Manual Therapy FAQs

What is manual therapy?

  • These are conservative techniques done with the hands. It includes deep tissue massage, stretching, and joint mobilization techniques to restore proper movement patterns. When combined with functional activities for rehabilitation it is the safest and most effective way to reduce and eliminate musculoskeletal pain.

Why do I have pain?

  • In mechanical pain syndromes there are three typical reasons a tissue is painful.
  1. Mechanical irritation is painful in and of itself. When the axis of rotation around a joint is altered because of movement dysfunction, irritation of tissue creates an immediate pain. This is pain that occurs only when a joint is in a certain position, like deep knee bends or raising your arm over your head. Only balancing the tensions around the joint will alleviate this problem.
  2. Mechanical irritation can damage tissue which leads to inflammation. The presence of inflammation causes pain that often lingers from hours to days after an activity. Medication that alleviates inflammation can help reduce the pain, but you must also remove the mechanical irritation to prevent a reoccurrence.
  3. Nerves must be free to slide past the surrounding tissues. If this does not happen tension on the nerve will stop the blood supply and create pain. Improving the ability of the surrounding muscles to lengthen as well as the nerves to slide past them will help this problem.

What is movement dysfunction?

  • There is an efficient way to move based on bone structure, muscle fiber orientation, and the pattern is rooted in our brain and spinal cord. However, changes in the body can prevent the most efficient way to move creating movement dysfunction. This includes a series of restrictions and compensations. Often, the compensation is the location of the pain.

What causes restrictions?

  • Restrictions to movement occur in a few different situations:
  1. A muscle is damaged. To protect the damaged muscle the body tightens that muscle and the surrounding muscles creating a restriction.
  2. After prolonged restriction a muscle is weak in the end-range. Even if you stretch the muscle, care must be taken to properly strengthen the end-range or else the nervous system will tighten the muscle back down.
  3. A joint capsule, the connective tissue surrounding a joint in all directions, can tighten down when not used through the full range.
  4. Nerves must easily slide past the surrounding tissue. If a nerve gets stuck to the tissue the muscles surrounding it will tighten down to protect the nerve from being damaged. However, this often ends up further adhering the nerve to the surrounding tissue in a negative spiral.

What activities cause the restrictions noted above?

  • Repetitive movements like running or throwing
  • Prolonged postures like sitting at a desk
  • Improperly rehabilitated injury

What cause compensations?

  • The body moves based on sensation. When your nervous system senses one of the restrictions it allows movement in a different area to achieve the goal. If you want your arm over your head, but your lat is too tight your mid back will arch further to allow your arm over your head. Often you will develop pain in your back but it is caused by a problem in your shoulder.

Do I have to be in pain? What is performance enhancement?

  • Restrictions and compensations from old injuries makes human movement less efficient. This means that greater effort and energy is required to achieve the same action. Our assessment will analyze your efficiency, our techniques will create easier and more efficient patterns, and we will show you exactly how to keep your improved state. This means your athletic achievements will be greater and your daily living will be easier.

What is an overuse injury?

  • Overuse injury is an improperly understood term. Typically, the prescription is rest because you “overuse” a tissue. However, it is not physiologically possible to overuse just one focal area without surrounding dysfunction. What really occurs is a series of restrictions create a compensation and the compensation is over-used. A better term would be a “mis-use” injury. Rest does not eliminate the restrictions, only proper rehabilitation and activity can eliminate the restrictions.

Do I have to come forever?

  • No. When going through a course of care, it is common to un-cover old injuries. Essentially, when an injury occurs a restriction and compensation develop. If not properly rehabilitated, these restrictions and compensations just create layers like an onion. As we delve into your specific case, we will often take a trip through memory lane as we deal with each layer. The end goal is to discharge you from care with the knowledge to keep yourself moving efficiently for years to come.

How many visits will I need?

  • It is impossible to accurately predict this without evaluation of your specific case. The rapidity of your success hinges on a few factors:
  • The duration and extent of your current injury
  • The number of past injuries that were improperly rehabilitated
  • Your adherence to the home rehabilitation activities
  • Your age, diet, and mental stress levels

Compliments of our friends from The Stay Active Clinic in Asheville, NC.