Learn about common physiotherapy treatments.
What are physiotherapy treatments?
A “treatment” is what you go to physiotherapy for. After your assessment is complete, your physiotherapist will develop a treatment plan that usually has several components including education, therapeutic exercise and various passive treatment techniques.
Physiotherapists are most known for using therapeutic exercise as their primary form of treatment. To be completely clear, therapeutic exercise has the best scientific evidence supporting its use. While the “hands-on” techniques provided by physiotherapists can be extremely beneficial, physiotherapists are taught to always use therapeutic exercise in combination and as the primary form of treatment. Exercise is used in different ways at different times of the healing process. At first, you may not be doing much exercise at all!
What are passive treatments?
This section contains a lot of information about passive treatment techniques. Basically, a passive treatment technique is almost anything except for therapeutic exercise. They’re considered passive because you’re typically receiving some sort of treatment (ex. hands-on technique, needling, TENS) from a therapist and not actively engaged as you would be with an exercise program.
Passive treatments can be effective, but they have limited evidence for long term benefit. They do, however, tend to have better evidence supporting their use when combined with therapeutic exercise. For example, a physiotherapist may choose to mobilize a joint to improve its movement. If you were to do nothing after receiving the joint mobilization, your range of motion will typically return to post-treatment level after a short period of time. If you take advantage of your new range of motion and perform exercises to maintain it, the effects can be longer lasting.
Sometimes passive treatments are used to simply reduce pain. Many people come to physiotherapy in an immense amount of pain. It can hurt to do anything sometimes! Passive treatments can be excellent for reducing pain and when your pain is better, it is easier to move and perform the necessary exercises.
Learn a bit before you go for treatment.
You don’t need to know it all, but it is to your benefit to have a general idea of what is available for you. When your physiotherapist recommends a particular treatment, it is nice to have a general idea of what it is. There are several resources available in all of the articles so you can read on if you’d like. You can also check out your provincial physiotherapy college for more info about nearly all services available from physiotherapists.
Learn about all of the different treatments that a physiotherapist might use when you go for treatment.
Therapeutic exercise is part of the core education of all physiotherapists. Physiotherapists are considered experts in therapeutic exercise, which consistently produces the best scientific evidence for treatment compared to other treatment modalities and techniques.
Therapeutic exercise is specific movement meant to restore bodily function, which may include restoring movement and reducing pain. The effects of therapeutic exercise are far reaching and for more information, it is advised to read on.
Cupping is an ancient treatment technique and there are many traditional uses. Physiotherapists generally use cupping to treat the myofascial system (muscles and connective tissue). Many patients report improvement in muscular pain and range of motion immediately after treatment.
The cups work through a vacuum that is created between the cup and the patient's skin. Like other forms of treatment, their therapeutic effect is believed to occur by promoting circulation.
Intramuscular Stimulation (IMS) is performed by inserting dry needles (acupuncture type needles) into myofascial trigger points (muscle knots). Simply spoken, IMS works by 'resetting' the muscle to its normal resting state. When placed properly, the dry needles cause the muscle to twitch. After the muscle twitch occurs, there is a restoration of normal nerve activity, resting muscle tone and consequently, blood flow. By restoring the aforementioned, muscle pain and function can improve, as well as range of motion of any nearby joints. The effects of IMS are far reaching; the impact is has on the nervous system is used by many therapists to treat more than just local tissues.
Despite the long name, IASTM is a group of well known manual therapy treatments. Physiotherapists performing IASTM usually use a stainless-steel instrument to mobilize soft tissue; however, there are a variety of instruments available. Depending on the instrument being used, the intent of IASTM may be different. Therapists usually use the stainless-steel tools to treat fascia, which is a very strong tissue and is like a vacuum-seal around our muscles. By applying gentle pressure over skin with the instrument, practitioners try to target the fascia to reduce adhesions created by a healed/healing injury, improve circulation and promote healing. Instruments may be used for different purposes; it is best to discuss the treatment with your provider prior to commencing.
Laser stands for "Light Amplification by Stimulated Emission of Radiation". Light from a laser is of one color (monochromatic), parallel (collimated) and have the same frequency (are coherent). When this type of light makes direct contact with our body it produces a cascade of cellular reactions which are believed to improve tissue healing, relieve pain and act as an anti-inflammatory agent.
Medical Acupuncture or "Western medical acupuncture" is traditional Chinese acupuncture with the scientific method applied to it to explain its effects. Specific treatments and protocols that were derived from traditional Chinese acupuncture may be applied, but the theory driving the treatments may be different than what comes from Traditional Chinese Medicine (TCM). For more information go to read more.
Acupuncture can have many positive effects on all bodily systems. Therapists may use acupuncture needles on their own, or with electrical stimulation. Acupuncture may also be combined with other treatments for greater effect. Intramuscular Stimulation (IMS) is not to be confused with acupuncture. For more information read the article regarding IMS.
Muscle Release Techniques (MRT) form a broad manual therapy category on Physio Roots. There are several patented treatment techniques that can be categorized under MRT. MRT techniques aim to change muscle tone to improve range of motion, pain and overall function. Techniques can be performed many different ways depending on a number of factors. Some common techniques involve actively or passively stretching a muscle throughout range of motion, simply applying mechanical pressure to an area, having patients alternate between contracting and relaxing or changing joint position. Most physiotherapists practicing in orthopaedics perform some form of MRT on daily basis.
Inflammatory prolotherapy (proliferation therapy) involves the injection of natural substances into specific tissues within the human body. The goal of prolotherapy is to promote healing by creating mild inflammation. Prolotherapy is often used to treat stubborn tendon and ligament injuries. Physiotherapists may recommend prolotherapy for joint problems to help stimulate healing and promote stability.
PRP Injections (platelet rich plasma injections) are another form of prolotherapy. The patient's own platelets are concentrated using a centrifuge, chemically activated and re-injected into the patient at specific site/target tissue. Platelets are part of the natural healing process. After an injury, they migrate to the site to form a clot, release growth stimulating chemicals and to signal other cells to migrate to the injury site. These properties are taken advantage of during PRP injections, with the goal of maximizing the rate of healing of the target tissue. Like inflammatory prolotherapy, PRP injections are often recommended for poorly vascularized tissues such as tendons and ligaments.
Shockwave is the application of sound waves of very specific characteristics to the human body. It is believed shockwave improves healing by stimulating certain cells and chemical growth modulators within our tissues. Because of these effects. shockwave is most often used to treat tendons, ligaments and connective tissue. These tissues have poorer blood supply than most other tissues and consequently longer healing times. Therapists try to maximize the healing potential of the affected tissue by using shockwave to stimulate local cellular processes.
Physiotherapy is sometimes not the first profession thought of when it comes to spinal manipulations. The truth is, physiotherapists have been performing manipulations for as long as the profession has been around.
Spinal manipulations are simply a joint manipulation of a spinal joint. Joint manipulations are a very specific movement at a joint and can have a powerful effect on the body. Joint manipulations often have a loud cracking or popping sound associated with them. This sound can be explained by movement of gas molecules within the joint, otherwise known as a cavitation.
Manipulations have shown to release a variety of natural chemicals in our body that can have profound impacts on our nervous system and can effectively reduce pain and muscle tension. These effects tend to be short-lived; however, in combination with other treatments it may be possible to keep them around.
Why is Therapeutic Exercise at the top?!
You may notice the list is alphabetical, but we still stuck therapeutic exercise at the top. That is because out of all the treatments, therapeutic exercise provides the most benefit, especially in the long term. Physiotherapists are taught to use the other treatments as an adjunct to therapeutic exercise, which consistently produces the best research results.