The text below is from one of my bibles “Manipulative Therapy” which was written by T H Hawes and V V Tucker – it still holds true today and, perhaps, explains why people come to me with their injuries rather than many other therapists. People know that I will (with few exceptions) get them moving pain free in a very short period of time and only see them the minimal number of sessions – rather than rip them off with an unnecessary number of visits, or excessive prices.
Soft tissue techniques – Deep Tissue Massage is undoubtably the ideal medium for preparing the body tissues for manipulative procedures. This is not the gentle stroking and rubbing movements employed as a comforting treatment in massage parlours, rather it is a deep probing technique using firm, rotary and other movements.
The practitioner’s fingertips seek and find spasm in deep muscles and, with pressure, stimulate blood flow to eliminate from the tissues the inflammatory deposits lying within the muscles and thus release muscle spasm before manipulating.
It is a well established rule that both patient and operator should be relaxed whilst deep tissue massage is given and it is the opinion of the writers that deep tissue work is an essential prelude to manipulation for two reasons:-
a) Any joint manipulation made with the surrounding musculature tightly contracted could result in straining or tearing of the muscles
b) An adjustment made against muscle tension is unlikely to be permanent as the contracted muscle is most likely to pull the joint into lesion again.
Manipulative techniques – Manipulation has its origins in the skills of the Bonesetter and some of the techniques used today are still those of the Bonesetter of bygone days. The Bonesetters techniques were widely used for both chronic and acute problems throughout Europe and the Americas with such a degree of success that it alarmed the members of the medical profession of the day. Despite a number of Surgeons (Paget, Mennell, Tucker and Cyriax amongst others) endeavouring to interest their brethren in manipulative therapy, and writing numerous textbooks on the subject, the subject was largely ignored by the medical profession whilst remedial therapists studied it carefully. Thus an extremely valuable therapy was left to practitioners of Complementary medicine.
Manipulation demands of the practitioner considerable anatomical knowledge and a great deal of skill and experience. He needs to be able accurately to locate a fixation and, equally important, he needs the ability to judge the strength, magnitude and direction of the adjustive thrust.
Over-treatment – Andrew Still (founder of Osteopathy), when discussing how to deal with lesions said, “Find it… Fix it… Then leave it” and B.J. Palmer (one of the original Chiropractors) said “You can adjust a man well… and you can adjust him sick again”. This shows that both of the professions agreed that you can over-treat an individual. One hears of patients with spinal problems attending an Osteopath (or Chiropractor) possibly up to ten or twelve times a month and have been subjected to spinal manipulation at each visit!