Ultimately, physical therapy helps the injured patient build muscle strength, increase flexibility and improve stability by working one on one with a trained professional. Strength training and weight is crucial to recovery, especially around the injured area, but also to the entire body. Initially, physical may make limited use of what is referred to as "modalities" to help treat pain. Modalities are considered to be a passive form of therapy as the therapist applies treatment to the patient but the patient does not exert energy to regain strength. This can include the use of heat, ice, and ultrasound to relieve pain so the patient can move quickly into more active, and constructive methods of rehabilitation, like exercise.
A manual therapist’s background typically begins with physical therapy education followed by additional training in spine. This specialized training distinguishes them from general physical therapists and can be within a host of manual therapy philosophies. Each school of thought involves unique, pain-relieving techniques that help patients return to function as efficiently as possible. Some of the spine-specific manual therapy skill sets are taught by schools such as McKenzie, Paris, Ola Grimsby, Cyriax and Maitland.
Manual therapy relates to the use of the therapist’s hands to achieve pain relief. Using specialized techniques, the spine therapist is able to provide pain relief through hands-on movements applied to vertebrae and soft tissue areas. The result is that pain relief is achieved not passively, with a modality like ice or heat, but through active movement of the joints and tissues.
A manual therapist works joints in a way that relieves pain and enables the patient to progress into the exercise gym. Although there are several schools of thought within the field of manual therapy, the most effective method involves the integration of several approaches based on each individual patient.
For instance, the Cyriax approach uses manipulation techniques to relieve back and neck pain. There is “low velocity, low amplitude manipulation,” involving slow movement over a small range of motion, and “high velocity, high amplitude manipulation,” in which movement is quick and covers a wider range of motion.
Perhaps the most mainstream and respected spine therapy technique is the McKenzie technique. Years ago, a New Zealand therapist named Robin McKenzie noticed that some back and neck pain symptoms were relieved through various specific stretches and movements. His treatment philosophy has since evolved into an entire therapy school. According to the McKenzie method, pain that may initially extend down a leg or arm can be centralized in the low back or neck. Ultimately, the pain will continue to shrink until, working with movement, it disappears. To become McKenziecertified, a therapist must complete numerous courses in evaluation and treatment techniques and then pass a rigorous certification exam. A certified McKenzie therapist is often able to relieve symptoms using special movements that arch or flex the back or neck. One of the most beneficial aspects of the McKenzie method is that the patient can learn the exercises and perform them at home.
Another therapy approach is called “spine stabilization.” This method maintains that back pain sufferers can control their pain by finding a painfree zone of movement and learning to hold the spine in this position to avoid injury. This can also involve retraining the patient in posture and walking techniques.
Regardless of the specific school of thought, the best spine specialized therapists do not use passive modalities such as ice or heat packs simply because passive pain relief methods do not have a lasting effect. The only way to permanently relieve pain involves altering the physiology of the back by using exercise to make the back stronger, more flexible and resistant to injury.
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