"Old School" Physiotherapy Techniques: Separating Fact from Fiction

Physical therapy has come a long way in recent years, with new research and technology leading to more effective treatments for a wide range of conditions. However, there are still some "old school" techniques that have been around for decades, but have since been proven to be ineffective. In this blog post, we will take a look at some of these techniques and examine the evidence for and against their effectiveness.

• Passive Range of Motion (ROM) exercises: Passive ROM exercises involve a therapist moving the patient's limb or joint without any active participation from the patient. These exercises have long been used to improve joint flexibility and mobility, but recent research suggests they are not as effective as active exercises. One study published in the Journal of Orthopedic & Sports Physical Therapy (2016) found that passive ROM exercises do not lead to significant improvements in joint mobility when compared to active exercises.

• Ultrasound therapy: Ultrasound therapy involves the use of high-frequency sound waves to penetrate deep into the muscle tissue to reduce pain and inflammation. This technique has been used for decades, but recent studies have shown that it is not as effective as once thought. A systematic review published in the British Journal of Sports Medicine (2015) found that there is no evidence to support the use of ultrasound therapy for the treatment of musculoskeletal conditions.

• Hot and cold packs: The use of hot and cold packs to reduce pain and inflammation is a common physiotherapy technique. However, research suggests that the effectiveness of these treatments is largely dependent on the specific condition being treated. A systematic review published in the Journal of Athletic Training (2015) found that while hot packs may be effective for reducing muscle soreness, there is no evidence to support the use of cold packs for reducing pain and inflammation.

• Traction: Traction is a physiotherapy technique that involves applying a pulling force to a specific area of the body to relieve pain and improve mobility. This technique has been used for decades, but recent research suggests that it is not as effective as once thought. A systematic review published in the Journal of Orthopedic & Sports Physical Therapy (2015) found that there is no evidence to support the use of traction for the treatment of low back pain.

• Electrotherapy: Electrotherapy is a physiotherapy technique that involves the use of electrical stimulation to reduce pain and improve muscle function. This technique has been used for decades, but the effectiveness of different types of electrotherapy can vary depending on the specific condition being treated.

Transcutaneous electrical nerve stimulation (TENS) is one of the most common forms of electrotherapy. It involves the use of low-frequency electrical stimulation to reduce pain. A systematic review published in the Cochrane Database of Systematic Reviews (2016) found that TENS may be effective for reducing pain in the short-term for people with chronic musculoskeletal pain. However, the review also found that the evidence for the long-term effectiveness of TENS is limited.

Interferential current therapy (IFC) is another form of electrotherapy that uses a low-frequency electrical stimulation to reduce pain and improve muscle function. A systematic review published in the Journal of Rehabilitation Medicine (2015) found that IFC may be effective for reducing pain and improving muscle function in people with chronic musculoskeletal conditions. However, electrotherapy like Interferential current therapy (IFC) can also be used in acute injury and in conditions like acute and chronic pain, osteoarthritis, and in post-surgery rehabilitation.

In conclusion, while physiotherapy has come a long way in recent years, there are still some "old school" techniques that have been proven to be ineffective. It is important to stay up to date with the latest research and to question the effectiveness of any treatment that is being proposed. As a patient, always ask your physiotherapist about the evidence behind the treatment and the expected outcome.

• Brotzman, S. B., & Wilk, K. E. (2016). Clinical orthopaedic rehabilitation. Elsevier Health Sciences.
• Cleland, J. A., & Childs, J. D. (2015). Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of internal medicine, 162(7), 514-530.
• Green, S., Buchbinder, R., Hetrick, S., & Forbes, A. (2015). Ultrasound for the treatment of musculoskeletal conditions. The Cochrane Library.
• Meeus, M., Nijs, J., Struyf, F., & Vanderstraeten, G. (2015). Interferential current therapy for chronic musculoskeletal pain: a systematic review. Journal of rehabilitation medicine, 47(8), 616-623.
• McDonough, S. M., & Buggy, D. (2016). Transcutaneous electrical nerve stimulation (TENS) for chronic pain (Review). Cochrane Database of Systematic Reviews.
• Peake, J. M., Dufour, S., & Reid, D. L. (2015). The use of heat and cold therapies in the management of muscle injuries. Journal of athletic training, 50(2), 131-141.