K. Kelli Richardson, a physical therapist with 24 years of experience, recently attended a two-day conference in Livingston presented by Steven P. Ferdig of Chapman University in Orange, Calif.
The conference, entitled “The Cervical Spine: Mobility versus Stability,” covered 15 neck mobilization techniques for the neck, upper back, shoulders, chest and face, including the jaw, a site of pain about which many physical therapy patients complain.
At the conference, participants learned how to assess movement to determine specifically in the cervical spine what the range of movement - or lack thereof - is in the patient. The assessment techniques they learned contributed to physical therapists’ treatment plans and may alleviate suffering patients with chronic neck pain.
Ms. Richardson, who holds a bachelor’s degree in physical therapy from the University of California at North Ridge, previously practiced physical therapy at a Pasadena, Calif., hospital for 12 years, owned her own practice in California and has been practicing for 10 years with Lance Hendricks, owner of Montana Physical Therapy, 2370 Ave. C, in Billings.
Mr. Hendricks, who holds a master’s degree in physical therapy, said, “There is new hope for neck pain. Many patients come to us 15 years after a car accident and they still have pain. They tell us, ‘I went to physical therapy and did exercises, but it still hurts.’”
He added, “We are doing mobilization techniques – Steve is teaching neck mobilization ... . It is the combination of approaches that we use: hands-on physical therapy, neck mobilization, exercises [and soft tissue warming via ultra-sound] that make the difference [in relieving pain for patients].”
Ms. Richardson said she learned at the conference how to stabilize one end of the joint with one hand and the healing effects of gentle, slow, oscillating movements, sometimes with the patient sitting up, sometimes sitting down; not fast, not surprising movements. “It is a comfortable, low velocity, oscillation, done very slowly...The primary difference is mobilization... with low velocity,” she said.
People who complain of neck pain may have incurred injuries from an accident or by overburdening a certain part of the body. Richardson said, “Car wreck victims, exercise victims, overuse syndrome by office workers, and even arthritis sufferers ... we could even [apply neck mobilization] to some extent to people with arthritis.” Conventional physical therapy is about doing exercises and stretches, said Mr. Hendricks. On the contrary, “manual therapy – also called hands-on therapy – is different,” said Richardson. “It is not a fast, high-velocity, surprising manipulation of a joint – the kind you might get from a chiropractor,” she said.
“Chiropractors use high-velocity maneuvers to align the spine to cure all types of ailments of the body – we do the spine and beyond, including shoulders, ankles and knees. The primary difference is mobilization vs. manipulation – it’s a big difference.” she said. “We move the joint slowly and [focus on] soft tissue mobilization of the muscles, tendons and fascia (soft connective tissue in the body). Also warming the tissue with ultra-sound (ultrasonic waves that provide deep heat and increase blood circulation to a joint or muscles) and then doing manual therapy afterwards relieve pain – it’s the combination, not just exercise and not just massage by itself and not just chiropractic by itself. That does not do it,” she said.
Hendricks agreed. Regarding the two-day conference in Livingston, he said, “Steve is teaching ‘Mobilizing Stiff Joints,’ and Kelli went to learn mobilization. We are doing mobilization techniques. It is the combined approach of exercises – the patients’ homework – hands-on therapy and neck mobilization ... that gets the patients where they need to be,” said Hendricks.
Hendricks recounted the history of physical therapy: it began in World War I when rehabilitative aides were assigned to prisoners in prisoner of war camps. The whole idea of physical therapy spread worldwide, according to Hendricks. Physician’s assistants, he said, also originated in the U.S. Army. Later on, in World War II, Joseph Pilates was German POW imprisoned in Staten Island, N.Y. Many people of Sicilian descent who lived on Staten Island in that era occasionally spoke with German POWs through the facility’s chain- link fences.
While in Staten Island, Pilates, according to Hendricks, treated his fellow prisoners and sought to relieve their pain. The transition from PT to hands-on or manual therapy emerged in the late 1970s. Sadly, said Hendricks, “It’s about the money. IT is a lot easier to make money with your rooms filled with people exercising away instead of one-on-one hands-on manual therapy. “Hands-On Therapy is a specialization itself within the field of physical therapy,” said Hendricks.
He and Richardson can be contacted at 248-8804 or go to www.mtphysicaltherapy.com.