Osteopath in Guernsey Ricky Brown demonstrating Exercise Therapy

Exercise is Medicine

Osteopath and Exercise Therapist

Within the world of musculoskeletal therapy, different professions are often associated with certain styles and methods of treatment. As a healthcare professional, I am well aware that our education, biases and preferences inform the way we treat our patients, however, our common goal as professionals should be to help people get better and stay better.

Misconceptions about Therapists

One of the most interesting and contentious characteristics that divides musculoskeletal therapies is the predominant use of either passive treatment techniques (the therapist applies the treatment to the inactive patient ) or active techniques (the patient is required to participate in their treatment). The stereotypical perception of the Osteopath and Chiropractor, is someone who uses mainly passive, ‘hands on’ treatment, such as manipulation, while Physiotherapy is commonly associated with the use of more active treatment such as exercise therapy.

The reality is that a good therapist (regardless of their professional title) will be skilled in the application of both passive and active treatments and, better still, know when to apply them. As an Osteopath and Exercise Therapist, I believe that both passive and active treatment modalities are important components of any treatment plan, and that a well-rounded therapist will tailor the use of both to each individual patient.

Passive Treatment

Touch therapies have been a part of our medicinal armoury for thousands of years and probably have a number of physiological effects on the body. The skin is highly innervated with nerve endings, and passive treatment  can provide a rich sensory input to the nervous system that feels fantastic. Unfortunately there is a lack of evidence for many of the specific effects that techniques such as manipulation, mobilisation and massage claim to provide. Myths about joints being realigned and fascia being released have kept bone crunchers in business for decades, but thanks to rigorous research we now know that the ‘crunch’ or stretch is a very short lived sensation that changes nothing but may feel nice for a short while.

Passive treatment can be very reassuring for someone experiencing acute pain, so the judicious use of ‘hands on’ techniques can be a useful treatment tool. Unfortunately many of the aches and pains we now encounter as therapists are a result of other comorbidities and often associated with poor joint/tissue health, lack of movement, and poor general health. With this in mind, passive treatment isn’t the most effective way to resolve aches and pains that require people to move more, as opposed to lay down on a bed and be moved!

Active Treatment

One of the most fundamental skills of the musculoskeletal therapist should be the ability to guide and progress people through therapeutic exercise.The more we understand about movement and exercise, the more we realise it’s importance in pain management and injury rehabilitation (not to mention the myriad of other significant health benefits).  Therapeutic exercise reduces pain and enhances the recovery process after injury.  Orthopaedic surgery such as hip replacement is a great example, where voluntary movement is favoured over bed rest at a very early stage. Both the physiological and psychological benefits of graded exercise are also demonstrated in the treatment of more chronic conditions such as tendinopathy and persistent lower back pain.  individualized and structured exercise relieves pain, improves tissue strength and endurance, reduces healing time and protects the body.  In contrast to this, the sole use of passive treatment often results in treatment dependency and is, at best, providing transient pain relief.

The Marriage of Therapeutic Exercise and Osteopathy

Engaging people in individualized therapeutic exercise  is both an art and a science that takes into account an individuals physical ability, preferences, fears,  goals and lifestyle. This can be combined with the judicious and reassuring use of ‘hands on’ treatment such as manipulation and passive stretching, to provide a spectrum of treatment that can effectively resolve both acute and chronic pain, as well as a myriad of comorbidities such as obesity, depression, type 2 diabetes, arthritis and osteoporosis.

Musculoskeletal healthcare is changing, and we as professionals must now acknowledge that most of the aches and pains we encounter are a result of a persons lifestyle habits- poor sleep, poor diet, high stress levels etc. If we are to really help our patients we should be looking beyond the symptoms of aches and pains, and swim upstream to tackle the root causes such as excess weight, lack of movement, low energy levels and low self-esteem .

That said, if you’re repeatedly going back to your therapist and just being cracked, twisted, poked and prodded, you probably aren’t getting best healthcare your money can buy. Your manual therapy should be complimented with an individualized plan of eating, moving and resting that helps you recover better and keep you out of the treatment room.

Ricky Brown Health has been honed over the last 15 years  to provide a comprehensive  and bespoke service that combines manual therapy,  acupuncture, tailored exercise therapy and nutrition coaching to help people make a strong recovery from aches and pains, feel great and protect their health.

If you’re looking for an Osteopath that can help you get rid of pain and transform the way you  feel, look and perform,  get in touch to see how I can help.

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