Joint manipulation and mobilisation both refer to manual techniques where the therapist will move your joints to restore movement in them, however they are quite different. Mobilisation is provided within available range of the joint, usually at the end of range, and the force is generally applied slowly. These techniques are generally aimed at stretching the capsule or ligaments around a joint.
Manipulation (often termed “cracking”) is where the joint is moved at a high velocity but low amplitude at the END of a joints range, to increase it. The “crack” which is heard is thought to be the bursting of a gas bubble in the joint from the vacuum created. Essentially this technique produces a rapid distraction of the joint surfaces.
Muscle energy technique is a gentle technique particularly used around the pelvis and upper neck to normalise muscle tone and assist in realigning joint surfaces. It is completely painless and can be highly effective.
Myofasical release and massage involves stretching muscle and fascia around joints which can become tight, restricting motion or altering joint mechanics. This sort of therapeutic work differs from relaxation massage and will usually have some discomfort associated with it.
Dry needling and Western acupuncture. Though both of these techniques involve the insertion of a needle, they are quite different.
Dry needling uses the needle specifically to address muscle tightness and dysfunction. A needle is inserted into a muscle with the aim of producing a local twitch response. Studies have shown that this “twitch” is effective at normalising muscle tone, and restoring normal biochemistry in the muscle (stopping it from becoming a pain producer). It can be used on muscles that are too tight to loosen them, and that are too weak, to lift their tone. Whilst highly effective, this technique can be uncomfortable. All Movehappy Physiotherapists have received additional training in Dry Needling.
Western acupuncture is a technique in which needles are used to manipulate the pain relieving systems of the body by altering neuronal firing and the production of the body’s own pain relieving chemicals. This typically involves leaving the needles in for extended periods. It is minimally painful or uncomfortable. Dave, Will, Michael and Adnan are trained in this form of needle application.
In addition to needles applied during a session in physiotherapy, you might be offered press stud needles which can be left in over several days. These needles are aimed at producing the same effect as the above mentioned form of needling.
5. Indirect techniques – cranial, balance ligamentous tension, balance membraneous tension, strain-counterstrain
Indirect techniques – cranial, balance ligamentous tension, balance membraneous tension, strain-counterstrain are gentle osteopathic techniques used to take injured tissues into a position of ease (ie. away from the position of pain). Moving strained tissues into a point of ease or relaxation allows abberant nerve firing to decrease, fascial tension to unwind, and increase in fluid flow, resulting in improved joint or tissue function. These techniques are particularly effective on babies and children as they are very gentle and well tolerated both on the developing child and their immature nervous system.
Orthotic prescription. At Movehappy Healthcare we stock two types of orthotic; heat moulded and gait scan prescription orthotics.
Heat moulded orthotics are an off the shelf base that can be built on the spot, heated and then moulded to be specific to an individual. These orthotics are particularly useful for young children whose feet are still growing rapidly.
They are indicated in children with “growing pain” where those pains are coming from torsions of the tibia or femur, kneecap pain, shin splints and hip pain in particular. The cost of heat moulded orthotics is $110 per pair.
ICB prescription moulded orthotics are made by The Orthotic Group in Canada, the fourth largest manufacturer of orthotics in the world. To make these orthotics we take a digital imprint of the foot while the patient walks. Using this technology we can see where the areas of peak stress are. These orthotics are best for adults or for use in running shoes. The cost of the orthotic is $400 for one pair or $650 for two pairs. They can be made in varying shapes and sizes to fit into different styles of shoe (for example dress shoes versus sports shoes). These orthotics typically take two weeks to come in from Canada.