injuries. Patients experience improved cardiovascular function and strength, less pain with normal activities, as well as improved balance and coordination.

You don’t have to be able to swim to participate in aquatic therapy, but it is important to be comfortable in the water.

Advanced Therapy Solutions provides aquatic therapy for their adult patient population at the indoor pool of the Hampton Inn, at 801 Spartan Boulevard, across from City Range restaurant, on the west side of Spartanburg.


Injury Prevention

Pre-Employment Testing:
Pre-employment tests include those designed by the employer, or isokinetic strength testing, which is specifically designed to determine an individual’s physiological strength and range of motion. These tests assist the employer with job placement in work areas with high injury rates. Advanced Therapy Solutions is a provider for pre-employment testing for both INRTEK and IPCS.

Physical Abilities Testing (Post-Offer Testing):
A job specific test based on data collected on site. This test is created by Advanced Ergonomics Inc. and provides data that will allow the employer to make a pass/fail decision on an applicant’s ability to perform the physical demands of a job. Data collection and testing are performed locally by certified data collectors and testers working for Advanced Therapy Solutions. Physical Abilities Tests are legally defensible and can be used to make a pass/fail employment or return to work decision.

On-Site Ergonomic Assessment:
Ergonomic assessments are performed to analyze and improve the fit between worker and workstation, instruction in safe work techniques and evaluation of tools, equipment and adaptive services. These assessments assist the employer in identifying high-risk aspects of a job and troubleshooting solutions to reduce these risks.

Job Task Analysis
This test is used to determine essential and non-essential job functions. This assessment is performed on-site and quantifies the physical demands of the specific job and is therefore used to determine the critical demands of that job. This analysis assists the employer in writing accurate job descriptions that describes the essential physical demands of the job.

Injury Management

Physical and Occupational Therapy:
ATS provides post-injury and general rehabilitation methods that are designed to treat, heal and prevent further injury and disability of any clients referred for service.

Work Conditioning Program
This program is designed to help the employee achieve a level of productivity that is acceptable in the competitive labor market. The work conditioning program is structured to facilitate maximum functional ability and is preceded by a functional baseline test. Once the program is completed, a functional capacity evaluation is performed to determine the client’s functional ability when compared with his physical job demands.

Case Closure Services

Functional Capacity Evaluations (FCE):
An FCE is a comprehensive and objective assessment used by employers, physicians and attorneys to evaluate an individual’s ability to function at home and at work. Advanced Therapy Solutions uses the Workhab format (Workhab International) to administer FCE’s.

The WorkHab FCE is an internationally recognized evaluation tool that enables a licensed evaluator to objectively measure, determine and report on the functional abilities of an individual. The system is predominately used to determine an individual’s safe and objective physical capabilities, to establish and monitor rehabilitation goals, and to aid in return to work facilitation. It is also commonly used as a medico-legal tool and for disability assessments for the purposes of payment/insurance determination.

Components of the FCE include:

  • Taking of thorough history and preparing client for physical portion of evaluation.
  • Screening of musculoskeletal system (functional range of motion, strength and flexibility). Testing and recording of functional abilities (lifting, carrying, pushing, pulling, sitting, standing, bending, reaching, and hand function).
  • Testing and recording of job specific activities and postures with progressive physical and time loading to assess response.
  • Overall functional cardio-respiratory conditioning level is also tested, monitored and correlated with each functional activity performed.

The Advanced Therapy Solutions FCE is easy to read and provides the employer, case manager or attorney with a summary of the client’s performance using DOL physical demand levels. The FCE also describes the client’s ability to perform the required job tasks with measured data and graphs that correlate and compare the physiological response to activities performed and pain responses on easy to read graphs.

Comprehensive Upper Extremity Evaluations (CUEE):
A CUEE is a detailed comprehensive assessment of the hand & upper extremity. It is primarily used to assist physicians in determining an Upper Extremity Impairment Rating and, if used in conjunction with the FCE, provides a more detailed assessment of the injured/affected upper extremity to better determine job readiness or restrictions. The CUEE can be individualized to the specific requests of the referring physician, nurse case manager, attorney, insurance carrier or other medical provider. The CUEE can also be used to assist medical providers and attorneys in determining Disability Status for those with Upper Extremity impairments.

Components of the CUEE include:

  • Obtaining a detailed medical & surgical history pertinent to referring diagnosis
  • Detailed assessment, comparison, documentation and interpretation of results of both upper extremities including, yet not limited to: goniometric joint measurements, girth, instrument & manual testing for strength, sensation (Weber 2PD, West monofilaments, Moberg, Ten test), pain scale.
  • Functional status (ADL’s, IADL’s, use of splints and/or other devices, or work status) using the appropriate functional scale: UEFI, DASH, etc.
  • BTE work simulator to compare instrument and manual testing results as indicated.


The Cybex Norm Isokinetic 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 Cybex testing mode allows the physical therapist to obtain baseline objective measurements of the force output of muscles surrounding the joint being tested (commonly referred to as torque). Cybex software analyzes 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 of the joint.

In the rehabilitation mode, the Cybex offers several modes of operation including isokinetic, isometric, eccentric and passive range of motion. These exercises can assist in improving range of motion, strength, and stabilization of the joint. The system software uses on-screen graphics/sound triggers and visual feedback to motivate patients during the session.


Using our BTE Work Simulator we can simulate a wide variety of jobs in our clinic and incorporate this functionality in a rehabilitation program that will be progressive and goal oriented. It can be used for testing, treatment, evaluating strength and also determining functional capabilities.

The BTE Work Simulator also records the patient’s progress in meaningful units of measure, producing objective data which are very helpful in measuring status, progress and ability to therapists, doctors, employers and the insurance industry.


By definition Massage Therapy is manual manipulation of soft body tissues (muscle, connective tissue, tendons and ligaments) to enhance a person’s health and well-being. It is often unjustly thought of as only a luxury treatment and its therapeutic benefits are often overlooked. While massage therapy is relaxing, it is also very beneficial and in many cases key to the healing process.

Benefits of Massage

  • Relieves Stress
  • Improves Posture
  • Improves Circulation
  • Lower Blood Pressure
  • Relaxes Muscles
  • Improves Flexibility and Range of Motion
  • Relieves Headaches
  • Strengthens the Immune System
  • Enhances Post-Operative Rehabilitation
  • Improves Rehabilitation After Injury

The highly experienced licensed massage therapists at ATS are unique in that they work in a clinical setting, in close contact with the physical and occupational therapists. This provides them with firsthand knowledge of a patient’s injury, pain and medical history to provide optimal care and maximized, positive results during the patient’s rehabilitation and pain management after surgery and/or therapy.

Massage therapy shouldn’t be thought of as a guilty pleasure and the stigma attached to it in this regard is slowly but surely becoming a thing of the past. With doctors now recognizing massage as an alternative to drugs for pain management, patients are becoming more aware of this as a legitimate way to help recover and live pain free.


Our physical therapists use this technique to treat myofascial pain. The technique uses a “dry” needle, one without medication or injection, inserted through the skin into areas of the muscle, known as trigger points. Physical therapists use dry needling with the goal of releasing or inactivating trigger points to relieve pain or improve range of motion.

Dry needling is not acupuncture, a practice based on traditional Chinese medicine and performed by acupuncturists. Dry needling is part of modern Western medicine principles and supported by research.

Preliminary research supports that dry needling improves pain control and reduces muscle tension. It also helps nerve pain and improves nerve function.

Our physical therapists who perform dry needling are educated beyond their entry level education and training, and have obtained specific postgraduate education in dry needling.

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