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Fast Pain Relief: Manual Therapy and Exercise

I was working with the Gilbert’s Gazelles training group at RunTex and had a great conversation with a patient about different types of treatment.  The runner/patient asked my opinion about her knee injury.  For the last year she has been getting treatment from another provider that consisted only of rehabilitation exercises and she did not feel that she was getting any better.   This greatly surprised me.  For one, I assume that all therapists use manual techniques (as opposed to only treating with rehab exercises) because manual therapy is proven to greatly speed healing.  And secondly, I am amazed that people (especially athletes) spend so much time and money getting treatment that is not getting them the quick results that are possible. 

• Manual Therapy- the use of physical “hands on” techniques to treat health problems. Manual therapy includes such treatments as massage, Active Release Technique, joint manipulation, trigger point and Fascial Distortion Model.

In my experience as an athlete and a sports doctor, patients with recent sports injuries can get better rapidly, in only a few visits with manual therapies, such as Active Release Technique.   But when rehabilitation exercises are used as the only treatment protocol, patients have considerably longer treatments and much slower recoveries.

The best way to treat most sports injuries is to first use manual therapy techniques and THEN to teach patients rehabilitation exercises.  Manual therapy is used first for many reasons, the most important of which is that it is the quickest method to reduce pain and get people back to their activity/sport.   Rehabilitation exercises are only then used to strengthen and stabilize the body after the injury is improved.  There is no point in strengthening and stabilizing tight and restricted joints, fascia or muscles (pain producing conditions).  At my office, we use various manual therapies, our favorite of which is Active Release Technique, on most patients to fix the cause of their pain.  We then teach exercises to help prevent recurrence and to reduce the number of total treatment visits required.