The Technical Side of Manual Therapy

Techniques can be therapist directed or by patient self intervention.  They may be passive, active assisted or active manoeuvres.  Procedures referred to as   mobilisation, traction, manipulation and high velocity thrust, are directed at the articular component to restore lost motion.

Muscle energy, proprioceptive neuromuscular facilitation(PNF),  soft tissue release, massage, muscle stabilisation exercise are those that refer to techniques aimed at restoring normality in the soft tissue.

Management  can include any of the procedures or may involve more comprehensive measures than previously considered and is not limited to just techniques.

Importance is also placed on the recognition of disorders not suited to manual therapy treatment.  This does not simply imply “non-mechanical“ disorders or pathological disorders requiring medical treatment, but disorders such as some chronic pain states which may have commenced due to an underlying mechanical cause.

Patients referred to manual therapy treatment when the nature of the disorder is not suited to physical treatment may become worse.  Some physical treatment which in another disorder would be painless may exacerbate the disorder and hence be detrimental.  It is thought this is due to non nocioceptive afferent information being processed abnormally.

Therefore although we have various treatment options, the most effective management strategy is always emphasized.

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