What are some of the problems with manual therapy?

Manual therapy is becoming fairly controversial in recent years. Manual therapy frequently covers the physical rehabilitation techniques of manipulation and mobilization. That dispute is predicated about the not having enough high-quality research that truly shows it improves outcomes. Which doesn't imply that this doesn't help, it really shows that the level of the analysis that advocates for its use is not very good. The other dilemma that is making it debatable is that if this will help, then what makes it work. During the past it was the amazing cracking sound like a joint is placed back into place. Lots of the proof right now demonstrates this that isn't how it helps plus it quite possibly works through some kind of pain interference system offering the sense the pain is improved. None of this is completely obvious and much more research is ongoing to try to handle this dilemma. This presents a dilemma for health professionals who use these types of manual therapy clinical skills and need to generate selections on how to help their clients clinically but still be evidence based in what they do.

A freshly released episode of the podiatry chat show, PodChatLive made an effort to consider these kinds of matters in terms of mobilization and manipulation for foot problems. In that particular chat the hosts sat down with Dave Cashley whom presented his knowledge both from his years of clinical practice and his own study on manual therapy. His research has been about its use for Morton's neuroma and it's appearing to be encouraging. Dave also voices his opinion on a lot of the criticisms that have been directed at mobilization and manipulation. Dave is a podiatrist plus a respected international speaker and teacher. David is a fellow of the Royal College of Physicians and Surgeons and has written and published a number of papers on podiatric manual therapy in the journals in recent times. During his career, he has worked alongside professional athletes, elite athletes, world champions, international dance groups along with the British armed service.

Why do Podiatrists measure pressure under the foot?

Plantar pressure measurement is a method that is becoming increasingly employed in clinical evaluations. It can be useful to assess for such things as just how much stress there exists underneath the feet, that may be essential to ascertain in those with diabetes mellitus who are susceptible to a foot ulcer. Plantar pressures will also be helpful to help determine how people walk and how pressure changes during the gait cycle. This is often useful information to help podiatrists order and design foot orthoses. This really is such an important problem that an episode of the livestream, PodChatLive ended up being devoted to this. PodChatlive is a Facebook live that has two hosts plus a different invitee on each show where they explore topics of relevance to podiatry and related topics. It is usually uploaded to YouTube and as an audio podcast.

In that episode, they discussed plantar pressures and pressure mapping together with Dr Bruce Williams DPM from Indiana, USA. Bruce is a Fellow and previous President of the American Academy of Podiatric Sports Medicine and who owns Breakthrough Podiatry in NorthWest Indiana and has substantial experience on plantar pressure measurements, pressure mapping and their interpretation and clinical use. Bruce uses both the in-shoe system and pressure mat devices within his clinic and has been doing this for almost two decades now. He is well published on this topic in peer reviewed scholastic journals, so is in a position to speak about this subject. In the episode of PodChatLive they talked about exactly what the centre of pressure can be and how it can be used clinically to determine what is occurring. Additionally they discussed how pressure info influences his clinical decision making, especially foot orthotic design. They reviewed the advantages and disadvantages of in-shoe versus the mat technologies and try to present some advice to those who might be thinking of including this type of service to their practice.