This is part 1 of a 4 part blog post series on manual therapy (using one's hands to treat their clients). I like to keep my blog posts a shorter length as, personally, I find it difficult to read a lot in one sitting, especially at a computer screen. Manual therapy is part of what makes New Leaf Physiotherapy different, getting our hands to touch our clients and feel how they move.
As for the pictures in this post, I always try to give credit to the website in which I found them. In this post I took some pictures from achieves, I have some from the teaching I do. I have had some of these photos for 5+ years and got them from other physiotherapists who got them from other physiotherapists. Enjoy!
Back when I was a student going to Physiotherapy school, I read many different textbooks, articles, posts on the internet about manual therapy. Things seemed to be quite positive about the results of manual therapy with clients. I wanted to learn more about this “manual therapy”. Teaching assistants and professors would talk about how much better ‘manual therapy’ made this client or that client feel. It sounded good but I did not know what it was. In fact, there are many different ways to define “manual therapy”. I like to keep it simple. So to me, manual therapy is technique that is performed by a therapist on a client using their hands.
Notice that I did not say physiotherapist or physical therapist. There are a large number of manual therapy techniques out there. For example, massage therapists perform manual therapy every time they massage a client. Their hands working on the tissues, the skin, fascia and muscles to name a few, are being manually manipulated by their hands. The thought is to decrease the muscle tension on the sore spot and let it heal.
However, this is a physiotherapy blog, so I am going to write about physiotherapy manual therapy techniques. More specifically, the friction, soft tissue mobilization, mobilization and manips (manipulation). Although I am writing about only these techniques, there are many, MANY more techniques. For example, ART (active release techniques), fascial manipulation, cranial/sacral techniques are all different forms of manual therapy.
What is a friction or frictioning? A friction is a specific technique used when you want to target a very specific area. The target is usually one spot or along a tendon or ligament. The basic technique for performing a friction is using your second finger, pointer finger, while it is re-enforced by the third or middle finger. These fingers push down onto the sore spot and generally move perpendicular to the orientation of the fibre you are frictioning. One extremely important aspect of frictioning, is that the therapist’s fingers do not slide over the skin. The fingers stay in contact with the same patch of skin. If the therapist moves and slides their fingers over the skin, within a couple of minutes, the therapist and the client would both have blisters!
What kind of conditions can frictions be used for? Most different types of tendonitis’ (acute or chronic), muscle strains (acute or chronic) and ligament sprains (acute or chronic).
What is the goal of using a friction technique? The goal could be to; prevent scar adhesion, cause analgesia (pain relief) and increase blood flow to a specific spot.
More importantly, there are times when you do not want your therapist to use a friction on your injury. Some examples are skin breakdown over the area to be treated, neuritis (inflammation of a nerve), long term corticosteroid use or calcification of soft tissues to name a few.
In the next part of our series we will talk about STM, soft tissue mobilization!
If you have any questions about this technique or curious to learn more. Please reach out to us using our contact page.