TotalMSK Musculoskeletal / MSK Clinic FAQs

TotalMSK Musculoskeletal Chiropractic treatment FAQs

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Musculoskeletal, Health and Wellbeing related questions

Why choose TotalMSK?

At TotalMSK, we specialise in treating Musculoskeletal / MSK related conditions and put the consumer's interests first. Unfortunately, the musculoskeletal healthcare sector is vast and largely unregulated, which creates the opportunity for "bad" actors. Some within the musculoskeletal field do not put the consumer's best interests at heart, and such a situation can even apply to some of the regulated professionals. The article on finding a good, ethical and moral MSK healthcare professional helps offer some pointers on what to look for and avoid when seeking treatment. We specialise in the assessment, treatment and rehabilitation of work and sports-related Musculoskeletal / MSK conditions. Our goal is to identify the root cause of symptoms and get you the consumer out of pain and back to activity, as quickly as possible. TotalMSK has extensive in-house experience covering the treatment of a wide variety of Musculoskeletal / MSK conditions and Work Place Health and Safety and Mental Health in the workplace. Not only do we work from a musculoskeletal perspective, but our practitioners have extensive training in multiple advanced soft-tissue techniques too. In our experience and opinion, such a mix of training allows our practitioners to treat a wider variety of conditions effectively.

Our practitioners tailor treatments to you the consumer's unique set of circumstances, and besides interventions, include preventative advice covering work and non-work-related activities. Initial consultations always look at multiple related aspects of the human body including; biological factors, social factors and psychological factors. Such factors include previous injury history, activity levels, previous conditions, stress, sleep, diet and much more. Stress within and outside of the workplace has become a significant issue over time, and besides having a physiological impact on the Musculoskeletal / MSK System, can also lead to Mental Health-related problems and other debilitating conditions. There are three articles on TotalMSK's blog covering the human stress response and the effects of this. Besides the expertise within TotalMSK, we also have a professional referral network. Meaning that should a specific issue not be of a Musculoskeletal / MSK nature, then a consumer can be referred to an appropriate and suitably qualified professional. Other noticeable differences are:-

Block and Discounted treatment plans

Although block treatment plans may be in the best interests of the practitioners using them, we do not believe they are in the best interests of the consumer. Our view is that such practices can psychologically and financially tie consumers into an extended period of treatment. Even in the case of practitioners that operate block treatment plans, such practitioners should make it clear about how consumers can cease treatment and any possible financial consequences. In our experience, our consumers have never needed multiple weekly treatments, extending over weeks and months. Hence, you will not find our services offered on discount voucher websites or block discounted treatments. (See how many treatments am I likely to need).

Treatment plans/frequency

We have found that treatment plans rarely require more than one treatment in any given week and this is partially due to the way we work, though there can be exceptions. There have been occasions in acute cases where a consumer has needed more than one treatment in any given week or where something has happened to irritate symptoms between planned treatments. That said, such incidents have tended not to reoccur during a given treatment plan due to several reasons. For example, we always aim to educate our consumer's about their conditions and the root cause, along with strategies to avoid irritating symptoms and the rationale and importance of following aftercare advice. In essence, treatment is a collaborative process aimed at resolving specific symptoms or in some cases, just managing symptoms.

Musculoskeletal symptoms tend to be caused by changes in biomechanics due to one or a combination of factors. Some examples of possible factors might include, injury (misuse, abuse or overuse type of injury), previous unresolved injury, stress, other medical conditions etc. Equally, symptoms may not be the root cause of a problem due to tissue adaptations (see the article on tissue adaptation) affecting biomechanics. Treatments aim to create biomechanical changes to relieve symptoms, and a lot is achievable in 30 minutes. In our experience, consumers typically notice the most changes in the first 72 hours post-treatment and symptoms can be better or worse and vice versa during that time window. The body has to adapt to the modifications created during treatment, which often means joints and tissue move and get used differently. Hence, tissues or joints can ache while the structures become accustomed to being used or used differently. Aftercare advice further supports the changes created by any given treatment and leads to further adaptations. Based on experience, consumers can often notice subtle adaptations for up to 7-8 days post-treatment. Our treatment process and taking account of the bodies adaptation process means consumers rarely need seeing more than once in any given 7-8 day period and indeed not 2-3 times a week. Follow-up treatments during a treatment plan aim to build on the adaptive changes created during the previous treatment and aftercare advice.

MSK Treatments

Our treatments are typically 30 minutes in duration and yet a similar cost to other far shorter treatments of between 8 and 20 minutes. The reason for this is due to the way our practitioners work with a combination of treatment methods. The combination of advanced Musculoskeletal and soft-tissue techniques has proved to be highly effective. However, to effectively treat in such a fashion requires time, and this is not feasible in a much shorter treatment window. Equally, follow-up treatment sessions involve adaptations to aftercare advice based on consumer progress. In our experience, it is also not feasible to get a consumer update between treatment sessions, provide treatment and adapt aftercare advice in less than a 30-minute treatment session window.

Professional Memberships and Registrations

All of our practitioners hold registrations and professional memberships with relevant voluntary and statutory regulators. Primary healthcare practitioners all have statutory regulators, which have legal requirements. Such requirements govern; continuing professional development, codes of conduct, the scope of practice, insurance requirements, criminal records, etc. Unlike, Primary healthcare practitioners, there are no legal regulators for many soft-tissue and other related professions. Regulators help protect the public, even voluntary based ones. Hence, if somebody is not registered even in a voluntarily regulated industry, then one should ask why not? There are associated costs with meeting yearly registration requirements for practitioners, but it helps to reassure the public. Other requirements of registration help ensure that practitioners are kept up-to-date with recent research.

What's the difference between a Chiropractor, Osteopath and Physiotherapist?

People often ask what the differences are between a Chiropractor, Physiotherapist and Osteopath. All three professions have a statutory regulator within the UK and have legally protected titles. Hence, it is illegal for anybody not trained and registered with the relevant regulatory body to profess to be or use the term Chiropractor, Osteopath, Physical Therapist or Physiotherapist. There are many similarities and some differences between the three professions. All three professions are Primary Care Health Practitioners and have to complete either a University degree or Masters level qualification. Each occupation also works with diagnosing and treating Musculoskeletal related conditions. Chiropractors and Osteopaths both learn manipulative techniques as part of their training and education, which typically comprises of a four year full-time Masters level qualification. Physiotherapy training usually takes three years full-time and results in a degree. The degree does not include training in manipulative therapy techniques (HVLA). Physiotherapists can complete further training and or a Masters and then can also use manipulative therapy techniques with consumers.

Historically, Chiropractors have tended to use manipulative therapy techniques as the primary way of treating musculoskeletal-related conditions. Osteopaths have typically used a combination of manipulative therapy and soft tissue techniques. Physiotherapists have tended to use a combination of soft-tissue techniques and prescriptive exercise. However, these days, there is a considerable amount of cross-over or blurring between what practitioners might do within each profession. The fundamental differences these days probably relate to philosophy and thus, how practitioners in each profession might assess and treat a specific condition. The definitions for each occupation can be found below and are the actual text used on each regulators website.

General Chiropractic Council (GCC) - UK Statutory Regulator

"Chiropractic is a health profession concerned with the diagnosis, treatment and prevention of mechanical disorders of the musculoskeletal system (bones, joints and muscles), and the effects of these disorders on the function of the nervous system and general health. There is an emphasis on manual treatments including spinal adjustment and other joint and soft-tissue manipulation."

General Osteopathic Council (GOC) - UK Statutory Regulator

"Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together."

Health and Care Professions Council (HCPC) - UK Statutory Regulator

"Physiotherapists deal with human function and movement and help people to achieve their full physical potential. They use physical approaches to promote, maintain and restore wellbeing."

Are there any reasons why I may not be suitable for treatment (contraindications)?

The following list is not exhaustive, and other conditions can contraindicate a consumer from having treatment. The list also covers other musculoskeletal related treatments offered by TotalMSK practitioners. However, treatment may still be suitable for a consumer and may only actually be locally contraindicated. Local contraindications mean that a specific area either cannot be treated or that only particular therapies may be appropriate. Global contraindications may mean that it is not currently safe to treat you the consumer with a specific technique at the time. There may be occasions where one may need to gain GP approval before commencing treatment. Getting GP approval tends not to be an issue. Just because it is not safe to use one type of technique, others may be entirely appropriate. Should you have any doubts or questions, then please contact a practitioner at TotalMSK. Our practitioners will be more than happy to talk you through any queries or concerns.

Typical types of Contraindications may include:-

  • Open wound, fractures or dislocations.
  • Myositis Ossifications.
  • Deep Vein Thrombosis (DVT.)
  • Varicose Veins (Local contraindication).
  • Infectious skin diseases (bacterial, fungal, viral, herpes and lymphangitis).
  • Severe Sunburn.
  • Pregnancy and within the first trimester of pregnancy.
  • Tumours.
  • Cancers.
  • Haemophilia and other bleeding disorders.
  • Acute soft tissue inflammation (muscles, tendons, ligaments, organs and other underlying structures). Acute soft tissue inflammation is typically treated using R.I.C.E (Rest, Ice, Compression and Elevation) as a means of reducing inflammation and which is usually applied at the time of the initial injury.
Are there any side effects of treatment?

One may experience some mild side effects after any Musculoskeletal / MSK therapy treatment. Such as MSK therapy techniques, Remedial Massage, Sports Massage, Dry Needling (DN) or Gua Sha/IASTM, which is perfectly normal. Not everybody is affected, but for those people that are the side effects typically occur within the first 12 - 48 hrs post-treatment and usually last between 48 - 72 hrs. These side effects tend to be the result of creating change within the body, which affects soft tissues, altering biomechanics/movement patterns and stimulating the bodies natural healing processes. One may or may not experience one or more of the following:-

  • Aches, soreness, tenderness or stiffness.
  • Different areas aching to those treated
  • Emotional changes.
  • Headaches.
  • Feelings of relaxation or of being invigorated.
  • Changes in sleep patterns.
  • Dizziness or nausea.
  • Spots.
  • Altered bowel movements.
  • Changes in urine output, colour or frequency.
  • Body temperature changes.

In some cases and particularly when a condition or symptoms have been long-standing (chronic), one will usually notice that symptoms can appear to be worse after the first treatment. As previously mentioned, such side-effects typically last for up to between 48 - 72 hrs. However, consumers can often notice positive or negative changes for up to seven to eight days, due to differences in biomechanics and the resulting tissue adaptations. Typically, in chronic conditions, there has been a great deal of time to enable dysfunctional tissue patterns to occur and indeed, physiological changes within tissue structures. Such changes can affect the Musculoskeletal / MSK system and result in altered movement patterns, aching, pain, restricted movement, and even affect other body systems. Hence, working on these dysfunctional tissues can make things worse in the short term.

Many Musculoskeletal / MSK therapy techniques create microtrauma during the treatment. Dysfunctional tissues then have to heal and adapt to these changes regarding function and biomechanics. Allowing the tissues to heal correctly is necessary if one wishes to return them to as a near-normal functional state. Hence, after treatment, one may notice other regions of the body aching and not just the treated areas. Also, dysfunctional movement patterns can develop over time due to "lack of use, misuse, overuse and abuse" (Leon Chaitow, Osteopath). Such changes, will impact multiple other tissues and create change in these too, especially in chronic cases. By treating these dysfunctional Musculoskeletal / MSK patterns, one is enabling the tissues of the body as a whole to work as intended. Hence, these other tissues may have been inactive for an extended period and so are likely to ache when they start getting used correctly. Side effects can often be minimised by following the aftercare and home care advice provided by the therapist at the end of the treatment session. The Basic Running / Sports Injury Prevention article briefly covers tissue adaptation. The principles equally apply to the prevention of and the rehabilitation of Musculoskeletal / MSK injuries in general. There is also a far more detailed article about Adaptation in a Musculoskeletal Context, which has relevance for injury prevention, rehabilitation and aftercare.

Why do I have to have an initial Musculoskeletal therapy consultation?

The initial Musculoskeletal therapy consultation is a requirement of being treated for many reasons. Primarily, it is to establish if it would be safe to treat you the consumer and if Musculoskeletal therapy care would be suitable. If it is unsafe to provide care for you, then you will be referred to a suitably qualified medical practitioner for further investigations and or treatment. The consultation is also to ensure that you get the best individualised treatment for your unique personal history. Your background information will be unique to you regarding medical, emotional, physical and lifestyle aspects, often referred to as BioPsychoSocial factors. One can view overall health from multiple constructs such as Physical, Mental, Emotional, Social, Environmental and Spiritual, with each part affecting the next. Hence, your treatment plan needs to take into account your unique history. Finally, the consultation is a requirement of regulated health professions, professional associations and also insurance companies. All suitably qualified practitioners will conduct initial consultations and keep consumer record card information. If a therapist or practitioner is not doing this, then there are good reasons for concern.

It is vitally important to be completely open and honest during the initial and confidential consultation process. Practitioners will be interested in all aspects of health, even if the consumer does not view them as relevant. In essence, there are a vast number of possible variables affecting how and why symptoms may have occurred. Such variables may include medications, habits, previous injuries, operations, diet, stress, other medical conditions, existing on-going treatments etc. Each variable is like a small piece of a giant jigsaw puzzle. Hence, the more a practitioner understands regarding a consumer's unique health circumstances, the better they can help. There is also an aspect of consumer safety, as certain existing conditions or medications may contraindicate some methods of treatment. There are usually multiple ways to achieve the consumer's desired end outcome via a combination of suitable techniques. There may be a contraindication for one method and not another, with consumer safety being paramount.

Why may I have to undergo more than one Initial Musculoskeletal therapy consultation?

Once somebody has undergone an initial Musculoskeletal therapy consultation, then one does not usually have to experience the same process again. However, there are circumstances where it may be necessary and is viewed as best practice by professional associations. For example, if a consumer has not been seen or treated by a specific practitioner or anybody working for the same said clinic in a six-month given period. In essence, a considerable amount can happen within six months, including, injuries, changes in medications etc. A regular appointment will not provide ample time to gather any additional details needed to assess and treat safely. An accident or other severe trauma may also mean that a consumer has to undergo another initial consultation process. Besides being viewed as "best practice", the initial consultation process is designed to protect you the consumer and ensure that you receive the most appropriate treatment.

Can Musculoskeletal therapists treat children?

Yes. If the child is under the age of 16, then written permission is required from either a parent or guardian, before providing any treatment. One can give written parental consent during the initial consultation process. Also, a responsible adult should attend and be present while the child/consumer is receiving treatment. These measures are viewed as best practice by professional associations and health profession regulators.

Can I have treatment if another therapist or professional is already treating me?

Yes. However, you should speak with your existing therapist or professional before seeking further treatment, which is partially out of courtesy. In some cases, differing therapies may be counterproductive or not advised in conjunction with one another. In other cases, therapists can work effectively with other disciplines to achieve an overall common consumer goal. However, various professionals/therapists need to coordinate treatment in such cases.

How many treatments am I likely to need?

On average, our practitioner's have found that the majority of consumers only need between three and five treatments to resolve the vast majority of Musculoskeletal / MSK related conditions. The three to five treatment figure includes the initial consultation and typically applies to one particular problem. Hence, if somebody has multiple ailments, then on average, it may take 3-5 treatments to resolve each one. That said, some consumer's have only required a few treatments for a specific condition, but everybody is different. The number of sessions needed can depend on a wide range of factors, as can the frequency of any maintenance treatment:-

  • Injury History
  • Age
  • Gender
  • Chronicity of Condition(s)
  • Following aftercare advice
  • Other relevant conditions
  • The number of individual conditions
  • Diet and lifestyle

Our practitioners have found that the combination of techniques used at TotalMSK tends to result in better consumer outcomes and a quicker symptom resolution.

Why bother with maintenance treatment?

The simple answer is because our bodies are constantly adapting to various forces, such as gravity daily. Forces impart loads on our entire musculoskeletal system. Our tissues will "adapt" to these forces over time, and one may typically notice these changes as restricted movement, tension, pain or a combination of symptoms. The article on adaptation goes into far more detail. Many consumers find maintenance treatments to be highly beneficial at countering some of the adaptations caused by the day-to-day stresses and strains of modern-day life. The frequency of any such maintenance treatments can also vary from anything from 4-6 weeks to a few months.

How much does it cost to see a Musculoskeletal therapist in the Brisbane?

Musculoskeletal therapy treatment costs can vary considerably, as can treatment times. Costs can easily range from $75 to over $130, which tends to be dependant on the type of treatment and duration. Initial consultations often take longer than follow-up appointments and as a result cost proportionally more. Please see the link to our current Brisbane Clinic treatment costs, appointment durations and any clinic promotions.

What does holistic mean?

The word holism originates from ancient Greek and means, (entire, total, all or whole). The concept of holism and its relation to health and wellbeing has existed since ancient times. Prominent historical figures who have advocated such an approach to health include Hippocrates and Galen.Holistic health is a philosophy or approach to medical care which views the whole as more than the sum of the parts. The holistic approach also aims to look at the complexed relationship between mind, body and soul and which in turn affects the end treatment. This type of approach to health has only really started being integrated and gaining significant support in mainstream health in the last 30 years. Today an individualised treatment approach is being advocated in many parts of mainstream medicine. Historically, general medicine has applied a particular treatment for a specific condition, and this has taken minimal account of individual differences. However, there have always been questions as to why two individuals with similar ailments could undergo the same treatment and yet have differing outcomes. Taking a holistic approach about how to treat the consumer is undoubtedly making a difference in mainstream medicine.

Another area of research and which also takes a more holistic view of the individual is the biopsychosocial model. This model stems from "social cognitive theory" and dates back to the late 1970s, though it is gaining much interest from a mainstream medical perspective. The model looks at how biological, psychological and social factors affect health and well being and thus has implications for treatment. In essence, a problem in one of these areas can lead to problems in the others and vice versa. A criticism of the biopsychosocial model is that it is an oversimplification of human health. Other models or constructs of health have sought to expand on the initial ideas of the biopsychosocial model and can include; Physical, Mental, Emotional, Social, Environmental and Spiritual. Each of these central aspects of health may further be subdivided, and there is still a lack of consensus on the exact main areas. Some models also include Financial health. The article on Biotensegrity explains in further detail the importance of the holistic view of health.

What is Holistic/Swedish Massage?

Holistic/Swedish massage is a traditional form of massage which uses many methods to either relax or to stimulate the body, depending on the desired effect. The techniques used include; (effleurage, petrissage, frictions, tapotement, vibrations, joint mobilisation and holding). Further details about such techniques can be found here.

Is Massage likely to hurt?

Massage is not usually painful provided that the tissues have been warmed up, and one applies the techniques correctly. However, deep tissue massage techniques can sometimes cause considerable pain, though this pain is tolerable, and consumers often refer to this pain as "good pain". Correctly used deep tissue techniques should not cause any actual tissue damage (bruising). However, such forms of treatment are designed to produce some microtrauma to congested tissues. It is often necessary to break down fibrous adhesions within dysfunctional tissues. Treatment aims to restore normal or as near normal tissue function.

What's the difference between Dry and Wet Needling?

How painful is Dry Needling?

Are there any risks with Dry Needling?

What is the difference between Dry Needling and Acupuncture?

What does the Myofascial Release feel like?

What type of conditions is Dry Needling used for?

What training to Dry Needling practitioners do?

What is a Myofascial Trigger Point?

What is Kinetic Chain and why is it relevant?

What is fascia and its relevance?

What is a Myofascial Trigger Point?

Does releasing myofascial tissue work?

What are the benefits of Myofascial Release treatment?

What is Muscle Energy Technique?

How does Muscle Energy Technique work?

What is Post Isometric Relaxation?

What is Reciprocal Inhibition?

What is Positional Release Technique?

What is Positional Release Technique used for?

What is Soft Tissue Release?

How does Soft Tissue Release work?

What is Neuromuscular Therapy?

Similarities between Neuromusclar Technique and Dry Needling

Is it possible to do self myofascial release?

Is it possible to do self trigger point therapy?

How can you help prevent injuries?


Massage and Myotherapy Registrations

Terry brings over 15 years of experience working in the MSK Therapy field back to Brisbane from the UK. He is highly qualified with training and experience covering many assessment methods, treatment types and soft tissue therapy (STT) skills. Terry's interests have led to him specialising in the treatment of trauma and myofascial pain relief. He also taught as a senior course coach over seven years ago on one of the first myotherapy courses in Brisbane. His skills are now available at the Morningside clinic, where he works as a Myotherapist.