Short answer? Both.
As physiotherapists, we have a huge variety of treatments we can offer. Manual therapy is often associated with physiotherapy- mobilisation, manipulation and sports massage are a few of the techniques we use to help improve symptoms. Most of these treatments are also offered by Chripractors as well though, so what makes physiotherapists different?
The short answer is exercise. Physiotherapy is all about long term strategies to pain. If you have had lower back pain for many years for example, there will be inhibition of the muscles that control and protect the spine. Manual therapy can help to alleviate symptoms, but all this is doing is targeting the symptoms, not necessarily the cause. If you are travelling in circles with your pain, replying on passive, manual therapies then you are never solving the underlying cause.
Often this is muscle inhibition, or muscle imbalance. Therefore, the only way to solve pain that has lasted more than a week and ensure it does not return is to move!. Exercise is key. Run, jump, strengthen and generally move. If you live a sedentary lifestyle, with a seated job, and a seated commute to work, you will need on average 5x30 minute moderate intensity sessions of exercise to combat the effects of this. Without it, our strength declines on average 1% every year over the age of 30. Often, this is the main reason people develop pain. Inactivity. Manual therapy will not strengthen these weakening muscles, exercise will.
But what if you already do plenty of exercise but you still have pain?
Then it is likely an imbalance rather than weakness. Rather than needing to be incredibly strong, the human body craves balance to stay pain free. If you perform on exercise or one activity over and over again, then the muscles responsible for this will build strength, but the muscles not being activated by the exercise will get weak.
Take cyclists for example – Very strong legs, often very strong quadriceps (thighs). But the stabilisers of the lower leg are not being used when you cycle because the pedals only allow a single plane of motion. This means you can develop bursitis, knee pain and hip pain despite being strong. Furthermore, the lower back is usually slouched forwards and so it is common to see lower back pain in these patient populations because the muscles that hold your lower back upright are not being used.
So the key is variety. Do something different, something varied. A good physiotherapist should be able to give you a structured programme to counter these changes. Strengthening programmes are probably the most effective way to counter pain, but also has a whole range of other physical and psychological benefits. A Chiropractor, whilst skilled at managing acute pain in the same way a physiotherapist might- with manual therapy, will not be able to guide you on how to improve the cause of symptoms. This means your pain will likely return, and you begin to feel dependent on your health care professional.
You should not feel dependent on your physiotherapist, chiropractor, osteopath etc when something goes wrong. Our job is to educate you on how to manage your issues, and more importantly reduce the chance that they even happen in the first place.
At Azzurro Training, we perform evidence based practice. This means we only offer treatments that have good bodies of evidence to reduce your pain in the short and long term. Our physiotherapists can help re-introduce you to exercise, improving your pain whilst helping you to lose wight and improve your fitness. Our personal trainers can guide someone on how to increase their activity levels in a safe way, whilst achieving and exceeding their goals. We offer the complete range of services to get you feeling your best again.