Manual Therapy Techniques | CB Physiotherapy Clinics

Many patients, who have never been to a physiotherapist, usually think that physiotherapy is all about doing exercises with equipment. Or it’s all about the use of electrotherapy and thermotherapy packs as a treatment intervention. Although all these interventions are utilized during the treatment program, manual therapy is a technique that does not require any modality to impart treatment to the patients. Many patients experience more value with ‘hands-on’ and less value with ‘hands-off’ approaches. Manual therapy a ‘hands-on’ technique is proven to speed up the recovery period by increasing the patient's range of motion, strength, and endurance. In this blog, we will discuss manual therapy, its benefits, and the various techniques of manual therapy used by the physiotherapist during the treatment program.

 

What is Manual Therapy?

Manual therapy is a form of physiotherapy delivered with the hands. It has an important place in Physiotherapy when used appropriately. Hands are used to put pressure on muscles, tissues, and joints to decrease pain caused by muscle tension, spasm, and joint dysfunction.

 

Benefits

·         Modulates pain

·         Reduces muscle tension

·         Increases relaxation

·         Decreases joint stiffness and ROM (range of motion)

·         Decreases inflammation

·         Improves tissue repair

·         Improves tissue stability and extensibility

·         Facilitates movement

 

Manual therapy techniques:

Manual therapy techniques can be helpful for the treatment of joints that lack mobility and ROM (range of motion). Manual Therapy is consists of a wide variety of techniques and some of them are:

 

Soft Tissue Mobilization

In this technique, the muscles are mobilized to break up the scar tissue. Mobilization also helps to remove the toxins from the damaged area thus increasing the speed of the healing process. Soft tissue mobilization helps to release the tension in the muscle causing an increase in flexibility and thus increasing the range of motion.

 

Massage

Massage is applied gently to the injured tissues to move the fluid which may assist in preventing adhesions. When massage is applied to the tendon it is kept taut and the muscle is usually kept in its shortened position when treating a muscle lesion, to separate the healing breach.

 

Scar Mobilization

A deep tissue massage breaks up the adhesions and the collagen fibers that are limiting the movement. Within the deep tissue, adhesions are broken down. The techniques used are friction massage, acupressure, trigger massage.

 

Myofascial Release (MRT)

Myofascial release technique (MRT), is applied by prolonged gentle pressure in specific directions, it may be used as an adjunct with any treatment prescribed to the patient. The treatment is given to treat the fascia which has become a tough connective tissue, under normal conditions it is like a gelatin substance.

 

Strain Counterstrain or (PRT)

Also known as positional release technique. It is a gentle technique used to relieve musculoskeletal pain and associated dysfunction, the treatment includes moving the patient's body passively away from the painful and restricted directions of motion.

 

Active Release Technique (ART)

Manual therapy is given to correct the soft tissue restrictions by breaking down the scar tissue and adhesions. The treatment helps to decrease pain, stiffness, and dysfunction. The patient is asked to actively move the affected muscle while the therapist maintains contact with the injured area, during the movement, the therapist can feel the structure as the therapist’s hands are in contact and thus effectively treating the restricted soft tissue structures.

 

Manual Lymph Drainage (MLD)

It is a gentle skin stretching massage technique that helps decrease various types of edema and also promotes the movement of lymphatic fluid out of the swollen limbs. The techniques used are static circles, scooping, pumping, and rotatory techniques.

 

Joint Mobilization

Passive traction techniques or gliding movements are applied to joint surfaces to maintain or restore the joint sliding, rolling, distraction, compression, and spinning, so that normal joint movement can occur as a person moves.

 

Joint Manipulation/Thrust/Mobilization

Passive skilled manual therapy techniques are applied to joints and soft tissues at varying speeds and amplitudes by using physiologic or accessory movements.

 

Muscle Energy Techniques

Muscle Energy Technique (MET) uses muscle's own energy in the form of gentle isometric contractions to relax the muscles. Types of contractions used in MET are isometric, isotonic, concentric, eccentric, and isolytic contractions.

 

Traction

The process of drawing or pulling. Traction is a manual technique is designed to reduce the pressure on the affected area, thus reducing pain.

 

A physiotherapist's extensive knowledge of anatomy, muscle physiology, and joint mechanics makes him highly trained in manual therapy treatment techniques. There is a specific technique for each type of injury and a specific part of the muscular system.  The physiotherapist is a trained professional who knows how much pressure is to be applied, where to be applied, how quickly to move, and for how long to do so.

 10 Benefits of Visiting a Physiotherapy Clinic

Do you often face the dilemma of not being able to decide whether or not to visit the clinic? Then, this blog is undoubtedly the perfect solution to decide that. As you know there is an increase in the number of new, advanced, and established personal physiotherapy clinics, hospitals, or rehab centers that provide treatment and care for patients with acute/chronic musculoskeletal, neurological, and cardiothoracic conditions. One of the most promising opportunities to improve care and functionality is through physiotherapy clinics. In these clinics, physiotherapy can be given by a team of therapists who are well-equipped and possess the technical know-how about the process. Clinical care can be a great way to start your journey of managing your health, mobility and achieve overall wellbeing.  Given below are the bountiful benefits of visiting a physiotherapy clinic.

1: Equipment and floor space: Most of the large equipment used for physical therapy is available in the clinic. Clinical care is the best option if you require special equipment and intensive therapy such as water aerobics, static cycling, etc. With the exponential advancement in technology and medical science, there is a wide variety of tools required for treatment that are easily available in the clinic. In case the therapist modifies the program, he/she can replace the current equipment with the other one. The clinic is a well-designed and spacious place, to meet the needs of the patients, so if more space is required to carry on the treatment program, he/she can do it easily.  Also, the treatment program may need ramps, railings, and chairlifts, which are available in the clinic.

2: Close monitoring and modifying: Clinical care facilitates close monitoring of the patient's progress and provides full opportunities for monitoring or modifying the patient's program, which helps in attaining the best and desired results. Most importantly by availing physiotherapy treatment in the clinics, the patient and the physiotherapist keep a track of the treatment process which ensures that the patient is getting proper physiotherapy care.

3: Provides support and motivation to the patient: The clinical program helps the patient to attend clinic sessions or requires regular attendance in the sessions. The therapists can support and control the exercises and modify them according to the patients' needs. With limited distractions and continuous support from the therapist, the patient gets motivated to do his exercises properly.

4: Decreased stress levels: A clinic is a place where a person mostly feels comfortable.  Sometimes having an outside influence can cause patients to feel comfortable and make them feel confident about their independence. Also, the interaction with the other patients can decrease their stress levels.

5: Feedback: The patient receives care in the clinic in every scenario.  Rehab centers and clinics provide all the care necessary to improve the patient's strength and function over time.  Though the needs differ from patient to patient so the treatment that works for one patient may not work for the other. The patient receives continuous feedback about the exercise, posture, and the way he/she is performing the exercises.

6: Geriatric care: When it comes to physiotherapy care for geriatric age, a clinic is one of the best options for many individuals and families. Because when the patient visits the clinic, he can meet a variety of other patients with similar or other problems giving them mental and physical support which helps them to maintain good health, both physically and psychologically.

7: Faster Progress: Considerable evidence has been gathered showing that continuous monitoring in the clinic gives good results and boosts the progress of healing. Because patients can perform exercises in a stress-free environment with their peer group, physical therapy sessions can be more focused and intensive. This is one of the benefits of being treated in a clinic.

8: Patient safety: There are no specific risks to patient safety in clinical settings. It is free of infection and maintains hygiene and sanitation etc. In the clinic, standardized methods for health aides, personal care aides are maintained

9: Cost-effective: Clinical care can be cost-effective i.e it can cost less. You could end up saving money in the long run by paying for sessions that are much more efficient.

10: Insurance benefits: Clinical care is less expensive. The patient should work with the insurance provider, to provide reimbursement. Although it's well known that the insurance companies will easily cover your care.

Thus, it is quite evident that physiotherapy has a lot of advantages, especially when it is availed in clinics. It also helps in the treatment of several conditions and helps to boost the patient's recovery.

 

Common Hockey Injuries | Prevention and Treatment

Field hockey is one of the most popular sport, with an injury rate of 6.3% per 1000 athletes. The mechanism of injury can be intrinsic or extrinsic, the extrinsic injury may be caused by a stick or a ball and intrinsic injury may be caused due to overuse or internal force acting on the muscles that include, shin soreness, tendonitis, plantar fasciitis, and many more. Being a fast-paced collision sport with non-stop furious action, players in this game are at risk of injury at any moment. They can sustain injuries to the head, face, shoulder, arm, thigh, and knee and to prevent these injuries the players need to ensure that the muscles and the joints are properly warmed up. These warm-up exercises should be done under the guidance of a physiotherapist. In this blog, we will discuss the common injuries suffered by field hockey players and tips for their prevention.

Prevention of Hockey Injuries

To help prevent or reduce the risk of hockey injuries the player should follow a proper conditioning training program.

• Proper Warm-up exercises like stretching should be done to prepare the body for activity.
• Wear proper protective gear.
• Maintain proper nutrition and hydration to help perform better during training and to heal faster after injury.
• Cooldown and stretching exercises should be done after the game.
• Proper Exercise programs should be maintained to build endurance and balance thus preventing injury.

 Common injuries in hockey players

Concussion

• Concussion is a brain injury the can occur due to a sudden blow to the body and head by a stick or elbow or by bone crunching. Symptoms may include headaches, dizziness, nausea, balance issues, mood changes, etc. Immediate medical advice is required in case of concussion. If a concussion is suspected, the player should not return to play until the symptoms decrease. The physiotherapist recommends rest in the initial days both mental and physical rest.

 Bruises and Contusions

• Contusions or bruises occur due to the rupture of the small blood vessels. Resulting in the discoloration of the skin, it might appear black and blue, due to the leakage of the blood under the skin. The player feels pain with a swollen red bruised area if it is a large bruise then immediate rest is the best treatment.

Whiplash injury

• Whiplash injury can happen by an abrupt or unexpected backward or forward motion of the neck. Falling suddenly or getting hit causes the head to jerk and the neck gets strained. It occurs commonly in contact sports, like hockey causing pain, numbness in the arms due to minor or major soft tissue damage to muscles and ligaments in the neck and vertebrae. The recovery of the player depends upon the severity of the injury.

 Acromioclavicular joint injury

• The prevalence of shoulder injuries is high in hockey. The most commonly seen shoulder injury is Acromioclavicular (AC) joint injury, also known as a shoulder separation. This injury occurs due to direct contact hit into the shoulder. The severity can vary from a sprain to a complete tear of the involved ligaments. The physiotherapy treatment includes immobilization by rest in a sling followed by isometrics and gentle ROM exercises.

Rotator cuff injury

• The most common cause of a rotator cuff tear is repetitive microtrauma, which can occur over some time. Bruising or swelling occurs due to the repeated rotator cuff injury by pinching or straining, catching, or squeezing the rotator cuff tendons. Physiotherapist focuses on reducing inflammation and pain. The therapist recommends ROM exercises, isometric exercises, and capsular stretching, followed by isotonic exercises and aggressive pain-free strengthening.

 Groin strains

• Groin or medial thigh pain is the most common injury in hockey players. The player feels tenderness and swelling. The strain of the hip flexors and adductors occur as a result of quick movements and change in the direction while playing. Initially, RICE is given. Gradually ROM, stretching and strengthening exercises including, active ROM exercises of hip and isometric exercises, straight leg raises (SLR), quadriceps are recommended. Followed by aquatic deep water pool running, stationary bicycling with no resistance.

Hamstrings injury

• A hamstring injury occurs due to a lack of flexibility, strength, and muscle imbalance of hip flexors, quadriceps gluteals, and lower back muscles.  Muscle imbalance and fatigue between hamstring, quadriceps, and gluteal. The injury also occurs due to a lack of warm-up exercises so the muscles are making it vulnerable to injuries. Physiotherapy treatment is directed towards the restoration of strength and flexibility of the muscles. After RICE, Isometric exercises are initiated, further replaced by isotonic exercises with light weights. When the player is pain-free.  a high-speed, low-resistance isokinetic exercise program is initiated with pool walking and stationary bicycle with no resistance.

Meniscal injury

• Medial meniscal injury usually occurs due to sudden rotation on a fixed foot. Damage occurs when the foot is partially flexed with the foot on the ground and rotational forces are applied to the knee. Lateral meniscal injuries occur less frequently than medial meniscal injuries. Damage to the lateral meniscus occurs when the foot is fully flexed with the foot fixed on the ground and both rotational and compressive forces are applied. Physiotherapy treatment aims to reduce pain and inflammation, maintain joint ROM, further improve strength, proprioception, and balance, using techniques like walking, running, squatting, and hopping and minimize chances of re-injury.

Anterior cruciate ligament (ACL)

• The anterior cruciate ligament (ACL) is the ligament in the front of the knee joint. Injuries to ACL occur most commonly in hockey, as there is a tremendous amount of side-to-side movement, cutting, pivoting movements, etc. An ACL sprain or tear occurs when an athlete turns while their foot stays on the ground. The physiotherapist recommends RICE and bracing. Followed by exercises for hyperextension- prone hang towel stretches, heel props, and wall slides.

 Shin splint

• Hockey players are often at risk of developing shin splints. This injury occurs due to the hard and unyielding nature of the artificial turf. Fascia, a connective tissue attaches along the edge of the tibia, when tension is put on muscles behind the leg, it causes inflammation or injury along this fascia. Repetitive bending and compression force may also cause bone stress. Physiotherapy aims to improve flexibility followed by isometrics exercises and progressed to Theraband practices and balance training.

Ankle strain

• Hockey puts a lot of stress on the ankles, causing ankle strain. This injury occurs when the ligament is stretched by rolling inward, causing a ligament tear. The damage can range from mild to severe. The patient feels immediate pain, swelling, and tenderness around the ankle. Physiotherapist instructs to take to RICE i.e. rest, ice, compress, and elevate. Followed by ROM, stretching, and strengthening exercises.

 Emotional stress can be caused due to pressure to win, sports are fun to play, and winning should not be considered as an important aspect of sports. Stress should be laid on being physically active and fit and above all feel good.