There are many approaches to the physiotherapist’s management of soft tissue injuries. Samantha Nupen explores these treatment choices and how to apply them in clinical practice.
Soccer Football - Cameroon v Brazil - Lusail Stadium, Lusail, Qatar - Cameroon’s Collins Fai receives medical attention REUTERS/Amanda Perobelli
Medical professionals are privileged to assist people in finding better health and happiness. This privilege is layered with trust, as patients are willing to share their personal lives with strangers before developing the famed patient-therapist relationship. Physiotherapists are granted the greatest privilege. That is the privilege of touch. This privilege comes with the responsibility to use touch as effectively as possible when treating patients. Manual therapy carries great power. Before the physiotherapist has even decided which treatment technique to use, the reassurance of touch has triggered the placebo effect(1). Practitioners should maximize and embrace the powerful placebo effect to benefit their patients.
The patient receives so many positive cues from the clinical setting. External cues include the therapist’s tone of voice, verbal suggestion, body language, and the treatment room setting. Internal cues include previous treatment memories, emotions, and the feeling that someone is listening and cares (see figure 1). These all activate a positive effect on treatment expectations. As soon as a patient walks into the physiotherapist’s treatment room, the therapy begins before they have been assessed.
During the Covid-19 Pandemic, the lockdown and social distancing regulations severely restricted physical contact and reconceptualized the positive power of physical contact. Intimate and caring touch positively affects anxiety and feelings of loneliness(3). Often anxiety and loneliness exacerbate a patient’s pain experience. This reinforces the power of touch in the therapist’s toolbox. The power lies in the practitioner’s hands.
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