Forum topic: Is physiotherapy losing touch with touch?

If you know me at all, you’ll know that for the past 6 months, I’ve been a bit preoccupied with a research project into chronic shoulder pain.

There’s one finding from my research that makes me feel particularly sad.

I learned that whilst physiotherapy is the most widely used treatment for long-term shoulder pain, physiotherapists now rarely use any touch at all. [1, 2]

The research showed that even before lockdown, physiotherapists were already opting to simply offer advice or exercise instead of touch therapy for issues like shoulder pain.

Then since the Covid-19 pandemic, there has been a sudden and significant further move away from any patient contact. Very few physiotherapists have returned to including manual therapy in their patient care. [3]

It’s also surprising, as the research suggests that treatments that combine exercise with touch therapy, are more effective than exercise alone. [4]

What has your experience been? Have you had a physiotherapy appointment during the past couple of years? Did it include touch therapy? What were the results? What are your thoughts?

References

[1.] Artus M, van der Windt DA, Afolabi EK, et al. Management of shoulder pain by UK general practitioners (GPs): a national survey. BMJ Open. 2017;7(6):e015711. doi:

[2.] Littlewood C, Lowe A, Moore J. Rotator Cuff Disorders: A Survey of Current Uk Physiotherapy Practice. Shoulder & Elbow. 2012;4(1):64-71. doi:

[3.] MacDonald CW, Lonnemann E, Petersen SM, Rivett DA, Osmotherly PG, Brismée JM. COVID 19 and manual therapy: international lessons and perspectives on current and future clinical practice and education. Journal of Manual & Manipulative Therapy. 2020;28(3):134-145. doi:

[4.]Brantingham JW, Cassa TK, Bonnefin D, et al. Manipulative Therapy for Shoulder Pain and Disorders: Expansion of a Systematic Review. Journal of Manipulative and Physiological Therapeutics. 2011;34(5):314-346. doi:

Steven Murdoch

Very surprising. Your conclusions are based on papers from 2012 and 2017, plus a covid related one only 2-3 months into the pandemic ([3] above is a May 2020 paper)?

I had long term physio, 2.5 years, ending in late 2020. All included extensive touch/massage/manipulation following major knee surgery. I had further physio over a 6 week period in 2022, from memory, regarding my neck which was also full contact each session.

Every physio session I've had for any ailment, leg, back etc, over about the last 10 years has been full contact.

So, no, I see no reality in your post.