Today I’d like to talk to you about how to choose a physio…..or more accurately, a manual therapist.
We see many patients who come to us from other allied health professionals including other physiotherapists, chiropractors and osteopaths. Frankly, we think the general standard in the skills of manual and exercise therapists is currently below par.
Quite often, the treatment is very recipe-like with little emphasis on reassessment and adjusting treatment to each individual’s needs. The complaints here are that “the therapist didn’t take the time to listen to what my problem was.”…….or….”I kept getting the same treatment every time in spite of my symptoms being unchanged.”
Other trends are around the use of general exercise to treat specific spinal segmental problems. Often, these issues require both SPECIFIC exercise prescription AND SPECIFIC manual therapy techniques, rather than simply general movement.
People often say that they are given a series of general exercises plus perhaps, some generic massage. Little effort is placed on actually moving the spine with emphasis on the specific directions of movement. It is only when repeated or sustained spinal movements are applied in the right directions (often with surprisingly astounding results…even in chronic conditions) does the realisation occur just what was missing in the previous course of treatment.
We see this pattern time and time again when we see people who have had previous treatment for a chronic pain.
So.……How do you figure out if the treatment is right or wrong for you?….. and….. How do you know if you’re getting the best care?
We’ve laid out some guidelines that we use as a framework for our treatments. We think they may help you find some direction in a jungle of many movement pathways:
- We assess you every session. We assess the effect of the previous treatment both in terms of movement (or function) and pain changes. We assess the effect of self treatment techniques that must always be prescribed to continue the improvement between treatments….or at worst, prevent worsening between treatments.
- We adjust your treatment techniques and your self treatment techniques promptly, if the condition is not changing.
- We expect a 30% improvement within the first four treatments. Also, we expect ongoing improvement consistently within each series of four treatments. When symptoms fail to change, we are quickly looking to adjust treatment.
- We always move your spine with manual therapy. Our treatment is NEVER passive (where you lie still and receive a pampering session). This is therapy….not a day spa.
- We teach you how to treat your own spine by learning how to apply specific gentle movement forces in SPECIFIC directions that clearly decrease your pain and improve your movement immediately. We encourage you to apply these forces proactively to prevent onset of pain and reactively when pain starts, so you can turn it off independently.
- We encourage you to use SPECIFIC spinal movement instead of drugs to turn pain off.
- We educate you about the mechanical reasons why you experience pain and how you can apply mechanical forces independently to supplement and enhance our treatment.
- We listen and question….and listen and question…..and listen and question some more throughout every treatment.
This all takes time. Each treatment session is 30 minutes. Most spinal conditions that have been present longer than 6 months will improve within four treatments over 4 weeks by at least 30%. If not, it is highly likely that the current treatment techniques are not effective and they are then changed.
This is what we believe are the basic foundations of good therapy. Add to that highly skilled and qualified therapists with years of experience and there you have the perfect recipe for quality manual therapy care.