Manual Therapy

Manual Therapy covers a wide range of hands-on treatments.  Although very much ‘hands-on’ they don’t need oil/lotion applied so I don’t class them as massage techniques in this review.

Joint Mobilisations

Again, lots of different techniques have been developed over time, these are frequently used by chiropractors and osteopaths – they often use joint manipulations as opposed to just mobilisations.   Joint manipulation (sometimes referred to as “back cracking” or “joint cracking”) require specialist training as the techniques are generally more forceful and require more care and precise application.  There are occasions when I would refer someone for this type of treatment, generally if a joint does not respond to mobilisation treatments.  Works very well in the short term but normally for lasting effects a rehab exercise programme is needed.

I do use Joint Mobilisations in my work – trained in Mulligan & Maitland Grade I-IV for anyone thats interested – and I find them very effective for treating chronic joint stiffness and/or pain.     The theory being that any joint movement (and/or pain) can be affected by restrictions inside a joint between two bones.  Take a finger knuckle for instance – although it looks just like a hinge joint bending and straightening – when moving the two bones inside the knuckle are slightly spinning and sliding on one another.  If the two bones can’t do these subtle movements it can stop you bending your finger, bend at a funny angle or cause joint and muscle pain when you do try and move.

Causes could be chronic immobilisation of a joint, direct damage and scar tissue development within a joint, strength imbalances between the muscles acting on the joint or neurological stress/emotion which can stop you moving properly (guarding).

By applying direct pressure on one or both bones of a joint (in varying directions) healthy movements can be ‘restored’.   It was generally thought this to be a ‘mechanical’ phenomenon, but recent evidence suggests this is more of a neurological effect than biomechanical.

 

Positional Release Techniques or Strain-Counter-Strain (SCS) Techniques

Part of the musculoskeletal self-defence system is to protect a misused, over-used or under-used muscle by preventing further movement, perhaps going into ‘spasm’.   Any attempt to stretch the area can cause a reflex response that increases the muscle contraction (or at least maintains it) and create further pain.

A therapist can use PRT or SCS (same thing) to position a muscle into the direction of the contraction, ‘until the greatest position of ease and comfort is found’.  Holding this position for 90 seconds can have a ‘calming effect’ on the area, reducing the muscle spasm.  Staying totally relaxed, the muscle is then very slowly stretched beyond the previously restricted range.  This technique works best with acute or ‘new’ aches and pains.

Graduate Sports Therapist Mark Skoyles uses a variety of manual therapy techniques in his treatments if indicated. The are considered an extremely safe, non invasive, drug-free effective treatment for msculoskeletal pain. Book in for a consultation here.