What’s the purpose of treatment?
Almost always, the answer will include some or all of the following;
– pain reduction
– preparation for re-emergence to activities*
This will differ a little depending on the degree of activity of the client and the types of activity that the client participates in.
For those that want to be more robust human beings without the fear of injury and with the ability to squat, hinge, push, press, pull, run, swim and jump, the key factors are going to be; the increase of load over time and the ability to hold position.
If we can progressively load a tissue it will allow for adaptation, which results in the ability to be able to withstand greater and greater demands. If we can hold position, we can apply these loads to relevant tissues that are prepared to accept the force. This is why the relevance of strength and conditioning to manual therapy and vice versa is becoming so apparent, because real ‘change’ is going to come down to loading tissues appropriately.
We as practitioners can use a range of tools to create transient change in tissues and joints, such as altering tone, altering joint position sense, decreasing pain and promoting or depressing an inflammatory response. However, without stressing the tissues and joints we cannot create adaptation. Hence the blending of manual therapy and strength and conditioning.
This is not fool proof. We cannot magically alter the way someone moves once and call it a wrap. Skill acquisition is a process and competence will be an ongoing challenge of awareness. We must be mindful of the positions or movements that we are creating.
As with most things, there are any number of ways to achieve an outcome, however the overlaying principles at this current stage are creating the movement, or the awareness of movement and then applying load to create adaptation.
If passive treatment alone ‘fixed’ things, why is there no graduation or discharge from treatment?
*this is more or less found wanting in most practices