A lot of neuromuscular problems can be treated conservatively without medications and surgeries in India if people here have an awareness about Orthopaedic Manual Physiotherapy (OMPT) similar to those in the US, Canada, Australia and New Zealand among others, says MS Pawan kumar, Orthopaedic Manipulative Physiotherapist & Ergonomist from Raa Physiotherapy Clinic, Chennai. He discusses with ARCHANA JYOTI what OMPT is and how it is used to treat patients

What is OMPT?

Orthopaedic Manual Physiotherapy (OMPT) is a specialty in physiotherapy which primarily focuses on diagnosis and management of neuro-musculoskeletal problems.  One of the advantages of OMPT is that it is non-invasive and does not involve medication, injections or surgery, thus making it a safe and effective treatment option for many patients.

Additionally, OMPT can be used in conjunction with other forms of therapy, such as exercise and electrotherapy, to provide a comprehensive treatment approach.

Please share its history

The practice of manual therapy existed since ancient times, Hippocrates and Galen had practiced it. In the middle age, the traction and manipulation of spine was in use. Bone setters used manual therapy in form of manipulation. Andrew Taylor, still an American physician in 1874 found osteopathy and emphasized Osteopathic Manipulative Treatment (OMT). David Palmer in 1895 found chiropractic which focuses on manipulation exclusively.  Orthopaedic physicians Menell and Cyriax in 19th century practiced and taught manual therapy for physiotherapists. In 19th century, physiotherapists Stanley V Paris, Freddy Kaltenborn , Geoffrey Maitland, Robbin Mckenzie, Brian mulligan and others developed their own school of thoughts in orthopaedic manual physiotherapy.

What about diagnosis and treatment in OMPT?

The diagnosis in OMPT is based on utilizing best research evidence in clinical diagnosis and treatment includes skillful application of manual physiotherapy techniques for spine, jaw, upper & lower limbs, and exercise prescription with clinical reasoning. The OMPT treatment includes Soft Tissue Mobilization (STM) for dysfunctional muscles, tendon, ligaments and fascia. Trigger point therapy release for myofascial trigger points deactivation. Mobilization with thrust (manipulation) and without thrust for spinal, jaw, upper and lower limbs joint restriction and mal-alignment. Neural mobilization for peripheral nerve entrapment and restriction.  Muscle stretching,  strengthening and proprioceptive training.

What orthopaedic conditions can be treated with OMPT ?

The orthopaedic conditions that can be effectively treated by using OMPT are: Frozen shoulder, osteoarthritis, impingements, tendinitis, bursitis, muscle strain, ligament sprain, nerve compressions (extra spinal), TMD (jaw pain), headaches, dizziness, neck and low back pains (due to spondylosis, disc bulge/herniation , nerve root compressions and facet joint impingement), Thoracic Outlet Syndrome (TOS),ribcage dysfunctions, pelvic girdle pain, tail bone pain, bone stress injuries (BSI) and etc. Nearly 250 neuro-musculoskeletal problems from mechanical origin can be treated with OMPT.

What is its status in India?

The OMPT practice and practioners are in India for past two decades, at the beginning physiotherapists went abroad for pursuing OMPT education. But now few universities and institutes in India are offering full time and part time OMPT educational programs. Currently, the awareness about OMPT among general population is fairly less compared to countries like USA, Canada, Australia and New Zealand. If the people in India are made aware about OMPT, a lot of neuromuscular problems can be treated conservatively without medications and surgeries.

How OMPT works in orthopaedic conditions?

OMPT practitioners provide patient management on neuromusculoskeletal conditions ranging from simple to complex, and provide recommendations and interventions in the area of health and wellness. Also, when someone suffers from a neuromusculoskeletal disorder, an exercise and movement re-education program may be sufficient to restore full pain-free movement, function, and return to full activity.  However, in some cases, soft-tissue and joint restrictions are present, resulting in these same interventions being painful or, worse, aggravating to the condition.  In these instances, an OMPT therapist can provide hands-on techniques to improve mobility, reduce pain, and restore normal function of soft tissues and joints.

(Pawan Kumar is Director, International Institute of Digital Teachings and Vice- President at Physio Plus Tech)