People come to Chews Health with a whole array of injuries and conditions that have been going on for various amounts of time. From acute ankle sprains to chronic neck pain and with our expertise and guidance the vast majority to these injuries and conditions can be rehabilitated back to a full recovery.

But one question we often ask in our initial assessments is this – what do you want from treatment? Do you want to just be in a little less pain than you are now? Or do you want to rehabilitate the problem so it doesn’t come back? Or both?

Physiotherapy can come in many flavours. Physiotherapists have a myriad of techniques that can help immediately to reduce pain, and we also have the rehabilitation skills and knowledge to improve pain in the long run and restore normal function. So the answer to the question- ‘what do you want from treatment?’ – has a direct impact on what our treatment will look like and importantly, how often we need to see you.

Active vs Passive

If we were absolutely forced to we could roughly categorise physiotherapy care into two categories – active care and passive care.

Active care is treatment that you, the injured individual, are very much a part of and are involved with. Without your significant effort or hard work no care would be taking place. Examples of this would be performing exercise or movement or stretching or self-mobilisation.

On the other hand, passive care is treatment that is done TO you. It includes techniques such as massage, manipulation, acupuncture or electrotherapy. It generally involves you lying or sitting still whilst a practitioner delivers these techniques.

Our Clinical Lead Mark Reid delivering some high-quality passive-care to endurance athlete in the snow in Norway

Each type of care has different pros and cons and may be used at different times in a recovery plan (or in combination). What passive care can be good for is providing short-term pain-relief that doesn’t involve medication. Manual therapy in all its flavours (massage, manipulation, mobilisation etc.) seems to share a common mechanism – it works by temporarily altering the sensitivity of the nervous system so that you might feel less painful or sore. However, its effects are temporary, generally providing a few days of relief before the benefits where off and importantly, it doesn’t seem to influence the structure or healing of an injury in any meaningful way that makes it recover faster.

Active care is treatment done BY you. Passive care is treatment done TO you.

For those who are currently struggling to function due to their pain, or those who just need to get through this one last upcoming event, it is absolutely the right thing to do to provide some short-term pain relief through passive treatments such as massage and manipulation. It isn’t going to cure the problem, but it might make it easier to live with for a short while.

However, active treatment such as rehabilitation exercise might not provide any short-term pain relief at all, in fact sometimes it can even temporarily aggravate symptoms. But in the long term it can promote healing, strengthen tissue and provide longer-acting changes in sensitivity of the nervous system.

During rehabilitation then, there is often a trade-off between short-term effects and long-term effects. What’s makes it feel good in the immediate future (a nice massage) may have no effect at all on the long-term outcome. And what might make it feel slightly worse in the immediate future (exercise) may be the very thing it needs to provide lasting changes and cure the problem once and for all.

We want to see you LESS

The main difficulty with passive treatment is it needs to be done TO you by someone else, which needs more contact time. Sometimes it’s necessary, but a lot of the time it isn’t. This is why at Chews Health we tend to favour a rehabilitation model of care. We want to find out exactly what it is that is causing your problem, and we want to rehabilitate that root cause as that is what matters most for a full recovery!

People come to us with different expectations of physiotherapy, some come wanting or even needing that short-term pain relief which comes with passive treatments. Others have no interest in the short-term and are only concerned about improving the root cause of the problem. At the end of the day, we work with you to get you and your problem better, and we will advise on what is most appropriate for you at that specific point in time. We aim to get your problem better with as little intervention from us as is possible because whilst it’s best for our cashflow to have you coming back every other day for a massage, it’s often not what’s best for you.

At Chews Health we guarantee that the advice that you are given will be always be focussed on what’s best for YOU, not what’s best for us. The package of care that we recommend will always be specific to you and your issue. Sometimes we may well recommend a little passive care to help temporarily reduce the symptoms, but we’ll always have both eyes firmly focussed on improving your problem in the long-term!

It’s this willingness to zoom out and focus on the bigger picture – the long-term rehabilitation over the temporary pain-relief – that makes us more than your average physio clinic. And it’s our particular model of care that allowed us to become one of the most recommended and referred to by other clinicians.

To book an appointment with one of our physiotherapist please use this link.

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