Those in pain want an easy fix. Who can blame them? But relying only on pills or magical passive techniques typically won’t do if longstanding pain relief is the goal. To a fault, many healthcare practitioners tend to over-rely on passive techniques. Physical therapists are no exception. A passive treatment is one that is done to you with little to no participation on your part. Massage, manipulation, and therapeutic ultrasound are a few examples. Active treatments are those that you participate in such as exercise and certain types of manual therapy. Many passive treatments are effective in relieving pain. However, this relief is typically short-term when not followed by an active approach.
We happen to use a good amount of manual therapy at Move Physio primarily because we see positive outcomes from its use. However, we ALWAYS follow-up with active treatments to complement the manual therapy. For instance, manual therapy may help to reduce pain, increase range of motion, or improve functional movements. The next step is key. Once the threat of pain is decreased, reinforcement with movement and exercise will help maintain the improvement. Simply, the brain says to itself, “Hey… this isn’t so bad. I can do this and not have to report pain.” If mobility is gained through manual therapy, it is crucial to safely move in that new range so that the body adapts and learns how to control within its new expanded boundaries.
Physical therapy should not ONLY consist of ultrasound, heat, and stim. Unfortunately, this still occurs within the industry. Therapeutic ultrasound (the “magic wand”) is fortunately on the decline but some practitioners still use it. Most do it for 8 minutes for billing purposes. Nonetheless, research for therapeutic ultrasound demonstrates little to no effectiveness even with longer durations of 20-25 minutes of application.
It’s important that you evaluate the true effectiveness if you’re a patient of a clinic that performs purely passive treatments. You have every right to be an active participant in your healthcare. Need more information? Contact us and we will be happy to help.
John De Noyelles, PT, DPT, OCS, CSCS