If you are recovering from injury or surgery, there are two approaches to support your rehabilitation and recovery: manual therapy and exercise-based physiotherapy. In this article, we’ll explain the different approaches and consider their benefits in terms of pain relief, speed of recovery and overall rehabilitation.
What is manual therapy?
Manual therapy is where a physiotherapist uses their hands to manipulate and mobilise the patient’s joints, muscles and soft tissues. The aim is to provide pain relief and support the recovery process. During manual therapy, the physiotherapist identifies what is causing the pain and uses a range of techniques to treat it. Among the techniques used in manual therapy are massage and soft tissue technique (direct pressure to relax muscles and stretch tight fascial structures); pre-exercise stretching; and taping to relieve pressure on injured soft tissues and prevent reinjury.
What is exercise-based physiotherapy?
Exercise-based physiotherapy – also called therapeutic exercise – is where the physiotherapist creates an exercise programme to support the patient’s recovery and rehabilitation. These exercises are designed to stretch and strengthen the muscles around the injured area and to improve the patient’s mobility. As well as relieving pain and supporting rehabilitation, the aim is also to avoid re-injury.
What are the benefits of each approach?
Both approaches are widely used in physiotherapy and each approach has its own particular benefits.
Manual therapy is an effective way to:
- Increase mobility and range of motion
- Relieve pain and relax muscles
- Support rehabilitation by improving circulation and tissue repair and reducing inflammation
- Reduce the need for painkilling medication by treating the root cause of pain
Exercise-based physiotherapy empowers the patient to take greater control of their recovery and rehabilitation. It can help to:
- Improve strength, balance and coordination
- Increase endurance and reduce the risk of falls
- Relieve pain
- Improve mood, fitness and energy levels (enhance quality of life)
- Reduce the need for painkilling medication
- Strengthen and stretch the muscles to reduce the risk of reinjury
Which is best for me?
A rehabilitation programme is tailored for the individual, based on the type of injury, degree of pain and personal circumstances. Therefore, it is impossible to say definitively whether manual therapy or exercise-based physiotherapy is likely to deliver the best results for you. It is down to your orthopaedic surgeon and physiotherapist to make an assessment and devise a treatment plan based on your particular circumstances and goals. They will consider a range of factors, including the severity of your condition, your age and overall fitness levels, your general state of health, what you want to achieve (your goals) and what you would prefer. Based on this, they will recommend a treatment plan for you.
In many cases, a combination of the two approaches is optimum.
Manual therapy can be an effective way to get to the root cause of the problem and relieve tension in the affected area. It can help to prepare your body for therapeutic exercise, however, there are some circumstances where manual therapy is not appropriate so you should always listen to expert guidance.
Whichever approach you choose – or if you receive a combination of both – it is important to work with a qualified physiotherapist.
At Thames Shoulder and Elbow, we have devised a protocol which specifies a typical treatment plan for patients who have undergone surgery for a range of common injuries and problems.
For example, a patient who’s had elbow arthroplasty may stay in hospital for up to three nights post-operatively. In the first four weeks, we recommend exercises that encourage active flexion and passive extension in the sagittal plane only (separating the right and left sides of the body). The patient should avoid weight-bearing. Between four and six weeks they can perform light functional activities but no lifting. By week six and beyond, they will be able to carry out a full range of functional activities, however, we advise patients to maintain a lifetime lift limit of 3kg.
If you are undergoing upper limb surgery and would like more information about manual therapy versus exercise-based physiotherapy to support your rehabilitation, contact us.
Orthopaedic Consultant & Surgeon | London
Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).
Telephone: 020 376 15987
Email: admin@thamesshoulderandelbow.co.uk
Our Locations
Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Medical Centre, Chiswick – Directions
West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth – Directions
