Manual Therapy @ Ace Physio
An important component of Physiotherapy is Orthopaedic Manual Therapy, which is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. In manual therapy, Physiotherapists use their hands to put pressure on muscle tissue and mobilize/manipulate joints in an attempt to decrease pain caused by injury, disease, muscle spasm, muscle tension or joint dysfunction.
Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion in certain musculoskeletal conditions. This limitation can cause discomfort, pain, and an alteration in function, posture, and movement. Manual physical therapy involves restoring mobility to stiff joints and reducing muscle tension in order to return the patient to more natural movement without pain.
In conjunction with a prescribed course of manual therapy sessions, our Physiotherapist may also integrate other treatment modalities such as heat/cold, electrotherapy, and specific exercise. Consistent with our treatment philosophy, education plays an important role in restoring our patients’ correct functioning, allowing the patient to play a more active and integrated role in their recovery. Each treatment plan is customized to the individual patient as we work together towards a common goal of restored health
Explanation of Mobilizations / Manipulations
Mobilization/manipulations use measured movements of varying speed (slow to fast), force (gentle to forceful), and distances (called ‘amplitude’) to twist, pull, or push bones and joints into position. This form of manual therapy can help loosen tight tissues around a joint, reduce pain in a joint and surrounding tissue, and help with flexibility and alignment.
In any joint, there are two types of movements–one which can be performed actively, e.g. lifting your arm and movements which occur within the joints but cannot be actively controlled e.g. when the arm is lifted, in the ball socket joint of the shoulder, there are finer gliding–rolling movements of the ball in its sockets. These latter movements are called the accessory movements of joints.
A manual therapist not only assesses the active movements, but also these finer accessory movements. If any alteration of these accessory movements is found, it can be treated in a more holistic manner using manual therapy, thereby achieving quicker and longer lasting results. Also, for instance, in knee movements–to bend or straighten, there are gliding accessory movements of the knee–cap (patella) which assist the movement. In many conditions involving the knee–e.g. surgeries, arthritis, sports–injuries, if the normal patellar glide is not maintained, any amount of exercise will not achieve a pain–free and/or stiffness–free knee joint, and will require manual therapy.
Our spine as a whole has many movements, but none would have been possible if there was no movement between each spinal segment with its neighbors. A manual therapist achieves this interplay by applying manual theraby and mobilizing each segment individually and thereby assisting the whole picture. Hence, various conditions of spondylitis, herniated/prolapsed discs, nerve impingements, stenosis, and many other spinal conditions have been treated successfully by physiotherapists using manual therapy.
Explanation of Muscle energy techniques
Developed by an osteopathic physician named Dr. Fred Mitchell, the muscle energy technique is a non-invasive method of manual therapy. Muscle Energy Techniques are used to help with relieving pain, fixing joint issues, reducing edema and improving a person’s range of motion. It is based on reciprocal inhibition, which is a theory that describes how muscles react. Based on reciprocal inhibition, the muscles located to one side of a joint relax when the muscles on the other side of the joint contract.
During this form of manual therapy, an indirect type of pressure, referred to as anti-force, is applied to the muscle, facilitating the relax/contract effect and optimal stretching. Essentially, the muscle energy technique uses the patient’s muscle energy against anti-force, which is a stationary surface that the therapist provides. This enables the patient to stretch his muscle and the accompanying joint fully. The idea is that each contraction will stretch the muscle further.
The first muscle contraction in the muscle energy technique is referred to as an isometric contraction. This simply means that the muscle is made to work at a fixed length, even as tension builds. Sometimes breathing techniques are incorporated into muscle energy technique therapies. The breathing exercises may help the patient to relax during manual therapy.
Most practitioners agree that muscle energy technique can be beneficial for nearly everyone, from the elderly and highly irritable patients to athletes as a preventative measure against potential injury in the course of sports, because this form of manual therapy is very gentle. The most common candidates for this technique are those with limited range of motion because of pain.
Explanation of Pin (Anchor) & Stretch Techniques
(Comparable to Active Release Techniques or ART)
Pin (Anchor)and stretch techniques (comparable to Active Release Therapy) is a form of manual therapy often used by our Therapists as a form of treatment. As a group, manual physical therapy techniques are aimed at relaxing tense muscles and restricted joints in order to decrease pain and increase flexibility. In general, manual physical therapy techniques employ the following types of movement:
Pin and Stretch is a style of soft tissue based massage technique that treats problems with muscles, tendons, ligaments, fascia, and nerves. When performing pin and stretch our practitioners use their hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.
In a conventional stretch, most of the tension builds up at the end of the muscle at its junction with the tendon. With this form of manual therapy the therapist will pin a muscle, you replace the natural endpoint of the stretch with one you define. While maintaining this pin with external pressure, you take the muscle through a range of motion, putting the targeted muscle fibers under tension.