Manual Therapy Left Me Disappointed and Feeling Worse. So What’s the Point In Trying Again?

I get giving up on physiotherapy. I’ve been there and felt exactly the same way.

You finally found the time and money to go see a physiotherapist/osteopath/chiropractor (to keep the word count down you’ll hear me refer to all of these professionals collectively as “manual therapists” for the rest of this post). 

They did some assessments and probably gave you a diagnosis of some kind. For a moment you might have felt hopefully, and maybe even optimistic about getting better.

Until. . . 

The exercises that they give you made your symptoms worse, not better.

They tried to get you to purchase a “treatment package” (and maybe even pressured you to purchase it with some sales tactics)

When you didn’t get better, they gave up or lost interest in your case, and yet again you were left alone and in pain.

 

They told you that if only you had . . 

• Done your exercises “better” (because they’ve worked on every other patient, so obviously YOU were the problem here)
• Rested more
• Been less stressed
• Or just changed your mindset and thought more “positively”

 

. . . That you would have got better.

They didn’t deliver results as clinicians, and instead of saying “Hey, you know what I think we might need to refer you to someone more qualified” they patient-blamed when they encountered a case that exceeded the limits of their professional expertise and handed you a lifelong pain sentence.

In fact, all of this happened to me when I was 16 with shoulder pain from swimming. The treatment felt pointless, the prescribed exercises made it worse, and it left me promising myself I would NEVER see a manual therapist of any kind again. 

And then I became one. 

I became one because by chance I experienced good manual therapy. I was on track to studying law (I was actually even accepted into a few law schools) and I gave up a career in law because I experienced manual therapy that literally changed my life. 

And I knew that I needed to bring more life-changing manual therapy to the world. Because unless you’ve been there, unless you’ve woken up with the same horrible, relentless, inescapable pain for months (if not years), you don’t get how awful experiencing chronic pain can be.

So I specialised. I studied. And I became very judgemental when it comes to what counts as good manual therapy (and what counts as not-so-good). 

Here’s my advice on what to do when you feel done with all this. 

 

1- Appreciate that Being Told to “Get Physio” Is Literal Nonsense

I routinely see patients who have been told by their medical doctor to “get physio.” The fact that they are even being told this by their medical doctor emphasises to me how little understanding there is when it comes to the whole big, wide, world of manual therapy. 

There are many, MANY kinds of different manual therapy protocols (for example, I’m qualified in Active Release Technique) and approaches to exercise prescription. This is just the tip of the iceberg, as we haven’t acknowledged any of the other aspects of effective treatment (including patient communication, decisions regarding medical imaging, and knowledge regarding safe and clinically appropriate referral).  Telling a patient to simply “get physio” is useless because it doesn’t tell them anything about what kind of manual therapy they should be trying to access. 

Let’s use an analogy to better illustrate this. . .

Imagine that you were hungry, and as your Food Expert I thought that a bowl of pasta was going to be the best way to address your hunger. 

Imagine that I told you to “Get Pasta.”

This could go super well. You might get the best pasta you’ve ever had and your appetite would be satiated and you would be thrilled. Maybe you even stumbled upon gluten free pasta (which helped you because you didn’t even know at the time that you needed gluten free pasta, but due to unidentified gut issues you do). 

This could also go super badly. You could get the soggiest, slimiest, mushiest bowl of pasta with the worst toppings and watery sauce. 

If you had the time and money to do so, you might end up trying another couple of pasta places. But you could STILL be unlucky and keep having bad pasta. 

And it’s the same with the whole “Get physio” instruction.

You might stumble upon a great manual therapist who has an understanding of hypermobile connective tissue from Day One. Or you might end up seeing a not-so-great manual therapist who hasn’t ever heard anything about hypermobile connective tissue. 

Not all manual therapy is created equal, and this is why it’s so important to do your research and be discerning when it comes to choosing who to trust with your body. So instead of just getting physio, try to find a manual therapist who can provide the right manual therapy for your specific issues.

2- The Type of Manual Therapist Doesn’t Matter As Much As Whether They’re Good (Or Not)

If I was looking for someone to treat me I wouldn’t be making the decision based off whether they are a physiotherapist, osteopath, or chiropractor.

I would make the decision by looking at their postgraduate qualifications (in the UK we refer to this as Continuing Professional Development courses or CPD). 

I would specifically be looking for someone who holds a current certification in Active Release Technique®, as I know that this would help to standardise to an extent the treatment I was receiving. 

I would also look for someone who demonstrated an interest in their clinical work outside the standard 9-5. I would want to be seen by someone who was truly passionate about what they do, and who tried to contribute positively to their field outside of their clinic hours. 

Years of experience wouldn’t matter to me as much as someone’s bedside (or should I say “treatment-table-side”) manner (also, years of doing something doesn’t necessarily mean that someone is good at it). I would want someone who not only was personable, but who clearly laid out the diagnosis, prognosis, treatment plan, and how we were going to measure progress. I would want someone who was a brilliant strategist in addition to being an excellent clinician. 

I know this list sounds long and demanding, and it is. But it’s important to be discerning in which manual therapists you work with as they can help you as much as they have the potential to hurt you.

One tip I always give out when asked how to find these great manual therapists is to send an email outlining your case and see how they respond (or, even better, see if they’ll arrange to speak with you briefly by phone). I always offer to speak with prospective new patients by phone as I appreciate that many of the people who reach out to me have had complex healthcare journeys, and I want to make sure that I am the correct healthcare provider for them to see before they make the effort to come see me in my clinic room. 

Good healthcare is about respect and thoughtfulness. So look for those qualities in your healthcare providers if possible. 

CONCLUSION

Be picky and be discerning when it comes to manual therapy. If you’re hypermobile then your body has specific needs, and although hopefully in future there will be more manual therapists who are familiar with the specific needs of hypermobile patients for now it’s still unlikely that the average manual therapist will be suitable for your injuries.