What is a Physiatrist?

This article explains the roles and qualifications of a physiatrist.

Written by: Richard A. Staehler, MD
Article re-posted from: www.spine-health.com

A physiatrist practices in the field of physiatry – also called physical medicine and rehabilitation – which is a branch of medicine that specializes in diagnosis, treatment and management of disease primarily using "physical" means, such as physical therapy and medications.

Essentially, physiatrists specialize in a wide variety of treatments for the musculoskeletal system - the muscles, bones and associated nerves, ligaments, tendons and other structures – and the musculoskeletal disorders that cause pain and/or difficulty with functioning. Physiatrists do not perform surgery.

A physiatrist's treatment focuses on helping the patient become as functional and pain-free as possible in order to participate in and enjoy life as fully as possible.

A physiatrist can be either a medical doctor (MD) or a doctor of osteopathy (DO). A physiatrist may be referred to as a:

• Physiatrist
• Physical medicine and rehabilitation physician
• PM&R physician

Physiatry Training and Specialization

A physiatrist's training includes four years of medical school as well as four years of residency training. The first year of residency training focuses on internal medicine (general practice), and the following three years of residency emphasize specialty training.

After residency, further specialization and training is available through Fellowships in a particular field. A Fellowship is typically one to two years of training in a particular specialty.

Physiatrists may complete one of the following Fellowships that provide additional focus and training in particular forms of treatment:

• Spine - for treatment of back pain, neck pain, sciatica, and any form of pain or dysfunction that originates in the spine
• Pain management - for treatment of many types of chronic pain (e.g. back pain, fibromyalgia, arthritis pain). Physiatrists who specialize in pain medicine have additional specialty training in injections used to treat pain.
• Sports medicine - for sports injuries
• Brain injury (e.g. stroke) - for rehabilitation
• Spinal cord injury - for rehabilitation
• Pediatric medicine - for physiatric treatment of children under age 18

Physical Medicine and Rehabilitation Specialty

The specialty of Physical Medicine and Rehabilitation, or physiatry, is approximately 60 years old. Today, there are over 8,000 physicians practicing physical medicine and rehabilitation1.

Many PM&R physicians who treat back pain are part of a Spine Center or Spine Hospital, treating patients within a practice that includes other specialists, such as physical therapists, spine surgeons, rehabilitation specialists, and more.

Whether or not they work in a multispecialty spine practice, many physiatrists also serve to coordinate the patient’s care with a multidisciplinary team of other doctors and specialists, such as physical therapists, spine surgeons, psychologists, chiropractors, and more.

Regaining life after stroke: Dr. Mary Kneiser and post-stroke rehabilitation

Mary Kneiser image credit: strokerehabonline.com

It is the utmost need of stroke survivors to get back on their feet and it’s the main duty of physical medicine and rehabilitation specialists like Mary Kneiser to help them fulfil this need.

Stroke is usually described as a ‘massive shock to the system.’ It is estimated that almost one-third of people who suffered from a stroke are left with physical and cognitive disabilities.

The effects of stroke vary according to its type, severity, and location. Regardless of what type of stroke a patient experienced, brain damage commonly occurs along with it, leading to the impairment of body functions. Though rehabilitation cannot totally eliminate the effects of brain damage, a recovery plan formed by a hospital’s stroke unit can significantly help people reach the best possible outcome. The road to recovery starts with a rehabilitation plan that’s tailored to the person’s needs.

Mary Kneiser image credit: buzzle.com

Dr. Mary Kneiser believes that the success of rehabilitation lies on the amount of time and effort rendered. A hospital’s stroke unit usually consists of therapists, including physiotherapists, speech and language therapists, and occupational therapists. A stroke unit can also tap into the expertise of dieticians, clinical psychologists, and advocacy groups in order to ensure that patients are getting the support to help them achieve the best long-term recovery.

According to Carole Pound of the stroke charity UK Connect, “stroke care is about giving the person who has had a stroke more choice and control and not necessarily independence.” He goes on to say, “Some people may never regain their independence, but it's important that they feel in control of their recovery.”

Mary Kneiser image credit: strokengine.ca

Read more about the duties of physical medicine and rehabilitation specialists like Mary Kneiser at this Twitter page.

Dr. Mary Kneiser: Debunking fibromyalgia myths

Mary Kneiser image credit: medicmagic.net

More than 6 million Americans suffer from fibromyalgia, a condition characterized by widespread muscle and joint pain and fatigue. Physical medicine and rehabilitation specialists, like Dr. Mary Kneiser, note that fibromyalgia is the most common musculoskeletal condition after osteoarthritis. Nonetheless, it is often misdiagnosed and misunderstood.

Below are some myths about fibromyalgia and the truth behind them.

Fibromyalgia affects only women and older adults.
Fibromyalgia strikes both sexes and people of all ages. Although it occurs in about 1 in 30 women, it also afflicts men, 1 in 200. Meanwhile, the risk of developing fibromyalgia increases as one gets older.

Fibromyalgia is caused by depression.
Fibromyalgia is not caused by depression. Anxiety and depression are among the symptoms associated with fibromyalgia.

Mary Kneiser image credit: uvahealth.com

Among the conditions treated by physiatrists, like Dr. Mary Kneiser, include spinal cord injury and musculoskeletal pain syndromes like fibromyalgia.

Fibromyalgia is not real.
Fibromyalgia is an illness recognized by healthcare professionals. Back in the 1800s, physicians wrote about “muscular rheumatism,” a condition characterized by fatigue, stiffness, aches, pains, and sleep disturbances. The current term was coined in 1976. Fibromyalgia is one of the most common types of chronic widespread pain.

Fibromyalgia is fatal.
Fibromyalgia is not life-threatening, but living with chronic widespread pain can be tough. With proper treatment, people with fibromyalgia can see symptoms improve.

Mary Kneiser image credit: abilityassessments.com

There is hope for people suffering from fibromyalgia. Rehabilitation specialists, like Dr. Mary Kneiser, can help those in pain. Visit www.abilityassessments.com for additional details.

Dr. Mary Kneiser: On backpacks and back pains

Mary Kneiser image credit: backpainpro.info

Back pains are usually experienced by adults. This is no surprise, given that their bones and muscles lack the flexibility present in younger ones’. But for Dr. Mary Kneiser and other physiatrists, this idea is becoming less true because many children and teenagers nowadays also suffer from back pains. One of the reasons for this is their student lifestyle, which most of the time requires them to wear backpacks.

Mary Kneiser image credit: bimmerboost.com

Backpacks are efficient for busy and enthusiastic students who frequently carry a number of books and educational materials around. But if not used properly, backpacks pose health risks to passionate students who are eager to learn. For one, if these are overloaded, they end up straining the students’ backs, necks, and shoulders.

From babble.com

The back continuously adjusts to any load applied to it. For this reason, as Dr. Mary Kneiser and other experts in the physical medicine and rehabilitation field believe, heavy backpacks cause the natural curves in the middle and lower back to distort, leading to muscle strain and irritation of spine joints.

Mary Kneiser image credit: modernmom.com

Likewise, when students tend to carry their backpacks over only one shoulder, muscles start to become overworked as they try to compensate for the uneven weight.

With this, parents should guide their children on how to properly use their backpacks. School officials should also consider toning down the amount of materials they require students to bring every day. They should take in mind that they are responsible not only for the students’ mental and intellectual state but also for their physical condition.

Learn more about Dr. Mary Kneiser by visiting www.abilityassessments.com.

Dr. Mary Kneiser: Managing stress fractures in athletes

Dr. Mary Kneiser is a board-certified physical medicine and rehabilitation specialist.

Summer is extra special this year with the staging of the London Olympics. With more than 10,500 athletes competing in 26 events, the spotlight is on the sportsmen and women who will be competing for their country’s pride.

But amid all the pomp and glory surrounding the Olympics, there is another facet of such sporting event, which is literally painful for athletes. Rehabilitation specialists call this stress fracture.

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Stress fractures are overuse injuries of the bone. These fractures, which may be nascent or complete, result from repetitive subthreshold loading that, over time, exceeds the bone's intrinsic ability to repair itself. Physiatrists, like Dr. Mary Kneiser, explain that stress fractures commonly occur in sedentary people who suddenly undertake a burst of exercise with their bones not used to the tasks. In athletes, stress fractures happen to those who do extraordinary quantities of high-impact exercise, such as professional and amateur distance runners who run high weekly mileage.

Symptoms and treatment

Stress fractures usually have few symptoms. A stress fracture could present as a generalized area of pain and tenderness associated with weight bearing. When running, a stress fracture in the leg or foot will cause severe pain at the beginning of the run, moderate pain in the middle of the run, and severe pain in the end of the run.

Mary Kneiser Image Credit: Medicaldaily.com

Rehabilitation experts such as Mary Kneiser note that the foundation of treatment for symptomatic stress injury is activity modification. For most stress fractures, the period of relative rest may be expected to last from 4-12 weeks. Factors influencing the duration of the activity restriction include the anatomic site of the stress injury and the extent of the stress injury.

Mary Kneiser Image Credit: Newsatjama.files.wordpress.com

When getting back on your feet following a stress fracture, you must balance the need to return to sport with the need for safe healing. Rehabilitation specialists, like Dr. Mary Kneiser ,can help you do so. For more information about Dr. Kneiser, visit www.abilityassessments.com.

Dr. Mary Kneiser: Exercise for stroke recovery

Dr. Mary Kneiser is a physical medicine and rehabilitation specialist based in Michigan. Among her most common patients are those who suffered from stroke and have difficulty in moving and speaking.

Mary Kneiser Image credit: Newsatjama.Files.Wordpress.com

Stroke occurs when a blood vessel in the brain bursts, preventing the flow of blood and oxygen to the brain. When the brain fails to obtain blood and oxygen, it starts to die, making the patient at high risk for brain damage. Symptoms of stroke include having difficulty in speaking and walking, sudden vision changes, and severe headache.

Treatment for stroke depends on its type. However, recovery from stroke, no matter what type it is, requires living a healthier lifestyle which includes being physically active. For rehabilitation specialists, like Dr. Mary Kneiser, exercise helps stroke patients in regaining the ability to move affected parts of the body such as the arms and legs. Exercise also helps in building strength and endurance, and in eliminating some of the risk factors for stroke, such as excess weight and high cholesterol levels.

Mary Kneiser Image credit: Dailyperricone.com

Before patients can start exercising, they should first consult with their doctor to formulate a proper exercise plan that suits their current condition. In exercising, it is recommended to include aerobic exercises and resistance and strength training to improve coordination and balance, and to decrease muscle atrophy.

Though many people think that exercising after a stroke is difficult, it actually helps the body recover more quickly and provides long-term benefits that can prevent another stroke from happening.

Mary Kneiser Image credit: AbilityAssessments.com

To learn more about Dr. Mary Kneiser and her specialties in medicine, visit www.abilityassessments.com.

Mary Kneiser and iliotibial band friction syndrome

Iliotibial band friction syndrome has long been acknowledged as one of the most common lower extremities injuries in long distance runners. Physical medicine and rehabilitation experts, such as Mary Kneiser helps in developing rehabilitation regimens for athletes who have iliotibial band friction syndrome or “runner’s knee.”

Mary Kneiser Photo Credit: Medicmagic.net

The condition is caused by repetitive movement of the Iliotibial band, a thick band of fibers running from the hip region to the outer thigh region. When a runner performs continuous unbalanced exercises or activities, such as running only on one side of an uphill road or running in one direction on track, this causes the pelvis to tilt to one side, putting stress on the iliotibial band on the knee. Factors that may lead to incurring iliotibial band syndrome injuries include:

Mary Kneiser Photo Credit: running4women.com

• Overuse syndrome
• Sudden and abrupt physical activities, and increase in training intensity
• Overtraining
• Ill-timed return from injuries
• Faulty biomechanics or movement
• Training flaws

Mary Kneiser and other physiatrists state that there are non-surgical alternatives for treating or alleviating the symptoms of this condition. These include:

• Alteration of warm-up regimens
• Using exercise machines that produce less stress on the iliotibial band
• Using addition heel lifts to compensate for leg length discrepancies
• Cessation or limitation of certain activities

Mary Kneiser Photo Credit: www.remedies-for-natural-health.com

To avoid incurring this type of injury, runners should carefully choose their running shoes, and take time to properly stretch the leg muscles prior to engaging in long distance runs. It is also advised to rectify any training errors to negate possibilities of either exacerbating the injury, or to avoid incurring it.

For more information about Mary Kneiser, log on to www.abilityassessments.com.

Mary Kneiser and muscular dystrophy

Muscular dystrophy is a hereditary illness, and it causes progressive debilitation and degeneration of a patient’s muscular and skeletal system. Though there is still no cure for this condition, Mary Kneiser and other physiatrists provide patients with various treatments to improve their quality of life.

Mary Kneiser Photo credit: en.wikipedia.org

Muscular dystrophy is a condition that weakens the muscles of the body that help it move. People who are afflicted with MD have flawed genetic information, restricting the body from producing the dystrophin, the needed for a healthy muscular system. Over time, the patient’s body is debilitated to a degree that it loses the ability to accomplish simple tasks like walking or even sitting up straight. Among the more common types of MD include:

• Duchenne muscular dystrophy 
• Becker muscular dystrophy 
• Limb-girdle dystrophy 
• Facioscapulohumeral dystrophy
• Myotonic muscular dystrophy 

Mary Kneiser Photo credit: en.wikipedia.org

Physiatrists such as Dr. Mary Kneiser have determined that muscular pathology or dystrophy is a gender-locked disease, meaning that people who are most likely to develop the illness are males. Many females, though carrying the genetic abnormality, remain unaffected, and are unlikely to develop the disease. Their children, however, may develop the disease. Females who carry the genetic defect have a 50 percent chance of passing the disease to their offspring.

Mary Kneiser Photo credit: en.wikipedia.org

Though there is no cure for MD, specialists such as Dr. Kneiser recommend several modes of prognosis aimed at keeping the patient independent of machine aids and to prevent any complications that may arise from the patient’s weakening muscles. Among these treatments are:

• Assisted ventilation 
• Medications 
• Physical therapy
• Nutritional changes and supplementing 
• Occupational therapy 
• Corrective surgery  

Mary Kneiser conducts her practice at Ability Assessments, PC. For more information, visit www.abilityassessments.com.

Standing right: Mary Kneiser on back pain

Physiatrists such as Mary Kneiser state that proper posture prevents the onset of back pains.

Mary Kneiser Photo Credit: backpainpro.info

Most people pay little or no attention to the way they sit, stand, and walk. It is only when they feel back pain that they begin to think about having a correct stance. When a person is not standing or sitting properly, the back muscles are strained, and the spinal discs are heavily impacted. The discs wear out faster due to the uneven stress placed on them, and the cushioning effect of the discs is lessened. Most of the pain is centered on the lower back, where majority of the body’s weight is supported.


Physiatrists such as Mary Kneiser state that good posture habits can help in the prevention of muscle and lower back pains. Practicing good posture benefits the person in a host of ways, such as leading to improved nervous system functions, blood circulation, and digestion, among other things. To practice proper posture, certain steps can be observed such as:


Checking of the curves -- the stance usually becomes exaggerated with age; some muscles lengthen while some shorten. Some exercises can help both in stretching shortened muscles and tone lengthened muscles.

Developing posture awareness -- individuals should develop an awareness of the position of their bodies.

Mary Kneiser Photo Credit: bhls.wordpress.com

Doing posture checks -- checking one’s stance at several intervals during the day

Doing several simple posture exercises every day

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Want to know more about Mary Kneiser and proper posture? Follow Dr. Kneiser’s updates on Twitter.

Mary Kneiser: Remediating the effects of Parkinson’s disease

Parkinson’s disease (PD) is not the end of life. Noted physiatrist and physical rehabilitation expert Mary Kneiser, MD, offers therapy programs designed to help patients adapt to the changes attendant to PD, thereby reducing the emotional and physical pain resulting from the disease.

Mary Kneiser Photo Credit: Scienceinclusive.com

According to the National Institute of Neurological Disorders and Stroke, the disease belongs to a category of conditions known as “motor system disorders,” resulting in the stoppage of the production of dopamine in the brain cells. Parkinson’s disease has four prime symptoms:


1. Trembling in the hands, feet, arms, legs and face
2. Rigidity (stiffness in the trunk and limbs)
3. Slowness of movement (bradykenisia)
4. Postural instability

Mary Kneiser Photo Credit: Nutritionalmagnesium.org

Should the condition prove resistant to medication, surgery is one of the avenues that doctors opt to use to relieve the effects of PD.

Dr. Mary Kneiser is recognized as one of the leading authorities in the practice of physical medicine and rehabilitation, owing to her numerous awards and accolades in her chosen field. She offers therapy programs to people with musculoskeletal injuries and motor function disorders, in lieu of surgical procedures, for people with neurological ailments, including those afflicted with PD.

Parkinson’s disease is considered to be a chronic and degenerative disorder, in that the condition is long term in nature and gradually increases in severity. Though the condition afflicts both sexes, the condition is more prevalent in males and is usually seen in people over 50 years old. In the United States, it is estimated that 50,000 people are afflicted with the disease each year.

Mary Kneiser Photo Credit: Sciencedaily.com

Compensatory treatment strategies: Noninvasive treatment for PD



Therapy programs cannot stop the onset of PD nor provide a cure. But with therapy, or compensatory treatment strategies, Kneiser states that patients with PD can learn to adapt to new techniques to help them move about and learn to use specialized equipment to help with mobility to compensate for the effects of PD. Patients are taught to adapt to the effects of the disease and reduce complications, rather than resorting to surgery, which may not be the best option given their weakened physical conditions.


Do you want to know more about compensatory treatment strategies and Parkinson’s disease? You can follow Dr. Mary Kneiser on Twitter

Losing control: Mary K. Kneiser and Parkinson's disease

Parkinson’s disease or PD is the most common movement disorder in the world. The condition has no cure, but physiatrists like Dr. Mary K. Kneiser offer therapies that can help patients cope with the changes brought by the disease, reducing the physical—and partly emotional—pain caused by PD.

From Mary Kneiser

Parkinson’s disease is a chronic and progressive disorder, which means that it lasts a long time and gradually worsens. First named in the 1800s, the disease is characterized by slow movement, shaking, muscle stiffness, and the impairment of balance, and can progress to total paralysis. Though it affects both sexes, it is more commonly seen among males and usually develops in people over the age of 50. In the United States alone, there are over 50,000 detected cases of Parkinson’s disease every year.

From Mary Kneiser

The therapy offered by physiatrists like Dr. Mary K. Kneiser cannot reverse the development of the condition. In fact, no drug or treatment can fix the damage caused by the disease on the brain. However, therapy or “compensatory treatment” can help patients learn new movement techniques and strategies, and the usage of special equipment that aid mobility. Therapists also teach individuals certain exercises that can loosen or return strength to the muscles.

Despite the absence of a cure, PD need not be the end for those who have it. Therapy can greatly reduce the pain caused by Parkinson’s disease. Physiatrists like Dr. Mary K. Kneiser can help patients regain control and be assured of a better quality of life.

From Mary Kneiser

More information is available at www.abilityassessments.com.

Mary Kneiser: Bracing yourself for orthotics

From Mary Kneiser

For physical medicine practitioners like Mary Kneiser, the word “brace” has meaning beyond its dental connotations. Orthotics is a medical specialty that uses a device called an orthopedic brace to aid in the treatment and recovery of musculoskeletal disorders.


This discipline combines many sciences, including pathophysiology, anatomy, mathematics, and materials engineering to create the specialized braces used to aid people with conditions like scoliosis.

Mary Kneiser, Google Images

Orthotic devices usually control the movement of a joint; they can also assist movement and aid in correcting the shape of the body to facilitate healing and promote pain-free movement. For the upper body, there are two types of orthotic devices that physiatrists like Mary Kneiser can recommend a patient to use:


• Static orthoses – do not permit movement and are used to provide rigid support for fractures, inflamed tendons, and other serious injuries

• Functional or dynamic orthoses – allow for a free to limited range of motion to help the function of weak muscles.


Braces can be made of plastic or composite materials, and are usually molded to the needs of the patient, although braces can also be bought over the counter.


It is recommend that braces should be placed on affected joints and appendages as determined by a qualified doctor. These areas include the spine, legs and knees, arms, and the hands, wrists, and feet. Choosing an appropriate brace, whether custom-made or off-the-shelf, can help bring back the functionality of a joint in relative safety and comfort.


More information on Mary Kneiser can be accessed at www.abilityassessments.com.

From Mary Kneiser