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Manual Therapy

Manual Therapy

There are several techniques that make up “Manual Therapy” these include:

 

Strain/Counter Strain

What is Strain Counterstrain?

An extremely gentle and pain-free treatment that will get rid of muscle pain, tightness, spasm, joint stiffness, and other “hard to explain” symptoms. The therapist uses his or her hands to guide the patient’s body and muscles into a position of comfort or ease that will decrease abnormal reflex spasms in your body.

 

Why does Strain Counterstrain work?

Strain Counterstrain works by correcting an overactive stretch reflex that exists in the painful muscle. This abnormal reflex causes the muscle to contract constantly, instead of just when it is needed. As a result waste products build up in the muscle and creates tender or “ trigger” points.

 

How was this developed?

In 1955 Dr. Lawrence Jones, DO discovered that positioning a patient for comfort could correct complex spinal disorders. The accidental discovery occurred after he helped a patient with severe low back pain try to find a comfortable sleeping position. After a brief period of experimentation, a position was identified in which the patient was completely comfortable. After a 20 minute trial in this position ( to see if this was a viable sleeping position) the patient was able to stand fully erect for the first time in 6 months. Shortly thereafter the patient made a full recovery.

 

What i can expect after Strain Counterstrain treatment?

You should have less pain and improved movement immediately following treatment. Even though the treatment is extremely gentle you can have soreness for 1-2 days following treatment due to the release of waste products from the trigger points.

 

What type of conditions does Strain Counterstrain help?

Many conditions can be treated with this gentle technique. The treatment has helped those with conditions that had previously failed physical therapy, chiropractic, massage, acupuncture, injections, and medications. The is a partial list of conditions that have been successfully treated with strain counterstrain: chronic pain, fibromyalgia, degenerative disc disease, bulging discs, headaches, heel spurs, low back pain, muscle strains, sports injuries, neck pain, myofascial pain, plantar fasciitis, rotator cuff injuries, carpal tunnel syndrome, tendonitis, tennis elbow, jaw pain, whiplash, some balance issues and vertigo, ankle sprains.

 

Muscle energy

What is muscle energy?

Muscle Energy Techniques (METs) describes a broad class of manual therapy techniques directed at improving musculoskeletal function or joint function, and improving pain.

 

How was MET developed?

Historically, the concept emerged as a form of osteopathic manipulative diagnosis and treatment in which the patient’s muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce. It was first described in 1948 by Fred Mitchell, Sr, D.O. Muscle energy techniques are used to treat somatic dysfunction, especially decreased range of motion, muscular hypertonicity, and pain.

 

Why does muscle energy work?

Muscle energy is a direct and active technique; meaning it engages a restrictive barrier and requires the patient’s participation for maximal effect. As the patient performs an isometric contraction, the following physiologic changes occur:

  • Golgi tendon organ activation results in direct inhibition of agonist muscles
  • A reflexive reciprocal inhibition occurs at the antagonistic muscles
  • As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion

There are peer-reviewed studies that have shown that muscle energy techniques can significantly decrease disability and improve functionality in patients with disorders such as low back pain.

 

What types of conditions can MET treat?

Muscle energy techniques can be employed to reposition a dysfunctional joint and treat the affected musculature. Indications include, but are not limited to: muscular shortening, low back pain, pelvic imbalance, limited range of motion, somatic dysfunction, respiratory dysfunction, cervicogenic headaches, and many others.

 

Myofascial release

What is Myofascial release?

Myofascial release (or MFR) is a type of physical therapy often used to treat myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder caused by sensitivity and tightness in your myofascial tissues. These tissues surround and support the muscles throughout your body. The pain usually originates from specific points within your myofascial tissues called “trigger points.”

Fascia is a thin, tough, elastic type of connective tissue that wraps most structures within the human body, including muscle. Fascia supports and protects these structures. Osteopathic theory proposes that this soft tissue can become restricted due to psychogenic disease, overuse, trauma, infectious agents, or inactivity, often resulting in pain, muscle tension, and corresponding diminished blood flow.

 

Why does MFR work?

Myofascial release focuses on reducing pain by easing the tension and tightness in the trigger points. It’s not always easy to understand what trigger point is responsible for the pain. Localizing pain to a specific trigger point is very difficult. For that reason, myofascial release is often used over a broad area of muscle and tissue rather than at single points.

 

How is MFR performed?

The point of myofascial release is to stretch and relax the fascia. The stretching technique is performed by the therapist. They are guided by your body’s feedback towards the firm compression on the muscles. The therapist estimates how much pressure is used, what direction the pressure will be placed and the duration of the pressure. Portions of the muscles are stretched one at a time.

Most of the time, people with myofascial syndrome are unable to verbalize where the sore spots are located. The trained and licensed therapist will be the one to locate the trigger points through the use of gentle palpation. After locating the hardened muscles, the therapist will loosen them one by one.

When the tissue starts to relax, the therapist will increase the pressure and force that is applied. This method is repeated until the whole muscle is fully relaxed. After that, the therapist will proceed to the next muscle. Trigger points may easily disappear with the use of myofascial release therapy.

A lot of myofascial pain syndrome sufferers have been relieved from pain and discomfort following this therapy. Intended to release the muscle tension that is found all over the body, myofascial release therapy is not an ordinary massage treatment.

 

What types of conditions can MFR treat?

MFR can be used to treat pain and increase mobility in patients with a wide range of conditions, including:

  • back pain
  • neck pain
  • fibromyalgia.
  • repetitive strain injuries
  • muscular imbalances

 

Joint mobilization

What is joint/spinal mobilization?

Joint mobilization is a skilled passive movement technique of the joint surfaces performed by a physical therapist to decrease pain or increase joint mobility. The result of an injury may be a loss of motion, contracture of connective tissue or resistance of contractile tissue to stretch. If left untreated the joint may become HYPO-mobile, motion may stops at pathological point of limitation. Joint mobilization is a technique that can be used to treat these limitations.

 

What type of conditions can joint mobilization treat?

Joint mobilization is an effective treatment for joint stiffness, muscle guarding and pain.

 

Why does joint mobilization work?

A small amplitude oscillatory movement can stimulate the mechano-receptors and decrease the transmission of painful stimuli at the spinal cord and brain. This same small amplitude movement can also bring nutrients to the avascular portions of articular cartilage helping to decrease the pain of ischemia. The gentle joint mobilization can also help to maintain nutrient exchange which can help prevent the painful effects of stasis when a joint is painful, swollen and cannot move through a full ROM.