Physical therapists have always used manual techniques to help relieve muscle tightness and soft tissue restrictions in their patients. Recent research has shown that patients may also benefit from manual orthopedic techniques in the aquatic environment. Because of the neutral warmth of the water, muscle tissues are more likely to relax and the patient will notice less pain because the increased sensory input from the water will block out the perception of pain.
Manual orthopedic techniques in the aquatic environment are an excellent way to decrease chronic pain and eliminate trigger points caused from muscle strains and sprains, as well as other soft tissue restrictions with a decreased sensation of pain. These techniques are typically performed by a licensed physical therapist or physical therapist assistant while the patient is in a supported floating position. The physical therapist or PT assistant then locates the area to be treated and use specific manual techniques to correct the restriction. Once the restriction has been released, the patient is pulled through the water in slow, oscillating motions to integrate the remaining muscle tissues and create a smooth feeling. Most patients notice some immediate relief, but usually several treatment sessions are necessary to release all of the soft tissue restrictions. Once the tissues have been released and integrated to their new length, the physical therapist or PT assistant strengthen the muscles to re-educate the muscle and joint complex for coordinated movements. This is then incorporated into functional movements and tasks.
Anna Helmstetter, a physical therapist assistant at Progressive Physical Therapy in Cumberland, MD recently attended a conference in Chicago, IL sponsored by the Aquatic Therapy & Rehab Institute. While in Chicago, Helmstetter attended several courses on aquatic therapy techniques. Course topics included proprioceptive neuromuscular facilitation techniques, Pilates, chronic pain, and manual orthopedic techniques. By far, one of the most beneficial was the course regarding manual orthopedic techniques. Several of the manual orthopedic techniques have already been put into practice at the Cumberland clinic for patients with chronic pain and soft tissue restrictions with great success.