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Orthopedic massage - the concept and strategies.
Orthopedic massage - the concept and strategies.
By Boris Prilutsky
It was said that most of arguments happen because of difference in terminology.
The argument I am about to describe couldn’t be reduced to purely terminological
discrepancies. Rather I can generalize it as differences conceptual approach
and treatment strategy.
Not long ago I was invited for a DPT presentation, organized by a physical therapy equipment distribution company. The audience where composed predominantly of physical therapists with some influx of orthopedic surgeons.
One of orthopedic surgeons from the group talked about different types of regenerative therapy injections, but cautioned not to forget that steroids injections are still the main route for making a difference in painful post-traumatic cases. DPT’s presentation topic was manual therapy for cases of sports related injuries. Mainly, this doctor of physical therapy, talked about soft tissue mobilization such as myofascial mobilization, trigger points therapy, and mentioned deep tissue mobilization as well as stretching.
When it was my turn to speak, I pointed out that actually and traditionally this type of soft tissue mobilization is called orthopedic massage, to which he gladly agreed. The disagreement was on presented diagnosed cases and chosen treatment direction. Discussing collateral ligaments injuries case due to severe sprain, the DTP proposed therapy by direct hands-on stimulation of injured component, and limited area around this injury, in the fact, proposing orthopedic surgeons’, rather than physical therapy rehabilitation strategy. Such treatment could inhibit pain, but will not provide adequate therapy and it will only be a question of time when this post-traumatic region will sustain re-injury and will demonstrate accelerated developments of degenerative diseases such as arthritis est. Ultimately, “is orthopedic surgeons strategy wrong?” as it was inquired by one of the orthopedic surgeons in the audience.
My answer was: “In general it’s not about right or wrong. Orthopedic surgeons have very powerful methods in their arsenal, which are applicable under variety of specific circumstances. But massage therapy implements altogether different approach, the approach that is not local, but comprehensive rehabilitative one. To their own admission, orthopedic surgeons are not experts in physical rehabilitation, while as massage therapists are, or should be. The concept of targeting inflamed components is incompatible with physical rehabilitation by means of massage conceptually, and as treatment strategy. The concept of targeting inflamed components is incompatible with physical rehabilitation by means of massage conceptually, and as treatment strategy. Injections, with which orthopedic surgeons target inflamed components, don’t accomplish extended comprehensive rehabilitation and therefore shouldn’t be a resources in massage therapist strategic arsenal.”
Knowing that some of our colleagues are still adopting orthopedic surgeon strategy, I would like to suggest viewing the following that includes extended explanations on the subject.
http://medicalmassage-ceu.com/CLASS/con_rehab.htm
Best wishes.
Boris
Views: 97
Replies to This Discussion
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Permalink Reply by Ravensara Travillian on
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"Injections, with which orthopedic surgeons target inflamed components, don’t accomplish extended comprehensive rehabilitation and therefore shouldn’t be a resources in massage therapist strategic arsenal."
It isn't a resource in our strategic arsenal, as it's out of scope for us. But for the client trying to figure out what to do, does this sentence:
"The concept of targeting inflamed components is incompatible with physical rehabilitation by means of massage conceptually, and as treatment strategy."
mean that they have to choose exclusively between injections and massage? Or can they receive both?
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Permalink Reply by Laura Allen on
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I don't practice orthopedic massage but I have had practitioners in my office who do. In my experience people could receive massage after injections as long as the injection site was avoided for 24-28 hours. We have a number of clients who have had cortisone, lidocaine, etc injections and they still receive massage.
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Permalink Reply by Boris Prilutsky on
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Hi Raven.
Absolutely. People can get both.of course better to avoid steroids injections or other oral medications and in many cases
comprehensive treatments such as,techniques for lymphedema size reduction,introductory including segment reflex massage,post-isometric relaxation techniques, trigger point therapy, hot and/or cold applications can reduce intensity of pain,increase range of motion, restore functional activities with the no injections involvement.usually during first five treatment objectively and subjectively we witnessing improvement. All this techniques is very easy to perform(this is not hard labor) , and in total orthopedic massage procedure taking between 28-35 minutes.Best wishes.
Boris
Ravensara Travillian said:
"Injections, with which orthopedic surgeons target inflamed components, don’t accomplish extended comprehensive rehabilitation and therefore shouldn’t be a resources in massage therapist strategic arsenal."
It isn't a resource in our strategic arsenal, as it's out of scope for us. But for the client trying to figure out what to do, does this sentence:
"The concept of targeting inflamed components is incompatible with physical rehabilitation by means of massage conceptually, and as treatment strategy."
mean that they have to choose exclusively between injections and massage? Or can they receive both?
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Hi Laura.
absolutely.in my commentary I am proposing not to adopt strategy/ concept of orthopedic surgeons not because it something terrible but because in my opinion it not applicable for our approach.actually my advice is not only to read proposed text but also to view proposed clip where I am extending more on the subject. I'm working a lot with orthopedic surgeons and in a way how you described .they injecting and referring to us for massage therapy. local antiinflammatory steroids injections this is what orthopedic surgeons doing in this cases,my message that if we will address localization of injury only it will be not good enough and can just temporary inhibit pain.
Best wishes.
Boris
Best wishes.Boris
Laura Allen said:
I don't practice orthopedic massage but I have had practitioners in my office who do. In my experience people could receive massage after injections as long as the injection site was avoided for 24-28 hours. We have a number of clients who have had cortisone, lidocaine, etc injections and they still receive massage.
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Ok. Thanks to you both for clarifying that.
cheers,
Raven
Boris Prilutsky said:Hi Laura.
absolutely.in my commentary I am proposing not to adopt strategy/ concept of orthopedic surgeons not because it something terrible but because in my opinion it not applicable for our approach.actually my advice is not only to read proposed text but also to view proposed clip where I am extending more on the subject. I'm working a lot with orthopedic surgeons and in a way how you described .they injecting and referring to us for massage therapy. local antiinflammatory steroids injections this is what orthopedic surgeons doing in this cases,my message that if we will address localization of injury only it will be not good enough and can just temporary inhibit pain.
Best wishes.
Boris
Best wishes.Boris
Laura Allen said:
I don't practice orthopedic massage but I have had practitioners in my office who do. In my experience people could receive massage after injections as long as the injection site was avoided for 24-28 hours. We have a number of clients who have had cortisone, lidocaine, etc injections and they still receive massage.
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Permalink Reply by Gordon J. Wallis on
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I dont know?? Its hard to believe that Orthopedic Surgeons and even a lot of Physical Therapists know virtually nothing about muscular pain and how to heal it. I dont care what they say. Ive healed many of their patients in one or two settings that they have worked with for weeks , months, and in some cases years. Its like if a client comes into see me. - And they have been seeing Orthopedic doctors, Physical Therapists, or and Chiropractors for six months or more...And yet have very little or no improvement...I just smile...Eight out of Ten of those people Im able to fix (usually just trigger points) , in one or two sessions...Ive been a Massage Therapist for over 25 years now..Those professions bother me. They know nothing about softtissue healing. Boris..I dont even know you..But If I was hurt. Id rather see you then any of those guys...Any experienced, skilled Massage therapist that takes pride in their work, and studies, is a much more appropriate person to see then any Orthopedic Physician , Physical Therapists(least incompetent of the bunch), or Chiropractor. Those people bother me. PS- some Physical Therapists are much more savvy when it comes to soft tissue then others..But still.
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Hi Gordon.
modern conventional medicine it is a very developed,including heart transplantation, and other inner organs transplantation, joint replacements ect., But you're right muscular syndromes causing to too many people terrible suffering, and this people consuming huge amount of painkillers, and spending time and money for MDs,physical therapists, chiropractors visits, and still cannot get adequate treatment with significant results. Absolutely agree with you that in this cases massage therapy is most effective and in a short period of time providing release of this pains,limitations of ROM and other discomforts.no doubt.massage therapy is a powerful tool but in case if one will not press vigorously and will call it deep massage.
Best wishes.
Boris
Gordon J. Wallis said:
I dont know?? Its hard to believe that Orthopedic Surgeons and even a lot of Physical Therapists know virtually nothing about muscular pain and how to heal it. I dont care what they say. Ive healed many of their patients in one or two settings that they have worked with for weeks , months, and in some cases years. Its like if a client comes into see me. - And they have been seeing Orthopedic doctors, Physical Therapists, or and Chiropractors for six months or more...And yet have very little or no improvement...I just smile...Eight out of Ten of those people Im able to fix (usually just trigger points) , in one or two sessions...Ive been a Massage Therapist for over 25 years now..Those professions bother me. They know nothing about softtissue healing. Boris..I dont even know you..But If I was hurt. Id rather see you then any of those guys...Any experienced, skilled Massage therapist that takes pride in their work, and studies, is a much more appropriate person to see then any Orthopedic Physician , Physical Therapists(least incompetent of the bunch), or Chiropractor. Those people bother me. PS- some Physical Therapists are much more savvy when it comes to soft tissue then others..But still.
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