Earlier this year I attended an eight day Spinal Manual Therapy certificate course, run by Manual Concepts.
Manual Concepts are well known and respected in the physiotherapy field due to the volume of research they put out and their role in changing the field of physiotherapy. They also run a manual therapy course which physiotherapists used to refer to as a ‘manips’ masters. (A manip or manipulation is a high velocity mobilisation of the joint, typically causing that ‘crack’). But perhaps we should change the name in our minds. As a skilled, patient specific treatment, when performed to its best physiotherapy should be about more than just a quick ‘crack’ or two and some massage. These days, all the research is coming out in favour of ‘motor control’ – educating the right muscles to do the job for which they’re intended.
There are 640 muscles in the human body (some figures quote this as up to 850… this depends on how you count them and whether you include cardiac muscles, etc – some people also have vestigial muscles, left over from when we walked on all fours! Really!). There are also ligaments (attaching bones to bones), tendons (attaching muscles to bones), fascia (connective tissue holding it all together), discs and cartilage within joints, different types of joints, skin, viscera (your organs- eg kidneys etc) and of course your nervous system. All of these things can cause pain- so why assume pain can be cured with a simple crack or two? That’s not to say there’s not a role for specific manual therapy… far from it!
Manual Concepts (and research that’s been coming out for years) teach us that correct assessment to identify the joint/s at fault, followed by mobilisation, is still completely necessary. But what caused that problem in the first place? Simply treating the stiff area without addressing this is like keeping your garden weed free by mowing, rather than pulling the weeds out from the root. If you’ve fallen and broken your collar bone, then the cause is obvious- we’ll work on restoring range of movement to that shoulder and strengthening it again. But in many cases, pain builds over a period of time. Clients go to multiple practitioners, for x-rays and other imaging studies, take painkillers and carry-on. As musculoskeletal specialists, physiotherapists are in the best place to step in.
I adopt a problem solving approach – we can use modalities like joint mobilisations, massage, needling, tape and more to help with pain, while layering specific rehab and strength work on top to help prevent future set backs – there’s often not just one quick fix and no two people are the same.
In an ideal world, I would see clients early- diagnosing injuries, problem solving what’s causing your pain and providing the treatments which we both agree on (whether these come from any or all of my modalities: physiotherapy, Craniosacral therapy or Pilates/ exercises) . I can also advise and refer quickly to excellent practitioners to discuss those other aspects which can help you to live the best, most pain-free life possible!
So what were you waiting for again?!
Written by Suzanne Rath, Practice Principal, Wellness Embodied Cairns. Find us on 53 Sheridan Street.
Our team of Cairns physiotherapists and remedial massage therapists love treating complex pain and conditions which have traditionally been difficult to fix. Our vision is for Wellness Embodied to be a centre for excellence and the first port of call for acute and chronic musculoskeletal pains and aches. Our problem solving approach leads us to treat the whole person’s pain- not just a body part. We also have a You Tube channel, where we frequently update playlists with strengthening, stretching exercises and information- see our strength channel here.
