TotalMSK Musculoskeletal (MSK) Clinic FAQs

Mobile Reading Chiropractic & Sports Massage FAQs

Why choose TotalMSK?

At TotalMSK, we specialise in the treatment of Musculoskeletal (MSK) related conditions and have developed specific expertise in the treatment of work and sports related musculoskeletal (MSK) conditions. Our aim is to identify the root cause of any given Musculoskeletal (MSK) related condition and get you the patient out of pain and back to activity, as quickly as practicably possible. TotalMSK has in-house expertise covering Musculoskeletal (MSK) Conditions (including sports and work related), Work Place Health and Safety and Mental Health in the Workplace. A number of highly effective techniques are used at TotalMSK to treat a multitude of Musculoskeletal (MSK) Conditions including: McTimoney Chiropractic, Advanced Sports and Remedial Massage, Dry Needling (Western Medicine Acupuncture), Gua Sha and Instrument Assisted Soft Tissue Mobilisation (IASTM). Treatments are tailored to the patient's unique set of circumstances and besides interventions, include preventative advice covering work and non work related activities. Initial consultations always look at a number 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 major 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. Besides the expertise within TotalMSK, we also has a referral network, meaning that should a specific issue not be of a Musculoskeletal (MSK) nature, then a patient can be referred to an appropriate and suitably qualified professional.

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How many treatments am I likely to need?

On average our practitioner's have found that the majority of patients 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 condition. Hence, if somebody has multiple conditions, then on average it may take 3-5 treatments to resolve each condition. That said, some patient's have only required a few treatments for a specific condition, but everybody is different. The number of treatments needed can depend on a number 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

Many patient's also find maintenance treatments to be highly beneficial. The frequency of any such maintenance treatments can also vary from anything from 4-6 weeks too a few months. The combination of techniques used at TotalMSK tends to result in better patient outcomes and a quicker symptom resolution. This in turn saves you the patient money, as often less treatments are needed.

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What is McTimoney Chiropractic?

McTimoney Chiropractic is a form of Chiropractic which was developed in the UK and has been used to great effect in the treatment of patients (MSK) for well over 50 years. The technique is very gentle and utilises precise and highly dextrous adjustment techniques to affect change within the musculoskeletal (MSK) and nervous system. Many people in the UK choose McTimoney Chiropractic as an alternative to many forms of Chiropractic and Osteopathy. The McTimoney technique rarely produces the "cracking or popping" sounds that most people associate with Chiropractic. As the McTimoney technique is gentle it is also suitable and safe to use on a wide range people and conditions from all age groups.

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

This list is not exhaustive and other conditions can contraindicate a patient from having McTimoney Musculoskeletal (MSK) Therapy. However, treatment may still be suitable for a patient and may only actually be locally contraindicated meaning that a specific area has to be avoided or only certain techniques can be used on the area. Local and global contraindications are predominately to protect you the patient. In some cases it may be necessary to get GP approval, though in reality this is not usually a problem. Should you have any doubts or queries then please contact TotalMSK and one of our practitioners will be more than happy to talk you through your queries or concerns.

  • 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.
  • Pregnant 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.
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Are there any side effects from the techniques (McTimoney, Musculoskeletal (MSK) , Remedial Massage) employed at TotalMSK?

One may experience some mild side effects after any Musculoskeletal (MSK) therapy, remedial massage, or McTimoney Chiropractic treatment and treatment, which is perfectly normal. Not everybody is affected, but for those people that are the side effects can last up to between 48 - 72 hrs and are a result of stimulating the bodies natural healing processes and altering the bio mechanics of the body. One may or may not experience one or more of the following:-

  • Aches, soreness or tenderness.
  • 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 in particular when a condition or symptoms have been long standing or (chronic) one will usually notice that symptoms can appear to be worse after the first treatment and as previously mentioned this usually lasts for up to between 48 - 72 hrs. Usually, 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 effect the musculoskeletal (MSK) system and result in altered movement patterns, aching, pain and even affect other body systems. Hence, working on these dysfunctional tissues can easily make things worse in the short term, as many techniques cause some form of specific micro trauma to enable correct tissue healing. Enabling tissues to heal correctly is necessary if one wishes to return tissues to a near normal functional state. Hence, after a treatment one may notice that other areas of the body ache and areas which had previously never ached. It is important to remember that if the body has developed dysfunctional musculoskeletal (MSK) patterns through injury, overuse or poor posture, then these very dysfunctional musculoskeletal (MSK) patterns will have prevented the musculoskeletal system from operating as intended. By treating these dysfunctional musculoskeletal (MSK) patterns one is enabling the tissues of the body as a whole to work as intended. Dysfunctional tissues in one area will effect tissues in other areas of the body and prevent them from working correctly, such as through inactivity or overuse. Hence, these other tissues may have been inactive for a period of time 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 instructions provided by the therapist at the end of a treatment.

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Why do I have to have an initial consultation?

The initial consultation is needed for a number of reasons. The consultation is partially used to establish if you would actually benefit by having Musculoskeletal (MSK) Therapy treatment. More importantly the consultation is used to establish if it is safe to treat you based on your presenting symptoms or condition(s). If it is not safe then you will be referred to a suitably qualified medical practitioner for further investigations and or treatment. The final reason for the consultation is to ensure that you are given the best individualised treatment plan in relation to your unique personal history. Your personal history will be unique to you in terms of medical, emotional, physical and lifestyle aspects, often referred to as BioPsychoSocial factors. Hence, your treatment plan needs to take account of your unique history. You may have previously been to a remedial massage clinic that did not perform any form of consultation and just treated you. Apart from being a highly dangerous practice, anybody doing such things will have been in breach of their association membership requirements, health provider registration requirements, possibly their insurance cover and most likely probably may not even been qualified.

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What to expect on your First Appointment?

The initial consultation requires the completion of some paperwork and a bit of this can be completed prior to your appointment; contact details, date of birth, medications, previous injury history etc. The actual consultation will then go into further detail and assessment. By filling the initial consultation form prior to the appointment there is more time available for any necessary treatment. The initial consultation form can be completed at the appointment from scratch and it is personal choice as to how you prefer to complete it. The Initial Consultation form can be downloaded here (TotalMSK Initial Consultation Form). It is also good to either bring or wear something loose fitting and comfortable for your initial consultation, such as a pair of running shorts or similar and comfortable top or t-shirt. Comfortable clothing makes it easier during assessment and treatment and avoids the need for juggling towels.

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Can you treat children?

Yes. If the child is under the age of 16 then written permission is required from either a parent of guardian, prior to any treatment being given. Also, a responsible adult should attend and be present whilst the patient is being treated.

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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 seeing further treatment, which is partially out of courtesy. The main reason to speak with your existing therapist or professional is to ensure that the work that they perform does not become adversely affected by the work the massage therapist is going to perform, which is in the best interests of the patient.

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What does holistic mean?

Holism is derived from the Greek word meaning, (entire, total, all or whole) and in terms of health and well being is a concept that has existed since ancient times. Important 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 complex 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 major support in mainstream health in the last 30 years and is most probably a major factor in determining the outcome of what appears to be similar treatment of similar conditions in different patients, where one patient recovers very quickly whilst another takes much longer.

Another and more recently studied area which is gaining much interest and resulting in great deal of research is the BioPsychoSocial model, which is based on social cognitive theory. This looks at the how biological, psychological and social factors affect health and well being and thus the implications for treatment. In essence, a problem in one area can cause a problem in another. Hence, as with the holistic approach, it is better to look at the whole than the individual parts.

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What is Holistic/Swedish Massage?

Holistic/Swedish massage is a traditional form of massage which uses a number of techniques to either relax or to stimulate the body, depending on the desired affect. The techniques used include; effleurage, petrissage, frictions, tapotement, vibrations, joint mobilisation and holding.

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What is Sports Massage?

Sports Massage uses a mix of Holistic / Swedish massage techniques, combined with deep tissue massage. The deep tissues massage techniques are designed to improve the suppleness and flexibility of muscles, the underlying tissues and the joints. Sports massage usually applied prior to activity (pre event) or after activity (post event). Further details about Sports Massage can be found here.

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What is Remedial Massage?

Remedial massage is typically used in the treatment of specific injuries, which may have been caused through work, an accident or a sporting activity, such as a strain or sprain. Treatment of the injury usually involves a mix of deep and superficial massage strokes and the techniques are aimed at relieving symptoms, pain and restoring normal muscle and soft tissue function. Remedial massage techniques are also designed to treat fascia, muscles, tendons, ligaments and joint structures which make up the Musculoskeletal (MSK) system. Further details about Remedial Massage can be found here.

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What is Musculoskeletal (MSK) Therapy

Musculoskeletal (MSK) therapy uses a combination of techniques from a variety of different professions and includes elements from Massage Therapy, Remedial Massage, Physiotherapy, Osteopathy and even Chiropractic. However, unlike Chiropractors, Physiotherapists and Osteopaths, Musculoskeletal (MSK) therapists are not primary care practitioners and are not taught manipulative therapy techniques. There are also some major differences between the aforementioned professions and a Musculoskeletal (MSK) therapist in terms of training, education and "scope of practice". In Australia one can actually train to become a Musculoskeletal (MSK) Therapist, which is a three year undergraduate degree. One can also complete an Advanced Diploma in Myotherapy, which is roughly on par with the Musculoskeletal (MSK) Therapy qualification.

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Is Massage likely to hurt?

Many massage techniques will not prove to be painful provided that the tissues have been warmed up properly and the techniques are performed correctly. However, deep tissue massage techniques can sometimes cause considerable pain, though this pain is tolerable and patients often refer to this pain as “good pain”. Correctly used deep tissue techniques should not cause any actual tissue damage (bruising), though the technique are designed to cause some micro trauma to congested tissues. It is often necessary to break down fibrous adhesions in order for the tissues to heal correctly and for the tissues to return to a normal functioning state.

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What to expect during your initial consultation & treatment?

Initial consultations are very thorough and take approximately 60 minutes. During the consultation process our practitioner will be looking establish if it is safe to treat your presenting musculoskeletal (MSK) condition and if the combined musculoskeletal (MSK) therapy modality offered by TotalMSK would be suitable. During an initial consultation a detailed medical history will be taken, details of your presenting condition(s), lifestyle information. A postural and musculoskeletal (MSK) assessment will also be performed along with orthopaedic and neurological tests where indicated. In essence, the initial consultation will include elements of biological factors, psychological factors and social factors, all of which can affect the body as a whole. Our practitioner then may perform further specific system examinations if indicated in the medical history or as a result other test outcomes, such as respiratory, cardiovascular, or abdominal examination. If at the end of the consultation the test results were indicative that further investigations were needed or that you would not be suitable for treatment then our practitioner would refer you to a suitably qualified professional such as a Doctor.

Provided it is safe to treat you and your are happy with practitioner's treatment plan they will also treat you during the first appointment. The treatment is duration is likely to be between 20 - 30 minutes. Hence, please allow around 90 minutes for a first consultation and treatment combined. Alternatively, many people live busy lives and would prefer to be seen in their lunch hour. This can be accommodated by having two appointments either of 45 minutes each or one of 60 minutes and then a 30 minute treatment later. The consultation price is the same regardless of how you prefer to do the consultation and your first 30 minute treatment is free.

As a patient your treatment will be tailored specifically to you and to your needs as everybody is different. The treatment itself will be based on a combination of factors covered during the initial consultation covering medical, emotional, physical and lifestyle elements and your goals and so takes an holistic view. Depending on your specific condition, the treatment itself will be aimed at correcting, improving, or managing your condition and this will have been discussed with you during the consultation. At TotalMSK, we do not believe in getting patients to sign up to prolonged treatment plans during the initial consultation or during later treatments. Typically, our practitioners have found that on average most patients only need between three and six treatments. However, everybody is different and such things as age, previous injury history, how long the condition has been present (chronicity), activity levels and following aftercare advice can all have a direct impact on the number of treatments needed. The actual treatment itself will involve a combination of musculoskeletal (MSK) therapy techniques, including McTimoney Chiropractic and advanced soft tissue techniques.

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What is Dry Needling or Western Medicine Acupuncture?

Dry Needling, Western Medicine Acupuncture or Medical Acupuncture is a form of Acupuncture, which is used purely in the treatment of Myofascial Trigger points (TrPs). The technique involves inserting fine monofilament needles in to active trigger points in order to relieve muscle tension and pain. The technique can be very effective and works particularly well on muscles that are hard to treat with other forms of treatment. Dry Needling can prove very effective in the treatment of various types of headaches, including migraines, depending on the underlying cause of such headaches. Dry Needling can also be extremely good at treating musculoskeletal (MSK) related Jaw Pain and Temporomandibular Joint (TMJ) Syndrome. There are other soft tissue techniques that can be applied to treat such conditions and some of these can prove to be particularly uncomfortable. Although, Dry Needling can sometimes prove uncomfortable, it can be far less uncomfortable than other soft tissue treatments for deep muscles of the Jaw. Further details on Dry Needling can be found here Dry Needling

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What is Gua Sha or Instrument Assisted Soft Tissue Mobilisation (IASTM)?

Instrument Assisted Soft Tissue Mobilisation (IASTM) and a number of other registered trademark techniques have their origins in deep tissue massage and the ancient art of Gua Sha. Hence, having a thorough knowledge of anatomy, deep tissue massage and Gua Sha or extremely relevant when administering Instrument Assisted Soft Tissue Mobilisation techniques, of which there are many. Further details on Gua Sha and IASTM can be found here Gua Sha and IASTM

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Chiropractic and Massage Registrations

All of our practitioner's hold relevant professional industry registrations and or memberships. Our principal practitioner Terry Davis MSMA holds additional memberships and registrations for Massage Therapy with the Complementary & Natural Health Council (CHNC) and a BTEC Level 5 Clinical Massage Therapy qualification with the Sports Massage Association (SMA):-

Chiropractic and Massage RegistrationsSports Massage Association (SMA)General Chiropractic CouncilComplementary & Natural Health Council