Manual therapy is both rewarding and physically demanding. Therapists use their skills and energy to relieve pain and enhance patient well-being, but this often makes them prone to various injuries.
A 2022 review in BMC Musculoskeletal Disorders highlighted that physical therapists face significant risks: thumb disorders (7.6%-52.5%), wrist and hand disorders (5%-66.2%), shoulder disorders (3.2%-45.2%), and elbow disorders (4%-16%). These numbers emphasize the importance of injury prevention and management in the field.
Regardless of whether you are a physical therapist, chiropractor, RMT, or another allied medical professional, repetitive motions and prolonged postures can lead to injuries. Over time, these can impact your professional abilities and personal quality of life.
However, the risks of injury can be mitigated with proper knowledge and techniques. Key strategies include understanding common injuries, recognizing high-risk procedures, maintaining regular exercise routines, seeking personal care, and using treatment systems that reduce injury risk.
Article Index:
Higher Risk Procedures For The Therapist
One of the most common issues manual therapists face involves their hands, particularly the thumbs. The thumb's unique saddle joint and ability to oppose other fingers make it a powerful tool for applying pressure, manipulating soft tissues, and facilitating joint mobilization. However, its extensive range of motion and frequent use make it susceptible to wear and tear, leading to conditions like De Quervain's tenosynovitis, osteoarthritis, or sprains and strains.
Therapists often rely on their thumbs and fingers to generate force, which can lead to cumulative stress and injury. But what if we could modify our techniques to protect our health and improve treatment outcomes?
This is where procedural diversity and adaptability come in. We don't always need to generate force through our fingers. Alternative methods, such as using our forearms and techniques like circumduction, can reduce strain on our hands while enhancing treatment effectiveness. By diversifying how we apply force and manipulate tissues, we can minimize the risk of overloading any single body part and expand the therapeutic options available to our patients.
Fewer Injuries Better Results
It's crucial to dispel the idea that there's only one "correct" way to perform a procedure. Practitioners can sometimes become overly focused on a specific technique, often popularized by an influential figure or "guru" in the field. While these techniques have value, they shouldn't restrict our approach. Each patient is unique, and our therapeutic strategies should reflect that.
Integrating techniques from multiple disciplines not only diversifies the physical demands on the therapist but also enriches the therapeutic toolkit. A practice informed by various methods—such as myofascial release, trigger point therapy, joint mobilization, and MSR—provides a more comprehensive approach to patient care. By blending techniques, we can achieve results that a single method might not, while also reducing the risk of repetitive strain injuries.
Self Care
As manual therapists, maintaining our physical and mental well-being is crucial. Just as we guide our clients in their healing journeys, we must also commit to regular self-care. This includes balancing strength training, mobility exercises, and maintenance treatments.
Strength training, especially focusing on the core, enhances stability and force generation during procedures, reducing the risk of injury. Mobility exercises prevent muscle imbalances and joint restrictions from our work, improving our physical capabilities and creating a buffer against the physical stressors of our profession.
Additionally, incorporating practices that promote mental relaxation and stress relief, such as yoga or meditation, is essential to our self-care routine. A healthy mind is as important as a healthy body in delivering effective therapy.
Exercise Recommendations
Below are some exercise routines that I commonly perform to prevent injuries for my hands and upper extremity:
The Value of Peer Treatments
Receiving routine treatments from fellow professionals serves as a preventative measure, enabling early detection and intervention for impending injuries. This proactive approach not only contributes to your physical well-being but also offers an invaluable perspective on patient care.
The Empathy Equation
Being a patient in your own discipline provides an illuminating viewpoint that can refine your practice. It nurtures a deeper sense of empathy and understanding, subsequently enhancing the rapport and efficacy of the relationships you build with your clients.
The following are some of the techniques that I frequently administer to other healthcare providers:
Conclusion
Our profession is like a unique dance, constantly exchanging force and guidance with our hands. To keep this dance in harmony, we need to integrate strength training and mobility exercises into our routines. Strengthening our bodies and improving our flexibility creates a resilient shield against the physical demands of our work.
Additionally, switching roles and receiving care can offer valuable insights. Investing in our own therapeutic journeys cultivates empathy and understanding, enriching the care we provide to our patients. In this dance of healing, we are both the dancers and the audience, learning, adapting, and growing with each step. By recognizing the physical demands of our profession and taking proactive steps to protect our well-being, we can deliver exceptional care, reduce injury risks, and fully enjoy our careers.
References
Bork, B. E., Cook, T. M., Rosecrance, J. C., Engelhardt, K. A., Thomason, M. E., Wauford, I. J., & Worley, R. K. (1996). Work-related musculoskeletal disorders among physical therapists. Physical Therapy, 76(8), 827-835.
Cromie, J. E., Robertson, V. J., & Best, M. O. (2000). Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses. Physical Therapy, 80(4), 336-351.
West, D. J., & Gardner, D. (2001). Occupational injuries of physiotherapists in North and Central Queensland. Australian Journal of Physiotherapy, 47(3), 179-186.
Glover, W., McGregor, A., Sullivan, C., & Hague, J. (2005). Work-related musculoskeletal disorders affecting members of the Chartered Society of Physiotherapy. Physiotherapy, 91(3), 138-147.
Campo, M., Weiser, S., Koenig, K. L., & Nordin, M. (2008). Work-related musculoskeletal disorders in physical therapists: a prospective cohort study with 1-year follow-up. Physical Therapy, 88(5), 608-619.
Alrowayeh, H. N., Alshatti, T. A., Aljadi, S. H., & Fares, M. F. (2019). Prevalence, characteristics, and impacts of work-related musculoskeletal disorders: a survey among physical therapists in the State of Kuwait. BMC Musculoskeletal Disorders, 11(1), 116.
Waller, E., Bowens, A. & Washmuth, N. Prevalence of and prevention for work-related upper limb disorders among physical therapists: a systematic review. BMC Musculoskelet Disord 23, 453
Briggs, M. S., Weber, M. D., Olson-Kellogg, B. J., DeWitt, J. J., Hensley, C. P., Harrington, K. L., Kidder, M. S., Farrell, J. P., & Tichenor, C. J. (2022). Factors Contributing to Physical Therapists’ Job and Career Satisfaction in the United States: Results From a National Survey. Journal of Physical Therapy Education, 36(3), 232-241.
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DR. BRIAN ABELSON, DC. - The Author
Dr. Abelson is dedicated to using evidence-based practices to improve musculoskeletal health. At Kinetic Health in Calgary, Alberta, he combines the latest research with a compassionate, patient-focused approach. As the creator of the Motion Specific Release (MSR) Treatment Systems, he aims to educate and share techniques to benefit the broader healthcare community. His work continually emphasizes patient-centred care and advancing treatment methods.
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