I'm curious on why exactly Dry Needling and Manual therapy are don'ts. Of course in isolation, as it says, that's a no go. But if it serves to add a temporary improvement in pain reduction why not? For example pain while squatting is one of the main diagnostic tools, and quad strengthening is a treatment, patients could be quite fearful that the exact movement you used to aggravate and diagnose the condition is now being used to treat it and this manual therapy could reduce the pain and increase participation?
As you say, it's a 'don't' in isolation. My personal opinion is that it is so short-lasting that I don't want to spend time on it (my time with the patient being limited). However, let's say that patient has a race the next day or two days later, you could try some manual therapy since exercises are not going to help so quickly when they are aggravated. I'd combine that with the taping technique. If you do everything right according to the guidelines (training quads and hips, education, load management etc.) and you still have time left for manual therapy, I don't see the problem in using it. I would be jealous of your time, though, because my 30 minutes are fully booked addressing all previously said things. As to your comment about the squatting, that's true. That's why clear communication is so important. Something is painful because it is sensitized. Thus, we want to lower sensitivity by gradually introducing that said load so the body can adapt. Thank you for your comment!
@@maxfromphysiotutors i was about to ask the same question again, then i see that i have already asked it. Thats funny. What do you think about the classifications? Do you use them?
Hey there, I have had some pain in both my knees since a few weeks and I was wondering what it was. The pain comes and goes (it is quite random) and the pain isnt really strong or anything luckily. I also dont have pain during exercises, walking down or up the stairs and also not while squatting. Sometimes my knees feel just a little uncomfortable and sitting on my heels so my knees are fully bend does hurt a little. Pressing on my knee cap also does hurt a little (but i think that could also be the case with healthy knees). Sometimes I hear clicking sound particularly while squatting. I have no clue what might be and the hard part is that my symptoms are a bit vague but I can feel something is off. I dont want to overtrain while being injured but also dont want to not train for no reason. Could you help me out? Thanks in advance
Short, precise, and evidence-based. Thanks
I just wanted to thank you for all the updates and videos, keep it up! It helps tremendously regarding clinical reasoning staying up to date
Great video and solid explanation
Thanks!
I'm curious on why exactly Dry Needling and Manual therapy are don'ts. Of course in isolation, as it says, that's a no go. But if it serves to add a temporary improvement in pain reduction why not? For example pain while squatting is one of the main diagnostic tools, and quad strengthening is a treatment, patients could be quite fearful that the exact movement you used to aggravate and diagnose the condition is now being used to treat it and this manual therapy could reduce the pain and increase participation?
As you say, it's a 'don't' in isolation. My personal opinion is that it is so short-lasting that I don't want to spend time on it (my time with the patient being limited). However, let's say that patient has a race the next day or two days later, you could try some manual therapy since exercises are not going to help so quickly when they are aggravated. I'd combine that with the taping technique.
If you do everything right according to the guidelines (training quads and hips, education, load management etc.) and you still have time left for manual therapy, I don't see the problem in using it. I would be jealous of your time, though, because my 30 minutes are fully booked addressing all previously said things.
As to your comment about the squatting, that's true. That's why clear communication is so important. Something is painful because it is sensitized. Thus, we want to lower sensitivity by gradually introducing that said load so the body can adapt.
Thank you for your comment!
Do we have enough data to use the subcategories?
Probably not, it is based on expert consensus.
@@maxfromphysiotutors thanks Max
@@maxfromphysiotutors i was about to ask the same question again, then i see that i have already asked it. Thats funny. What do you think about the classifications? Do you use them?
Do you provide any kind of online consultations or offer online programs for patients in chronic pain condition?
Hey there,
I have had some pain in both my knees since a few weeks and I was wondering what it was. The pain comes and goes (it is quite random) and the pain isnt really strong or anything luckily. I also dont have pain during exercises, walking down or up the stairs and also not while squatting. Sometimes my knees feel just a little uncomfortable and sitting on my heels so my knees are fully bend does hurt a little. Pressing on my knee cap also does hurt a little (but i think that could also be the case with healthy knees). Sometimes I hear clicking sound particularly while squatting. I have no clue what might be and the hard part is that my symptoms are a bit vague but I can feel something is off. I dont want to overtrain while being injured but also dont want to not train for no reason. Could you help me out?
Thanks in advance
Manual therapy , TENS not even control pain ?
They might help. Check out my reply in another comment for the full explanation!