Physician Services
3246 N. Carson St.
Carson City, NV 89706
775-885-9965
Physicians
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Prescriptive exercise outcomes are only as good the evaluation performed at identifying the patient's dysfunction and the resulting compensations.

At Ascent Physical Therapy we have the time, knowledge, and experience to correctly identify and treat the functional pathology underlying the structural pathology. By continually reviewing new and insightful research, we have gained a better understanding of how muscle impairments and stability control are influenced by the neuromuscular system. This knowledge allows us to more accurately prescribe the most suitable exercise for a particular dysfunction.

Our services include:



We focus on:
Function & Characteristics of Local Stability Muscles:
  • Increase muscle stiffness to control segmental motion
  • Controls the neutral joint position
  • With a contraction there is minimal or no length change, therefore they do not produce movement
  • Activity is independent of direction of movement
  • Continuous activity throughout movement
  • High concentration of muscle spindles that provide proprioceptive input i.e. joint position, range and rate of movement

Function & Characteristics of the global stability muscles:
  • Generates force to control range of motion
  • During contraction there is eccentric length change; therefore control throughout range especially inner range (‘muscle active = joint passive’) and hypermobile outer range
  • Low load deceleration of momentum (especially axial plane: rotation)
  • Non-continuous activity
  • Activity is direction dependent

Function & Characteristics of the global mobilizer muscles:
  • Generates torque to produce range of movement
  • During contraction there is a concentric length change; therefore concentric production of movement (rather than eccentric control)
  • Concentric acceleration of movement (especially sagittal plane: flexion / extension)
  • Shock absorption of load
  • Activity is direction dependent
  • Non-continuous activity (on: off phasic pattern)


Clinically, the typical pattern of dysfunction that is seen is a decreased recruitment efficiency in the local and global stability muscle systems. This coincides with an increase in recruitment and functional changes in the global mobility muscle system. The loss of ideal local or global stability control results in abnormal strain on the joint, it’s supporting soft tissue structures, and related myofascial and neural tissue. Each of these ultimately can cause pain.

Once the key deficits in the neuromuscular system relevant to the patient's pain have been addressed, then an individualized treatment plan can be initiated. Every individual has a unique clinical presentation, therefore no two treatment programs are the same. Protocol based treatment programs assume that all patients with the same diagnosis have the same etiology, which is rarely the case. If you look at the evidence, individualized treatment programs , give far superior results to generalized ones. This is where the skill and knowledge of the practitioner comes into play.

True physical therapy is about providing patients with the necessary tools to move, be active and exercise in ways that create favorable tissue loading and efficient pain free movement. Exercises should be patient specific (prescriptive) according to their impairment, work, and recreational demands. Patients also need to be made cognitively aware of how these compensating patterns of stability and control are connected to their pain and dysfunction, and given simple strategies to correct them. By controlling directional movement (typically rotation) and joint instabilities, they can return to their normal activities pain free.