Here are 5 ways to maximize your manual/physical therapy.
1) Educate the patient about the technique
- patients are more likely to tolerate a manual technique if it's uncomfortable (different than painful) if they know why you are doing it
- their options
- what may happen if they choose not to have a certain treatment
- i.e. thrust manip vs mob, manip may improve ROM and pain faster for a few visits but in the long term will have the same effects
2) Always take pre-test and post-test measurements of motion/function
- one of my most important points during OMPT teaching is: if you're going to cause a patient some discomfort, there better be a demonstrable improvement afterward
- motion/function is easily measured, just choose one thing to focus on improving
3) Give 1-2 home exercises maximum to lock in the corrected and improved movement/function
- less = more, the patient is more likely to be compliant if they're only doing cervical retractions, or lower body rolling patterns until the next visit
- if they get worse, and you gave them 2-3 things to do, which exercise was it? Was it a combination? You may not know until you remove 2 of those things and that was a visit that rings negative in the patient's mind
4) Think outside of the box
- too much tone to make headway with STM/IASTM? Use reciprocal inhibition of the antagonists to quickly decrease it (vids coming up for OMPT channel subscribers sometime next week)
- alternatives to traditional joint mobs
- stabilize the part you normally mobilize and mobilize the other (mob scap on stab humerus, or mob cranium on stabilized mandible)
- perform STM in a tissue folded position to make it more tolerable
- perform STM in a tissue lengthened position as a force progression
- combine techniques
- perform JM while in neural load
5) Be interested, not interesting!
- Some patients like participating in conversation around the clinic, others are very egocentric and only want the visit centered around themselves
- learn to recognize this and focus on and listen to the patient actively
- ask them occasionally how they are feeling, especially as the technique progresses
- even if they come in acutely painful, be very positive and explain the acute phase is the BEST time to treat, "As quick as you flared up, we can just as quickly find some relief."
- ask them about their family, job, etc... remember these things and personalize the visit
I hope everyone has a great holiday weekend (in the states), be sure to sign up for manual-therapists.com forum when you get a chance!