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Manual therapy

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There are several techniques that make up manual therapy. These include:

Strain/counter strain

Strain/counter strain is 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 physical therapist uses their 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. Strain/counter strain 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.

After a strain/counter strain 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 to 2 days following treatment due to the release of waste products from the trigger points.

Conditions that can be treated with this technique include 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, ankle sprains, and balance issues and vertigo.

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. Muscle energy techniques are used to treat somatic dysfunction, especially decreased range of motion, muscular hypertonicity and pain.

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.

Muscle energy techniques can be employed to reposition a dysfunctional joint and treat the affected musculature. Indications include muscular shortening, low back pain, pelvic imbalance, limited range of motion, somatic dysfunction, respiratory dysfunction, cervicogenic headaches and many others.

Myofascial release

Myofascial release (or MFR) is a type of physical therapy often used to treat myofascial pain syndrome, a chronic pain disorder caused by sensitivity and tightness in the tissues that surround and support the muscles throughout your body. Myofascial release focuses on reducing pain by easing tension and tightness and by stretching and relaxing the fascia.

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. This tissue can become restricted due to disease, overuse, trauma, infectious agents or inactivity, often resulting in pain, muscle tension and corresponding diminished blood flow.

During MFR, our physical therapists will locate pain points through the use of gentle palpation. After locating the hardened muscles, the physical therapist will loosen them one by one. When the tissue starts to relax, the physical therapist will increase the pressure and force that is applied. This method is repeated until the whole muscle is fully relaxed.

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

Joint mobilization is an effective treatment for joint stiffness, muscle guarding and pain. 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, meaning there is a decreased range of motion. Joint mobilization is a technique that can be used to treat these limitations.

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