Treatments

My Specialist Skills

This is an assessment tool that analyses adverse changes that have occurred in someone’s body through trauma (emotional or physical) or due to postural habits and repetitive ways of moving (how many of us sit in the same spot, in the same position, on the sofa or armchair every day?).

Our bodies are constantly aiming to balance mobility, and flexibility, with the need for stability so we can get on with our lives smoothly. This is aided by tissue cells called the connective tissue cells. These cells create the large types of ‘building materials’ we need to hold our bodies together and up against gravity while being able to move (bones, cartilage, tendons, ligaments and fascia). These building materials are interwoven by the fascia, which invests in and supports everything else, like a special ‘web’. When damage occurs this tissue system responds and works to restore the interrupted ‘web’. This damage is not always through injury but can be caused by us sitting, standing or moving in the same way repeatedly, placing a strain on the body with less freedom of movement and often ends in pain. As a therapist, my aim is to help free the body up so the natural healing and adaptative processes can take place, restoring back flexibility and resolving pain.

This web also wraps around and through our internal organs (often referred to as viscera) giving us slippery joints inside. These organs are richly supplied with nerves and blood vessels and are vital for our overall health. As these organs are slippery, they move about against each other and our skeleton; for example every time you breathe out your abdominal contents need to be able to be pushed down and out of the way by the diaphragm. Now imagine you have an upset stomach. Think about how it affects your breathe and how you move around. This is because our organs are also affected by trauma, illness, infections, diet, environmental toxins, repetitious movements and emotional stress. The result is that they become inflamed and stop moving about freely (you could say that they ‘dry out’ due to becoming inflamed with the healing process then replacing normal tissue with a less elastic type). The blood supply and nerves, going to and from the organs , are also affected and become less efficient. This restriction in movement inside is recognized by the body, which is clever and to prevent placing stress on these organs further will change how our skeleton moves around them.

If these problems do not resolve on their own it can lead to ongoing issues which we usually become first aware of when we have a musculoskeletal pain or are generally not feeling well; for example, reduced blood supply to the gut can affect food absorption and breakdown. VISCERAL MANIPULATION is a pain-free, gentle technique applied with the aim of aiding the organs to be able to self-correct, so stopping the rest of our body adapting to protect the organs in difficulty. Restoration of normal movement to the organs also has a positive effect on the function of the nerves and blood supply flow.

Visceral Manipulation

Advanced visceral manipulation is a comprehensive approach to the brain developed by Jean Pierre Barral, French osteopath and physiotherapist, over forty years ago and one that he is still building on with research and clinical
exploration.

During this forty-year period, Monsieur Barral has successfully utilized this treatment method with patients presenting with head trauma,
strokes, brain diseases and psychomotor disabilities. The technique works on the principal of the brain being inherently plastic and
encourages the central nervous system to self-repair. Its focus is on striking the balance between ease of minimal manual effort of the practitioner with the finesse of maximal manual precision when treating a patient.

It is all pain free and works with the brain using two main approaches to problems presenting:

  • Intensification – this is a technique used to stimulate and release areas
    of decreased activity within the brain.
  • Dissipation – this technique seeks to calm hyperactive areas within the
    brain to restore a balance of information being processed.

Balance is achieved by our brains co-ordinating information from our eyes, ears and our awareness of the position and movement of the body, which is called proprioception. Proprioception is facilitated by special receptors in our muscles, joints and tendons.

Damage to the eyes, ears or proprioception will interfere with our balance. Some of the symptoms of this are dizziness, nausea, unsteadiness, and/or vertigo (the room spinning or you spinning) all of which ca, understandably, lead to anxiety.

The affect of this on daily life is not to be underestimated with it causing problems from being able to get out of bed to going to, and being able to, work. It can often lead to anxiety and depression with sleep disturbance if it doesn’t self resolve.

Some of the vestibular conditions seen and treated by physiotherapists are:

  • BPPV (Benign Paroxysmal Positional Vertigo)
  • Labyrinthitis
  • Vestibular migraines
  • Meniere’s
  • Dizziness
  • Acoustic Neuroma

Treatment consists of exercises, designed to target the identified problem system, to aid the central nervous system to compensation for any disorder to restore balance and resolve the unpleasant symptoms mentioned above. It is carried out by the client at home in their own time several times a day with a review by the therapist once a fortnight, or even less, to progress the exercises to work towards complete resolution of the symptoms. This exercise program is put together by the physiotherapist once they have completed a thorough assessment that checks the eyes, ears and proprioception for disorders (sometimes referred to as dysfunction). For BPPV, the therapist can perform various head and body movements to resolve the dizziness.

Some examples of a treatment plan are:

  • Eye and head movements
  • Exercises to improve standing and walking balance
  • Fatigue management – for which a client may be referred to a local Occupational Therapist
  • Gradual exposure to daily tasks that normally result in a client’s symptoms
  • Referral to a counselling service to help with anxiety and/or depression

In the majority of cases, one to two sessions will considerably reduce symptoms or eliminate them.

Scars are described by the NHS as “a mark left on the skin after a wound or injury has healed.” They are a natural part of healing and most people have a scar they can show you. Some scars are barely visible whereas others are vivid and sometimes keloid in nature, which is an abnormal overgrowth during the healing process. Scars however aren’t just on the surface but can have an effect deep into the body as in the process of healing tissues become adhered together. This can also result in trapping nerves and blood vessels. These adhesions alter the way our movements are dispersed around the body and can lead to adverse stress being focus on one part of our bodies instead of distributed evenly. This an lead to reduce freedom of movement and pain. Scars can also have a strong emotional and psychological effect on us with a feeling of being disfigured and wanting to disown that part of us.

The technique was discovered in 1973 by Sharon Wheeler, a fascial release therapist, and one that she continues to develop. It looks at gently reintegrating the scar tissue into the rest of the body and releasing any restrictions the scar has placed on the body. The technique is light and casual and almost always painless. Some scars are small or have healed well, so will only take one or two sessions to work on, whereas others may take longer to reintegrate. There is often resolution of any residual numbness around the scar area and it can help with working through the trauma associated with the scar. The improvements are permanent and stimulate the circulatory, lymphatic and nervous systems leading to improved general tissue health and aiding any ongoing healing process.

To work on a scar it needs to be fully healed, i.e. not weeping, open, infected, red or inflamed. Any stitches need to have been out for two to three weeks and the scar signed off, if relevant, by the surgeon as ready for massage type treatments (this will usually be at 6-8 weeks post operation). The age of the scar does not matter as however old it is it will still respond to treatment. Scar work sessions finish with some work to integrate the part worked on back into the body as a whole.

Examples of the types of scars that respond to this treatment are:

  • Joint replacement
  • C-sections
  • Skin grafts
  • Burns
  • Surgery of any type, including cosmetic
  • Traumatic injuries

Contraindications to treatment:-

  • Scar containing inserted mesh, e.g. in the abdomen or pelvic area. (Mesh used in breast reconstruction is safe for work however as it is different from that used elsewhere).
  • Pregnancy
  • Scars red or swollen following radiation therapy
  • Open, infected, inflamed or weeping scars

Clients undergoing treatment for cancer are required to have a letter from their oncologist to confirm that they are safe for work.

Neurological physiotherapy looks at the person as a whole, working with muscle weakness, changes in sensation, and loss of awareness of where the body is in space. The aim is to improve quality of life for the individual and restore control to that person, for example helping them return to walking, gardening, or being able to move in bed independently. As each person is affected differently, the treatment focuses on what is most important to the client in terms of what they wish to aim to achieve with therapy.

The approach is to look at addressing the symptoms caused by the condition/event. This could include management of spasticity, addressing changes in ranges of movement in the joints, re-educating of lost or altered normal movement and looking at ways to slow down physical deterioration. It incorporates balance, strength, relief from pain, improvement in fitness levels and endurance, postural and sensory re-education. It may result in onwards referrals to Occupational Therapy to aid return to work, memory or fatigue management, and to counselling services (or psychology) to relieve the anxiety and depression that can often accompany the changes a person is having to deal with. Any issues identified to do with swallowing or speech will result in a referral to the local Speech and Language Therapy department.

The length of treatment, in terms of number of sessions, is very individual being based on the skills a client identifies as wishing to work on. Treatment can be at home or in a clinic setting, depending on the level of assistance each client may need, e.g transfer equipment, assistance of more than one person to move or high fatigue levels. This would all be discussed at the initial assessment and a plan agreed with the client on how to work towards maximizing potential.

Some of the conditions that can be treated are:

  • Parkinson’s
  • Multiple Sclerosis
  • Strokes
  • Head Injuries
  • Physical deterioration caused by tumours

(this list is not exhaustive).