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Manipulative therapies

Postural balance and coordination of movement reflect the capacity to function optimally and as a whole. Disturbances and dysfunctions can be treated according to two approaches: the manipulative therapies and the re-education techniques. The form of therapy depends on the willingness of the patient to be active in the process of healing.  Re-education techniques may be used in prevention and as an adjunct to the manipulative therapy.

Types of manipulative therapies

Manipulative therapies range from manual reduction of joint dysfunction to spinal manipulation and mobilization and also to manually applied external massage of muscles and connective tissues. Most common are chiropractic medicine, massage, and osteopathy.

Osteopathy, or osteopathic medicine, was developed by Andrew Taylor Still (1828-1917). He reasoned that health correlates with the amount of natural flow of blood (disease is the effect of local or general disturbance of blood). Osteopaths believe that the primary role of the physician is to facilitate the body’s inherent ability to heal itself. This is achieved through normalization of body mechanics and a perfect alignment of the musculoskeletal system eliminating obstructions in blood and lymph flow which, in turn, maximize health.

Chiropractic refers to the system which is based on the belief that the nervous system is the most important determinant of health and that most diseases are caused by spinal subluxations which respond to spinal manipulation. Chiropractic medicine was founded by D.D.Palmer (1845-1913).  Malalignment or subluxation of the vertebral joints causing excessive or deficient pressure on the spinal nerves is corrected by adjusting vertebrae which restores health.

Massage refers to methods that manipulate soft tissue of entire body areas utilizing pressure and traction. Massage is one of the oldest forms of treatment. It was founded in ancient cultures all over the world. The development of modern massage is attributed to the Swede Per Henrik Ling (1776-1839), who developed an integrated system consisting of massage and exercises. This classic massage is also termed “Swedish massage”. Since then, several other forms of massage were developed. The massage of the connective tissue (connective tissue massage) was developed by Elisabeth Dicke (1884-1952). Another form of therapeutic manipulation is Craniosacral therapy. This technique was developed in the 1970’s by J.E. Upledger. It focuses on movement restrictions within the sutures of the skull.

A special type of manipulative therapy closely related to massage is Reflex therapy (Reflexology). This therapeutic method uses manual pressure applied to specific anatomic zones known to be able to treat specific physical disorders. In foot reflex therapy, it is believed that organs, muscles and other components are represented at specific zones on the foot. Pressure activates a reflex mechanism involving nerves or meridians (acupressure). Reflexology may utilize other techniques by manual therapists that include ear acupuncture (Auriculotherapy) and Korean hand acupuncture.

Two forms of Chinese manual or manipulative therapy form an integral part of Traditional Chinese Medicine (TCM). Tui na is a technique which refers to a hands-on body treatment that facilitates the body’s return to “balance”.  The practitioner uses various types of massage stimulating acupressure points. Gua Sha refers to a therapeutic manipulation of the skin by scraping/rubbing while applying oil on the skin. Scraping is applied to areas of discomfort using special tools.

Education or learning techniques 

Education or learning techniques have been developed. The aim of the different techniques is to re-educate patients to improve balance and coordination. The Alexander technique refers to the process of psychophysical re-education to improve postural balance and coordination. It was developed by Frederick M. Alexander (1869-1957). The Feldenkreis technique was developed by Moshe Feldenkrais (1904-1984). It refers to a process of relearning dysfunctional movement habits and is based on the principle of “awareness through movement”. The exercises improve the function of bodily movements and the self-image.