A New Perspective on Manual Therapy

A New Era in Understanding the Human Body

Our comprehension of the human body’s mechanics is on the brink of a revolutionary transformation. The traditional model, which posits that we have 600 muscles functioning through tendons over separate ligaments that restrict joint movement, has long been our best explanation. However, this model is now outdated, obsolete, and grossly inadequate. All these elements are part of a single, integrated system known as the BARS (biomechanical auto-regulatory system), commonly referred to as the ‘fascial system.’

The old paradigm of vectors and levers explaining this system’s function is becoming obsolete. We now understand that fascia extends into and impacts all aspects of our cellular physiology and even our genetic expression. Future generations will grasp the mechanics of movement in an entirely different manner from what we have learned. Replacing our familiar yet flawed Newtonian biomechanics will be a more complex, Einsteinian world of relativity and uncertainty.

Touch is essential sustenance, and we live in a society starved of it. To meet the unique challenges of the 21st century—keeping ourselves and our children physically engaged in an increasingly virtual world—we will need all our skills in touch and movement. This includes a deep understanding of the neural and chemical systems, as well as the fascial system (BARS).

Addressing Chronic Pain: A Holistic Approach

When it comes to chronic pain, the location of the pain is rarely its source. Czech physician Karel Lewit astutely observed, “He who treats the site of pain is often lost.” His colleague, Vladimir Janda, conceptualized musculoskeletal pathology as a chain reaction, advocating for looking beyond the immediate area of pain to find the true source of dysfunction, often located far from the pain site.

The manual therapy industry has evolved to recognize that specializing in just one discipline or modality is insufficient to address complex pain conditions and sports injuries. The term “Integrated Manual Therapy” represents the synergy of multiple modalities and disciplines combined. This approach allows therapists to treat each client in a genuinely individualized manner, addressing the unique needs and complexities of their conditions.

As we move forward, embracing these new understandings and integrative practices will be crucial in enhancing our ability to manage pain and improve overall physical well-being.

The Evolving Art and Science of Neuromusculoskeletal Care

As the field of neuromusculoskeletal care continues to advance, it is increasingly evident that manual techniques are crucial in managing patients with related issues. However, what remains challenging to quantify is the influence of the clinician’s skill level on the treatment outcome. Most practitioners who employ manual techniques to address locomotor system dysfunction would agree that the practitioner’s expertise is paramount to the success of any treatment strategy.

Intuitively, a clinician with limited skills and a narrow range of methods is likely to be less effective, especially in complex cases, compared to a practitioner with extensive knowledge and proficiency. Among the various techniques, muscle energy techniques (METs) are some of the most valuable tools a manual clinician can possess.

In the words of Dr. Ida P. Rolf, the creator of Structural Integration, “First, put everything back where it belongs, then introduce movement.” This quote encapsulates a highly effective therapeutic sequence of manual therapy, meeting the essential criteria for successfully treating painful functional lesions.

Key Takeaways:

• Manual techniques are essential for managing neuromusculoskeletal issues.
• The skill level of the practitioner significantly impacts treatment outcomes.
• Practitioners with a broad range of methods and extensive knowledge are more effective, particularly in challenging cases.
• Muscle energy techniques (METs) are indispensable tools in a clinician’s arsenal.
• Dr. Ida P. Rolf’s approach emphasizes the importance of structural alignment before introducing movement, a principle that underpins successful manual therapy.

Effective Reduction of Neuronal Hyperexcitability in Chronic Pain Management

To significantly diminish the heightened excitability within the neuronal pool, it is crucial to interrupt the pain-generating stimulus until the neural memory associated with pain is entirely erased. For many individuals suffering from chronic pain, a serial deep-tissue therapy proves to be most effective. This approach involves clients undergoing sessions twice weekly.

By consistently applying this therapy, hyperexcited receptors that communicate with the central nervous system (CNS) can be calmed. This consistent treatment helps prevent the chemical activation of pain at its peripheral origin, enabling the brain to reassess the condition and often resulting in the alleviation of protective muscle spasms.

Improving the Understanding and Treatment of Low Back Pain

The differential diagnosis of low back pain remains a significant challenge for physicians. Despite advances in medical science, approximately 60-80% of low back pain cases are still deemed idiopathic, meaning their exact cause is unknown.

Exclusion of Structural and Organic Pathologies

Orthodox orthopedic and neurological tests are typically employed to rule out structural lesions (physical damage) and organic pathologies. Once these are excluded, the examiner faces the complex task of identifying other potential treatable sources of the pain.

The Role of Functional Abnormalities

In patients where structural and organic causes have been ruled out, the ability to identify and treat functional abnormalities of the musculoskeletal system proves to be clinically effective. By incorporating a functional diagnosis, physicians can significantly reduce the number of cases classified as idiopathic.

Clinical Implications

Including a functional diagnosis in the evaluation of low back pain helps in uncovering treatable sources that might otherwise be overlooked, leading to better patient outcomes and fewer idiopathic cases.

(Reference: DeStefano, L. in Greenman’s Principles of Manual Medicine, 2011)

 Discover the Pain-Free Movement Experience!

Embrace a Pain-Free, Active Lifestyle

I am deeply committed to fostering pain-free living and promoting an active lifestyle. My goal is to enhance sports performance and prevent injuries through a cross-disciplinary approach. This method integrates the sciences of Anatomy, Physiology, Postural Biomechanics, and Functional Movement, alongside a wide range of proven Structural and Functional Bodywork techniques.

The Holistic Connection

I firmly believe in the holistic connection between these fields. By leveraging a cross-disciplinary approach, we can tap into synergies often overlooked or misunderstood by traditional mainstream practitioners. This unique integration can unlock new levels of physical wellness.

Next Generation Physical Wellness

My vision is to expand and merge these disciplines into what I call the “Next Generation” configuration for physical wellness. This approach is grounded in:

• Structural Integration
• Functional Movement
• Pain-Free Movement Experience

By adopting this configuration, you can expect to:

• Sleep better
• Eat healthier
• Feel more vibrant
• Exercise more consistently
• Train more efficiently
• Perform at your peak

Live and Move Pain-Free

Join me in this journey toward a pain-free, active lifestyle. Have fun, train well, and experience the joy of living and moving without pain!

 

-JHB