Physiotherapy – manual therapy

Physiotherapy – manual therapy

Physiotherapy (manual therapy) is a detailed patient examination and treatment. The physiotherapist uses special holds and diagnostic and mobility techniques (compression, massage) directed at treating pain in muscles, ligaments, fascia, and joints, as well as teaching movement, breath and posture patterns. Often it is complementary to kinesiotherapy.

The goal of manual therapy is to relax the tissues and extend the range of motion, which improves locomotor functions and the patient's well-being. In addition, it is an incentive to start pain-free physical activity.

Manual therapy is recommended in acute and subacute spinal pain and post-traumatic or post-operative conditions in order to return to full fitness as before the injury or surgery.

The main indications for manual therapy include:

• muscle pains,
• spinal pain ailments, including spondylolisthesis and discopathy,
• migraine pains,
• bad posture,
• sciatica, brachialgia,
• neck pain,
• functional joint blockages,
• overload conditions,
• tension trunk pains and headaches

Contraindications

Contraindications to manual therapy include recent mechanical injuries to tissues, disease processes in the skin or surrounding tissues, including tumours, arthritis, fresh bone fractures, advanced osteoporosis, bone tuberculosis, blood coagulation problems, pregnancy, and lack of cooperation between the patient and the physiotherapist.

Benefits of physiotherapy (manual therapy):

• it reduces pain,
• it increases joint mobility and range of motion,
• it improves tissue flexibility and mobility,
• it reduces muscle tension.

Duration:  30 minutes

In manual therapy, it is essential to diagnose the health problem. The physiotherapist uses differential diagnosis, which involves the gradual elimination of the causes of musculoskeletal dysfunction.

At the appointment, a physiotherapist:

• takes a detailed medical history of the patient, including surgical procedures, posture defects, injuries, overload, and physical activity habits;
• analyses the patient's posture;
• performs a thorough manual examination of the selected area, which involves touching, applying pressure, assessing the skin condition and checking the tension of the tissues;
• use appropriate holding and pressing techniques to restore normal tissue tension, which consequently reduces discomfort and pain;
• provides recommendations for the patient, including exercises to do at home to maintain the effects of therapy.

The therapy is carried out on a special height-adjustable table. During the procedure, the correct position of the patient is important.

Techniques used to work with a patient during manual therapy include transverse massage, functional massage, deep tissue massage, compression mobilizations, joint mobilizations, and manipulations. The selection of techniques is personalised and depends on the patient's dysfunction and tolerance.

The first appointment is primarily to assess the patient's health. The number and frequency of appointments are determined by the physiotherapist in consultation with the patient after the first appointment. They depend on the type of dysfunction and the nature of the ailment.

• Physiotherapy (manual therapy) does not require any special preparation.
• It is a good idea to have the results of imaging tests of the spine (X-ray, MRI).
• A patient should also be ready to expose the area of the body to be treated.