Treatments We Offer

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We specialise in soft tissue (muscles/tendons/ligaments) injuries and rehabilitaion. Available treatments include:

Muscle Energy Technique

Muscle Energy Technique uses an individuals strength to induce relaxation in tense muscle tissue. There are two main variations of this technique.

Post Isometric Relaxation (PIR) can be used very effectively on muscles that have become shortened due to poor posture or injury. It is very useful in strengthening and lengthening affected muscles because there is an element of muscle contraction in addition to muscle stretching. The process of PIR begins with the therapist identifying the barrier point, where the affected muscle begins to feel restricted. The client may not feel an active stretch at this point as it is about mid-range of full range of motion (ROM). The client is then asked to perform an isometric contraction of the affected muscle against the resistance given by the therapist. This contraction is isometric as there is no movement of the muscle and should be held at approximately 25% of the client’s maximum strength for about 10 seconds. The client is then asked to take a deep breath in, and completely relax on the out breath. At this point, the therapist can take the relaxed, inhibited muscle, slightly past the point of restriction as it is in a state of increased relaxation following the contraction, which should allow for greater flexibility. This process can be repeated until the client is in full ROM and the final stretch should be held for an additional 20 seconds to allow the golgi tendon organ and muscle spindles (which monitor muscle tension) to send appropriate messages to the nervous system, indicating that the muscle has lengthened safely. PIR works very well on muscles that move joints with a larger ROM, for example the quadriceps, iliopsoas or biceps brachi. It is also effective in the later stages of rehabilitation following acute injury, although it should not be used in the acute stage. It would be best not to use this technique on already over lengthened muscles, although the isometric contraction, (without the stretch) might be beneficial in theses cases as over lengthened muscles are often weak. The process of contracting while stretching has a strong effect in breaking up fibrous adhesions, therefore PIR is a great aid in treating areas affected by fibrosis.

The second variation is called Reciprocal Inhibition (RI). Muscles work in opposing groups in order to counteract each other and allow the body to move freely. Obviously, if one muscle group is contracting, its opposing group must relax and stretch, otherwise, there would be no movement at all. The nervous system is designed to inhibit responses to the opposite group of muscles that are contracting, for example, when the bicep in the arm is contracted (the agonist), the triceps (antagonists) must be inhibited and vice versa. This is the principle on which Reciprocal Inhibition is based. Treatment using RI is not dissimilar from using PIR, except for one important difference. Instead of resisting the force in the opposite direction from that which is provided by the therapist (contracting the muscle about to be stretched), the client should attempt to contract the muscle in the same direction (contracting the opposing muscle from the one about to be stretched). RI is especially effective in treating more acute injuries, as the problematic tissue is not directly treated, just indirectly affected by treating the tissue that opposes it. This technique is also useful when addressing muscle cramps.

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