Manual therapy can be divided into intrinsic and extrinsic
according to the type of force applied. Intrinsic forces are forces that occur in a person's body, such as muscle strength, respiration, and pressure created by body fluids. Extrinsic
forces are forces applied from outside; Forces such as pushing applied by the practitioner,
stretching, bending, gravity, forces applied with belts or pillows
forces can be counted.
The concept of direct and indirect treatment, the force used on the barrier. It is related to its direction
. The force applied by direct methods is directed towards the pathological barrier or increased resistance. Thus, an attempt is made to ensure that the pathological barrier is displaced towards the physiological barrier that should normally be
.
In indirect methods, the movement that occurs with the applied force,
resistance is minimized. is in the opposite direction of the pathological barrier. This application increases mobility, leading to a change in the relationship between the pathological barrier and the normal physiological barrier
positions.
The concepts of direct and indirect can sometimes be used for different purposes.
Direct technique, in which the physician directly puts pressure on the relevant segments.
In this technique, the force is applied directly to the vertebra. The applied force is short, sudden and quite hard. It is generally done with the palm of the hand.
Pressure is applied to the protrusions of the vertebrae. One of the hands is placed diagonally on the right side of the problematic vertebra, while the other is placed on the left side of the vertebra below
. With direct manipulation, the upper
vertebra is rotated to the left. This technique may be harmful because too much force
is needed. Interventions performed by using the patient's body parts or
joints as leverage are called indirect techniques
.
Considering the patient's contribution to manual practice, active, passive and
A classification can also be made as active + passive method.
Another classification is push and non-push techniques. Indeed
the word manipulation is used in many places to describe the push technique
. Pushing technique is the most commonly used manual treatment method.
En action; It is a technique used to stretch soft tissues and separate bone and its surfaces or
bone fragments using a pulling force
. While resisting the body's movement with equal and opposite
force, the applied force must be of sufficient magnitude
duration and in the appropriate direction.
Muscle energy technique; It is directed specifically by the physician
and involves the patient moving his/her body voluntarily.
The manual therapist holds the part to be treated in a certain position and
asks the patient to contract the muscle against the holding force. tells. Since the patient controls the amount of force
injury is unlikely.
For manual therapy, the patient should be comfortable and relaxed. The patient should be completely relaxed and
feel safe. The manual therapist should be relaxed, for therapeutic purposes
the grip should be tight, painless and protective. The physician should stand confidently, comfortably and
supported. The relationship between the patient and the physician should be harmonious, like "a couple dancing well"
. The joint should be pain-free. The anatomical movement limit should never be exceeded by applying excessive force. The height of the table should be adjustable for force transfer
.
Read: 0
