Before we begin a treatment we need to know about you – your current health, your past medical history, lifestyle, in addition to your current complaint. A case history is a discussion to find out about these points and help us direct our assessment and treatment. This could take 10-20 minutes depending on your current complaint and history.
After the case history I will need to examine you. You may be asked to remove some layers of clothing, change into loose clothing, or you can wear your own clothing that doesn’t restrict movement. Generally yoga or other sportswear works well.
I may perform some medical screening or orthopaedic tests to assess the health and structures that may be affecting your complaint. Then your posture and range of motion will be assessed along with some osteopathic tests. Some of the testing may be provocative, meaning it may cause the symptoms to increase temporarily to help make a diagnosis. The assessment and treatment often overlaps as I’ll be assessing and retesting throughout the course of the session.
In the treatment itself I can use a wide range of techniques but it all depends on what the problem is. Common techniques I use include:
- Soft tissue manipulation – this is specific massage to a muscle, tendon or ligament.
- Joint articulation – this is passively moving a joint to improve the range and ease of movement.
- Muscle Energy Technique (MET) – this is a contract-relax stretch that may be applied to a muscle or group of muscles around a joint. This is used to help improve the range of movement and sometimes gently strengthen specific areas.
- High Velocity Thrust (HVT) – this is a short, quick, usually low amplitude, thrust technique applied to a joint to reduce pain and restriction to that area.
- Visceral manipulation – yes our organs move! Sometimes they don’t move as well because of post surgery (such as C-section and abdominal surgery) adhesions, poor breathing or poor postural habits. Visceral manipulation aims to gently restore the movement lost because of these reasons.
- Trigger point therapy/Counterstrain – sometimes focal areas of pain and tenderness appear in a muscle for various reasons. There are a variety of trigger point approaches that can be used to help reduce the pain and restore function to the affected muscles.
- Cranial osteopathy / functional technique – these may have slightly different applications but they are both subtle techniques that aim to gently restore balance to an area.
Due to the nature of the treatment, you can sometimes feel some soreness post treatment. If this happens it usually subsides after 24-48 hours. Each case is different, some techniques are not appropriate for some patients, or in some parts of their body. The treatment aims, risks and expectations will be discussed.
I’m a big advocate of getting the patient involved in their recovery. Some of the techniques may just give you a temporary window of pain reduction and improved quality of movement. What makes the treatment more effective is using this as a window of opportunity to strengthen, improve flexibility, improve mobility, and retrain bad habits.
Some cases may just need 1-2 sessions to see an improvement, some chronic cases may take several months to see significant results. It depends on the case and what the patient would like to achieve. Some patients just want some pain relief, some want optimal health. I work with the patient to set realistic expectations, and a treatment plan to work together. Sometimes I may refer a patient for further investigations such as imaging (MRI, X-ray), or blood tests, or I may refer to other therapies to compliment the sessions and give the best possible outcomes.