May 8 23

How to Choose an Inpatient Rehabilitation Facility

by Jon Brannan
How to choose an inpatient rehabilitation facility

A severe injury, disease or condition can be life-changing. The quality of care you receive in the hospital and your choice of an inpatient rehabilitation program are crucial for your recovery.

But how do you choose an inpatient rehabilitation facility at a moment like this? You and your family have just been through a life-changing crisis and you may find yourself in unfamiliar territory, unsure of where to turn for help.

Every inpatient rehabilitation facility offers different services, specialization and expertise, so it’s essential to find one that best meets the needs of your recovery. Your choice should have a proven track-record in successfully treating patients with similar conditions to yours. It should also have professionals on staff who will help you address the emotional component of your condition: Does it provide emotional support like neuropsychologists, support groups and similar services to help you navigate the changes in your life?

What is an inpatient rehabilitation facility?

An inpatient rehabilitation facility (IRF) is a type of hospital that provides care and therapy after your health is stabilized in the hospital. An IRF administers therapy to each patient at least three hours a day, five days a week, by licensed therapists who specialize in treating your condition. A highly trained, multi-disciplinary team of therapists, nurses, physicians and physiatrists oversees your care.

What should I look for when choosing an inpatient rehabilitation facility?

During a health crisis, the thought of choosing an IRF can be daunting. Here are six questions to ask to help you make an informed decision:

  1. Does the facility specialize in treating your illness, injury or condition? This is especially critical in the cases of stroke, spinal cord injury, major multiple traumas (multiple injuries at once), brain injury or amputation. The nursing and therapy staff should be specifically trained in the type of care you need.
  2. Does the facility have a successful history of providing physical rehabilitation as its core focus?
  3. Is the program led by doctors who specialize in physical medicine and rehabilitation?
  4. Do they have the highest level of accreditation from an organization like CARF (Commission on the Accreditation of Rehabilitation Facilities)? This official rating is based on high care standards and positive health outcomes.
  5. Does the facility practice individualized care? Do they take your goals, preferences and anxieties into consideration?
  6. Does the facility offer inpatient and outpatient care? If your rehabilitation team can follow you through your outpatient rehabilitation, it will set you up for long-term success.

Why choose Penn Medicine Rehabilitation?

Penn Medicine Rehabilitation offers innovative, individualized rehabilitation programs that meet a high standard for patient safety and care. Our highly skilled nurses, therapists, physiatrists, physicians, neuropsychologists, and case managers are recognized for their excellence in treating spinal cord injuries, traumatic brain injuries, neurological conditions and cancer.

The staff who will treat you at our inpatient rehabilitation facility includes experts who conduct research, author text books and peer-reviewed publications, hold advanced certifications in their fields and are board certified in physical medicine and rehabilitation, physical rehabilitation, and neurology.  You’ll have access to comprehensive, specialized, leading-edge care and will participate in at least 3 hours of therapy 5 days a week, utilizing innovative technology.

Penn Medicine Rehabilitation offers a calm, quiet atmosphere with modern, private rooms and bathrooms to support your healing. To learn more about the benefits of inpatient rehabilitation at Penn Medicine Rehabilitation, visit our web page or call 1-877-969-7342.

Learn more about why you should choose Penn Medicine Rehabilitation for your inpatient care needs.

Mar 23 23

How Physical Therapy Can Help Sciatica & Lower Back Pain

by Jon Brannan
Happy black physical therapist assists seniors during exercise class in park.

Anyone who’s ever had sciatica knows how debilitating it can be. You may believe that crawling in bed and resting for a few days is the best treatment, but that can be counterproductive. One of the most effective ways to relieve your back and leg pain is physical therapy that includes gentle exercise, like stretching.

A physical therapist can guide you through exercises that will keep sciatica and lower back pain at bay. Movement may seem counterintuitive when you’re in excruciating pain but physical therapy is usually the best treatment for sciatica.

What is sciatica?

The sciatic nerve is the longest and widest single nerve in your body. It begins with five nerves in the lower back that join to form one nerve that branches through the pelvic bone. From there, it travels down the back of each buttock and thigh to the back of the knee, ending in the heel area of each leg. The sciatic nerve provides motor function to the abductor muscles in the hips, the muscles in the front of your lower leg and calf, and some muscles in your foot. [1] 

When the sciatic nerve becomes inflamed and painful, it’s referred to as sciatica. Sciatica is a type of lower back pain, but not all lower back pain is sciatica. The cause of inflammation is usually pressure on the nerve from a bulging disc, overgrowth of bone, pregnancy, muscle spasms, degenerative diseases like spinal stenosis, or an injury. The inflamed nerve causes pain and sometimes numbness and tingling anywhere along its path. In severe cases, a person with sciatica can also experience leg weakness and bowel or bladder changes.

Symptoms of sciatica

Sciatica usually appears on only one side of the body, anywhere along the nerve’s path. Most commonly, pain is felt in the low back, buttock, back of the thigh or calf. The pain may appear as a mild ache, sharp or burning, or like a jolt or electric shock. Numbness, tingling or muscle weakness can accompany sciatica, including pain in one part of the leg and numbness in another.

What causes sciatica?

Pain occurs when the sciatic nerve becomes “pinched” or compressed at one point or multiple points. The nerve compression can be caused by:

  • Bone spurs in the lumbar area of your spine
  • A herniated or bulging disc
  • A tumor
  • Damage to the sciatic nerve from diabetes
  • Age-related changes in the spine
  • Stress on the spine due to obesity
  • A job that requires twisting the back, carrying heavy loads, standing for long periods in awkward positions, physical stress on the spine or driving or sitting for long periods
  • A sedentary lifestyle – inactive people are more likely to develop sciatica than active people

How physical therapy treats sciatica

With sciatica, resting can be counterproductive. Stretching and strengthening the nerves, muscles, and joints causing the pain, as well as education on posture and positioning, may help to decrease pressure on the nerve and thereby reduce pain. That’s why physical therapy can be of great benefit in relieving sciatica.

If you’re suffering from sciatica, Penn Therapy & Fitness physical therapists will design a rehabilitation program to alleviate your pain. They’ll focus on strengthening your spine and core, as well as muscles in the lower back, abdomen, buttocks and hip to improve the flexibility of the muscles and nerves and restore pain-free movement.

“Patient participation is important. Physical therapists need to ensure that the patient understands what we are trying to address and how it can help.”

Michele Little, PT, DPT, Penn Therapy & Fitness West Norriton/Trooper

Your sciatica rehabilitation program may include:

  • Backward bending (extension) and forward bending (flexion) exercises to promote movement of the spine.
  • Manual therapy techniques to reduce nerve compression
  • Exercises to strengthen the abdomen, lower back, spine, hips or legs and supporting muscles or tendons. This may include isometric or isotonic exercises.
  • “Nerve glides” (nerve stretching exercises) to increase movement and reduce symptoms
  • Joint mobilization or manipulation
  • Gait training to correct walking patterns that may contribute to sciatica
  • Hands-on movement of the leg, hips and back to facilitate movement of the muscles and joints contributing to the pain.
  • Posture and lifestyle modifications
  • Home exercise program
  • Massage

If you’re experiencing sciatica, make an appointment with Penn Therapy & Fitness for an evaluation. Visit our back and spine pain treatment page or call 877-969-7342.


[1] Physiopedia, Sciatica

Jan 6 23

The Impact of Outpatient Therapy after Stroke

by Jon Brannan
Woman therapist providing stroke rehabilitation to older man.

After a stroke, patients can have a wide range of challenges, including paralysis on one or both sides of their body, abnormal posture, behavioral disorders, a reduced capacity or inability to communicate (aphasia), cognitive deficits, chronic pain, and/or depression. These symptoms may linger or even appear weeks after a stroke. Most patient being with inpatient therapy and then continue their recovery through outpatient therapy. Every stroke recovery is unique, so how much outpatient therapy is needed depends on your unique symptoms and their severity.

Outpatient therapy is typically provided in a rehabilitation clinic or community setting and is a valuable part of stroke recovery. It can help you regain function and independence, improve your quality of life, reduce the risk of further complications or disability and reduce the likelihood of a second stroke.

Why outpatient therapy has a critical impact on recovery

When outpatient therapy is tailored to a stroke survivor’s specific needs and goals, the patient can significantly improve their mobility, balance, and functional ability. This has a positive impact on quality of life and may also help to reduce the risk of falls, fractures and a second stroke. Most patients need a combination of physical, occupational and speech therapy. Your team may also include a physiatrist, psychologist, social worker or nutritionist.

Outpatient physical therapy

Physical therapy (PT) benefits individuals who experience weakness, paralysis or other mobility issues due to a stroke. PT uses exercises and stretches to improve mobility, balance, strength, range of motion and coordination. It may also include the use of assistive devices or adaptive equipment, such as walkers or canes.

Outpatient occupational therapy

Occupational therapy’s goal is to address and regain independence through participation in meaningful activities of daily living (ADL) and instrumental activities of daily living (IADLs). These include bathing, dressing, grooming, eating, cooking, household management tasks, community re-integration, etc. Additionally, occupational therapy creates a client-centered treatment plan that supports a patient’s goal of resuming meaningful roles of spouse, parent and/or caregiver. Regaining independence may include addressing strength and motion in the affected arm to further support resuming roles and habits in their lives.

Outpatient speech therapy

If a stroke affects an area of the brain responsible for language, a stroke survivor may have trouble speaking, listening, understanding language or swallowing. In speech therapy (ST), you may learn exercises to improve the clarity of your speech, language comprehension, expression and swallowing. ST may also include training to use assistive devices, such as communication boards or computer software.


Find information on stroke rehabilitation at Penn Medicine Rehabilitation and Penn Therapy & Fitness or call 877-969-7342.

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Dec 19 22

Regaining Bladder Control After Spinal Cord Injury

by Jon Brannan
Portrait of African businessman with disability sitting in wheelchair and smiling at camera during his work at office

In the United States, there are nearly 18,000 new cases of spinal cord injury (SCI) each year, and roughly 250,000 patients living with SCI.[1] [2] In addition to impairing motor functions like walking, sitting and standing, SCI can also cause problems with the nerves that control your organs and those that communicate sensation.

Depending on the location of your injury, bladder control may be among the challenges after your injury. When the nerves that control your bladder don’t work the way they should, the condition is called neurogenic bladder.

About 80 percent of patients with SCI experience some form of neurogenic bladder and regaining bladder control consistently ranks as their top quality of life priority. [2][3]. Aside from incontinence, a lack of bladder control can also lead to kidney problems, urinary tract infections, bladder and kidney stones, and a poor quality of life.[2]

Why does an SCI affect bladder control?

The nerves that control your bladder originate from an area at the base of your spinal cord called the sacral micturition. These nerves signal the brain when the bladder needs to be emptied. They also control the sphincter, a muscle at the base of your bladder that acts like a valve – it tightens to keep urine from leaving your bladder when you don’t want it to. When you urinate, your brain signals the sphincter to relax and for muscles to squeeze your bladder, helping to vacate your urine.

If you have a spinal cord injury, communication between your brain and this area of your spine (sacral spine) is totally or partially blocked, since in most cases your injury site will be above this point. With a SCI, only areas above the injury site function as they did prior to the injury.

What is neurogenic bladder?

When your bladder and brain are communicating correctly, the muscles and nerves of the bladder work together to hold and release urine on command. When this communication is blocked by an SCI, the bladder muscles may remain permanently relaxed. You will have no sensation that your bladder needs to be emptied, and incontinence – an inability to control urination – is the result. Conversely, the muscles may be tight, and you may not be able to empty your bladder without the help of a catheter. Both of these are symptoms of neurogenic bladder.

Symptoms of neurogenic bladder

  • Frequent urinary tract infections (UTI)
  • Kidney stones
  • Inability to control urination (incontinence)
  • Small volume when urinating
  • Frequent feeling of needing to urinate immediately
  • Loss of sensation that your bladder is full
  • Dribbling urine

These symptoms may be indicators of other conditions as well. Please consult with your health-care provider.

How to regain bladder control after SCI

There is no single solution that will work for each patient, but there are a variety of approaches your healthcare team can suggest to help you regain bladder control.

  • Exercises and therapy to strengthen bladder control
  • Medications to improve bladder function
  • Antibiotics to reduce the risk of infection
  • Botox ® injections into the bladder muscle to reduce the frequency of contractions
  • Emptying the bladder at regular times with a catheter
  • Nerve stimulation therapy to stimulate or slow down bladder activity (Percutaneous tibial nerve stimulation and sacral neuromodulation, also known as PTNS and SNS.
  • Surgery to remove stones or blockages
  • A procedure that places a cuff round the neck of the bladder, which can be inflated to hold urine or deflated to release it

To learn more about the spinal cord injury rehabilitation program at Good Shepherd Penn Partners, please call 877-969-7342 or visit our spinal cord injury rehabilitation page.


[1] Spinal cord stimulation for the restoration of bladder function after spinal cord injury, Healthcare Technology etters, May 2020.

[2] Neurogenic bladder in spinal cord injury patients, National LIbrary Of Medicine, June 2015

[3] A Proof-of-Concept Study of Transcutaneous Magnetic Spinal Cord Stimulation for Neurogenic Bladder, Nature, August 2018

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Dec 19 22

(VIDEO) Sophie Borrelli Regains Independence After Stroke with the Help of Penn Medicine Rehabilitation

by Jon Brannan

On July 15, 2022, the unthinkable happened: 18-year old Sophie Borrelli suffered a stroke. Care teams at the Hospital of the University of Pennsylvania, Penn Medicine Rehabilitation and Penn Therapy & Fitness worked together to help her recover.

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