Manual therapy consists of a variety of hands-on intervention techniques ranging from soft tissue mobilisation, joint mobilisations to joint manipulations. Manual therapy is a highly effective treatment method that can provide pain relief, improve range of movement and function.
When arriving to see a physiotherapist, you may have concerns as to what will happen over the course of your session. You may also wonder why and what the therapist is doing. In general, physiotherapists will utilise the following treatment techniques and tailor these to meet your needs.
Soft Tissue Mobilisation
Physiotherapists use various techniques that have an effect on the soft tissue. Deep friction techniques, myofascial release, and trigger point therapy are the common techniques used by our therapists to breakdown scar tissues, improve the extensibility of the soft tissues, enhance circulation, and encourage drainage.
The most common techniques are from Maitland and Mulligan. Varying degrees of passive mechanical pressure is directed at a particular joint, encouraging a specific movement in a specific direction. The movement aims to improve joint mechanics and/or correct joint positional faults. It also stimulates mechanoreceptors which helps to reduce pain. Because of their knowledge of joint kinematics, physiotherapists are able to facilitate small movements in joints to have a big effect in the overall range of movement.
Joint manipulation is characteristically associated with the production of an audible ‘clicking’ or ‘popping’ sound. This sound is believed to be the result of a phenomenon known as cavitation occurring within the synovial fluid of the joint, which is the rapid release of trapped gases in a high pressure environment similar to uncorking a champagne.
Maitland technique is a manoeuvre classified as a high velocity low amplitude movement. This technique is also commonly seen in the traditional barbershops, Thai massages, and chiropractics. It is known to provide good short term relief. There can also be rare complications that arise from this technique especially to upper cervical spine. The rapid rotary movement of the neck has the potential to shear an artery supplying blood to the brain, hence this technique is only performed by experienced and qualified physiotherapist with a prior assessment of the client to ensure safe, effective, and appropriate application of the technique.
Which of these techniques can best work for your condition?
Your physiotherapist will have to perform a consultation and physical assessment to determine the cause of the problem before choosing the appropriate technique that works best. It is also important to determine the pain pattern in terms of severity, irritability and nature of pain. Sometimes, it is a combination of a number of these techniques over a certain time frame which is required to achieve the best results.