Manual therapy is a dive into a wonderful world of mystery and excitement. I love being able to make changes with manual techniques and feel the tissues respond under my hands. I feel like I get to "talk" with the body. It truly is a magical experience.
I'm often asked how someone can expect to feel after a treatment session. I'm sure my response may be rather confusing when I say, "You will either feel better, worse, or nothing at all. The only thing I can guarantee from hands-on treatment is there will be a change!" But how the body and mind processes that change can be a wild card.
Knowing that the body is a complex system, there is so much that feeds into its response to treatment. The level of inflammation that already exists in the body (diet, stress, etc.) and the mind's interpretation of new sensations in specific areas of the body (fear vs. excitement or curiosity) are key components that influence what is experienced after a session. For example, if there is an area of the body that has had physical trauma or stored emotional trauma, touch to this area may register as threatening to the brain. Sometimes we don't know that an area is dysfunctional until we experience soreness after treatment. It is also common to feel soreness in an area that wasn't even touched.
Certain techniques of manual therapy use friction to address fascia, which creates an inflammatory response and starts the healing cascade. This soreness usually lasts for about 48 hours. During this window of time, it is important to avoid taking an anti inflammatory medication so that the healing cascade can proceed. If you are sore after treatment, at the very least, do some gentle movement that is tolerable. This can be an easy walk, stretching, focused breathing, your home exercise program, yoga, tai chi, etc. Drink plenty of water and make sure you are getting enough protein since this is essential for repairing and building tissue. Ultimately, the changes that you gain in the clinic are maintained by the "use it or lose it" paradigm. Your exercise program, is designed to encourage this.
Since I have gone to many manual therapy courses over the years, I have been on the receiving end of treatment to every inch of my body! I have had all sorts of experiences afterwards like feeling more fluid with movement, improved breathing, soreness, feeling taller, feeling more grounded, feeling like I'm floating, a great night's sleep, a more efficient gait, improved mood, stomach pain so bad that I skipped dinner and ugly cried while watching Lady Bird (true story), and an intense menstrual cycle that later progressed to subsequent great menstrual cycles. These reactions have happened even with very gentle techniques! As you can see, you just never know. It's all just information. Nothing is wrong or worse but it is changed.
There have been great responses to hands-on treatment over the years that I have heard from patients. Here are some of my favorite quotes that I can remember over the (almost) 13 years of being a PT:
"Now I have to poop."
"I feel giddy."
"My body just became really relaxed."
"I suddenly got very sleepy."
"I feel qi coming out through my fingers."
"My Oura ring thinks I just took a nap!"
"It feels like I'm floating."
"I just had a really good breath."
"I feel light!"
My intent is always to assist the body to move more efficiently. Sometimes that requires very delicate techniques while other times it takes some friction to actually change the properties of the fascia. Receiving manual therapy is like the unraveling of an onion; there can be years of compensation to address. Will you feel better after a session or sore? It's hard to tell. The only thing I can guarantee is change.
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