At your Initial Consultation, your physiotherapist will perform an in-depth interview and physical assessment in order to determine the source and nature of your problem. He/she will then choose which evidence-based treatment technique they deem most appropriate for you, taking into account your current presentation and your past history of injury or treatment reactions. This choice of treatment technique, and how it will be specifically applied, will also be influenced by a number of factors, including how acute, chronic or irritable the injury is AND which structures appear to be involved. A combination of these techniques will be used in instances where the physiotherapist decides that this will maximize the recovery response.
Listed below are some commonly used physiotherapy techniques (Click title to expand):
Electrotherapy is a particular form of physiotherapy treatment used to repair tissues, reduce pain, stimulate muscles, improve sensation and build muscle strength. Patients often recall electrotherapy as the physiotherapist’s use of “machines” as part of their treatment. There are several different forms of electrotherapy available to physiotherapist, including ultrasound, Interferential therapy, Transcutaneous Electrical Nerve Stimulation (TENS), Laser and electrical muscle stimulation (EMS).
- Ultrasound uses high frequency sound waves to facilitate the body’s natural healing process.
- Interferential and TENS treatments involve introducing electrical impulses into the body via electrodes. This is done with the intent of reducing pain by directly stimulating nerves in the targeted area and will be felt as a tingling sensation by the patient. In the case of Interferential therapy, the electrical impulses can also promote cellular healing.
- Laser therapy is a form of phototherapy which involves the application of monochromatic light over tissues to elicit stimulatory or inhibitive reactions within these tissues.
- EMS is the use of electrical impulses to stimulate motor nerves and, subsequently, muscle contractions. This can be of assistance where there is obvious muscle wasting and weakness or in more extreme cases such motor nerve injuries.
Electrotherapy modalities are often used as an adjunct to manual therapy. Combined with the latter, the combined treatment more effective than each on its own. Ask your physiotherapist today whether electrotherapy can be of benefit to you.
Manual therapy consists of a variety of hands-on intervention techniques. These include mobilisations of soft tissue, joints and neural tissue. In some cases, joint manipulations can be utilised. Overall, manual therapy is a highly effective treatment method that can provide excellent pain relief, improve range of movement and improving physical functioning.
Soft Tissue Mobilisation (including Massage)
Physiotherapists use various techniques to have an effect on soft tissue (including muscles, ligaments, tendons, connective tissue/fascia). Deep tissue massage, frictioning, myofascial releases and trigger point therapy are techniques employed by our therapists to improve the extensibility, elasticity and tone of soft tissues, promote the formation of “good” scar tissue, enhance circulation and encourage fluid drainage. Soft tissue mobilisation techniques can be applied at different depths, depending on which tissues are being targeted and, obviously, patient tolerance. Physiotherapists can use their hands, forearms and elbows to alter the strength of the massage.
The mobilisation techniques most commonly used by our physiotherapists are derived from Maitland and Mulligan teachings. Varying degrees of passive, mechanical pressure is directed at a particular joint, encouraging a specific movement in a specific direction. The gentle movement aims to improve joint mechanics and/or correct joint positional faults. It also stimulates mechanoreceptors, which helps to reduce pain. Because of their knowledge of joint kinematics, physiotherapists are able to facilitate small movement gains at implicated joints which then can lead to significant improvements in the overall range of movement of that body segment.
Joint manipulation is characteristically associated with the production of an audible ‘clicking’ or ‘popping’ sound. This sound is believed to be the result of a phenomenon known as cavitation occurring within the synovial fluid of the joint (the rapid release of trapped gases in a high pressure environment, similar to uncorking champagne bottle). Maitland has classified a manipulation as a joint manoeuvre of high velocity and low amplitude. This rapid and forceful end-of-range movement is complex and is associated with a degree of risk, especially when it involves the spine. Hence, this technique is only performed by experienced and qualified physiotherapists who are required to perform a pre-screening of the client to ensure safe, effective and appropriate application of technique. The technique involved should always be explained to the patient and all risks outlined clearly. The patient’s informed, written consent must always gained before administering this technique.