Manual physiotherapy involves hands-on techniques for assessment and treatment, while modality-based physiotherapy uses equipment and machines for therapeutic interventions.
When you havepain or movement dysfunction, your doctor may recommend Physiotherapy. It is important to understand that you stillhave many options within Physiotherapy and that the philosophy and approach ofthe Physiotherapist you see may be very different from clinic to clinic. Understanding more about the differentservices provided under Physiotherapy may help you decide which type is bestfor you. Manual Physiotherapy and modality-basedPhysiotherapy are the two types of treatment that need to be considered. You may also find some Physiotherapists thatdo a little bit of both types. Tounderstand the difference between each, when they are used, and which one isbest for you, we’ve put together this short guide to help walk you through bothapplications and other treatment options in more detail. We’ll alsooutline why Inertia Physio+ focuses on manual therapy, exercise therapy andneedling in our practice.
In manualPhysiotherapy, the Physiotherapist treats clients using skilled hand movementsto manipulate soft tissues and joints in order to improve range of motion andalignment as well as reduce swelling, inflammation, and pain. Techniques ofteninclude massage, stretching, moving joints in different directions and speeds(soft tissue or joint mobilization), along with resistance movements, muscleenergy techniques (MET) and active release techniques. It focuses primarily onthe joints and myofascial system and often starts with a soft tissue release toprepare the joints for mobilization and manipulation. Manual therapy is anevidence-based approach that is proven in research to be effective. It elicits quick and real results that wehave witness first hand for all our years of practice. We believe Manual Physiotherapy to be themost effective tool we have and that is why it is the focus at our clinic.
Exercise therapy has some of thestrongest support in research. Stretching has been proven to lengthen short muscles, thus maintainingand furthering the soft tissue release we achieve in treatment. Activation andstrengthening has been proven to support joints and allow proper function. Thisdecreases the stress on the area of injury in every day life or activity. Balance exercises have also been proven toaide in proprioception or the connections between the brain and the musclesthrough the nervous system. All of thesethings can have a very positive effect on supporting a joint or soft tissuethat is in an injury state. We also considerexercise therapy to be a must and therefore, combine it in almost all caseswith manual Physiotherapy.
The otherside to Physiotherapy treatment involves the use of modalities. There are a few modalities that have some strongresearch to support them and some that have not been well supported inresearch, but have been theorized to work in certain ways or at the very least,provide a placebo effect that makes you feel like you are getting better.
Thesemodalities can include ultrasound applications, electrical stimulation, heattherapy, ice therapy and needling to reduce pain, swelling, and aide in repair.Let’s look a little bit further into each type of application.
Ultrasound isa common modality-based application. It works by using a hand-held device thatproduces high and low-frequency sound waves over the injured area. These wavesare theorized to penetrate the tissue and muscles to provide heat to the areato improve blood flow.
Also known asE-stim, electrical stimulation is sometimes used to attempt to relieve pain andimprove activation. By placing electrodes on the skin, an electric current cantarget a single muscle or group of muscles. Two popular types of E-stim forpain control are TENS and IFC (Interferential Current). These modalitiesare theorized to cause a non-painful stimulus that is able to travel to thebrain faster than a painful stimulus. In this way, the stimulation disrupts theability to feel pain for the duration that the machine is on. Another type of E-stim is Muscle Stimulation.In this type of stimulation, the muscle is stimulated to contractinvoluntarily, thus aiding in the ability to activate voluntarily and thereforestart using a muscle more efficiently following an injury.
Dry heat andmoist heat packs are the two most common forms of superficial heat therapy. Theheat causes an increase in blood flow to the area, which may help to increasetissue elasticity and promote healing. This is a modality that can easily be applied at home with the advice ofyour Physiotherapist, thereby not using precious time with yourPhysiotherapist.
Cold pack applicationworks in the opposite way of heat therapy in that it reduces blood flow to thearea in which it is applied. By reducingblood flow, it can reduce swelling and inflammation in an injured area. The numbing effect as well as the reductionin inflammation can help to reduce pain. It can also allow you to move through greater range of motion in yourexercises by reducing inflammation and pain and allowing more freedom of rangeof motion. Physiotherapists will often use ice therapy in conjunction with heattherapy, where the heat will be first applied to enhance therapeutic exerciseand then ice after to reduce any potential inflammation. Cold and hot can alsobe used together in contrast therapy to create a blood vessel pump to pushswelling out. Research has been somewhatcontroversial in the area of use of ice versus heat. Stay tuned for a future blog post on thisvery topic!
Kinesiologytape can also be used to reduce pain and improve circulation and musclefunction. It’s simply applied to the skin for up to five days to allow forgreater movement of the lymphatic fluid that puts pressure on tissue and causespain. It can also be used to enhance proprioception and remind a muscle toactivate. Other types of taping techniques can be used to remind the bodyhow to move or protect an injured joint.
NeedleTherapy is also used to promote healing, improve function and reduce overallpain. Through stimulation on trigger points of the body, Physiotherapists cantrigger endorphins and pain-relieving hormones to relax muscles, increase bloodflow, decrease symptoms and restore balance. This topic requires more discussion and a future blog post as well!
At InertiaPhysio+, our views are based largely on research and what we have seen worktime and again clinically. We believestrongly in the power of manual Physiotherapy. As such, we spend dedicated time with our patients working one on onewith you and only seeing a maximum of one to two patients per hour. We do not have assistants that help us withmodality application, nor do we spend patient time setting up machines that areonly theorized to work. We prefer tospend our time hands on, doing manual therapy, as this is our strongestevidence-based practice, and is where we get a majority of our results. Manual therapy has and always will be our focus. It’s who we are.Empowering our patients with a strong exercise program to help maintain andfurther results is also of critical importance to us. We design a treatment plan unique to you,only involving the evidence based practices of manual and exercise therapyalong with the needling, taping and education on using heat and/or ice at homeas necessary. Throughout our time with you,we do our best to explain our findings and answer all of your questionsthoroughly. Through patient education,we aim to empower you to make the best health decisions for you.
If you after reading this information, you feel the same as we do,that one on one manual Physiotherapy with a focus on hands on treatment,exercise and education is the right choice for you, then Inertia Physio+ is theclinic for you. Our team of highlytrained professionals will assess your situation and suggest a treatment planthat will treat your pain and symptoms. We take your treatment seriously andwill ensure that you receive the utmost care and attention. We believe in ourtreatment methods, and we work aggressively with you to achieve the bestresults in the shortest time possible.
Book your first manual Physiotherapy appointment today by visiting us online or calling us at 613-672-2200.
