Who it is for

The diagnostic therapeutic approach of Dr. Picotti is advisable in all situations and pathologies which involve the postural and proprioceptive system and the locomotive apparatus in general in any situation in which movement is involved. Broadly speaking, I can confirm that each pathology or trauma will have a more or less pronounced effect on the postural system.

This modification of the posture does not usually manifest itself immediately with specific symptoms except in situations of serious imbalance.
Normally, postural modifications occur slowly causing irreversible secondary damage to the locomotive apparatus

 

(such as the rupturing of a tendon, the wear and tear of articular cartillage or the onset of arthritis). We thus treat patients with problems and/or symptoms in the following areas: orthopedic-traumatological, pathologies in sport, neurological illnesses.

I would suggest, moreover, that such an approach should be the basis for better prevention in the search for the best possible balance for the body. Therapy sessions are strictly on an individual basis, independent of the method chosen. The programme of therapy is personalised during the course of rehabilitation based on the responses of each single individual.


Orthopedic traumatological pathology

Childhood scoliosis, curved spines or other dimorphisms of the skeletal apparatus, (flat feet, bow- leggedness, dysplasia or dislocation of the hip) in the adolescent or the adult; pathologies related to advanced age such as osteoporosis, osteoarthritis in its various locations (hip, knee, spine etc.); tendon, capsular, myofascial and muscular pathologies, both traumatic and degenerative in nature. Of significant importance is the approach to spinal disc pathology in its different locations and manifestations: sciatic, brachialgia, degenerative discopathy or discal hernia – so common in industrialized countries; not least, lumbago and cervicalgia; results or preparation for surgery on the limbs, the spine (reconstruction of the anterior cruciate ligament, prosthesis, discal hernias); fracture results

 

Pathology of sport

Thanks to the experience gained in the field, first as an athlete and then as a doctor, Picotti has worked with professional basketball and volleyball teams at an international level, with alpine and nordic skiers, tennis players and other sporting professionals. Sport exposes the subject to risks of muscular/tendon lesions and to the wear and tear of the articular cartillage which are secondary to the imperfect articular system. Too often we forget that the quality of the movement of the whole body, the economy and security of the physical movement in sport or in daily life are born of the control of the placement of the lower limbs (we are bipeds). A refined control of posture is the indispensible pre-requisite for an efficient execution of all movement. Before anything else we have to learn how to manage the force!!! Economy of movement may be the critical factor for reaching a high level of performance, both from the energetic perspective and from that of the mechanical stress which is created at the level of the more pressurized osteo-articular structures. Energy doesn’t get dissipated in compensatory and parasitic movements, but is managed with a clean and fluid gesture. Moreover, there will be minor osteo-articular, fascial and tendon arthritis, for the best rapport between the joints and their greater functional stability.


Neurological pathology

Results of stroke, hemiplegia, peripheral paralyses, Parkinson’s, ataxias or other pathologies where in any case there is a reduction in the motor capacity and the management of postural balance. Our aim will be to correct posture and to optimize the residual motor capacity, re-activating that important potential linked to a functional deficit in the proprioceptive-postural system constantly caused by neurological pathology and the reduction of movement. When we move the first task above all else is the management of being upright. If there is no direct damage to the subcortical system (basal ganglia, encephalic trunk, archicerebellum, marrow) the recovery of the management of anti-gravitational movement will allow for an improvement at the motor level of the subject with a neural lesion.

 

Prevention

If the postural stability is not refined, independently of its origin, there will be an inadequate articular-functional stability. In the presence of unrefined postural strategies therefore, even if our support structure (for example a lower limb) is anatomically healthy, a refined calibration of the stabilizing muscles will not be able to take place. This leads inexorably to a biomechanic overloading of the osteo-articular structures involved with the risk of muscular/tendon lesions, wear and tear on the articular cartillage and the intervertabral discs, secondary to the imperfect articular system. The first task of our body is to manage gravity, balance and being vertical Balance of the joints, of the postural system, of different sub-systems which interact in us to regain that “unstable” balance which is the homeostasis of the body and the mind. Balance is life!