Over many years a Musculoskeletal Specialist I have acquired many "Hands on" treatment techniques and skills. These include;
- Mobilisations of joints.
- Massage, including soft tissue and fascial release.
- Strengthening and mobilising Exercises.
- Postural Re-education/positioning.
- Gait Re-education and advice on appropriate walking aides, post injury and Surgery.
- Exercises and stretches.
- Interferential and Tens machines which I can loan out for patients to trial.
- Heat treatment with more traditional wheat bags or Pulsed Short wave.
- Shock Wave Therapy – for those difficult to treat chronic soft tissue conditions that have failed to respond to more traditional therapies.
- And of course reassurance and advice on how to rest or retrain your body in order to maximize recovery, i.e the Do's and Don'ts of your particular problem.
I have used simple hands on soft tissue massage as one of the most effective treatment techniques for muscle spasm and tension for years. Effleurage, wringing, hacking and deep pressure are all part of traditional massage repertoire. More recently, however, I have used a lot of fascial release to help patients with tight tissue, pain and movement problems. I have been on 2 John Annan courses and find these release techniques really useful. I also combine traditional massage with heat and stretches particularly in sports people.
Acupuncture Originated in China over 2000 years ago. The traditional Chinese medicine (TCM) model of this technique supports the concept of inserting super fine needles into the skin at specific points along lines of energy called meridians. This is believed to influence the levels of Qi (pronounced Chi) which is the body’s energy or life force. According to TCM any change in the flow or balance of Qi can cause disease, pain and disability by using acupuncture needles in certain specific points the pain or imbalance can be resolved and the body’s natural equilibrium restored.
I trained in acupuncture for pain relief. This method uses the traditional points and meridians but with an evidence based western medical approach in 2008 when in did my Foundation course in London. Scientific research has for many years backed up the effectiveness of acupuncture to decrease pain and many Physiotherapists worldwide are trained in this valuable technique and use it along other techniques too.
I would first assess you condition and before embarking on any of course acupuncture treatment to make sure it was safe to use in your case. The points used would be individually tailored to your pain and would be used as an evidence based treatment programme. All physiotherapists that use acupuncture are required to train to a recognised minimum standard and to adhere strictly to a mandatory number of hours of continued professional development.
Like many other physios I also use needles in the treatment of myofascial trigger points to relieve the pain of theses painful jelly beans of tension and pain, where the muscle fibres are in constant contraction and never switch off!
Exercises and Stretches;
I think these techniques speak for themselves. Improving muscle strength is important in supporting poor posture and weak arthritic joints not to mention everyday functional ability to perform the movements we need to work or play sport.
Identifying the tight muscles, fascia and ligaments that effect our movements and performance is also a vital part of good rehabilitation - after the pain of an injury has been overcome - and is also part of continued injury prevention.
I give both strengthening exercises and stretches as home work! And can provide written sheets as a reminder to patient who forget the correct technique.
I trained in London in the late 80s when a lot of Physiotherapists were trained in Maitland techniques of joint mobilisation. These mobilisation techniques are specific, isolated oscillatory movements that can increase the range of joint motion in stiff joints and help decrease pain on certain directions of movement. They are usually pain-free but may feel a bit uncomfortable. I use these techniques from time to time depending on the joint problem I‘m dealing with.
I use this common form of electrotherapy to help in soft tissue healing of injured muscles, ligaments and tendons. This pain-free treatment pushes sound energy waves into the tissues which helps stimulate the body’s natural inflammatory process to continue to resolve, and can have an effect on the alignment of collagen fibres (along force lines) during healing.
I am lucky enough to have invested in this new treatment modality. Used for those chronic soft tissue injuries that have failed to get better after the more traditional physiotherapy techniques have failed. It is great for chronic:
- Plantar fasciitis
- Trochanteric pain syndrome
The machine uses a high pressure wave of energy created by a ball bearing which moves back and forth in a metal barrel creating a shock wave of energy. Although some patients find this an uncomfortable treatment, its effects are well worth a few minutes of discomfort with 70% success rate in decreasing their symptoms.
Pulsed Shortwave Heat Treatment;
This may be considered a rather old fashion way of applying heat to the body’s tissues but its use was very popular back in the day. It uses electomagnectic energy to travel deeper into the tissues and create a heating effect. Whilst I may not use if for superficial heating of muscles and fascia (I usually apply a heat pack) It does have a place in the relief of deep arthritic joint pain and I have had great results with arthritic knee, hip and back pain.
Interferential and TENs machines
Both of these electrical therapy machines work in a similar way. By applying small electrodes to the patient’s skin and using 2 medium frequency currents to mimic the effects of a low-frequency current we aim to stimulate the Alpha nerve fibres and flood the Pain Gate( the nerve junction where pain impulses are carried up to the brain) with the body’s natural opioids- endorphins and encephalins. Whilst I use my own Interferential machine to help settle nasty acute pain in my clinic I am more than happy for my patients to bring in their own TNS machines with them, so I can give them a lesson on where to place the electrodes for best effect and a fiddle about with the dials and intensity settings to get the best pain relief out of their machine.
I'm trained to apply both traditional hard white sports strappings to support healing injuries and the more modern flexible Kinesio tape that has other applications like reducing swelling, as well as supporting healing tissue and preventing further injury. Its flexible structure and elasticity make it comfortable alternative to the more traditional white tapes we used to use.
I have a variety of patient information leaflets and exercise sheets and am always happy to liaise with your GP by writing reports or Discharge Summaries to make sure the correct action is taken.
Whilst it is preferable to see patients in my clinic, (as I have access to all my equipment) Home visits are possible at an increased rate.