Musculoskeletal and Manipulative Therapy
Spinal and peripheral joint therapy including mobilisation
Passive Mobilisation is gentle-to-firm small movements of a joint to improve range of motion and reduce pain. It can relieve pain generated at deeper joint structures as well as soothe spasm and pain in the soft tissue surrounding the joint.
Manipulation (in Musculoskeletal Physiotherapy terms) is a short, high velocity movement of a joint often associated with a ‘click’ or a ‘pop’ sensation. It can relieve stiffness and unlock joints that may have been locked due to injury and subsequent spasm. This technique is only used with the informed consent of the patient. Safety testing is a standard protocol when manipulation of a joint is indicated. Dramatic benefits can result with the use of this technique. Manipulation may be recommended for your condition however alternatives do exist if you have any concerns.
Manual traction is hands-on controlled, stretching of a joint to open up the joint space. This is commonly used in the neck region as well as the peripheral joints e.g. shoulder, elbow, wrist, hand, hip, ankle and foot.
Mechanical traction utilises a motorised mechanical device to apply longer, controlled traction treatment rather than hands-on techniques that have a shorter duration. Traction treatments are either applied on a constant or intermittent mode to a neck or lower back condition.
This is a hands-on technique that in this definition refers to the stretching of muscle and tendon structures. Methods of stretching can depend on the body part. Common methods include sustained stretches or ‘contract-relax-stretches’, also known as Proprioceptive Neuromuscular Facilitation (PNF) stretches. This method is commonly used to stretch the trapezius (neck/shoulder muscle), gluteals, hip flexors and hamstrings muscles.
Soft tissue techniques
MPPFG combines a variety of hands-on soft tissue techniques.
- Remedial massage
- Frictions. Short high intensity massage over a small area e.g. ligament attachments
- Trigger point therapy.Trigger point therapy.
- Myofascial release. Loosens tight and tense regions to help restore normal length and function to muscle/tendon units.
This involves the use of Eastern ‘hardware’ (acupuncture needles) within the Western Musculoskeletal model. This modality has been a valued addition to the modern physiotherapists’ toolkit. It is only used after informed consent from the patient, for the following main applications:
- Release of trigger points and tight myofascial bands. Very useful in tight shoulder muscles (trapezii), tight rotator cuff, tennis elbow, spinal muscles, gluteals, hip flexors, hamstrings and calf muscles.
- Tendon pathology (tendinopathy) where it is believed to stimulate the release of blood and cell products that can stimulate a healing response.
Exercise Programs for Musculoskeletal Conditions
A very important aspect of your successful treatment is the prescription of specific exercises that will assist your recovery. An even more important aspect is the active performance of these exercises!
MPPFG has the expertise to not only prescribe the exercises that are appropriate for your condition but also precisely manage the timing and progression of your exercise program. We also have the track record in designing programs that are executed by the patient for a speedy and full recovery.
Exercises that MPPFG practitioners prescribe are designed to meet the following goals:
Stretching of muscles, tendons, ligaments and joint soft tissue is undertaken to improve the available mobility and to reduce pain.
Activation of weak and disused muscles
Muscles not only weaken but can also shut down due to the body’s response to pain – a concept known as ‘pain inhibition’. This aspect of your exercise program requires advanced knowledge and careful management. It is also known as Motor Control Theory and involves low load exercises repeated regularly. You may benefit from state of the art technology such as Diagnostic Real-Time Ultrasound which provides images of the muscles you are trying to activate.
This technology has advanced the ability of patients to accurately turn on affected muscles and also the sequence of co-ordinated movements that need to be relearned for optimal outcomes. You will be referred into this service under MPPFG’s ‘Co-ordinated Care’ model if it is deemed appropriate for your condition.
This concept can apply to any region of the body but finds common application in the spine, pelvis, hip, and shoulder regions where muscle instability produces profound negative effects.
This aims to remove barriers to poor and often chronic drivers of poor posture so that physical comfort and function are enhanced and sustained.