Physiotherapy is an evolving profession and prides itself in practicing in line with research and evidence based practice. Physiotherapy was once far more entrenched in manual therapy such as massage, joint mobilisation, stretching, myofascial release than it is today. The goal was to promote healing and relieve pain. Today physiotherapists have many tools in their belt to help patients with pain and recovery with manual therapy still hanging on by a thread.
If you look purely at the research it is difficult to support massage in the practice of injury prevention and rehabilitation. In a science driven profession such as physiotherapy it would be easy to suggest that it does not have a role in practice. With strong anecdotal support for massage and manual therapy, perhaps it is the challenge of how research is conducted that has led to these conclusions. In my practice I certainly find great benefits from hands on therapy.
In my opinion and through my experience, hands on physiotherapy or manual therapy has benefits in creating immediate change in pain level, in function, in movement availability, strength and also helps psychologically. To me it is a powerful modality. That said, it is important to understand that it is only one tool and one element of the recovery and rehabilitation process. I think of it as creating a window of opportunity to then push forward and progress with exercise or activity modulation through advice and understanding of what the patient is experiencing.
Physiotherapists, as I have said, have many tools and the skill of the therapist lies in choosing the right tool and the right time. They will assess your symptoms and presentation and may prescribe exercises for home or gym etc, provide you with education about how you can best manage the problem, they may help you with stretches, or tape you or they may do manual therapy with massage, or joint mobilisation, or dry needling. There are many, many options and combinations.
Physiotherapists have many tools themselves, but I think the network they build is also important. When a more hands on approach is needed than physiotherapy, we have massage therapists to call on. When supervised exercise is needed we have strength coaches and personal trainers. The list goes on - podiatrists, dieticians, doctors, alternative medicine etc. These relationships and networks are added tools and expand the expertise available to our patients.
For you, it is important to find a physio or other therapist that connects and listens to you and your needs.
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