How often will I be scheduled?
We treat a range of conditions so it is difficult to say how many sessions you will need. It is largely dependent on the severity of your injury or condition. Be assured however, that we do not subscribe to over-scheduling patients. Your treatment plan will be tailored to suit your individual needs.
Our primary goal is to have you return to normal activity as soon as possible. We place a strong emphasis on ensuring you understand your condition, and the self-management techniques available to accelerate your recovery in between treatments. We understand you most likely have work and family commitments, but a return to health is only achievable if you are committed to both the treatment plan and the exercises we prescribe.
Various tissues in the body heal at different rates therefore the timing between consecutive treatments is an important factor in recovery. If you are serious about addressing your physical concern, it is essential you adhere to the proposed treatment schedule for the best results.
Is there a cancellation policy?
If you cannot make your appointment, please provide 24hrs notice. Failure to do so will incur the full fee of your consultation (at the discretion of your practitioner). Providing us with sufficient notice of your cancellation allows us to help others who may be able to fill your appointment time. Practitioners also appreciate being informed so that they may better utilise their own time. Thank you.
Will I have to keep seeing you indefinitely?
You don’t have to do anything you don’t want to do. The majority of our patients, once fully recovered from their initial complaint, return every six to eight weeks. We strongly recommend visits at this frequency to consolidate the results achieved in the initial treatment stages, and reduce the risk of re-injury.
By having regular treatment, you can achieve peace of mind that your body is being looked after by a professional and gain from the ongoing health advice we will provide you. In this way you will prevent general de-conditioning and maintain excellent physical health.
What is "manipulation" or "adjusting"?
You can consider manipulation or adjusting to mean the same thing. Manipulation is highly effective in treating joints with reduced range of motion. Simply put, manipulation” is to joints what massage” is to muscles – it “loosens” them up. Predominantly manual manipulation techniques are used at Cartwright Physicaltherapy (using hands and body weight). This is opposed to manipulative instruments such as activator or drop piece, although activator adjustments can be requested.
Manual manipulation typically involves the practitioner placing the patient into a specific position. This could be lying face down or face up on the bench, seated, standing, side-lying etc. The practitioner then delivers a specific and controlled force to the patient in an effort to restore proper range of motion to a joint.
You may have read elsewhere that chiropractors use a “high velocity low amplitude thrust” or “HVLA thrust” to adjust or manipulate joints. This pertains to the manipulative movement being a very quick action whilst at the same time being not too heavy-handed. Having said this, the amplitude or force required to adjust or manipulate someone is relative to both the degree of restriction of a joint, and often the size of the patient. For example, the force required to adjust a baby is significantly less than that required to adjust a well built rugby player.
You can read more about manipulation here.
What is the crack sound?
Joints are tightly wrapped in ligaments forming an almost, airtight capsule around the joint. When two joint surfaces are separated enough, but still within a natural range, there is a large reduction in pressure compared to atmospheric pressure. This causes gases to escape from the synovial fluid within the joint (synovial fluid provides for a friction free surface and nourishes the joint) forming a bubble; a momentary vacuum. The contents in this vacuum are water vapour, nitrogen, oxygen, and carbon dioxide. Eighty percent of the contents is carbon dioxide. The bubble quickly collapses causing the ‘crack’ sound.
Thus, the ‘crack’ sound is more accurately described as a ‘popping’ sound. Rest assured, there is no cracking of bones occurring anywhere during a spinal manipulation.
You can read more about manipulation here.
Is manipulation good for me?
A lot of patients question whether being manipulated is good for you, and how it is supposed to help someone. As creatures of habit, we find ourselves performing repetitive tasks on a daily basis, whether it be work related, such as a mechanic working over an engine all day, or leisure related, such as playing squash or cycling regularly throughout the week. During these activities, we may find ourselves using different body parts more so than others. You might use one arm more than the other, twist to one side only throughout the day, or rest your body weight mostly on one leg for example. All of these unequal forces are distributed throughout the entirety of your body.
The result is the development of movement restrictions. Sometimes these movement restrictions reside in the muscles, ligaments and other soft tissues of your body. In these cases, the restrictions can be cleared through soft tissue massaging techniques. More commonly however, restrictions reside at the level of the bony joints and manipulation is used to free the joint from aberrant motion. If aberrant joint motion is allowed to persist, the more mobile joints in your body start to take on more workload, becoming increasingly mobile to the point where they are at risk of also being injured.
Manipulation can be effective if it is targeted at those joints which are less mobile. These joints are found all over your body, not just in your spine. If all your joints are moving to the best of their ability and within a healthy range, this means that the workload your body faces each day is spread evenly and your joints will not be overly or underly exerted.
You can read more about manipulation here.
What conditions do you treat?
Essentially, we treat musculoskeletal injuries, which translates to injuries to do with muscles, joints, ligaments, nerves and fascia. This could include anything from sprained ankles, up to neck and headache pain, with everything in between, hamstring strains, low back pain, shoulder rotator cuff injuries, etc.
You can get more information about some of the conditions treated here.
How do you treat?
We adopt a whole body approach in that if you present with a low back problem, you could expect your practitioner to assess your feet as part of the treatment for example. The site of pain does not necessarily indicate the site of the problem and so it is always advantageous to look elsewhere in the body for explanation as to why you present the way you do.
‘Please have a look at the services page for more information on the various modalities offered at the practice.
What is Active Release Technique (ART)?
ART is a state of the art soft tissue system/movement-based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Every ART session is actually a combination of examination and treatment. The ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.
These treatment protocols – over 500 specific moves – are unique to ART. They allow providers to identify and correct the specific problems that are affecting each individual patient. ART is not a cookie-cutter approach. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles.
Overused muscles ultimately produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.
How can I get better quicker?
To accelerate your recovery, we will provide you with safe and effective home exercises. We always ensure you understand how these exercises will assist your condition, and that you can perform them correctly in front of me. Patients often forget, that whilst they might see their practitioner twice or even three times a week, there is an abundance of time in between sessions they could be using to improving their state. If you adhere to the proposed treatment plan as set out in your initial consultation, and you are diligent with your home exercises, you can expect to return to normal activity much sooner.
What's the difference between a physio and a chiro?
Not a great deal. Physiotherapists treat physical injuries to the body, whether they be from accidents, post-operative or long term postural pain from desk work etc. You might see a physio for an injury to your ankle, your low back or your shoulder for example. Chiropractors are traditionally known for treating the spine alone using manipulation. Today however, many chiropractors have furthered their interests in the treatment of other injuries to do with the arms and legs as well.
Many chiropractors will claim they can fix your knee problem, for example, by treating your spine. Sometimes, this may be the case, but you will most likely need local attention to your knee as well. Rarely is there an arm or leg complaint that is solely due to a spinal cause. Chiropractors spend five years studying anatomy and biomechanics of the entire body whilst at university (physios spend four) so you can be certain all chiropractors are just as familiar with structures of the body as are physios.
In terms of the actual treatment, physios might include ultrasound or interferential therapy, the McKenzie Method, Feldenkrais, massage, stretching and even manipulation. What most people don’t realise however, is that chiros can utilise all of these modalities as well. You can expect all physios and chiros to know the basic techniques like massage and stretching. The other aforementioned modalities are just a few of many other extra-curricular studies these practitioners might choose to add to their treating skills through further study at treatment seminars or conferences. Working in health is the same as working in any other profession, once you get qualified, you’re free to specialise in a multitude of different facets. Knowing this, as a prospective patient for physical therapy, you might want to research just who it is you plan to seek help from, and the methods he or she uses to get you better.
Gone are the days where you can say chiros treat spines and physios do everything else. Like all professions though, there is great diversity amongst practitioners, and so you need to do your research before wandering into a practice expecting to have your knee treated.