Manual therapy

„Healing should be fast, safe and nice“, Hippocrates

Manual therapy is a system of diagnostic and therapeutic methods, designed for the normal structure and functioning of the muscles, achieved by doing special movements, not exceeding physiological amplitudes of the joints. Usually the manual therapy is given for healing, correction and eliminating the pathologic processes after diseases and various alterations in the spine, joints, muscles and ligaments. Manual therapy is also used in cases of:

• Functional blockade,
• Hyper mobility,
• Dysbalance of muscles,
• Not optimal way of movement.

Main components of manual therapy:

• 1. Relaxation,
• 2. Mobilization,
• 3. Manipulation,
• 4. PIR (Postizometrical relaxation),
• 5. Auto mobilization .

Mobilization

Mobilization is a method of manual impact, which allows gradually remove the functional blockade and the movements were possible without pain, also the manipulation would be possible afterwards (if there are indications). The mobilization is based on passive movements in fast or slow pace. Manipulation

Manipulation

Manipulation is a method of impact with hands, assuring sudden removal of the functional blockade, doing fast and short, limited amplitude displacements without pain. It is made in a position, when a maximum of joint movement amplitude is reached in advance. The manipulation is based on passive movements of low amplitude, usually the same direction as the direction of the movement mobilized.

PIR

PIR is a special method of manual impact, practically without any contraindications and giving the possibility for quick relaxation of the muscular tissue. The goal is stretching the muscle, also removal of the cramps and pain. The method is working on two modes – dynamic and isometric. During the dynamic mode the length of the muscle changes; during the isometric mode the degree of the muscle contraction is changed. The muscle, which has worked in the isometric mode (especially cramps) is at once relaxed well. Using this method, the patient should actively participate and perform the directions given.

Indications

After the analysis of the diseases of the patient, the conclusions show that there are lesions of the spine, which can be removed by a certain manipulation. In this case, if the object of the manipulation is not osteochondrosis and scoliosis, but the dysfunctions of the intervertebral movements, there is only one indication for manual therapy – decreasing mobility. The manual therapy gives fast and significant effect, providing the relations between the complaints of the patient and the condition of one’s spine are well determined.

Absolute contraindications

• Serious condition of the patient;
• Elderly age;
• Oncologic diseases;
• Acute arthritis;
• Impossible to reach the pre-tension;
• Impossible to reach the fixation;
• Diseases of blood and blood vessels;
• Injuries and bone fractures;
• Osteoporosis;
• Some anomalies of the cervical part of the spine;
• Rupture.

Relative contraindications

• Disc herniation (neurologic symptoms, reflecting the compression of the spinal nerve roots in case of the disc protrusion;
• In case of the instability II degree and organic blockades manipulations are not allowed;
• Pregnancy.

Complications

• Increasing of the pain in 24 hours period;
• Possible vegeto-vascular reactions to the manual therapy;
• Circulatory disturbances with developing clinics (weakness, loss of consciousness);
• Movement disturbances (paralysis, paresis);
• Fractures and dislocations;
• Death .

Dosage

Two sessions of manual therapy per week, in difficult cases – three. The medical course consists of 3 – 5 to 7 – 10 sessions. If the condition of the patient after 3 – 5 sessions of manual therapy is not getting better, it is not purposeful to continue manual therapy.