Thursday Thoughts: Is Your Patient Sore from Treatment? They Shouldn't Be! | Modern Manual Therapy Blog

Thursday Thoughts: Is Your Patient Sore from Treatment? They Shouldn't Be!


Sore from general strengthening and conditioning is one thing, sore from manual treatment, particular soft tissue work or joint mobilization/manipulation is another.


If your patient is sore, you are most likely over treating. Your paradigm should be to introduce the least, but most effective manual therapies/inputs to help reduce threat and get the patient moving. There are a few ways to accomplish this

  • start with light IASTM across broad tissue patterns and re-test movement
  • choose one other intervention to stimulate the nervous system, joint mobs, neurodynamics etc

The next 2 points are the most important
  • use each treatment you choose for LESS duration
    • it's often not only choosing too many treatments, but spending too much time in one area and doing the same technique over and over can be irritating
    • I recommend for IASTM/general mobs to perform for 30 seconds to 2 minutes per area depending on how large, and patient response
  • move on to another to another area quickly
    • example: shoulder patient
      • IASTM to cervical, scapular patterns, lateral upper arm, 30-60 seconds each
      • cervical retraction with SB repeated motions 20-30 reps
      • should mobs another 1-2 minutes in various wiggles
Most evaluations and follow ups should follow a similar pattern. If the patient has many asymmetries to address, choose first the proximal DP and then move onto the more asymmetrical or relevant distal DN next. You do not have to do everything at once. Things have a way of working themselves out once threat is reduced and confidence in movement is restored.

Keeping it Eclectic...

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