Jan 19, 2014. Sunday Times Of India
Its unique and holistic whole-body approach makes Functional Manual Therapy™ truly transformative and patients emerge more mobile, pain-free and confident, explains Foster King
What makes Functional Manual Therapy (FMT) different from other forms of Physical Therapy?
FMT, developed by Gregory and Vicky Johnson of the Institute of Physical Art (IPA), USA, looks at the whole person as an integrated unit – not a skeletal structure or muscular system. Our approach includes mechanical, neuromuscular and motor control interventions.
Our mechanical treatment addresses the mobility of all the various tissues in the body that can limit function or prevent you from getting into motion, such as joints, muscles, fascia, viscera, nerves, lymphatic and vascular structures. But, just being mobile does not mean you have better function! You need your muscles to work for you.
FMT’s Neuromuscular treatments generally include very specific handling techniques to achieve proper initiation of a muscular contraction, strength and endurance. You may think your core is firing & your muscles are being exercised, but a Functional Manual Therapist often discovers weaknesses that the body is compensating for with inefficient muscle use. The Functional Manual Therapy system ensures that all your muscles are active & strong as needed.
And then, there are those patients that say, I stretch every day & exercise a lot, but my back still hurts. Often this is because even with good mobility of all your body tissues & strong muscles, you can still be using your body inefficiently. Once we have mobilized all the tissues in your body & established good strength initiation & endurance of your muscles, we use a comprehensive educational program that focuses on restoring motor control, which we call CoreFirst ™ strategies for posture and movement. Basically, we retrain the brain to be able to use your body more efficiently.
FMT is based on the belief that every person has existing potential that can be tapped to enhance function. And that philosophy can only be applied through the whole-body treatment approach.
That is what sets us apart.
So why should people opt for FMT?
There are other therapeutic interventions but in my 8 years of experience, I have not been able to find one that is more comprehensive than FMT. Some do joint mobility, others do soft tissue or exercise very well, but to my knowledge only FMT integrates them all seamlessly and effectively.
A lot of the therapy here in India is symptom based: treat the inflammation and turn the spasmodic pain off. Of course, that is necessary to get someone through the initial acute stages of pain. The problem is the underlying condition that led to that point.
If you don’t treat that, then it becomes a repetitive cycle of inflammation on, inflammation off, pain on and pain off. That keeps people dependent on pain medication and symptombased treatment. Actually, pain alleviation is only 1/3 of the job. Then comes restoration of mobility and the rest of the rehab begins.
When a person has pain, the brain cannot clearly recognize and therefore control movement in that region. So the patient cannot use the muscles needed for rehabilitation. The Johnsons, through FMT, have demonstrated that these muscles can be facilitated through specific resistance patterns and by using stronger/more integrated parts of the body.
The aim is to change the mechanics so the person has access to movement, and facilitate the neuro-muscular system so that the brain can control the body in its new range of motion. Then the person can function better; building on the foundation, we have established to get on in their lives.
How did you turn to FMT?
After getting my physical therapy degrees I struggled to rehab 50% of my patients to a mutually satisfactory level. I found most therapies one-dimensional and not applicable in real world scenarios. Then I observed Gregg and an associate treating a girl’s cranium for her balance problem.
When I saw they achieved great results with FMT and re-education of her inner ear – eye connection, I realized FMT was special! So I began to take the courses. As I developed my FMT skills, I saw how my patients benefitted. After I completed an FMT Fellowship with Gregg and Vicky, this opportunity to work at VARDAN opened up in India. And here I am!
What is the level of proficiency of Indian PTs at VARDAN?
I’ve gotten to know the IPTs at VARDAN as individuals and have seen their skill levels grow. Their eyes open a bit more every single week, as they clue into different ways of assessing patients and different ways to circumnavigate the patient’s problem. I see their intellect churning, always trying to process how they can be more effective.
We discuss cases frequently and I advise them to try new alternatives and options, which they immediately implement and internalize. They are really enthusiastic and I see them carefully sorting through what patients are presenting, to find solutions.
Are Indians different as patients?
There is no huge difference in the problems of patients here and in the US… Pain is universal and people are willing to talk about that. What I like about Indians is that they are willing to take self-responsibility & are hungry for knowledge on how they can fix the problem themselves rather than finding someone to fix it!
And are VARDAN’s IPTs also no different from their US counterparts?
The Indian therapists at VARDAN started to learn FMT more than two years ago. And they have done all the courses. It is a tremendous accomplishment to have taken all that material, digested it & applied it. The courses are intense & have to be gone through many times to really get the nuances.
At VARDAN we give them additional mentorship. As we work through treatments, I see them applying their knowledge again & again, I get excited as a mentor as I feel I’ve turned them into something powerful, effective and beneficial!
Foster King is a Fellow of Functional Manual Therapy and a part of VARDAN, a Wellness initiative by the Times Group
NEERU FELIX | 48 | Sciatica
I was suffering with left leg and lower back pain from a herniated disc in my lower back. The pain progressed to include my left leg in what is commonly referred to as “sciatica.” It was so bad that I was unable to stand for more than 2-3 minutes, or walk for more than 5 minutes. I was 47 but felt like 97.
The only position in which I got any ease was lying down. Even my posture changed as I was leaning to one side to take the weight off one leg. I tried everything and everyone in France – orthopedics, osteopaths, physiotherapists – but no one could do much. Finally, everywhere I went I would look for a place to sit. Then I read about VARDAN and FMT and decided to go for it.
My MRI findings supported their diagnosis of pain stemming from a herniated disc in my lower back. My FM therapist asked if I’d had any falls but I could recall nothing except that a couple of times while walking my dog I had landed on my buttocks. There had been no pain then, but this injury had displaced, or “jammed” a combination of bones in my pelvis and spine leading to increased stress placed on discs. The herniated disc in effect was the symptom of an underlying mechanical problem. Treatment was directed to restoring the mobility and stability of the pelvis and spine using FMT techniques.
I was then put onto follow up exercises to strengthen my abdominal core muscles and education to improve the efficiency of my movement patterns.
Now I can do everything again – sit, stand, walk, run… I am a free woman again! I can say that thanks to VARDAN I have got my life back!
GAURAV MITTAL | 39 | Back and hip pain
Ihave lived with the pain in my lower back for half of my life. I resided in the US and over the years I consulted many doctors, went through every routine investigation and took several treatments but nothing made me better. No one could identify my problem and diagnose why I had this pain. It had become so bad that I could not sit or stand for any length of time. That meant I had to pretty much sit at home unemployed.
Then I read an article on VARDAN, about someone who had the same symptoms as I had – chronic back, hip and pelvic pain – and so I decided to give FMT a shot. From the very first evaluation, I knew this was different. Examination revealed major mechanical dysfunctions of the hip and pelvis, including visceral restrictions especially within the right lower abdomen. Treatment of these dysfunctions relieved my pain and my sleep times also began to increase. Further treatments were directed towards my pelvic floor and tailbone, using FMT techniques, which proved to be critical in further reducing my lower back and hip pain.
I have resumed my regular activities and professional wildlife photography work with greatly reduced symptoms. The mobilizations done to my joints and soft tissues are maintained through a specific home exercise program that I am following, along with posture re-education.
Now, after 2 months of FMT, I am 70% better. It won’t be long before I can say I am totally pain free! Nothing happens overnight. No pain no gain!
NEHA JAIN | 28 | Cervical Spondylosis
Ihad cervical spondylosis for three years and had tried just about everything – from physiotherapy to acupressure. Eventually it aggravated to lumbar spondylitis and I was advised bed rest for a month. I then read an article on VARDAN and thought I would try FMT.
I don’t understand exactly what they do with their hands, but from the second session itself my condition showed definite improvement. My back pain became better with correction of my sacrum and coccyx dysfunction, along with neural tension release; and posture education in sitting, standing and sleeping.
I have continued with the follow-up supervised exercise sessions. Even if the pain occasionally returns, I know exactly what has to be done to manage it. Now, I am taking antenatal sessions at VARDAN to build my upper body strength and core & pelvic muscles!
SANJAY SETHI | 49 | Herniated Disc
Ihad an acute pain in my neck and left arm, that even painkillers did not help. Life came to a full stop, as I was totally immobilized. I’d had spinal surgery in my lower back and did not want to undergo surgery again. My doctor saw my MRI and straight away recommended FMT at VARDAN. The herniated disc between the 5th & 6th neck bones was putting pressure on the nerve to my arm. Treatment of my neck and upper back reduced my pain, but it returned often. My FM therapist further enquired into my past medical history to identify the reason. Palpation of my small intestine showed a major movement restriction or “scar” that was limiting the mobility of my ribcage. Mobilization of my “guts” combined with manipulation of my ribcage using FMT techniques proved to be very effective at reducing my pain.
The pain is 90% gone. Now, I need to keep up the exercises that they have taught me to strengthen my muscles, and I know what to do if and when the pain ever recurs.
RICHA WAHI | 56 | Low back pain
Ihad a problem in my lower back for many years. Whenever I bent down, I would get a catch in my back. I took painkillers, consulted doctors, and went in for the usual physical therapy and massages without significant improvement. Then I learnt about VARDAN and decided to try it, to avoid the surgery that was suggested.
It turned out that my standing posture was in lumbar extension and this was provoking my symptoms! Treatment started with soft tissue & joint mobilization to the pelvic girdle and lumbar spine, as well as visceral mobilization to release fascial restrictions from two abdominal surgeries. This allowed my pelvis to drop and my rib cage to settle over my pelvis. I was given exercises to help strengthen my core muscles to maintain this new posture. My pain has decreased by 70%. Even if it returns, I know what to do as they have taught me exercises to deal with it.