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NHS physiotherapy protocols for musculoskeletal issues are based mainly on two approaches:
The NHS physiotherapist uses the first approach for more important injuries such as muscle tears, ligament tears, tendon tears, and joint injuries.
This approach is basically a self healing approach that, most of the time, mainly with athletes, is not the best one to choose or at least not the unique one.
In fact, the self-healing (RICE) approach could take more time to heal the injury and there could be more chances of getting the side effect of prolonged inflammation.
Chronic inflammation and swelling, which only with the RICE approach could persist for a long time, can have side effects such as tissue adhesions and calcification.
The second approach of physiotherapy exercises is broadly used for the majority of musculoskeletal injuries.
Physiotherapy exercises for sure are an important part of the rehabilitation process but sometimes it is not the first step to take into the rehabilitation recovery journey! For example, when there is an active inflammation or a swelling of a joint exercise is not advisable because it could increase the active inflammation and create further swelling or calcification later on.
In these two cases, the best approach is specific hands-on physiotherapy techniques to reduce the swelling and increase the joint’s range of motion. Another approach very effective for the first stage straight after a muscle or joint injury is the utilization of physiotherapy machines such as laser therapy, shock wave therapy, ultrasound therapy, and magneto therapy. They are a very effective rehabilitation method to reduce inflammation, and swelling, and recover the range of motion of joints and muscles in a short time.
There are two categories of alternative physiotherapy techniques that we can consider in addition or substitution to the NHS physio protocols.
The first category includes hands-on physiotherapy techniques and the second category includes the utilization of physiotherapy machines.
The most important physiotherapy hands-on techniques are:
These two physiotherapy techniques are both soft tissue mobilization techniques but with different physio tools and the efficiency of the treatment depends on the expertise of the physiotherapists and their manual skills.
The IASTM technique uses stainless steel tools with different shapes to adapt to different muscles and joints. It helps to relieve muscle tension, knots, and tissue adhesions. It requires the medium-high manual skill of the sports physiotherapist.
The diacutaneous fibrolysis is a bit more advanced technique that requires more time for training of the physiotherapist than the IASTM. It requires good manual skill and sensitivity to be performed properly and safely.
It utilizes special stainless steel tools with hook shapes to reach the dipper layers of tissue and muscles.
The Diacutaneous Fibrolysis is indicated for more specific musculoskeletal conditions such as:
As an alternative physiotherapy technique, we could consider a mix of sports therapy techniques and instrument-assisted soft tissue mobilization.
In our sports injury clinic in London, we have developed a service that includes sports massage techniques and instrument-assisted soft tissue mobilization, and we call it Instrument Assisted Sports Massage.
Physiotherapy machines, thanks to technological progress, are becoming progressively more efficient with many types of musculoskeletal injuries.
There are dozens of different physiotherapy machines but here we are going to highlight the most important for sports injuries.
The most important physiotherapy machines for sports injury are:
These physiotherapy machines, using different physical principles, are very effective in reducing inflammation, joint swelling, calcifications, chronic pain, tendonitis, and muscle soreness.
In conclusion, the best physiotherapy approach for any kind of sports injury is a multidisciplinary approach with a combination of different physiotherapy techniques well combined and integrated into a rehabilitation plan.
Example of a physiotherapy plan for a knee injury with swelling and pain without structural issues of the knee: